asylum

Psychiatry is very pervasive in my life, not because I am surrounded by it, but because I regularly seek it out. I've had a fun filled weekend filled with living pathology (oxymoron?) for I just finished watching The Talented Mr. Ripley and I've just finished reading Asylum by Patrick McGrath. The former deals with a homosexual sociopath who impersonates other individuals to win status, affection, or whatever it is that sociopaths seek to achieve in life while killing everyone who might set their path astray. The latter involves a depressive wife of the medical superintendent of the psychiatry department who quite ironically has an affair with a psychopath of her own who had previously killed his wife, decapitated her, put the head on a sculpture stand and stabbed it repeatedly making sure to enucleate it.

I think Mag said something that really resonates with me when I think about the psychiatric population: "You'd be surprised to see how normal they are until you speak with them at length and you realize something isn't quite right." Mag has noticed psychiatric patients sharing the aisle with her at Safeway, her colleagues have ridden the bus downtown sitting amongst discharged patients; psychiatry is rather pervasive whether you recognize it or not.

It's quite astonishing to see how well Mr. Ripley and Mr. Stark are able to charm their way through life until something sets them off and they kill. These are simply fictitious homages (wrong connotation, maybe simply a reference?) to individuals like Ted Bundy - real life charmers with less than moral convictions.

So then be careful the next time someone kindly chats you up by the bus stop. They could very well just be the serial killer living next door.

psychosis

I was just thinking this morning about Vince Li, the individual who beheaded a sleeping passenger on a Greyhound bus almost a year ago now. As one YouTube member said, "As usual, a crime of this nature is an excuse for every frustrated racist and sadistic creep to come out of the woodwork demanding the death penalty, the repeal of gun control, stricter immigration laws and the right to lynch and torture."

That being said, I forgive you if you can't look past your feelings of disgust and aversion. With rumours swirling around Li being released, it's only natural to be worried.

This is the way I see it. Morally, nobody should get away with murder. Taking a life is taking a life, regardless of whether you are psychologically fit or not. We can all agree on the fact that killing someone, whether by beheading or by death penalty, is killing all the same. This is why I feel that a death penalty for Li is just as atrocious a response and is not remotely to be considered an effective solution. Having a tit-for-tat mentality in this case is not morally justified.

We cannot, however, simply turn the other cheek and let Li get away unscathed. A murder deserves punishment, which I presume would be a long term sentence in a secure facility with a strictly regimented day of activities - isolation and the removal of freedom. While this obviously doesn't seem like justice, we are essentially bestowing the harshest of punishments we can offer without exceeding moral boundaries. If we don't follow what makes us distinctly human, even in moments where our moral line is questioned, what separates us from purely killing for fun? We would be traipsing down the path towards ethical anarchy.

Furthermore, we should also attempt to rehabilitate Li, because leaving him there to rot is cruel. Naturally, our first instinct is to bubble up with emotion and do as the victim's aunt did, exclaiming "Hey, Vince, rot in hell, you filthy bastard!" But out of the goodness of our own heart, out of the fact that life is about love however cliché that may seem, out of the idea that almost all religions and moral imperatives seem to come to the conclusion that love is an ideal, it seems like the way to go is to give Li a smattering of forgiveness. We cannot forgive that he committed murder, and I'm not suggesting we should, but we should allow him the chance to recover from his psychiatric affliction.

Why am I so interested in psychiatry? Because psychiatry is the fool's department of medicine, the branch of health care that is ridiculed for its patients (who are 'looneys' and 'wackjobs') and its lack of results. Very few psychiatric patients become "fully cured", most turn out zombies or relapse within a very short time. Psychiatric illnesses are lifelong afflictions with unknown organic origins, so it's so easy to assume these people are pretending, and that they could just behave like the rest of the world and "snap out of it" if they wanted to. This is the mysterious branch of illness, and so we have so much to learn about helping these patients.

Schizophrenia is very real, and the most difficult thing to realize is that these individuals do not see the world as we do. One of the defining features of psychosis according to the DSM is that there be an element of not being attached to this world, whether it be hallucinations or delusions or bizarre behaviour; essentially, their reality must be altered in a way we cannot understand. They see demons and alternate universes, imagine they have physical goat horns growing out of their heads, perceive God's voice upon their tympanum. These individuals are sick in a way that is both disturbing and impossible for us to grasp.

