Bloodletting

Newsflash: I'm easy. For a mere $30, I gave up 120 milliliters of Grade A, 100% disease-free, drug-free, human blood.

Every other month or so, Mitch goes on the prowl for destitute graduate students only too willing to give up their bodily fluids for his "research." Don't be fooled by his pleasant countenance - Mitch LOVES to dish out the pain. Every time I donate blood, he includes an extra little service where he violently pricks me with a thumbtack and sucks up the blood into a small tube. He calls it "measuring my hematocrit." I call it an "exercise in sadism."

Anyway, all is forgiven when I get the form to go pick up my $30 from the hospital.

As an aside: Blood certainly isn't the worst biological fluid a researcher works with. Here are some keywords from my very first job after college: bovine; reproductive; proteins. Luckily there were professional cowhands on hand to harvest said fluids. It's a little known fact, but although they're domesticated, bulls are amongst the most dangerous animals man comes into contact with.

Soon after tiring of that job, I moved on to the National Cancer Institute where I was a technician in a lab studying the pharmacokinetics of the anti-cancer agent 9-aminocamptothecin (9AC). Pharmacokinetics studies, in short, measure both the accumulation of drugs in the human body and how quickly they are eliminated from the system. How the drug is eliminated determines what bodily fluid the technician assays - I was fortunate that 9AC is merely filtered through the kidneys, so a urine sample was all I needed. Pity the poor technician that has to measure stuff coming out the other side.

*******

What I'm listening to now: Classic Yo-Yo, Yo-Yo Ma

You know, this Yo-Yo Ma fellow is pretty good.

Training Days

Barb is out this week, at an immunology conference. Or perhaps she's skiing. Anyway, that leaves me to train Yue in many of the lab techniques she's going to become familiar with over the next year or so.

I can't help feeling a little conflicted and frustrated by the situation. I like to teach, and thought for a while that I would choose a career as a physician-educator, hence my reason for choosing the MD/PhD track. I feel that I'm a pretty good teacher and have had success in the past with incoming members of various labs that I have been in. Additionally, in the long term, training Yue to the best of my ability works out to my advantage, as she will be finishing up the work that will lead to the publication on which I will be first author.

However, given the time crunch that I'm experiencing, by no fault of her own, training Yue is truly testing my patience. No, not patience. Perhaps...endurance? It's just very hard to take that time to train someone when I have to work on writing my thesis - kinda like showing someone the railroad tracks as the train comes barreling in.

Barb has me showing her how to do two experiments this week: chromatin immunoprecipitations (ChIPs) and transient transfections. Briefly, for those of you not familiar with these protocols, ChIPs let us look at specific proteins and the sites to which they bind genomic DNA. The transient transfection lets us inject a small loop of DNA into mammalian cells so we can study things like protein function. The ChIP is about a 3-day assay with about 25 steps, while the transfection takes about an hour of preparation and about 5 steps. I find that it takes a lot to train somebody new, and I really didn't even go into detail about more empirical topics such as experimental design or how the particular protocol fits into the IL-1ß project.

Things have gone reasonably well - it's always a good sign when a new member of the lab hasn't broken any equipment or set fire to the building. Plus Yue is a very nice person. When preparing standards for quantitating the amount of DNA we purified in the ChIP experiment, the curve was almost perfect, with a R²-value close to 1. Our transfections turned out equally well, with almost 40-50% of our cells positive for green fluorescent protein (GFP). If I ever figure out how to take a picture on that microscope, I'll post it.

There's an inherent amount of handholding when someone new enters the lab, and I feel somewhat like a hypocrite for doing that with Yue. I detest being micromanaged, as I was when I worked for Matt. Plus it's not like Yue's inept - she's holding an MD from China. Yet there are valid reasons for doing this with someone new as I'll describe with Yue's sterile culture technique.

Only two criticisms, the first being that Yue's sterile culture technique needs some work. She frequently forgets that the grille at the front of the tissue culture hood is considered non-sterile, and she often puts objects on it that need to be kept sterile: lids, cells, plasmids, etc. Also, she often keeps media open in the hood longer than I would like. Mistakes here can be costly, as contamination of any of these components may lead to the loss of hundreds of dollars in reagents or time spent preparing said reagents. But technique is something that will come with experience.

