8.30.2011

immortality

Forgive me for the brief posts, but my mind is filled with several tasks with which to fulfill in order to move on with my life.

One pal in the neighboring lab has been kind enough to send me some of the secondary essay prompts, in order for me to fill them out before my application is processed, before secondaries just start piling up in my inbox.

So the current list (8):
Cincinnati (Kenneth Campbell!)
Tufts (this one has been challenging because of the research available)
Case (Jeremy Rich!)
Emory (Marla Luskin! I think...)
USC
Rush
UC Davis
Illinois

My plan is to not ask him for any more essays until I finish these. That way, it'll motivate me to complete these quicker in order to ask him for more prompts.

That's the plan, folks. Resolve! (as Nants would put it)

---update: I can confirm prompts for 24 of 27 schools. I should have started this weekend! ---

Should I add Yale, Vermont, and UMass-Worcester?

8.29.2011

pulse-chase

Currently, I have received 2 secondary applications so far, even without my primary application having been verified by AMCAS.

Is that a good sign, or are those schools just not selective just yet?

I'm looking at the research available. One school has great research and a great hospital but is located within a terrible city (so I've been told) within the Midwest. The other school has minimal research and is nestled within a decently diverse city. If split between these two cases, I would pick the quality research over the city. My reasoning is that I really don't enjoy much of the city aside from the food and the weather. As long as there's a cold season, nothing could bring me down.

My lab mate Mant should be coming back this week, with tales of her adventures in India. She told me before her trip that she would be riding elephants and hiking through some lush jungle. She better have the pictures to back this up.

Not much else is really happening outside of work. I have resumed running- R&D wants me to run some race with him on Sunday, although I am very much out of shape and have no desire to pay money, drive to a city 2 hours away, run, and then come back during a weekend when I should be writing or resting. Also, passing the qualifying exam has not done any good to his ego. It's still big as ever! Sometimes I wish I did not catch the mistakes that he often makes while performing experiments. It makes me think less of him as a scientist each time he makes the same error.

3 letters of recommendation have been sent to my pre-health committee. The only 2 remaining are my ED volunteer coordinator and my PI. Hopefully these 5 letters will compose some laudatory image in the minds of the admissions committees, but how well do people really know me? If people directly asked me questions, I don't think I would beat around the bush with my response. My replies are usually straightforward, honestly blunt. If people don't appreciate what I try to say in order to help them, how will they react against other people who say things simply to hurt their feelings? In any case, penning the essays for my application required much more self-reflection than I had expected. This was both good and bad for me, good in that I have a clearer answer in my head about why I want to help people and do research, and bad in that I had to access buried memories or feelings towards people who have died.

Tonight's plan will be trying to go to sleep early (failed- it's already midnight...) and waking up early to have a healthy breakfast before running in my other new pair of shoes. 8 pairs of running shoes lie across the floor of my bedroom closet. I have run in only 62.5% of them while the thought of purchasing another pair has crossed my mind more than once this past week. Goodnight!

8.27.2011

beta blockers

Lessons from the Emergency Department last week.

This patient was lying in a gurney.

NaCl hanging up high. Pressure. Flow rate. Bernoulli's equation? If below vein, blood backflows. Push additional saline into IV to prevent clotting, backflow of blood.

Low HR. Average 60-100. Unless you're an athlete.

Pulse/Ox.

Best moment of the night: "Thank you... for all you've done today!"

This old gentleman was pacing about in the ED during my volunteer shift, and I was concerned that he was just lost, so I just walked up to him and asked, "Sir, are you lost? Can I help you?"

He wasn't lost- he was just walking back and forth down the hallway because he was waiting for his wife in x-ray. He thanked me and went about his pacing ways.

Later on in the night, he was walking around again, so I asked him if he needed anything. In his hand was a card that he had picked up from a patient, possibly his wife, and she forgot to take it up with her. She was apparently admitted to the hospital, and this card contained information about transplants. I told him that I would find her and return that card to her, to which he thanked me profusely.

