Shortie: What about the Pigs?

Above: The American Pig's POV (Part 1, Airdate 4/27/2009)

I COME TO YOU TONIGHT FROM THE
ASSOCIATED ASSOCIATION OF AMERICAN PIGS.

A few weeks ago, I posted a clip featuring Craig Ferguson's serious side on his late night talk show (The Late Late Show) on CBS. Here, I've put a few clips of how this late show host can make a serious issue quite funny by shining a different light upon the subject. Ferguson brings up an interesting point of view of the H1N1 Influenza A Virus (aka the Swine Flu)... Have we really thought about the pigs? How do they feel? What is their point of view?

Well, Craig will make their case best, so enough from me, and watch the following 3 clips (above / below) from The Late Late Show with Craig Ferguson (which airs at 12:35 PM EST on your local CBS affiliate).

BTW - To those new to the show, "The Scottish Conan Guy" refers to Mr. Ferguson himself.

Above: The American Pig's POV (Part 2, Airdate 4/28/2009)

Above: Manfred, The ProfessNor of Dangerous Flus (Airdate 5/4/2009)

All clips above are (c)2009 CBS and Worldwide Pants Productions.

Retrospective: The Flight of Hell

Above: A McDonald's. In America? Nope.

Being at a Caribbean Medical School seems awesome in many aspects: you get good weather, get to taste a different side of culture, and it is an experience of a lifetime. However, last week marked the one year anniversary of an event that was best put as a Hall & Oates song title:

SO CLOSE (YET SO FAR AWAY).

See, the one huge disadvantage about going to school in the Caribbean was moving my life away from the States and taking it someplace else for such a short time. I had to take my life, and restart it over in the Atlantic. But I amazed myself on how much I actually accumulated in terms of experiences and physical things. Talk about baggage... and I only had 70 lbs (sometimes 50 lbs) of it to carry it back home.

Last year, when I was heading home after my fourth semester at Ross, I had my biggest flight nightmare ever. My itinerary had me leaving Ross on the 19th of December in the morning, and arriving late at night on the same day. I was definitely grateful to have a schedule without a layover... unfortunately, one unexpectedly came my way.

PRELUDE:
When flying to Dominica, there are two major options: LIAT and American Airlines. The advantages of flying American Airlines is one layover (24hr) in San Juan and a direct flight from Dominica to San Juan, but the disadvantage is that it was a hefty ($1100 two-way) trip at the time. Utilizing LIAT, you could save $200-$300 depending on the flight connection combinations, but those combinations could result in disastrous transfer times of less than 60 minutes at unfamiliar Caribbean airports. Utilizing my budget mind, I had booked my flight to Dominica that semester on LIAT. I had survived 7 flights, over the past 4 semesters, utilizing my budget itineraries and a handful of crammed transfers.

I guess eight is a charm.

DECEMBER 19, 2008:
Posting my 11 AM flight out of Dominica from the small, but nicely refurbished Melville Hall airport in Dominica, we noticed that our LIAT Airplane was an hour late. Fortunately, during that time I had caught up with my friends Jo and Jemini in the waiting room. They also had similar flight connections with me, as they both were heading back to Chicago. The caveat was that Jo had an international flight to Asia the morning after she arrived. As soon as the plane arrived, we were engulfed with constant promises (and apologies) from LIAT, but I really started to feel unsure about the rest of my itinerary, with a short transfer time in Antigua, I thought everything had screwed up.

Fortunately, we made it. Home free? Not exactly. When I was going through the transfer desk in Antigua, I noticed that my baggage tag copy did not have my name on it. It was someone elses. Because of this tag mishap, the LIAT staff sent me through customs (which was a much longer process). Being the talker that I was, I started talking to people in line about my issue, and I started to talk to someone else who had the same problem happen to him. The name on his tag: mine... and my tag: his. With a jump for joy, I got out of the customs line and went back to transfer after we both gave each other our respective tags. It was then that I had a quick hot dog with one my fellow Rossies, John (which I do truly recommend from the Big Banana Food Bar in the waiting area), and soon Jo, Jemini and I we were ready to board the flight to our next stop, St. Maarten.

When we reached St. Maarten, I ended up staying behind at the luggage carousel to pick up my baggage for my next flight (due to my switching of airlines, I had to re check-in). After a long wait where my patience was tested, my bag did not appear on the belt. I had to spend time to report it. Just great, more hassle, I thought.

At that point, time was of the essence, so I ran through customs and right to the check-in desk... My next flight was a U.S. Airways scheduled flight for Charlotte, N.C. If you imagine the scene in the original Home Alone where the McCallister family is running to catch a flight, you're imagining the way we were running to catch our next flight, with 45 minutes on the clock. As soon as I got to the desk, they said that they had their policy for international flights is that 60 minutes before boarding check-in stops. We pleaded to get on the plane, as the plane was still at the dock, but unfortunately that was a no-go.

Jo, Jemini, and I decided to wave the flag that night, and U.S. airways was happy to reschedule our remaining flights to the next day (making me on target for arriving the next day). We ended up gathering another follower to our "screwed over" group, George (who was heading for Detroit). We ended up staying at a hotel and splitting the bill in St. Maarten. It was good though that it was a touristy area, and everything was close to the airport (including this grand Steakhouse called Ranchero, which we dined at for dinner). After splurging on McDonald's (because haven't had any in a while), we decided to rest before heading home the next day.

DECEMBER 20, 2008:
After grabbing a quick breakfast at the Mickey D's, we scheduled our Taxi for the airport. Jo had left our group earlier that morning, as during the previous night she spent time contacting her husband in America to schedule a flight for her on another airline. Our midday flights out of St. Maarten would make her tardy for her international schedule.

Jemini, George, and I made it to the check in desk to find out that our new schedule combination was not reserved, so we ended up going to the reservation desk to hassle our way to get our way back home today. We were soon rescheduled on another flight just an hour later, also to Charlotte, so we were relieved. Once again... Check-in... customs... wait. When Jemini and I caught ourselves at the gate, we congratulated each other for making it through finally.

We jinxed ourselves. The PA soon announced: "U.S. Airways flight XXXX has just been canceled due to mechanical issues with the airplane. Please come to the desk at the gate to reschedule your flight."

Jemini and I were in disbelief. We rushed up to the desk, and soon were about 40 people back in line. I reached for my cell phone... At this point, I thought that not even roaming charges could keep me from arriving home. I kept dialing the U.S. Airways number, but my phone was not only out of batteries, but kept disconnecting from the signal. It was fortunate that my cell phone could plug into a laptop and charge off of it. And that's exactly what I did (see below). I kept calling, but due to the holding time for an "available operator", my laptop battery had been burned just about to zero. I just had enough time to put in my schedule change (which was for a flight about 3 hours later to Charlotte), but my phone died when I was about to schedule in Jemini's and George's.