The other minor complaint is one that I'm just going to have to deal with, and that is she tends to get too close. She's always either at my elbow or closer, observing my every move, even when she doesn't need to be. Just the other day I was taking a rack of microtubes to the freezer, and when I stopped at the freezer, Yue ran right into me. On another occasion, Yue was observing me aspirate some fluid from a microtube, and she just got a little too close for comfort. I'm trying to ascertain whether this personal space issue is an individual thing with her or a cultural difference. Either way, I'm not sure how to effectively communicate that issue without confounding her too much:

"Yue, look at this, no, not too close, no, now you're too far, lean in a little bit, no, not that far in, back a little, okay, a little to the left, okay, good....Can you still see?"

The good news is that Yue is a talker. She and Barb are going to get along fine.

So, for the first week, here is my (informal) evaluation of Yue's performance:

Enthusiasm: A
Lab Competence: A
Pipetting Accuracy: A
Sterile Culture Technique: D (will improve over time)
Not violating Mikey's Personal Space: F-

*******

What I'm listening to now: Disturbed, The Sickness

Not sure what this band is saying - they could be Satan worshippers for all I can make out, but, hey, it's loud - and that's kinda what I need to focus on what I need to do. This album includes a cover of Tears for Fears' "Shout", and Disturbed is able to handle the key change very well, indicating that they know at least more than four chords. Always a plus.

Facial Dysmorphia

Today, instead of being productive, I decided to play around with online avatar makers. Little applets that let people make portraits of themselves. Regrettably, I sent the links to Bracken, who came up with these startlingly accurate portraits of yours truly.

The first comes from dookyweb:

The second is a South Park avatar maker:

It's always a little bit of a reality check when you get to see how others view you. In my case, I look at these pictures and realize how little they actually resemble Brad Pitt. Nor do I have a prominent jawbone nor a cleft in my chin. My head is a beachball. And that really is about as full as my facial hair grows. These aren't caricatures. Sigh.

New People

Barb has hired two people as post-doctorates to work in her lab. The first one arrived a couple days ago, and she will be continuing the work that I started here on the IL-1ß project. Her name is Yue. There's no easy way to describe the pronunciation using our alphabet, but I'll give it my best shot: Start by saying 'you' but as soon as the 'y' even starts to pass your lips, suddenly switch over to saying 'way'. But instead of ending with 'ay', shorten up a little so the ending vowel is somewhere between 'eh' and 'ay.' Got it? Good.

For at least two days, Barb was pronouncing Yue as 'You'. Which, of course, is logical if you aren't familiar with Asian name pronunciations, and it's loads easier. Pronoucing 'Yue' correctly is even mildly difficult for me, and usually, I'm pretty good with Asian pronunciation, having grown up with it. (My parents laugh at me every time I try.) So listening to Barb finally realize that she'd been pronouncing it incorrectly, then practicing the correct sound for like 5 minutes on end is one of the funniest things I've ever heard. Poor Barb.

Anyway, not only will I be trying to write my thesis in record time over the next two months, I'll also be training Yue in the lab protocols that are necessary for the IL-1ß project. Not sure how it will work out with scheduling, but somehow we'll work it out.

Careful What You Wish For

Well, the results of the clerkship lottery have come back. It used to be that MD/PhD students returning to the third year curriculum got preference in choosing their schedules - part of the rationale was that we could get priority in scheduling the 'easier' clerkships (usually psychiatry) first, so we could catch up with the regular medical students, because MD/PhD students have been away from the material so long. Well, the regular medical students didn't like that, so they lobbied the higher-ups and got that priority scheduling taken away from the MD/PhDs. Crybabies.

Oh, well.

I figured I would put in my preferred third year clerkship schedule and get something like pick #165 out of 165. I discussed my scheduling choices earlier. So, even though I scheduled surgery first, I figured I would get it last. Surprisingly, I got exactly what I asked for. SO! Surgery FIRST! Medicine SECOND! Others would try to ease into it or perhaps have a couple easy rotations in between two of the most grueling clerkships during third year. NOT ME, BABY! Because I'm nuts!

