Nephro

As with many other times during the past three and a half years, the relative dearth of posts in the past week has been related to an increased level of busyness on my part. My busyness is secondary to the rotation I'm now on - Nephrology, medicine dealing with the kidneys. I was scheduled to be on this elective rotation for two weeks but I extended it to a month because I was learning a lot. A nephrologist I'm working with recently remarked that nephrology is the "final common pathway" of internal medicine patients. I think this remark has a lot of truth to it. It seems like almost every patient I've seen in internal medicine has some electrolyte or acid-base issue, all of which relate to the kidneys. If someone's potassium, sodium, chloride, magnesium, phosphorus, etc., etc., is too high or too low it almost invariably has something to do with their kidneys. If someone's blood is too acidic or too basic it often has to do with their kidneys. If someone can't hold onto their water so they have to drink all the time or if they can't get rid of extra water and they swell up - yep, the kidneys. This is one organ you don't want to screw up. But unfortunately some of the diseases that are becoming more and more common like diabetes and high blood pressure directly affect the kidneys and basically destroy them.

I chose this rotation because I know this is an area of weakness for me. The kidneys are extremely complex. During our second year of med school we had to memorize a much more complicated version of the schematic of a nephron below. Some of it is slowly coming back to me on this rotation.

As with many other parts of the body, when you look at them in detail you can't help but exclaim with the Psalmist that we are, "fearfully and wonderfully made (Ps 139:14a)."