It always embarrasses me when the patients thank me. As much as I appreciate the feeling, it never feels like I did enough to earn their gratitude.

Tonight I will be summarizing a few patient stories to send to my ED volunteer coordinator, in order to highlight some poignant interactions I've had while volunteering here.

8.24.2011

primary colors

8.23.11
Primary application submitted.

8.24.11
Secondary from University of Cincinnati received.
Checked the research faculty: not bad! Checked the neuro department: not bad!
Their children's hospital has a very good reputation I hear.
Finished everything except the research portion. Will fill that in tonight.

Essays I know I could work on:
Pittsburgh
Minnesota
Illinois
Colorado

I think I'll cover 4 schools per day after work. I am really behind on lab work, so I'm planning on spending time to resume my projects and mouse crosses while working on essays after 5 PM.

New plan: run in the mornings before work, work, and then write essays while doing calisthenics to relieve stress.

8.21.2011

The Fray

One drawback to introspection is that when I dig deep to pull out my real reasons for becoming a doctor, those reasons are intimately linked to emotions.

As a consequence, these reasons turn into water and attempt to force their way out of my eye sockets.

However, I have trained myself for such circumstances, so only a film develops over my cornea.

My mother sent me another email a few days ago, declaring that she missed me. How different are Asian parents from one family to the next? I compare myself to Nants, and it seems as though she has more parental pressure. In my case, my mom and dad just miss me, so she send out emails to my brother and me wondering what we are up to. Perhaps I mentioned this in an earlier post, but in any case, she wrote a previous email stating how proud she was of me in relation to my promotion at work.

From my experience in Nants' phone calls with her parents, maybe Asian parents raise a male and female differently. I remember reading a while back that Asian girls tended to have higher suicide rates than any other ethnicity, possibly due to social pressures and expectations.

Something about this just can't be right. Sometimes I feel that parents should be proud if their children turn out to be good and nice. That isn't asking for much, is it? If their progeny turn out to be genuinely decent human beings, what more is there to ask of them?

8.20.2011

coke girl

After going through multiple iterations of what is essentially the same thing, I am left wondering a few things:

Am I a good person?
Is this path worth it?

If I had to guess, I would think that doctors think about these two questions as the number of years increases. Once school begins, the countdown also starts. Time is the investment, and the return you get is increasing doubt, leave alone debt.

What factors, then, keeps one afloat in this turbulent sea? Confidence, or optimism?

There are cases where some people fall off board and opt for one degree. Where is the commitment? Does that only happen to the commitment-phobes, or do they suddenly reflect on who they were and what they have become, only to realize that what they see in the mirror is no longer a reflection of themselves?

Hope is what I stow away inside, in my own hiding place, to help push me towards the future. That hiding place is different from the one where I lock up my emotions.

8.19.2011

bitter dreams

+1.

1 more dream about R&D. Sigh.

This time, it involved a bed.

He was laying in bed, and I needed a place to sleep.

The dream first began with me walking around a neighborhood reminiscent of the setting from the Prince of Persia videogames, where we would travel around on rooftops, walking past several restaurants clustered nearby.

I was traveling with a friend from high school, who used to do CosPlay (and still does, I believe), and we could not decide on a restaurant in which to dine. Eventually, we picked some place in an obscure corner hidden by the other structures. It felt like Thai food... no, I couldn't taste it for some reason in my dream; there was just this feeling of spicy and sweet lingering around in the air.

During our post-dinner walk, I probed her with questions concerning her personal life. The only question that seemed to put her on edge was the one about her husband. She at once became despondent, not wanting to comment further on that part of her life.

In any case, I returned to a room, and R&D was laying there. Someone had already occupied the floor. Being a queen- to king-size bed, I had commanded him to move over so that I could rest on the other half of the bed. In no mood to argue, he continued to bring up excuses as to why I couldn't have that side. Not that I was eager to share a bed with him, as that made me extremely uncomfortable.