I ended up to be the only member of our group that day to land in America, as Jemini and George ended up taking a voucher from U.S. Airways to stay in St. Marteen. Getting out of Charlotte-Douglas International Airport into 50 degree temps and getting a little soggy from the pouring rain was actually an amazing feeling (especially since U.S. Airways picked up the tab), so I boarded my shuttle bus to head back to the Four Seasons hotel they had me post up in for the night. Not bad for a free night, I'd say.

My final flight was at 9 AM tomorrow. I prayed that this escapade would finally run smoothly that night.

Above: The cell phone laptop battery concoction I put together.

DECEMBER 21, 2008:
Awakening from my amazing sleep at a Four Seasons hotel in Charlotte, I took the earliest airport shuttle to the airport. Drowsy and tired, I was welcomed by long lines a the U.S. airways check in booth, and with 2 hours remaining until my flight, this sight was not one for sore eyes. However, things moved along smoothly, and after checking in, security and finding my gate were easy as pie.

I arrived in Chicago, IL at 9-10 AM that day, on time for the flight I was scheduled on, but almost a whopping 36 hours and 2 layovers later than my itinerary had originally proposed.

I visited the U.S. Airways desk at Chicago O'hare hoping my bags had made it... but they didn't. The U.S. Airways representative said that they would bring my bag to my home soon. About a day later, I got the call that it was here. However, by the time the delivery guy appeared at my door, I looked down and a small, blue bag was looking at me. It was unlikely some magical shrinking machine came to life (like the one from that Rick Moranis movie) and shrunk my big rectangular roller suitcase, so I had to come up with the other logical conclusion: this the bag of the man who got his baggage tag switched in Dominica with mine. I ended up sending the bag back to the delivery man (he seemed rather confused, as he seemlingly had rarely heard of this type of issue before).

Although I made it home, my flight nightmares had not ended. Now, I knew that my baggage tag was also switched onto the wrong baggage (talk about wreckless baggage tag placement by the LIAT staff in Dominica), and I needed to find it to study for my big post-break exam (the Comp). To put a long story short, after several calls to U.S. Airways about my baggage, I got in contact with Patrick, the man who I had my bag switched with (fortunately he too was also a Ross student). He told me that my bag was nowhere near Chicago... it had made it to L.A., and on a different airline. After a few more days of intense phone calls, my bag finally... and I mean finally, made it home.

I was glad to be in the right place for the holidays, at home. I was also fortunate enough to have American Airlines tickets to school up my sleeve for next semester.

THE AHA MOMENT:
To those of you to fall upon this long blog entry, and are just about to enter Ross or another medical school in the Caribbean, here's my tip for securing flights:

1. It's okay to have a lay over.
Make sure you select an area that you feel secure in laying over, and reserve a hotel ahead of time, if you are flying during a peak period (i.e. when everybody else is traveling to/from school).

2. Get your tickets early.
For some instances, its best to start knowing what you're going to be doing next semester and getting your tickets once you arrive at school. For Ross students, this could mean securing the limited amount of flights on American Airlines.

3. Make sure your baggage is tagged appropriately.
Always ask to see your bag tagged before you leave the counter.

4. Check all baggage restrictions for all your airlines.
At the point of time I wrote this entry, baggage policies are accepted on the first airline you board until you exit an airport. If you switch airlines after a layover, your baggage restrictions reset to the airline you board the next day (meaning this is the limiting factor). The last thing you want is a hassle of ridding your bag of meaningful things just so you can make it to your next flight... and I know of people who have ended up doing that.

5. Do your research.
Know the check-in and customs policies at each of your connecting airports. it would have made me think twice about my itinerary sending me through St. Maarten with such a short connection time.

Yes, some things do turn out to be the airlines' fault, but as a good doctor would say, prevention can help from a horror trip like mine from ever happening to you. Stress should end when a semester is over, not begin.

Holes in the Net

Above: The hustle and bustle of Interstate 75/85 in Atlanta, aka the "Downtown Connector." Courtesy Wikipedia.

"ATLANTA CAN'T LIVE
WITHOUT GRADY."
From the Grady Health System main page.

Although health care is a quintessential part of society today, the 2008-09 recession has shown that money could still be more powerful. One example: Grady Memorial Hospital of Atlanta was about to be closed in 2008 after gathering $53 million deficit, produced due to the hospital's dedication to taking care of those disadvantaged for health care in the region. However, with the following statistics showing how crucial the hospital is to the area, it would seem that closing should have not been an option:

1. It takes in 850,000 outpatients and 30,000 inpatients each year.
2. It has Georgia's only Poison Control Center.
3. It is the area's only Level 1 Trauma Center
4. It is Atlanta's main safety-net hospital.
5. Its network includes Grady Memorial Hospital and 9 more area community clinics.

In the New England Journal of Medicine, Grady Memorial Hospital was featured in an article about the holes appearing America's current safety-net.

Okay, pause for a second.

For those of you unfamiliar with the concept, a safety-net hospital is a hospital that serves a significant amount of low-income, uninsured, and disadvantaged populations. One thing that really surprised me about the definition of a Safety Net, is that ownership (public or private), isn't really the factor, but other determinants, from philosophy (e.g. having an "open-door" policy for care) to usage (i.e. proportion of incoming patients with low-income or proportion of people who utilize medicare). Most of these hospitals are eligible for what they call Disproportionate Share Hospital (DSH) payments from the government, which aid the hospitals for the costs of providing uncompensated care to those uninsured or under insured.

Whew.

Fortunately, with private donations and grants, the hospital was able to stay for the most part, open. The dialysis clinic at Grady was forced to close. Grady has done much for its patients to assign them to temporarily set them up with other clinics and to help ease transitions for those patients struggling. Although the damage to the hospital itself was minimized, there were patients that were still critically affected by the situation.

Closer to my neck of the woods, the main Safety Net Hospital of Chicago, John H. Stroger, Jr. Hospital of Cook County, is a refuge for those without health insurance benefits. According to a September MSNBC story, these disadvantaged patients are very happy to have some place to go. However, recent health care reform may reduce DSH payments to hospitals such as Grady and Stroger, potentially weakening important links in our health care system, leading to reduced coverage and maybe closure for some institutions. We've seen already how financially tight things are at Grady, for all I know there could be another handful of hospitals that are teeter-tottering in the same financial situation.

To me, the idea of losing funding for these hospitals could be disastrous. Personally, I think that its dangerous to cut funding from these hospitals, as health care for more than the low income could be affected. One hypothetical situation that I thought of is if these high capacity hospitals are closed, where else will these people go? Potentially to other hospitals that are not prepared for the added patients, stressing the rest of our health network in America. A unseen domino effect might be on the horizon.

