More Cowbell

It's been an exhausting two months

2007-10-14T21:52:00.000-04:00

I guess I should post.

For the past six weeks, I have been on my surgery rotation. Read: the most grueling of rotations during the third year of medical school, which is the most grueling of four years of medical school.

However, I love every minute of it. I love being on the wards and meeting new patients. I love working with the rest of the healthcare team, even if most of the time I am being corrected. I love reading about things I see and going to conferences. Most of all, I love being around other people when I work.

There are parts of it that I do not love, but in general those have been few and far between.

In being on the wards, I have learned a lot about myself and experienced many new things:

- I took staples out of a patient's wound
- I explained the risks and benefits of a surgical procedure to a patient
- I saved a patient from losing her leg as part of a post-operational physical exam
- I joined one of my seniors when we told a patient she has cancer

It is a rush to be here and to learn. I hope I get to post more about it though. Right now, I barely get enough time to pee, let alone blog.

2007-08-13T13:22:00.000-04:00

Relaxing and working in Toronto right now. I love Toronto. The culture of this city is so friendly and progressive and international.

My cousin has a loft downtown. Here is the view from one side:

And here is the view from the other side:

I will be very very happy if I can find a view like this when I move to Chicago next year.

Three more days

2007-07-24T20:22:00.000-04:00

Only three more days, and I will be done with Step 1 forever!

I have been studying at the University of Cincinnati during the day. I am a library person, perfectly content about being locked to a cubicle or table for ten hours so long as there are people around who I don't know. UC is an interesting campus, mostly because of the extreme architectural displays.

Here's an example: at Emory, if someone were to ask "How do I get to the library?" I might respond "Follow this pathway down the hill, turn left once you get to the street, and it is the tall building you will be facing". At the University of Cincinnati, a sample response might be: "Walk straight, up the curved stairs, then down the curved stairs, and keep walking straight until you are in a grassy area and see a crazy metal stairway to your right. Go down the stairway and past the glass pyramids."

It is a nice place to study, but the parking fees are driving me crazy. I don't know if I can do this for much longer.

Think of the Children!

2007-07-14T21:39:00.000-04:00

Now, HERE'S a good way to piss off your population base.

Many Americans will vote for anyone who promises to lower taxes before considering the ramifications. However, it is very difficult to argue with funding an established healthcare for children, especially after the nation is talking about the movie "Sicko" over their dinner tables.

It probably doesn't help, either, that the tax money would come from cigarette sales. I typically do not support prohibitions on smoking; regardless of the risk, people reserve the right to do to themselves what they want. However, I am all for taxing the right to smoke; people who exercise their privilege to smoke should also take responsibility for the healthcare cost burden they create by smoking. That aside, I have a hunch that Philip-Morris is ready to put a nice chunk of change in a few people's pockets to make sure their cigarettes do not get taxed and their profit margins do not sink.

I hope that funding for the SCHIP program does come through. It would be a good step in expanding access to adequate healthcare coverage. I also hope that the red tape around the program is released soon. Right now, many qualifying families do not know they are even eligible for the program. The registration process is more complex than it needs to be.

Scandalous ...

2007-07-11T00:36:00.000-04:00

See a kindergartener's rendition of scissors.

Shiny! Shiny!

2007-07-08T15:01:00.000-04:00

I started out looking at simple keyless entry systems to install onto my car.

That turned into iPod integration.

That turned into me wanting this. The Pioneer AVIC-D3 not only has the iPod integration I am looking for but also has Bluetooth integration for my phone and PDA as well as a GPS system that works in Canada. The DVD player plays DivX videos as well. I also like the clean touch-screen interface as opposed to the horde of buttons on other devices, and the muted color of the trim (the last aftermarket radio I owned had this odd fluorescent glow that would not mute at night and is very distracting when driving long distances).

What I like most about Pioneer is its interface. The problem with purchasing products like this is that it is next to impossible to see the interfaces used on the systems. Not so with Pioneer; click on the upper right corner of that link and it will take you to a Flash version. This is what has made Apple so successful: the plebeians love Apple interfaces for their simplicity of use and immediate access to services. Motorola could learn a lot from the importance of a good user interface.

For me, it would be a long-term investment. My car has 30K miles on it and I plan to drive it into at least 120K (that is, through medical school, residency, and a few years of practice). So, if I were to install an audio system such as this, I would be using it for a while. I would also have to install a security system for my car, because there is no way in hell I am putting something like this in my vehicle and parking it streetside on the Ohio State campus without one.

But I have MANY MANY MANY better things to do with $1000. Like ... oh, I don't know ... my apartment rent. I suppose I should wait until I am actually a doctor or have save up the money before I start considering something like this.

Le sigh.

S. aureus

2007-07-04T11:40:00.001-04:00

Happy Independence Day, for those of you in the US.

Somewhere in blogland (I can't find it again for the life of me ... pipe up if it is your blog ... I could have swore it was Morgen) mentioned a quote along the lines of how great it is that we celebrate our independence with picnics and potato salad and jello molds instead of military displays (with the possible exemption of fireworks). I agree; I like being able to celebrate peacefully.

If I have not made it clear, I hate potato salad. Don't get me wrong, I have tried my hardest to like it. I have tried all sorts of dressings and potato preparations and side dishes and seasons. I have tried it hot, cold, and lukewarm. I have tried it with all forms of alcohol. I've tried pleading, I've tried begging, I've even tried to cover it with bacon. Bacon is supposed to make everything taste better.

I still hate potato salad. But if it means peace, I will tolerate it any day. There are far worse things in this world than potato salad. The people of Tibet and of Cambodia and of Zimbabwe would fawn over potato salad compared to their current quality of life.

My brother was watching the Jet Li film Hero (英雄) produced by Zhang Yimou (張藝謀) yesterday. I will set aside a discussion on the interpretation of the ulterior political motives of the film. In it however, they kept mentioning that "The sword and the brush are one". The sword represents warfare, whereas the brush represents diplomacy. Maybe I am slightly pessimistic, but I came to a different conclusion: it seems that warfare and diplomacy are one and the same, and inextractable from one another. Both enforce an unnecessary and divisive power struggle.

In that case, how do we step beyond the power struggle to retain a state of natural peace? I hope the answer isn't "warfare is nature", because that would royally suck. I would much prefer Mimi's world of peace. I would prefer that we create our own definition of nature.

And so, I will gladly accept a plate of potato salad if it means that we can celebrate what peace and stability our forefathers have secured for us today, and in hopes that we can secure greater stability and human rights tomorrow.

I wish I had full rights to a monopoly ...

2007-07-03T14:12:00.000-04:00

And so, the price of postage goes up AGAIN.

The US Postal Service retains its monopoly on both domestic and international letter mail. It also reserves the sole privilege to use private mailboxes. Each time an exception is made (e.g. the decision to permit extremely urgent mail), the USPS loses most of its business to the competitors in other services offering lower rates.

Why is this? Step into a post office and the answer is obvious.

From a business standpoint, the USPS operates as if it were still trapped in the sixties. Each outlet operates like a "Mom and Pop" store. Middle management has exploded and operates unchecked from central management.

There is an argument for the monopoly. The USPS is also commissioned with the responsibility to execute mail service to all points within the US. Outsourced companies have motivation to isolate their activities to areas that have high rates of mail turnover.

However, from an economic standpoint, the argument is a tactical sidestepping of principles of competition, on which capitalism is based. The price of postage has steadily increased over the past thirty years with inflation. No other public service has retained this luxury, including phone services or data plans. Other industries are forced to complete and to undergo corporate restructuring to increase profits, whereas most of the income accrued through the USPS ends up being spent on a corporate system that needs to be overhauled in the first place instead of actual costs of product.

On the other hand, we live in a luxurious environment. Is it really so horrible to have to pay 41 cents to send a letter via the US mail? I don't think so. It would be nice if overinflation of standard mail was the worst of our problems in this great big world.

Darth Vader Gone Wild

2007-06-30T00:33:00.000-04:00

My buddy Chris just got hitched last night. Great wedding. If only I had made it on time :(.

Let's just say that their entrance music into the reception was "The Imperial March".

In other news, anyone want to talk me out of buying a seat on a flight to London?

8-bit

2007-06-29T14:40:00.001-04:00

You know what? I want to find an old-school 8-bit Nintendo and play the Super Mario Bros. suite.

I am now going to suppress this thought because I have neither the time nor the money to be thinking about it, let alone probe eBay for a cheap system and suite.

Forget value and forget financial gains; how awesome is it to be able to say that YOU created something that people will remember for the next 100 years? Something that defined culture? Something that the world looked at and appreciated? Who knows, maybe even something that is named after you? To be honest, I am not sure that even the iPod will have the same permanence in popular culture as Mario has acquired.

I would be thrilled to have that opportunity.

One of my heroes in medicine is Dr. David Ho (何大一), famous for his foundational work on the use of protease inhibitors in treating AIDS patients. His work completely changed the culture of AIDS from hopelessness to a vision for a future. Can you imagine the rush it must be to be able to give people back a sense of hope or to make them feel like humans again? Maybe people won't remember his name just as people do not associate Shigeru Miyamoto with Mario, but they will remember AIDS and they will remember finding a cure for it.

The group I knew at Emory that is working on an AIDS vaccine after having licensed an AIDS medication (emtrictabine) to Gilead Sciences in 2003 for $525M. They have the same ambitions, and I hope that they are able to successfully produce an AIDS vaccine soon.

I talk a lot about relative gains. The idea behind proper investment principles is that one manipulates short-term transitions in value by taking money out of commodities that will be decreasing in value and reallocating it into commodities that are to increase in value. It is sort of the chicken-shit way of accruing value. The greater way is to instill value, to create it, to fight for it, and to establish it.

Very disappointed in the mile

2007-06-27T18:42:00.000-04:00

I'm alive, I swear! Studying for Step 1 + AMA conference = not enough time to breathe, let alone blog. I'm currently stuck at the O'Hare airport waiting for my flight to leave. Leave it to O'Hare to be ... well ... O'Hare. I'm probably too tolerant, though, considering that I am accustomed to Hartsfield-Jackson Int'l in Atlanta.

The conference was nice. However, I was disappointed of my jaunter down the Magnificent Mile. I was looking for a D&G and walked the entire mile only to find out that Chicago does not have one.

As far as the fashion industry goes, the main players on the high luxury level are the LVMH conglomerate, Prada, Versace, and Dolce and Gabbana. LVMH, being a massive holding company with the administrative processes of a massive holding company. Prada and D&G, being independent, appear to have more autonomy on the artistry of their products as well as more general public appeal.

Versace is independent, too, but Donatella Versace is a crackpot whom I do not trust.

Fashion is an interesting industry because product value is created and destroyed at an incredible rate and at the whim of the public. It feels closer to gambling. Versace is still considering an IPO, presumably trading on Euronext. I am very tempted to buy, but I still don't trust Donatella very much.

Helping to keep them down

2007-06-11T01:41:00.000-04:00

Here's an interesting conundrum: how much does aid to Africa really help? The interviewee within this discussion asserts that, by continuing to finance aid within Africa, we perpetuate a cycle of poverty for the country. The best way to help Africa is to stop throwing money at the continent as a whole and, instead, permit the country to delineate its own plan for success.

Easy to say when you are not the one living in a corrugated metal hut with seven family members, nothing to eat, HIV infection, and no access to clean water, right? Well, this guy is a Kenyan economist so his statement is a little more credible, I suppose.

Let's hypothesize a model where we set a moratorium on all aid to be funneled into Africa's hand. We will maintain regulated resources that do not conflict with market forces, such as HIV therapy and expansion of education. However, no more mass shipments of corn or donations of money into the hands of governments. In an environment like Swaziland, a relatively wealthier country in Africa, local entrepreneurs could continue their ventures in a competitive environment and bring trade development with South Africa and Namibia. Dependence on local business development would create mechanisms for fair sales of farm products by the impoverished rural populace, who would no longer be contending with the outrageously low black market prices for UN corn.

Ah, but there is one more thing to worry about: blood diamonds. One could also see expansion of the already gutwrenching industry focused around the mining and sales of conflict-related diamonds in order to continue the estates and dictatorships of the wealthy. So then, does Africa get gutted of its natural resources? I hope not.

What a tangled web we have weaved as a global community, looking shortsightedly at the mass poverty and health crisis in Africa. We need to work together to fix it, but the solution is bound to be long and complicated, and a lot of human suffering will occur if it is not thought through properly.

In the end, I do agree with the author: Africa needs to stand on its own two feet. South Africa has been relatively successful at this; while there is still a lot of disparity between the rich and poor, the country can subsist on its own and has an effective plan in place for changing this. The gap is narrowing and there is optimism within the country. South Africa's history is unique in many regards, but does provide a model for other countries to pursue internal reform and stand on their own feet.

Lambchop part 3

2007-06-04T03:45:00.000-04:00

I have been asked to give an update on the adventures of Lambchop.

Altogether, Lambchop is doing quite well. However, I have had some disciplinary problems with him:

We elected for the Chinese Opium Republic approach of discipline:

I think Lambchop is learning from his misdeeds.

The plush cow you see there is Mutilated Cow. Joe cut his arm off. However, my good colleague Kristen was able to repair the arm (bandaid + Scotch tape). So now, Mutilated Cow and Lambchop fight over the ladies.

You know, all I really want right now is enough peace of mind to be able to study. Is that truly so much to ask?

2007-06-04T02:55:00.000-04:00

I was reading an article about a Polish railroad worker who woke up from a 19 year coma. He describes how much his world has changed from the Communist world in which he originally lived.

My friend Kasia has occasionally opined on the differences between life under communism and life today (favorite quote = "bubble gum tasted different under communism"). However, at least she had the pleasure of living through the 19 years of transition. Can you imagine being reawakened in an entirely different cultural system? Quite a shock.

I wonder what life will be like in 19 years. Perhaps we will see an entirely reformed health system, or leaps in human rights. Or, perhaps our entire sense of public ethics will be dismissed as the US economy finally fails.

Or maybe ... just MAYBE ... seahorses will rule the Earth!

I'm putting money on the seahorses.

I really should be asleep

2007-06-04T02:51:00.001-04:00

Tomorrow is our first day of ICM. ICM is a class we take to prepare us for the clinical component of our education; during it, we learn the policies and procedures to which we are bound in our rotations, an initial round of medical procedures, and we review our limited clinical education to date.

As you might imagine, I am slightly apprehensive.

The two week session is not really a big deal. However, it does symbolize the start of my clinical education. The part where I am actually responsible for patients. The part where I could possibly hurt someone if I am not careful.

I think I am ready for it, but I suppose that a little apprehension is fine for now.

A few choice letters

2007-06-01T22:36:00.000-04:00

Dear Boards,

Go eat poo. You have 48 hours. After that, I will be bending you over.

Sincerely,
Justin

------------

Dear Mme. Miuccia Prada,

Please reconfigure your phone to be serviceable on the 850 GSM band. You have 48 hours. After that, Lambchop will eat you.

Yours truly,
Justin

------------

Dear Canadian Healthcare System,

While I applaud your promotion of primary care, I am utterly disgusted of your caretaking skills for my grandmother. I suggest you fix it. You have 48 hours before I decide to invade.

Thanks,
Justin

------------

Dear Bank of America,

I am not pleased with these overdraft charges. You have 48 hours to remove them. If you do not, I will throw Joe at you.

Love,
Justin

------------

Dear Crazy Old Man in Nigeria,

For the 273rd time, I refuse to engage in your harebrained money transfer scheme, and I agree with Mimi that 5% of $22M is far too much for the dude who stamps the paperwork. You have 48 hours to drop the entire $22M on my desk, or I will pee on you. I would prefer dollar bills so that I can swim in them.

Cordially,
Justin

Why I've been remiss

2007-05-27T23:34:00.000-04:00

This time I have a good reason for not posting for a while.

My grandmother had a heart attack this past Wednesday and has been in the ICU since then. Yes, this is the grandmother who insists that she will be going to India to find a nice Indian girl and arrange my wedding for me.

The circumstances all fit into place. My grandfather fell and fractured his hip, so she was in the hospital when the heart attack took place and could be immediately attended to. My mother was unable to go to South Africa with my dad and brother for two weeks, so she was in the US and could travel to Toronto. My grandparents were planning to come to my brother's graduation, but they stayed in Canada because of my grandfather's hip fracture ... being Canadian, they do not have and have no need for additional health insurance except for their travel insurance and God only knows what sort of care they would receive if they were in the market-driven US.

I'll gladly accept all prayers, well-wishes, and good vibes you can offer her.

Thanks

Free Bag

2007-05-18T19:39:00.000-04:00

Many of you have been to conferences, I am sure. At these conferences, companies like to give marketing materials away. It is usually cheap stuff: lots of pens, sometimes notepads or keychains.

Sometimes they give away cheap gadgets such as pedometers, cheap alarm clocks, or calculators.

Sometimes they give away interesting stuff; I have some racquetballs, a Nalgene water bottle, and a spatula, too. Normally, stuff is only interesting; these are the only three things I ever used more than once after receipt. Most of the time I simply don't accept the product or toss it aside.

But at a recent conference, I got the coolest bag ever.

This bag is designed to be a simple gym bag for a regular workout. It isn't that big, perhaps the size of a grocery store basket. It has one central pocket, but it also has a pocket on the end with a deep recess that fits my shoes, another one on the end for various oddities (racquetballs, my water bottle, and deodorant right now), a pocket on the side just large enough for a towel, and another pocket on the remaining side for more oddities (my lock goes in there, and my wallet and keys go there during my workout). On the top is a pocket with a removable plastic pouch for toiletries that I can carry to the shower, and a pair of cheap flip flops fits there too so that I can avoid the joys of athlete's foot on the way.

Honestly, who ever thought of producing marketing materials that people might actually USE?!?

Why Do I Do It?

2007-05-18T00:24:00.000-04:00

One of the questions I get a lot is why I get so involved in public sector advocacy and leadership. There are some weeks when I myself can't come up with a good answer. Like last week, when I was drowning in my leadership commitments and barely got in forty hours of time for schoolwork. Then, friends like my old friend Stefanie from grade school, who is now a special education instructor, mention things like this:

Then there is the deaf student who really benefits a lot from being in our program. He turns 3 tomorrow and is eligible for special ed services from his school district. We have been trying to get them to pay for him to come to our school because they do not have a program that would be good for him in their district. Instead, we found out today they plan to send him to "school" at a daycare center in a class with 17 kids and teachers who are not certified and don't have college degrees, much less experience working with kids with cochlear implants. Not to mention that he probably won't be able to hear in a classroom with 17 kids that is not acoustically designed for kids with hearing loss. Wednesday we have a meeting with the school district, but I'm sure it won't go well. Then it will go to mediation and then a due process hearing which will be tons of fun. I just hope they end up finding a better placement for him. Even if it's not our school, he deserves something better than that.

And I remember very quickly. The reason I get involved in leadership is because I feel it to be a personal skill and, as such, a personal mandate.

My first choice universities for medical school where a very highly ranked Ivy League and OSU. When I originally did not get into the Ivy, I was disappointed and shocked. Disappointed because I felt that I had failed myself, and shocked because I genuinely felt that I had an incredible package that clearly deserved the acceptance.

In reviewing my application and my image, I presented myself as someone who wants to be involved in strategic leadership. I presented my skills in finance and entrepreneurship, my plan for why I wanted an MBA, and what I intend to do for the field of medicine. Looking back over the programs in more detail, the Ivy didn't want that. It wanted to train more academics to continue doing things the way they are being done.

I came into medicine because I think a lot of things need to change, and because I want to be at the forefront of strategies for change. This is why I invest so much into business, I think.

Blondes everywhere

2007-05-16T22:37:00.000-04:00

Sign #273 that I have been studying too long:

A side effect of antimalarials such as chloroquine is night blindness.

In my notes, I have a typo attesting that night blondness is a side effect of these drugs.

I thereafter fell asleep on the couch and had a crazy dream about an epidemic of people throughout the Northeast turning into blondes at night.

Scary.

What good has milk done for me lately?!?

2007-05-12T20:19:00.000-04:00

If you have grown up in North America (possibly other areas of the world, although I do not want to make assumptions), you probably grew up with the idea that good boys and gils drink milk. You probably learned that 2-4 glasses a day was appropriate consumption. You were likely encouraged to drink it during lunch and may have had a few cents every day to purchase them at school.

Why? Most likely for "strong bones and teeth".

This mentality was probably conditioned in you thanks to mainstream childrens books and educational commercials. If you grew up with my generation, you remember the "four food groups", and the "food pyramid", both of which inviolably insisted that you consume milk every day. If, of course, you are a good boy or girl.

Many children in their formative stages live by this adage when, in reality, vitamins from other sources as well as comprehensive nutrition provide a more productive health benefits.

Milk is noted to have a large amount of saturated fat and cholesterol. Additionally, as factory farms continue to push the envelope in agriculture by injecting cattle with hormones, there is little research on how the residual hormone content in milk affects public health.

