Only in medical school (#4) …

by Lorien E. Menhennett

… is this set of transitions possible:

Test question about a tumor
⬇︎
novel ice cream flavor
⬇︎
Google image-aided illustration complete with
organic chemistry molecule sprinkles

But that’s exactly what happened last week as I was doing practice questions in advance of my medicine shelf exam. A question came up about pheochromocytomas, which are tumors usually found in the adrenal medulla. These tumors cause inappropriate secretion of catecholamines such as epinephrine. This can cause episodic headaches, hypertension, sweating, and a fast heartbeat. I don’t remember if I got the question right or wrong. What I do remember is that in the answer explanation, there was mention made about how these tumors can cause elevation in the urine of a catecholamine breakdown product called vanillylmandelic acid (VMA).

You have to understand that doing these questions is hard work. The questions themselves are incredibly difficult, often to the point of being demoralizing, and the detailed answer explanations require exquisite attention. It’s easy (and tempting) to get distracted. And on this particular evening, I did.

“If I owned an ice cream store,” I thought to myself, “I would name my vanilla ice cream flavor ‘vanillylmandelic.’ ”

I chuckled (probably out loud). And then, reluctant to return to the practice questions, I thought about how I might illustrate this hilarious (to a medical student) concept. I minimized the test question window, and brought up Google images. I found a luscious bowl of vanilla ice cream, in a turquoise bowl to boot. (Turquoise is my favorite color.) I also found the molecular structure for vanillylmandelic acid. (Whew, definitely brought back memories from organic chemistry.)

My sense (of dedication? guilt?) returned after perusing Google images though, and I went back the practice questions.

This morning, with medicine behind me, I finally completed my illustration: a bowl of vanillylmandelic ice cream with multicolored vanillylmandelic acid sprinkles. Here is the final result:

 

On a side note, I also learned today from Wikipedia that not only is vanillylmandelic acid a metabolite of catecholamines, but it is also a chemical intermediate in the synthesis of artifical vanilla flavoring. So really, my idea isn’t so crazy after all. Right?

Don’t answer that.