I personally think that there are other options that are not being looked over, such as tort reform (e.g. protecting doctors from suits, so we can work more efficiently without having to worry about our backs) and many inconsistencies and inefficient ways that medicare and medicaid are being provided. Sometimes I think that the government is attempting to do so much to health care right now that if something goes wrong, we won't be able to figure out what made it go wrong, due to the extreme complexity of our health care system.

Like I said a couple of months ago: I'm all for reforming the system, but we need to be careful and think about all the potential consequences of our decisions in the long term. It concerns me that things that may appear to be good for us now might not be good for the next generation.

Sources:
1. Forum on Displaced Grady Dialysis Patients Held. Atlanta Progressive news. December 7, 2009.
2. The Grady Health System main page.
3. Redlener, I. and Grant R. America's Safety Net and Health Care Reform - What Lies Ahead? The New England Journal of Medicine. December 3, 2009: 2201-2204.
4. Will safety net hospitals survive health reform? MSNBC / AP. September 8, 2009.
5. What is a safety net hospital? National Association of Public Hospitals and Health Systems.

Now, Really?

Above: JD (Zach Braff) and Lucy (Kerry Bishe) are the leads for their respective versions of Scrubs.

“MEDICINE IS A DEAD CAREER.”
Dr. Cox during an orientation to his new Medical School class.

After having two years of medical school under my belt, it is interesting to see ways that Hollywood portrays the medical profession (with some series much more interest than others). Hence, I was willing to plop myself down in front of the television with the recent release of Season 9 of Scrubs (aka Scrubs 2.0) taking place at medical school. With all the crazy stories that we’ve had after two years in Dominica, I’m not amazed they haven’t targeted one of us Caribbean medical schools yet for a screenplay (perhaps an idea to the creator of Scrubs, Bill Lawrence).

As I was watching J.D. pass on his 8 years of experience in the medical profession, now as a professor, onto Lucy – who inherits the next chapter in the Scrubs series – I saw a great example of one of the realities of a medical education: Although one may know every single aspect of the plethora of scientific findings made over centuries, without real life knowledge passed down through the medical hierarchy – from senior surgeon down to medical student – one cannot really survive in the medical world.

That same night, I took a few moments to gleam over a couple episodes of the first season of Scrubs – before the humor got so into a niche that the next time I flipped on the show, I thought J.D. (Zach Braff) and Turk (Donald Faison) had "hooked up "– and watching an “innocent” J.D. walk into Sacred Heart Hospital (along with an innocent Lucy in Season 9) for the first time really reminded me of… well, me.

And its for one big reason: We all go in thinking we’re there to help people, but only to initially discover there's so many obstacles to get to a good outcome sometimes: including red tape, insurance and malpractice claims, and not to mention patients who won't follow every piece of advice we give. Scrubs isn't a 100% realistic show, but that doesn't mean that non-compliant drug addicts, bitchy doctors, and crazy colleagues aren't a part of a typical medical student's / resident's life. As for this season's Scrubs, I think they're covering some very important lessons, and definitely with laughs along the way, I want to see how our new narrator Lucy develops, and what she learns as J.D. passes on the torch.

Oh wait... I just thought of another reason Lucy, J.D. and I are similar: we all think blue sky. I can bet my bucks that we all disagree with Dr. Cox: medicine is not exactly dead... We'd prefer to think that parts of it need a little tweaking.

Shortie: That Late Night Alcoholic

Above: Craig Ferguson on his February 20, 2007 Telecast.

"IT'S A GREAT DAY FOR AMERICA."

... is exactly the way Craig Ferguson starts every single monologue.

There was a lot of hustle and bustle going on with late night TV shows at the time I wrote this entry (such as O'Brien overtaking Leno on The Tonight Show to Letterman's feud over sexual relations), but it reminded me to get connected again to one of the late night show hosts who gets my profound respect, and that's Mr. Craig Ferguson. I knew him from his previous stint on The Drew Carey Show as Carey's boss (his catchphrase: Carey, You're Fired!), but when he stepped up to The Late Late Show, I became a huge fan of his. What's most striking to me about him is how down-to-earth he is to his audience. Hence, when he has to strike up a serious point, he hits a home run, such as in his clip above.

In the monologue I attached, Ferguson tells the audience a few stories of his old alcoholic days and after a turning point, he turned sober... and has stayed that way for fifteen years. However, what got my mind thinking was his perspective on what the concept of an alcoholic really is, referring to the issue as "a thinking problem" and saying it doesn't end when counseling is over. In med school, we learn about the numerous effects of alcohol. Contrary to what many of us learned probably in middle school health class - it does much more than just damage the brain, with various systemic side effects like nutritional deficiencies, anemias, even liver damage (that itself opening up a potload of other effects). As doctors it would seem easy for us to use health-scare tactics say to other alcoholics, "Let's not have this happen to you. Don't drink." Ferguson says there's much more to that.

To me, it reminds me that no matter how much knowledge we have about the human body, it can only go so far. As doctors, we need to utilize our communication skills and our ability to build rapport with our patients to take care of their spirit. Body and mind do go together. We just can't forget about the latter, even though our minds are crammed with information from the former.

And with that, cheers to Mr. Ferguson for keeping his thinking straight for such a long time. With that accomplishment, I think, to him, every day that comes is a great one.

Shortie: Tuba Player

Top: One of the jazz greats, Louis Armstrong. Image found via Google Images.
Bottom: A CT scan of a kid with Parotitis. From the New England Journal of Medicine.

One of the biggest figures I associate with jazz during the 20th century is Louis Armstrong. Known for his quite exquisite trumpet playing and great scatting, I've actually associated him with another distinctive visual quality:

BIG CHEEKS.

February 2009. I remember logging into the New England Journal of Medicine website to start to see what the world of truly revolutionary science could be. I came across that day an article with a title was simple (at least more simple than I'd expect from a medical journal): A Tuba Player with Air in the Parotid Gland. Keeping it simple, the parotid gland is one of the glands that's critical for producing your saliva in your mouth.

When playing the tuba, one of life's truest physical properties comes true: If something gets trapped, it needs a way out. Playing the tuba requires physical air pressure in your mouth to get the instrument to play. However, because 1) blowing against a tuba (or other wind instrument) creates air resistance, and 2) Your body has locked the air in the oral cavity (keeping it simple again, your mouth), there's only one other way for that air to go... the force to play that instrument actually flies down the tubes that connect your mouth to the glands that produce saliva. The scientific name of this phenomenon is: pneumoparotid.

With the origin of the name including that for "air" (pneumo-), this diagnosis stays true to its name. The air that gets blown into those glands gets trapped, resulting in enlargement of the glands, with enlargements appearing around the point where your jaw pivots to open: the place that the glands are located.

