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The Human Body: How We Fail, How We Heal

The Human Body: How We Fail, How We Heal

Dr. Anthony A. Goodman M.D.
Montana State University
Course No.  1564
Course No.  1564
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Course Overview

About This Course

24 lectures  |  30 minutes per lecture

Your body is a fortress under constant assault. Infectious diseases, parasites, environmental toxins, physical trauma, allergens, and natural disasters are some external enemies it faces. From the inside, it is threatened by occasional overzealous allergic, immune, and inflammatory responses, as well as by the cellular mutations that produce cancer.

Fortunately, the body's defenses are remarkably successful, and most of the time we are unaware of the intense drama taking place within our cells and organs.

The intriguing details of this drama make up the field of pathophysiology—the study of the disruptions in a normal body's functions that are caused by disease or injury. Medical students get an exhaustive introduction to this subject early in their training, and the best clinicians are masters of it. Yet few laypeople understand the story of how our bodies fail and the marvelous ways they heal themselves.

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Your body is a fortress under constant assault. Infectious diseases, parasites, environmental toxins, physical trauma, allergens, and natural disasters are some external enemies it faces. From the inside, it is threatened by occasional overzealous allergic, immune, and inflammatory responses, as well as by the cellular mutations that produce cancer.

Fortunately, the body's defenses are remarkably successful, and most of the time we are unaware of the intense drama taking place within our cells and organs.

The intriguing details of this drama make up the field of pathophysiology—the study of the disruptions in a normal body's functions that are caused by disease or injury. Medical students get an exhaustive introduction to this subject early in their training, and the best clinicians are masters of it. Yet few laypeople understand the story of how our bodies fail and the marvelous ways they heal themselves.

The Human Body: How We Fail, How We Heal is designed to fill this information gap. In 24 half-hour lectures, you will explore the many ways the body meets the challenges of disease and injury with remarkable defenses and restorative powers, and how, in some cases, it may either fail or overreact.

A Doctor Who Can Tell You What's Wrong and Why

Your guide is Dr. Anthony A. Goodman, surgeon, professor, novelist, and a superb communicator of medical information. Many Teaching Company customers have already experienced his reassuring bedside manner in his other course, Understanding the Human Body: An Introduction to Anatomy and Physiology. That series covered the normal functioning of the body's organ systems, with glimpses at the more common clinical problems.

Now, Dr. Goodman presents a systematic survey of what can go wrong, why, and how the body itself responds, as well as what doctors can do to intervene. There is no better demonstration of the wondrous intricacy of the body and the everyday miracle of good health.

Hundreds of Medical Examples

In these lectures, Dr. Goodman brings up many subjects you may have wondered about, while also taking you down fascinating paths that will be completely new to you. Among the hundreds of examples he discusses are:

  • Grapefruit and medicine: Cells react to many medications as if they were toxins, which is why the medicines work for a short time before being excreted. Some chemicals in grapefruit interfere with this "toxin-recognition" function in some cells, keeping the medicine in the system longer than usual—a dose that may have been normal could become too much.
  • The eyelid: If you go to an ophthalmologist for a condition such as conjunctivitis, a corneal abrasion, or an infection, the doctor will have you close your eye and then cover the eyelid with a piece of gauze and adhesive tape to keep it closed. The inside of the eyelid is the world's best dressing. It has never been surpassed.
  • Human bite: The flora of the human mouth is extremely toxic anywhere but in the mouth. Therefore, the human bite is one of the most dangerous. The "boxer's fracture"—a broken hand from a blow to the opponent's teeth—must be treated very aggressively if it is contaminated with bacteria from the mouth—even more aggressively than a dog or cat bite.
  • Appendicitis: An initial pain near the site of the appendix is more likely to be a kidney stone than appendicitis, which usually begins as pain around the navel due to the way nerves interpret swelling in the intestines. Dr. Goodman describes the distinctive migration of pain as the appendix becomes obstructed, enlarged, and then infected.
  • Colon cancer: The tumors that cause most colon cancers are unusual because they develop from benign to malignant in a predictable sequence. Early intervention can remove the precancerous growths, called polyps. "We practically wipe out colon cancers in that population willing to be colonoscoped about every five to ten years or so," observes Dr. Goodman.