Eventually he gave in, and we were sleeping head-to-toe, but this wasn't where the dream ended. He tossed and turned, turned right onto my body- his hairy skin contacted mine, sending shivers up my spine. My problems with intimacy immediately revealed itself on my face, red with embarrassment.

The feeling of trying to even be hugged by R&D pushed my consciousness above the subconscious, back into the comforting reality and emptiness of my own bed.

Suffice to say, I need to find a way to eliminate the possibility of these dreams ever happening again.

sterling cooper

I tried to anesthetize a mouse today, and it bit me. The mouse was a male, so it was surprising because usually when we handle mice, the females are the more aggressive ones when it comes to scruffing. This mouse was specifically for Mant- I had to take care of it for her while she is currently traveling through India, celebrating a friend's wedding. She will be getting Henna tattoos all over her hands, riding elephants, and eating never-ending Indian cuisine served on banana leaves. India would be one destination I'd like to visit in the next year, along with Tibet, Australia, Europe, and South America. The problem is that I usually do not enjoy traveling unless it's work-related or has a purpose. Which is why I have been trying for the longest time to get people to come with me to Nepal to volunteer at an orphanage or hospital. People simple don't think that they can remove themselves from civilization, devoid of internet, for merely 2 weeks.

Maybe Clare was in fact accurate in his assessment of me. Maybe I do obsess over people.

Sometimes I think I like observing people simply to analyze them.

R&D needed some help on how to process the microarray data, and so I sat there next to him for most of the afternoon. I couldn't do much since he was at the helm, steering the windows on the computer to whatever panel he was interesting in viewing at the time. Therefore, I just stared at him.

He has a scar on his left middle knuckle, and an abrasion on the other, quite possibly from scraping a surface. I was inclined to ask him how he cut himself to get that scar, but he was staringly intently at the computer screen monitor, so I didn't want to disturb him.

The cuticles are also very pronounced on his fingernails. The whites elongate for about 2 to 3 mm before the pink of the nail emerges and fills the rest of the nail bed.

His arms are quite hairy; in fact, I believe they're the hairiest arms in lab. Underneath that forest of hair is a nice skin tone, even though it does not match with his upper arms nor his torso.

Errant hairs lie all about his neck, from front to back. In the front, one hair is emanating from a mole, which indicates that it's not cancerous. Definitely a good sign that it's not cancer. Other hairs sprout out from his back- I'm hardly comfortable with my body, being almost entirely smooth all over, and those hairs did nothing to ease my discomfort.

The elbows definitely aren't dry, and I can tell his skin is semi-soft, based off the numerous times he uncomfortably brushed against my arms. I'm not entirely sure why I prefer not to be touched, but the slightest skin contact with R&D made me uncomfortable.

Don't even get me started with the ears. Tiny bits of earwax are sprinkled on the outside perimeter, which could account for his difficulty in hearing sentences I say to him. The pinna are thin, which made me wonder if this was due to the birthing process. I've only heard that baby's head shapes can be altered because of the birth canal as well as how the baby sleeps in their bed. Discount the freckles on the nose and the recessed, narrowly positioned eyes.

This habit of his was only noticeable in the beginning, but it seems to happen whenever his eyes are concentrated on staring at something while actively working to find a solution. Does not matter if it's the microscope room, dissection scope, or simply staring at microarray data.

--- Ok, after some time I fell asleep. Now it's 12:42 AM, and I have food regurgitating up my esophagus. Not a pleasant feeling AT ALL. Should I stay up and write some more? ---

I should.

8.17.2011

plaid and sand

11/18/11. 7:38 PM. That was when my grandfather passed away.

The following Thanksgiving WAS pretty grim, considering we spent almost the entire week mourning his loss through the funeral, the procession, and the rituals to cleanse or free his spirit from this plane of existence.

I have finished now 2 of the 3 essays required for my application. Later tonight I will be working on the Significant Research Experience section, which SHOULD be the easiest essay to fill out. However, this time, I would like my essay to replicate story time. I want to compose an essay that explicitly details the rationale behind the project, why it is important, and its implications or contributions to the current body of knowledge. I hope I can convey that through 10,000 characters. I should be able to, if afforded that much space.