Such is Li's crutch, but it is not his excuse. Li should be detained indefinitely, and should adhere to a regime of social and environmental rehabilitation. We should also allow him meds and therapy in the effort to return him to as normal a state of mind as he can become. If Li shows promise in the long term, especially because schizophrenia shows only a 20% chance of a good prognosis, he must be closely monitored at all times if he does return to society, so that he adheres to his drug schedule and that his integration is both safe to him and safe to the public.

I feel that forgiveness means mercy, but it does not excuse going beyond moral boundaries. Law should be there so that people may take the insanity defense if a psychiatric or neurological illness exists, but that its repercussions would cause anyone else to avoid it under any other circumstance.

clinic pt. 2

Got to witness a coil embolization today of a basilar tip aneurysm today. The basilar artery comes up the brainstem - some pontine arteries and cerebellar arteries branch from it. It bifurcates into the two posterior cerebral arteries (PCA), but at that junction, oftentimes an aneurysm can result:



The patient was sedated and the doctors worked for a long, long time performing a coil embolization. Basically they take a metal wire made out of some inert metal like titanium or platinum (today they used eV3 TRANSEND Platinums), run it up through the vessel to the aneurysm, then coil it a bunch of times inside the aneurysm, thereby reducing if not halting blood flow to that area. Over time the aneurysm becomes harmless as a result. It shows up on scans like this:



There are supposed to be two more coil embolizations done tomorrow, which will be an exciting day. The aneurysms are supposed to have a wide-necked too, which will make the coil process interesting. If you want to see what it looks like in real time:



In other news, remember how I had gone on and on about the fabled Dr. Kar a long time ago? After getting waitlisted at Dalhousie, I decided to start doing my backup applications for an MSc. Psychiatry. I'm meeting Dr. Kar tomorrow to discuss a possible role as a Master's student doing Alzheimer's research, one of my favourite areas. Hopefully it all goes well and my lack of research hours doesn't deter me from this. V. excited!!!

IED

I am always drawn to bizarre psychiatric anomalies, and managed to stumble across a rather strange disorder whilst perusing some of my lectures (I had some time to kill). I remember this story Jon told us about a patient one of his friends had. She was terrified at the time because she had to be escorted by three guards to go see this patient, whose chart said that he was diagnosed with rage. Neat hey, like so you think like this guy has probably bludgeoned a lady who had cut him off in rush hour traffic with his hood antennae, or maybe one of those grannies who insists on writing a cheque with far too many items in the express checkout at the supermarket, or maybe he choked the guy who can't quite figure out what he wants at KFC by shoving a drumstick down his throat. You know, something normal where he just snapped for a second and now he's gotta live with it, right?

No, this guy was the real deal - he makes a Mara Salvatrucha member look like Mary Poppins. To get into his cell, they had to order he lie facedown on the floor with his hands on his head, then the guards would cautiously enter his cell. One would pin him down to the floor and the other had to hold his belt to make sure he didn't bolt. He was ridiculously strong and could be set off by the most benign of comments.

I thought it was neat that this guy had uncontrollable rage, but didn't really think much of it. I stumbled across a peculiar disorder in my notes by the name of Intermittent Explosive Disorder. It's extremely rare, like 1-2% of those with conduct or impulse disorders are thought to actually have it. The DSM is puzzled by how to classify it, but basically say that it involves discrete aggressive episodes that are grossly out of proportion to a typical response, and result in assault or destruction of property. Nobody knows the neuropathophysiology behind it (there are some speculations about serotonin, testosterone, and catecholamines) but nothing conclusive.

Clinicians often don't know what to do with IED, and classify it as a conduct disorder or an impulse control disorder appended with terms like, "rage attacks" or "episodic dyscontrol". How cool, you could say something like "This guy destroyed a truck with his bare hands in a moment of episodic dyscontrol."

What I find most amazing is that this is a psychiatric disorder. One of the exclusion criterion in the DSM is that it cannot be a result of another mental disorder, substance abuse, or a general medical condition. These individuals have brains that have been wired in such a way that they physically manifest aggression as a regular emotion. These people are angered by the slighest provocation, and explode into a frenzy that is something like Rambo plus Charizard with a little bit of Arnold thrown in.