Become Familiar with Terms Doctors Use

One of the valuable features of this course is the exposure you will have to medical terminology. Dr. Goodman is generous in his use of technical terms and equally generous in the care he takes to explain them. You will learn the difference between signs and symptoms; when a disease is acute versus chronic; how to distinguish endemic, epidemic, and pandemic; and why the malapropism elephantitis means "inflammation of your elephant," when elephantiasis is the correct term (meaning "appearing like an elephant").

Reminding viewers that medical students are exposed to thousands of new words in their first two years, Dr. Goodman emphasizes that physicians have to understand each other as well as the biology of the body, and that is why a precise, familiar vocabulary is so important. "We'll try to keep these terms in play all the time, and I think you'll find them just a part of your vocabulary as we move along," he says reassuringly.

It's just one of the many ways that Dr. Goodman treats you with collegial respect when introducing you to the body's astonishing, yet natural, mechanisms of healing and self-defense when it faces the assaults and accidents of daily life.

What You Will Learn

Cellular level: After an introductory lecture describing the scope of the course, you begin at the cellular level, exploring the function of cells and the several common forms of injury. This lays the foundation for all that follows.

Inflammation and the immune system: The inflammatory response is the body's most primitive and immediate reaction to most forms of attack. The immune response is slower acting but more highly evolved, and it is tailor-made to each threat, for which it develops a distinct memory.

Infectious diseases: Infectious diseases are humankind's most persistent and deadly perils. They have a wide range of causes, including molecular prions, viruses, bacteria, parasites, and worms. These lectures focus on their prevention and treatment.

Shock: When the body perceives a dire threat it begins an automatic, progressive shutdown of systems in an effort to protect the brain and heart. This ultimately life-saving response is called shock, and yet it can quickly lead to death unless corrective measures are taken.

Cancer: Cancer is a self-inflicted wound caused when the genetic machinery of a cell goes awry. Theses lectures explore the environmental causes of cancer, the specific steps in its molecular biology, and strategies for treating its different forms.

Wound healing: The complex and astounding processes of bodily healing and repair are well illustrated by wound healing—in infections, trauma, and surgical intervention. You may be surprised to learn that no wound has to be closed, and that it is often a bad idea to attempt to close a wound that might be contaminated.

Dr. Goodman's goal is to give you the tools to understand diseases and injuries and the body's reaction to them. Such knowledge is no substitute for seeing your physician; however, now you will be better able to communicate with your doctor, know what questions to ask, and have more clarity regarding your own illness or that of a loved one.

Please Note:

These lectures are intended to increase the understanding of the structure and function of the human body. They are in no way designed to be used as medical references for the diagnosis or treatment of medical illnesses or trauma. Neither The Teaching Company nor Dr. Goodman can be responsible for any result derived from the use of this material. Questions of diagnosis or treatment of medical conditions must be brought to the attention of qualified medical personnel.