I am not saying that milk is bad. It is a cheap and readily available source of proteins and carbohydrates as well as essential vitamins. The health benefits of milk are well researched. Studies show links between low-fat milk consumption and reduced risk of arterial hypertension, coronary heart disease, colorectal cancer, and obesity. Some of the enzymes used in dairy products have been explored further as agents for therapy of patients with inflammatory bowel diseases.

Milk is great in moderation, but multiple glasses a day are hardly necessary, and milk with fat content does more harm than good. The public is falsely informed that overzealous milk consumption is necessary to derive its benefits. Children are taught that milk and juice are "healthy" alternatives to sodas and powder-based drinks, and falsely believe that more is healthier.

The Federal Trade Commission announced that it will be ending a marketing campaign that teaches people that milk can help people lose weight. Recently, it has also eliminated its "3-A-Day" campaign. I hope that, as we advance in public health, education points people to economically accessible and easy ways to integrate more sources of vegetables and unsaturated fats and lean sources of protein into their diets.

I'm so ashamed

2007-05-12T20:11:00.000-04:00

I'm going to tell you a secret.

One about which I am sometimes reluctant to discuss, but not ashamed. It is who I am, and I can't be ashamed of who I am.

I won't be surprised if some of you decide to stop reading this blog. I won't be surprised if some of you are enraged. Some of you will be disgusted.

Some of you know already. Some of you don't. Joe, I think you suspected for a while, and I won't be surprised if you never talk to me again. But I have to be open with it.

I ... am a New York Yankees fan.

*sigh* I am very glad to get that one off of my chest.

Networking

2007-05-11T22:31:00.000-04:00

Jesus H Christ!

Apparently, my site count skyrockets when I post pictures of peeps. At this rate, I think I will have to get more of Lambchop's antics on here too.

Being that I am a business student in med school, I tend to get questions from my colleagues about business questions, primarily real estate or professional development. I suppose it comes with the territory, and I imagine I will get all sorts of medical questions when I go to business school.

One of the questions I received today is how and why to network. The "how" was easy; the "why" made me think.

She says that the reason she doesn't like to network is because it makes her feel ingenuine, as if the only reason she is meeting people is to get something from them. With good networking, this could be farther from the truth. A good networker engages people and makes friendships. There may be an intent to receive something from the relationship, but the inherent purpose of networking is to build friendships.

Think about your own friendships. You give and you receive. You don't tabulate a bill to make sure the exchange is equal, but you give in a friendship without expectation, and your giving most likely comes back to you. There are some relationships where you get more than you give. There are others where you give more than you get. But ultimately, you have engaged in meaningful relationships with other people transcending whatever exchanges hands, and the friendship itself cannot be quantified.

Networking is just a bigger group of professional friends. The downside is that you don't get to make fart jokes. The upside is that you get to count it as productive work time.

That is not to say that you network everyone under the sun. No, you can target people based on your interests. So, for example, I go to medical conferences and events but I also go to marketing and investment banking conferences. I also get involved in activities I enjoy. Next week, for example, I am going to "learn" how to play Texas Hold 'Em. I already know how to play, but maybe I'll learn a few tricks of the trade. And in the meantime, I'll probably meet twenty other people who want to play Texas Hold 'Em, and who may have other interests that I share. Today, like every Friday, I went to play racquetball with my friends. I've met other friends who play racquetball, and sometimes we jump in on a volleyball game. They all have my cell phone number and are my friends on Facebook, meaning that I am in ready contact and I know how to get in touch with them for things other than racquetball, like coming to play Texas Hold 'Em next week.

Networking is just making friends. Everyone knows how to make friends. Some people just think they are bad at it, but with a little practice and a little extrovert attitude they realize otherwise.

The number one rule of networking is that you have to be able to engage people in who you are and what you have to offer. You don't have to present yourself in detail. You just have to engage them.

So when I want to meet someone I don't say "Hello, I'm Justin. I'm a medical student, but I also am pursuing an MBA. Here, have my card." I get them in a conversation. I start with a question that provokes enough of a response to get them to talk about themselves, because people love talking about themselves. That starts the conversation. THEN I can hand over my card and I am more likely to create a connection. I'll tell them about The Great Peep War on my blog or my travels in South Africa or something like that. If you think about it, that's how you start a friendship. You meet people, you find interesting things about them, and you create a connection that can be pursued later.

If you can offer them something, even better. The part about networking I enjoy the most is being able to give. And the one thing people like more than anything else in the world is a ride from the airport. Other things include a coupon you might have to a local vendor, some contacts in a particular company or city or department, or part of your lunch if you are at a luncheon (do you like french fries? I don't eat them).

Networking is nothing more than making friends professionally. And, thanks to the laws of karma, the relationships you develop come back to you.

The Great Peep War

2007-05-10T21:33:00.000-04:00

If you think that we study in medical school ... you are sorely mistaken.

No, we engage in Peep battles. And today, I give you The Great Peep War.

Tensions had been mounting between the Chicks and the Bunnies for quite a while. This continued for weeks until the Bunnies saw it fit to take several Chicks prisoner.

The Bunnies, however, were not satisfied.

The Chicks were outraged, and so they prepared for battle.

They found in the great Chick-Chick III a great leader, duly noted by his Spartan Helmet and his noble steed, Plush Cow.

They found allies in the Lizard Kingdom

And they equipped themselves with bazookas

The Bunnies were very afraid. And so, they armed themselves for battle, too.

Preparing for the defense of their motherland, the constructed ramparts.

Also taking cues from the Greeks, they donned shields and spears.

And so, facing off along the Great Table Divide

The battle commenced

It was a hard fight, and a gruesome one. It became ugly. The Chicks even engaged in biological warfare.

Finally, the Commanders caught sight of each other, and sparred off.

Commander Chick-Chick was slain in the course of battle ...

But true to his Spartan nature, he was victorious even in death as his noble steed Plush Cow chowed down on the Bunny Commander.

And so, the Great Peep War was finished.

Druggies

2007-05-10T20:25:00.000-04:00

FINE, I suppose I should post something of substance.

Today, Purdue Pharma, maker of OxyContin, pleaded guilty to misleading the public about thr risk of addiction seen with oxycodone and will pay $634.5M in fines for these claims. The company gave false information to sales representatives, who falsely assured healthcare professionals concerned with the addictive nature of oxycodone that the drug has less potential for abuse and addiction than other painkillers.

Here is my fear: will we be seeing more of these tactics over the next few years? Pfizer has seen declines since 2000, and took a hard hit at the loss of torcetrapib, slipping to #34 of the Fortune 500. So has Merck. As are Eli-Lilly, GlaxoSmithKline, and Bristol-Myers Squibb. Furthermore, academic research has kicked their impact up several significant notches over the past decade, noted well by the licensure of emtrictabine by Emory University at $525M in 2003.

People with money generally aren't happy when they don't get to get more money.

And allegations that Pfizer tested an oral form of Trovan on children with brain infections in Nigeria do not speak well on the ethics that frame pharmaceutical companies.

Syphilis

2007-05-10T20:09:00.001-04:00

You have no idea how hard it is to study for the boards.

Especially when you are studing reproduction.

Especially when KAPLAN throws you a picture of the head of a penis with a 1cm lesion while you are sitting at Starbucks alongside a long paragraph of text for you to read.

...

I-banking looks really good right now ...

2007-05-06T17:43:00.000-04:00

Today, cellphone video clips showing the stoning of a 17-year old Yazidi girl in Iraq have circulated the Internet. Do'a Khalil Aswad was swarmed by a crowd of 2000 who stoned and kicked her to death after she had engaged in a love with a Muslim man. Her plight is that of too many Yazidi people throughout Iraq and the Caucasus, but what makes it different? People know about it because witnesses with cell phones were able to record video clips and put these on the internet.

What a dichotomy. On one hand, the incident brings light to an indefensible atrocity of human rights against the people of the Kurdish autonomous region in Iraq. Honor killing is still practiced widely. Yet, on the other hand, it requires film footage of a poor girl's tattered body and a Hollywoodesque story of forbidden love to receive the attention of the media, and only because Britney Spears isn't up to anything right now.

I wonder how many more innocent people had to die before the media finally took note and the UN finally elected to act. I also wonder if these events are bring brought forward to North America and Western Europe because of the election of new French president Nicolas Sarkozy and failure of the House to override President Bush's veto of the plan to withdraw troops from Iraq.

Do the Right Thing

2007-05-03T23:30:00.000-04:00

Over the past few months, I have been fervently deliberating what I want out of my business school education when I start it next September.

Recently at the Fuqua school of business at Duke University, a huge cheating scandal was unearthed involving 34 students, over 8% of the entire first year class. In general, I presumed that ethics were an element of all business schools in one way or another, much as humanistic medicine is an element of all medical schools in one way or another. Apparently, this is not the case. In fact, as I look over materials, I am noting that some schools emphasize business ethics whereas others mention it. And as I look back to the schools I visited, some school admissions staffmembers mentioned ethics as part of the educational experience whereas others skimmed over it.

I think I will have to look back over schools that emphasize ethics. Not because I am depending on a school to educate me on it (I do feel confident in my ethics abilities), but because I want to be part of a school that considers it important. I don't want to be one of the other 380 or so students whose grades lose credibility and whose degrees are tarnished by a legacy of students without ethical principles.

I think that, in the process of visiting schools, I have learned a lot about what I want from my career and how I want my education to contribute to that. I remember that, in December, I was gung-ho about applying to one school in particular, and pretty sure that it would be my first choice. I traveled to the city in which it was located to visit it and decided that, as long as I was in that city, I would visit another prominent institution that didn't strike my fancy that much but still appeared appealing.

The first school (the one for which I scheduled the visit) completely turned me off. The faculty members I met were jackasses, and I noted that most of their business experience, especially in the health-related program in which I am interested, was in academia. Additionally, there was little development in finance, entrepreneurship, or strategy, all dimensions of management that have prompted me to pursue an MBA and not an MHA (Masters of Health Administration, an equally appropriate degree for health management but not one that meets my needs).

The other school (the one I decided to stop by on the way) was amazing. Its students seemed like reasonable people, the faculty were warm and had experience in industry, the facilities were incredible, the career center was well-developed, and there were no undergraduates to be seen. It is equally if not more reputable to the first school and its programs in finance and entrepreneurship are both well developed.

In selecting the business school from which I will take my degree, I need to find the program that will ultimately give me the greatest educational opportunities without hindering my progress in medicine. Unfortunately, it seems that there are a lot of things to consider in finding that program.

Giving law school the finger

2007-05-03T18:25:00.000-04:00

I believe I have mentioned my old roommate, Joe, in a previous post.

Anyways, he wore the following shirt while at law school last week

Thank you, Joe, for making my spray Diet Coke all over my desk. For once, I wish I went to law school so I could wear a shirt like this, too. Or maybe that there was a med school version.

Demonstrations? Where?

2007-05-01T23:49:00.000-04:00

Last year, around this time, rallies all over the nation brought attention to immigrant rights, setting the topic as one of the key points of discussion for the 2006 election cycle.

This year, the numbers are more than halved in most areas. Last year, several hundred thousand people turned out is Los Angeles last year, and one of every three businesses was closed. This year, attendance was at 25,000. Likewise, in Chicago, attendance was estimated at 150,000, down from last year's 400,000.

Why? There are several reasons.

In Atlanta, demonstrations were not conducted, mostly because people were worried about deportation raids. Couple this with new laws in Georgia calling for more frequent legal resident checkpoints in the job application and criminal arrest processes and sanctions against employers hiring illegal immigrants and it is easy to see why people are anxious to join a rally.

Also, last year around this time, the media was a prime source of advertisement of the rallies. Last year around this time, nothing much else was going on. This year, the media has devoted coverage to the Virginia Tech crisis as well as President Bush's veto of the troop withdrawal bill.

People are on all sides of the fence (excuse the pun) regarding immigrant rights. Some would say that illegal immigrants deserve no rights. Others would say that illegal immigrants are people, too, and should be treated like people. Putting either point aside, two things are true. First, our society is now so dependent on illegal immigrants as a source of cheap labor that these people do have economic bargaining power. Second, illegal immigrants do consume public resources within the United States and, just like everyone else, should be entrusted to contribute to paying for public resources. A model for addressing immigration and particularly illegal immigration should respond to both of these points. Kicking everyone out is not a possibility. Letting everyone in and unabatedly granting citizenship is not a possibility, either.

2008 seems to be more promising. There is little doubt that immigrant rights will be a key issue in the presidential election. The hispanic community forms a large contingency of swing voters and is easily able to dictate the vote of a large swing state like Ohio. While many hispanic voters have traditionally voted Republican, the community has a prominent sense of family and may be persuaded to vote against anyone who places undue burden and injustice on immigrants and their rights.

I will be interested to hear the plans of the presidential candidates on this and on healthcare because, for these two issues, their plans will present their abilities to strategize and consider all parameters in an issue. Ultimately, I want a president with an ability to strategically address problems.

Canton

2007-04-28T23:36:00.000-04:00

Stop 4 of 7 on the Roads Scholars Tour, a tour for new and newly-tenured faculty at Ohio State to travel around Ohio and see where Ohio State has engaged in outreach.

5:00

We packed up operations and made our way to Canton. Driving through downtown Canton was an experience. Like many Midwestern cities, as Canton has experienced changes in the industries that run the city, many people and business have relocated to suburbs. Others have left Canton entirely. Canton, like many Midwestern cities, is regrouping and identifying its upcoming industries so that, eventually, they can be revitalized. There is optimism, as most Midwestern cities are experiencing slight increases after a history of decreases in population.

As for other cities, Cleveland has prospered from the advances in healthcare seen at the Cleveland Clinic and Cincinnati has benefitted from its banking and manufacturing industries and will have an IKEA built by 2008 (back in my day, a city was measured by the number of Starbucks within; nowadays, it seems that IKEA is the symbol of progress). And who knows; perhaps within ten years, Ohio will see the construction of The Ohio Hub, a train system to unite Cincinnati, Columbus, and Cleveland with each other, the Chicago hub, and the Keystone and Empire Corridors into Philadelphia and New York City.

6:30

Again, House Representative William Healy over District 52 took time out of his schedule to welcome us to Canton, a symbol of how important Ohio State is to this community. We met with several local students over dinner, some of whom are involved with the youth leadership program 4-H and others who were involved with Young Scholars. One student at my table has traveled to Japan on exchange program and looks forward to doing it again. Another student is aspiring to be a corporate lawyer and, thanks to the Young Scholars program and her excellent performance in school, can look forward to a full scholarship at Ohio State for four years. The leadership programs engage these students in active learning and leadership and prepare them well for their career endeavors.

7:30

Ohio State students came forward and offered their perspectives on campus. I had the opportunity to sit on this panel as well as to listen to other students, four undergraduates from the Columbus campus in different specialties. As a professional student, I often feel distanced from other students; the College of Medicine provides services in-house comparable to services offered to the university at large, except targeted towards us.

It was interesting to hear the perspectives of current undergraduates and compare their educational experiences to my undergraduate experience. For example, one student, when asked what he would change about the university, mentioned his experiences with the general educational classes. I, too, had to take general educational requirements at Emory and, while I was not fond of them at the time, I now appreciate the importance of the liberal arts education and feel just as confident in an art museum or a board room as I do in a clinic.

I think it was refreshing to see how the faculty wanted to know about student life and wanted to connect to students. I feel the same way; I enjoy my personal and professional relationships with my professors.

8:30

I think we were all exhausted from the day. After all, we had been on the road for thirteen hours. The experience was enlightening, but definitely exhausting. I resolved to finish some reading for class and go to bed.

10:00

After watching Let’s Make a Deal, I resolved again to do some reading. After I check my e-mail, of course.

11:00

After checking my e-mail, looking over my stock portfolio, browsing a few blogs, and completing an online crossword (Reading? What reading?), I thought I would take a little trip down to the hotel bar to see who was around. I figured someone from the trip had to be down there. Seeing no one I recognized, I figured it wouldn’t hurt to meet new people. I sat down next to a young lady who, after the conventional introductions, proceeded to tell me her life story. She is on rehab for drug use and, while she had not touched the stuff for a month, was drowning her sorrows (I scolded her). She has two children, three years old and four months old, and was trying to get out of what she considered an abusive relationship. She was petrified of the thought of going out on her own. Except for one brother, her family abused drugs as well. Her rehabilitation officer was strict but helpful. I talked to her and used some of the lessons I learned so far in medical school. I recommended she reconnect with her brother and accept his invitation to go to church, in hopes that she could find a community to talk to. I advised her to call the National Domestic Violence Hotline (1-800-799-SAFE) to put together a plan to escape the relationship and gave her their number, emphasizing that she need to protect herself and her children. I emphasized that she needs pillars of support like her brother and her rehab officer and a community such as a church or daycare group. But most importantly, I listened to her. Just talking to her and listening to her, she seemed energized and strengthened. In that short interaction, I felt like I genuinely helped someone, the reason (albeit sappy) I was drawn to medicine in the first place. I hope that she is getting the help she needs. Having done my good deed for the day, I finally went to bed, feeling justified in not having finished my reading.

The Farm

2007-04-27T23:29:00.000-04:00

Stop 3 of 7 on the Roads Scholars Tour, a tour for new and newly-tenured faculty at Ohio State to travel around Ohio and see where Ohio State has engaged in outreach.

At 2:30, we arrived at the Ohio Agricultural Research and Development Center (OARDC) in Wooster, OH. While our visits in Mansfield spoke to my medical experiences, our visits in Wooster spoke to my business interests. Dr. Steven Slack, Director, escorted us around campus and then for a driving tour of the Secrest Arboretum and ATI campus. On the way, we learned about OSU’s department of Food, Agriculture, and Environmental Services. When I first arrived at Ohio State, I was entirely confused the first time I drove on Lane Avenue and saw the farm in the center of Columbus. Apparently, that farm exists as a resource for agricultural research. They want to design methods to preserve nutrient leaching after rains.

We started in driving through the Secrest Arboretum in Wooster is gorgeous. I only wish that I could have been there in summer to see the fully-bloomed rose bushes and meander through the walking paths lacing deeper into the arboretum. Every tree had a purpose. Trees planted here are used to identify their ability to grow in Ohio’s environment. The space is open to the community for pleasure walks, for birdwatching, and even for weddings. Furthermore, people browse through trees and use this information for landscaping, commodity production, or anything else that the entrepreneurial spirit entertains.

Interesting story: Taxol (paclitaxel), an effective tool for patients with coronary stents following interventional procedures and for patients with lung and breast cancer, is synthesized from Taxus, which has been grown and harvested at the arboretum.

Interestingly, the arboretum has interested people in the community to contribute to this valuable resource for learning. Companies and people have engaged in partnerships with the arboretum; some have sponsored theme gardens, others have attended to services such paved walking routes so that people using wheelchairs can take advantage of these paths. The important idea is that people want to be involved. People approach the arboretum to see what they can do.

After returning to OARDC from the arboretum, we visited the Molecular and Cellular Imaging Center, directed by Dr. Tea Meulia, involved in genetic engineering of soybean strains best for Ohio based on properties such as disease resistance, optimal growth, and proper oil and nutrient content. She led us through her laboratory, showing us some of the imaging techniques she uses to determine cause of death for strains of soybeans throughout the state. Using this information as well as methods of DNA sequencing and analysis, her group is able to breed for strains of soybeans that are resistant to some of the viruses that have affected soybeans and reduced production. Some of her research is directed towards optimizing soybean strains for biofuel production by increasing oil content. Her group is also able to educate the public on how genetic modification works.

At 4:00, we made our way to a greenhouse. Two members of OARDC shared their research with dandelions. Yes dandelions, those things that will not stop growing in my backyard. The entrepreneurial spirit in Wooster is certainly alive. Apparently, they work with a species from Kazakhstan from which rubber can be produced that is comparable in quality to rubber produced from rubber trees in Asia. They hope to domesticate the species for growth in Ohio, optimize its breeds to increase production of rubber, and develop techniques for harvesting and extraction. I still see dandelions, but no longer as the enemy. No, these dandelions could be my car tires someday because this group sees an industry of the future.

Mansfield

2007-04-26T01:20:00.000-04:00

Stop 2 of 7 on the Roads Scholars Tour, a tour for new and newly-tenured faculty at Ohio State to travel around Ohio and see where Ohio State has engaged in outreach.

We arrived at Ohio State’s regional campus in Mansfield late Thursday morning. Ohio State consists of several campuses; the Columbus campus is the most renowned campus and to most is considered the main campus. In addition, there are four regional campuses, of which the Mansfield campus is one. We were greeted by the dean of the campus. Dr. Freeman is, perhaps, one of the most spirited people I have ever met. She spoke with a remarkable pride about her campus, about students and faculty there, and about the growth seen at the Mansfield campus. It is easy to see that Mansfield’s ship is being guided by a vivacious and insightful captain.

The theme of the experience was "small liberal arts college". A panel of leaders at the school, including the chief of student life and faculty members, spoke affectionately about their programs and the students at the institution. They beamed in talking about the great and exciting things that students do, from one student who completed her honors work at Mansfield to other students who worked in the community at various work-study sites to others who host fun events such as Halloween parties, regional campus sports events, and speed dating.

I still don’t know what speed dating is, but it sounds intense. We’ll see what Wikipedia says.

