Wednesday, April 25, 2007

absolutely crazy exchange about PANDAS...

...with someone trying to make a joke about an unfunny topic. i posted a rather terse and pissed off comment on a blog entitled, "over my med body" which is written by a third year medical student at stanford. it appears he does not recognize the difference between "humor" (which he tagged the post as) and "irony" (which is what the acronym PANDAS is as a pediatric disorder). it kinda got out of hand, and i probably overreacted, but this guy absolutely pissed me off because of his attitude--he seems to be quite compassionless already and he is only a med student. it is disheartening to see how glib a soon-to-be medical professional can be about a pediatric disorder, a thing which is by definition tragic. i'm not saying the manifestation of gus' disorder is tragic--however it could have been--but that pediatric diseases in general are about the worst thing imaginable. i think i got so pissed at this guy because he just cannot possibly understand what he is saying. what does this say for the future generation of physicians? i am thinking about PANDAS again because gus had a strep test last week and has to have another one on friday.

feel free to skip the dialogue below (if you haven't already stopped reading this!)--he, interestingly, removed it from his blog and qualified his original post with a throwaway sentence.

(from over my med body blog, april 10, 2007--now removed)
PANDAS Syndrome

While reviewing infections of the neck and complications of strep throat, I read about PANDAS, which stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections.

I hereby decree that all new Pediatric Syndromes must have similarly-cutesy acronyms. Like BUBBLEGUM or DUCKY or KITE or BINKY or BUNNY. Alternative spellings, like ELEFUNT, are acceptable.

March 29th, 2007. Humor, Pediatrics

iskandar m i basal:
The other pediatric condition that is related to Strep infections is the Sydenham Chorea where the antibodies attack cells of the basal ganglia (striatum) where MRI studies has shown abnormalities. The mechanism should be I think that of the antigen mimicry. I guess where the Antibodies has attacked in the cases of PANDAS.

parent of a pandas kid:
can i tell you how unfunny or cutesy it is to have a kid that has this? can you imagine waking up with a completely different child one day and having them spend months asking you if someone accidentally put needles in their food, or if they are going to die from mesothelioma over and over and over and over again? or perhaps they develop sydenham’s chorea or tourrette’s? no need to publish this comment, however if you are to be a successful clinician in the future you might want to consider having a tad more compassion for your “potential” patients. let’s hope you’re not going into immunology or pediatrics and be thankful your views are not published along with your name because i SO would not go to you for medical treatment.

Never found the syndrome funny or cutesy, parent–in fact, have a classmate with probable PANDAS with tics. Pride myself on my compassion, actually. Sorry you misinterpreted my comment!

parent of a pandas kid:
PANDAS is by definition a pediatric disorder–do your homework.

It develops in childhood, yes–but my understanding is that some of the sequalae (Tourette’s, OCD, tics, etc) often last for life. In fact, now that I think back to it, I did a short presentation on the all the possible sequelae of group A strep.

parent of a pandas kid:
good for you for doing some research; you are still mistaken. the sequelae (you misspelled it in your response–sequalae is the singular form) have not been proven to last a lifetime; i challenge you to send me citations from peer-reviewed journals stating definitively that this is the case.
i don’t wish to spend my limited time in this dialogue with you, but i am going to tell you one thing about myself and two valuable things i have learned: i have spent my entire adulthood to date around people in academic medicine. and these are not people who are barely getting by in the field, but medical scientists, exceptional clinicians and educators, who have done exceedingly well in their professions and are highly respected members of the medical community. they are the people who will someday be administering your board exams or readers/editors for the journals you submit articles to, if you get that far in your field. the main thing i have learned from being around them is that those who become very successful and who become excellent clinicians NEVER lose their respect for either the disease or the patient, no matter what the circumstances may be. they certainly aren’t spending their time writing clever witticisms on a blog about serious illnesses.
the second thing i have learned comes more from being a parent but also applies in this instance: pediatric disorders are NEVER funny. they are tragic. they are unnatural. they are devastating. that does not mean you have to have a bleeding heart for every sick kid you treat–in fact allowing yourself some distance from it may keep you sane–but it does mean you do not take it lightly. ever. that was why i emailed you in the first place–your callous attitude towards PANDAS speaks volumes about the type of physician you are on the path to becoming. i don’t know you personally and i have no idea what your goals in life are, but i can guarantee that you will not rise to the top of your field with the attitude displayed throughout your blog. i am guessing that since you are at stanford success means a great deal to you. you should step back a bit and listen to yourself.
good luck.

okay, i fully admit that i do sound crazy, but within the craziness there are some kernels of truth.

No comments:

Post a Comment