Hence: Big Cheeks.

Folks, I guess I can come to this conclusion: If your kid can't play the tuba, your kid might be able to pull off the look.

Source: Mukundan, J. and O. Jenkins. 2009. A Tuba Player with Air in the Parotid Gland. New England Journal of Medicine Vol 360. p.710.

Incurable Optimism

Above: Michael J. Fox on the cover of his latest book, Always Looking Up.

"Simple things can change the world -

be the difference you want to see in the world."

Sam Malek, Extreme Makeover: Home Edition

Optimism has definitely been my "cuppa tea." To me, its quite an interesting concept: How can people who face battles where the odds are against them possibly see a light at the end of the tunnel. I think that strong optimists are goal makers who love to think of the extreme, and perhaps the impossible. Some people term these ideas "blue sky." (I love thinking of it this way: Without blue sky ideas, how can one possibly enjoy the sunshine?)

(One of my fellow med students has given me the nickname Mr. Sunshine, by the way.)

I finished Always Looking Up, by Michael J. Fox a few weeks ago. I loved the subtitle he threw on the book: The adventures of an Incurable Optimist. The obvious meaning first strikes: his optimism is shadowed by a lack of a cure for his condition of Parkinson's. However, I can see him meaning optimism has become such a stronghold of his life, he just can't let go of it. I think Mr. Fox does a great job of showing how it gets him through life and through his foundation and the values he advocates (not only through his public life but through his family).

It got me to think,there have been times I haven't felt a strong sense of optimism surrounding me during my medical school career. And for an optimist like myself, negativity is like kryptonite. I can recall examples: seeing motivations for studying simply driven by potential failure, healthcare agendas in congress seeming more like battlefights to avoid the worst, and even today's doctors simply saying that they either joined a specialty simply for the "lifestyle" or complain about the profession becoming a defensive one, saying our job is basically to avoid being sued.

No, it's not bad to assume the worst or to be realistic. It becomes a problem when one gets infatuated with negative ideas.

Even in the light of those ideas, I still believe medicine is about optimism. I could ask myself: Why should we take care of people, even if the odds are bad? Because, there's hope that person can continue to live life potentially to do something great. I believe that everyone has a right to go on and do something amazing, for themselves (e.g. go explore a place one has never been to before) or even society.

A quick example of the latter: Mom's been on a roll getting me to watch TV. This time it was Extreme Makeover: Home Edition. Sam Malek is a coffeeshop owner in the metro area of St. Louis, Missouri. However, Sam Malek is not your average Starbucks owner. According to Sam, a man who was born premature with cerebral palsy (an umbrella term to describe conditions where damage has occurred in brain areas that affect movement and posture), he was thrown right into a trash can. Today, he goes around with the aid of crutches, but never complains and clearly loves his life. He wanted to give others like him an opportunity he always wanted. He started up a coffeeshop called More Than Coffee, dedicated to employing those who have crutches, wheelchairs or other disabilities who might not find a job elsewhere. His idea was spurned by his philosophy, as quoted above (I love that quote). You know, had nobody taken care of him, I don't think he would have ended up taking that idea to do something that I deem amazing.

And perhaps, I've strolled across another reason why I love medicine. I see it as a field where the work we do teaches (or at least should teach) people about hope and optimism. Through our amazing job, we can teach others to be amazing in their own way too.

Proof Positive?

Above: Dr. Andrew Wakefield surrounded by supporters, found via Google Images.

VACCINES?
FRIEND OR FOE?

My mom always calls me down from upper deck (my term for the second floor of our house) to watch television programs. Sometimes, I don't really care (e.g. America's Got Talent results shows), but when my mom mentioned the words "autism" and "Dateline" put together, I said to myself, "This 'oughta be good." Next thing, I'm flying down the stairs and next to my mom I plopped myself in front of the television. The show: "Dateline: A Dose of Controversy" on NBC.

The story was behind Dr. Andrew Wakefield, formerly a researcher in Britain, now a head of an autism intitute in the Americas called "Thoughtful House." Reporting by Matt Lauer of NBC centered around the growing trend of people stopping vaccinating their children, due to a believed link between autism (a brain developmental disorder that hinders social interactions with others) and the MMR vaccine (a combination vaccine against the Measles, Mumps, and Rubella viruses), an idea being pursued by Dr. Wakefield. It was soon encouraged that patients start taking vaccinations in separate form (one shot for measles, another for mumps, and another for rubella). In the wake of his research, published in The Lancet (a reknowned British Medical Journal, similar to our New England Journal of Medicine), a slew of controversy over motivation for the research arose as families started demanding the single vaccines (creating a shortage of supply) instead of the combination vaccine.

The program also presented the pro-vaccination side of the story, featuring Dr. Paul Offit, a renowned researcher in Pediatrics in the United States, co-credited with the creation of the Rotavirus vaccine, saying that vaccines are not associated with autism and are very safe. In his 2008 book, Autism's False Prophets, he talks about the misinformation going on in the This point of view is shared among many doctors, autism researchers, and medical journals, according to the New York Times. However, in pop culture, Jenny McCarthy, along with Jim Carrey, a Hollywood-led grass roots effort has been going strong, raising questions about the true safety of vaccines. At Autism conferences, Wakefield gathers great support from parents who believe that their kids have autism.

Since the report now over a week ago, a lot of parents and advocates on the Autism Web Newspaper The Age of Autism have spoken out for their support of Dr. Wakefield, and Dr. Wakefield has released a statement saying that Matt Lauer's report on NBC had left out critical facts, such as Dr. Paul Offit's connections and associations with vaccine makers, and crediting research that has supported Dr. Wakefield's findings (Just like other mass media, bias was definitely present in this report towards the pro-vaccination point of view).

For a medial student like me, it makes me wonder, 1) Where did the distrust in medical science begin? and 2) How can we earn the trust in these people again?

That is... especially when our empirical research shows differently from what others believe. Disagreements in empirical research and in the information being conveyed to the public could take away from the giant strides that vaccines have made in fighting diseases. Outbreaks of diseases we thought we have had a control over are coming around in areas that are not being well vaccinated. If this trend grows, these outbreaks may grow.

I wish I had the answers to the questions I proposed in this entry, but at least this debate has a lot of ethical food for thought for both us clinicians and patients in today's world.

Sources: Dateline NBC, Thoughtful House and The Age of Autism.

Oh... So that's where that came from?

Above: My old workspace in the Aquatic Ecology Lab, during my old research days at the University of Illinois, Summer 2007.

“To me it was obvious, we can’t improve survival unless we test new treatments against established ones.”
- Dr. Scott Ramsey, M.D. in the New York Times.

