Everything I Learned in Medical School: Besides All the Book Stuff by Sujay M. Kansagra Md

time, the population has more members with these traits. New species are formed when old species move to new regions where a whole new set of traits now have the advantage, or if the environment itself changes.
    In college, I would think about this concept, and wonder whether it applied to humans. Are we still evolving? Is there a trait that has some genetic basis that would be considered advantageous, thereby slowly changing the makeup of the human species over hundreds and thousands of generations? My conclusion was that we were evolving, but not in the old Darwinian sense where those that are more physically capable survive. We now lived in an environment where we did not have any predators, and for the most part, despite any physical disadvantages, you still had access to the food and water necessary to ensure survival and future reproduction. My theory was that we were slowly becoming smarter. After all, those that were more intelligent were able to obtain jobs with higher income. With this income, they could provide themselves with healthcare when they were sick, eat healthier diets, and have access to recreational facilities to ensure a healthy lifestyle. Intelligent people were more likely to avoid situations that endangered their well-being, such as using illicit drugs, driving intoxicated, or speeding down the freeway on their motorcycle without a helmet. And finally, smart people were more likely to protect their offspring from danger. They could install car seats correctly, afford vaccines, and have the resources to provide for more children. Sure each of these things may only affect someone’s chances of survival by a very small fraction, but over thousands of generations, this would make a large difference, just as Darwin had observed with various other species.
    My pediatric neurology rotation during the fourth year of medical school quickly debunked my theory. During this rotation, we often saw patients that suffered from seizure disorders. Seizures are events characterized by synchronous firing of neurons in our brains that lead the body to do very different things. Most people think of seizures as events where the person collapses and starts shaking uncontrollably, as if possessed by demons. But in actuality, seizures are very diverse, and can present in a variety of ways. For example, if the neurons that control the arm start firing together, the arm starts jerking uncontrollably. If they occur in brain areas that control eye movement, you’ll often see someone with eyes that are stuck in one direction. Rare seizures that occur in areas that detect smell will manifest as funny odors to the patient. In short, a seizure can mimic anything the brain is capable of doing during its normal function. Often times, the firing of neurons will spread throughout the brain, leading to firing in multiple areas of the brain and causing what is known as a generalized seizure. These are the seizures we see on television in which the person loses consciousness and jerks uncontrollably.
    Luckily for patients that suffer from seizure disorders, there are medicines that often times will completely prevent seizures. But unfortunately for some, no amount of medication can completely get rid of their seizures. During a day in the pediatric neurology clinic, I met one such patient. She was a young girl, probably 7 or 8 years old, who came in wearing a helmet. This is a bad sign in pediatric neurology. It means that the seizures are occurring so frequently that the patient needs a helmet to protect her head when she collapses from a seizure. This patient was indeed having seizures multiple times each week. During the visit, the doctor discussed changing some medications to help with control. Near the end of the visit, when the mother was almost out the door, she turned and very casually said,
    “Oh, we’re planning on getting a pool this month.”
    “A what?” the doctor asked, hoping the mother didn’t say what he thought she