I Love My Friends

Meet John:
John is one of my dearest friends from college. We became friends our freshman year when our roommates were interested in each other (they are now married). John and I got to hang out during the awkward moments of our roommates testing the waters -- we owe much of our friendship to the ridiculous "open-house" rules at TU.

Since then John has been one of "my people"* -- those people you turn to when you need to talk about something, need a shoulder to cry on, need advice, etc. Basically, "my people" are the few select people in my life that I trust with and in everything -- they are incredibly important to me.

Anyways, back to the reason for this post. John has impeccable timing for so many reasons. These past few weeks have been wrought with anxious and self-questioning thoughts -- some pertaining to school and others to general life.

When I get into this mindset it can be easy for me to start to get depressed. In fact, I was starting to get into this mood on my way home from a friend's house last night (after having a pretty good day).

Needless to say, it amazes me how amazing my friends are -- and how good their timing always is.


*to find such people is rare - although with each place in my life a have a good 2-3 close friends that would qualify.

A Side Note

Some of you know of my love for photography (an art in general)... I started taking photographs when I was in high school when I enrolled in two photography classes. Since then my brother stole my SLR (I want that back at some point John), and I now have a Canon Powershot.... which although is not the best, gets the job done.

All this to say: I have started a 2nd blog where I'll be trying to post new photographs every day - 1 a day. I have a good stock in my iPhoto (currently registering 2,494 items.... not all which are good, but none the less... still lots there).

I started the blog as motivation to get me back outside taking photographs -- and hopefully convince me to start working more of portraits. So... I've added the link on the side... check it out... subscribe... leave comments.

I will still post photographs in this blog when the story requires (just like normal).

Book Review #3

Book #4: Better: A Surgeon's Notes on Performance, Atul GawandeI finally finished the book, the finishing was delayed by the start of my externship.... which shouldn't really be an excuse but I'm using it anyways.

I really enjoyed Gawande's first book (Complications) so I was expecting this one to be good as well. However, I was a little concerned when my friend started reading it (while I was reading How Doctors Think/ Into the Wild) and mentioned that it was hard to get through. Needless to say, I found it an easy read. Gawande's style is fluid and fast. He makes so many good points through his observations. The stories and research that went behind it are amazing. All in all, I recommend this book (can you tell that I recommend most books? maybe I'm too easy to please... hmm).

Grade: A

What's next? Many have mentioned to me that I MUST read House of God by Samuel Shem. For those of you unfamiliar with it, it is "The Classic Novel of Life and Death in an American Hospital" (according to the cover). For a little more, I'll add some of the stuff from the back: "...a mesmerizing and provocative journey that takes us into the lives of Roy Basch and five fellow interns at the most renowned teaching hospital in the country."

So that's what's next.... if anyone is interested in reading it along with me, email me! We'll start a book club.

Heads up on what's coming next: Snow Flower and the Secret Fan, See and Under the Banner of Heaven, Krakauer (both books given to me by my wonderful mother)

Beautiful Beliefs. Beautiful Photographs.

Anthropologist Wade Davis muses on the worldwide web of belief and ritual that makes us human. He shares breathtaking photos and stories of the Elder Brothers, a group of Sierra Nevada indians whose spiritual practice holds the world in balance.

http://www.ted.com

Beautiful photography mixed with wonderful stories...

It's Laundry Day

(www.kevino.net)

It's laundry day.. or laundry weekend. I hate having to do laundry. Let me re-state that: I hate doing laundry in my building. Laundry is a process anyways, but my building makes it an even bigger process.

There's having to get all my laundry in a basket... then getting to the elevator... waiting 5+ minutes for the elevator to arrive... the ride down to the basement... the walk to the laundry room... finding that half of the washers are broken and the other have are being used... waiting for a machine only to find out that you cannot get change cause the change machine is broken... throwing the wet laundry in the dryer... going back up upstairs... coming back down only to find that all your clothes are still damp (we cannot add minutes to our dryers... it's a completely new cycle, which I refuse to pay for)... folding it all in the middle of the laundry room... and carting it all back up to the apartment.