Walking around the campus, it feels like a small, private liberal arts colleges that I looked at way back when. The campus is a community and students, both traditional and non-traditional, were walking around chatting or studying in different spaces. Some live at the residence halls less than a mile from campus (I wish MY room looked like that!), others commuted. Our student tour guide spoke affectionately of her favorite professors and her program and her plan to continue her education at the Columbus campus to finish her degree. There were many students from out of state, let alone outside of the region.

I appreciate the regional campuses and their contribution to Ohio even more. We see the dichotomy of a university trying to accommodate the needs of broad groups of people. The Columbus campus has selective admission, whereas Mansfield has open admission and students can move to Columbus if they perform well. The Columbus campus is a large campus with hordes of resources, whereas Mansfield is a small campus that can provide an intimate environment for faculty and student and opportunities that the Columbus campus cannot. If students please, they can even complete their degrees at Mansfield.

One of the things I did not like about private university life was its exclusivity; it focused on rankings and elitism and forgot about the entreating call to educate those willing to learn. To see the Ohio State structure make education available to anyone who wants it and will work for it is refreshing. Any student can work hard at a regional campus and live on a modest budget by living with family and saving tuition, and then transfer to the Columbus campus or even complete one of a few degrees at the regional campus. Other programs available to students willing to learn are business seminars and programs and joint articulations to grant BSNs to students receiving a liberal arts education with Ohio State and vocational education with MedCentral at Mansfield Hospital.

Later, we spoke with a panel of leaders from the city of Mansfield. It says something when the Mayor of Mansfield AND the Chair of the Chamber of Commerce both take time out of their schedules to meet with us and to praise Ohio State for its contributions to Mansfield, both through a regional campus and through the clinic. We had another panel, this time of community members in Mansfield, to talk about the relationship of the city and the institution. Dr. Freeman and the community members were all on first name relations. Everyone told us about the contributions that this campus has made to the community. I also learned a little bit about the history of Mansfield and the goals of the community over the next several years as it grew from a recession and strengthened its small business based economy.

2007-04-24T11:35:00.000-04:00

Back to regularly-scheduled programming.

A week ago, I had the opportunity to tour Northeastern Ohio with new and newly-tenured faculty in conjunction with the Office of Outreach and Engagement and the Office of Continuing Education here at Ohio State. We made seven stops, and each one was an eye-opener.

For our first stop, we arrived at Third Street Family Health Services in Mansfield, OH on a Thursday morning and were welcomed by Dr. Anna Jose, an OSU graduate from and faculty member to the school of dentistry who has seen tremendous changes in dental education at Ohio State.

The center is certainly a great resource in the community. It sees 120 dental patients per month and is able to offer patients procedures such as routine and emergency exams, prophylaxes, sealants, operative procedures, restorations, and routine extractions, all of which improve quality of life for people in Mansfield. The medical sector of the center is just as laudable; it saw 2700 patients in 2004 and anticipates more thanks to expansion. Hopefully they see more. The center has extended from 6 to 17 patient rooms, and is now struggling to recruit the physicians necessary to use these rooms and see patients. Getting patients in is not an issue; the center accepts Medicaid patients and offers sliding scale payment for patients without Medicaid, and has met its pledge to never turn patients away. It has days when it offers opportunities for open enrollment, where patients can walk in, have a patient interview taken, and schedule an appointment for treatment within the week if not that day.

The center has also concerned itself with patient education. Mansfield’s city water is not fluorinated, accounting for the high numbers of cavities within the community. People have continually voted against adding fluorine to the water, partially out of fear and partially out of protectiveness of their health and how they perceive their health. Education is important. When I was in Japan, I met people who believed that AIDS did not spread through the country because everyone smokes and the tobacco wards off HIV. Even when I volunteered in clinics in Georgia, I met people who believe that there is a treatment for AIDS but that the government is concealing it. These mentalities do not help people understand the disease and it is our responsibility as an institution to share education in a way that people can understand. It is good to see that the center provides education to the community.

Later that morning, Dr. Jose, together with Dr. Canise Bean, director of the OHIO Project, presented on the impact of the clinic to the community and to dental education. The OHIO project is the component that unites this service to the community with education; students in the school of dentistry can come to the center to learn about community and poverty healthcare. I was appalled to see that, of 75 physicians in the Mansfield area, the physicians at this center are the only ones to freely accept Medicaid patients and to use a sliding scale for patient care. Of the 124,000 people living in Richmond County, about 38,000 either have Medicaid or are uninsured. If it were not for this center, this means that 38,000 people would have nowhere to go for health services except the hospital emergency room. I thought my student diet packed with Ramen noodles and Easy Mac was bad; for some of these people, their diet is Pepsi and cigarettes. To come into the clinic, they see the $10 fee as $10 less of food, or no eating for one whole day.

There is a clear difference between having healthcare coverage and healthcare access. Even those people in the community with healthcare coverage from Medicaid only have one center for primary care and have to drive an hour to Columbus (and lose a day of working income) for specialty care. Some people with insurance are no better off; they cannot afford their deductibles, and they cannot afford to wait for an insurance company to reimburse them weeks down the road when they live paycheck to paycheck.

Dr. Jose’s energy and concern for the people of Mansfield and for educating students who come to the clinic are truly commendable. I knew I liked her when she bashed Paris Hilton; she won me over with her descriptions of real people in Mansfield with real problems that we could help. I think it is important that Ohio State continue to meet this need and continue to train students to understand the needs of people in Ohio.

Six more stops to go.

Not so different

2007-04-21T23:58:00.000-04:00

From Destiny.

Sometimes, the rat race doesn't seem so different.

I get so caught up in what I "need" to do and what my dreams are that I forget to enjoy what I have now.

At the same time, I could interpret this video to say that a difficult dream is worth it, and the kiwi's tears are tears of joy and not tears of sadness.

It is interesting to see the two drastically different interpretations of what is important in life conveyed by this clip. YouTube's Mona Lisa, in a way.

What do you think?

Speaking

2007-04-21T23:35:00.000-04:00

Campaign school has been intense. We have had all sorts of training exercises on every major activity related to a campaign, from giving speeches and producing press releases to compiling a campaign staff and fundraising. The project has been a rush.

Tonight, we gave speeches. We were given three hours to prepare a speech for a targeted audience in which we were to speak as a surrogate for our opponent who could not attend and focus our discussion on small business economics. I consider myself a reasonable speaker, but none of us had nearly enough prep time to do the assignment well, which is a reality for campaigns at times.

The exercise was a good opportunity to see myself speaking. We were videotaped and watched the videotapes together. I learned the following about myself:

I look like a JACKASS when I am speaking. I don't smile, my body language is not open, and my voice is condescending.
My glasses reflect too much light and I need contacts.
I really don't project enough, and I speak too fast.
I lean on my left knee a lot (which explains why it hurts on occasion).
I look constipated at times.
I had some nosehairs I should have trimmed.
My goatee is way too bushy right now.

However, I also learned the following:

I clean up in a suit.
Red is my color.
I am creative with my message.
In public speaking, I do convey authority and reasoning.
My arguments are logical and clear, but simply need better articulation.
I know how to read audiences.

It was quite a wake-up call. I am tempted to do it again a couple times. I did my speech in front of a mirror after than and managed to clean up a little bit.

How to sell a house

2007-04-18T14:31:00.000-04:00

As I mentioned earlier, I am in Washington DC at the moment at a program called Campaign School. This program is operated by the political action committee of the American Medical Association and is designed to train physicians and friends of healthcare on how to operate a political campaign. It has been fun so far. I jumped in not knowing a thing about running a campaign and spent today learning procedure for operations and strategy development.

I find it remarkable how much running a campaign is like managing real estate. In real estate, just as in a campaign, one has to be proactive in advertising the product and able to make a sale. There really is intense strategy involved, from complex issues such as identifying an appropriate sale price based on parameters of the home and the location to deciding whether to paint a wall in order to increase home value. Elections are the same, in that every detail matters and one's successes are found in paying attention to and manipulating the details.

Today, I offer the top ten "trinkets" of advice for selling a home. These are quick things to do, not part of a master plan for preparing to sell a home. There are more effective total strategies, but these quick changes should translate to an increased sales price.

1) Clean the place up. Your home should look well-maintained inside and out. Don't be bashful about moving around furniture or painting a few walls to make your home look like it should be in a magazine. Houses are like designer products - the ARE designer products.

2) Get rid of as much clutter as humanly possible, either relinquishing it outright or packing it away. If you can afford and you can't relinquish your clutter, rent a space to store your clutter in; the $50/mo investment is worth the extra $5000 in sale price. Take a few boxes to your neighbor's house or your office. If you must, put it in nicely packaged boxes (NB: it does not have to be neatly packaged within the boxes, only appearing neatly packaged) and stow it away in an attic or basement or other space meant for observation. Every space within your house should look neat, tidy, and uncluttered.

3) Clean your closets. People look in closets. Messy closets look smaller.

4) Paint the door yellow. Not bright yellow; cream or deep ivory work well. I don't remember where I heard this, but it works. While you have the paint out, consider painting a few rooms white or off-white.

5) Replace all burnt-out lightbulbs and repair any random squeaks or creaks around the house.

6) Consider your curb. Make sure that it looks tailored, neat, and uncluttered. Replace the numbers if necessary, and spend an afternoon pulling weeds and trimming hedges to get things right. Make sure to water and mow your grass regularly, preferably in the early morning or late evening, so that it looks bright green. No flamingoes or elves, please. A potted plant or two in front can go a long way.

7) Have an open house. This is not only for prospectives but for neighbors and friends who may know other people in the market. This also puts you on the spotlight for most real estate agencies and brokers. Offer nice-smelling foods, including some savories (cookies, veggies, cheese, hummus = good. Garlicky foods, shrimp, pate = bad) and arrange them on your kitchenware and not the plastic Kroger container they came in (and there is NOTHING wrong with that). Make sure the bathrooms smell excruciatingly clean and that there is something baking in the oven, even if it is cinnamon and water. There is debate on whether or not to have pictures of you and your family around the house; I think that a few are fine, but it may be an appropriate time to take down the collage of Billy's artwork since he was two.

8) Don't be afraid to negotiate with buyers, especially if a realtor is handling your negotiations. Know the value of homes in the area and how your home compares to others.

9) Buyers like bling. If your home has any interesting features such as a pool, attachment to a golf club, a large garage, or a gargantuan entry or great room, be sure to accentuate these features in all of your advertisements. It sends the message that your home is unique and not to be missed.

10) Many a great deal is lost between the bid and closing. Once you have a deal that you like, be sure to close as soon as possible. Better yet, if you are working with realtors, the bid process is a little more firm. Know whether or not you intend to include closing costs and what-not in closing the deal on the home.

2007-04-18T12:01:00.000-04:00

I've been bad. I can't believe it has been a month since my last post!

If you visit my blog (as opposed to using a feed), you may have noted a countdown in the upper left corner. This is the countdown to when I take the boards, except the date is not firm. I decided to do a delayed start to my next school year, so that I can work with a Phase I-IV research firm in Toronto for two months.

Today, I am in Washington, DC, at the Ritz-Carlton. Why, you ask? For a conference. Over the next five days, I will be learning how to run a political campaign. I am excited about the prospect.

Being at the Ritz-Carlton highlights exactly why it is the premier name in service. To compare it to a typical Hilton hotel:

1) Aesthetics within the entry are impeccable
2) Everyone greets the guests by name, carries bags, etc.
3) The room indicates an immaculate attention to detail, featuring appropriate elements of design and comfort and screaming luxury from the bathrobes to the 32" flat screen TV to the lion's head printed glassware.
4) Many of the services with extra hidden fees at three-star hotels are free at the Ritz-Carlton
5) It even smells nice.

Hospitality may be a dying art, but the Ritz-Carlton has preserved it well.

----------------

Last Thursday and Friday, I had the opportunity to tour Northeastern Ohio with new and newly-tenured faculty in conjunction with the Office of Outreach and Engagement and the Office of Continuing Education here at Ohio State. We made seven stops, and each one was an eye-opener. So over the next few days, I will either post about the conference I am at right now or that tour.

----------------

I can't believe it's been a month! There are so many things that I haven't posted about in that time:

- The American College of Cardiology's findings regarding long term survival with invasive procedures such as stent placement
- Alberto Gonzales
- Displays in Ukraine and Moscow
- The Supreme Court's ruling on the EPA's responsibility to regulate emission of greenhouse gases
- Nancy Pelosi's ventures into Syria
- Zimbabwe. Just ... Zimbabwe
- Ahmadinejad's capture of the British sailors
- Sinking of the Sea Diamond
- Elections for Governor of Tokyo
- Don Imus
- Kurt Vonnegut's departure

Thank you for all of the nice comments; I plan to reply to everyone and visit your blogs over the next few days.

It's heating up

2007-03-21T22:28:00.000-04:00

The weather has been heating up lately, meaning the beginning of spring. And I am enjoying every minute of it!

Last year, I learned how to throw a football. I had a very deprived childhood as far as the social skill set goes; before third grade, we lived in an apartment complex in Detroit while my dad completed his fellowship and, as such, weren't allowed out of sight very often. There was one girl in the entire building even remotely close to my age. We did, however, go to a montessori school, where I think I acquired my interest in inquisitive learning. Unfortunately, throwing a football was not part of the curriculum.

So whenever I get the chance, I have tried to recruit people in the library to go outside and throw around the football. And it feels like the college days (even though I couldn't throw a football then). It is nice to be out in the sun and have fun. I enjoy it.

I doubt, however, that I will enjoy it once allergy season kicks into high gear. We'll see what happens.

Pink Ribbon

2007-03-20T19:03:00.000-04:00

Today, we had a few cancer survivors come to speak for PCM, our class on humanistic medicine. I typically tend to avoid these lectures becuase they are usually filled with the same information found in our readings for the class but only presented in a more confusing fashion; I find it easier to learn from the readings. However, because today's seemed to be more interesting, I decided to go. One of the panelists is a breast cancer survivor and talked about her experience with the physicians and mentioned Herceptin. When I heard that name, part of me shuddered.

Herceptin is a monoclonal antibody that is used for the treatment of advanced metastatic breast cancers. Our blood systems have a special barrier to restrict material flow from the capillary system supplying the brain to the brain tissue itself. This barrier can act as a double-edged sword, not permitting some drugs to act on brain tissue. Herceptin is one of the few drugs that can cross this barrier. It is administered once a week to once every three weeks intravenously for up to 90 minutes.

Herceptin also costs $70,000 a year. Medicare and private insurance companies do cover the costs of the drug, but 1/6 of all Americans are currently uninsured, including females who are susceptible to breast cancer. In Canada, the Ontario Ministry of Health only in July 2005 offered to start paying for treatments with Herceptin and two other newer controversial anti-cancer drugs. Controversy arises every other year in both the UK and New Zealand over the public health decision to pay for treatment with this drug in both countries. Australia started making the drug available in October 2006; before then, women would sell everything to receive therapy with the drug.

At the same time, research costs money. LOTS of money, considering the expense of new technologies, private investigators, and management. Unfortunately, that money can't be magically pulled out of the air; it has to be forked over by someone. The price tag is incredibly steep for public health to pay. For the most part, Medicare and insurance pay these high prices, but the few who don't have these avenues are bent over. And strangely, whenever reporters have questioned Genentech over the price of the drug, Genentech has refused to give details to explain the costs.

Although there has been substantial education on the importance of onducting breasts exams, few females do it and even fewer do it properly, in most cases because they have not been taught what they are supposed to feel for and, so, give up. Many women also elect to not have mammographies performed, recognizing the discomfort and awkwardness of the procedure (with good reason; I can't imagine having any part of my body clamped between two cold plates, let alone a body part as sensitive as the breast), but not realizing that the breast self-examination is not sensitive enough to be a diagnostic tool on its own. Furthermore, thanks to the consistent decline in Medicare and private insurance funding of primary care physicians, physicians often have to choose between doing an accelerated physical exam or closing down shop entirely. Primary care physicians are too strained to be able to conduct proper breast examinations and patient education. OB/GYN's, thanks to ridiculous malpractice insurance rates, are dwindling in number.

For these reasons, it is not uncommon to hear the horror story of a woman who has to sell her house and ends up losing her husband in order to pay for cancer therapy. Many of these women end up resigning, considering themselves a burden to their families; it is a horrifying experience to see the look of defeat in their faces. It would be nice if, someday, screenings and affordable therapies were enough to make these horror stories a thing of the past.

There is a new drug on the map. Tykerb (Lapatinib) is a treatment for solid tumors such as breast and lung cancer and is effective on a class of the cancers currently treated with Herceptin. It is different in that it can be administered orally and is about half the price. So there is hope, but the light is far away.

Travel bug

2007-03-20T01:33:00.000-04:00

I've been bitten by the travel bug again. Many of you know that I am a sucker for it. I'm thinking desperately of a way to get to Montreal this weekend, where my cousin is celebrating his birthday. I'd like to return to Prague or to South Africa, and I am also having a craving for Moscow. I have been looking at my pictures from Tokyo, and fawning over last minute packages to Acapulco and Placencia. However, there is one destinatin that keeps making me drool, lately every day.

India.

All of a sudden, I feel this sudden urge to see what I consider to be the motherland in many senses. In a way, I feel a connection to the country, and yet I have not seen it since I was maybe ten. Then, I was young. I had no idea what India was, or what it meant to be there. All I knew was that we weren't allowed to drink tap water, I had diarrhea for several days, it was hot and sticky, and everyone spoke in a language I did not understand. My cousins' family recently visited for a few weeks; they had the opportunity to see everything.

There is one thing I remember about India:

It is very interesting; of the famous monuments built throughout the world, this is one of the few that was not constructed for economic motives. In the center of a dusty city, the Taj Mahal stands, arguably, as a testament to love and passion, two spirits that India certainly embodies. Shah Jahan had the mausoleum constructed for his wife, sparing no cost. Other myths vouch that he had the constructors of the mausoleum either killed or deprived of their hands, so that they could never again create anything so beautiful. Other myths display the audacity of British lords as they attempt to take economic gain at the expense of the mausoleum, either by selling its marble or chipping away its encrusted stones, but with no success.

Today, the Taj Mahal represents many things to India. I find it interesting that, even though it is an Islamic-stylized mausoleum, Hindus and Muslims alike recognize the Taj Mahal as a national treasure and symbol of India. Both flock to the grounds every year to see the national treasure.

I Robot

2007-03-14T20:43:00.000-04:00

There is a Wendy's in the basement of the hospital, a few hundred feet away from the building in which I study on campus. To get there, one can either walk outside on a beautiful day like today or take the tunnels on a day that is not so beautiful.

Around January of last year, I took the tunnels to Wendy's for the first time. It was all well and good until I got to the pathway that connects the basement of the hospital to Tunnel #1. In this hallway, there is what I will call a robot that traverses the hallway regularly.

The first time I traveled down the hallway, I turned my head about halfway down to see the robot entering the hallway from a side tunnel. Then, it started beeping at me. I don't know why, but I ran for my life, all the way down Tunnel #1 and halfway past the library. I peek back into tunneil #1 to see that the robot was not following me.

Since then, I have had several encounters with the robot, which I have aptly named Uncle Jesse, because its voice sounds sort of like Uncle Jesse from Full House. Don't get me wrong, Uncle Jesse still scares the bejeezus out of me (both of them). However, at least I'm on friendly terms with the robot version.

I have learned all sorts of things about Uncle Jesse. For one, he carries linens between two rooms. Sometimes dirty, sometimes clean. Second, he is able to sense if I climb on top of him and try to get a ride. Finally, Incle Jesse doesn't scare the crap out of other people ... only me.

I'll let you know if I learn anything else.

Devil, just take me now

2007-03-12T10:39:00.000-04:00

I'm sure you've caught on to my schedule of blogging:

1) Blog consistently for a week or two
2) Test gets closer; I start slacking
3) Test gets even closer; no more blogging until test is over

And this cycle is no different!

Board review has been a lot of fun; it feels like finding old friends again. Yesterday, I reviewed the anatomy of all structures in the heart, and this week I have been reviewing cardiology pathophysiology. Tomorrow, I'll be returning to the anatomy lab to find a few heart specimen and review structures.

I've come to the conclusion that will be nothing short of a miracle if I make it through April. In fact, I think April will probably be more intense than the month before I take my first board examination. On top of it being the last month of material to learn, all of our peripheral curricula culminate in tests or final events. On top of that, I am heading to Atlanta for a day, DC for five, and I have to wedge LA in there somewhere. I was originally thinking that I would have to squeeze in a trip to New York City, but I ended up pulling that into March.

It is nice, however, to look forward to a two week hiatus I will have for the second half of June, with no work whatsoever. This will really be the only true break I will have had since the start of medical school; even with other holidays, there is always a test or a project or something looming. Included in this is a conference in Chicago and a vacation to Toronto. There may be a safari outside of Johannesburg involved, too. It's true that it would probably be a good idea to review some things based on my first rotation (which I think will be surgery), but I think it is in my best interests to enjoy the two weeks off.