The brain is fascinating.

busy

Busy day today. I'm really digging this piece by Paul Dateh & Ken Belcher, this violin/guitar duo. He did this song on violin/piano to begin with, but I think the acoustic guitar sound just makes it feel a little more intimate. He's a fantastic artist, like he's actually technically really REALLY good, just check out his warmup which features songs like C.R.E.A.M. and T.R.O.Y. by the Wu, and an amazing pizzicato rendition of SaltnPeppa's Push it at 2:10. Nasty.

We've got Tourette's Syndrome tomorrow, which will be fantastic, I'm sure. Funny thing today actually, was that Christine and Linda were talking about neuroanatomy and Christine decided she was going to name her kid after a deep cerebral nuclei. Her kid would be habenula, which is I guess a set of fibres that make up the pineal stalk, so it isn't really a nucleus per se. I figured my kid was going to be named claustrum, which is a little gray matter strip that has been postulated by Crick (yes, of DNA fame) to be the neural correlate of consciousness. Neuro is so awesome.

thesadcycle

Dr. Pawluk came to talk to us about sleep medicine today, and managed to condense his lecture into about 50 minutes to our relief. He's obviously in the right field because the way he talks just makes you want to curl up inside his vocal cords and take a long nap; it's so soothing and slow and soft... a..nd...zzZz.z....Zz.z.....

Anyways, people with major depressive disorder (MDD) tend to have low quality sleeps, despite the fact that they display hypersolemnence (and just general avolition really). Normal people tend to have this sleep architecture where they'll experience a some slow wave sleep in the early stages, then flip to lots of REM earlier in the morning. People with MDD generally have lots of REM, replacing the early slow wave sleep they should be getting to feel well rested, and generally have little to no slow wave sleep at all.

One could think this is epiphenomenal, but a very very interesting hypothesis presented is that the insomnia is therapeutic. What? There was an interesting note that someone published a long time ago that found that total, partial, or just REM sleep deprivation (waking the patient up when they hit REM) led to extremely positive antidepressant effects, with up to a 60% success rate! Of course, this makes for a shitty long term therapy (imagine depriving someone of sleep every day) and isn't long lasting, but it prompted the idea that increased REM pressure in your sleep cycle is not a good thing.

Adrien (2002) thus proposed that the body attempts to create a therapeutic, protective state to rectify affective dysfunctions by mimicking sleep deprivation. This is done by creating insomnia, the mechanism of which lies in increased REM pressure, as seen on the EEGs of MDD patients. Unfortunately, increased REM also means poor sleep, but I guess the body decided to make the tradeoff between sleep hygiene and affective function.

Fascinating, I know. It goes to show that things don't necessarily share a causal relationship, and that there may be a more complex relation between two entities. It's always important to keep the most basic elements of the scientific method in mind, no matter the nature of your research.

neuroethics

From my long disappearance from the interwebs realm, I learned a lot about neurosurgery. I learned that the frontal lobotomy still taints the name of neurosurgery to this day, which is kind of why the term "psychosurgery" isn't used anymore (surgery to alter behavior rather than surgery to alter a dysfunctional brain). A brain scan of a Freeman-Watts frontal lobotomy (note the degeneration of frontal tissue) and a well-known case of a 12-year old receiving the rather crude "ice pick" transorbital frontal lobotomy:




The frontal lobotomy has the rather disgusting history of being blown out of proportion as one of those cure-alls for psychiatric patients. Moniz invented the procedure and squeezed a Nobel out of it, but never intended this technique to be used like Freeman & Watts adopted it for, which was essentially to slice and dice the white matter connections (actually in the end they just cut anything in the way) in the frontal lobes, strongly affecting many structures including the limbic system. Essentially, whether you were suffering from schizophrenia or your mom just found you intolerable (like that 12-year old), you'd be recommended for a frontal lobotomy that would change your personality and emotionally blunt you forever.

