Another one bites the dust

Fainting. The medical term for it is vaso-vagal syncope, and it seems to be a rite of passage in medical school.

On the first day of anatomy lab, my hallmate was standing a few tables over from me. We were listening to the anatomy professor discuss standard procedures in the lab. About 15 minutes into his lecture, I heard a thud, followed by a louder thud and the sound of something dropping. I saw my hallmate attempt to get up, only to swoon and fall again. Luckily the guy next to her caught her this time. She was helped out of the room by some of the preceptors (doctors, fortunately). Later I heard that the smell of the phenol, combined with not having enough to eat for lunch, had caused her to faint.

About a week ago, an unnamed relative of mine told me she had fainted during an autopsy for pathology. They had opened the abdomen, and the smell had been the culprit again. She sustained a few bruises -- nothing serious I hope.

We had a demonstration of electromyography in class today. This is a set of tests designed to measure the response of nerves and muscles to electrical stimulation. Students from the "studio audience" were selected to participate in the demonstration. The nerve conduction study was fairly benign, involving the application of an electrical stimulation that was supposed to feel like a shock from static electricity. The youngest member of our class volunteered for this study and smiled/giggled throughout the demonstration.

Next, we observed needle electromyography. This requires a needle electrode (the size of a hat pin) to be inserted into the muscle of interest. The patient is then asked to flex the muscle to varying degrees. Like in the first study, the responses are recorded on a computer. A solidly-built rugby player volunteered for this demonstration. He sat down in the chair and grinned as the needle was pushed into his right deltoid muscle (upper arm). We watched the sine waves blip across the screen. They went crazy when he abducted the muscle, indicating the recruitment of larger motor units to generate more force. The whole time, the lecturer was talking about the test and its relation to the (patho)physiology of the nerves/muscles.

At some point, his assistant, who was performing the test, asked the student if he wanted to end the demonstration. He nodded, stood up, and walked toward the end of the stage. Just as the student reached the podium, his knees buckled & he went down. The assistant had been keeping an eye on him and quickly ran to his aid. I couldn't see what happened next, because the podium was blocking my view, but I saw his feet & his toes were pointed toward the ceiling. Fortunately, he was able to get up a minute later and seemed fine. The lecturer paused to explain the phenomenon of vaso-vagal syncope, which frequently happens in young people after a particularly strong stimulus. 30-40% of med students end up experiencing it during their training. Here's a website that summarizes the physiology behind it:

http://hora.cpmc.columbia.edu/dept/syncope/vvstilt.html

I wonder who's next ...