Agonist vs. Antagonist: Lost Opportunities for Metaphor

I am having such a hard time keeping my mouth shut right now!

My professor is giving us a Pharmacodynamics lecture and explaining the difference between an agonist and an antagonist. Basically, an agonist binds to a receptor and produces a response that mimics a natural body response; an antagonist binds to a receptor and prevents that natural response from occuring. Both have an affinity for the receptor site but one acts, the other prevents action.

A few slides before this, my prof greatly amused herself (and us) by explaining the concept of intrinsic activity as follows:

“So, you know, you meet someone, and sometimes the hormones are just like PING! That’s like what a drug with intrinsic activity does when it binds to a receptor – it’s going to elicit an intense response! So think when you and that person biiiiiiiiiiiind” (wink wink) “there could be fireworks! Or, you know, someone who doesn’t have that ability to activate the receptor after binding . . . womp womp, not such an intense response. Too bad so sad, maybe next time you should just Netflix and chill.”

What does this have to do with agonists and antagonists?

I am DYING to explain antagonists as follows:

“Ever heard of a cockblocker? The hot chick’s friend who hangs out at her side all night and keeps sketchy guys from scoring? That’s an antagonist! She’s not actively making it with the hot chick, but she’s blocking any dick from getting entrance.”

Super scientific and easy to remember, if I do say so myself!

 

The SJWs have made it into medicine

Good morning everyone! I hope you’re having a splendid weekend!

As I mentioned in my I’m back! post, I recently started Nursing School. Very recently, in fact. As in, the first week of January recently. And it took exactly one hour and seven minutes for me to encounter the first whiffs of SJW infiltration.

My Health Assessment class started at 7:30 A.M. sharp on Monday morning. The professor reviewed the syllabus and began explaining “The Interview”: the process by which you introduce yourself to the patient and begin gathering data about their health (or lack thereof). We talked about properly identifying the patient using name and at least one other piece of data, usually their date of birth. And then at 8:37 A.M., she said this:

“So you’ll say Hi, my name is [Lissa] and I’ll be your student nurse today. May I please have your name and date of birth? and what is your preferred pronoun?”

Wait, what?

Seeing the confused / gobsmacked / soul-crushingly disgusted looks on her students’ faces, my professor confirmed the instruction:

“Yes, they will look at you like you’re crazy. Especially in this area of Florida, where as likely as not it’s someone elderly who has never heard of being transgender. But up on the screen you’ll see a snippet from HHS-1557, which among other things says that any healthcare provider that accepts federal funds – and that’s ALL the hospitals around here – can’t discriminate on basis of gender or transgenderism. That means that we can’t assume their gender. And THAT means you’ll need to ask every patient what their preferred pronoun is, whether you – and maybe the patient – finds it ridiculous, or not.”

Here’s the relevant section of 1557:

Section 1557 builds on prior Federal civil rights laws to prohibit sex discrimination in health care. The
final rule requires that women be treated equally with men in the health care they receive and also
prohibits the denial of health care or health coverage based on an individual’s sex, including
discrimination based on pregnancy, gender identity, and sex stereotyping. The final rule also requires
covered health programs and activities to treat individuals consistent with their gender identity. [emphasis mine]

Sixty-seven minutes. That’s how long I made it in Nursing School thinking that evidence-based practice was going to be the arbiter of good performance and I’d left the politically-correct BS behind.

Do you know what it’s going to do to my relationship with my patient when I ask them what their preferred pronoun is? He or she is going to think I’m a lunatic, that’s what.

Now don’t get me wrong – I will treat transgender patients to the best of my ability and with utmost respect, as I will treat any patient. If I encounter an individual whose gender identity isn’t clear, of course I would ask how he or she would like to be addressed. That’s my responsibility as a healthcare provider.

But we’re not talking about Best Practices here. We’re not talking about using my judgment to decide when I need to lead with a pronoun inquiry or if I can comfortably assume that the seventy-year-old man wearing suspenders, trousers, and a smoking jacket doesn’t need to be asked how he identifies. We ARE talking about hospitals making policies in order to follow federal guidelines and laws that result in requiring nurses to ask about gender pronouns in the first thirty seconds of encountering a patient.

This is madness.

P.S. More fun? We went over pedigree/genotype charts, in which you trace back the patient’s family and note any genetic, mental, physical etc. problems that have manifested in their relatives. I raise my hand.

“Professor? So if the patient is a biological male, but identifies as a female and wants us to use female pronouns, how do we diagram that on a genotype chart? Do we use the square for a male or the circle for a female?”

The professor looked as though she wanted to swallow cyanide.

“Um . . . well . . . I’d . . . I’d write both, with a slash between them. That’s the best way to cover your bases.”

