From Sunny To Snow

This is me headed out on a walk this afternoon with my landlord's dog, Coral. I'm also testing out one of my new coats and found it works great (thanks!). It arrived just in time for today's snowfall.

Yesterday it was sunny and warm and snowless. I went for a hike after class with two of my classmates in an area that I discovered on my return from my Thanksgiving travel. Crossing the suspension bridge we had the view below:

I guess the weather changes pretty quickly here in Ithaca.

I composed the beginning of the following poem in my head after making a trip to the farmer's market this morning, heading home in the snow:

cocooned in confetti
white specks against a grey sky
falling silently

My post on blastomycosis generated more responses than I anticipated (not everyone posts comments, sometimes I get emails etc from those who know me). The lecture wasn't actually part of my cell biology course, it was open to the whole college. I don't know if we cover blastmycosis in our disease course, I won't take it until next year. The talk didn't go much into treatment so I had no idea it took so long to treat, thanks for the info, Ceres.

This was the first case of blastomycosis that has presented to the Cornell hospital in recent years. It wasn't treated as blastomycosis because no one realized that was the organism causing the dog's illness until the dog had died and was sent to necropsy (by the time this dog was referred to Cornell it was too late in the course of the disease to have any real shot at a successful treatment judging by the pathology report-- there were blasto yeast buds in the brain, not to mention everywhere else, and the dog was only hospitalized a brief time before death so those lesions were likely there on presentation). The reason that it was not diagnosed as blastomycosis was because the presentation was anything but classic. I wonder how many cases of blastomycosis are atypical and don't present with a cough? I was also impressed by how difficult it is to accurately diagnose blastomycosis-- I remember the resident saying that to get a sample one must typically do a lymph node or lung aspirate, that tracheal washes aren't usually sufficient. Yuck. It seems like a pretty nasty disease all around.

For those of you looking for some interesting reading, check out _The Medical Detectives_ by Berton and Boueche. It is a compilation of puzzling human medical cases and includes one that involved a systemic fungal infection. I won't tell you which one that is, I don't want to spoil it. I did get to show off though during my orientation week when the dean of learning picked this case to use as a model to teach us how to tackle problem based learning and I knew the answer. I kept quiet until the end of her presentation, after my classmates had taken their best stab at it, and then I raised my hand and gave the answer. It was quite satisfying, although she would point out that problem based learning is not about the answer at all but rather about the process. Bah humbug.