Avocado

2007-02-22T20:36:00.000-05:00

All I want is one good avocado. Is this REALLY so much to ask?

Oh, wait; I'm in Ohio.

Let me describe my adventures in avocado-land:

Avocados 1-5: picked these up at Kroger's on sale.

#1: Way too mushy and brown. Taste was OK
#2: Tasted like nothingness. Decent texture, still way too mushy.
#3: A little firmer, odd veining. Taste was alright, still not buttery enough. Somewhat like soy cheese.
#4: Didn't even taste it. It smelled like sewage when I cut it open.
#5: Rock hard; I picked it intending to let it ripen longer, but after #4 I was feeling the avocado pangs. I have found better avocados in gas stations.

Avocados 6-8: picked these up at Giant Eagle, known for having (slightly) better produce.

#6: Not bad. Still, not an awesome avocado, had a little more taste, and a little more color.
#7: A stowaway from Kroger. I think I could have just squeezed this one out.
#8. Dark, good texture but quite bitter.

Avocados 9-11: drove to Whole Foods in Dublin, OH (northwestern suburb of Columbus where the people with the Hummers live). Not a complete blow, though, because I did pick up some excellent starfruit there.

#9: Better than Giant Eagle #6. Nice coloring, texture, and taste. Getting there.
#10: Similar to #9, and best in show. I had half of this avocado alongside the starfruit with a little bit of lox and sour cream dressing, delicious. Still, this was not the avocado of my dreams.
#11: Similar taste to #9 and #10, weird texture and smell. Became guacamole. Better off reincarnated.

So now, I am sitting here, avocado-less. Next weekend, I am going home to Cincinnati, where we have a farmer's market (largest in the nation) called Jungle Jim's (if you can't find it here, it doesn't exist). If they can't satisfy my avocado fantasies, I'm screwed.

What do I want in an avocado?

Appearance: Pale yellow-green, more yellow than green. The color should be smooth, with the exception of a green rim around the meat. There should be no unsightly dark blemishes around the seed until seed removal.

Texture: The avocado meat should cut well and retain its shape when cubed or sliced. It should have a buttery texture, with a little bit of resilience. It should not be fibrous at all, and should not mush easily.

Taste: Like fragrant butter, with the poignancy of a fresh vegetable. It should have the distintive floral background that typefies an avocado, brought out by a dusting of salt.

The nice thing about South Africa was the produce. It was everywhere. Vendors would walk from car to car at each toll booth and sell lychees and mangoes and sugarcane for coins. They were the best anywhere, too. One vendor had a chain of coconuts, freshly hewed. I miss walking produce.

Citigroup

2007-02-19T01:47:00.000-05:00

Hey I know, let's toss a Western bank into the most isolated, conservative banking environment in the world and see what happens.

Citigroup has announced that they plan to seek approval to have their shares exchanged on the Tokyo Stock Exchange. Interestingly enough, though, Citigroup already appeals to Japanese investors, who are sick of the isolationism in Japanese investing. In a country with a buyers market, foreign investors also want to tap into a solid investment in Japan's financial future.

Citigroup has had some problems in Japan, after its association with a scandal at Nikko Cordial Corp. Japanese investors don't like the smell of scandal. It is presumed that they will take their 0.001% APY CD over anything even hinting at scandal. I think this presumption is flawed. I think that Japanese investors will continue to support Citigroup's growth.

It would be interesting to see if this prompts any discussion of an NYSE-TSE merger, which would be a fantastic way to counter the growth of the European markets.

God help them if they offer free checking.

IKEA

2007-02-18T22:25:00.000-05:00

Cincinnati is getting an IKEA!

WHOO HOO!

The sucky part: Spring 2008 is what the website says ... just in time for my move to a big city like Chicago or New York. However, that will likely not deter me from picking up a bookshelf or a coffee table while in Cincinnati for our apartment ... or end tables ... or a futon ... or an armoire ... or an entertainment console ... WHEEEE!!!

Prada + phone

2007-02-18T02:31:00.000-05:00

You can probably tell from my past postings how excited I am about the iPhone (i.e. not very). It's a nice phone on first display, but there are so many quirks about it that I don't like, such as:

Incompatibility with Microsoft Outlook for Windows despite the calendar features. This could be a deal breaker. I live off of Microsoft Outlook for my calendar and contacts.

Inability to purchase media directly from iTunes. Not a problem, I suppose, since I don't actually buy media off of iTunes.

No expansion slots (as is Apple's style). Because, you know, it's not like I actually NEED extra space or portability.

Battery life stinks.

No stylus ... okay, I don't mind this part, but apparently, one must touch the screen WITH BARE SKIN to use the phone. Does this mean no screen protectors either?!? Because I don't intend to cover the interface of a $600 investment with oily finger residue. And Apple-quality plastic is born to be scratched.

Requisite two year Cingular contract. Sorry. I am far too content with my Cincinnati Bell service and freedom from a contract to convert to Cingular. But this is still not as bad as my personal favorite ...

Non-removable Battery accompanied by Non-removable SIM Card. So not only can I not take out and replace the battery while away from a charger, but I can't replace my Cincinnati Bell SIM card with a pay-as-you-go SIM card while in another country.

Steve Jobs has this fetish with making Apple customers do things his way. What is especially frustrating is that the iPhone already has people across the country drooling, especially people who vehemently oppose the use of iPods. The iPhone is a revolutionary product, and Steve Jobs gets to decide how it will define it's place in the universe.

Or does he?

Back in the day, I mentioned the idea of Prada endorsing a phone. It appears that Miuccia Prada is not a crazy old bat and has, indeed, decided to do this. Featuring the LG KE850:

That is correct; you are looking at a product with the same touch-screen functionality as the iPhone, but branded by Prada, and free from all of the strings that Apple has wound around their products. The product has a sleek finish and the interface is Prada-designed, described as "modern-classic". Differences are that it does not have WiFi accelerometer or proximity sensors, or a significant internal storage. However, it does have a microSD expansion port (why not SD?) and freer interconnectivity with Windows programs. Additionally, its movie player is compatible with a broader range of media than the iPhone (putting videos onto my iPod is like pulling teeth from a pregnant mare).

At €600 (~$777 right now), it is comparable to the iPhone, considering that there is no bound contract. And that is WITH the Prada name. On sale later this month in Western Europe and in Asia by March.

Part of me is hoping that Apple had a collective heart attack over the news of this device. It was intending to clean up in both of these markets. But who can say no to Prada?

The tragic flaw in this play? The LG Prada is a tri-band phone ... the fourth band out being one necessary for communications along US networks. The iPhone is quad-band. PLEASE for the LOVE of GOD make this device quad-band, LG! I will gladly profess my undying devotion if you would grant me this one wish. I'm still waiting on a final answer to compatibility with my network ... the second I find out that it is possible, there will be an LG Prada en route to my apartment complex from London.

The best way to feel better

2007-02-17T00:04:00.000-05:00

I forgot to mention what got me out of the "I hate Step 1" rut.

Every year, the first year medical students work on cadavers as part of their anatomy experience. Tying this into their understanding of the importance of respect for patients and of the gift of a human body towards their educations, they prepare a memorial service for the family and friends of the people who donated their bodies to science. As part of the fundraising for this, the class of 2010 decided to sell "singing-grams", entailing an impromptu embarrasing love song for the selected person for only five dollars.

I volunteered to help.

This turned into me singing "Love me Tender" to Dr. Fertel, our main professor of pharmacology.

Yeah ... that wasn't awkward AT ALL! No, actually I had fun with it, and I think Dr. Fertel did too; I can think of other professors who would make me feel awkward about it, but Dr. Fertel has a sense of humor about these things. It is a good thing that he has a sense of humor.

Lobby Day

2007-02-16T19:04:00.000-05:00

My schedule was true: this week was my full-on boards breakdown. However, it was mostly because I was sick. I think it is a step-up from the flu. On Wednesday, I could barely stand up. Thursday was better; I managed to get through some school work, and today I am still sick but able to get through a normal day of work. I had to, unfortunately, push back some tests a few days, but such is life.

However, that was not my attitude two days ago. On Wednesday, I had all of these horror plots going through my mind of how this sickness would be the end of me and how I would be relegated to practicing palliative healthcare.

Other than that, I don't have much of anything to say. I was in Washington DC last weekend for the AMA-MSS Lobby Day, which was a rush. I also got to cruise around town with Alexa's mom and sister and see a lot of the sights of DC including Arlington Cemetery, where we watched the Changing of the Guard. A post on that some other time; I'm going back to working this flu off.

Public Service Announcement

2007-02-07T00:01:00.000-05:00

I felt it necessary to let all of you know something:

I'm bringing sexy back.

Sincerely,
Justin (the better one)

Step 1

2007-02-05T18:15:00.000-05:00

A little while back, I prepared a calendar for studying for the boards. Today marks the first day of my preparation for taking Step 1 of my board certification. If you visit my blog (as opposed to using feeds), you will have noticed that I have a countdown in the upper left corner representing my countdown to my test date, June 2nd. In reality, I have 90 work days available to me. The first 65 of those days are partial work days (5 days, 22 hours a week), and the last 25 are full work days (14 hours a day, 5 days a week).

If you are not in medical school, you will likely not find any of the following interesting.

My plan is very similar to one established by KAPLAN. For 4 hours a day, I will study the following:

Biochemistry: 11 days
Anatomy: 13 days
Physiology: 11 days
Microbiology/Infectious Diseases: 7 days
Immunology: 3 days
Behavioral Sciences: 7 days
Pathology: 11 days
Pharmacology: 11 days
Final Review: 9 days
Day of Rest: 1 day

On top of this, for each day I will be reviewing five different drugs, seven different pathological diseases, and four different microbiological organisms by means of flashcard systems designed for review of each subject. The "Microbiology" and "Pharmacology" sections listed above are really for review of the science as a whole, and I will likely cut down on the number of Pharmacology days.

Goal: A score that will still make me competitive for dermatology

Currently, I am still working on curriculum work, which should end for me on April 25th-30th. I do about 8 hours a day of work on my main curriculum. As the boards draw closer, this leaves 10 hours per day for board review, most of which will be spent drilling practice questions, but some of which will be spent looking at clinical scenarios.

The breakdown above is ideal; it lets me take two days per week off, which I will be using for personal things. This includes items such as conferences I have to attend, business school visits, and simply having normal weekends.

Wish me luck! I'll be needing lots of it.

They went there

2007-01-27T22:13:00.000-05:00

And I thought I Love New York was bad:

http://columbus.craigslist.org/stp/269451815.html

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Looking for a teenage black girl to beat up my racist son - mw4w

Date: 2007-01-27, 9:09PM EST

Some how or the other my 16 year old son has turned into quite the little racist. He constantly belittles black people and has no problem dropping the N-word at almost any moment. I attempted to manage his actions with long talks, exposure to black people/culture and then punishment, none of which have worked. Now I'm going to have to resort to embarrassing him in front of his friends.

I need a black teenaged girl to come over to my home around 6pm on Feb. 3rd. I'm giving my son a birthday party and all of his friends will be there. All you have to do is come over and drag him outside and work him over a bit. No permanent damage is expected just maybe a black eye or two. My son has braces so to prevent damage to your hands you can bring brass knuckles if you wish.

Free cake and ice cream will be provided.

-----------------------------------------

Well, hell ... I would be game for free cake and ice cream.

Snot?

2007-01-27T21:40:00.000-05:00

Everyone has been saying that, apparently, I will have a great epiphany when I figure out what specialty of medicine I want to enter. I will be going primarily into management, but I have heard across the board that, to be effective in healthcare management, I do need clinical experience and should consider a residency. For my purposes, the long residencies (e.g. cardiothoracic surgery) are out the window; 5 years would be ideal, which covers most programs. However, I haven't really found an aspect of healthcare besides business that entices me. There are fields I enjoy; I like internal medicine because of it's broad spectrum, dermatology because of its lucrative lifestyle and the fact that I might possibly have a chance at it, and radiology because of its appeal to my technical background from my physics major and research. I can pick specialties that I do not like, and specialties I could see myself doing, but nothing incredible.

That has changed. I think Pediatrics might be my "epiphany specialty". I like the culture, I like working with kids (which is the biggest obstacle for most), and I prefer clinic work. I also feel like Pediatrics would be something that could accomodate my real interests in healthcare management and still let me pursue my hobby work in private investment and real estate.

The one thing I have to get over, though, is that it isn't a glamorous specialty like Derm or Radiology. I think that I simply have to realize that a glamorous specialty is not what I want. I think I put Derm on a pedestal; It is pretty much just as monotonous as Pediatrics, except more lucrative. Part of me just doesn't want to think about commitment. I feel like I should have a tangible response whenever I get the question "What sort of medicine do you want to practice?" I like focusing on my first step of board certification because then I get to ignore the fact that I should be thinking about specialties.

And ultimately, I know that my heart is not in practicing medicine. I knew that from the day I submitted my application to medical school, as this was part of my plan to enter healthcare management. My heart is in medicine, but I need to go where it takes me. There is still a lot of important work to be done in the administration of healthcare to the general public ... a LOT of work. I'll do whatever it takes to get me there, but I'd like to think that it might be possible to enjoy the journey there.

2007-01-24T04:40:00.000-05:00

I should finally get to the good part about South Africa.

As I mentioned, the country is in a state of transition. South Africa has traditionally been a country of disparity. On one hand, the major cities are home to the wealth; on the other hand, the countryside is inundated with the poor. South Africa is only now seeing the development of a middle class, in which there will be a sustainable future. There have been significant reforms in education and in public services, and with these come hope for a better future.

For this reason, real estate in the country is incredibly lucrative. Areas along the coast that were once considered townships or poor farming communities are now being tapped as sites for luxury communities. South Africa is establishing itself as a major tourist spot for Europeans and Middle-Easterners during the winter for the North, which would be summer in South Africa. Cape Town has continued to flourish, and crime rates in Johannesburg have significantly decreased as unrest in the city has relatively stabilized and job opportunities have opened up.

I am considering a few communities on the Eastern coast of South Africa north of Durban, in what is traditionally considered the Zulu territories. A regional airport is opening up about 100 km north of Durban, which should facilitate tourism to the area. Buildings in this area are gorgeous, and going for throwaway prices. While real estate is approaching its saturation threshold, niche markets such as these and the housing explosion in Moscow still prove to be lucrative ventures for investment.

These coastal communities should bring in a significant amount of revenue for the country, money much needed for the area. South Africa is certainly faring better than it was fifteen years ago, and in many ways has exceeded progress in developed countries, but still has a lot of progress to make. Hopefully, such progress will spur regional economic progress and bring develop to other countries in southern Africa. Not that I have anything against celebrities adopting African children, mind you; I think they will agree with me that the best way to bring relief to the area is to empower southern Africa to develop its middle class and strenghten itself within the global economy.

Yeah ... it is days like today when I wonder why I didn't just go into investment banking instead of medical school.

VH1 never fails to amuse me

2007-01-23T20:04:00.000-05:00

I mentioned that I anticipate seeing a guest star soon on I Love New York. VH1 does not fail to amuse. For the episode last night, the contestants were told that, to win New York's love, they have to have a plan for success so that she can maintain her high society lifestyle. For that reason, they were given two hours to compile a master business plan and present it in a board room before New York, her mother, and a guest star. As you might anticipate, the guest star was someone involved in the business world, and with a personality similar to New York (i.e. bitch). That star was ...

Omarosa.

Yeah, um ... I think the world let out one humongous "OHHHHHHH SHIIIIIIIIIIIT!" when that bit of information was broadcast over VH1. It would be interesting to see if more television sets were broken in that moment by flying remotes than were broken within the initial week of launch of the Nintendo Wii.

I don't think I can handle this level of drama. While I live for trashy TV and horrible pop music, this is just too much for my feeble mind to handle.

So how did they do? Let's just say one of the contestants had a nervous breakdown and voluntarily left the show.

Oh, and for the record, Omarosa was born in Ohio. Youngstown, Ohio. WHY do all of the *best* celebrities have to come from Ohio?!?

My typical thought process while studying

2007-01-21T02:28:00.000-05:00

In A.D. 2007
Renal module was beginning.
Captain: What happen?
Mechanic: Somebody set up us the Henderson-Hasselbalch equation.
Operator: We get signal.
Captain: What!!
Operator: Main screen turn on.
Captain: It's you!!
Cats: How are you gentlemen!!
Cats: All your acid-base disturbances are belong to us.
Cats: You are on the way to renal failure.
Captain: What you say!!
Cats: You have no chance to survive make your time.
Cats: Ha ha ha ha...
Operator: Captain!!
Captain: Take off every 'Salicylate'!!
Captain: You know what you doing.
Captain: Move 'Salicylate'.
Captain: For great justice.

Personal victory

2007-01-20T23:47:00.000-05:00

As many of you know, I am a huge fan of the television show Flavor of Love and its recent spinoff I Love New York. One of my favorite characters on the show is Goldie (Courtney Jackson), who was a contestant for the first season and a commentator for the second season. I find her charming for the same reasons I like Aishwarya Rai and Natalie Portman: she is good at what she does, and doesn't compromise her morals in the process.

Most of my colleagues think I'm crazy for enjoying this show. With good reason.

Anyways, my former colleague Kris, who is now pursuing a career in acting in LA, bumped into her twice now. They have talked about medical school, and Kris mentioned me to her. So the personal victory is that Goldie knows I exist.

:O)

Things I know about Goldie:

1) Her name is Courtney Jackson.
2) She lives in Los Angeles.
3) She wants to go to medical school.
4) She is not considering Ohio State because of the Ohio weather.

Naturally, this means that I have to go to UCLA/Andersen School of Business for my MBA.

Billboard Top 100.

2007-01-20T01:49:00.000-05:00

And so, Billboard puts out ther Top 100 for 2006. Here are my reviews: My favorites are bolded. What are your favorites?

01. Daniel Powter - Bad Day
I think he got it for the same reason that U2 has Apple's contract ... everyone like it. Maybe not the best, but everyone likes this song, and anyone can enjoy it.

02. Sean Paul - Temperature
Sean Paul continues to lead the way in reggaeton entering the US (keep in mind that Billboard is marketed towards the US market). I still think that ever Sean Paul song sounds the same to every other song.

03. Nelly Furtado Feat Timbaland - Promiscuous
The first time I heard this song, I thought it was Fergie. I was so proud that Fergie could create something semi-decent. Then I realized it was Nelly Furtado. Nelly Furtado has gone so far down. SO SO SO far down.

04. James Blunt - You're Beautiful
I thought this song was older than 2006, but I was wrong. Similar to "Bad Day" but not as happy and upbeat.

05. Shakira Feat Wyclef Jean - Hips Don't Lie
I am utterly shocked that this one isn't #1. I thought EVERYONE loves this song, even if they won't admit it. At least, you have to admit that it is the source of the best Internet music video of 2006.

06. Natasha Bedingfield - Unwritten
I didn't really think there was much special about this song. Nice pop beat. That's it.

07. Gnarls Barkley - Crazy
There are few songs and artists which mark transitions in popular music taste. This song is one of them. That's gotta be worth something.

08. Chamillionaire Feat Krayzie Bone - Ridin'
Every time I hear this song, I think of Ene for some reason. And no, it has nothing to do with "white and nerdy", which is the only reason this song became popular enough for Top 10 of 100.

09. Justin Timberlake - Sexyback
He's Justin Timberlake. Enough said. I wish I could have seen his face when he heard that the rest of N'Sync wanted to make a comeback with him.

10. Beyonce Feat Slim Thug - Check On It
Beyonce never makes any sense to me.

11. Mary J. Blige - Be Without You
I also have no idea why this song is so popular.

12. Nelly Feat Paul Wall, Ali & Gipp - Grillz
This song inspired me to consider buying a grill. For two seconds. Then I sobered up. It was fun, however, cruising down The Strip in Las Vegas in a topless 2007 Ford Mustang with this song on full blast, though.

13. The Fray - Over My Head [Cable Car]
I have this ridiculous urge to sing along to this song when it is on the radio. NB: I am horrible at singing low tenor.

14. Cassie - Me & U
I'm surprised this song didn't end up in more remixes. It would be really cool with a deep bass beat in the back.

15. Pussycat Dolls Feat Snoop Dogg - Buttons
Baby can't you seee / How these clothes are fitting on meee sounds weird. However, any song that mentions frottage automatically gets cool points.

16. Chris Brown - Run It!
Sounds like a reject version of SexyBack. I'm too lazy to go on Wikipedia and figure out which came first.

17. Ne Yo - So Sick
Contrary to popular belief, I like this song. It helps me relax.

18. Yung Joc - It's Goin' Down
I think I would hear this song WAYYYY too often if I were still in Atlanta.

19. Rihanna - Sos [Rescue Me]
This song also helps me relax. Like cocaine helps me relax. WTF is with this song? Seriously, I have ADD and there's way too much stuff going on in it even for me!

20. Panic! At The Disco - I Write Sins Not Tragedies
I guess every year needs a token emo song.

21. The All American Rejects - Move Along
I think this is a good song for a movie soundtrack. Perhaps American Pie 5 or whichever one they are up to.

