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Below are the 20 most recent journal entries recorded in the "Tikkun Olam" journal:[<< Previous 20 entries]
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10:48 pm
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Evidence Based Living
Where's the literature on how to know when what you've done is good enough?
And, since there's an audience and to keep this from being completely emo-I'm-gonna-hide-in-a-corner... What metrics do you use in day-to-day living to decide when you've done well vs. poorly in day to day life?
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01:00 pm
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Pluses and minuses
Minus: Just managed to (semi-accidentally) call out one of my instructors for potential breach of patient privacy. In a large group of people.
Plus: He forgave me.
Minus: Self-importantly offered to give a 5-minute schpiel on internet security and unencrypted email to the same group.
Plus: Someone actually was interested enough to take me up on the offer.
Overall, I guess a minor plus: Maybe my comments will make my fellow students and future colleagues think twice before assuming that email is secure.
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09:57 pm
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In the Lab
The day is beautiful, perfectly fitting for a wedding... or a funeral. All medical students in their first and second years are to attend a mandatory event: the memorial service for our cadavers.
Before we get to the event itself, however, you might want a bit of background on the anatomy lab and what we do there.
( The Anatomy Lab: A kind cut for those who are bothered by images of death or gory bodily processes. )
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08:30 pm
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By popular demand...
Below is a list of entries I've got queued up in my head. Which do you want most to read? I'll survey results by about this time tomorrow, and start working on the one that's most in-demand.
1) Patient presentation: Huntington's Disease (a genetic disorder that causes progressive brain damage later in life but can be detected before symptoms show)
2) Patient presentation: Down Syndrome (a genetic disorder that causes mental retardation)
3) Memorial service for the cadavers - speaking with family members about their loved ones... whom we were recently tearing apart on cold slabs.
4) Basic overview of breast cancer for the laymen
5) Patient presentation: Colon Cancer (specifically, a genetic variant which virtually guarantees CC)
It should be emphasized here - and this goes for all of my posts on medicine - that I am *not* writing this as a doctor. I'm most especially not writing any of these as *your* doctor. I am not qualified to give medical advice, so if you learn something from me that you think you might put into use, DOUBLE CHECK IT FROM A REPUTABLE SOURCE, preferably your doctor. Then believe their version.
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07:39 pm
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My week in profile...
Just in case you folks were wondering where I'd gone/why I haven't been posting often like I said I would.
This list ignores travel times, breakfast, and general self-maintenance.
( My schedule in ridiculous detail... )
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12:24 am
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As procrastinations go...
I suppose writing software is one of the more productive ones.
You guys might prefer I wrote LJ posts, though ;).
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04:30 pm
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Household remedy: Salad Dressing. Or: Not yo' cheese, flies.
Plagued by drosophila, as is properly befitting one who studies genetics.
But it's getting old, especially when I want to eat my fresh mozzarella and balsamic vinegar in peace. Apparently and unsurprisingly the little buggers have a thing for fruit vinegars.
My solution, recipe-like in case you have the same problem:
Ingredients: A long, thin glass like a pilsner. Cheap fruit (e.g. Apple Cider) vinegar. Oil of any sort. A tupperware lid, if you're squeamish.
1) Fill your pilsner about two inches with the vinegar. Leave it out on the counter in a still room full of flies for a few hours.
2) Return. The flies will have preferentially congregated (read: swarmed!) on the inside of the glass.
3) Slowly cover the top of the glass with the tupperware lid (if you're squeamish) or your palm (if you're not).
4) Shake the glass vigorously up and down, using the vinegar to wash all of the flies within to the bottom of the glass. Sadly, flies swim, so this will contain but not kill them.
5) Quickly pour in a few drops of oil. This is the trick that kills the flies, since flies are heavier than oil but lighter than water (and can't breathe in oil).
Voila! Fewer flies... and a bit of crunchy salad dressing, if you're really low on protein.
Repeat until your fly problem is under control.