Anyway, yeah. Surgery first. A chance for Mikey to show his father his quality. Better start reviewing my Anatomy...last looked at it almost 5 years ago.

Here goes: The headbone is connected to the neckbone. The neckbone is connected to the chestbone. Oh, wait. Or is it the shoulderbone? Uh oh...

Mikey's Thesis Committee Meeting: A Synopsis in Three Acts (Cliff's Notes Version)

I. Inferno

It doesn't matter if it is good.
It only matters if it Rocks.
The main thing that we do is to Rock your socks off.
- Rock Your Socks Off, Tenacious D

Scene 1. In Mikey's office, late night.

I wasn't too happy with the report that I sent my committee members last week, as it was hastily put together at the last minute, and, in my opinion, some of the sloppiest writing I've ever done. So, I stayed up late (again) to polish my Powerpoint slides for the committee, hoping that my presentation will wow them out of their seats. As I'm looking over the pieces of data that I've put in the presentation, I get this knot in my stomach, and this voice saying, "That's ALL?! You've worked on this project for 2+ years and that's all you've got to show for it???"

Alas, I think those thoughts plague most graduate students trying to finish up their thesis work. I think I have solid speaking skills, and above average BSing skills - I wasn't captain of the debate team for nothing. I look over my slides a second time to burn the transition phrases in my mind, and head to bed for a good night's sleep.

Scene 2. The Conference Room

Ten minutes until showtime, and I'm hastily setting up the room for the meeting: laying out the snacks and drinks (fruit salad and spring water - my committee gets to eat healthy at my meetings), setting up my laptop and connecting it to the projector, shooing any lunch stragglers out of the room. Funny. I'm still not feeling nervous (nor am I throwing up in the bathroom, as a certain sarcastic penguin would have you believe).
The committee members file in. Greg, Barb, Cyrus, Jackie, then Wellington. Jackie, the committee chair, smiles at me as she walks in and remarks, "You're report is outstanding. So much better than your first one." Cyrus agrees with her. I laugh to myself inside, in disbelief, because that document was such a mediocre effort. A good omen? Perhaps. The cynic in me believes she's playing games with me already, lulling me into a false sense of security.

At last, Jackie says,"You're up."

Scene 3. The Presentation

I begin the presentation. I won't bore you with the specifics of my project, only to say lies in the realm of molecular biology. I explain my findings, propose a couple more experiments that will tie up loose ends, and answer their questions, calmly and as completely as I can. The committee members are helpful with their comments, their questions are asked out of genuine curiosity rather than just to see how far they can push me before I'm stumped. I feel confident that I did a good job.

The presentation ends. Jackie wraps up by asking me about my timeline. I tell the committee that I'm back in medical school at the end of June. They agree that for me to finish up with any more experiments, to write the thesis, then defend the thesis...3 months is not much time. But they accept it, and everyone just wants to see me succeed and get back into medical school. I want to give my committee a hug.

Jackie says,"Okay, please step outside while the committee talks about you behind your back."

End Act I

II. Purgatorio (The Downward Spiral)

And they're coming to take me away ha-haaa
They're coming to take me away ho ho hee hee ha haaa
To the funny farm
Where life is beautiful all the time
And I'll be happy to see those nice young men
In their clean white coats
And they're coming to take me away ha haaa
- They're Coming to Take Me Away, Ha-Haaa, Napoleon XIV

Scene. Mikey sitting alone outside the Conference Room

This time that the thesis committee uses to discuss the student and kick him or her out to reflect on what just happened the last 2 hours can be a difficult one. They're usually in there discussing quality of the presentation, the student's work ethic, and what else the student needs to do to fulfill their expectations. Meanwhile the student sits outside waiting...and waiting...and waiting.

It's always a dangerous time for me when I'm sitting alone with my thoughts. I began this interlude rather confident, but then my mind starts to play tricks on me. Paranoid thoughts start trickling in - I imagine nightmare scenarios in which the committee proposes more experiments that would keep me in graduate school beyond June, effectively keeping me out of medical school another year. I can take criticism of my presentation and my experiments (especially because my committee has been nothing but constructive and supportive), but moving on with my life is of the highest priority here.