22. Fergie - London Bridge
The entire city of London should be insulted by this song. What on God's green earth does a bridge have to do with this girl's sexual arousal? Was she trying to coin a term more elusive than "milkshake"? Because if so, Fergie has succeeded with flying colors!

23. Red Hot Chili Peppers - Dani California
EVERY DAMN ONE OF THEIR SONGS is about this girl! It's getting old. With that said, I will continue to listen to them.

24. Lil Jon Feat E40 & Sean Paul Of The Youngbloodz - Snap Yo Fingers
I think Lil Jon was shoved in a blender with Ludacris and the product was this. I am not convinced that Sean Paul is even part of this.

25. Dem Franchize Boyz Feat Lil Peanut & Charlay - Lean Wit It, Rock Wit It
Oh great. I've deduced that all one needs for a popular hip hop song is to think up a nonsensical phrase (e.g. "riding dirty", "lean wit it, rock wit it", or "aw naw, hell naw, boy, y'all'n' up and done it"), add a drum beat, and go with it.

26. Rascal Flatts - What Hurts The Most
Thank GOD the top country song isn't by Kid Rock. With all due respect to Mr. Rock, it's time to leave the music industry and go play with Pamela.

27. The Fray - How To Save A Life
Again, this song seems to be announcing a transition in popular taste in music. I don't know what I think of that transition, but I have respect for songs that can do that.

28. Rihanna - Unfaithful
First two-time appearance on the Billboard (excepting Sean Paul, but again, I'm not convinced that he actually is in 'snap your fingers'). THIS is the song that Nelly Furtado should have been singing. In fact, I thought it WAS Nelly Furtado until I decided to go buy it.

29. Snow Patrol - Chasing Cars
Another song I am notorious for singing while in the car.

30. Hinder - Lips Of An Angel
Sounds like a bad Aerosmith song to me.

31. Cascada - Everytime We Touch
For the token techno song, this one doesn't meet expectations. Although, it does seem to have House echoes.

32. Christina Aguilera - Ain't No Other Man
I'm glad she didn't get the memo Britney Spears got, stating that she was supposed to sluttify, marry an all-american reject, and get preggers. Because, you know, she's actually talented.

33. Fall Out Boy - Dance Dance
Why couldn't God (the hand puppet, not the deity) eat Fall Out Boy instead of my flip-flops?

34. Kanye West Feat Jamie Foxx - Gold Digger
I still jump whenever I hear the intro to this song on the radio. It's just ... scary. Like a bad Prince impersonation.

35. Ludacris Feat Pharrell - Money Maker
I like how Ludacris's songs show off his inferiority/Napoleon complex. If you have ever seen him perform live, you know that he is actually pretty short.

36. Bubba Sparks Feat Ying Yang Twins - Ms. New Booty
I have a general distaste for songs that have police sirens, because they always freak me out when I am driving. However, it should be noted that this song came out, and then Deelishis entered the scene on Flavor of Love. This is a great year for The Booty (tm).

37. Sean Paul Feat Keyshia Cole - [When You Gonna] Give It Up
This song has been in all of the clubs in Toronto. It works well.

38. Nickelback - Photograph
Song #3 to which I compulsively sing along. Although, I perform well with Nickelback, mostly because my singing voice is most attuned to their lead singer.

39. Kelly Clarkson - Because Of You
I don't care with the rest of you people say, I am a HUGE Kelly Clarkson fan and, like all of her songs, think this one was amazing.

40. Pussycat Dolls - Stickwitu
This is a new direction for the Pussycat Dolls. I think they should turn around and continue with previously scheduled programming.

41. T Pain Feat Mike Jones - I'm N Luv [Wit A Stripper]
Ha! Well, at least he's honest.

42. Black Eyed Peas - My Humps
WHOO HOO! It's ALL about the lady lumps and the humps. I have generally been disappointed in the gradual decline of the Black Eyed Peas, but the mentioning of the humps was nothing less of awesome.

43. Fort Minor Feat Holly Brook & Jonah Matranga - Where'd You Go
If I still lived with Joe, he would likely play this song at least once a day. In fact, I bet he does even though I don't live with him.

44. Chris Brown - Yo [Excuse Me Miss]
Nothing about this song stood out to me.

45. Kelly Clarkson - Walk Away
Okay, Kelly; you're starting to sound more and more like XTina. I don't like this.

46. D4L - Laffy Taffy
Exactly what IS one's "Laffy Taffy"? As an aside, I still crack up when reading the jokes on a Laffy Taffy wrapper.

47. T.I. - What You Know
I always have to pee when I hear this song. I don't know why.

48. The All American Rejects - Dirty Little Secret
I wish they would just go back to being skater punk wannabes. Because at least then, their music was reserved to a very minor enclave that (thankfully) didn't include me.

49. Nickelback - Savin' Me
OK, now they're getting old. I think they are on their last legs. Every Nickelback song sounds the same.

50. Mariah Carey - Don't Forget About Us
This was a pretty weak year for Mariah. Isn't she supposed to be the next Madonna, singing until she's 50 and then adopting a random kid from an African orphanage or something like that? Eh, Marial will probably just buy an extension to her closet so that she can store more shoes.

51. Ne Yo - Sexy Love
Blarrgh. I think Ne Yo should have stuck to being a one-hit wonder with "So Sick".

52. E40 Feat T Pain & Kandi Girl - U And Dat
Who are these people? I have never heard of them before. Needless to say, the song sucks.

53. Nickelback - Far Away
I take back what I said about Nickelback. This song is a hint different.

54. Nick Lachey - What's Left Of Me
Dear Nick. No one cares about you. The only reason you are famous is because you married Jessica Simpson and millions of preteen girls wanted to stare at your manboobs. Please to be going home and leaving the music industry alone. No one cares about whatever is left of you.

55. Field Mob Feat Ciara - So What
This song needs more techno remixes. It did a lot better in the clubs than I thought it would.

56. Cherish Feat Sean Paul Of The Youngbloodz - Do It To It
Do WHAT?

57. KT Tunstall - Black Horse & The Cherry Tree
I liked this song the first few times. It was okay the next few times. I could deal with it the next few times. I got sick of it when I had to listen to it at least twelve times a day this summer. I think I would appreciate it more if the radio didn't overplay it, as it did that first Linkin park song that put them on the charts.

58. Juelz Santana - There It Go [The Whistle Song]
The whistle reminds me of my friend Alan from work the summer before I graduated, mostly because he had this habit of whistling like that. I think the whistle is probably the only redeeming factor of this song.

59. Young Dro Feat T.I. - Shoulder Lean
Too many songs about leaning. Leaning is overrated.

60. Jamie Foxx Feat Ludacris - Unpredictable
I like thos song. Mostly because Ludacris isn't being Ludacris.

61. Justin Timberlake Feat T.I. - My Love
Classic Justin Timberlake. I like it.

62. Eminem Feat Nate Dogg - Shake That
Eminem is losing it. Oh and Kris, if you really want to know, the sound that Eminem makes that is supposed to replicate screaming is an "AAAUUUUUGGGGGGHHH".

63. Chingy Feat Tyrese - Pullin' Me Back
Great. I wish whoever is pulling Chingy back develops arthritis.

64. Kelis Feat Too $hort - Bossy
The ONLY part I ever hear of this song is the ticking drum beat in the background. I have this uncanny ability to tone out the rest of it.

65. Jibbs - Chain Hang Low
Another great song to blast on my speakers while cruising down the highway. It also inspired me to invest in a "bling".

66. Akon Feat Eminem - Smack That
Again, weak performance by Eminem.

67. Ray J - One Wish
I've heard this term several times ... exactly what is a "boo"?

68. Fall Out Boy - Sugar We're Goin Down
Again, I prefer to pretend that Fall Out Boy doesn't exist.

69. Chris Brown Feat Lil' Wayne - Gimme That
Catchy. I like it.

70. Yung Joc Feat Brandy 'Ms. B.' Hambrick - I Know You See It
This is the only song of the entire 100 that I haven't heard until now. I wish it would have stayed that way.

71. Bon Jovi - Who Says You Can't Go Home
Not a bad comeback for Bon Jovi. Not good, but not bad. I hope it was a one-time deal and isn't his way of trying to pull a Madonna.

72. JoJo - Too Little Too Late
Again, how old is she?!? She was thirteen for "Get Out". Is this supposed to be a sequel?

73. Busta Rhymes - Touch It
Now THIS is a good song. Forget Cascada. It has echoes of Outkast early on. It should be higher, IMHO.

74. Daddy Yankee - Rompe
Again, too much going on, even for me and my ADD. I kind of want to go to Tijuana and find a carnival.

75. Beyonce Feat Jay Z - Deja Vu
These two just go well together. They need to stop performing and just start making little Beyonce/Jay Z babies.

76. Rascal Flatts - Life Is A Highway
I thought this was a country song at first. I thought it was exceedingly progressive for new country. Go them. Then I found out it was just a bad attempt at an emo song.

77. Evanescence - Call Me When You're Sober
Evanescence is Evanescence. There are few artists who really create their own identity in the world of music. Evanescence is one of them. It is almost like reparations to the world for Madonna's big, bright idea to create "pop".

78. Carrie Underwood - Jesus Takes The Wheel
She has a pretty voice.

79. Danity Kane - Show Stopper
Meh. Just ... meh.

80. Ciara Feat Chamillionaire - Get Up
Again, I am somewhat shocked that this one isn't up higher. Another great song defining 2006.

81. Sean Paul - We Be Burning
Sean Paul being ... Sean Paul. Not that there's anything wrong with that.

82. Blue October - Hate Me
If you say so. But at least the song is catchy.

83. Lifehouse - You & Me
Song #4 that I sing along to. Their lead singer reminds me of John Mayer. Except good.

84. Pussycat Dolls Feat Will.I.Am - Beep
Another classic club song. I'm surprised I like it as much as I do.

85. Dem Franchise Boyz Feat Jermaine Dupri, Da Brat & Bow Wow - Oh I Think They Like Me
The fact that this song made the list represents the general paucity of quality music in 2006.

86. Chris Brown - Say Goodbye
This song reminds me of the R Kelly series. Bad decision on his part. That reminds me, whatever happened to the R Kelly series?

87. John Mayer - Waiting On The World To Change
What's that song "We are all sensitive people"? That's what this song reminds me of.

88. Young Jeezy Feat Akon - Soul Survivor
Big Load Of Crap

89. Black Eyed Peas - Pump It
Regardless of their criticisms, I am a Black Eyed peas fan. I appreciate the risks that they take in their music. This song has B-52s intonations, which really set it apart.

90. Eminem - When I'm Gone
There you go, Eminem! This is what you do well. This song is a callback to classic Eminem.

91. Madonna - Hung Up
What sort of year would this be without a token Madonna song?

92. Three 6 Mafia - Stay Fly
Three 6 Mafia also sets themselves apart from the rest of the mainstream. In a way, I'm happy they are down here because I don't think most of the public can appreciate the quality of their work.

93. Keyshia Cole - Love
This has to be the most unoriginal song I have ever heard.

94. Ne Yo - When You're Mad
One-hit wonder. Please just go back to being a one-hit wonder

95. T.I. - Why You Wanna
Not as risky as Black Eyed Peas, but there's potential.

96. P!Nk - Stupid Girls
I never noticed the exclamation mark "I". Is that supposed to be like the Prince symbol? That's a really piss-poor way to steal Pink's name and identity. especially when you sound nothing like the real Pink.

97. Gorillaz - Feel Good Inc.
Again, I wish this song was higher. It is like Wisconsin's football team: extremely under-ranked.

98. T Pain - I'm Sprung
Heh heh ... he said "sprung".

99. Taylor Hicks - Do I Make You Proud
I typically have a good idea of why a song is popular, but I can't figure it out for this one. I'm guessing it's only here because it just barely made the cut.

100. Teddy Geiger - For You I Will [Confidence]
I wish this song had been more popular. I think it has good elements. Maybe he'll have some more songs next year.

2007-01-08T09:03:00.000-05:00

I am a bit worried that people are viewing my analysis of South Africa as hypercritical, mostly my fault because my Cardiology test started bearing down on me before I could start writing the good stuff. So for presenting the negative without enough positive, I apologize.

Firstly, view my analysis of perspective on race here; to summarize, I think South Africans have superceded the maturity of perspective on race of Americans in the short time since Apartheid. Pertinent to that post would be the point that several people have made: South Africa has legalized same sex marriages.

Secondly, YES, the country was absolutely gorgeous, and the people's energy was vibrant! I can't wait to show you my pictures and tell you about the people in the church that my grandmother attends. They are amazing people and a resource for the community.

Don't get me wrong however, I have no intention to sugarcoat. There are a lot of problems with South Africa, just as there are lots of problems with the United States and India and Japan and Congo-Kinshaha and every other nation on this planet, and there is no justice in hiding the problems.

Public Service

2007-01-03T04:14:00.000-05:00

I wrote this post on the 24th.

I thought American police forces were corrupt … and then I came to South Africa. Most buildings in South Africa are framed with shatter-proof glass and metal bars. This is to keep criminals out. Because he only has a one-car garage and we rented a car to accommodate everyone for trips, my uncle currently parks his car at the hospital parking garage every nights and walks home (about five city blocks) instead of parking his car on the driveway, because he knows that the wheels will not be there if he does otherwise.

Police officers have traditionally been either Indian or White, and have been accustomed to being able to display brutality. Also, unlike in the US where the police force is considered part of the executive branch of government, in South Africa, it is considered part of the military. As such, it acts militantly in its affairs. The police force can also take on the responsibilities of other government officials such as wardens, court clerks, and civil prosecutors. Operations reflect attitudes from Apartheid, during which the population was managed through fear and a Big Brother level of regulation, some of which still exists in the mind of South African police officers.

How does a country repair such a corrupt system? Every possibility I think of ends in stalemate.

Similarly, education in South Africa is only now being reformed. Just today, the matriculation announcements were made for about 500,000 students in the state I am in
(KwaZulu-Natal), which is a developing state. 65% of students passed, a decline from the 70% of students last year, but progress for a state in which, five years ago, 23% of the population over age 20 had received no institutional education whatsoever and less than 5% noted having any form of higher education. Hopefully the decline is simply a blip on the radar,

It should be noted that to call South Africa a developed nation is not a fair statement. There is still significant disparity between communities within the nation. In major cities (Johannesburg, Cape Town, Durban), developed is an accurate term. However, drive an hour out, and the community is now impoverished farmland. There is virtually no middle-class in South Africa. There is little moderately-developed area in between.

This is to say that South Africa has a lot of growth to do, and a lot of potential. Now that Apartheid has been overturned, I think we will be seeing a formation of a middle class in South Africa. Right now, the rich are very rich and the poor are very poor. As the formation of a middle class occurs, we will also see the development of South African economics. More on that tomorrow, but as a tease, let's just say that I'm considering real estate in the country.

Claudine's Third Post

2007-01-03T04:12:00.000-05:00

Another post from Claudine while I was in South Africa, also sent 12/26. Tell her you love her, because she's great!

I have 2 more nights of work after tonight. Tomorrow I have the day off so I'm going to go to the movies (my sister wants to see Dreamgirls) and I want to head down to the national portrait gallery to see the Josephine Baker enhibit. When I came home in early November and stopped at the NPG, they were just setting up the exhibit. I'm not sure when I'll be back in DC so I'm gonna check it out while I'm in town. In case you missed it, I'm obsessed with all things French, so expatriate Josephine Baker qualifies. :)

I'll report back on the movie and the exhibit. Another exhibit that I plan to go see is the Nan Kempner exhibit at the Met Costume Institute in New York. Nan Kempner was a socialite who amassed a HUGE collection (over 3000 pieces) of couture. The Met also has an Americans in Paris exhibit that I'm dying to see. It's going to be a busy winter and spring for me (school-wise) but I will have to schedule in time to see these exhibits.

Race in South Africa

2007-01-01T05:39:00.000-05:00

I should have mentioned that the reason I can post now is because I have returned from South Africa. The trip was wonderful. I can’t wait to post some pictures (some postcards, some of mine).

This post is not only part of my South Africa series which you can look forward to reading, but is dedicated to my dear friend Kasia, who just recently became engaged (congratulations, Kasia!). She assures me that her fiancé is neither a Slightly Feminine J-Pop Star nor a Deranged Psychotic Anime Villain, reminding me that these are qualities of a man desired by our other friend, Judy … I am obligated to worry about these things.

Anyways, back in the day, Kasia told me about her disgust of the American usage of the word Caucasian, which hardly reflects most White Americans. Kasia was born in Poland and considers herself to be Polish or Polish-American, not Caucasian. Caucasian more accurately refers to people of the Caucusus region between the Black Sea and the Caspian Sea, extending through Georgia, Armenia, Azerbaijan, Iran, and in surrounding enclaves.

In a similar way, people in South Africa run the gamut from being amused to being disgusted at the use of the term “African American” to describe Black American culture. White South Africans are even more revolted if one tries to imply that they are Caucasian or European, because they identify themselves as being distinctly African. Instead, the terms “Black” and “White” are preferred. The Indian community here also considers itself African; however, it still retains cultural ties with India; Indian is an acceptable racial term, but to ask where in India an Indian person was born is considered rude, as most Indian people have lived in Africa for several generations. The White community does not retain cultural ties to the Netherlands, and as such does not consider itself European-African.

America is making a similar transition. No longer is “African American” a correct term, as people realize that the cultural construct that America defines as “Black” encompasses Caribbean and Polynesian enclaves as well. However, America has not made the progress in maturation of racial identity in 142 years that South Africa has made in twelve. For starters, interracial marriages are much more liberally accepted in South Africa than they are in the United States. People of Muslim descent do not have to live in fear of the government. Indian people who have lived in South Africa for several generations are not made to feel like foreigners, and yet people of Chinese origin in the United States are still assumed to be recent immigrants. In some ways, we are restricted to living in a world where race defines our existence. In other ways, we confine ourselves to this means of existence.

2006-12-31T18:59:00.000-05:00

Post #2 from Claudine. I found this one in my inbox, dated 12/26.

It's definitely nice to be back in the hospital. It's good to catch up with people I haven't seen in a year. Unfortunately I arrived a day too late for the annual Christmas party. I was hoping to make it this year since I've missed every Christmas party since I've worked here (either because I was working or studying for a test). From the pictures it looks like it was fun times.

It's also nice to be back because sometimes being a student, you forget what the end result of all the studying will be. You sometimes feel detached from the actual practice of medicine. What's funny to me is that now I understand the pathology of the diseases that patients have. I'm able to ask more thoughtful questions about what's going on with the patients.

It's incredibly sad to be in the ICU around this time of year. Lots of patients hooked up to various machines. Some with failing kidneys that need dialysis or lungs that need the assistance of a vent. Everyone is hooked up to a monitor (the bare minimum if you are in the ICU). Some patients will never make it home. What makes it worse is that it's Christmas, a time when you're supposed to be thankful and feel full of love.

On another note, tonight a nurse got stuck with an EEG needle that just stuck an HIV patient. We were just about to chang his sheets when I saw it peeking out from the bandages wrapped around his head. I asked her why that was sticking out like that and told her to be careful. Of course, she got stuck--not just grazed with the needle. She was bleeding. What's worse is the patient was also bleeding so it looks like it stuck him and then her. I was freaking out for her and telling her to go to the ER, clean her finger with alcohol, SOMETHING! She continued to finish changing the bed linen. I was like, if it stuck him and then stuck you, you need to take care of that. She just said, "should I file an incident report?" Maybe she was in shock. Maybe she didn't want to face the gravity of the situation. I don't know. But I was freaking out. Anyway, I said a quick prayer for her. If she reports it (I don't know why I get the feeling she might not?) she will probably have to take the HIV drugs for prophylaxis. That will suck.

Anti-PPP: Delta Eats Poo

2006-12-31T16:22:00.000-05:00

NB: This post was written on 12/21/06; however, I only now have internet access and can post it.

Finally, I am in Durban, South Africa. It is fantastic to be somewhere that feels like home. I haven't jumped on the PayPerPost wagon, but I want to provide an anti-post anyways: NEVER FLY WITH DELTA! With their customer service and lack of efficiency, it is no wonder that they had to declare initial stages of bankruptcy.