Is it any wonder I despise this activity and put it off as much as possible?

I told myself at church that I had to do it right when I got home... still haven't, but need to in the next few minutes. I have no more work-appropriate clothes, which is a huge problem seeing as I'm working at the hospital.

I don't think I would despise doing laundry so much if I had my own washer and dryer in my apartment. In fact, it makes me want to live in a house... From now on, I will not live in an apartment without washers and dryers in-unit.

The Sad Truths of American Excess

Chris Jordan uses photography to show some American statistics that should make us all stop, pause and think. (about 10 minutes long)

Progress!

Last year at orientation on the city tour one of the tour guides mentioned that the city was trying to add "green space". Specifically, he told us about a project to connect the Riverfront to the Farmers Market. Here's a little map to help you out (c/o Google Maps and my awesome Mac skillz):
**CLICK TO ENLARGE**

Basically the important things are the Riverfront Walk (in green, bottom right), the Farmer's Market (in purple, top right), and the red line connecting them... which will one day be an awesome walk.

Now, when the walk way was mentioned I got all super excited because I can see it from my apartment (like directly below it)... and I love both the Riverfront and the Farmer's Market! When I mentioned it to others they were a little cautious... mentioning of course that the city is not that safe. Let me illuminate you a little on the walk: Where it is located is not that bad of an area (the bad areas are a little more north), we are close to the financial/ business district which is nicer. Also, the walk will supposedly have lights and security cameras (but I'm not stupid and will not be walking it at night or alone -- but run or bike it alone in broad daylight, but that's about it).

Fast forward a few months: Ridiculous amounts of jack hammering at 7 am. After the jack hammering was complete there seemed to be no change for many months (even though there were people in trucks there every day). A few months ago some pipe concrete pipe things appeared. And then nothing. A few days ago there finally seemed to be some progress: A ramp was made and some vegetation put in.

And then this morning when I looked down I saw what looked like a finished pathway just awaiting some cement.

Behold... I give you PROGRESS!


It's hard to see.... but it's there. A real pathway! There is some shubbery in between the "Y" and more has been added along the sides. Finally, a year later we have something to grasp onto. Hopefully it will continue to move quickly through the rest of the summer. I'm not so optimistic on it being done by fall, but maybe by next spring.

Who would of thought adding a walkway would be so time consuming?!

Disturbing

Teen girls reportedly make pregnancy pact (CNN)
GLOUCESTER, Massachusetts (AP) -- A pact made by a group of teens to get pregnant and raise their babies together is at least partly behind a sudden spike in pregnancies at Gloucester High School, school officials said.

Principal Joseph Sullivan told Time magazine in a story published Wednesday that the girls confessed to making the pact after the school began investigating a rise in pregnancies that has left 17 girls at the school carrying a child. Normally, there are about four pregnancies a year at the school.

Sullivan told Time that nearly half of the expecting students, none over 16, were involved. Sullivan said students were coming to the school clinic multiple times to get pregnancy tests, and "seemed more upset when they weren't pregnant than when they were."

Some of the girls reacted to the news they were pregnant with high fives and plans for baby showers, Sullivan said. One of the fathers "is a 24-year-old homeless guy," Sullivan told the magazine.
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Superintendent Christopher Farmer confirmed the deal to WBZ-TV, saying the girls had "an agreement to get pregnant."

He said the girls are generally "girls who lack self-esteem and have a lack of love in their life."

Whoa.... this is crazy and incredibly sad! How is it possible that these girls can find no love outside of what they will have with their children? Where are their parents and adult role models? Do they understand how this is going to affect their future? What will they do about paying for the costs of taking care of a baby? How did the school not do more education on this topic? What has the media done to stem this trend?