Looking through a First Aid book the first few times may be daunting: in almost 400 or so pages, the book tries to compile the whole nine yards about the human body. And in order to compress all that information, the information comes in quick-n'-dirty tabular form, where usually the information can only be understood if school had taught that concept properly (at least with the way I studied... so I thought).

But amidst this compression, I think sometimes us med students neglect to acknowledge how much effort and time actually goes into the conclusions that is now common knowledge for medical students. At a point, what we sometimes think now is a typical fact, was previously a conclusion that was came upon due to a series of clinical trials or scientific experiments. Who knows how many studies led toward a single line of "common symptoms" that us clinicians (with the MDs, DOs, and others) need to know.

In the series called the "Forty Years War" in the New York Times, I read a few weeks ago about how getting cancer patients to participate in studies has been quite a fight. From a patient's point of view, initially, the costs mount up quite well: the treatments aren't guaranteed to work, there might be risky side effects, and there's quite a deal of "red tape" and extra meetings that the patient needs to participate in order for the researchers to gather data.

For instance, in one of the latest New England Journal of Medicine articles that I've read, 3200 patients were selected for a study. Even before the actual treatments and data collection were underway, 3059 of them were already excluded (everything from not meeting minimum patient criterium to not even wanting to be a part of the study). That left 141 people to represent the thousands of people with similar conditions in the study. That's quite a small sample, but the researchers did the best with what they had.

In the world of research, the smaller the sample size, most probably the less powerful the findings. I don't know we could exactly fix this problem though... the benefits are there, but I can definitely empathize with the patient, and their concerns. However, they are the ones that hold the power towards the progression of treatment in the world of medicine.

Using lab animals just isn't the same as using good old 100% human beings.

Source: The New York Times & The New England Journal of Medicine

Valuable Talents

Above: A former Cuban doctor continues his medical career as a nurse in the United States. From The New York Times, Maggie Steber, 8/4/09.

MORE PROOF THAT ANYONE WOULD DO ANYTHING
FOR A DREAM.

January 2009. I remember that one thing that struck me about the medical staff of Princess Margaret Hospital in Dominica was that the doctors were not just of Dominican descent. In addition to working with the natives, I also worked with a few Cubans, and not to mention an American, and a Filipino (that's luck!). I remember asking one of the Dominicans where he got his medical degree, and he told me that many of the Dominicans really don't go to Ross, but they head to Cuba to get their education. I'm guessing this partnership in medical education explains why many Cubans also found a place in medicine in Dominica.

August 2009. The New York Times featured in their Tuesday Science & Health section, an article about doctors who are fleeing from the political oppression in Cuba and heading for a life in medicine in the states. However, many of these doctors face the challenges that many IMGs face: a language barrier (see my previous IMG entry below) and board examinations that might feature knowledge that outdated textbooks in the Cuban system lack. I really enjoyed former doctor Carlos Domínguez's story about how he traveled to the United States in a boat that didn't have a reverse gear, because he knew he was never going to return to Cuba.

Working with the Cuban doctors during my fifth semester was quite a treat. When working with them, their enthusiasm for the field of medicine definitely showed through their willingness to teach (along with their patience for a set of medical students just bound to mess up). When observing one surgeon perform a hysterectomy, I can clearly remember how excited he was when he saw the patient's fibroid (an abonormal mass originating from the smooth muscle of a woman's reproductive system), and his eyes lit up exactly like a little kid in front of a candy store. After student presentations, the Cuban doctors were more than willing to announce their praise for the students and for the work that went into it.

I absolutely enjoyed working with the Cubans.

The thing I respected a lot about the doctors I worked with was their excellent bedside manner and the ability to speak with them on a first name (okay, semi-first name, because they had us put the doctor title in front of their first name) basis. They also were more than willing to crack jokes left and right to keep the mood light - for patients and for students. For me, it doesn't jive well that doctors from Cuba making it to the U.S. (many of them with great experience, work ethic, and strong motivations) are ending up not working at the level their title, and instead working in other positions in health care (e.g. nurses). Some even go on to work in other unrelated fields.

I understand that coming to the states for freedom is a dream... but there has to be a way for these doctors to be utilized. There's definite potential.

I don't know, perhaps this is a "Hail Mary" idea, perhaps they could be a part of a solution to cure our shortage of primary care physicians? From my experience, they do have the knowledge, the passion, and the ability to be a part of our American Dream of good health care. I don't think that their talents should be wasted; instead, I believe their talents should be refined.

Source: The New York Times

And now...

Above: A saying from Cesar Chavez, posted in the halls of The American Adventure, Epcot, Summer 2009.

LIKE ZACK MORRIS SAYS:
TIME OUT!

When I started this blog in January, one of the reasons I called this blog The Great Medical Adventure (instead of other options I considered like Amazingly Awesome Med Student or Slicing and Dicing for a Living) was to demonstrate how the little things in life allow me to do my best in this field called medicine, and its a long (and at times, extremely difficult) trek. However, now that I'm done with the most important exam of my life (and living in suspense waiting for the score), my adventure has me in a state which is quite similar to hitting a pause button. I'm not going to be in a hospital until I get my score back (which is an unbelievably fast six weeks), so stories from the bedside and inside the wards won't continue until then. I'm hoping I get my rotation schedule soon and can get jumpstarted with practical experience.

However, the adventure has continued in other ways.

It's six weeks (potentially less) to think about issues in health care that I might not get to learn in medical school... whether its learning a little bit more about that humanitarian side, taking some time off to read some literature and get a more in depth with some of the medical science relevant to my career... think about what fields I might really enjoy working in... and yes... take time off to enjoy life. For the upcoming entries, I'll share some of my thoughts & findings with you (the last entry was a good example of one).

However, we'll unpause soon, and we should then be blasting through the gate to continue my trek through medicine. I can't wait until I write about real experiences... again.

Soundbytes

Above: President Obama reading letters in the Oval Office regarding HealthCare. From www.whitehouse.gov, August 4, 2009.

AN AVERAGE TV NEWS BYTE IS
120 SECONDS.

Usually, I'm a fan of the quote, Time is of the Essence. However, with the recent news on health care, I see rushing the issue could be bad... very bad.

I remember being told that the average soundbyte on the news is only about 2 minutes long (after watching today's midday news, I believe it is even shorter). And, with all the news stirring about health care reform, how much can the American people be enlightened with the pros and the cons of the current bill that's being transferred into congress. I'll be honest, with the free time that's been given to me post-examination, I've been digging left and right, trying to find the core of what the bill is and why is there such a rush.

I've started reading up articles online from the New England Journal of Medicine, the New York Times, various websites stating the democratic and republican points of view upon the issue, and even rewatching President Obama's hall conference had on ABC a few weeks ago. To be truthfully honest, it seems that not everyone is addressing the same points, although there might be some overlap, and I find it rather irritating when I can't answer the question, What did the other side think?