Once I finish that extensive report, I should revise my activities section. The medical student that is still rotating in our lab, even though he is on preceptorship, offered the advice that I should briefly describe the activity, state my involvement, and what I learned or got out of that experience. I really hope that I don't have to related these activities to why I want to do medicine- that would just come off, again, as cheesy to me.

Ugh, R&D is back from Mission Bay. And I was so productive, too, today during his absence.

For volunteering, which I will attend at 5:00 PM, I have been wearing these same black "dress" slacks from H&M. Stiff as cardboard, they finally ripped a month ago at the bottom, where I roll them up so that they do not drag along the ground. The seams are bursting everywhere- in the crotch region and at the knees.

The person with whom I used to volunteer has moved finally to Larkspur? It might have been Alameda... just when I thought my memory had never been better, it fails me.

Okay, enough of this writing break. Time to return to my other writings.

8.14.2011

back 2 school

I think I may have to hold off on additional blog entries this week as well as next week.

One MSTP in my lab, R&D, is having his qualification exam next week. He will be presenting a practice talk tomorrow.

I am also focusing on writing my essays and finishing my application so that I can send them in this week ASAP. I have delayed it for too long, but hopefully not too long. The most reasonable course of action now is to turn in my application, and quickly write all my secondary essays so that they can be sent in conjunction with my letters of recommendation. If turned in at the same time, I believe my application shouldn't be too late in the cycle. It would be halfway between the early birds and late risers, which isn't too terrible of a spot to be in.

We'll see.

So the point of this short story is to say that, besides helping that selfish oaf in my lab, I will also be thinking of myself for once and focusing on my personal future career goals.

I hope you don't mind.

Oh, and I will also be focusing more on New Yorker Journal Club once these essays are finished. Another activity I want to be involved in for the short term is clinical neuroanatomy with Janey. I want to try to keep up with the notes for that class, not necessarily the reading, but the lectures should be informative as well. Although, I guess I could also be preparing for interviews. Perhaps that's the type of positive mindset I need to have. If I believe in receiving an interview, and I actively prepare for them, then it will surely come to me, no?

Let's test out this theory, shall we?

8.12.2011

Roswell

Do you believe that people are ultimately good?

I've always perceived that every individual comes into this world with a blank slate. They are clean, they are pure. Untainted by the world, we slowly begin to open our eyes.

The "lab manager" did not come to lab this morning. He texted the postdoc he worked with, informing him that his friend is in serious condition, so he would either come in later or not at all.

One would find themselves sympathetic to the victim in this circumstance, yet if you knew this person, you would not be surprised if you hesitated on doling out your regards. Coming back to lab from the mouse facility, I find this person sitting with his lab coat on, playing games yet again on his iPhone, and chatting with friends on his gmail and facebook accounts, smiling the entire time. Was his friend actually in a "serious" condition? Or was he just hungover from the night before, and this employee found an excuse to ditch work?

After everything I've been through, I sometimes find myself jaded by people who throw out these excuses. I only associate serious situations with near-death experiences or death of a loved one. That criteria is probably too stringent for most people, but if that's what I apply to myself, should I be faulted for treating others the same way I treat myself?

One example would be when my grandfather passed away. I was just sitting there, watching "The West Side Story" with my lab mates, and I get a text from my brother, with the official time of death. The one comfort was knowing that he died with a smile on his face. Regardless, I finished watching the show with my coworkers, and went to work the next day. Finding the entire place still in a mess, not cleaned up nor organized while I was away at a conference, I spent the entire weekend cleaning everything up and organizing all our supplies. No absence from work. On the contrary, I spent the entire weekend dealing with lab organization.

This topic is too negative for my tastes right now. Expect another post!

8.10.2011

Jose Ole

Nothing of note tonight in the Emergency Department. It was certainly filled with several residents and medical students. Even the medical students themselves state that the nurses are nicer. I wonder why. What is it about the medical field that turns it into a clique?

