Wednesday, August 31, 2011

Salt and Pepper is fine but I prefer Cumin and Paprika

I'm sure that it is just the stress, but in today's neurocentric histology lab I got to thinking about the neurons and other tissue types in the brain, and how metabolically active they are. Perhaps, when they are being pushed (as my neurons feel now -- I've heard of meta-writing before, but this is a different kind -- the neurons writing about themselves) they steal nutrients from the pigment producing cells in the scalp causing more grey hairs to sprout forth. I'm not saying this is the case, but I like to think so. However, I think that I've done fairly well so far, as I am still, for the most part, not grey and I have not succumbed to male pattern baldness, as most of the men in my family have, or had done by my age. It may be coming soon, though.

The last week or so, I've been waking up in the middle of the night thinking about what I need to do -- what notecards need to be produced and then studied, lectures to pour over and previewed. I've resisted the compulsion to actually get up and go to the office, but I think I soon may be giving in. And, I'm not totally sure that this is a bad thing, as I've been discussing with a few fellow students, fear based motivation can be useful. Waking up in a cold sweat out of concern that the Purine salvage pathway isn't completely understood may be worthwhile.


Friday, August 26, 2011

0.5 mm is as wide as I can take it.

First, let me address some of the concerns sent to me about my last blog post. Considering I've yet to study the GI tract of a demon, I don't know what kind of gas would be most prevalent in it's flatulence. For those of you who said that it is mostly likely methane, just like most mammals, I would argue that there is a good chance that sulfur may be in larger concentrations. Either way, it would have to be a fairly potent fart to allow a proper explosion to occur in the engine. Maybe the little guy just blew some air in my fuel line, perhaps we can just leave it at that?

I'm very particular concerning pens and pencils. I don't use wooden pencils, and the mechanical pencils that I use are Zebra m-301 0.5mm. I can't go to the store and buy another type, as I feel as if I've properly explored the mechanical pencil market and made the appropriate choice. When it comes to pens, I allow a wider variety but there are some I just can't stand. The Sharpie brand writing pens are nice, but even the finest tip available isn't fine enough for me. In fact, my favorite pen, which is nearing the end of it's life and is the inspiration for this post, is a of unknown origins except for the fact it has a drug company logo on it. I don't know where I got it from and, more importantly, I don't know what brand it is. There is no identifying information. Now, usually, in every day life, the type and width of the tip means relatively little, but when it comes to writing and producing note-cards, it is of utmost importance. I'm thinking of calling the drug company advertised on the side of the pen and begging them for either more pens or at least some info on where they got them so I can get some for myself.

I see many thousands of note-cards in my immediate future. I think that making my own cards is valuable because the work that goes into producing them is not only custom to what my needs are (which is obvious) but the benefit from processing and organizing the material to produce the cards in the first place is often where a good portion of the learning comes from. There is also something to say about the little bite-sized portions that the information can be broken down into. And, oh boy, let me just give a nod to all those before me who told incoming med students about how it feels to take a drink from the flow from a fire-hose. They weren't lying. However, let me also acknowledge the fact that none of this material is exactly too difficult to learn, it has more to do with the sheer volume of it that one must process and then regurgitate. It. Just. Doesn't. Stop.

Concerning the test I took earlier in the week: they didn't kick me out yet. In all seriousness, I passed what I needed to pass but I can't say much more than that, and to say that is a serious wake up call, as I put in more effort to learn that material (which much of it seemed like review material anyway!) than nearly any other test in undergrad. Looking back over the past couple of weeks since school got underway, I can't help but think of those nights I slept a full 8 hours, or I went out to dinner, or I watched Big Bang Theory streams on my computer instead of studying. This is a scary path to go down though, and I strive to achieve a balance between hitting the books and hitting the wife -- Uh, no, wait a minute, I mean, spending time with the wife and kicking the dog, no, wait, what I mean is I need to hit the pavement and go for runs to train for the half-marathon coming up. This will be a large chunk of my own personal time I'm going to make an effort to preserve -- in that order, time with the wife and running. This upcoming Sunday will mark 13 weeks until the race, and I am starting a structured training plan this coming week. Thankfully, I enjoy running on the island where the school is located, and there is some extraordinarily beautiful scenery in every direction.

Anyway, can you tell that my mind is segmented and distracted? Well, it is. I can't wait to go pen and pencil shopping tomorrow.