I believe that health care is such a complex problem, that there's potential that fixing one thing might lead to exasterbating other problems that might not have been thought of. But something needs to be done.

I respect the president's goals with health care and the viewpoints too, but if I'm a medical student who's been trying to follow this with simply newsbytes, even with question and answer sessions, and now has gone to lengths to start digging for information, YET still has NO idea what the overall costs and benefits of this legislation is, what is it for millions of other Americans who are getting concerned, with only time to get their info through soundbytes? I want to make sure I'm eduated on this issue too, and I hope that my representatives and senators are making educated decisions too.

Healthcare policy is critical for everyone's lifestyle, their budgets, and of course, our economy.

Hopefully with this August recess, I can do that, but I hope that the Government slows down. However, the president is right: we need a deadline (however, realistic) or nothing will get done.

But for now, the digging continues. Soundbytes aren't enough.

Countrified 3 - Suburbified

Above: A view of the 2007 Champaign-Urbana July 4 Parade. In any Independence Day parade, nothing beats the marching guard.

YESTERDAY, I flicked on the television, and one of my classic TV favorites, The Dick Van Dyke Show, was showing. In the episode, I saw that Mr. Petrie, portrayed by Van Dyke, was having an absolute hard time trying to write the story of his life into a biography. Soon surrounded by broken furniture, and a mound of crumpled up paper, he was just so distracted by being isolated from the real world to write his story that he just gave up.

As much as I get distracted, I have keep the story going. To begin, I’m going to take you a few weeks back.

July 4 Weekend: When I was in High School, my congresswoman, was a big help to me, allowing me to volunteer in her local office for my AP Government class and helping me to learn about the ins and outs of congress when I was part of the Presidential Classroom program in Washington, D.C., during the summer of 2002. In return, I help her out every year – provided I’m not in Dominica – I usually parade with her in her congressional district.

However, it wasn’t exactly the best day for a parade, with cloudy skies and light drizzle to light rain (there really isn’t much of a difference to me). In our attire, we were ready to hit the road, awaiting deployment from the gates and onto the main street. Soon, the policemen at the end waved his hands, and our feet started marching.

We then made the turn around the corner and started our route.

A warm feeling of community started to take over me. Even on this cold, dreary day, the streets were lined with people of all races and ages, a lot waving American flags and looking upon the marchers ahead of us with a multitude of smiles. At a moment, I did have to start looking up to wonder if I really am in the suburbs. I never expected the suburbs to have a community-like feel, but at least Hinsdale, the suburb I was marching in, certainly presented itself with one. Walking in the parade surrounded me with an astounding sense of community.

I had felt that a lot of suburban communities have lost their character, with large mass-built subdivisions, with houses that have similar facades and colors and streetlamps that you could probably find on one of the nearby expressways. Nearby businesses would be pushed into strip malls, and all of them could be classified either as a “chain” or a “big box” retailer.

HOWEVER… when we turned our second corner, right into downtown, I started to look at things differently. Many of the commuter suburbs of the western Chicago area have a downtown that surround the commuter/cargo rail line that pass right through it. With the recent trend towards bringing businesses back into the downtown areas in many smaller communities in the nation, a renewed vintage feeling has been instilled in many of them. And here in Hinsdale, the feeling of a small city downtown was preserved, while allowing businesses (such as the Gap or Starbucks) to niche themselves. Wide sidewalks, lots of foliage, and vintage streetlamps really set the scene for a relaxing time for some daytime shopping, or even a classy dinner.

So, in the race about where I should live in the future, suburbia finally hits the ball into far left field for a double. The recent "Downtown Revival" occuring in suburbs across the nation is saving a suburb from becoming just another "suburb." It's true: I enjoy that feeling of being in a small town, but also with the services and the sophistication provides. Perhaps living in a suburb that values its own identity would do the trick.

That’s a critical part of an area I want to live in: it has to have its own charm and character that makes everyday not just another ordinary day.

Prelude to "The Mind of an Examining Med Student - The Sequel"

Above: A Dominican kid climbing in the Salybia territory.
You'll find me climbing trees after my exam. Keep your eye out.

I never thought that I'd write again before my exam, but...
I'm in need of a break.

Here's why.

I think that another med student on a forum put studying for the big exam well... It's like running a marathon. Practice. Practice. Practice. So, out there, several studying-aid companies offer practice exams that are only 4 hours long, and there's exams that are also more like the real thing, about 8 hours long.

Well ... I took the 8 hour practice exam today.

As I took my exam in a deep corner of the library, stuck in a cubicle to separate myself from the rest of the world... I tried to simulate what the big day in a couple days would be like. Let me tell you, that the exam threw my mind left and right. At a point, I had no idea how I was doing. As much as every question is "mutually exclusive" from another in terms of content, I felt my confidence wane left and right, as one question that I was unsure about, totally made me doubt myself on a question I would typically be sure about.

And then... after all that, my reward: a number. My brain felt fried, cooked, well-done, over-easy, scrambled, and dipped in Tabasco all at once, but it did feel good to be done.

I think that's exactly the way that my exam will go on Tuesday (other than the number actually coming six weeks later). But... there's 5 days left to study, and here's the dash to the finish to making my score the best it possibly can.

It's game time.

Almost There.

Above: A Dominican Rainbow... so much better than reading pages of text. Spring 2008.

I'M STILL ALIVE...
I THINK?

The days are flying by, sometimes to the point where I the only thing reminding me of the date is the monday $1 special at the Caribou Coffee(s) I hit up. I moved my test date back to the 28th, but seeing how my progress is coming along (if there is one), I'm glad I did. However, as tempted as I am to keep pushing it back, I have to remember... I can't keep the test waiting forever. So... 28th, Regis, is my final answer.

It's me, my "bible," and a laptop, against the NBME in just a few days.

I'm still blogging, and I'll get y'all updated on what its been like these last couple of weeks (trust me, my nomadic travels of studying have taken me to some interesting experiences). This was just to let y'all know I'm still kicking. So thanks for keeping up with reading, for your support, and... stay tuned. We're almost there.

For now, its back to the books.

Two IMGers, Two Different Perspectives

Above: A view of the valleys of Dominica from Horseback Ridge.

12:45 PM. My typical lunch rush. I'm usually the type of person who schedules his lunch to avoid the lunch rush that occurs (I always thought it was a stereotype to head out for lunch at 1:00 instead of everybody else who leaves about 12:00 from their offices). However, I started my blog entry in the wrong place (I just ate Taco Bell, so it must be the food that's giving me coma)....