The negative thoughts just keep pouring in as I ponder another year in graduate school:

my car's starting to fall apart I hate having to fight for laundry machine time with 30 other apartments in my building when am I going to get a place of my own with a lawn and my own washer and dryer I'm not getting dates I'm getting too old I haven't been to the gym in months my pants feel tight I'm eating like a pig I hear laughing in there is my committee laughing at me? Ohnoohnoohnoohnoohnoohnoohnoohnoohnoohno

Just as the negative thoughts crescendo into a massive din, the door opens and Jackie says, "Come on in."

End Act II

III. Paradiso

Theme music: "The Great Gates of Kiev," from Pictures at an Exhibition, by Modest Mussorgsky

Scene 1. The Conference Room

As soon as I walk into the conference room, Jackie is putting on her coat and rushing out. "I have to leave I have another meeting, listen to whatever the other members tell you" as she bolts out of the room. Hank laughs: "She's escaping before you go all postal on the committee."

I calmly sit in my chair. The remaining members look to Barb to break the news to me. And then Barb utters the following words, that every graduate student should hear:

"We want you to put down your pipet"

She said something after that, but the bells and the heavenly choir that just appeared keep me from hearing it all.

"...put down your pipet...put down your pipet...put down your pipet..."

No more experiments. Just start writing. A couple recommendations regarding my presentation. Cyrus: "You do a disservice to yourself with the way you're presenting your data. By your explanations, we know that you can make a stronger case for your finding, which is a unique one. Just do that and you'll be fine." Wellington concurs. Barb says that we should talk at some point to make some deadlines. I just hear echoes:

"...put down your pipet...put down your pipet...put down your pipet..."

Wellington and Cyrus say 'Good job' and leave. Barb exits. I slowly clean up the room, just trying to figure out what just happened.

Scene 2. Next day, in the lab

I got in today about noon. I woke up with a hangover, having had drinks with Heather and Bracken the night before. Great friends that put up with my annoyingly giddy state.

I'm raring to go. Barb and I marked down deadlines for me to write this thesis over the course of the next 3 months. I'm going to try to beat that - her schedule doesn't leave me any room for a vacation before I start my first clerkship, and it certainly doesn't leave me any wiggle room so I can shadow a clinician so I can get back into the swing of things in the clinical world.

But that's a minor point right now. The sun is shining, not a cloud in the sky, and life is good. Barb's working in lab, she's asking me tons of questions about protocols, and I don't mind one bit. We're making small talk, and I'm even laughing at her jokes. Welcome to the Twilight Zone.

End

Epilogue

Thanks to everyone who's been following so far and offered me encouragement and support all this time. I'm certainly not finished yet, but I wouldn't have made it this far without you.

Mikey's Committee Meeting - Keys to the Match

Hi,

Hank here. Only hours before the meeting, and Mikey's a little busy in the bathroom (offering the technicolor yawn as tribute to the porcelain god, heh heh), so I thought I'd sneak onto his precious little laptop and write an update of my own. Allow me to provide a little pre-committee meeting analysis.

Mikey needs to perform well so he can get on with his life. If he gets out this year, he may still have roughly 2½ years of earnings before he hits retirement.

The Committee has a vested interest in not letting him go too easily. As you can plainly see by reading through his blog, Mikey has developed quite the Attitude Problem, and it's starting to show in all aspects of his grad student life. Don't think that the faculty haven't noticed, so they wouldn't mind laying some smack down on this GEEK to set an example.

For Mikey to win this match, he needs:

1. To show breadth and depth of knowledge of his area of research (or, at the very least, fake it effectively),
2. To start off with a good joke - everyone loves a killer 'Knock, Knock' joke,
   
3. To present all data in classic 'NIH Grant' format, whatever that means (supposedly it means presenting hypothesis → results → conclusions, but what do I know?),
4. To get all committee members to eat one of his marijuana brownies,
5. To learn how to beg and grovel,
6. Learning how to evoke a tear would be useful.
   
7. Three words: Deus ex machina

For the Committee to win this match, they need:

1. To psyche Mike out - during the presentation, DO NOT: smile, nod, laugh at his jokes, or give any other signs of approval.
   