The white coat ceremony is this Sunday. Basically, we get to walk across the stage in the school auditorium in front of everyone, have our name called out and have the white-coat put on. My white coat is about 2X larger than it needs to be, which is saying something. Even the sleeves are too long for me, which almost never happens with any garment I've ever owned in the history of my life. Whats funny about that is this, med students, in a clinical setting wear white jackets that are shorter than the other "real" doctors. My white jacket is nearly long enough on me so that I could be mistaken for a "long-white-coat" doctor, or, a "real doctor," in other words. Not that I'd ever do anything like that. Don't get this confused with us taking the oath or anything like this, as I believe that comes much later in our academic career, graduation, I'm assuming. I kind of wish that they'd save all the ceremonies for the end of this all, as I don't particularly feel like celebrating right now.

My wife wanted to buy a love seat for the office I use for studying. I talked her into letting me buy a OMT table instead. Basically, its a modified massage table in that it must be able to bear higher loads and have denser and less padding. Considering she will be the beneficiary of all my practice, I think she'll be happy -- unless I screw up or something and render her paralyzed! As long as she doesn't sue me for malpractice . . .

I've dedicated Friday nights as the only night I can intake any alcohol, and I discovered that the convenience store down the street (the only on in the little town that we live in, by the way) carries my most favored beer, Full Sail Amber Ale, and for a good price to boot. Life is good, mostly because the next test is a few weeks away. Cheers.

Monday, August 22, 2011

Just for today: Toyota > Subaru.

A period of my life of many firsts. Today was my first med school exam. I was up at 5:30, the coffee pot was going and I even made some breakfast (other than instant oatmeal) and I was feeling good about things. I figured I was gonna get to school early and get settled in and make sure the test taking software was working properly on my laptop, so I head out the door a little earlier than normal. Key inserted in ignition, key turned, and . . . something, but not everything you need for the engine to start. The battery was fine, the starter was trying it's best, but there was no fuel to burn in the internal chamber of the engine. Never before in 4 and a half years has the trusty Subaru not started when asked. Not even once. And today is the day its gonna pull this!? Thankfully my wife was still at home and her Camry didn't let me down, so I made it just fine to school, but still, not a good way to start the process of getting in the right mind-set.

I took the test and I am, as of right now, strategizing for better study techniques and methods. I haven't got the results from the test but there were at least half-a-dozen questions (out of 80) that I really didn't have much of a clue as to what the answer was. That is unacceptable. Thankfully, it is only 10% of our semester's grade, so even if I did poorly, I'll still be able to receive a good grade. If anything, and I think this is how the process is set up, the test provides a good diagnostic of how we are preparing and studying. I'm curious as to how other people felt about the test, because I left for home after the test to try and figure out the Subaru issue.

After checking the fuse for the fuel pump, I had this sinking feeling that it was probably the fuel pump itself, which on this Outback model is in the actual fuel tank. Urgh. Thankfully we have AAA, but the hassle to get the car towed and find a mechanic in a new area who is trustworthy was something I wasn't (and still am not) looking forward to. I thought I'd try one last thing, really the only thing I could think of doing, which was taking the fuel filter off and trying to see if fuel was even getting to that point in the fuel line. Sure enough, I pop off the intake line and fuel squirts all over me and into the engine compartment. I take off the out line and fuel spills all over the place. Hmmm. This isn't good, I think to myself. Did the engine somehow seize? So I put it all back together and, for turds and snickers, I try and start it up again. Of course, it fires right up like nothing ever happened. All I can think of is some little demon farted in the fuel line to place an air bubble in there to block the fuel's arrival into the engine. I must be destined for great things, since I have to overcome all these secondary issues just to take a darned test!

I am really looking forward to a long run after class today to sweat all this stress out. I couldn't run for the last few days, as I had such a bad blister (most of the pad of my right big toe was torn from the toe -- ouch) from playing in last's week basketball tournament. That really is the nice thing about jogging, it is like a sweaty form or meditation.

In separate news, our dog, who is an Akita is solidly into her "molting" process. Our hardwood floors are barely visible through the thick layer of dog hair. It is everywhere. Too bad there isn't much nutritional value in dog fur, as I'm sure I'm eating a few barrels of it per day. I'm curious where her coat-blowing cycle will configure to her new climate. In Colorado, she was subjected to seasons very much like her ancestral homeland, the foothills of Mt. Fuji in Japan. Here in the San Francisco area, not so much. We'll see. I'm seriously thinking about making her swim in a huge vat of Nair to just get this process over with.

I've been saving a bottle of wine for the after test destress, and I'm very much looking forward to sinking into my couch tonight with a glass of vino.


Thursday, August 18, 2011

A butterfly or a moth?