What needs to change? Cause something has to.... something must be done to reach out to girls like these and give them hope and acceptance and love. Some one needs to sit down and discuss what teen pregnancy really means... not what they see in movies or in celebrity lives, but what it means for an average girl... who will now have a hard time finishing high school.

I Remember My Excitement

It's almost July! Can you believe it?! My summer is almost over and 2nd year is almost here! At this time last year I was voraciously reading anything I could about what to expect in medical school.... I was so excited, scared, and nervous and that lead me to reading almost all of Inked-Caduceus' blog.

This same excitement can be seen all over SDN: pre-M1s asking what books to get, how to prepare, whether having a roommate is a good idea, and all those other questions. My favorite thread is the Official Accepted Pre-Gunner Advice. It's hilarious... so check it out if you want to laugh.

Already I've gotten a few messages from people specifically coming to my school... but I thought I'd add my 2-cents to the blogosphere.

To Roommate or not to Roommate? ROOMMATE! I've heard/ experienced nothing but good coming from living with another medical student. I'm sure that there is the potential of running into a crazyee once and awhile, but you can usually screen these out by "interviewing" your roommate. What I mean here is that you'll probably be emailing/talking to a few people before jumping into a lease with any one person. Use your common sense -- if someone seems weird, they probably are. But remember, no normal person ends up in medical school. We're all a little weird to firstly want to go through another 4 years of school, and secondly to want to be put through this craziness (where your best becomes merely average and you are consistently told you are not good enough).

When Class Doesn’t Really Matter. That’s a misnomer, but let me explain. My school (and many others) are starting to stream all their lectures -- for some this is audio only, at my school it’s video streaming. That means that you can watch all the lectures at your own pace (0.5x-2x) and whenever you like. My school also provides ALL notes (you don’t have to make for a note-taking system). Basically, everything is given to you when it comes to info that school makes available. That leaves the matter of, should you even bother waking up before 10 am and going to class. A lot of this depends on the type of learner you are (and your school’s requirements). I personally learn best by forcing myself to go to class -- if I don’t I sleep far to late and won’t actually have time to study the material. Others find it beneficial -- they can take it slowly and get it all done well the first time. I tried streaming biochem and just got frustrated.

How to study effectively. Medical school is overwhelming… there’s a lot of information to digest and it comes rather quickly. That leaves a lot of people freaking out about how to actually study. There are at least 2 SDN threads asking how to study. During my first week of class one of the upper classmen sat me down and told me the most valuable piece of advice: Whatever you did in undergrad that worked, just do it 100x more. NOW IS NOT THE TIME TO SWITCH YOUR STUDY METHODS! Only change if after one exam set you find that what you are doing is ineffective, otherwise, assume that it’s okay based on past performance.

Pre-preparation? For the love of all that is good and holy DO NOT START STUDYING for first year until first year actually starts! PLEASE! You hear this from everyone and it’s so true. I was really stressed out about starting medical school because I took a year off and was super scared I forgot everything and how to study…. Believe me, if you did, it will come back. Relax and enjoy your summer. If you are bent out of shape on not having anything to do (for the first time in your life), read a medical-based book like: How Doctors Think, Better, The Spirit Catches You and You Fall Down, Complications, Stiff, Walk on Walk, Not An Entirely Benign Procedure, Singular Intimacies, Final Exam, (I could go on… but I think you get the point… IF you want other titles I have a few more I can recommend…. Yes, I have read all of those over the past few years).

What text books do I need? A lot of this depends on what school you go to and what they recommend.. But I’ll give you my list:
-Anatomy: BRS Anatomy, Gray’s Anatomy for Students, Netters Atlas of Human Anatomy, Netter’s Flashcards, Rohen’s Color Atlas of Anatomy
-Histology: Class notes (I had the advantage of taking a med school level course in undergrad -- we used Histology: A Color Atlas and Text)
-Embryology: Langman’s and BRS Embryology
-Biochemistry: BRS Biochem … USE THIS STARTING ON DAY ONE (especially for the diagrams…. At least at my school, this made it all so much easier)
-Physiology: BRS Physiology and Costanzo’s Physiology (both are written by her, but she has a REAL text book for more detailed explanations if needed)
-Genetics: Class Notes (at my school, memorize the student guide that’s passed around)
-Neuro: Atlas, BRS Neuroanatomy
-Nutrition: Class notes (this is a class unique at my school I think… so, I throw it out there… just memorize the student guide thats passed around)

One site that I found helpful that you might want to reference is Medicine from the Trenches.