Here is the chain of events:

12/20, 10:00a: Left for the Cincinnati/N. KY airport (trivia: Cincinnati's airport isn't in Cincinnati. Hell, it isn't even in Ohio. It is across the river in Kentucky)
12/20, 10:30a: Tried returning a call from the EVP/CEO of the AMA. While I am on the phone with his secretary, my brother is being an obnoxious pain in the rear and I elbow him in the chest. He's cranky for the rest of the time in the airport.
12/20, 1:48p: Flew out of Cincinnati to Atlanta. Painless, really.
12/20, 3:00p: My parents have this ridiculous idea that our plane is leaving and we need to run to make it to the gate (Terminal A to Terminal E, you Atlanta folk), even though the Delta website and the monitors all say 4:40. We get to the gate. The flight is, indeed, leaving at 4:40.
12/20, 5:10p: It ends up leaving 1/2 hr late (welcome to Atlanta)
12/20, 6:00p: The reading lights stop operating for the center row on the plane. There goes all of the flashcards I intended to do. Bugger.
12/21, 6:00a UTC (1:00a EST): We land in Dakar, Senegal for the refueling. Horrible landing job #1. It is supposed to take only 1/2 hr. The security check takes 1 hour, and they have to replace some dumb hydraulics pump which takes another four hours. You want to know why Dakar was such a waste of my time? It is a sister city of Ann Arbor. BOO on them.
12/21, 11:00p UTC (6:00a EST): We leave Dakar. I am stuck between my brother and some other big guy, both of whom have an aroma. Not pleasant.
12/21, 12:00p UTC (7:00a EST): The hosts announce that they are required to spray down the cabin with some insecticide in keeping with South African policies for flights coming from Dakar. The stuff smells awful.
12/21, 9:30p SAST (2:30p EST): We land in Johannesburg, four hours late. Horrible landing job #2. We dawdle for another 1/2 hour in taxi and get off of the plane, knowing that most of our connecting flights have already left. Even two hours would not have been a problem, as flights commute between Johannesburg and Durban every 15-30 minutes.
12/21, 11:30p SAST (4:30p EST): We finally have our bags and make it through customs. That part only took 45 minutes. The other 45 was spent waiting on Delta to rebook all of our flights (only one person at the counter) and to get our hotel for the night. Our instructions from "Ryan" are to report to the Swissport ticket counter in International Departures the following morning.
12/22, 12:30a SAST (5:30p EST): Finally, we are settled in the hotel. A restless night ensues. Waking up at 4:30a SAST to make it to the airport on time doesn't help.
12/22, 5:45a SAST (10:45p EST): We are at the Swissport counter with a handful of other travelers from our flight. "Ryan" is nowhere to be seen.
12/22, 6:30a SAST (11:30p EST): Frantic, we head over to the South African Airways terminal in Domestic; this is the airline that had our connecting flight from last night. Our plan is to just buy tickets (thank you, plastic), get to Durban, and contact Delta later to get our money back. South African Airways apparently noticed the delay last night and took the liberty to rebook our flights for 6:00a that morning, but were easily able to rebook us for 8:00a SAST, giving us plenty of time to check our bags and board.
12/22, 8:30a SAST (1:30a EST): We get breakfast. On a one-hour flight. The food is far better than any of the sludge Delta tried to force-feed us.
12/22, 9:00a SAST (2:00a EST): We land in Durban, get our bags and our rental car, meet my uncle and grandmother, and drive to their home for a week of fun.

Total time: 40 hours.

Time I spent studying: 20 minutes.

Time I spent watching episodes of The Sopranos on my iPod: 12 hours.

Talking to the other people on the flight, this isn't unusual for Delta. Most of them typically fly South African Airways, then opted for this flight because it was cheaper ($2100 instead of $2400). My parents are the same, and will probably never fly Delta again. South African Airways provides each passenger with more leg room, a personal LCD screen, better and more food, and free cocktails. Most importantly, the reading lights work and the flights always land on time. All of which seem to be worth the extra $300. In addition, in business class (Delta has nothing between first class and economy), one's seat can fold down to a flat bed-like surface for sleeping. Delta, on the other hand, was very good at saying "We're sorry for the inconvenience. We're not going to do shit for you. We hope you choose Delta the next time you travel."

The part that disturbs me the most was the reading light bit. My mother doesn't ask for much in life. She had her books and was looking forward to reading them. She doesn't care for DVD players or iPods or fancy toys or anything else. She is one of the sweetest people you will ever meet, and all she wanted was to read in peace. Delta couldn't even give her that. They wouldn't even let us get off the plane in Dakar to buy a reading lamp for her from a gift shop. They wouldn't accept money to go buy one for her. She just sat in the dark, slept some, and watched the movies with little interest. All over something as simple as the reading light.

NEVER AGAIN!

Claudine first guest post

2006-12-22T01:24:00.000-05:00

As promised a post by a guest blogger. If you have been reading for a while or know my colleague Kris, you have no doubt heard of the Great and Powerful CLAUDINE. Here she is; enjoy!

So, Justin asked me to write an entry or two for his blog. I warned him beforehand that this might turn into some artsy, entertainment, celebrity gossip type blog. :)

I guess I should introduce myself. I’m Claudine. I’m a second year medical student at OSU, which is how I know Justin. I’m very much into artistic things (which makes it hard to concentrate on school sometimes!) but I also enjoy medical science. I’m pretty confident that I won’t just be a doctor. There are too many other things I want to do in my lifetime. And while medicine will be a huge part of my life, it will by no means be the only part. Let’s see, I love tennis, football and soccer. I love reading the biographies and autobiographies. Oh, and I love movies. My DVD player stopped working and I broke out into a cold sweat before I remembered that I still have my laptop. I’m very serious abut my movies. Audrey Hepburn is one of my favorite actresses. I love French and am trying to learn it in my “spare time.” (As if medical students have spare time!) I love going to museums and hearing lectures about art. I’d love to go back to school to get a degree in art history when I’m older. Finally, traveling is very important to me. Even though I don’t like to fly, I’ll gladly do it to see the world.

That’s all I have for now. I’ll be back to regale you with my adventures in the intensive care unit. I’m working as a critical care tech at GWU Hospital over Christmas break.

Raw Food

2006-12-21T22:02:00.000-05:00

I have been reading about different types of diets, and I found one that looks pretty cool. Raw food-ism.

Apparently, you don't eat anything heated to more than 102°F, and all of the foods you do eat are preferably organic. This preserves the natural enzymes and bacterias found in foods.

However, one is allowed to use a dehydrator to prepare foods, as well as a juicer, blender, or food processor. Apparently, the brief use of steam to warm a soup is also okay, and, one can also freeze and reheat food to break down cellular fiber. In such ways, one is able to recreate replicas of common foods.

The best part, however, is that it permits RAW MEAT! and RAW EGGS! I am thrilled! This means I can eat all of the steak tartare I want. Dried meats are permissible, too - hooray, beef jerky (dehydrated, not smoked). I also get to live off of sashimi, and it looks like ceviche is also permissible. Losing fine sources of protein is the main reason I have stayed away from vegetarianism and veganism. I confess, I do enjoy tearing apart the body parts of primitive creatures with my teeth.

I will, however, have to either make some exceptions or forego some things. It appears that this diet would not permit coffee or tea. However, I can drink all the alcohol and soda I want, so long as there was no heating involved in either process.

I have been thinking up other things I can substitute. I can prepare rice dishes, I just use alfalfa instead of cooked rice, or I soak rice and beans overnight. I was reading on a website about how one can slice a turnip paper-thin and use it as pasta, either to make ravioli or a raw lasagna. When I get back from holiday, I am going to try out this diet for a week. The first recipe I want to try is this turnip ravioli, filled with olives, coconut, and feta cheese. I may also make a ceviche.

Dreidel

2006-12-20T09:49:00.000-05:00

As most of you know, my old roommate Joe is a Joo. What some of you may not know is that I, too, am a Joo.

Not Jew. Joo. There's a difference.

Anyways, I played dreidel this week for the first time ever.

The dreidel is a blunted top with four sides. Players sit in a circle, each with a number of tokens, commonly chocolate coins. The pot starts with an ante of one coin from each person. Each person takes a turn spinning the dreidel, and the side that faces up once the dreidel is finished moving determines the action that the player takes:

Nun (backwards "C"): You get nothing. That's right, nothing.
Gimel (looks like a well-endowed hunchback): Take everything in the pot, you selfish cad. Everyone else puts one more in the pot.
Hei (dude on all fours): Take half of what is in the pot. Grabby, yet tasteful. I think it's rather ingenious.
Shin (looks like a "Y" that has fallen but can't get up): Put a coin in the pot. Seriously, you have problems if you lose at dreidel.

Apparently, you get to sing this song, too:

I have a little dreidel. I made it out of clay.
When it's dry and ready, with dreidel I shall play.
Oh dreidel, dreidel, dreidel, I made you out of clay.
Oh dreidel, dreidel, dreidel, with dreidel I shall play.

I wish Christianity had authorized gambling games as part of the holidays.

Person of the Year

2006-12-19T00:34:00.000-05:00

I'd like to thank all of the little people for making this possible. It is an honor to be Time Magazine's Person of the Year.

On the other hand, it is true that the perfusion of Internet use has been a defining trend for 2006. Consider this: American Apparel, a newer clothing store which is anticipated to be comparable to names such as Abercrombie and Fitch and American Eagle sold for $385M. I would quote stats for those two companies, but they have seen consistent decline in value since 2000. MySpace, created by two college students in 2003, had a net value of $327M at sale. Facebook received a bid of $900M in September, with rumors of offers from Google of up to $2.3bn.

Time Magazine professes that the Person of the Year should be someone that made an indelible mark on history and defines that year, be it in a good or bad way. As such, men such as Hitler, Stalin, and Khomeini have been declared Person of the Year; few would contest that they most influenced events in the year of their declaration. Mahatma Gandhi, Martin Luther King, and F. W. DeKlerk have also made the list. It is surprising that Saddam Hussein has not made the list. He would have been a great candidate for 2005 or 2006.

Time is no stranger to going for the jugular, either. Don't forget the Whistleblowers (Cynthia Cooper of WorldCom and Sherron Watkins of Enron), Endangered Earth, and The Generation Twenty-Five and Under.

In that case, why not Zuckerberg, owner of Facebook; or Eric Schmidt, CEO of Google? These are the leaders of the surging revolution in modes of communication and interfacing. It is a bit hard to think that we as bloggers changed history. We took a resources and ran with it; we have those who created the resource, who engineer blogging servers and make it easy for us to post our messages, to attribute the plume of internet communication.

My delay on posts

2006-12-18T23:42:00.000-05:00

And so, it happens again. This time, my excuse for not posting is a cardiology test tomorrow. I feel okay, but still a little inadequate. I'm sure I'll pass, but I don't know if I'll ace it. However, the alternative is taking it after I return from South Africa, which is not an option I like.

In order to avoid these lapses, I have decided to take on some guest bloggers. I have invited a few other medical students to post items of their interest, and I hope you find their commentary intriguing.

Now for the actual post: iced tea.

I have a penchant for acquiring new hobbies as exams come close. This time it has been making iced tea. I brew a strong tea and serve over ice, sometimes with lemon, and other times with milk and sugar.

I started with trying to get a good black tea. Lipton provided a decent tea for everyday consumption. I also tried a few other large names (Bigelow's English Breakfast, Tazo's Awake). I enjoy a full-leaf tea produced in Arizona called Revolution Tea. In fact, I believe I have raved about them in one of my earlier posts. Anyways, they serve a fantastic English Breakfast that makes for an even better iced tea. Because it is a full leaf tea in a bag with enough breathing space, the tea leaves release their natural oils into the water, giving the tea a full-bodied flavor and background that is hard to emulate otherwise.

Revolution Tea's other teas that I have had on hand served me well, too. They offer a Black Citron tea that brings out the taste of lemon, and an excellent Dragonwell-based Oolong tea which adds a smoky flavor to the naturally delicate taste of green teas and supplements with a little bit of fruit in the pouch. Both served up well on ice. I tried their Southern Mint tea, which I normally enjoy hot, but which was a blow on ice.

From there, I switched over to masala chai. I don't even know the name of the brand, but I know it is the brand of tea that my mother keeps in the cupboard and that I was fortunate enough to find sitting out at Ohio State's business school's waiting room when I visited. You know the tea is good when the nutritional information is written in Hindi and Gujarati as well as English. The tea was better iced, but I think I am going to try it with cream instead of milk next time.

There is one inherent problem with drinking tea while studying ... the continual peeing. They need to fix that part.

Just read this one

2006-12-10T12:52:00.000-05:00

This is what it can be like to be on the NICU.

There are definitely days when it stinks to be a doctor.

Taking care of the weakest

2006-12-09T14:03:00.000-05:00

And so, physician payment cuts to Medicare have been averted.

This is a victory for healthcare, as physicians can continue to care for Medicare patients. Most primary care physicians would have been forced between keeping the lights on in their private practices and accepting new Medicare patients. Estimates presented 5% - 20% estimated decreases in most physician budgets.

At the same time, this victory is a temporary and not a permanent fix. Unsustainable pay-for-performance funding models and Medicare's flawed sustainable growth rate formula continue to unseat physicians from being able to care for patients. The fact that our complement industries are either exempt from antitrust or maintain a monopoly on the US market does not help.

Ultimately, it is of concern that the financing of healthcare is a for-profit venture in the United States, which is both good and bad. Good because such private venture creates a ridiculous influx of money into research and product design, which would likely not occur if two of the top ten companies of the Fortune 500 were not pharmaceutical companies. Bad because people throughout the nation are consistently bilked for their life savings as their lives are ruined thanks to rising healthcare costs.

The process of repairing healthcare in the United States is not an optimistic venture either. Healthcare costs money, and everyone believes that it is someone else's responsibility to pay. For this reason, there is general disagreement among proponents of models for healthcare in the future of the United States and change is slow. Add to this the general stagnancy of changes in the public sector as well as the general conservative nature of the healthcare industry, and one can see why changes are slow to occur.

I think we will be seeing some drastic changes to the structuring of primary care within the next ten years.

Wardrobe Malfunctions Gone Wild

2006-12-08T00:32:00.000-05:00

Last night was the Victoria's Secret Fashion Show. That show gets crazier every year. The clothing gets skimpier and more out there. For this show, one of the girls came out in some sort of chain mail curtain. For another,

The show also featured Justin Timberlake performing his hit single "SexyBack". No innuendo there. Really. Interestingly, it was his first prime-time network TV performance since his infamous Super Bowl blunder. What? No wardrobe malfunctions this time?

I think the girls (or, should I say, the "angels") appeared a lot younger than usual. I'm not sure what the choice was there. I hope that CBS won't have to flash the models' IDs to prove to the world that they hired girls over 18. Besides, making young teenage girls strip down to their skivvies on national television is TATU's territory. The girls also looked a lit more anorexic than usual. I have no idea what was up with that; it was rather disgusting in a Mary-Kate-Olsen-meets-Nicole-Ritchie sort of way.

At least Heidi Klum showed up. I was about to give up hope. So was Lambchop.

The show appears to be getting old, though. Apparently, only 6.8M people tuned in, the lowest in its history. This is less than the number that tuned in to watch a "Law and Order: SVU" rerun in the same time slot. Compare to the 9M last year, or the 12M in 2001. The Washington Post claims it is because they let the models talk. Apparently, CBS does not realize that Barbara Walters and Katie Couric get the privilege of talking. Not over-starved Victoria's Secret models. Their job is to catwalk and be pretty. No talking. Talking=bad.

As you may know, Victoria's Secret is part of the Limited Brands label. If you are not an Ohioan, you may not know that the CEO of Limited Brands, Les Wexner, is a prominent Columbus businessman and a trustee to Ohio State. Wexner is also an acclaimed philantrophist; he and his wife, Abigail, are known for donating exhorbitant sums of money to all sorts of philanthropic endeavors, including Columbus's Children's Hospital, the United Way, and his namesake foundation, the Wexner Foundation. Also a supporter of the arts, he is purported to maintain a private Picasso collection. He paid for the construction of the Wexner Center for the Arts at the Ohio State campus, and also donated a $42.1 million Picasso painting to the center.

It is crazy to think what a company that throws ladies' underwear on stick figure bodies during prime time can do.

Maita'i

2006-12-07T23:53:00.000-05:00

I have fallen in love with the Mai Tai.

The Mai Tai is one of the half-fruity, half-whammy tropical drinks that will probably (or, at least, I hope) be hitting the popular market any day now, in a style similar to the Mojito or the ever-famous Margarita given its fame by Jimmy Buffett. It is a rum-based drink, bring together lime and almond flavors and maintaining a distinct tropical (NOT Carribean, mind you; tropical) feel. As for taste, it is sort of like fruit punch, with a little sour kick. The almond comes through indistinctly; if you are not familiar with almond flavoring or syrup, it is very easy not to notice.

I think the drink has not been as popular because it requires a few ingredients that are not normally stocked by the average homeowner at her or his bar. People know what is in a margarita or a screwdriver, and for that reason are comfortable with the drinks. The Mai Tai features light and dark rum, and many people don't recognize a difference between the two. The Mai Tai also uses almond syrup, a product most people have not heard of, let alone not in most cupboards. It is garnished with a pineapple; most people can handle the lime and the mint sprig and the maraschino cherries, but freeze when it comes to chopping up a pineapple on the spot.

For this reason, I think the Mai Tai is a great theme drink. Have a summer block party and serve them up cold. The best part is that they are unheard of in frozen form. I don't do frozen drinks. If I wanted pulverized ice, I'd buy a slurpee and spike it. I don't think Apu on The Simpsons would appreciate that.

I live off of orgeat (almond) syrup, which I keep around for making almond Italian sodas, so using the syrup isn't a big deal in my department. I wonder if it would be comparable to make sugar syrup and flavor it with almond extract for a quick fix. I think I'll stick to Torani syrups, though. I do, however, want to try and make one with a little froth. I think that, if I add a little carbonation and a little vanilla bean ice cream, and then shake it well, the touch of froth and creaminess will make the drink even smoother. I think the vanilla will work well with the almond, too.

Reawakened

2006-12-06T20:59:00.000-05:00

I’m about to blurt out a lot of things that I probably should not be posting online. Don’t be surprised if this post is gone by tomorrow morning.

You know that I am a medical student. If you have read for a while, you also know that I have ambitions to enter business. I would really like to enter healthcare management and eventually work my way to a CEO or COO position of an organized medicine company or regional healthcare system. I believe that the effective administration of medicine calls for someone with clinical experience and input.

I am assembling my plan to realize these goals, and am in the process of an appeal to override an existing policy so that I can complete all of the goals I have as part of my medical education. If the appeal is successful, I will be permitted to study business in a Chicago-area school and have the time availability to fulfill the duties for the AMA trustee, an exciting prospect. The appeal is submitted, and now I wait. From my discussions, I feel optimistic that my reasons are legitimate and unique enough to warrant the exception. I’m allowed a little nervousness since the exception has not been officially granted yet, but not only do I feel optimistic, but I feel that I have a course of action if it is not that will still allow me to reach my educational goals.

Just last week, I was not convinced of this.

It was a scary time. There were nights that I couldn’t get to sleep, and I would just lie in bed, staring at the ceiling and running the possibilities through my head. I have a picture in my mind of how the stucco ceiling in my room works. Some nights, I would just count the stucco Styrofoam marbles in the patterning. I came to medicine to pursue healthcare management, and I was seeing this prospect disassemble itself so easily. I felt foolish for wanting to fuse two degrees into two careers. I wondered why I even bothered coming to medicine into the first place, and why I was not intimidated by the prospect of $200,000 of debt before I turn 30.

Tonight we had a speaker come to the medical school. I will admit, the only reason I went to see the speaker is because there was free food involved. I was so stressed out I didn’t want to think about guest speakers. Her message was custom-written for me. She spoke about how she followed her dream, and used her medical training to pursue work that could be considered unconventional. She leads the Ohio chapter of the Council on American-Islamic Relations, and she also writes children’s books, one of which has been published and the other of which is on its way to the printer.

She had two prominent messages. Her first one was to be active in learning in order to see your dreams come true. She mentioned a learning process in medicine we call “see one, do one, teach one”. When learning a procedure, such as putting an IV into a person, oftentimes we don’t have the luxury of reading four or five textbooks on the procedure and completing an online training and asking questions and watching four or five before we try it out on a prepared learning model. We often just have to watch it, and then complete it without hesitation based on our reading. Sometimes we don’t have the luxury of watching the procedure before doing it. This is a prominent lesson for me because, one time at the free clinic, we did not have a trained phlebotomist and we couldn’t draw blood. I had completed a workshop a few months before, but didn’t really remember much. I did not have the luxury of hesitating in front of the patient. I could refuse, but then my patients, who came in for care, would have to wait for a week to come in again. I ended up refusing. I justified it as not being protected by the malpractice insurance, but in reality my activities in the clinic are protected by Ohio’s Good Samaritan laws. Someone came in later who was trained and experienced to draw blood. But I still hesitated, and in doing so impaired quality care. The lesson is marked in my mind.

This is one of the parts I will probably delete.

Her second prominent message was to push forward in achieving one’s goals. She noted that at times, one has to be a little belligerent, since no one else will admire my passions as much as I do, and it is my responsibility to advocate for them. I have been more forward in requesting what I want in my education, and planning for what I need to do to get what I want.

I feel energized by her words. I feel that, even if the terrain is uncharted, I can mark it out and push forward. I will secure my degrees, and my public policy experiences, and I will succeed in meeting my goals. I don’t necessarily know the path I will take to get there, but I know the destination, and I have a light in front of me to help me see far enough to keep walking.

I wrote her an e-mail to thank her for her message, and to tell her my story, and she left me with one final piece of advice. She is not currently practicing, and she confesses that she, too, is sometimes shy to tell people that she is not currently practicing medicine. However, she notes that, while there are plenty of pediatricians to practice effective medicine, right now there are few people working to open avenues of communicaiton for understanding the Islamic culture and advocating for the rights of Islamic people in the United States, and she feels her calling right now to be there. I feel the same way; I can be an effective clinician, but I don't mind investing my energy into healthcare management because today people need responsible clinical minds to enter management and repair the turmoil there.