As a result, both the general public and clinicians are hesitant to give our neurosurgery, and it is generally saved as a last-resort measure with intensive screening that goes on prior to approval. It's funny though because in neurology, many clinicians are extremely hesitant about giving a psychiatric patient a neurosurgical intervention - for them they see a psychiatric illness as a disease state of the mind, and not of the brain. Psychiatrists, on the other hand, are glad to recommend for surgery, knowing full well that these disorders are biologically based. Perhaps this is why neurosurgery for somatic disorders such as Parkinson's Disease are rather ho-hum, while if you say to someone you can get surgery to cure your OCD, it might come as more of a surprise.

So then I ask, what is the personality? Is all neurosurgery psychosurgery? I read this paper by Walter Glannon (2006) who posed, "for the patients who experience significant memory loss or personality change aas a result of the procedure, the cure may come at the cost of their identities, their selves. In these metaphysical terms, the cure may seem worse than the disease." These procedures often come with frontal disinhibition, minor personality alterations - some are transient, some are persistent sequelae. Is any neurosurgery appropriate, when we are effectively changing who someone is? Or do the benefits of neurosurgery outweigh the risk, that even though a person may be different at least they get to live a semi-normal life free of psychiatric illness?

***

Anyways, if you'd like to read my paper on 'Theoretical foundations underlying neurosurgical interventions for the treatment of intractable OCD', you can find it >here. Don't worry, I won't blame you if you don't read it.

***

Glannon, W. (2006) Neuroethics. Bioethics, 20(1), p. 37-52.

paper

Remember when I mentioned that when important events rolled around, I might take a few days off from this? Unless I feel like procrastinating, I'll be a little busy writing my psychiatry paper, and probably won't write anything intellectually stimulating for the next little bit.

I have a question that Jia asked me today, though. It's honestly Philosophy 101, but it's important:

In the name of love, would you sacrifice your career (say you're going to be a doctor, and the public health policy you would eventually implement hypothetically would save thousands), just to be with the love of your life? Is it stupid to do this, or is this the ultimate love, the one that sacrifices everything just for that one person? Is love selfish, or does love trump all?

telephone pictionary

I'm sure you knew that Coca-Cola used to contain cocaine, and that doctors once said you should smoke cigarettes to improve health, but did you know that 7-Up used to contain high contents of lithium, a metal/ion that is used as a mood stabilizer to treat mood disorders? Gosh, how crappy for normal people but how fortunate for those bipolar individuals out there who were undiagnosed.

I updated the Heschl's Gyrus section with some Hip that's been going around on the radio lately. I've liked the band since their song Music At Work debuted on Muchmusic it seems like eons ago now, but they were such a strange addition to rock, almost like if you mixed rock with old people and suddenly The Hip emerged from the darkness as a result. Watch his eyes, they're like closed for the majority of the video. Sight's overrated anyways.

***

Okay, so during Reading Week, we played this fantastic game called Telephone Pictionary. The game goes like this: You get a stack of small pieces of paper, one sheet for every team that's playing (I.e. If you have eight teams, your stack would have eight pieces of paper). Each time then makes up a phrase, anything you want. When you're done, each team passes the whole stack to the next team, who reads the phrase, puts it to the back of the stack, and then draws what was written. When they're done, the stack is then passed onto the next team, who then sees what was drawn, and then in turn moves that picture to the back and writes a phrase based on the picture.

Naturally, you can see how the phrase the game started with gets distorted, like in the game telephone. You know, telephone + pictionary = telephone pictionary. GENIUS. So now that you know, let's show you some examples of the hilarity that ensued:

"Seals Visiting Paris"
"I like donkeys"
"Albert loves Jen Bong
"dirty indian baby
"I'm all over your face
"Static" - I love this one.
"Geekbots" - Start from the top right. I love robots. But seriously, best ending ever.
"Gray rhinos"
"Hips don't lie"

And for my personal favorite:

"Bunny doing leapfrog"

(not)studying

Tuan, Eds: I figured out where I got "bug out" from. That was some good times.

***

I have a lot of friends that have excellent memorizing skill where they will sit in front of their notes or their textbook the night before the exam, read while highlighting or something, go write the exam on 4 hours of sleep and still get 97.85%. One of my friends reads statements aloud while making funny faces and somehow this is how he aces everything. From a neuroscience point of view, if size does equal function (I'm just assuming, it's hardly ever true), then you have massive hippocampuses.