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24 Lectures
  • 1
    How We Fail
    Pathophysiology is the study of changes in the normal functioning of the body due to disease or injury. Dr. Goodman begins the course with an intriguing look at how, in his general surgical practice, he developed a broad knowledge of this field. x
  • 2
    Cell Biology—Introduction and Definitions
    Cells are the smallest fully functioning units of life and therefore the fundamental level of reaction to an attack and subsequent healing response. This lecture shows how cells can maintain the status quo and how they react to different challenges. x
  • 3
    Inflammation—Basic Principles
    The acute inflammatory response is the body's first reaction to infection or invasion. During this response, chemicals are released that consume invaders, while other processes remove the invaders and initiate healing of the injured site. x
  • 4
    The Inflammatory Response
    Several kinds of blood cells are instrumental to the inflammatory response. Blood platelets initiate clotting; some types of white blood cells eat debris in a process called phagocytosis, while others release chemicals that direct the phagocytes. x
  • 5
    Inflammation—Clinical Manifestations
    This lecture reviews the four classic signs of inflammation: rubor (redness), dolor (pain), calor (heat), and tumor (swelling). The inflammatory response also produces different exudates and transudates, exemplified in burn injuries. x
  • 6
    The Immune Response
    The immune system is the next line of defense after the inflammatory response. Two distinct but related modes of action are the humoral response, induced by invaders in body fluids such as blood; and the cell-meditated response, directed against viruses, parasites, and foreign cells. x
  • 7
    The Immune Response Continued
    The secretory response is another aspect of the immune system, which aims to neutralize invaders before they enter the body. This lecture also examines natural and acquired immunities and vaccine development. x
  • 8
    Hypersensitivity and the Allergic Response
    Hypersensitivity turns a protective re­­sponse into a potentially dangerous one as the body overreacts to a foreign substance. Such reactions are generally called allergies and can be stimulated by foods, medicines, natural toxins, and various chemicals. x
  • 9
    Infectious Diseases—General Introduction
    Infectious diseases account for more death and illness than all other threats combined. Infectious agents include: prions, viruses, chlamydiae, rickettsiae, bacteria, fungi, protozoa, and helminths. x
  • 10
    Bacteria
    Two major classes of bacteria are distinguishable by the Gram stain. This lecture examines different gram-positive and gram-negative bacteria, including staphylococci, streptococci, and clostridium; and the diseases they cause, such as tuberculosis, gonorrhea, and plague. x
  • 11
    Viruses
    Viruses survive by replicating inside the cells of their hosts. The inflammatory response is ineffective against them, but the immune response can be successful. There are many viral diseases ranging from the common cold, to polio, to Ebola. x
  • 12
    Spirochetes, Rickettsiae, Chlamydiae, Prions
    This lecture looks at syphilis, typhus, chlamydia, and Lyme disease, some of which can be treated successfully with antibiotics. You will also look at some of the newly identified diseases caused by prions, such as mad cow disease, which have no known cures or treatments. x
  • 13
    Malaria
    Many tropical diseases involve parasitic organisms that have complex life cycles. Often these organisms do not kill but rather sap the vitality of their hosts, keeping them barely alive. Malaria is one of the most widespread and devastating of these diseases. x
  • 14
    Schistosomiasis, Filariasis, Tapeworms
    This lecture covers a series of parasitic diseases that have been largely eradicated in the developed world, but that still affect millions in poor nations. Among them is a form of filariasis, called Loa loa, that Dr. Goodman, as a student, encountered in a dramatic case. x
  • 15
    Infectious Diseases—Treatment
    Sulfa drugs opened the antibiotic era in the early 20th century. Penicillin followed along with a host of antibiotics with specialized uses. Today, many bacteria have evolved drug resistance, turning back the clock to the preantibiotic era. x
  • 16
    Infectious Diseases—Triumph and Failure
    This lecture looks at some of the great success stories in conquering infectious diseases: Edward Jenner and smallpox, John Snow and cholera, and Louis Pasteur and rabies. All were working in the period before the organisms responsible for these diseases were known. x
  • 17
    Shock—Principles and Hypovolemic Shock
    Shock is the inability of the heart to provide adequate perfusion to the body's organs. Shock may lead to multiple organ failure, and if untreated, death. Forms of shock share the failure of the heart and vessels to keep up adequate blood flow to the organs to sustain life. Hypovolemic shock usually starts from severe blood loss x
  • 18
    Categories of Shock
    Other forms of shock include cardiogenic shock, the failure of the heart to function effectively; anaphylactic shock, stimulated by a severe allergic reaction; septic shock in response to infection; and neurogenic shock, resulting from damage to the nervous system. x
  • 19
    Cancer—The Enemy Within
    Stem cells are found throughout the body and can differentiate into specialized cells to replace normal cell attrition or to repair damaged tissues. Cancer, says Dr. Goodman, is the failure of stem cells to differentiate, and results from mutations lead to uncontrolled cell division. x
  • 20
    Environmental Carcinogens
    Carcinogens are chemical, physical, and biological agents that cause cellular changes that may result in cancer. Tobacco, as a chemical, is the world's number one carcinogen. Physical and biological carcinogens include radiation and certain viruses. x
  • 21
    Mechanisms of Carcinogenesis
    By damaging the DNA, carcinogens interfere with the passage of information from the parent cell to the daughter cell. This lecture investigates the various pathways at the molecular level that can lead to cancer. x
  • 22
    Invasion, Metastasis, and Angiogenesis
    This lecture reveals how cancer spreads in the body. The turning point is the establishment of distant metastases. This generally defines incurable disease and unleashes its lethal potential. However, antiangiogenesis therapy shows promise for curing some metastatic cancers. x
  • 23
    Treatment—Surgery, Radiation, Chemotherapy
    For well-defined cancer tumors of known location, surgery does well at removing bulk, while radiation kills malignant cells around the margins. Chemotherapy is ideal for finding residual microscopic tumors where the exact location is not known. x
  • 24
    How We Heal
    The final lecture looks at the complex process of wound healing, focusing on the surgical wound or the traumatic wound as the prototype. Dr. Goodman discusses a range of factors that influence wound healing, illustrated by some of his own cases. x

