As pre-med students, about ninety percent of our time is spent in classrooms, lecture halls and the library learning about the numerous, obscure laws of nature. The remaining ten percent of our time is divided between eating, sleeping and breathing. We take classes such as physics, organic, general and biochemistry, biology, statistics, upper level math and psychology and often wonder, well when the heck are we ever going to use something like this as doctors? Are the science classes we take too boring? How can we apply physics, chemistry, and biology to the real world? Through my first three years of college, I had the same recurring thoughts, making me lose motivation in school because nothing I was doing seemed directly applicable to a clinical setting. Now I’ll give it to you, many of the dense specifics that we cram into our heads are omitted and irrelevant to a degree when it comes to practicing medicine. After going through paramedic school, I see where I was wrong. I know this is easier for me to realize and say, but every treatment that I perform in the field, in one way or another, relates back to these classes. It just takes a little time to think that way. A good way to think about it is using what’s called the bottom-up process. This is a processing method done by the visual system in which it takes the smaller components of an image and builds it up into a complete picture. Obviously you can’t do this every time you’re sitting with a patient, but it’s a very good way to start thinking as students. Here’s an example: You have a patient that presents as pale and sweaty and altered level of consciousness. Their vitals are heart rate of 112, oxygen saturation of 98%, and a blood pressure of 76/40 (the obvious problem here because I know you guys learned that the normal is 120/80). So how do we approach this? Well what is blood pressure? Blood pressure is defined as the pressure of circulating blood outward on the walls of a blood vessel. And if we view the vessel as a pipe with fluids flowing through it, we can easily apply the fluid dynamics concept of Bernoulli’s Principle. This essentially describes the conservation of energy for flowing fluids and states that an increase in the speed of a fluid occurs simultaneously with a decrease in pressure and potential energy. The smaller the volume of the pipe, the slower the blood has to flow, which means to get the same volume of blood flowing, the pressure must rise. So back to our patient, we now know we have to pick a medication that causes vasoconstriction, so our pressure will increase to get the same amount of blood circulating through the body. If you’re an overachiever (just like I am), you’ll think of the drug/hormone, epinephrine, which is used by the sympathetic nervous system to regulate fight or flight responses via adrenergic receptors. So to sum it all up, everything that can be wrong which a patient originates in pathophysiology. What is pathophysiology? Biology at work. Biology is just chemistry at work, and chemistry is physics at work, and physics is the fundamental basis of life. So next time you’re contemplating dropping out of college because you can’t derive an expression for the work done by a gas, remind yourself that the basis of your care for patients originates in these classes. Source
