The Updates
We finished the second semester of grad school! I’m writing this on the first day back to fall classes, excited to get back to sweater weather.
What I did over break:
My girlfriend, Meital, flew over from Washington to come visit for a couple days. We spent time together in Pittsburgh visiting the Phipps conservatory, the Mattress Factory Museum (which has nothing to do with mattresses), and eating at some local restaurants. I also showed her around Morgantown and we went to the Morgantown Cryptid Bash put on in the Morgantown Art Bar, which had dozens of WV art vendors, panelists and live music (see a video below!). I’m a sucker for local art and bought too much, worth every penny!
For the rest of the break I spent time catching up on my TV/movies, going to the gym, getting my car fixed and doing a little bit of painting.
The day before the start of classes I also went and did a ropes course through the university recreation center - Adventure WV - with some classmates which was a fun experience. Four of us worked through a series of obstacle courses ~40 feet up in the air, supported by harnesses, of course.
Fall term!
Class for this term include:
Microbiology - 5 credits
Physiology - 5 credits
Surgical and Autopsy procedures - 3 credits
Lab management - 2 credits
Advanced Microanatomy - 2 credits
The class schedule we received through the university was really only our lecture schedule. Now that classes are underway we are learning about the labs, presentations, gross room rotations, and exams that are scheduled outside of lecture times. As a result my schedule is starting to look a little nuts. I’ve made it this far though, so I have confidence that I can make it another term!
Another thing that will be happening this term is that we will be receiving our rotation placements in October. I am beyond excited and nervous about that, the schedule that will dictate most of life in 2023!
Reflection: Personal resilience and avoiding burnout
Being a graduate student requires resilience, and recently finishing a book on nonviolent communication (NVC) has helped me bring into focus just what that means. Practically speaking, it means being compassionate with yourself during difficult times. But what does that even mean? Well, I find that the best way to do that lies in asking myself: What do I need at this moment in order to ensure my continued ability to stay mindful of myself and my surroundings? The key word here, and the word that is stressed in NVC, is “need”. Our needs as humans dictate how we operate in the world, and so it is wise of us to pay close attention to what they are.
Here is a list of some needs that humans have: https://www.cnvc.org/training/resource/needs-inventory
Now, obviously we cannot always be meeting all of these needs all the time, and these needs will have different levels of importance to us as people or at different times in our lives. But I have found that the consequence of not paying attention to my own needs results in the symptoms of the dreaded ~Burnout~. So when I sit down to schedule out my week, and schedule in the critical “Me Time”, I think about what needs of mine I can meet during that time. Me Time is NOT spent thinking about what I “should” be doing, or what responsibilities are being neglected, instead I am fulfilling one of my needs as a person, some examples of how I do that include:
Generate a feeling of self-worth by celebrating a small accomplishment (E.g. watching a movie and drinking hot chocolate, or going for a drive with the music turned up)
Find meaning in my day-to-day struggles by journaling
Release any built-up physical stress by exercising/dancing around my apartment/crying/etc.
Foster my sense of community support by talking to my friends and family back home.
By paying attention to my needs I am able to study more efficiently, get better sleep, and generally feel better about being here, in other words, it creates resilience! Being compassionate with ourselves in this way allows us to be compassionate with others too, and there really isn’t any downside to that.
The Disease of the Day! Atherosclerosis
What is atherosclerosis?
Atherosclerosis is a vascular disorder and is the leading cause of morbidity and mortality in the western world because it causes conditions such as coronary, cerebral and peripheral vascular disease.
Etiology
There are many risk factors for atherosclerosis, which can be constitutional (meaning they cannot be changed) or modifiable (meaning changes in lifestyle can alter the magnitude of risk).
Some of the constitutional factors include: genetics, family history, age and traditional male physiology.
Modifiable risk factors include: high cholesterol levels (specifically LDL), Hypertension, cigarette smoking and diabetes mellitus.
Pathogenesis
The current understanding of atherosclerosis views it as a cycle of inflammation and healing.
The initiating factors of atherosclerosis are endothelial injury and dysfunction, meaning that the layer of cells lining the blood vessels is damaged or otherwise not working properly. All of those risk factors I listed above? Those cause endothelial injury or dysfunction.
Next comes the accumulation of a variety of cells, lipoproteins, and lipids which all result in inflammation. Eventually the body responds to this inflammation by creating new smooth muscle cells and extracellular matrix in a layer of the vessel called the intima. It is the Smooth muscle cells and extracellular matrix that determine the progression of atherosclerosis, and these factors are in turn mediated by growth factors such as platelet-derived growth factor, fibroblast growth factor and transforming growth factor-alpha.
Morphology
The precursor to atherosclerosis is called a Fatty streak which are flat, yellow macules that do not cause any flow disturbances. Many times fatty streaks are not destined to become plaques, but all plaques originate from fatty streaks.
Atherosclerosis eventually manifests as atheromas, aka atherosclerotic plaques. These are raised, yellow to tan patches found in vessels that disturb the flow of blood. They are most commonly found in the lower abdominal aorta, iliac arteries, coronary arteries, popliteal arteries, the internal carotid arteries and the vessels of the circle of Willis, which supplies the brain.
Plaques are composed of a fibrous cap and an “atheromatous” core that contains smooth muscle cells, extracellular matrix, inflammatory cells, calcifications, lipids and necrotic debris.
Once formed, atherosclerotic plaques can undergo secondary changes that lead to
Rupture, ulceration or erosion leading to occlusion of the vessel
Hemorrhage into the plaque
Atheroembolism, where the plaque breaks off and travels through the bloodstream
Aneurysm formation caused by atrophy of the vessel wall