I barely even traversed the hallway when a resident, upon eyeing me, starts pulling the curtain ever closer towards the doorframe, obscuring the patient from my view. Isn't learning a privilege? Why would a person revoke another person's right to be educated?

Afterwards, all I saw was somebody on the bus whose facial profile/silhouette reminded me of Drab. Nothing particularly fascinating about his face strikes me; I just notice details in people for some odd reason.

what's the most exciting part of my day? When I emailed my biochemistry professor from San Francisco State, asking for a letter of recommendation, she replied that she indeed remembered me. It's nice to know that you have a lasting impression in someone's mind, even if it has been 2 years since you last communicated with them. I honestly did enjoy her class, too, even if I were really bad at it.

8.09.2011

soul man

Easy listening for one is how I would describe the album Drab gave me for my birthday not so long ago. Not so long ago... is 4 years not a long time? Easy commitment, as Clare told me.

The new landlady scheduled an appointment from 7:00 AM to 6:00 PM today for the apartment to be heated so that most animal and/or life-forms should not survive. She hired an exterminator to come treat our recurring bedbug problem. Well, not MY bedbug problem, but the problem that's pervasive to the second floor of the house. Anyhow, pest control is placing heaters within every person's room, setting the temperature to 140 degrees Fahrenheit for the entire day. In theory, this is the most effective, yet costly, method of dealing with bedbugs.

I went through my secret boxes and various drawers/containers to remove photos from the living quarters, as the landlady said that they would melt at that temperature. This situation was interesting- I had to choose which belongings to take with me to essentially preserve.

What was most important to me at the time? My passport, licenses, checkbooks, and other government-issued identification. Alongside that, I packed into my shoe bag postcards from Kaiser, and this cd from Drab.

"Love Songs for Siu: Round Inside." To reiterate, the cover detailed 2 hearts encircling both of our heads, with embarrassing facial expressions directed towards each other. On the inside cover is a 17-track listing of songs, and at the bottom is the word "FOREVER," in all-caps, with the letter 'o' being replaced by a heart. UGH!

Hold on a minute. That's not the end of it. On the CD itself, Drab has written, "Siu to You my Love," and on the bottom, "Love Songs from Brad."

I suppose the terrible handwriting could be attributed to his sinister nature, but aren't there lefties in the world with excellent handwriting? I suppose right-handedness of hand doesn't say much, since R&D is a righty, but his writing is terrible in form.

Synthesizers all in my head! Excellent!

Where was I going with this? I think I was trying to warm up so that I would spend time writing other things.

Adios.

8.08.2011

Lo Profile

You reach a certain threshold, and once you hit that barrier, all hell breaks loose.

I'm starting to resent my lab again. I used to target and channel this anger towards mainly one person, from the lab manager, to my boss.

Now I'm stuck at this stage, where I find almost everybody annoying to an extent.

My frustration is directed at the arrogant graduate student sitting behind me.

How was he raised, to turn out into someone as messed up as he is? One problem with MSTP's is that they act just as entitled, if not more so, than any other medical student Nants sees in Dallas. They think that nothing is ever their fault, even when the evidence is clear that their laziness pervades every aspect of lab work. What is the point in trying my hardest to help them out, when they turn out to be nothing more than arrogant, selfish, insecure, dick heads?

I have been so annoyed with the one sitting behind me. I think I have lost respect for him. How can somebody be so oblivious to the garbage that flies out from their mouth? I have reached my limit where I try to hold myself back from blurting out," Why are you such a fucking asshole?"

Mant was probably correct in her advice. Maybe I should tell him why he was out of line. I shouldn't expect people to be intuitive about these situations, but how can these so-called future doctors not be able to draw from context clues? It's surprising how they can be emotional morons, and this comes from somebody who rarely feels anything towards another human being.

Maybe I am just finding a reason to leave my work. I do not feel productive anymore when I enter the workplace. I have been in an oddly frozen status for 4 years, and nobody around me has changed. It always seems as though I bend over backwards to help out everyone around me, putting myself before them every single time. I thought that was what it meant to be altruistic, some obscure quality I thought all doctors should possess. The more I interact with these future physician-scientists, the less inclined I am to believe in the good of our future.