Lecture Titles

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Anthony A. Goodman
M.D. Anthony A. Goodman
Montana State University
Dr. Anthony A. Goodman is Adjunct Professor of Medicine at Montana State University and Affiliate Professor in the Department of Biological Structure at the University of Washington School of Medicine. He earned his B.A. from Harvard College and his M.D. from Cornell Medical College and trained as a surgical intern and resident at the University of Michigan Medical Center in Ann Arbor. He completed his surgical training and served as chief resident at the Harvard Surgical Service of Boston City Hospital, the New England Deaconess Hospital, the Lahey Clinic, and Cambridge City Hospital. For 20 years, Dr. Goodman worked as a general surgeon in south Florida and served as Clinical Associate Professor of Surgery at the University of Miami School of Medicine. In addition, he served as a surgeon with the U.S. Army Medical Corps and on the hospital ship for Project HOPE. He was also Visiting Professor of Surgery at the Christchurch, New Zealand, Clinical School of Medicine. Founder of the Broward Surgical Society, Dr. Goodman is a Fellow of the American College of Surgeons and a Diplomate of the National Board of Medical Examiners and the American Board of Surgery.
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Reviews

Rated 4.6 out of 5 by 49 reviewers.
Rated 5 out of 5 by Outstanding Intro. to Patho-Physiology This course is really an introduction to the med school course known as pathophysiology and is presented in an informative and entertaining manner. Since its inception I have watched the entire course several times. Dr. Anthony Goodman; med school professor, board certified surgeon and practicing surgeon has done a superb job in presenting complex medical information in way that both facilitates an immediate level of understanding and allows the student to move directly into medical school textbooks for a more in depth look at specific topics. The course follows the general flow of the medical text "Understanding Pathophysiology" included in the reading list. That makes for a relatively easy transition of this complex material from lecture to actual med school textbook if you would like a more in depth understanding. Dr. Goodman does a courageous and exceptional job with his lectures on cancer starting with the definition itself. "The first characteristic in my definition [of cancer] - now if you go into a textbook, you're going to see a slightly different definition - but I really think this definition works... criteria number (1) failure to differentiate ... stem cells are the players here… the next one is potential to invade... the next one is potential to metastasize... means 'growth at another place'... then finally we go to the potential for lethality… cancer cells are lethal by design..." Dr. Goodman's clear and insistent definition clarifying what is and is not cancer enabled me to ask informed questions saving me a lot of trouble. I shudder to think how much. In other words Dr. Goodman puts the patients' health before profits. Thank you Dr. Goodman. And the cancer establishment is finally coming around. For example in July, 2013 the Journal of the American Medical Association (JAMA) published an article from researchers at the National Institute of Cancer that broke ranks and caused quite a stir. "Overdiagnosis and Overtreatment in Cancer: An Opportunity for Improvement" Esserman MD, et.al., jama.2013.108415 states "In the case of an indolent [slow growing] tumor, detection is potentially harmful because it can result in overtreatment... Physicians, patients, and the general public must recognize that overdiagnosis is common and occurs more frequently with cancer screening. Overdiagnosis, or identification of indolent cancer, is common in breast, lung, prostate, and thyroid cancer." One of the other points of the article is that treatment of non-lethal disease increases the per cent survival statistics. This deceptive use of statistics is medicine at its worst and has been practiced in cancer treatment. Unfortunately that is not the only misuse of statistics in cancer and medicine. The Teaching Company might consider a course on medical statistics from Dr. Goodman or another good choice would be med school professor, Dr. Marya Zilberberg of the U. of Mass., who has written popular and technical articles and books on the subject. In addition to cancer, the