Peanut Butter and Jelly

The gourmet classic of any medical student is obvious; one slice of bread slathered in fruity preserves married to another slice plastered with smashed peanuts. It’s the “go-to” of meals when the cereal box has poured its last bits or the milk carton has gone dry.

The (Un-Starving) Nourished Student

Available on my shelf of kitchen space I have a small variety of cold cereals, half a loaf of bread, half a container of peanut butter and a can of beans. The half shelf in the refrigerator is barely enough room for a half gallon of milk, a handful of bananas, celery and a few remaining hot dogs. The granola bars are used to stock my work bag in case of a snack attack and I have some Tootsie Rolls to complement my meals as a small dessert. There is no question that my in-house meals are lack-luster and definitively not the most nutritious. The occasional meal is had at the hospital or a fast food joint on the way there which is surely not helping my case. I am just now realizing that I don’t even have said jelly on hand…how pathetic is that?!

Just when you thought medicine was about teaching healthy habits, you notice that those who teach it are having a hard time following the rules. Certainly, this does not go for every student as the outliers exist, but if you ask, there is commonly a stock of supplies to make the most basic of meals. Whether short on time to prepare meals, no desire to eat healthier, or an attempt at saving money we are probably not properly filling our fuel reserves. One student I work with is staying in a local hostile making the effort to find the nearest free meal even if it means walking into a nearby hotel for their continental breakfast! The best counsel I heard a while back: “somewhere there is a free lunch, and it is my job to find it.” It holds true, but when the advice proves futile I return to my meals of simplicity with minimal ingredients and little variety. So Mom, no need to worry, I am being fed and there is something from every food group.

Question of the Week

A known alcoholic man presents to the emergency department showing signs of confusion, unsteady gait and horizontal nystagmus. Upon questioning he tells you he does not remember much about the day but just finished eating a meal fit for a king. What is the first step in treatment and what structures are likely being affected?

A. IV glucose, mamillary bodies
B. IV thiamine, hippocampus
C. Oral glucose, hippocampus
D. IV thiamine, mamillary bodies
E. Disulfiram, amygdala

Answer & Explanation