Variant (but I haven't tried this): Instead of the above, try leaving a glass or a dish of vinegar outside an open window - the theory being that the concentration of flies outside of your kitchen is much lower than the concentration of flies inside the kitchen, plus flies outside may fly away or be eaten, and you're thus osmotically pulling flies from the kitchen.
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11:04 pm
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The military wants my (white-coated, graduated) body
Uncle Sam will be happy to pay my medical fees, if only I'm willing to sign up for 4 years of military duty post-school (and pre-residency, I believe).
I've been told so at least half a dozen times by now. Something tells me doctors don't often join the military without heavy recruiting and incentives... :)
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09:15 pm
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Day In the Life: Terminal and Ultimate
A few days into med school. Geeky medical details are found in footnotes so as not to detract from the story.
The morning is uneventful - lectures on basic pathology(1) and on the role of genetics in medicine(2). I could tell you about the cool things I've learned from those, but there are many better resources out there for that sort of thing - those portions of my audience that really want to know will probably go look them up, and those that don't wouldn't enjoy being spoonfed medgeekpap anyway.
Suffice it to say that diseases aren't just caused by external or internal factors, they're caused by the interaction of the two. Also, epigenetics is damn cool and we have very little idea how it works. With the possible exception of Barr Bodies. And I'm not talking Roseanne here.
After lunch we had a patient presentation, our first chance to meet a real, live sick person... Well, meet might be an overstatement - we're a well-dressed, white-coated, overeager mob of nearly 200 people. ( Hidden to protect those who might be squeamish or easily triggered by medical problems )
In the afternoon, I am reminded forcibly about my own mortality in a much more enjoyable way - I re-encounter the limiting natures of asthma and chronic knee pain when I join a pick-up game of Ultimate Frisbee. I can still forearm huck a disc, but there's no way I can keep up with someone a decade my junior(5) and make sure he doesn't score multiple times upon our team. I feel a bit like I've let down my vibrant young teammates. I leave the game early due to the combined pressures of lack of oxygen and lack of time before running to pick up the boy from day care.
In the evening, I spend time with my wife and our son, and I'm reminded that there are rewards to no longer being 21.
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1 - When injured, cells lose potassium, influx calcium and sodium, swell, get fatty, lose energy (ATP), undergo nuclear condensation and enucleation, lose membrane integrity, and lose cytoskeletal-membrane connectivity. If your cell is lucky, the process can be reversed if it's only a matter of swelling, fattiness, and ion concentration/ATP issues. Once you get to the nuclear changes and membrane integrity levels, well, you're lucky if you can apoptose rather than simply necrosing and digesting your neighbors.
2 - Personalized medicine is a shibboleth(3) euphemism for genetics-based medicine.
3 - Cool word from ancient Hebrew. Look it up. It involves genocide and grains(4).
4 - Yes, I'm so geeky my footnotes have footnotes. See also footnote(4) for recursion.
5 - Pending current changes. I'm biking to school and exercising a lot with classmates. Perhaps I'll regain fighting trim. Also, I need to do more fighting to stay trim.
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01:15 am
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On a lighter note
(possibly not work-safe due to general (fake) grossness and music)...
http://www.youtube.com/watch?v=8y8G4s1yxi0
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07:56 pm
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Of symbols and ceremonies
My white coat ceremony was last week. For those of you not in the know, the purpose of the white coat ceremony is to officially indoctrinate incoming medical students into the profession.
There is a line of thought that criticizes the white coat ceremony. The reasoning goes: if you are set apart as a different class than your patients, then your patients cannot truly ever be close to you. That extra distance, the width of a swatch of white polyester, is a means of proclaiming your power over everyone who comes into your office. It is as powerful as the whip or the yellow sleeve, and as harmful.
I believe that criticism is sometimes valid when applied to the white coat as worn when treating patients, but I also believe that here, at the beginning of our careers, the white coat is an important reminder to the new student. We have no power over patients until later - we have yet to learn the spells and potions.