course also covers inflammation (whose importance in a wide variety of conditions including cancer you might under estimate), the immune response and infectious diseases including drug resistant infections as well as cancer mentioned above. Each item is presented from multiple technical viewpoints ranging from molecular biology to cell biology to tissues to organs and systems of organs. It is also presented from multiple personal points of view from researchers, practicing doctors and surgeons as well as patients. Some of Dr. Goodman's stories from being a med school professor, his military practice (triage), his civilian practice, and being a patient himself add another dimension to this course. November 8, 2013
Rated 4 out of 5 by Become more at Ease about knowing Disease This course certainly is slotted into the right category "Better Living". What can better contribute to better living than knowing how our bodies react to pathogens and fight off disease? This course is a great introduction to pathophysiology with a level of technical detail somewhat less than a medical school course but comprehensive enough to give the student sufficient information to work effectively with their own doctor(s) and be a better self advocate in the diagnostic and treatment process. Dr. Goodman takes the student through the fundamentals of our pathogen response systems, the pathogens themselves and the diseases they cause, the body's reaction of shock, and the basics of wound healing. Five lectures focused on cancer give a great explanation of how this "enemy within" really happens and the pros and cons of various treatment options. Dr. Goodman is unabashed in pointing out some misinformation that is out there and willing to admit what is and what is not known in the field. This frankness and humility is not at all typical for medical professionals. Dr. Goodman's presentation style is quite different from the typical TGC lecturer. He wears his white lab coat and is seated in front of a lectern. Actually this contributes to his effective "bedside manner" and enables him to be colloquial yet professional as he presents the medical topics right down to the basic biochemistry and cell biology level. Expecting to deal with lots of medical jargon, I purchased the transcript book so I could look things up following the lectures. This helped as expected but also provided an added benefit; Dr. Goodman often followed a description which included a lot of different technical nouns, and with a simple "it", "they", or "these guys" in a follow-up sentence. Fortunately, whoever edited the transcript book caught most of these and added clarifications for the right noun (e.g. it [DNA]). The graphics used are adequate though relatively primitive by today's standards. The course guide is also adequate but sure could have used a glossary for keeping track of all the technical terminology. Fortunately, the URL for the Farlex Medical Dictionary was included. One thing the student must realize is that this course was produced in 2007. Significant advances have occurred in medical science since then particularly in genetics and molecular biology. The material in the course is still valid and provides sufficient foundational knowledge to enable the student to read and understand current articles on more recent discoveries in these areas. Without hesitation I recommend this course. I would have rated this 5 stars if the graphics and course guide were a bit better. February 18, 2014
Rated 4 out of 5 by A great pathology review Dr. Goodman is a wonderful presenter. His good-natured attitude and wealth of experience made it a joy to watch this course. Unlike most other Great Courses I have viewed, I watched this one for work as I needed a refresher on pathogenic microorganisms for a recent job promotion. This course was a wonderful supplement to the infectious disease and microbiology textbooks I was studying. My only complaint, and it's a minor one at that, is that the lectures could have been longer, with a little less emphasis on cancer. December 31, 2013
Rated 5 out of 5 by Superb Course This is an excellent course enjoyed by my wife and myself. Dr. Goodman is a fine teacher with a conversational and easy manner. The course content is superb, providing an understanding of the defenses we posses against disease or injury and once overwhelmed, how the body attempts to heal the damage. September 25, 2013
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