I'm all about brute force memorization, which means I'm extremely inefficient, but I eventually get the job done. If my friends are Gary Kasparov, I have the computing power of Deep Junior at 3 million times less the computing speed. I read the notes with a highlighter, then I write out a set of notes to accompany these notes. I will read these notes again while I copy out important facts on a scrap piece of paper, then I will cover both these sheets and write out a new concept summary sheet with the facts I just memorized. Eventually this concept sheet will be discarded and unused; just a step in the process. I then open up my .pdf/.ppt documents and go through the slides rather quickly. My second time around, I'll open up my class notes and go through the .pdf/.ppt slides very carefully, being sure never to miss anything. My couple times around I'll just open the slides and copy down anything onto a scrap piece of paper, then I go into the exam.

I have difficulty memorizing anything long (Miller's suggested magic number 7 ± 2 does not apply to me, I have more likely magic number 2), so I tend to make these awful pneumonics or diagrams or anything to remind me of what the content actually is:



I actually woke up this morning thinking the one on the top: "FACCS", which are indicators for when a person diagnosed with a unipolar disorder actually has a bipolar one (features, antidepressant response, time course, comorbidities, symptoms). I also have ones like "HAPPIHARO" to remind me of the parts of the brain largely associated with emotion (hippocampus, amygdala, PFC, parietal, insula, hypothalamus, anterior cingulate cortex, retrosplenial cortex, orbitofrontal cortex).

I then have strange diagrams like the ones on the bottom left. The one with the cloud floating on the teeter-totter is thought disturbances in schizophrenia: The line represents tangentiality, the distance from the point represents loose associations, the cloud represent incoherence, the arrow pointing to the cloud is stereotypical thinking, the one pointing away is echolalia, and the box around all of it represents concreteness or autistic thought.

My diagrams can also be spatially oriented so I have previous anatomical knowledge to guide me. The brain with two eyes on the bottom right represents the Papez Circuit, the proposed areas involved in emotional cognition in the brain: fornix, thalamus, hippocampus/amygdala, mamillary bodies, cingulate cortex, (parahippocampal cortex)). I also have these actions that I do to remember things, like how I remember what pathologies can accompany GABA dysfunction: The only one I know for certain is that GABA is associated with epilepsy, so I start by touching my head, then I mentally trace the circuit my arms make with my head - in my hand I would hold a bottle of Beck's which would signify alcohol addiction, my arms would symbolize Parkinson's disorder and Huntington's chorea, then going back to my brain would be anxiety disorders.

I literally have two pages in really small writing of these stupid things, some with sexual connotations like "M PNS & CLT" for functions of acetylecholine (memory, pain, nicotine addiction, salivation, concentration, locomotion, thermoregulation). So while you people with perfect memories are pounding back pages of information like they're tequila shots on your birthday, I'm the guy pushing up his glasses in the corner cradling his academic appletini. I'm going to go study...

somebody's arms

Pick up any psychology or neuroscience textbook and undoubtedly within the first one or two chapters you will come across both these names. The history of neuroscience has been forever changed by these two characters, and with good reason. Franz Joseph Gall pioneered phrenology, the idea of modular brain mapping, where different brain areas act as functionally discrete modules carrying out specific functions. He was absolutely incorrect in this idea, mostly because he emphasized that the skull was an extension of these brain areas. He would claim something along the lines of that if your forehead protruded ever so slightly forward, that meant you were more likely to be aggressive, and went on to state that most prisoners had more protruding foreheads (a generalization that was both incorrect and somewhat bizarre if you think about it - imagine what the heads of Charles Manson or Ted Bundy must've looked like if this were true). While we don't subscribe to brain mapping anymore, we do take his idea of specialized brain areas into consideration, but are very keen to keep in mind that the brain is a functionally connected entity, and no part is truly in itself responsible for any set action. In the meantime though, phrenology has been immortalized in a Roots album, and even Dr. House has a phrenology head in his office.