At the ceremony, we are given a white coat and told "You are no longer of the people. You are of the elite. While you do not yet hold the skills to lead the way, you are now newly responsible. You must act as if you were already leaders. You must be discreet and above all, you must be trusted and trustworthy."
At the end of the ceremony, all of the doctors present are invited to reaffirm their Hippocratic Oath. The words roll around the auditorium, echoed from hundreds of mouths and blending into a community voice which speaks for those who have been here before. It is a prayer, a blessing, a benediction upon all who come to us garbed in gowns, hat in hand and hopes in heart.
I am not a religious man. I don't know what the true face of evil is. Is it selfishness? Is it sin? Is it repression of others to further your own beliefs? Despite my pristine new raiment, I'm no priest to be able to answer those questions.
All I can say is that here, in the presence of so many who have dedicated their lives to combat illness, I find at least one thing that I can point to and say "There. That is goodness. That is righteousness, as pure as it comes. That is, finally, my purpose too."
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12:38 am
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Warning: Change in tone
Since the creation of this blog, I've been very careful about what and how I posted. I had coworkers reading it, and generally didn't feel that the minutiae of my day to day corporate life could be revealed - or, if they were revealed, that they'd be interesting.
Now, I'm in med school. I'm going to assume that my path toward being all fledged up as a doctor is indeed interesting to most, and I've no coworkers reading the blog. So, the tone's going to change a bit. I'm going to be more confessional, likely post more frequently, and give you more of my day-to-day doings. I'm going to still protect patient confidentiality though.
Hope this'll be a welcome change - give me feedback if you like :). Do you look forward to tales from medical school? Do you dread them? Is your friends list already cluttered enough?
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12:26 am
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Mission: First year pub crawl.
Outcome: Successful. Intoxication induced. Embarrassment avoided. Contacts made, contacts reinforced.
Didn't -just- stand in the corner like an antisocial wallflower.
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11:07 am
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Out of the country
Hey all - if you're looking for me in the next (roughly) two weeks, you won't find me. I'll be far, far aweh.
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11:25 am
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Last Day
Today's my last day before voluntary unemployment. It'll be my first time in a decade that I'm not employed full time.
How very, very odd.
PS - anyone who wants to play lots of Diablo II in the last half of July, drop me a line ;)
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01:56 am
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On black magic...
I am a firewall god. I can convince appliances to do things they were never meant to do. You probably don't want to ask for details unless you really care about the innards of iptables on a linux platform.
... Making the world safe from spammers, malware, and rootkits, one machine at a time.
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12:34 am
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Fun idea...
People are always talking about how great the hydrogen economy will be, but it's inefficient to transport hydrogen, and current manufacturing techniques often make more pollution than they save (e.g. making hydrogen from methane rather than electrolysis).
It'd be pretty cool, though, if we had electrolysis stations throughout major cities, powered by this type of high-altitude wind farm: http://www.wired.com/wiredscience/2009/06/highaltitudewindpower/
You could generate hydrogen by electrolysis when the wind was blowing strongly, storing it for use when the wind was blowing only weakly. Convert back to electricity via fuel cells or burn in hydrogen powered cars...
Anyway, just dreaming. Enjoy!
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11:02 pm
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Foot, meet mouth.
Wife: I have to go get beautiful.
Me: Yeah, that's gonna take a while. (Thinking of all of the preparation we have to do to get ourselves and the baby ready so we can have a formal night on the town after dropping him off at the sitters)
IQ: 156 (at the age of six)
GPA: 4.0 (fudging and only looking at recent data)
Foot: Firmly inserted into mouth. Priceless.
It's a good thing I've a patient wife who knows me well.
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01:23 pm
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Back in contact
Brief summary of events: Several family members ill at once. Was not expecting to start my doctoring career on my own family and before actually starting med school.
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09:53 pm
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Update
Out of contact until further notice. Dealing with multiple stacked family emergencies.
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