Most likely I am just venting, but there is always some grain of truth to what is spoken when one is angry. Am I angry? Maybe that's what I'm feeling right now.

I can't believe I even prepared all the mouse crosses for this prick. For all his future experiments, I set up the appropriate mouse crosses in order for him to graduate within 4 years, because lord knows, this guy cannot plan ahead when it comes to his experiments, let alone perform them correctly. He can't clone, he waits a month before even freezing down his virus, and his pups get cannibalized for 6 months before any even survive childbirth. Would it be wrong of me to just sacrifice those mice, and let him spend the next few years setting up his mouse crosses, waiting for the correct pups to be born, delaying his experiments for months?

*Aside* somebody's screaming my name from outside my door. Who is it?

Turns out, they were my roommates from the top floor. They locked themselves outside trying to throw the garbage away. What is it with boys calling out my name all the time- it must be the city.

*Another aside* DEAR LORD this ginseng chrysanthemum with honey drink is disgusting!

Maybe I DO "hate" R&D, even though one postdoc, and most of my Rice friends, tease me about being in love with him.

You know what it boils down to? It's that feeling one has where they try to put their faith in somebody else, thinking that, hey, this person could be a really good friend that I would want to keep for the rest of my life, and then falling flat on your face, getting mud kicked in it for further embarrassment. It's the effort you put into thinking that somebody else could be worth your time, no matter how short your lifespan may be, and then becoming disappointed after the fact, realizing that you made a mistake. Maybe I'm angry that it was my choice that was the mistake, and I thought I would be good at picking lifelong friends by now.

I compare him to Drab, and Drab would never do that to me. Drab is a genuinely decent person. Never egotistical, and certainly seems more interested in science for the sake of enjoying it, is how I would compare the two.

Why can't times be more relaxing, like Suntory Time?

Reflex Neurovascular Dystrophy

There's a tiny little fly/moth in my room, except I have no inclination to ablate its existence with the swat of my hand.

It just flutters about, aimlessly.

I wonder if that's how I am right now: just aimlessly wandering about life.

I'm watching it traverse the room, and that's not such a bad life. Although, if memory serves me well, the insect may seem to possess a random pattern of motion, but it could be alternating halfway during flight because of the chemoattractants drawing it to its destination or reward.

Why don't I have such a strong chemoattractant pulling me towards a certain fate?

Maybe I just enjoy existing outside of the reality in which most people live. Is it because my imagination is more interesting? Are there more exciting worlds to explore than this one?

I'm really hoping that my writing is slowly improving with each blog post. At least that is what my intentions are from now on- to constantly improve in whatever activities I seem to be placing myself. So far this includes running, blogging/writing, and researching. I want to become better in every field.

Another surprise came in my gmail inbox. My mom emailed me on behalf of my parents. She first wanted to congratulate me on my job promotion, wanting me to continue being a good worker. Then, she wanted to say that she was proud of me and that she's glad my boss recognized that I am a good employee. Lastly, she wanted me to enjoy my life, so she told me to have some fun even while working hard everyday. Her last sentence was confusing, though. "This is your mom and Dad the big gift. Thank you!" I have absolutely NO idea what to interpret from that remark.

Still, I'm a bit surprised from that letter. My parents have actually never said that they were proud of me. What's changed within them at their current age?

8.06.2011

california dreaming

I had 2 more dreams about R&D this week.

The 4th dream involved him packing up his stuff in our bay, preparing to move out of it.

The 5th dream last night involved him actually moving away from lab for good.

I'd like to think that he failed his quals, and that resulted in him having to move out of our lab, but that probably was not the case.

Instead, the dream only involved his stuff being packed onto a moving cart again. This time, though, he was planning to move out of the lab for reasons unknown. Whatever the case, I ended up being happy about it?

8.03.2011

betelnut

This place was not that impressive, no.