12:00 PM. Everyone else's lunch rush. I'm dashing between my First Aid Book and my USMLE QBank, trying to make connections for my upcoming exam (which by the way has been set on the 24th of this month, so wish me luck!). With my table of four at the library, I was taking up a lot of space on it, and this man comes in, trying to find a table. The man seemed to be about middle-aged and from the middle east. He pulls out the chair, and with simple enough body language (I had my headphones on, listening to Ramsey Lewis), I nodded to give permission to take a seat. As soon as he smiled back, I couldn't help but noticing a USMLE First Aid for Step 2 CS in his hands.

Okay, now its 12:45 PM. I see the man look like he was about to head home: he was putting together the gradually widening mess of papers that grew around his First Aid book, and I broke the ice...

Hey, are you starting studying for Step 2?, I asked him.

He nodded back to me, and also let me know he couldn't help but notice the Step 1 book in my hands, saying Step 1, I pass. Step 2, I think is hinderance for International Medical Graduate. He told me the whole story of his pathway with the ECFMG, as a foreign medical graduate, and how he now has to take the Step 2 again. I then told him that I also was part of the ECFMG as a medical student, and pointed right to the cover of my book: USMLE Step 1, it says in giant white sans serif font.

(Let's back up a step. As a Ross Medical Student, I'm a part of the ECFMG (spelled out, the Educational Commission for Foreign Medical Graduates). This is the sponsoring organization of Foreign Medical Graduates, such as myself from the Caribbean, but also from other countries, such as the middle east, where this gentleman was from.)

He then replied... I notice you speak good English. I smiled a little and then said, I was born here. After sharing a few more bits about myself, I learned the man was about to take his important exam for his career at about the same time that I was about to take the most important exam of my life. I then wished him good luck and told him I will see you in the library quite frequently. After he nodded with a smile, I packed up my stuff and I was off to lunch.

Apparently he wasn't off to lunch: he was about to duke it out with his books for a few more hours...

---

As simple of a conversation that was, it made me take a look again at where exactly I fit in the whole realm of medical students for the United States. We've got the U.S. Medical Graduates, and then the International Medical graduates (IMGs... like the middle-eastern gentlemen). As an IMG in the Caribbean, I forget that there's IMGs from other countries trying to find their medical niche in the states, but combatting battles such as language barriers and medical technique differences. These are differences that the Carribbean schools have worked hard to minimize, something I am grateful for.

However, although we have differences as a very diverse group of Truly foreign IMGs and Natural US Citizen IMGs, I believe we're all in this together, all finding our way to work for improving healthcare and for a decent living in the United States. And that realization on this July 4 weekend has brought a smile to my face.

Shortie: How I Truly Blog

"HOW EXACTLY DO YOU BLOG?"

... is a question I have been asked by some of my readers. Well, here's a true screenshot of how I get my uploads onto Blogger. For more, click on the image.

(And yes, I do turn on my Doogie Howser, M.D. Theme music as I type).

The Iced Coffee Property

Above: A motivational graphic provided courtesy, Dr. James F. Catroppo, Ross University.

Becoming a doctor requires a lot of sacrifices... time... effort... but the most significant sacrifice of all was brought up by a late New York Times article...

"... A TEMPORARY LOSS
OF THE SENSE OF SELF."

We'll get to that in a second.

Saturday. I need to take breaks. Some of the latest research has said that taking breaks is actually quintessential to remembering and organizing material (the brain does some subconscious file-sorting thing). Or, sometimes I could just be using a break to push back studying the next 70 psych drugs I need to memorize. So, I have one of three choices:

1) Stand up, grab some random book on the shelf that looks interesting, and read it.
2) Sit at my computer and Facebook and Gchat away.
3) Stare at a nearby window and start daydreaming about being outside.

On Saturday Night, I was at one of my local Starbucks, so #1 really isn't an option, and #3 was already next to me (the Starbucks next to me has some amazingly giganormous windows), so #2 was up my alley. After strumming along, I notice that my friend Cathy posted up an article from the New York Times, with the following title: Taking Time for the Self on the Path to Becoming a Doctor.

I started to read, getting the main gist of the article about the sacrifice and how us medical students embrace that sacrifice to have this sense of disconnect between our professional and our personal lives. Let's back it up a step, and put it in less technical terms. The article acknowledges through a John Hopkins University School of Medicine research study that although medicine is a time and resource demanding job, finding that appropriate time to spend with family, enjoying hobbies, and enjoying time with self, will lead to less burnout in the future.

(The article put it dramatically with the sacrifice as stated above... LOSING MYSELF? I CAN'T LOSE MYSELF!)

I learned that disconnect between was a horrible thing back in Undergrad. My friend Neal taught me that I need to be in touch with my personal self, by doing a lot of the things the Johns Hopkins' study provided and by spending that quality time with me. However, through the Illinois Leadership Center, I also learned that introducing personality and embracing a job as a "hobby" of one's own allows for a gratifying crossover between the two seemingly separate worlds. I think that both are critical for maintaining my morale.

When I was done, I looked up and there was a perfect example of how to accomplish some of this... right in front of me.

Sunday Night. I go to many coffeehouses in my area. There's some with free wi-fi, some with comfy leather chairs, others that serve time-saving lunch and dinner, and even some with all of the above. Like I said before, I can't study at home. However, this one Starbucks near my house has one characteristic that all the other coffeehouses, even other Starbucks, didn't have.

I'm observing one of the baristas, Adam, and how he interacts daily with customers, such as myself:

"Hey, how you doing today?"
"Great! How are you doing?"
"Doing well. What can I get you started with today?"
[Insert customized Starbucks order here]
"What are you guys up to tonight?"

And through this, he started a conversation learning a few things about what people get to do on a staurday night, and all with a genuine smile that says, I'm enjoying my job. I've seen him have a great dialogue on race and the suburbs with several people who just walked in, and even talk about computers with a guy who set up his own office in the corner of the shop. And on Sunday night, he came and talked to me about medical school. As I kept watching, I felt that same aura of the rewards he was reaping through simply talking; it was that enjoyment of getting to know people.

Don't get me wrong though, he was still getting his job done (and well, may I say), cleaning up floors at appropriate intervals, taking customers up as they were walking in the door (even mid-conversation), and even putting bags of coffee on the shelf appropriately. His interactions with his co-workers were also noteworthy (with Adam and Chaz at the counter, it can get quite entertaining).

You know, he could easly be a Barista who:

1) Did his job, day in and day out, not caring about the interactions with his customer. (Burnout in the forseeable future, no?)
2) Talked and talked, but never did anything for his job. (Just a talker, not a doer.)

But he was neither. He did something what many doctors can't do (combine doing their job while enjoying learning from their customers)... in a coffeeshop. And thus, with this, I name the following The Iced Coffee Property.*

"To live every day of my life with medicine, a day I don't learn just more about the science itself, but to also enjoy learning from the people who I take care of everyday, not just about medicine, but about the fulfilling lives they live. And to encourage them to live their life to their fullest, through encouragement and through allowing my personality to penetrate the job."

