Information gradients

Mini-med is back from its brief hiatus, hurrah. Ooh, and it brought lemon squares. Digression ahoy: Patch clued me in to the fact that the best coffee in DC is to be found at Illy, an easy stroll from my office and oh-so-conveniently on the way to G-town. It's criminal that I've been drinking Starbucks froth when I could've been indulging in Illy's luscious crema. The only downer is that the artisanal steaming process takes forever, so you have to just stand there and think wistful thoughts of how much you would enjoy bathing in a vat of the stuff.

So this week's class actually was about drugs, or more generally the science of pharmacology, and since I'm not expected to do the calculus for titrating doses to correct maintenance levels over time, it was perfectly fascinatin'. We got a zoom-through of the basic principles of pharmacology: all drugs are poisons (if poison is defined as something affecting a system's function), there is no single-effect drug, the definition of the main effect versus the side effect can depend on what you're treating (for instance, morphine can be given for pain relief, with nausea and constipation as side effects; to stop diarrhea, in which case the buzz and nausea are the side effects; or to induce vomiting, in which case I'm betting you've already got the picture), the therapeutic window must be defined and sustained fairly carefully, et cetera. There was also a massive tasty infodump about normal neuron function, how lethality is defined relative to effectiveness, delivery mechanisms, the history of drug regulation, interactions between drugs, and the function of the most addictive drugs. Kids! Take your meds on time! Follow directions! Nicotine is bad! Cocaine is worse! Chewing coca leaves with ash enhances the buccal membrane's uptake of the good stuff! And so forth.

The downside of the classes is that some of the attendees use the Q&A periods to air grievances—"I had to show ID to buy Sudafed!" "Drugs are too expensive!" "My cat's breath smells like cat food!"—that don't add value. But other students ask short topical questions, such as how to set up a schedule for maintaining a certain minimum drug level if you don't want it to fall to zero before the next dose. Those people were also smart enough to sharrup and listen to the answers (which, for that question, is to use a loading dose: a large amount of the drug to start, followed by smaller maintenance doses). The information gradient is denser around the person with the laser pointer than it is around you, Mr. "I read in the New York Tiiiiimes that antidepressants have a substantial placebo effect and I'm going to imply that people who need Prozac are whiners and I'm going to talk over your answer because it sure seems like you should agree with me so that's my question." Is there a real-world way to rickroll someone without bystander casualties? God, it would be so handy.