Lettuce cups: too salty. Beggar's chicken: not quite as flavorful as I thought. The curry noodles were okay, the shrimp fried rice wasn't spectacular in any way but consistent. The cauliflower was cooked in an interesting manner- it seemed as though it were breaded before being pan-fried, but it was difficult to tell from the lighting. The alcoholic green tea lemonade wasn't that strong, or at least it didn't taste that strong when I drank it very quickly. Then the room started spinning 10 minutes later.

For dessert, we had a dish of mochi, ranging from white chocolate to milk chocolate to dark chocolate, paired with a lemon sauce, a butterscotch flan of sorts, and whipped cream with strawberries. Out of the sides, I approved of the whipped cream with strawberries the most, and out of the mochi, I don't think I liked any of them. Mango or green tea were always more of my thing when it came to mochi desserts.

My brain can function no longer on this fever.

Post ends here.

8.02.2011

5K

The SF Marathon was held this past weekend. (Side note: I think my hands are becoming dyslexic. Every now and then when I look up at my text, several words always appear scrambled, sometimes rearranged into words that make sense, other times into unintelligible garble.) I had registered for the 5k at the last minute, partly in an attempt to win a bet, and partly in an attempt to test myself.

For the entire week, I had conditioned myself to withstand longer distances, and to increase my pace. I ran 4 miles one day; I performed interval training the next. As instructed by several websites, I did not train 2 days before the race. I ran a light jog the day before the event and felt great, confident even.

My bib was picked up, my clothes were laid out the night before. The night before, I loaded myself up with carbs- mac and cheese- and I ate several berries high in fiber.

Although I did not sleep until midnight or 1:00 AM, I managed to wake up around 5:30 AM. I emptied my bowels, microwaved some instant steel-cut Irish oatmeal and ate that with a side of banana. My gear was on me, and wrapped in warm clothing, composed of a windbreaker and windpants, I headed out the door to stop at the corner of Carl and Stanyan, waiting anxiously for the 6:51 AM N-owl bus.

I felt amazing. This feeling was reminiscent of those days in high school when I would wake up early to ride the schoolbus to various Texas cities to compete in math/science contests. An entirely different venue altogether, but the thrill of competition was still there.

I waited, and waited, time rolling by me. It wasn't until 7:25 AM that the N-Owl actually arrived, which I boarded in hopes that it would get me there by my race time, or even a later wave. Apparently, these races place contestants in waves, in order to separate the packs and keep the races uncrowded, allowing the faster runners to lead first.

The first problem occurred when I entered the bus- some French tourists were bothering the driver about receiving the adequate amount of tickets. The second problem involved the backdoor of the bus-it failed to close again after passengers left the bus through that exit door. The driver ultimately had to stop the bus, turn off the engine, and turn it back on for the doors to reset itself. Once that ordeal was over, we encountered another problem, where the driver hits a dead end, and had to circle all the way back to where I was originally picked up, where we headed northward and turned to meet a lady at the corner. This lady worked for the SF MTA as well, and incidentally was the only person who had detour directions for our driver.

Once that driver was told where to go, he started heading towards the Embarcadero, where my race was to be held. The next problem was that part of the city was closed down along Market Street for the full marathon. Every time we met an intersection where the race was passing through, the bus had to stop to allow racers to run across, and only until there were no more were we allowed to cross the street.

All these delays were interspersed with fellow commuters debarking the bus because they were frustrated with the detours and did not want to deal with this bus. Suffice to say, I was mortified the entire time, and disappointment kept sinking in from the moment the clock started ticking past 7:45 AM, which was my planned time to begin the 5K.

There was nothing I was able to do but follow through and get off at the Embarcadero. I walked to the edge of San Francisco and saw the race starting without me. I observed the cheering, the musicians, and the string of booths for race finishers, where they were handed food and drinks to replenish themselves after a hard run.

I think this feeling, trying hard for something, only for it to be taken away by another thing that's out of your control at the last minute, was quite possibly one of the worst feelings imaginable. Everything that I was in control of, I managed to do. This feeling is almost like science, except I didn't even get the chance to meet success or failure. It's like performing science without ever getting a result, positive or negative.