2. DO: mutter to other committee members, cough intermittently, roll eyes, snore - LOUDLY.
   
3. DO NOT: compliment his choice of refreshment.
4. DO: interrupt his presentation at every slide.
5. DO NOT: let the Question & Answer session last for any less than 90 minutes.
6. DO: propose at least 10 more experiments, at least three of which will take another 18 months to optimize.
7. DO NOT: give in to any amount of begging/pleading/crying.
   
8. DO: apply the following two words to Mikey's life: Raptus regaliter

Well, game time is this afternoon at 2pm. My money's on the Committee, at 30:1 odds, with Mikey spending the rest of his days at the lab bench, a broken shell of a...geek.

Check for an update later, time and date to be determined, depending on the severity of Mikey's hangover.

Now buzz off,
Hank

5-second break

I'm busy preparing my presentation for the thesis committee meeting on Monday, so only a short update until then.

And now, a baby penguin:

A Night at the Opera

A review of Richard Wagner's The Flying Dutchman, by Mikey

I totally lucked out tonight. My friend Jill didn't feel like sitting through an opera, so she gave her ticket to me, and I sat at Boston Symphony with her husband, John. Free opera tickets! W00t! Mikey's in tha opera house! Fo sho!

First things that are handed to us are the program and a copy of the libretto. Cool! Perhaps this is a sing-a-long. You know, for someone who took 6 years of French, and 2 semesters of Mandarin in college, my German is pretty lousy. We walk into the hall and I notice immediately that there's no scenery, the orchestra seats are on the stage in front of the chorus stand. The opera is to be a concert performance (I ask John what the term is for such a performance. "On the cheap?" he replies.)

The Flying Dutchman is one of Wagner's earlier works, so I'm thinking it's more early Romantic. It has a memorable overture, but no landmark musical elements from his later works like the "Tristan chord" from his Tristan und Isolde or the wafting muscial sound of his Ring cycle, for which he had a special theater built in Bayreuth.

Alas, the concert is not a sing-a-long. In lieu of an electronic ticker showing the audience a translation, we follow along with our libretti. This leads to the most annoying thing about the evening: people just don't know how to turn pages quietly. As soon as the page turn comes, all you can hear is the rustle of hundreds of page turns. I remember what an art it is to turn pages quietly - I have a solid page turn that makes minimal rustle, and it takes about 5 seconds. I figure there's no hurry. For Pete's sake, the opera is in German, people - you could take 20 seconds to turn the page and chances are the singer is still singing the same darn word.

The lights dim, and the performance commences. Here is my 1-minute, Cliff's Notes-like synopsis of the plot, with random notes about the concert itself:

Richard Wagner's The Flying Dutchman (Der fliegende Hollander) takes place off the coast of Norway

Act I: The orchestra begins with the overture. The French horn section blares the theme of the Flying Dutchman (Mikey tried to get a sound out of a French horn, once. I felt like my eyes were going to pop out of their sockets and my brain was going to shoot out my nose. I'll stick to the violin and piano, thank you very much. I tip my hat to all those brass instrument players who are able to get a sound out of a mouthpiece with a hole about the same gauge as a hypodermic needle).

We are introduced to Daland, a Norwegian captain, who is the father of Senta, a young woman engaged to the huntsman, Erik.

(The ship of the Flying Dutchman approaches.)

Dutchman: I'm cursed to sail the seas forever until I meet a woman who falls in love with me. Yo, Captain!
Daland: Whassup?
Dutchman: Can I stay at your place? I've got treasure.
Daland: OK.
Dutchman: You got a daughter?
Daland: Yeah. I'll introduce ya. Gimme treasure.

Act II: Inside Daland's hizouse.

Senta: (Stares at a portrait of Flying Dutchman on a wall.) Yowza, that guy's hot!
Erik: Your father is trying to hook you up with some other guy!
Senta: Well, I gotta listen to my Dad...
Erik: No! I had a dream...(Erik goes on to spoil Act III. Yo, Erik - ever hear of a SPOILER ALERT?)

Exit Erik. Enter Daland and Dutchman.

Daland: Senta meet Dutchman.
Senta: Yowza.
Dutchman. Yowza yourself. Commit yourself to me.
Senta: Fo shizzle.
Daland: Yo, Dutch. About that treasure...

(At the end of Act II, several people get up to leave. What?!?! They're trying to beat traffic? Or perhaps they're upset that Erik gave away Act III.)