I hope I can calm myself down to returning to post every day. It probably won’t help that I will be in South Africa for ten days and can barely guarantee electricity, let alone an Internet connection. I am also not thrilled about taking my laptop to Johannesburg, one of the most crime-laden cities in the world.

Besides, I have a LOT to say about Pfizer and its new Lipitor gone wild.

Grilled turkey

2006-11-26T22:47:00.000-05:00

Back from Thanksgiving.

Yes, we grilled the turkey.

Unfortunately, the oven gave out on Thursday morning (fortunately, I had baked a cheesecake the previous evening, so that was fine). So we quartered the turkey and tossed it on the barbie. I should also mention that it was slathered in tandoori spices, giving the turkey a fantastic smoky spicy taste that simply cannot be emulated otherwise.

I will be advocating for grilled turkey from now on. I'm not a fan of deep-fried turkey because the turkey is too dry and the deep frying process is exceedingly dangerous. Baked turkey is also too dry. However, this turkey was perfect. The tandoori marinade seeped into the turkey, and the grilling process seared the outside and kept juices in.

This, of course, meant no green bean casserole. I was devastated. I live for green bean casserole. Green beans create the perfect vector for deep-fried crunchies and rich mushroom soup sauce. I could easily eat an entire casserole.

Because Iowa Guy told me to

2006-11-26T22:35:00.000-05:00

3 Things that scare me: rollercoasters, clowns, and Bea Arthur.
3 People who make me laugh: Kathy Griffin, Dave Chapelle, and Jon Stewart.
3 Things I love: Italy, Ferraris, and Aishwarya Rai.
3 Things I hate: bad odor, narrow-minded people, and soggy noodles.
3 Things I don't understand: burning couches in Columbus, Tickle-Me-Elmo, and spam (the meat product, not the unsolicited e-mails).
3 Things on my desk: A handpainted ostrich egg from South Africa, a painting I did of Britney Spears and Madonna during the MTV music awards, and Lambchop in a strange sexual position.
3 Things I'm doing right now: studying Cardio, completing Business School applications, and brewing coffee.
3 Things I want to do before I die: own a Ferrari, cure someone's terminal cancer, and finish a piece of artwork that people will appreciate after I am gone.
3 Things I can do: bake cheesecake, pick my nose, and manage my stock portfolio.
3 Things I can't do: walk and chew gum at the same time, whistle, or listen to a boy band song without singing along.
3 Things I think you should listen to: my grandmother (both of them) and my friend from undergrad, Laura.
3 Things you should never listen to: Ludacris, my drunken uncle, and the Rhett.
3 Things I'd like to learn: how to ballroom dance, how to whistle, and how to communicate in Italian.
3 Favorite foods: Roman pizza, sushi, and pho.
3 Beverages I drink regularly: espresso (REAL espresso from my stovetop kettle), Black Cherry Vanilla Diet Coke from the machine in the library (exclusively), and Crystal Light flavoring packs.
3 Shows I watched as a kid: Speed Racer, Power Rangers, and old school Teenage Mutant Ninja Turtles.
3 People I'm tagging (because they intrigue me): I say Serena, Lizza, and Irene ... but of course, any of you are welcome to do it.

Interstate WHERE?

2006-11-20T18:31:00.000-05:00

Question of the day:

Why does Honolulu have highways designated as interstate routes according to the Eisenhower Interstate Highway System?

Catch-up

2006-11-19T01:30:00.000-05:00

I have come to the conclusion that playing Post Catch-Up is exhausting and cumulative. I now fear going to my blog because I feel like I have to catch up. This is not the reason I started writing in the first place.

So instead, I am starting fresh today.

Many of you know that I like to go off on tangents with business ideas. Today is no exception. For dinner, I stopped over at Chipotle to pick up a burrito. Steak, with black beans, mild salsa and the corn salsa sour cream, and cheese. Not a bad idea, considering there was a line of people who agreed with me. However, I am smarter. I pre-ordered my burrito on their website, so all I had to do was walk up to the front, pay, and walk out.

Chipotle does not have drive-thrus, for several reasons. I think the real reason is that it is harder to prepare a burrito to order than it is to prepare a combo meal by number. Here is my idea: you sign up for an account online, and instead of placing an order online every time, you pre-register your "usual". That is, you decide how your burrito should be on Chipotle's website. You can even pre-register a credit card. Then, all you have to do is call Chipotle's phone number, dial your happy little pin code, and have your "usual" waiting for you at the time you specify. The voice prompts will ask if you want guac or chips or all of those blings, so that Chipotle can upsell its regular product. Then, you just stop by your local Chipotle (which you have indicated by registering) pick up your burrito or salad or tacos, and head off into the sunset.

It is great for Chipotle, because it makes picking up lunch or dinner easy AND it relegates you to get your meal from Chipotle instead of another retailer once you have placed your order.

Y - Yuletide

2006-11-14T23:18:00.000-05:00

And so, the Christmas season begins. At least, this is what the music at Las Vegas’s airport tells me. I’m going to address it as the holiday season because I do not like associating my religion with this commercialized monstrosity; I would presume that people of other religions may have similar views on distancing their celebrations from the aggregate holiday season.

I really hate holiday seasons being extended to mid-November. I am of the belief that the subject should not be breached until December begins. Or, at least, after Thanksgiving. In my opinion, Thanksgiving more clearly typifies what the holiday season is intended to convey, and it should not be breached by the commercial squalor of the holiday season.

In a way, the holiday season is a lot like Las Vegas, in that the world becomes surreal and the flashy lights, inherent culture, and strategic marketing convince people to pour money out of their pockets. Some small businesses (mostly specialty boutiques) break even all year with marginal profits on other holidays just to rack up on Christmas. Both Wal-Mart and Target have departments specific to holiday season operations. The amount of cash flow on extravagancies is ridiculous, just as in Las Vegas, there are departments based on casinos alone.

One difference, however, is that the holiday season doesn’t advertise brothels. Well, maybe it does. I did see a naughty Mrs. Claus in the Bellagio at the casino, and lost a pretty penny to her craps table.

Oh, that SCANDALOUS Mrs. Claus. I don’t know what Santa did, but DAMN if he didn’t luck out with that one.

Star-studded life

2006-11-13T23:09:00.000-05:00

I really don’t gamble that much. However, being in Las Vegas, I suppose I am obligated to an extent. I have been somewhat successful. I made $20 playing craps two nights ago, and I thought I would stop there. Tonight, I went down the hole $40 total, and this was likely my last endeavor gambling in Las Vegas because I leave tomorrow afternoon after the last day of business. But, if I count the free drinks every night (including maybe seven Long Islands tonight), the great people I met on the conference, and the experience of being in Las Vegas, I think $40 isn't a bad price to pay.

Every time I think of gambling, I think about money I could instead put into my stock portfolio, where at least the odds are in my favor.

I am in awe of some of the buildings here. In awe and disgusted. Some of these buildings cost billions of dollars, about the size of the endowments of many large public and growing private universities. The endeavors towards extravagance seen here are ridiculous. Money and resources that could go to great public endeavors, just as the money Bill Gates and Warren Buffett have established for their endowments, is instead focused into the Disneyland plastic extravagance of The Strip.

The funding for such endeavors is produced by exploiting people’s weaknesses. Gambling has propensity towards addiction, just as do alcohol, barbituates, pornography, and the World of Warcraft. People drain their pocketbooks in this city, some from enjoyment of the culture and the time, but others because they can’t stop. Las Vegas turns life into a game, as pulling a slot machine bar and tossing down happy colored chips take precedence over fiscal responsibility.

On the other hand ... it’s a lot of fun.

I feel like I'm in Disneyland, in a fantasy world that operates by strange paranormal rules. I don't know what life will be like when I return to the normal world. In a strange sense I want to be back in the familiar world, where logic rules and the fantasy is merely a distant dream. I like that grounding.

W - World of Warcraft

2006-11-10T22:58:00.000-05:00

When my brother is home for vacations, he plays The World of Warcraft almost incessantly. There are times when he will be on his computer for sixteen hours a day, playing that game. It appears addictive on the surface, but I don't know why this is the case because it seems like he is doing the same thing over and over. He and his friends to whom he talks by means of a microphone and speakers band together, start a campaign, share the individual skills of their characters to win the campaign, and then argue over who gets what spoils. I’m not sure what people find so exciting about it.

If I haven’t admitted it yet, I enjoy reading advice columns. I was a huge fan of Ann Landers because of how blunt and caustic she was while still being helpful. Although she has passed away, her two former chief editors write a new column titled Annie’s Mailbox. In a letter to Annie’s Mailbox, one woman wrote that she was fed up with her husband. He would work from 9-5, and then come home to start playing World of Warcraft. She would bring him his dinner and set it next to the computer. He never wanted to play with their children, and never talked to her except if something was present to interfere with his game. Their sex life was nonexistent. He did the same on weekends, and he would call in sick once a week to work just to play the game. She was fed up with it, and had no idea what to do. The writers of the advice column recommended that, if he is unwilling to enter counseling, she should contact a lawyer to arrange for divorce. I have heard of other situations like this ending in divorce, where the game player couldn’t care less and is thus further isolated to a lonely lifestyle.

Just as with Alcoholics Anonymous and Gamblers Anonymous, there is a group directed towards helping people with addictions. People meet in small groups similar to the other organizations where they support each other in competing with their addiction on both a psychosocial and a spiritual level. As a double-edged sword, gaming addictions have not received the notoriety of alcoholism and of gambling: good because the stigma is gone, bad because the addiction is not recognized as a serious concern. And as something that takes people away from their regular lives to apply uncontrollable fantasies, it is a serious concern that needs to be addressed by the public.

Boy bands

2006-11-09T23:04:00.000-05:00

Here’s a secret: I sing along to most boy bands that I hear on the radio. It isn’t tame, subtle whispers of singing along. No, I belt tunes out. I’m not half bad, either, except when I’m drunk. And then I try to sing along to everything in the song, including beatboxing if there aren’t any words going on. At least I’m entertaining when I’m drunk and singing along to boy bands.

If I’m really drunk, I’ll sing along to Mariah Carey. That’s another post.

I’m not the only person in the world who enjoys boy band music. I think boy band music tends to be addictive because it is so upbeat and simplistic in nature. One needs not understand tenets of music or dive into a deeper respect or understanding of a song to enjoy it. The message is superficial and clear. The tunes are simple and homogenous. The music style itself is not meant to surprise, but to give people exactly what they expect from boy band music.

I have been listening to an Italian group lately called Massimo Di Cataldo. They have the same high-spirited pop attitude in their music as American boy bands. I an curious as to which was the origin of this type of music, because this band has the strange ability to get me to sing along in Italian. I don't know any Italian.

V - Vegas

2006-11-08T22:53:00.000-05:00

How apt … I am in Las Vegas. And it feels so good!

With a rare turn of events, I am cruising around in a Ford Mustang. My intend was to just rent a car while here so I can run errands before the meeting, visit my uncle and my friend, and have fun cruising around. I ended up securing a 2007 Ford Mustang for dirt cheap. Convertible, too. This thing is awesome. The only problem with it is that, since hertiz doesn’t take care of their cars, the carpet is filthy. However, the exterior is shiny. Very shiny. I like the shiny part, personally. I now know why Dr. Stone invested in one. It doesn’t have the maneuverability of my Celica, but it definitely has allure and a convertible top.

By the way, have I ever mentioned that our Dean of Student Affairs drives a Ford Mustang? Bright blue like my Celica, too.

I am in awe of how blue the sly is out here. Perhaps as blue as our cars. It is like driving under a gem all day long. I have to resist looking up while driving, because looking up is not a very good thing to do while driving.

I was hoping to check into the hotel by now, but unfortunately the rooms are in someone else’s name. Boo on that. Anyways, I will be visiting my uncle and his wife in the meantime, and it has also been a treat to run around Las Vegas. Additionally, there are no Panera Breads or other coffee shops with free wireless access around, and Starbucks wants to charge me way too much to access the Internet. Especially since, typically during the conference, the AMA sets up booths for Internet access wherever the lobby is.

Unfortunately, things in Vegas are expensive. Don’t get me wrong, they are not at the level of Los Angeles or New York. However, they are noticeably more expensive, with the exception of alcohol in grocery stores. Alcohol is cheap. I think I’m going to have to stock up once Chris and Chaz get here, because we are likely doing lots of drinking over the weekend. Well, not lots, but enough to warrant a stopover.

I am waiting for jet lag to kick in. I know that it should really feel like it is 6:00 right now, but it doesn’t. I’ll probably feel it hit home in a little bit, though. I can’t wait to see nightfall; I don’t know how the stars will look in the city, but I am tempted to drive out of town just to see them.

Finally, they broke up!

2006-11-07T19:33:00.000-05:00

It's about DAMN time!

I want to tell you about one of the most beautiful weddings I have seen

2006-11-05T07:40:00.000-05:00

This weekend, I was in Atlanta for my friend Alexa's wedding. This was the first wedding I have been to where I really knew the bride well, and it was interesting to see how much of it reflected her sense of style and her perspective. Alexa is a sophisticated person. Her bouquet was a ball of red roses to match the scarlet red bridesmaid dresses. The wedding hall was amazing, reflecting a vineyard chateau. The reception hall had the same level of class, but was more modernized and upbeat. I wish I had pictures of her new husband, Michael, and the best men; they had penguin tail tuxedos, and their suits were very dapper. The reception hall, just below the wedding room, was a little bit of style and a little bit of bubble.

The officiant asked the attendees to remember something special about the wedding, as part of a special collective memory for the bride and groom. I remember seeing Alexa in her dress. For starters, her dress itself was gorgeous. It had the Vera Wang sleek form (it may have been a Vera Wang, I don't know), with very smooth lines clearly defining and complementing Alexa's figure. It was not one of those boat-shaped dresses; it formed a perfect figure. The veil complimented with a stiff weight trim paralleling the curves of the dress. More so, it hinted at Alexa's sense of sophistication and style. Alexa pulled it off smashingly. She took that dress from amazing and made it incredible.

I also got to meet Alexa's mom. I always hear wonderful things about Alexa's mom, but I have finally had the fortune to meet her. She is just as amazing and nice and pretty as everyone says. She has a lot of Alexa's demeanors and certainly her spirit. I think I see where Alexa gets her sense of style and, more so, her spirit.

The wedding and reception were both a lot of fun. The DJ was great, the open bar was a hit, and the cake was excellent. I agree with Michael; I typically don't like carrot cakes, but this one must have been laced with LSD because I couldn't get enough of it. I got to see some people I haven't seen for a while and meet lots of people I had only heard about until now. Alexa has one aunt in Baltimore who was an absolute riot. She kept referring to herself as "so-and-so's lesbian partner" and had all sorts of stories to tell about DC and Baltimore and healthcare and the legal system and the rite of passage she felt she was making in being "one of the old people". I barely know the woman, and I already look forward to having lunch with her when I go to Johns Hopkins for a rotation or DC for my business internship.

Brown Shoes

2006-11-03T23:07:00.000-05:00

I have been spending way too much time trying to find the perfect pair of shoes. For a while now, I have needed brown dress shoes. Well, really nice brown shoes, but preferably shoes that I could either dress up or dress down. Preferably a color of brown that goes well with my grey pants as well as with khaki pants.

Yesterday, I decided to walk through Famous Footwear, the sixth store I have entered with my goal. All of the shoes that fit my specifications were either WAY too expensive or Skechers (which fall apart in a year). This has been the trend. I thought I found an astounding pair at TJ Maxx, only to note that they were Prada brand and, as such, definitely out of my price range.

I went to the clearance rack at Famous Footwear. Everything looked like crap. The only redeeming pair of shoes I saw at first were flip flops. But there, at the bottom of the rack, were MY SHOES.

They are Bostonian shoes, and a deep brown color with a little bit of red in the brown. They are the shape I want (smooth contour), slip-ons as I prefer, and comfortable. I got them for $30. Normally, Bostonian’s go for $150 or so; I at first didn’t even look at the box because I know this fact. Strangely, they look almost identical to the Prada brand I mentioned earlier, except with a slightly wider toe (the Prada pair had the classic Prada pointed toe).

I am ecstatic.

The one thing I have against them, though, is that their heel is very thick, such that it becomes cumbersome to try and dance in them. Oh, well; can’t expect the world on a silver platter, I suppose.

S - Sushi

2006-11-02T22:13:00.000-05:00

Sushi is quite an experience. To the unitiated Westerner, the concept of eating raw fish is sometimes not appetizing, and definitely lends itself to amplifying the conception of the Far East as exotic.

Sushi is very prototypical of Japanese food. Japanese food tends to be simple, highlighting the pure taste of elements in a delicate manner. Tempura, for example, is a light coating of crisped flour over a vegetable, cooking the vegetable and bringing out a new texture and flavor. Miso soup is a clear broth with simple additives highlighting the taste of miso while bringing new textures with subtle additions of conserved flavors to the soup itself. One thing people don't realize is that "sushi" is actually the name of the rice on which the raw fish is served, and not the seafood product served on top; hence, it is a simple base of rice meant to highlight the pure taste of the seafood product, or meant to be a subtle background behind which several elements can play together.

One of my favorite piece is the Tuna (Unagi) sushi or sashimi. As a simple piece, it most clearly demonstrates the quality of a sushi vendor's work. The tuna itself, when good, has a very subtle flavor, almost like a tiny hint of beef braised in peaches, but without the burnt taste ... if that makes any sense. Different tuna breeds have different flavors, almost as if one is selecting between wines or olive oils. It also offers itself as a display, and the graining of the fatty layers within the tuna define the classic appearance of unagi no sushi.

The rice is not excused from being quality. Koshihikari rice is the traditional rice of choice when preparing sushi; however, the percentages of aged versus non-aged rice in a rice blend very subtly defines the texture and taste of the rice bed on which the tuna is sampled. Different blends lend themselves to different tunas, but in general a 70-30 blend of old to new is preferable, as the older rice has a subtler flavor and imparts texture without overpowering the delicate tuna.

Sushi is traditionally consumed with both wasabi and soy sauce. Soy sauce alludes to the sea with a taste of saltiness, while also imparting a blend of caramelized and burnt flavors. Wasabi ... if you get sushi in the US, you have likely not had real wasabi, but a horseradish blend. Real wasabi has a punch that simply cannot be mimicked by horseradish, and also a flowery aroma and taste.

From the simple unagi no sushi with these basic elements, we can expand. Real urchin (uni) has a buttery, sweet taste and silky texture. Salmon roe conveys that classic pearly smooth texture seen with roe, coupled with a little bit of bite and a certain wetness.

Man ... now I have to go find sushi. GRRRR!

R - Racism

2006-10-31T00:22:00.000-05:00

Ralph, one of my cousins ... well, second cousin ... well, really second uncle ... ANYWAYS ... sent me an IM about two child performers, Lynx and Lamb Gaede. These two girls, 14-year-old fraternal twins from Madisonville, TX, formed their duo (Prussian Blue) in 2003 and have been performing throughout the country. They started their career singing in 2001, and learned to play instruments in 2002. They have been compared to the Olsen twins, and could be considered identical to them except for one very large difference:

Prussian Blue's material is of a white supremacist nature. Your math is correct; they have been publicly sharing this message since they were nine years old.

They selected the name as a reference to the blue staining left behind with the use of Zyklon B, a poison used in Nazi Germany to kill millions of Jews. On an interview with ABC news, the girls stated that they believe Hitler to have been a great man, and that his philosophy on eugenic standards was laudable. They also insisted that all money they donate to Hurricane Katrina victims be donated to whites only.

Whaaaa .... where in the world does this sort of mentality come from? It demonstrates the impressionability of children, and yet it also illustrates the capacity for independent thought to develop into corruption. The girls did grow up in a white supremacist household, and their social existence is centered in the white supremacist community. This provides the opportunity for a lot of mental conditioning of fragile minds.

Q - Queeny Behavior

2006-10-29T00:22:00.000-04:00

Alright, who listed this one? I can just see the diversity training I am going to have to do after my assistant deans read this post.

I consider myself a pretty accepting person. That doesn't mean, however, that my stomach can't turn every now and then. My one gross-out of sorts is queeny behavior. Maybe gross-out is harsh. More accurate to say I just don't get it.

I consider queeny behavior to be similar to "acting black" or "being a goth", in that a person takes on a culturally reinforced pattern of behaviors. Some people are truly acculturated to acting queeny, just as some people are truly acculturated to modern urban black culture or to gothic culture. Other people act and are chastised for acting. And it is very difficult to differentiate the two. All three are in reality cultural concepts; as opposed to being hard-wired behaviors for gay people or black people or (I guess) D&D players(?), they are manifestations of collective but not necessarily universal culturalisms contained within communities, defining stereotypes by focusing on communities.

It would be interesting to consider ethnographic studies of these communities to consider the development of these collective viewpoints and culturalisms. I would like to see where each developed, and how transition in thought within these collective culturalisms has developed over time or has responded to public affairs.

