Sun, Radiation, and Summer Break Plans

That would have been nice. I, I, I would have liked to put you in a little straight jacket. What? That is crazy.

You want to put me in a straight jacket as a child.

But babies like that. They like being all like.

Hi, everybody, and welcome to the podcast. This is Generations md. My name is Stephanie, and I'm joined here by my colleague, Dr. Sarah Davis, who's also my mother. Welcome, everybody.

Hello. Nice to see you.

Nice to see you.

You know, it's not really fair that this is, like, the only time I get to talk to you.

That is not true. We literally called the other day.

The other day. You know, some people call their moms every single day.

That's too much.

Some people call their moms, like, multiple times a day. That's probably a little much.

Yeah. Actually, we were just talking about this. I was talking about this with some people and, well, I was actually talking to this attending and she was saying that her parents aren't in medicine and they don't really get it. And she, even in med school, she never talked to them about, like, her grades or, like, anything about med school because she was just like, when I talk to my parents, I want it to be independent of that. She's like, I never called and complained about a test or anything. I was like, yeah, I don't know. Interesting.

Well, still, like, you want to know what your kids are doing? I mean, like, I don't understand anything about what Ryan's doing, but he still sometimes attempts to tell me.

Yeah, yeah. She also said that her husband's a doctor, too, but they never talk about, like, anything healthcare related at home. They just kind of.

What do they talk about?

Well, then, yeah, I said, I was like, well, maybe your kids will have less of a chance of going into medicine then. Because I grew up, I feel like, with a lot of talk at the dinner table about medicine, and here I am, so.

And here you are, so that's study complete. Yeah. I don't know. Once in a while I tell dad, okay, no shop talk. And then he's kind of just silent. Well, so speaking of shop talk, what's going on with school?

Yeah, we're in our last. We have, like, three more weeks, so. Yeah, so we're in our last module. It's our pulmonary module, which I actually had the opportunity to work or to do, like, a preceptorship in a pulmonary clinic this semester, so.

You're killing it.

So. Yeah, that's what I kept telling. I told you. The guy that I was with, we had our last preceptorship on Monday. And I told him, I said, well, I'm just gonna do so great on this pulmonary module. Like, I don't need to do anything. Cause you prepared me so well. He said, cause he mostly just sees a lot of cancer, a lot of just biopsing nodules and stuff. So he said if I get any nodule questions wrong on the exam, he's gonna be very disappointed.

Yeah, but I imagine your pulmonary module has a lot to do with things other than nodules.

Yeah, unfortunately, there's a lot of physics and like that sort of air flowing and all of that, so. Yeah, yeah. Not just, you know, ask them if they have fever, night sweat, weight loss, and then pet. Look at the pet biopsy.

Right. Wow. But so your. Your very last one of just a few more weeks and then some exams and boom, you're out of there.

Yeah. Yeah. It's definitely hard to get motivated for this last. Last couple weeks. It's like, it's tough. I'm. I'm ready. I'm ready to be done.

Well, you still got another three years.

Well, I think it's. It's like when you're running a race or you're just running and you told yourself you're going to run, you know, five miles, and then you get to mile four and you only know that there's one mile left, and it's like, that's harder. Even though the next day I could run 10 miles and that fifth mile would not feel the same as the fifth mile the day before. You know, that's fair.

That's fair. Yeah. It's all about the expectations and all that. So.

So we have welcome weekend coming up. So the. We're bringing in the incoming students and kind of showing them around and giving them tours and like club fairs and stuff. So I already kind of feel like I'm. I. I don't feel like a first year anymore.

Did they give you a, like, little buddy or little sibling or something like that?

Yeah, yeah, they do. I think I might help with the match process with that. That happens later in the fall, but yeah.

Oh, there's a match process.

Like you just fill out a Google form saying what you're interested in and like, how. Yeah, just like a couple of questions and then you match people up.

Well, you should have Ryan write some sort of AI thing for it. Write an algorithm and then just, you know, feed them all in there. Here you go. Here's your match.

Like AI algorithm versus, you know, a couple of sorority girls who have done big Little stuff. I feel like it's hard to compare.

