Sunday, September 14, 2008

Syncope is funny. Until it happens to you.

So I fell out during anatomy lab on Monday. I wasn't anywhere near the cadaver--we hadn't even uncovered him yet--and I was just listening to the professor talk about the sympathetic nervous system. It was interesting, enthralling even, so it wasn't like I was short on sleep and fell into a mini-snooze (I was short on sleep, true, but also highly caffeinated...to the point of buzzing, in fact).
I remember what he was talking about--the sensory innervation of the diaphragm, and the tests they do for fallopian tube patency (they inject some air into the uterus, the woman stands up, the air leaks out the openings of the fallopian tubes and impinges on the diaphragm, and the woman sometimes feels a little pain in the region of her shoulders or neck...because the fibers that innervate the diaphragm actually arise at the cervical--read: neck, not the 'downtown' cervix--level. Which is actually good, because it means that at least the fallopian tubes aren't scarred shut, which is a fairly common cause of infertility). I had to sit down. Stood up again, sat down again. Went out into the hall, sweating and nauseous, and prostrated myself (note my cunning use of vocabulary to avoid the lay/lie difficulty--something I still don't have a complete handle on after all my years as what I would consider an English speaker of some facility) on what is probably one of the nastiest floors--make that nastiest surfaces, period--I've ever been privileged to make contact with. So of course one of the professors/lecturers/coursemasters/whatever the hell we're supposed to call them now happened upon me, which was probably good considering the fact that I was horizontal and still felt like I was losing consciousness. Why me, dammit? I'm not especially squeamish (though the bone saw did make me flinch). I'm not some consumptive Victorian who keels over at the first sign of stress or pressure. So what gives?
Anyway, it was an embarrassing albeit unique opportunity to be escorted to and chill on the floor of the prof's office for a few minutes, eat a granola bar, and get my blood sugar up into range (I've decided it was probably an, ahem, glycemic control problem, which is a way of conveying the issue without getting all up in my business). This was the coursemaster who scared the hell out of me at the beginning of the year; I still have a healthy respect-to-fear ratio, since she comes around the lab and fires questions like bullets ("And what's this structure here, just posterior and medial to the thoracic duct?" [Silence, as the table collectively tries to remember what medial means in this context]), but she's also phenomenal at explaining things and was quite nice when she could have just shipped me to student health or something. So there's that. And the fact that I almost wanted to say, when she asked me what was wrong, "I'm either having an exaggerated vagal nerve response to stress, a particularly intractable bout of orthostatic hypotension, or a brief period of hypoglycemia that will probably rectify itself once the epinephrine from talking to you mobilizes the glycogen stores in my liver." Maybe I'm learning some of this stuff after all.

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