So then, just as white people can "act black", are metrosexuals people who "act queeny"? Hmm ... interesting comparison.

Of course, it is not my place or my requirement to "get" it. If people are happy acting the way they do, and it doesn't hurt other people, there isn't much more one can wish for in the ways of the world.

Expansion of Medical Education

2006-10-27T03:38:00.000-04:00

It amazes me how little my colleagues understand the business practices behind medicine. Many of them have never even heard of coding, the system of billing for Medicare and insurance reimbursements. Others seem to think that we as physicians have more political and business power than do insurance companies and pharmaceutical companies. Apparently, our "M.D." affords us some inherent bargaining power that makes people such as chief officers of Fortune 500 companies grovel before us.

I have yet to observe this purported bargaining power in action.

One of the big grievances I have with medical education in the United States is the focus on research and academia. Scholarship programs are targeted at bringing academics into medicine. Also, many academic programs focus on keeping students in academia and education. Yale requires its students to complete a thesis at the end of their program. Duke and Case Western start early and trim down the length of their basic sciences education period to create a pocket of time for students to conduct research. UCLA requires its fourth year students to sign up for times to assist in the education of first and second year students by leading small groups or instructional seminars.

There are very few programs detailing the importance of understanding litigation; at most, we learn about techniques of professionalism that can, as a side effect, make us less likely to be sued. I am not sure that many medical students have an idea how to interact with a lawyer or with an accountant, and could easily be shafted by either if a case were to come forward. Many students do not understand the importance of being involved with organized medicine, which can easily save one' s rear if a case were to come to fruition.

I am going to Las Vegas on November 8th for a conference. Over the next week or two, I'll be posting some of the bills we will be seeing there. My job is to assist our student delegates with all bills categorized as private business concerns. The business world of medicine is expansive and can easily intimidate.

Over the next few weeks,

P - Pho

2006-10-27T00:23:00.000-04:00

Pho (pronounced "fuh") is a classic Vietnamese soup that accentuates the freshness of farm ingredients. Unlike Korean cooking, which focuses on refined flavors from complex preparation processes rooted in preservation and fermentation techniques, Vietnamese food is simple in taste and design, reflecting simplicity and freshness in taste. Pho is no different.

The soup base is a clear broth prepared from beef bones (on occasion, chicken; vegetarian, this is not), and includes oxtails, flank steak, and various spices. The broth is clear, as the materials are steeped once briefly in boiling water to remove excess clouding exudates from the bones and then boiled for a full amount of time to release the flavors from the materials without the clouding suspension.

In this broth are served Banh Pho, or rice noodles cut from a large sheet. The noodles are about the shape of fettucine noodles, but taste like rice and have a chewier consistency. They absorb the broth very well. Also in the bowl to begin are probably some onions.

Upon service, the host first presents a plate of various herbs and other additives in a plate to the side, such as mint, cilantro, lime, basil, bean sprouts and fresh jalapeno. The host also adds your choice of meats to the pho, featuring selections from thinly-sliced tenderloin steak and beef meetballs to beef tendon and tripe. These are added raw, so that they cook in the broth in front of you, and you can eat them when their temperature reaches your liking. As you eat the soup, you slowly add the herbs and other tchotchkes to the soup bowl to preserve their freshness. Other additives include sriracha sauce, a ground red chili paste; hoisin sauce, a savory sweet paste made from plums, I think; and fish sauce, a salty, thin sauce.

Other Vietnamese foods feature the same orientation towards freshness. Vietnamese spring rolls and steamed instead of fried, and feature freshly prepared shrimp and pork. Bun, a rice noodle salad of sorts, comes with fresh, minced vegetables, freshly grilled meats, and a fish sauce and carrot-based dressing.

Pho has an interesting history. It is originally a Northern Vietnames cuisine, but migrated South after the defeat of the French and the partitioning of the country led communist North Vietnam to close all private pho establishments. Immigrants to South Vietnam and departure of post-war immigrants introduced pho and other Vietnamese foods to the rest of the world. From this etiology, most Pho restaurants are named with a two digit number following, such as "Pho 54" or "Pho 62"; the number signifies an important year to the family, such as when the family left North Vietnam or when the family members became citizens of the new country of origin.

My favorite restaurant in Atlanta to enjoy Pho is Pho 79. This is the only everyday Pho restaurant I have encountered that is also Zagat rated. I went there all the time throughout all four years of my undergraduate career; the owner knows m by name, and now recognizes my friends and demands they tell me to stop by (I think that's what Sarah said, anyways). The food there is exquisite, because they concentrate on ingredient freshness and presentation; other restaurants are crappy because they don't care about how fresh the pho is when it comes to your table, it may be cold, or the noodles may have been sitting for a while, making them waterlogged.

I can't wait to go back when I go to Atlanta in November.

A phone by any other ring

2006-10-26T15:35:00.000-04:00

I have typically been skeptical of devices attempting to take down the iPod market, but here's one that may have a chance (a CHANCE ... not a likelihood):

The Nokia N91 is an MP3 phone. MP3 phones to date have been horrible. Between Motorola's piss-poor interface and Samsung's speakers and audio auxillary connection that have been laughable at best, and the pittance of a storage drive found on pre-N-series devices, there are no other MP3 phones that could possibly come close to natural MP3 devices. However, the N91 does so and does it well. Its audio systems are impeccable, options for storage go up to 8GB, and the Nokia interface is easy to navigate, even while driving.

The price? $599. Not so laudable for a device comparable to an iPod nano mated to a cell phone.

However, to take a bite from the market, several things need to be done. First off, while a device may be comparable to the iPod, it will never come with access to iTunes or any of the other services Apple provides. Secondly, it also needs to infiltrate the Apple culture bubble, as most of the public adamantly clings on to their iPods like first-born children (one iPod to rule them all ...).

In reality, even if this device were to succeed, it would take a while.

The focus has always been on trying to take the market from Apple. I think that this phone provides a new hope for advancements in technology. Nokia is not building a phone to take Apple's clientele, even though that may happen. Nokia is building a phone to appeal to the public and sell. There is no doubt that this phone could do that if it secures line contracts and markets itself appropriately.

O - Oxycontin, Oxycodone

2006-10-25T00:29:00.000-04:00

My friends know that, with the exception of The Sopranos, I have a horrible taste in television shows:

Flavor of Love = greatest show ever,
I could watch SpongeBob SquarePants all day long,
My favorite anime series centers around baking bread(Yakitate! Japan), and
I own season 3 of Little House on the Prairie

It should come to no surprise that I also enjoy watching a horrible teen drama called Degrassi: The Next Generation. This is a teen soap opera of sorts targeted towards junior-high and high school students, with the self-proclaimed goal of breaching taboo topics that other shows wouldn't dare to breach.

NB: Spoilers ahead

One of my favorite episodes, which really hits home at this goal, focuses on two characters (JT and Liberty). By this point, the show is in its sixth series, and we have seen the two grow up through junior high, where their biggest concerns were running for student council positions, winning a geography bee, not losing milk money, and having the hots for teachers. In this episode, we find that JT (10th grade) has impregnated Liberty (also 10th grade), and neither of their parents know. Liberty is already three months pregnant but won't see a gynecologist or talk to her parents. JT, working for a pharmacist, has entered the world of drug sales and is earning money by stealing oxycodone (generic drug contained in oxycontin) and selling it to a dealer. Both of their lives are completely screwed up as they try to afford an apartment together, as JT continues to steal and gets caught as well as gets beaten to submission by his purchaser, and ends up in the ER after deliberately ODing on oxycodone, after which he has to have his stomach pumped. If you know any college-bound 10th graders and can imagine them in this situation over the course of a month, you can imagine the change in lifestyle for these two students.

End spoilers

For those of you not reading the spoilers, the episode references an addiction to oxycodone (generic drug in oxycontin), hence the association with the title. Oxycodone is an opioid analgesic similar in structure and mechanism of addiction to morphine and heroin, but is more similar in structure to codeine. It is used for pain relief and is very often given for post-operative pain control. According to the DEA, addiction is uncommon; however, it is purported. Unlike Percocet (also containing oxycodone), Oxycontin has been more prone to abuse because it does not contain paracetamol. It is designed with a coating to induce a time-release, but abusers will wash off this coating and crush the drug to defeat the delayed release effect.

The drug itself is rather inexpensive; legally acquired oxycontin in the United States, however, costs as much as $400 for a month supply (60 20 mg tablets). Illegally, it can catch up t0 $25 per 20mg pill on the East Coast. Compare to $5 for 60 tablets in Australia. The market is huge because of the ease of access to OxyContin in the United States as well as the tolerance and effects to which oxycontin abusers are prone, meaning they must buy more each time and cannot resist buying more.

The FDA and DEA have been strangely slow in regulating OxyContin. Unlike other illicit drugs, OxyContin is produced by a major pharmaceutical company in the US (Purdue Pharmaceuticals L.P.). Half of the FDA's budget is produced through fees pharmacy companies are willing to pay for accelerated services. Interesting considering that the FDA's responsibility is to regulate this group, from which it receives money. Our current government isn't helping, as it will take every opportunity possible to cut budgeting for anyone anywhere.

Scusa se ti chiamo amore

2006-10-24T00:15:00.000-04:00

Excuse me if I call you my love

Sadly, the wheels of medical school do not slow down for the passage of love. I think I have found a girl whom I like, and whom I could grow old with, and of whom my extended family might actually approve. And yet, I am unable to open my damn mouth and ask her out.

WTF?

Any words of advice?

What do I want in a companion? I am not the sort of person who clings to another person's arm for dear life. I hate clingy people with a passion. I want someone with personal development of her own. I want to know someone whom I can help grow, and who can help me grow. The trouble with most girls I meet is that they want the clingy sweetheart part of romance without the real parts. BUT BUT BUT I think this one could be different.

Wish me luck!

N - Nose picking

2006-10-23T00:29:00.000-04:00

Admit it ... you do it when no one is looking. Everyone digs for gold every now and then.

Don't know why ... part of it is just something to do, other parts are the irritation of the nasal mucosa or interference with breathing.

Compulsive nose-picking is known as rhinotillexomania. People with rhinotillexomania are at risk for chronic nosebleeds due to repetitive irritation of the nasal mucosa and nasal infections from the repetitive invasion. However, contrary to popular misconception, there is little to no possibility of loss of smell, as the olfactory nerve endings are too far within the nasal cavity to be injured. There is no risk of injury to the brain. The largest concern is any form of infection from injury to the nasal mucosa; this can lead to necrosis of the nose, prompting nasal removal or even death. There is one known instance of furious nose-picking requiring cauterization to halt the bleeding of the nasal mucosa; essentially, you can imagine having a saudering iron jammed up your nose to burn the cut blood vessels.

I'm not so sure I want to know what entails furious nose bleeding ...

New friends

2006-10-22T17:22:00.000-04:00

The big problem that I had with my life at Emory, my undergraduate institution was that, while I had a great circle of friends, I had very few friends outside of the world of Emory University. I am determined to not have that happen here in Columbus. It is even more important to me now because, although my friends at Emory were all studying different things, now all I know are medical students.

So when I saw a group on Craigslist (yes, Craigslist ... lame, aren't I?) advertising itself as an "eclectic group of people wanting to make friends", I couldn't resist. I linked to their Yahoo! group website, browsed through some of their messages, and read up on the events they had done and were planning, including happy hours, a hike through a phenomenal display of jack-o-lanterns, and a party at one members house complete with hookah and other cultural entertainment. It all sounded like fun, so I joined the group and introduced myself.

It then occurred to me: I hope I haven't joined a swingers circle.

I am happy to report that I am alive and STD-free. The group does not consist of axe murderers, nor is it a swingers circle. It is a nice group of friends who, like me, want to make friends outside of their respective work communities. This past Friday, I went to a happy hour at The Kitchen Lounge, a cool little bar on High Street, featuring a line of college-oriented bars, shops, and restaurants and lining the east border of the Ohio State campus. I met a lot of nice people, including Alex (the group organizer and a mechanical engineer), Jessica (working on her PhD at OSU in social work), and Kathryn (a regular at the Kitchen Lounge who may have suggested the happy hour). Kitchen Lounge itself was a fantastic bar and restaurant; the food was great, and Jason, the bartender from LA, remembered everyone's names and was very excited about sharing his drink expertise and dishing out lots of samples.

Afterwards, about a dozen of us went back to Alex's house to hang out and play some board games. Jessica whooped people's butts in Dr. Mario. We hung out in what appeared to be a crawl space in the basement that Alex decorated and furnished, and was now a fun little nook. It would have been fun to stay longer, but I said my goodbyes and headed off to study more Infectious Diseases.

All in all, a fun evening. I am looking forward to more adventures with new friends.

M - Mana

2006-10-21T00:29:00.000-04:00

There are ugly women, there are pretty drag queens, and then there is Mana. Mana is, by far, the prettiest male on the face of the Earth.

Made you double-take, didn't I? That's correct; these are pictures of a male.

Mana is considered the founder of the Gothica/Lolita fashion movement in Japan, reviving Victorian imagery and character among women. As you probably note from her appearance, Mana's style features a lot of lace, curls, and dark imagery mimicking Gothic culture.

Mana is known for rarely speaking or even smiling. In communication, she will either whisper to a co-performer who speaks on her behalf, look at a camera as subtitles appear, or hold up a "Yes" or "No" card. Very little is known about her off-camera life, other than her personal statement that there is no distinction between her camera and non-camera lifestyle.

Mana is one of few Japanese artists attracting and recognizing fandom overseas. In some ways, she is a figurehead for innovation, almost recreating an element of Japanese pop culture and opening the doors to the spread of Japanese pop culture to the world. In some ways, she could be considered Japan's version of Madonna ... except prettier.

L - Liposuction

2006-10-19T00:50:00.000-04:00

It always amazes me how someone can be so narrow-minded and not realize it. I especially hate it when I hear on of my colleagues say something is "obviously" the case, implying that no argument is applicable since all pieces of information directing an argument are necessary and reasonable assumptions. Usually, that something is not obvious, and arguments can easily be proposed to the alternative. I am used to hearing it from the population in general, but I tend to cringe when I hear it from one of my colleagues. Perhaps because it is a signal to me that, if something seems so "obvious", then all of the assumptions have been necessarily adopted and there is no room for receptiveness of alternate opinions. Or perhaps it is because it indicates an inability to coherently present an explanation to someone, displacing the necessity of understanding to the listener and excusing the speaker from explanation. Few words irritate me more than "obviously".

I believe that medical schools should also require coursework on introductions to logic and to ethics. Not to make a medical student ethical, but to teach a medical student the established philosophical tenets of logic and of ethics. The law students are all expected to take them. I think I see why the law students are expected/strongly recommended to take these courses; they teach the tenets of argument and logic.

Okay, okay ... what does this have to do with liposuction?

A few months ago, I heard the world "obviously" used in reference to obese patients who opt for liposuction. The whole statement was "patients who need liposuction are incapable of contributing to society" ... except with not as nice words. To which the explanation was "isn't it obvious?" And it definitely wasn't obvious. I don't see how a physical condition which still allows for significant liberties in behavior and functionality and that, in some cases, is surgically modifiable, renders someone "incapable of contributing to society".

The explanation ended up being that, because a person opts for liposuction instead of control of diet and exercise, that person is obviously worthless to society. Yeah. Great explanation.

The further explanation ended up being that such a person does not have enough self-control or discipline to join the workforce. It was prefaced by isolating the situation to extremely obese people who cannot walk on their own, and who require caretakers.

I think it is important to remember that extreme obesity takes years to manifest, and slowly debilitates a person physically. Just as it isn't possible for slightly overweight people to lose weight easily and overnight, it takes years and energy for extremely obese people to lose weight. Furthermore, the years of manifestation of extreme obesity are so long that they can mentally defeat a person, just as cancer and AIDS therapy can mentally pummel a patient. It is amazing to see how a surgical procedure can improve the physical health and mental self-image of a patient, removing walls of self-isolation and, more importantly, self-defeat. Both of these are powerful blockades that can prevent a person from contributing in conventionally recognized methods, such as taking on employment, and that can be easily removed by proper health management including, if deemed beneficial, liposuction.

This is where education of principles of logic and of ethics comes in. The commenter talked a lot, but never presented an argument. I think that my colleague would have been able to see the fallacy of his argument if he had been educated on principles of logic. Very simple ideas, such as supporting an opinion with pertinent factual evidence and providing coherent explanation connecting the factual evidence to a defense of the opinion, at times evades people. This should not happen, especially among a populace that will eventually be trusted to explain details of medical management to the very patients receiving medical regimens.

On the other hand, medical education could use a dose of everything under the sun. Unfortunately, not everything can be included as part of medical education because then quality of education is thinned. It would be nice for all physicians to be informed of the research process and of legislative action and of ethics and of logical principle, but not everything is possible, and not every future physician will benefit from all aspects of such a comprehensive education. I would not be surprised to, for example, see medical students who took a course on ethics and earned a 92% on the final still unable to apply an understanding of emotivism to restrain themselves from misinterpreting the opinions of a patient on stem cell research based on initial statements.

People ... Ene, Sanjida, Kris C, and Alison especially ... and Konrad b/c I know you read this anyways ... thoughts?

Wireless

2006-10-18T14:45:00.000-04:00

Today, I am sitting at Panera Bread. Honestly, these people are geniuses. They appeal to a middle-upper class clientele, yet everyone and their mother comes here. Why is that?

Free wireless.

Starbucks was founded in 1971 and, after 1987, encountered a mass surge in popularity throughout the nation, making it a wonder company. Panera, first marketed in 1999, quickly stole that honor. People no longer go to Panera just for bread products, but for lunch and dinner and lounging around and meeting and all sorts of other encounters they would have had at Starbucks. And all because Starbucks has stubbornly insisted on charging people for accessing wireless networks.

It is amazing how a simple insurgence in technology can change market forces. Both voice-activated GPS navigation equipment and iPod integration technology provided sales surges for BMW glosing the gap on Chrysler/Daimler's Mercedes models and slamming down Porche's insurgence after releasing the Cayenne to market. The success of HD-DVD versus BluRay will be a key force in how much of the market share Sony's Playstation 3 is able to usurp from Microsoft's XBox 360. And if Palm indeed comes around and switches to Linux platforms for its devices, Linux might finally receive popular acceptance by the public. Maybe. I don't know; that one requires a wild amount of speculation.

However, not all large technology advances result in market changes. To really take a market, a form of technology has to either look really cool and new or appear to be something exceedingly useful. Going back to the Motorola RAZR, making a phone that feels thin is not such a quantum leap of a technology advance. On the other hand, Linux has been available to the public for a while. It does things that Apple is now "innovating", like sectioning hard drives for operating systems and allowing users to select monitors and the like. People still use Windows and Macintosh operating systems, because they are popular and cost money.

Here is what I see: I want a device that integrates the functionality of my cell phone, iPod, and PDA. I don't want a Blackberry, those things are worthless. Instead, I want something similar to a Lifedrive, but thinner. I want it to have wireless as well as phone network capabilities. I also want it to do my laundry, walk the dob, organize my sock drawer, and prepare dinner.

I'll take 5000, please. Kthxbye.

K - Kool-Aid

2006-10-17T03:51:00.000-04:00

I was thinking about Kool-Aid today, and what do you know? It's "K"! Almost destiny. Kool-Aid has a lot of surprises.

It surprises me when I find that I am the only one in a group who understands the reference "Don't drink the Kool-Aid". I'm not astonished, but it surprises me. For reference, the reference has multiple etymologies, but the most popular one is associated with the mass suicide executed by the cult People's Temple in Jonestown, Guyana. There, Jim Jones ordered his flock to drink Flavor-Aid (ultimately changed to Kool-Aid as the story progressed, since Kool-Aid is better known) laced with potassium cyanide. Next thing everyone knows, 913 people are found dead after drinking the stuff in an open field. I figured it would be more popular, seeing as how the incident was spoofed in an episode of The Simpsons.

It also surprises me how many people are turned off by Kool-Aid as unhealthy, but will gladly turn to juice as a beverage alternative. Juice is debatably worse for one's health. It has a high sugar content (higher than some non-diet sodas), no fiber (the prime reason for eating fruit), and in most cases added vitamins (in which case you might as well take a multivitamin ... and if you put anything in your mouth, you are not at a loss for vitamin C in this day and age). Granted, Kool-Aid is no better, but at least one can make sugar-free Kool-Aid. Additionally, Kool-Aid is about 1/5 the price of juices; take that extra money and buy some carrots or celery for a nice treat, or even splurge on Sara Lee White Whole Wheat bread instead of regular white bread to up your fiber. Or don't nitpick and don't feel guilty for choosing Kool-Aid over juice.

The last thing that surprises me is how many people dye their hair with Kool-Aid. Apparently, both Kurt Cobain and Pink have used Kool-Aid to dye their hair for performances. I didn't realize that Kool-Aid was so effective for dying hair. Other uses are as a base for being laced with drugs, to dye fabrics, as an exfoliant, and to cure gonorrhea (I think the last one is a bit doubtful).

Okay, no more surprises. It's Kool-Aid. That's it.