If you are an incoming M1 and have ANY questions, leave a comment and I’ll see what I can do to help you out. On that note: if you are anyone with any questions... let me know. I like answering questions (I've almost made a career out of it).

Reflections

**Warning: Religious post... just skip it if you're not interested**

Sometimes I think that the only thing that identifies me as Christian is the fact that I go to church. How is my life different? It should be, that's what the Bible calls Christian to be... sanctified (a big word meaning set apart). How does this play out when in the "real world"?

These two questions have been on my mind all year, and to be honest, I still don't really know. I feel like living life is how you get the answers. And all I know is I feel like I not only failed at answering them, but living them out.

That's left me feeling pretty distant from God.

At the end of April I was re-reading some of my blogs from college (only 2 years ago mind you). As I sat there reading I was blown away by how close I seemed to God at the time. Even last year in Thailand I felt so close to His presence.

I know that my relationship with Christ is not judged on my feelings, but my distance has manifested itself in un-Christian (aka sinful) behavior. I'm not perfect and although I haven't done anything horrible... my imperfections this past year have lead me down a path that I'm not too happy with...

It's a path that my friend Bethie used to call me out on mixed with new challenges. And since I tend to be a pretty honest person I'm going to share them... cause I need them out there, I need people calling me out and pulling me back to the center.

The new challenges first: I think I've eluded to it before, but I tend to be easily swayed by the people I hang out with. It's my drive for acceptance. Don't get me wrong... the people I hang out with are amazing and I love them all to death. But they aren't like the people I've been around for the last 5 years in my different bubbles. I've found myself getting more cynical, using more language and not having my priorities in the same order. I cannot blame anyone but myself for this -- I should have been more keen to the changes that seemed to take place in my life.

The ever-old friend challenge has to do with my priorities, but it can be summed up more eloquently by Bethie: "KT, has it become an idol?" This can be related to so many different things, but it usually has to do with my school work. And in all honesty, my studies seem to go better when my priorities are right, but it's hard to keep it that way: I like to be in control and it's hard for me to give that control up.

Whenever things start going out of control I get this vivid picture of Beth and me walking back towards English Hall and her stopping me and asking the idol question (it happened more than once). Of course, my instant reaction was, "Beth... NO!" But the next day I would end up pulling her aside and saying something along the lines of "Beth, sometimes I hate that you can always pin point what's going on."

Needless to say, I'm longing to get back to where I was. I miss it and want to get rid of all this pent up crappiness in my life. I've found myself at this place before: needing to reconnect with God. But before my sophomore year I was really feeling like this (only not where I am now) and needed something to pull me back... I was given a book by my friend at Family Christian Store (where I was working at the time): Revive My Heart! by Catherine Martin. All I can say is WOW.

Since then I've gone back a few times to find the other books in the series to no avail... finally I gave up and ordered them from Amazon the other day. And now, in an effort to reconnect I'm going to try going through A Heart that Dances.

I've also realized that I need more Christian fellowship (outside of the medical field), so on a whim I went to the Sunday night service for young adults at my church. Again, all I can say is WOW and I can't wait to go again.

I guess the only way to end this is pray that God would meet me where I am and that I would feel his presence in my life again.

I Need to Be Better About Updating.