Act III: On the rocky shore.

Erik: Senta, don't go!
Senta: Nope, I promised Dad I'd hook up with this guy. Although, dying might suck...
Dutchman: No, if you don't come with me, I'm cursed forever and ever!

(Love triangle ballade ensues. Audience pores over their libretti. Are you kidding me? You're following three-part harmony in German? You posers. I know you're all faking.)

Senta: Okay, I'll go with you, Dutchman.

(Senta climbs to the top of a crag and dives off it into the water and dies. Her scores: 3.9, 4.7, 5.6, 2.2, 4.7, with the Russian and French judges getting into a fight, and the Korean judge filing a protest).

The ghosts of Senta and the Dutchman then rise from the sea and float toward heaven.

End.

A Temporary Reprieve

Rachael_saucer
Originally uploaded by ironchefmike.

Where does Mikey go when he's feeling this stressed about writing his thesis stuff? Why, over to a friend who has been through this already. I took a lunch break and visited my friend John. He gave me this piece of advice about writing: "No matter how bad it is, just write it down. Write it all down. You can fix it later."

Hmm...I've heard that advice somewhere before...if only I can remember where...oh yeah, it was me. Looks like I'm a blowhard who can dole out sage advice but who is also pretty lousy at following it. Yep. I rock.

Anyway, I get to spend my lunch hour playing with John's baby daughter, Rachael. Works pretty well as stress relief.

It took about a dozen takes, but I finally got Rachael to smile into the camera. "Rachael loves her Uncle Mikey, isn't that right, Rachael? Coochie coochie coo goo goo gaa gaa da da whoopie coochie coo..."

All-Nighter

I have this sick feeling in my stomach - I think it's guilt. I've given myself weeks to write this committee report and I only made headway 24 hours AFTER the deadline I gave myself. I holed myself up for quite a long time in my apartment, and I did anything and everything I could to avoid working on this - washing dishes, doing laundry, vacuuming, brushing and flossing my teeth, polishing furniture, backing up my hard drive, cleaning up my hard drive, defragging my hard drive, adding stupid little graphics to this blog - ANYTHING.

Finally, I begin making progress, at the cost of a night's sleep. My behavior has been so utterly stupid, it literally makes me sick to my stomach.

I used to be good at this stuff. Putting together facts and figures, building an argument to illustrate a point, and I loved it. Now I just stare at the screen and my mind is blank. I should have been motivated to do this - doing this to the best of my ability is my ticket to finishing graduate school, but I couldn't do it. What the hell? I'm behaving like someone with Attention Deficit Disorder. Everyone else seems to go to work and get their stuff done. Me, my mind wanders here and there, daydreaming like Walter Mitty. I keep yelling at myself to grow up and just get it done, but it doesn't happen.

I'm terrified at the way I'm functioning.

I'm going to the opera tonight to see The Flying Dutchman. It's Wagner - it had better be loud...

Blockade

Uhhhhhhhhhh...

I'm trying to write up my committee report and make some Powerpoint slides for my presentation, and it's just not happening. I'm not sure whether it's burnout in general from this graduate school experience, or the fact that I've lost so much interest in my project, but sitting down to write science is just so difficult.

That's it for now. Gotta go force myself to finish off this stuff.

Boston Covered in Clouds

Prudential_Cloudy
Originally uploaded by ironchefmike.

This is a view of Boston from my lab. Pointing my camera north, I get a clear view of the modern John Hancock Tower (the very top obscured by cloud cover) and the Old John Hancock Building, just to the right. On top of the Old John Hancock is a weather beacon, which announces approaching weather. A short poem helps us remember the meaning of the signal:

Steady Blue, Clear View
Flashing Blue, Clouds are Due
Steady Red, Rain Ahead
Flashing Red, Snow Instead

PS Can you tell? I just got a new camera - good thing I'm playing with this thing instead of writing my thesis committee report. Yes, Heather, I'm waiting for you to come down here and wrench this thing from my hands. From my Cold. Dead. Hands.

Benched

bench_mikey
Originally uploaded by ironchefmike.

A picture of my lab bench. Ladies and gentlemen, THIS is where the magic happens. HA! Can't say that with a straight face.

