The Professor in Paediatric Pulmonoly has done wonders for my brain. He told us to question everything he tells us, and that we should only expect 30% of what we are taught to be true.
He forces us to ask WHY.
For example, WHY are we comfortable with an Oxygen Saturation of 92% as opposed to demanding a 99% saturation for all patients?
The answer is quite interesting. View the graph alongside: between 100 and 92, the graph is relatively flat, meaning that a great variety of changes will cause little to no change in saturation. However, as soon as saturation drops below 92%, the graph becomes very steep and a small external factor can cause a massive drop in saturation.
Similarly, he asked us WHY, if in Cystic Fibrosis the Sodium and Chloride Transport is impaired, does a person with CF have salty skin?
Again, it’s so obvious that I didn’t even consider the possibility. In the alveoli, chloride must be moved from the epithelial cells to the alveoli in order for water to mix with the mucous of the respiratory tract. Because this doesn’t happen, one gets the characteristic thick mucous.
In the skin, it’s just the other way around. Normal physiology states that sodium and chloride must be reabsorbed by the sweat glands in order to maintain electrolyte balance. Thus it’s just a secretion of ions in a different direction. (In layman’s terms. I don’t enjoy jargon.)
It’s really so simple, but I feel like medicine tends to take our logic from us by demanding large amounts of rote-learning. I wish I could be more regularly exposed to professors who consider learning to be fun. Don’t you miss the days when learning was an adventure?