R&D didn't help either, when he persistently teased me Sunday, and then through lab meeting Monday, when everyone was sitting around the table. It would have been one thing if I had backed out at the last minute. I would have definitely deserved it then. It's one thing to tease someone, but it's another to embarrass them in front of an audience for something that one has no control over. Even if I do make fun of my friends, I would never make them feel worse about themselves intentionally just to hurt their feelings in front of people they know. (I'm actually thinking this through, to make sure my statement isn't a lie...) I suppose the point I want to make is: I've already been hard on myself for the entire ordeal, and I don't need somebody else to make me feel worse about myself. At this point it just comes across as malicious behavior.

To say the least, I haven't felt like talking to him after lab meeting yesterday, except he was using the microscope when I had reserved time for it, and he entered the microscope room later to ask to borrow my ID card, which I fortunately didn't have on me, so I wouldn't have to see him again. Once I took all the pictures I needed to take, I left to return to my apartment because I did not want to deal with him for the rest of the afternoon. Even when he tried to announce aloud that he finally found a person to chair his quals committee, I had no desire to respond.

This morning, people were trying to talk to me, which I was in no mood for, nor did I have a desire to see anybody. R&D had come in during the morning because he had a personal meeting with our PI. I tried to get all my experiments done before they finished talking, so that I could leave for the day, both to avoid him and to focus on my writing.

I am in no mood to deal with my lab, except I have to meet with Dan tonight to discuss my work and future plans. Boring.

The recurring thought in my head is, the longer I stay in this lab, the less I believe in the innate good of people. My hope is that this isn't true.

general neurology

5 patients. One attending. One resident.

I shadowed a neurologist attending, more so a buddy from an adjacent lab, at the general neurology clinic in the Ambulatory Care Center last Thursday, July 28th, from about 1:30 to 4:30.

It seemed more relaxed that I had previously thought. The physicians actually were able to spend 30 minutes to 1 hour for each patient, which was nice in itself, being able to engage in conversation with the patient over their life/history. Human history is interesting to me- this probably connects with my fascination with life and death again.

I want to know how people live their lives. What makes people want to live, and what decisions do people make in order to make themselves happy? Why do bad things happen to good people? Why is the body so frail, and why does our corporeal form revolt?

Sometimes it's also fun to live vicariously through patients, since it's near impossible to do everything we want to do in this one life given to us. You get a chance to see with each patient what it might have been like to be a long-distance runner, a grandmother of 8, or playing chair volleyball at the retirement home.

What did I learn...

Patient history is, obviously, extremely important, although I think they call this PMH now. Past medical history, which in itself is sort of redundant, so I don't understand the reasoning for that nomenclature. Being able to focus during a patient's conversation while sifting for relevant information is another useful tool to possess.

Once that history is taken, the physical exam is also crucial. I saw my attending friend suggest some techniques that she could have used to diagnose neurological deficits. (Totally forgot the names here, but probably not important for me until later on...)

Now that both parts are complete, it was time to go through all the data, pick out which symptoms were more important to treat first, and then deliver a diagnosis and treatment plan. As neurologists, they first needed to decide whether this patient's case was a neurological problem. If not, they would either recommend that the patient's PCP do additional testing before going back to them, or they would tell the patient not to worry unless their incident occurred again.

However, if it were a neurological issue, the doctors tried to identify the cause of their illness. Which disease, or condition, would result in or best explain all the symptoms seen? At this point, it really seemed like the show House, involving differential diagnosis.

Next time, I think I'll get the chance to shadow her in an ALS clinic, which I'm told may be rather tragic, since confirmation of ALS spells out death basically for the patient. If it's ALS, it's always bad news to break to the people involved. I still want to see this though, for myself. How do other people react to bad news, especially when it concerns the rest of their life?

I thoroughly enjoyed this experience, I would say. This hasn't changed my mind about wanting to pursue a neuro-specific field, but I'm still uncertain about neurosurgery versus neurology.