All the poisonous chemicals are on the shelf just above the bench.

Note how organized it is.

Good news: Neatness and orderliness.

Bad news: Usually, in my case, orderliness is inversely correlated with productivity.

Confidence? Pfffft

Any of you who have been reading this blog for a while know how I feel about returning to medical school. Feels something like this:


Today I had a meeting with the Dean of Student Affairs, who wanted to talk with a group of us MuD-PhuDs about the trials and tribulations of entering the clinical curriculum after 4+ years hidden away in the research lab. Her survey of past returning students indicated that MD-PhD students tend to do not as well as their MD student counterparts in the first couple of rotations, and she wanted to advise us of steps we could take so we could hit the ground running.

Among the options:

• Sit in on the Biology of Disease course, currently being taught to second-year students (informative, and would ideally be one of the best options, but impossible due to the time required)
• Shadow a physician for two intense weeks, suggesting opportunities with the Departments of Internal Medicine or Pediatrics
• Ensure that we schedule one of the 'easier' clerkships first, i.e., pediatrics, family medicine, or psychiatry

If you recall, my GOOD FRIEND DAVE advised me to go with surgery first, the logic being that everyone is equally clueless in surgery, especially if it's the first clerkship. You can see my scheduling preferences here. What did the Dean of Student Affairs have to say about this?

No, not the best plan because:

• The surgery clerkship is intense, much more so than pediatrics/family/psychiatry
• Success in clerkships has much to do with student confidence, and MuD-PhuDs tend to be least confident in their first couple of rotations, and surgery would be the LAST place you want to look like a wimp.
• Attending physician/resident understanding of the fact that MuD-PhuDs have been in the research lab for the last several years is variable. But she suspects that surgeons are probably the least likely to accept that fact.

So instead of flying as high as a kite, my confidence levels look more like this:





So Thanks, Dave, old buddy old pal ;)

Aaaaaaaaaanticipation....

The planets finally aligned, and I was able to settle on a date and time for my second thesis committee meeting. Monday, March 21st, 2005 at 2:00 pm. My own personal D-Day. (Obviously I can't get away with calling it D-Day. T-Day? I'm open to suggestions).

I believe these thesis committee meetings have several purposes:

• Inclusion of scientists who don't work in your field are able to give objective critiques on the science being performed in the project
• Multiple suggestions are given regarding the best direction in which the student's thesis project should go
• It is an opportunity for the student to demonstrate whether he or she can function as a scientist independently, through the presentation and discussion of the data
  

Now, I must turn my attention to preparation for this day. I'll be spending the rest of this week writing up my report, chock full of all the progress I've made since my last meeting. Next week I'll be preparing my oral presentation to the committee. Will Mikey be able to convince the faculty that he has enough data to finish his doctorate? Or will the committee remain stolid and request that he perform more experiments?

There is a question of how much the student can dictate the course of his/her own fate. Obviously, I can't just walk in there and state "I'M DONE" and expect to be taken seriously. But there are some small subtle things one can do to nudge the committee in the right direction. Barb has been very helpful in this regard - she wants to review my committee report and have me rehearse my presentation in front of her. And she gave me this advice: "You tell the committee what experiments you need to do to finish. Don't let them dictate that, or they'll put too big of a load on you and you won't make your deadline." We'll see how that works.

Due to the difficulty in organizing the third-year schedule, MD-PhD students must join the class at the beginning of the school year, in late June. If a student cannot finish his or her thesis until August, they're pretty much out of luck and have to wait until the following June to rejoin the medical school curriculum. As you can see, the stakes are high - the outcome of this meeting determines whether I move on with my life or I mark time for another year in graduate school.

We don't want that to happen now, do we? Seriously - can you take yet another year of Barb tales?

Portrait of Hank

Hank the Surly Penguin wouldn't stand still for this picture. Until I threatened him with getting a pet sea lion, he wouldn't behave. So he finally stood still and lit a cigarette. I coughed, "Hank, this place is non-smoking. The smoke stings my eyes. And did you know that about 3000 Americans die every year due to the inhalation of secondary smoke?"

Hank just gave me an annoyed look and muttered: "I'm a figment of your imagination, you WHACK JOB!"