Phineas Gage, on the other hand, revolutionized psychiatry and neuropsychology since he introduced that anatomical destruction could induce personality changes. This went past simply somatic features, but that you could actually alter one's mind by distrubing a brain region. The brain's mysticism really lies in the Gestalt principle that all the parts are not additive, but are rather a product of its components that build the whole.

Speaking of the mind separable from the brain, I bought a book today that looks like it will be fun:



Beauregard is a well-known cognitive neuroscientist who studies consciousness, specifically bridging religion and neuroscience in a field colloquially referred to as "neurotheology". I think it goes without saying that if you can convince nuns to go under MRI, you're really doing some novel investigation. I'm really looking forward to reading this because I've always stipulated a neural correlate for consciousness (religion included), but I'm sure there's more to the story that I haven't (beau)regarded (haha!). I'll keep you updated as I go.

***

Try this on for size: Sarah Slean's Somebody's Arms. It's the version from the Day One album, which is actually her only song that I like better on the album versus live or remastered. Delicious.

maintenance pt. 3

Posting for me will be rather sparse for the next few days due to an upcoming midterm that's so large that its penis makes the Great Wall of China look like a ruler. I'm not making good progress with it either, because our prof is making us memorize every single DSM-IV classification that accompanies a mood disorder (major depressive, dysthymia, bipolar I, bipolar II, cyclothymia) including modifiers, specifiers, epidemiology, treatments, and exclusion criteria. I don't like mood disorders to begin with, so this makes me actually want to have a major depressive episode myself.

I have new linkage as I promised every Monday. I think it's decent, but I suppose it's up to you to decide whether you agree. I'm trying to make medical conditions a recurring theme (I think I try to do that throughout all my posts, whether it's effective or not, I don't know), so let's check them out:

Asia's poem The Waiting Hour was something I came across when I was in my Def Poetry Jam phase. I still kind of am (remind me to show you guys The Beach next week) actually. It's about testicular cancer, and my favourite part of the poem "playing Russian roulette with α-feto protein levels and tumor markers" really defines what the human body is like fighting pathology. Continuing with medical themes, Man in the Box (which is actually one of my favourite YouTube subscriptions) features Greg with paruresis. Actually Woody halfway mentions about a kid who couldn't take a shit just anywhere - I knew a kid somewhere I used to work with that actually had to leave being on shift (leaving me alone by myself to fend for customers for 15 minutes) so that he could drive home and do a deuce. Weird.

The next has nothing to do with biology, but is just a mind-blowing cover I came across of Outkast's Hey Ya. The ONN clip is just really funny.

I think my favorite this week is Bobby Hundred's Pat vs. Oranges I. I had mentioned in an earlier post about disorders that we can get earlier in our years - 13% of people will get a specific phobia in their lifetime, most people around 7 years. The general case is fear of: situational > natural disaster > blood injection > animal > other. I'm not really sure what category Pat's falls under...maybe just plain bizarre?

lucky

I added a new track from Winnipeg based Inward Eye (Shame). Heard it on the Bear driving home last night and really enjoyed it - they're apparently a Kinks/Clash mashup, which represents like everything great about gritty rock, so fantabulous for them!

***

So last class was our schizophrenia lecture, and to give us an idea of what the disease was like, the prof showed us a 10 minute clip from some 70's instructional DVD of a case study. I've seen a lot of cool disorders, but all of them usually have a really discrete organic cause or a well-studied pathology. Schizophrenia on the other hand is like many psychiatric disorders in that they are all these theories as to what their dysregulation is, but a lot of it is speculation based on retrospective approaches off of drugs that seem to work. What's so weird about it is that under any other circumstances you'd assume this individual was just another one of those strange fellows on the bus who sits strangely, but once he opens his mouth and starts talking, you quickly realize there's something a little off.

This guy starts rambling on about how he was arrested by the police for masturbating in his own bed, and how his brother-in-law put the devil and Lucifer in him. He also claims that when he drinks milk, specifically a quart of it, that he grows cinesthetic horns that disappear without leaving scars. He orates that he can see himself in this parallel universe, where there's all this food and he ate this wonderful magical food and that is how he was born.