It's been like a week since I last updated, and that wasn't even a real update. So... let's see what can I tell the world today:

1. HAPPY FATHER'S DAY DADDY! I know I called you, and you probably won't read this, but still.... LOVE YA LOTS!

2. My brother, being the genius that he is, broke his finger. This is ironic on so many levels, but I won't go there.

3. My externship is amazing.... Loving the pediatrics, makes me excited for 3rd year but even more terrified of 2nd year (since every time I ask a question or get asked a question, the answer is always the same... oh, you learn that in 2nd year; relate this to my fear of neuro due to 1/2 of histo/anatomy telling us that we would learn it in neuro).

4. I'm on a committee.... not much else can be said, except, God, please never let me get to that point or need to stand in front of ANY committee like that.

5. My externship, while amazing, has left me utterly exhausted at the end of the day. I may have lucked out somewhat on hours, but mine has assignments (boo assignments).

6. As sick as this is: I want 2nd year to get here so I can stop worrying about it and see all my friends again.

Ok... that's all for now.

Sometimes you have to wonder...

So apparently Michigan grads are not smart... They are "morons". The question then stands: did they know when they had this vanity plate made what it was going to say? Or are they really that moronic?

(This pic was taken from a friend's facebook album... I wish I could take credit for it).

Book Review #2

The summer is the time when I can finally read all those books I've been meaning to read, or at least spend a great deal of time reading. I think it's one of my favorite things about the summer. So, look for more book reviews as the summer goes on (I only have 2 more on my self that I haven't cracked, so I'm going to have to make a stop to find some more). On to the review.

Book #3: Into the Wild, Jon Krakauer

I finished this book about 2 days ago and have to say that I enjoyed it. The writing is very fluid and the story moves quickly. I read a few reviews before actually picking it up and a few people mentioned getting angry at the main character: Chris McCandless/Alex Supertramp. I can see why, but at the same time, I cannot fault him. He wanted to live at the edge and he had done so successfully for over 2 years before heading into the Alaskan interior. Granted, he was a little stupid for not taking maps and not having any backup plan.... but still.

The author did a wonderful job or portraying the story of the boy, with a fair amount of bias, but still laying out everything that transpired.

Grade: A, a recommended read.

Although I cannot review it yet, I'm about half way through Better by Atul Gawande and enjoying it... More to come soon.

In other news:
My brother's graduation openhouse is this weekend... My jobs as of last weekend include making cotton candy for all the critters and guarding the keg from the underagers. Sounds delightful and makes me out to be both good cop and bad cop at the same time. Interesting.

Also, my orchestra conductor from HS is retiring after 40+ years. So there's a huge party with people from all over the world coming. I'm looking forward to it, but it should be kinda sad. She's amazing and it's hard to imagine the program without her at the helm.

Childhood Cancers in the News

**click on the pics of the articles to open them.

This morning as I was getting ready to shadow in in-patient heme/onc I saw this article on my google reader (oh how I love thee, google reader, for keeping me on top of news I would otherwise never see):

The Nitty-Gritty of the article:

The highest rate was in the Northeast with 179 cases per million children, while the lowest was among children in the South with 159 cases per million. Some experts suggested that could mean cases were under-reported in the South and over-reported elsewhere.

The rates for the Midwest and West were nearly identical, at 166 cases per million and 165 per million, respectively.

The cancer incidence in boys was 174 cases per million, compared with 157 cases per million in girls. In white children, the rate was 173 per million, versus 164 per million in Hispanics and 118 per million in blacks. Teenagers had higher rates than younger kids.

The article is based on the study found in June issue of Pediatrics that came out on Monday (see below for a link to the full article). This morning Dr. T and I tried to find the article, but the AAP had yet to actually update the May to June articles online (I found it when I got home today). But, it's really interesting since it kinda plays into what I've been doing for research; although my research was a little more specific, looking specifically at ALL and the differences in occurrence in different subpopulations. But, nonetheless, very cool to be able to talk about the article with Dr. T upon arriving at the hospital (he also had me mention the article during rounds).

So yeah, check out the full article if you're interested!