Driving In The Snow: Do Not Try This At Home (Or More Specifically, Do Not Try This On Burns Road In Ithaca)

This morning was quite an adventure. It was snowing heavily when I left for school at the crack of dawn. In my naivete, I decided to take the backroads because I was in a rush to get to school and the backroads are a short cut that shaves over ten minutes off my trip. In retrospect, this was a stupid, although everything worked out OK in the end.

Above is a picture of Burns road this morning-- totally deserted (for good reason). I got stuck on the iced-over bridge at the bottom of the photo and had a moment of brief panic, and then remembered that rather than spin my wheels I should try to reverse and rock the car. Thankfully reverse worked just fine and after reversing partway up the hill I went back over the bridge at a slightly faster speed and did not get stuck.

Finally, after traversing one more difficult spot (the steep hill when turning off route 79 onto Pine Tree road), I arrived at the vet school. There's my little car in the not ploughed parking lot of the vet school (at least not recently ploughed). As another student pointed out, the vet school has the earliest classes yet its parking lot is ploughed last. Go figure.

(I'm not quite sure why these two pictures came out so incredibly blue but it was still getting light when I got to school so it may have had something to do with the night-like sky).

And here's the view of Burns road on the return trip home. Much better!


Thanks all for the many comments on my last post. I was surprised to see so many people read something so lengthy! It really made my day.

I got two more clinically relevant lectures today. I was especially intrigued about the part on imaging lung metastases. Met checks, as they are called colloquially, always mystified me as a technician. I understood what the doctors were looking for and even the rational behind how we shot them-- the up side is magnified because of increased distance from the film which is useful if you are looking for something very small (also the up side is more inflated on inspiration). You take two laterals in addition to a ventrodorsal or dorsoventral view so that you get good views of both right and left lungs. Rather it was the interpretation part that seemed so mysterious-- sometimes I'd think I'd see masses and the doctors would declare the films clean with no metastases. Other times I'd be sure there were no masses and the doctors would see metastatic lesions.

Well, I finally have a bit of a better idea about why I didn't see the same things the doctors did on met checks, besides my inferior experience. For one thing, when viewed end-on a blood vessel can look just like a soft tissue nodule. Blood vessels tend to enter and exit at the base of the heart (right and left atrium) so the radiologist advised not looking there to start but instead examining the periphery of the lungs.

Another thing I learned about is ossifying pulmonary metaplasia, the formation of tiny bits of bone in the lungs. This is a normal degenerative change in older dogs' lungs (kind of like spondylosis and some other normal degenerative changes that occur elsewhere in older dogs I guess) and surprisingly does not cause clinical problems. It shows up as tiny little radioopaque dots, just like metastases, but their density is bone. How can you tell? For a mass that is less than 5 mm in size to be visible it has to have a mineral density otherwise you wouldn't see it as a white dot-- soft tissue just isn't visible at that tiny a size. Ossifying pulmonary metaplasia, as its name suggests, is not generally cancer-- so if you see mineral densities in the bone you can pretty safely assume that it is not metastases (the radiologist said that in the ten years he'd been at Cornell he'd only seen one osteosarcoma produce bone metastases in the lung).

That's as much truly clinical information as I'm going to get for the moment (that and my two lectures on cancer therapy/treatments). Unfortunately I don't get to the bulk of the clinical course work until Block 5, which is one year away (I'll be starting more or less at this time next year). It's sad to hear that I will forget so much of this. I'm enjoying it but I know that I will need to make room for the more clinically relevant material and so some penguins may fall off the iceburg (that's the analogy everyone here uses for forgetting what you just learned to make room for more new information). I do know at least one veterinarian who still remembers most of his basic science, the very cool Dr. Cool, now chief-of-staff at the emergency clinic in San Jose. His memory is like a steel trap, he lets nothing go (when I was back on break I'd just finished learning about apoptosis and he knew just as much about the genes and proteins involved-- Bax, Bcl2, caspase3 etc even though it had been almost ten years since he'd last seen that material!) But I guess even if I aspire to retaining information to that level of detail I may have to be more realistic and settle for less...