Yeah, yeah. I mean, sorority all the way. Do you want to tell what you've got going on this summer?

Yeah, so I'm doing kind of a hodgepodge of stuff. So my school, we get 10 weeks for the summer and I'm gonna. Yeah. So the first couple weeks I'm doing a preceptorship with family medicine doctor. So it's actually like hospitalist, but, uh, gonna be doing that for a couple of weeks. Uh, I keep throwing around this word preceptorship. If you don't know what that is. Um, essentially it's just like you do what you would kind of do on your third year, which is you like are kind of shadowing and learning, but also you're going in and you're taking history, doing physical, like interacting with the patients in that way, kind of just working with the team on like the lowest part. So yeah, you're kind of just like. So in regards to the team, you have, you know, residents, fellows and the attending. So you're kind of in, in the mix with them, helping them out and like talking through different cases with people.

So it's more than just shadowing. I mean it's a step up from shadowing because you go and interview the patient by yourself like first. Yeah, yeah.

So. Or you have a resident with you and you know, there's a little bit of shadowing involved. If there's some sort of, I don't know, complicated case or some like minor procedure thing, then you kind of just tag along and you'll go and see that. But yeah, you're definitely. I mean the main thing is like doing history and physical. Yeah, yeah.

And I mean, I imagine when you are doing your precentorship thing this summer, I mean that's not really. It's not, isn't. It's not really an academic institution where you're going to be. Right. No. So there won't be like residents and fellows. So. But you and the attending. So you may be on your own. Yeah.

And honestly it's really good because hopefully that will get some of my history and physical skills a little bit better. Because then I'm. Well then we're going to Japan, doing a trip, like a 10 day trip there. And then I'm going to the Himalayas to do this health care thing and I'm going to be. Essentially we do these clinics in the small towns up in the like the Spiti region. It's called in on like in India. And I am Going to be doing a lot of history and physical that, like, they see upwards of, like, 60 patients a day per person. So it's.

Oh, like you're gonna see 60 patients, like.

Yeah, up to, like. Yeah, I could. Yeah. So it's gonna be a lot. And I mean, that'll definitely get my skills a lot better, but I need to be able to, you know, do it quick. And also, there's a language barrier there, so it's gonna be. It's gonna be difficult, but I'm really excited. I think that this is a really good program. We work with the. Essentially, there's a school, a medical school at the bottom of the mountain that we work with. So we work with the doctors and the students there to then go up into these towns. And they have to get all of their health care from May to October, because that's the only time that people can get up there, because the rest of the year it's frozen, like, too cold, like snow. So the communities really appreciate it. They go up there and, you know, do, like, normal health screening. And then if there is anything more that they need to be sent down the mountain to get, then they go to the big, like, institution that is there.

Okay, so you're doing both sick care and, like, preventative care type things?

Yeah, a lot of it is. A lot of it is like, pediatrics and just kind of. Yeah, a lot of preventative care screening. Um, I mean, yeah, sick care, too, but a lot of it is. I think we're just seeing people that are coming in for their annual visit sort of thing.

Huh. Like obstetrical care, too.

They. They're not. Not a lot. But there is. I. They were saying that in previous years, there were a couple OB GYNs that came, so.

Yeah, well, that's. That's exciting. And, I mean, I. I do bet that you're gonna see other things that you would not normally see. Yeah.

Yeah. It kind of brings a conversation of kind of this, like, voluntourism thing, which can be a dicey situation. Any company that, like, isn't really vetting people to go do some sort of volunteer thing. I kind of looked into a lot of this, and it did just seem. I don't know, it's a complicated issue. I think that overall, it's important to put resources and money into global health, but it's difficult to find a way to do that that isn't giving, like, white savior complex and stuff. But after talking to people and this is a really reputable organization, and the point that we're working with the school there and working with people there. Um, makes it, I think, a big difference than just like, popping in and doing some screening and then leaving.

Well, I think it's also important to understand that you're. You're going there almost more for your benefit than for the people's benefit, you know, I mean, there, yes, they will benefit from you being there, but you're going to learn a ton. And so rather than that philosophy of saying, like, oh, I'm going in to help these people and then I'm going to leave, like, you. You understand that you're going there to learn.