Schizophrenia's greatest threat is that it hits young - prodromal stages occur in teenage years and full blown psychosis hits by 21 for men and 27 for women. So I was thinking, how lucky are we to have escaped so many disorders that could have plagued us already, like social anxiety disorder which strikes in the early years or even autism that ravages all social interaction. We have so much to be thankful for, in that we are not necessarily part of the 20% of young adults afflicted with some sort of personality disorder.

The flip side of that coin is kind of frightening though - what diseases await us that we haven't yet experienced? Panic disorder strikes around mid-30s, as does Huntington's chorea - as made famous by 13 on House. Cassius Clay (better known as Muhammed Ali) and Micheal J. Fox both were hit with Parkinson's Disease around the same age, and God knows dementia is waiting for us once we hit 70. Very little separates us from being sociologically abnormal and biologically broken apart from some susceptibility genes and a conducive environment for derangement.

So then I wonder as I'm travelling home impatiently on the 43, maybe we just need to chill out and enjoy life once in a while. We've obviously been blessed with existence, and only God knows how long that will last us, so maybe Rihanna and Numa Numa kid's advice is laced with truth: Live your life. Turn your music up to 18 even though it may irritate everyone around you to listen to Pussycat Dolls' Buttons, purchase a trip for yourself to some random town in Idaho just to get to actually meet a cow named Bessie, eat that last piece of cake and play it off like you don't know who ate it. I'm not saying go be a badass and buy a Harley and spend the rest of your life eating at diners and being no stranger to leather, I'm saying go ahead and buy that puppy even though your parents don't want a dog, because sometimes you really don't need to sweat the small things in life. Priorities matter, but give yourself a break from time to time.

We only live once. Make use of it.

sigh

I find myself waking up with a heavy heart this morning, mostly because I know that today I need to memorize almost the entire PSYCO 478 (Psychopharmacology) course in a single day. You see, the class I'm taking right now, PSYCI 511 (Introduction to Psychiatry) features two lectures by the fabled Dr. S. Kar, the main reason I dropped NEURO 410. I went to that class on the first day, observed his very first lecture on the nature of K⁺ channels, distinctly remember myself muttering, "Eff this..." and getting up early to leave. I find myself face-to-face with this professor again, but now he's rattling on about neurotransmitter and neuromodulator profiles, going through each NT in about 15 minutes or less. Mind you, in PSYCO 478, an NT system would take us at least a week and a half to finish, so he's zipping through this stuff pretty fast.

Just to give you an indication of what this guy wants me to memorize, let me introduce you to one of the seven circles of hell:



Try memorizing ~50 pharmacological agents with names like hexahydrosiladifenidol (Ach M3 selective antagonist) or heaven forbid the three metabotropic glutamate receptor identifiers: 2,5-dihydroxyphenylglycine (Class I mGluR), 2-(2,3-dicarboxycycloepropyl)-glycine (Class II mGluR) and 2-amino-4-phosphonobutyrate (Class III mGluR). Their short forms don't even match their names (DHPG, DCG-IV, and L-AP4)!!

You can understand why I find myself dragging my feet to Second Cup today to study this garbage. I have to deal with memorizing synthesis/release, distribution, receptor profile and functions of 8 major NTs, followed by a few neuromodulators to boot. My class is starting to freak out - some girl e-mailed the whole class requesting that we form a study group to go over the material because there's so much and she doesn't know where to start. I'm just glad I've done this kind of thing before in PSYCO 478, but it's still causing my brain to hurt.

***

Anyways, I posted a great joke I made up in class the other day on Facebook, but I think it probably eludes the majority of individuals (you'd have to be 1. male 2. heavily into neuroscience to get it). That being said I'll explain it:

Question: What do Snake Eyes, Storm Shadow, and the majority of metabotropic glutamate receptors have in common?

The first component: Snake Eyes and Storm Shadow are characters from the timeless classic series G.I. Joe.
The second component: G-proteins are specific second-messenger signalling pathways that are often used to jump-start a physiological reaction (according to Dr. Kar, 40% of clinical drugs use G-protein pathways). That being said, there are three types of G-proteins: G_q/G₁₁, G_s, and G_i/G_o. The majority of mGluRs operate via G_i/G_o.

Thus:

Answer: They are all G_i/G_os!!!

Brilliant huh? I know, I am so proud of myself; my claim to fame.