And there, folks, is my hobby, my way of envisioning crossing my personal and my professional life... a way to make sure that I live my love for medicine, while satisfying my thirst for always learning something new. For those of you who struggle with the idea that medicine is a burnout field, go grab some iced coffee. Then you'll see.

Source: The New York Times.

*Named after my regular item on the menu: A grande iced coffee with nonfat milk, and sugar-free vanilla sweetner. I have to watch my calories you know.

Blue Collar, Blue Scrubs

Above: Michael Collins, author of the 2009 book Blue Collar, Blue Scrubs.

"BELIEVE IN
THE SYSTEM."

I needed some inspiration... but we'll get to that in a second.

Two weeks ago. Just past nine in the morning, central standard time, I'm walking up to my standard desk at a local library, and oddly enough, a plastic placard was standing on it. I knew it wasn't there yesterday, but my mind was eerily perplexed why of all desks, my desk, had to have a placard on it. After laying down my bookbag on the floor, my eyes zipped right to the title heading the advertisement.

"A Night with Dr. Michael J. Collins, M.D."

Doctor coming to speak? At first I thought, meh. Well, I kept reading the mysterious placard for more... It was then I learned he was a construction worker, then turned medical student, then turned Mayo Clinic resident, into a distinguished orthopedic surgeon. He was there to promote his new book, Blue Collar Blue Scrubs, a story about his experiences before and during medical school, a transition from working in construction to medicine.

Whoa, I thought. Mind you, at this point I've been days into studying for the boards. The books were starting to get to me... I needed some inspiration to kick me back into gear.

So, I signed up.

Last night. As usual, things never go as expected. I always thought 15 minutes to my library would be just enough time to get there (it usually takes me five). Unfortunately, storms in the area, and an accident down the road, almost made me tardy for something I was really excited to go to. However, as soon as I got into the library's meeting room, dripping wet from a failed dry-dash across the parking lot, something surprised me about the audience.

Not a single med student.

In fact, I probably was the only patron under probably about the age of forty in the room. I sat in the back row, and patiently waited for Dr. Collins to make his entrance, starting to wonder if this was going to be a presentation that would be exactly tailored to me. I have material to study, my time is quite a commodity right now.

It turned out to be a well-spent 45 minutes in that room. My eyes were glazing up, watching him as he read a few passages about his experiences from transitioning from construction work into medicine, and then as he lived a life that... well was quite similar to one that I'm leading right now. Here's a few highlights & quotes:

---

He said: "It's easy to fall into something and just drift along."
It's so true. Collins was referring to him choosing to go into construction initially, and enjoying it. See, it wasn't until he had an "epiphany" wondering how he could do something useful and good with his life that he started thinking about the medical field. To me, I saw this quote as referring to my tendency to believe its just easy to pass exams, and be satisified with just passing. I'm just drifting along medical school... but to improve, there's gotta be a challenge: the academic challenge to get out of the rut of just passing.

"Who wants a 25 year old beer guzzler in their medical school?"
Collins was referring to his doubts about getting into medical school when the idea came along. He overcame that doubt to get on the track of where he is now. Quite, quite impressive.

"Work isn't painful, it's rewarding."
So true... us med students gotta remember what we're here for, and it'll remind us that the work that we put toward it is all worthwhile.

"If you love enough and care enough, can't we get through the obstacles that get in our way?"
Sometimes I end up thinking like this if things don't work out. However, I'm glad that I'm not the only one pulling up those doubts sometimes. With the rigor of medical school, its hard to see sometimes when the obstacles end, and it goes back to one of the themes of Collins' book: Hard work results in accomplishments.

"Believe in the system."
During the question and answer session, I raised my hand. Upon his eye contact, signalling that I could ask my question, words came flying out of my mouth... "Understanding that a humanitarian drive called you toward medicine, when you were in the first years of medical school, faced with the loads of scientific and non-human seeming information, how did you get through it all?" After a deep pause, Collins said he didn't like the first years of medical school and compared it to a kid in the library carrying 30 books in his hands (so true). But he said that believing in medical education carrying students through is what got him through. I'm thinking about finally putting some trust into it too, even though it may be hard at times to do so.

"There is nothing like medicine."
The man's interest in medicine resonated in his voice when he said this to the crowd.

"Keep the faith."
I got a second chance to shoot another question at Collins. This time I asked, "Looking back on your experience years later, if you had one piece of advice to give a medical student, what would it be?" I felt a drop of sweat plop against my skin after the question, as one of the ladies in the audience told someone next to them, "He must be a medical student." When I heard that, I'll admit that I kind of laughed under my breath. However, again, with a deep pause, Collins replied back to me that simple quote. He then said, "As medical students, you come in idealistic... as residents, you might come out cynical." True, medical school can do so much to the students that are in it (I think I see some cynics already :P).

---

At the end of all this, I can see some of you saying... Yeah, anyone can say any of that. True, but with these quotes coming from someone who broke through the obstacle of a non-scientific background to become a distinguished physician... to me, it means so much more. I'm now ready to hit my notepads and books once again.

I'm looking forward to reading Dr. Collins' Blue Collar Blue Scrubs... but for now, I gotta believe in the system.

Shortie: Family Values

Above: No other great family gathering than getting around greasy Chinese food.

Last sunday. I'm at one of the nearby Chinese buffets (which by the way are unbelievably unhealthy, but yet so irresistable). As my mom and dad are I having some healthy conversation on what's going on in my mom's workplace (which is always pretty entertaining), I look over and there's a pretty attractive girl sitting there with her family. There I am... staring... actually getting kinda distracted (okay, horrendously)... and then she pulled the ultimate turn off...

She yanks out her cell phone and starts texting in the middle of a family conversation.

And she keeps texting... and texting... and texting... Minutes pass by; minutes that I see precious enough to spend with family. Quite disgusting, if you ask me.

Folks, I'm not even close to married yet, and It feels weird to already have these warning lights flashing. It's just that the coherent concept of family is so important. I just can't stress the importance from family being the indestructible backbone of support to their kids to families keeping open channels of communication. And, how can I speak of this? It's because I experienced how critical family support has been in getting me to where I am right now.

In a world where communication devices (cell phones, e-mail... Twitter?) can bring people together and make the world a smaller place, I can see how they can easily take families apart. No: I'm not wishing every minute to be family-centric, as every teen should have the right to go hang out with friends and be young. Nobody's young forever, you know. However, in a society that's getting busier every minute and won't stop for anyone, I believe its definitely rewarding to give a few hours to have that quality bonding time with family.

Remember: your mom and dad's clocks are ticking too...