Yeah, no, that's so true. And it's not like I'm learning at the. It's not at the disadvantage of them. It's not like I'm learning.

It's not at their expense that you're learning.

Yeah, yeah.

I mean, it can be a win. Win. Yeah. But, yeah, I know that was, you know, something that people would talk about, like, when they're applying to college, that they, you know, people would kind of do these mission trips and things and then want to say, like, oh, we went in there and helped these people and it was like, okay, you flew in a bunch of rich kids and you built some little thing and then you left and abandoned it. And that was, you know, you didn't really, really help those people. But you. Then you came back and wrote this essay about it. Like, you were so fantastic. And I think that's. I remember hearing college admissions people, like, saying how much they rolled their eyes to those kind of essays. But this is not, you know, this doesn't sound like that type of thing. Yeah.

And like, I have some qualifications. Like, I know I'm not. Like, I know I'm only a first year, but I. I can. It's not like a. I can't do anything. Like, I'm a high school kid, so.

Right.

Yeah.

Right. Yeah, you are. You're better than. You're better than a teenager for sure.

Did not sound convincing.

Oh, yeah. And I. I think I told you, one of my friends said, oh, yeah, well, you and Matt need to volunteer in the organization and go with her. And I said, we were specifically told. We are not allowed to do that by you. Right.

Yeah.

What? Dad wanted to go?

Yeah. No. Oh, no. Yeah. He's not invited.

That's what. When I was telling him we were going to Japan and he said he was like, well, I don't want to go to Japan. I want to go to the Himalayas. I'm like, well, that' not what the trip is. Or you. You can't go. He's like, it's. It's free country. I can go to the Himalayas if I want. I'm like, yes, but not with the family or not with Stephanie's group. So.

Yeah.

Okay, that's good. I'm glad to kind of get that explanation you had told me some about it, but people are asking me what you're doing this summer, and I'm kind of trying to explain it, and so now I have a little bit more explanation about it. Yeah. Wait, and for how long are you doing this Himalayan thing?

Three weeks.

Three weeks.

So we go to. From town to town. We go up there, and then. Oh, I also just booked because I'm getting there a couple days early. There's some people from my class going, and we just booked, like, a. A tour thing to go see. We're gonna see the Taj Mahal and go on a safari.

A safari? Yeah. Oh, I don't know.

I didn't really plan or really look into much of this, but, you know, they're. They're in India. I got to see the Taj Mahal.

Right. Yeah, obviously. So, yeah, take a bunch of pictures of that.

Yeah. So.

And then. And. But then you're like. So. So then you go to these different towns, and you're staying in these kind of.

We're saying we're staying in tents.

Okay.

So, like, it's for most of it. So it. We go to one, we'll go to, like, one town, and. And it'll be two nights, and we'll be camping there. And then we'll go to another place and we'll say, in, like, a guest home. I don't think there's running water anywhere, though. Yeah. So, yeah. And then we'll. They said something about a bucket shower, so. Yeah. And then we'll go to another place in camp. And then. So it's kind of a mix between these guest homes and then just camping.

Okay.

If y' all can see her face right now, she's like, I'm glad I didn't sign up for this.

It'd be. It's going to be good. Yeah, that's gonna be. Now that's gonna be a great experience. These are good things to do when you're young.

No, I think it'll be really good for me, though, and give me some good perspective on things.

Right. Think about. Yeah. Coming back and getting some gratitude.

Yeah, for sure.

And. And then you come back, and then, boom, hit the ground running.

Yeah, actually, I come back and then that same night, I have to go. I have to go to the retreat, the MS.1 retreat. So then I have to camp again. Or, like, I stay in a cabin. But, yeah, it's the first thing, so at least I'll be used to it.

Gosh, I guess so, huh? Make sure you take some sort of shower before you show up there, because people are gonna be like, man, med school's rough.

Yeah, so.