Our first test is this coming Monday. The test is only 10% of our overall grade this semester, but I, and many of my peers are really getting worked up over this. Granted, much of it is because it is the first one. But I can't help thinking that in undergrad, as long as I had been keeping up (which I've been trying to do here, but with less success and much more effort) I would have no problem. I didn't ace every test in undergrad, but if there was one I needed to kill, I'd come in and destroy it. All I can think of is this: lack of planning is planning to fail. So, I'll keep this posting short.

I was noticing my hands today. In the span of less than two months my hands have gone from moderately callused to soft and relatively supple. I still have man hands, but compared to when I was roasting thousands of pounds of coffee per week and making hundreds of lattes per week, my hands are starting to look like the hands of a doctor. I'm very happy about this. When I was a contractor, installing floors all day everyday, I had thick, grey calluses on my knees (insert jokes about professions that cause callused knees here) that stuck around long after I exited the field. Around this time last year, when I began to ramp up my load of the roasting at KBC (Kaladi Bros Coffee) it involved not only moving heavy bean bags around but the transport of hundreds of buckets of coffee. Buckets to wash (amazingly, the oil from coffee can accumulate to a substantial thickness on the inside of the buckets and needs to be removed) and then to fill with coffee, and then to move into the freezer at the roasting facility. Then, a few dozen filled buckets need to be transported in the van to the shop, where they need to be taken through the shop into the freezer there. And, of course, during the course of a normal in shop work-day, I was constantly carrying buckets to and fro. I was a big proponent of stacking and sliding the buckets, but often the best way to move them was to hold them, with thumb on top and the fingers under the lip of the lid. This created a very thick callus on the base of the pad of my thumbs. Only now is most of it gone and healed, leaving a civilized looking thumb.

For me, this means more than the sloughing of some extra layers of protective keratin, in a very cheesy and corny way it symbolizes the new and soft fleshy surface of a new creature; yes, I'm thinking caterpillar into butterfly. I don't think I would have ever been willing to use something so cliche and pedantic such as comparing myself to a chrysalis a few months ago, but with my mind so preoccupied, it feels like the lowest common denominator concerning analogies is what I have to utilize. It just goes to prove that I am still glad that I took the time in undergrad to hone and improve my writing capabilities. I apologize to anyone that reads this that my skills in this area will probably be handicapped by having to spend the next couple of hours studying the kinetics of enzymatic rxns. Oh well.

At least my hands are soft.


Sunday, August 14, 2011

The beginning of week 3 of med school is upon me. To be fair, the first week was full of congratulatory pats on the back and clapping -- and last week we had Tuesday off from classes, as it was the Fast of Tish'a B'av. So, this coming week is the first full week.

Already I've come close to completely dissecting the thorax and back of a cadaver. I've been in OMM labs nearly naked with a fellow student doctors touching and looking for bony landmarks in regions not often touched or felt between the closest of friends. So far everything has been really positive between classmates, but our first exam is next Monday (a week from tomorrow) and I think that people will have a little bit of a reality check. I've seen many people looking for cohorts to go drinking and exploring the area, which is understandable at this point and due to the fact we live in the Bay area, with so much to offer. In fact, people have been so supportive with supplemental material and offering help and such that I can't help but wonder what it would take for the stereotypical horror stories that I've heard about med students to come to fruition. We have a long way to fall.

I really am not so worried though. I've tried to strike a good balance between getting to know people and becoming involved with social get togethers and the like and trying to stay relatively isolated. Because my wife and I live 20 minutes from campus, it is somewhat easier than if we lived closer to school like so many others. I registered for a half-marathon that will take place on November 20th, in Montery CA so that I will also stay balanced and focused with exercise. I've also found a partner to run (read: slow jog, as we are both bigger guys) with, which I am thankful for. These kind of social interactions are what I'm seeking, versus drinking buddies and I am glad that there is such a variety of persons in our class, as there are so many different personalities to get to know. I'll also be playing in a 3 0n 3 basketball tournament this week, which will be fun.

I don't have much philosophical thoughts this time around, but that is to be expected. I'm just trying to keep up with the curriculum coming my way, which is a monumental undertaking. However, I do have one little interesting nugget to share. It seems that much of my class has some consternation concerning their cadaver dissection. I say this not to downplay, demean or belittle their feelings, but I think if this experience in the anatomy lab had the contrasting experience of dealing with a recently deceased body, it would become more clinical in nature and not as nearly as concerning as it is now. I could get into how our culture here has really taken the aspect of death from our scope of experience, leaving us, for the most part only to see a dead body after the embalmer preserves it, make-up is placed on it and it is dressed in a 3-piece suit then to be placed in the ground in a hermetically sealed casket. I personally believe that life and the living would be valued more if a larger percentage of society had to deal with dead bodies more than they do. Anyway, I'll leave it at that for now.


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