P.P.S. Page 1297 of my Davis’s Drug Guide specifies that there are different doses of zolpidem for males and females. The recommended intermezzo (middle of the night) sublingual tablet for an adult male is 3.5 mg, while it’s only 1.75 mg for adult women. Should I dose them according to their biological sex, or their preferred gender identity? Zolpidem is Ambien, by the way. You think we should be careful to get that dosage right??

Life comes at you fast

7:10 PM: “Gronk, you made peepee in the little potty! I’m so proud of you!”

7:10 and fifteen seconds: “AUUGGHHH NO DON’T PUT YOUR FOOT IN THE POTTY NOOOOOOO!!! MIIIIIIIIIIIIIKE!!!!!”

Things are a little bit different now!

Hello, everyone!! How ARE you?? What’s going ON???

There’s no non-awkward way to come back after a 2.5 year hiatus (and much, much longer than that for regular blogging). There’s no smooth transition or easy segue. But who needs easy anyway? Not me!

So here are some things that have happened recently:

• My boys are growing! Bigger, smarter, and (sometimes) sassier each day. I’ve used various aliases for the kids over the years, so let’s re-introduce them:
  • Son #1 = Doogie Howser*, age 6. He’s incredibly sweet and earnest, scarily smart, and VERY concerned that everyone follow the rules. As the biggest and the oldest of the clan, he’s the default leader. As a younger sibling myself, I thought that meant that he would be the most independent and fearless, but that’s not his character. It’s almost the opposite: when he doesn’t have his built-in entourage (i.e., one or both of his youngest brothers) he becomes shy and hesitant. A general needs an army to lead!
    *Doogie Howser is the best I can come up with right now, but I hope to find a better moniker.
  • Son #2 = Casanova, age 4. Oh my LORD, this child! He believes that the entire female half of the species exists to coddle him, cuddle him, admire him, and generally provide for his every want. Sadly, he seems to be right: he’s a VERY good-looking kid, which when combined with his charm makes every woman melt. He thinks nothing of asking to be picked up and hugged by near-strangers, nor of kissing the occasional random 13-year-old girl at Disney World before running off. (Yes, this really happened.) He’s also SCARY smart – I’d guess he reads at about a first or second grade level. I think he may take over the world someday, and I’m not at all convinced that he’s going to be a benevolent dictator.
  • Son #3 = Little Gronk, age 2. This kid is either rambunctiously, riotously happy or melodramatically devastated, with very little in between. His favorite activity in life is to jump. He prefers height jumps – i.e., off the couch onto the floor – but will hop up and down on the ground when that’s the only option. He’s also a giant, metaphorically speaking: he’s in the top 10% of his weight and height cohorts, and unbelievably agile. There’s statistically zero chance that any of my kids will become professional athletes, but if any of them did it would DEFINITELY be Gronk.
  • Watching the three of them play and interact is a never-ending amusement (except when they occasionally try to kill each other). I am very, VERY grateful I have three boys; I never have to arrange for a play date, we just pack up and go.
• My wonderful husband remains my wonderful husband. That’s a more private relationship (and he’s kind of a private person) so I won’t say much about it – just know that he’s still awesome.
• My politics have gone off the rails. I pretty much don’t believe anything that any politician says nowadays, including the words “and” and “the.” I’m focusing on tending my own garden and crabbily telling people to get off my lawn and leave me the hell alone.
• One of the reasons my politics went off the rails is that I don’t follow the Standard American Diet (SAD) anymore. I read a lot about how that monstrosity got established and what it does to your body, as well as literature establishing the science of my current low-carb, high-fat diet, and lost forever my faith that The Established Wisdom Must Be True. No, it was all of a load of crap, and if they f*^*ed up THAT badly, for THAT long, with THAT AMOUNT of catastrophic results, over FOOD – what else did The Establishment screw up? I just assume “everything” – it saves time.
• And finally, the most recent big change: I quit finance and went back to school. If all goes well, I’ll graduate with my ASN (Associate of Science in Nursing) in July 2021 and sit for the NCLEX in August. That’s right, after fifteen years of being a cubicle monkey I’m learning to take blood pressures, look up drugs in my Davis’ guide, do cardiac and respiratory assessments, and fun stuff like that. So far I LOVE it!!

So, that’s me nowadays! Why am I coming back to the blog? (Or, let’s be honest – intending to come back to the blog. We’ll see how it goes.)

Stories. I have stories, and I want to record them and share them.

Between the kids and the new experiences in nursing, I have things I want to say. Things that I think are entertaining, or that I want to remember. And apparently texting my close girlfriends isn’t scratching the itch.

Who wants to come along and play? 😉

… am I back?

… I might be back …