Oh, well, good. Okay, well, shifting gears, I wanted to follow up on a couple of things from last week's podcast. When we spoke with the dermatologist, she mentioned something called thymic irradiation. And I didn't really know much about that, so I kind of just. I looked up and basically she had implied that that was, you know, possibly what caused her mother's breast cancer. And so I was kind of looking into seeing, you know, is that really. Okay, so the thymus, it starts off very big in childhood, and then it gets smaller and smaller and smaller until by the time you're old, it's basically non existent. But it is where it's part of the immune system. So the T cells go there and basically get trained up on how to be a T cell and how to recognize self versus non self. And then those. Then that gets. Then they get kind of released out into the body. Yeah. Okay, so the thymus is located in the chest, kind of between the lungs and breastbone. But basically, you know, what happened was that they. They found that. So these babies had what they thought seemed like a big thymus. And what they were worried about was that that was actually going to cause the babies to asphyxiate and die because they thought that this thymus was, like, kind of pressing on their windpipe. And that that was like, part of the cause of, like, you know, sudden infant death syndrome, that kind of stuff. And so, you know, I don't know. I mean, I looked back and I actually found a study that was published in 1927, which I couldn't believe it was still, like, around in this journal of radiology. And the person was saying that, you know, especially if a. If a kid was getting anesthesia, which they said, like, you know, they were using, like, chloroform or something like that. If they were using anesthesia on somebody and they had this big thymus that. That could cause them to suffocate and die. So they. So they never really knew if somebody had a big thymus until they started doing X rays on people. And so they could kind of See on X ray that some, that some of these babies had a big thymus. So the thinking was, and you know, I mean, I guess I don't have any literature to know, you know, was that really killing these babies or not? But so they thought, well, if we just kind of shrink it down with some radiation, then these babies won't suffocate. But by doing that, they did increase the risk of these kids for cancer. But it doesn't mean that it actually. So like I looked up. So for they, they did a really long term study. The. I mean, basically this happened between 1926 and 1957. And they like. So I did see a study that, that found with people who had this, and they compared them to like siblings who didn't have it and they found like for, you know, for girls, that the risk of breast cancer was about triple in people who hadn't had it. They also found some increased risk of some other kinds of cancers, especially thyroid cancer. So, so, you know, with the dermatologist's mom, you know, she did end up having breast cancer. We'll never know. I mean, maybe she would have had breast cancer anyway. But having that certainly increased her risk for having breast cancer. So. But I didn't really know. I didn't know anything about the history of all of that. And so I thought that was, it was just interesting from a historical perspective and then obviously on a personal perspective from her to kind of hear about that. But when she mentioned that, I was like, what is she talking about? So thought I'd dig into it a little bit and if our listeners were wondering, I thought I would just explain that.

Yeah, that's crazy. Do you. Did they know the risk for radiation and cancer then or was that discovered later?

I think that was discovered later. Yeah, I think there was. I think they discovered radiation, you know, was a lot worse than they thought that it was going to be. Now sometimes people have to get radiation. I mean, they talked about how people will have, you know, radiation for childhood cancers. And then in some ways that does increase their risk for other cancers as their life goes on. So, you know, but I mean, obviously now people know that those are risks and you have protocols in place to kind of follow people and all of that. But yes, I don't think they had any idea. I think they just thought, hey, let's push, you know, put this little beam on here, shrink this thing down. And you know, I mean, you can imagine if you're thinking, oh gosh, this thing's so big, it's going to suffocate my baby? Yeah, like, zap that thing. That seems like a good idea.

Well, did you. So you didn't find anything if it actually did lower death rates in babies or.

I didn't find that. I guess we can look into that next week. Okay, stay tuned, everybody. Stay tuned. Yeah, I don't. I don't know. I mean, like I said, this One article from 1927 seemed to really, you know, seem to think that it was something that was going on. But, you know, I don't even know how much randomized controlled studies were going on. Although, you know, again, this. They were doing this up until, like, the 50s, so certainly there was probably more studies. Although then probably finally, at some point, they're like, oh, wait, this isn't doing any good. Or, you know, maybe they also figured out other things to, you know, to help babies not suffocate.

Yeah, I mean, the. The sudden infant death syndrome, though, that's still. That's still kind of like a. They don't really know what causes that. Right. There's still lots of theories, but no one really knows.

Yeah. Yeah. And they, you know, there's all those things, like, you can't have any little blankets in the bed anymore. We. We didn't do that much with you guys. Oh, we used to. But the. But you. We used to at least have. Be able to have, like, a bumper around the crib. Can't do that anymore. No, no, bumpers. Can't have that anymore. But they put babies in little sleep sacks now that are kind of like little straight jackets. So I don't know, maybe that helps with stuff as well. That would have been nice. I. I would have liked to put you in a little straight jacket. What? Because that is crazy.

You want to put me in a straight jacket as a child.

But babies like that, they like being all, like, snuggled up.

Not me. I want to be free.

Okay, well, just, you know, you're. They'd been in the womb all, like, you know, in a little ball, and so they come out, and they still kind of want to be in a little ball.

I didn't. I remember.

Okay, sure.

And you said also you looked into sunscreen. Right?

Okay. Yeah. So what I wanted to find out. So you know what she says, what the dermatologists recommend are. Oh, so they. Oh, you. You want mineral or physical sunscreen, not chemical sunscreens. Yes. And so they have to have either titanium or titanium dioxide or zinc oxide, which is kind of funny because that's. That takes us way back to when you know, when we were, when we were kids, that was one of the only things you had was zinc oxide, this big white thing that you'd put on your nose and look still was good. But I didn't. And so then I was trying to look up like, what brands? Like what, what do you, what do you use?

Yeah, I have Blue Lizard, which, yeah, it only has titanium and zinc. And then Ulta Sunscreen, which was a little bit nicer. So I got Blue Lizard that I'm using for like body. And then I got like a little thing of the Ulta sunscreen for my face.

Okay. Well, yeah, I felt kind of bad as she was saying that. And then I was reading about like that some of that gets systemically absorbed, those chemical sunscreens. So. And then those sprays that I used to spray you guys down with those things.

So does that say causes? Like what does it.

Cause I don't know, it just seems like it's not a great idea to have all these chemicals absorbed in your body. You know.

Something like foo foo. Like why? Well, but I guess it's like, why would you. When the other thing works perfectly fine.

Right, right. If you can do something with it, you just put it on your skin and that keeps the sun from, you know, burning you or causing you damage. That's better than putting on this other stuff that can kind of see that sort of seeps into your skin.

Yeah.

So I don't know. But. And then I think those spray sunscreens also, like, you don't really want to breathe that stuff in. It's probably, that's probably not great. I don't know. Yeah, but you know, I didn't want you to get sunburned. And I mean, kids don't want to just sit still while you rub that stuff all over them. No.

Yeah, but I'm on the. I'm, I'm big on the sunscreen now. I'm all in on sunscreen. I wonder if there's been any studies about the stuff in self tanner.

Yeah.

Because it's probably not good. It can't be worse than the sun, right?

Well, it could be good to just have whatever your natural skin tone is. Yeah.

But I don't know, it goes into mental health, man. Like when I put on some self tan, like I just feel so much better. Like when I'm a doctor, I. And if a patient comes in being like, I just been feeling a little bit down recently, I'm going to prescribe them to maybe put on some self tan.

Tan.

Yeah.

Okay. And you can have like, everybody in your office be all tan.

Yeah, yeah, yeah. Maybe I'll just have a three tan machine in there.

There you go. I mean, I guess, like, thinking about that stuff getting absorbed. I don't know. We put on makeup on our face all the time. Well, surely that stuff gets absorbed too, right?

Yeah, but you should put on like a base, like a. Like some sort of lotion first so that you don't. Because, yeah, it's definitely not. I mean, if I don't, then my skin breaks out and gets all gross.

I don't know. Yeah, you know, live and learn. You're always learning. Like, okay, we should have done this, should have done that.

But like the cymic radiation, right?

You know, it's. It's just one thing after another. But then stuff comes full circle. Like coming back to zinc oxide.

Yeah, true, true.

Who knows? Maybe thymic radiation will come back into fashion.

I think that's all we have for you guys. Thanks for listening to the podcast. If you have any questions or interested in being a guest, you can email us@askgenerations mdgmail.com. you can find us on Instagram at Tick Tock at Generations md. And we will talk to you next week. Bye, guys.

Bye.