Epiphany Symphony - IV. Psycho

IV. Psycho - Accecato da scienza

science
poking probing proposing posing
vanity insanity inanity profanity
gathering blathering bleating bleeding
vying sighing lying dying
schmience

I have a Love/Hate relationship with science. Okay, not so much with the "Love" and a little more "Dislike." I view science as a tool, albeit a powerful one, but I can't 'love' it any more than I can 'love' my favorite fork. I certainly can't ignore the 'good' things that have come from research and innovation like, say, the automobile, the internet, antibiotics, or my iPod, just to name a few examples. I think, more truthfully, I'm jaded with academic science. Truly, the people I'm surrounded by are all very articulate and intelligent. But I can't fathom what gets them out of bed in the morning to do what they do.

I know what I'm supposed to be doing here, and that's trying to figure out how to apply the scientific method. But I thought I was also in graduate school to learn about a lifelong career in science. In medical school, we get an inkling in the first two years about becoming a professional (it may or may not be taught very well, but at least they try). In graduate school, however, there is no dialogue about becoming a career scientist. From what I gather, choosing to be in academic research means:

• doing experiments and getting said experiments to work at some point
• putting results into some form and praying it gets published in a scientific journal
• locking yourself away in your office reading papers and writing grants
• emerging from your well-deserved plush office to oversee your underlings
• teaching a class or two to keep the department head happy
• random timewasters in organizing journal clubs and seminars (you can bypass this by pushing it off on senior graduate students. Or even junior students. Half the people that do manage to attend the function aren't paying attention or are outright napping, anyway).
• posing as a mentor to wannabe career scientists so they can grow up and replenish/supersaturate the medical research industrial complex and this whole science geek life cycle renews itself. This would be a KILLER episode of 'The Crocodile Hunter':

  "You see boys and girls? The common lab rat is a shy creature, and usually hides in the dimly lit laboratories of academe. Ooh! There's one now! Watch me lure him closer with this sign saying "FREE FOOD". GOT HIM! This is a typical specimen, pale complexion due to lack of sunlight, rather flimsy, and very nearsighted. Here - you want to hold it...they're quite slippery....Crikey! There it goes, back to its bench..."

What this place really lacks is true role models. Am I too old to want a role model at this point? I don't think so, because so much of my education is centered around learning the academic system. It just seems that they don't even try here.

Perhaps it's because nowadays you can't be the proverbial Renaissance Man anymore. Training here seems to lead people into pigeon holes where this person studies chromatin, that person studies cell signalling, the person in the next office studies atherosclerosis, and so on and so forth. And yet, the bottom line in academia is money. Every researcher here is scrambling for dollars to bring into the University so they can keep their jobs. I feel like we work hard for our experimental results not to make the world a better place but to help fund the bloated institution of academic science. The system is such that you ignore the forest because of the trees.

But what good is it doing our society to spend so much money on biomedical research? Is the quality of our health any better as a result? According to the groundbreaking World Health Organization report in 2000, the United States healthcare system is nowhere near where it should be. The U.S. spends the most money on health care, yet comes in last in indicators such as infant mortality rates, low birth-weight percentages, and years of life lost. And I'm not even going to touch on the problem of fair access to quality health care.

Reflecting on some of the 'hot topics' in cancer research the last decade, we have a bunch of things that teach us a lot about cellular biology, but precious little that can leave the bench and make it to the bedside: apoptosis, p53, Ras, src, telomeres, to name a few. See any magic bullets? There are none. How about this: focus on preventive measures. The U.S. spends the least amount of money on preventive medicine amongst developed countries, and it's showing. Instead of looking for yet another cancer mutation, take that money and put it into programs that help people to stop smoking, eat healthy, and exercise.

Better yet, trim the fat from the university. Medical centers across the country have been able to fatten up on 5% increases in the NIH budget every year. Nice, if you believe more medical research leads to a better health care system. It also allows more mediocre science to go on - more scientists who have learned to work the grant system so they can hang on in academia instead of going out into the world and doing something useful for society. I call it Nerd Welfare. Here's a thought: thin the herd a little, use their collective mindthink to solve the problems that I can see if I just walk a block or two away from the hospital, like homelessness, hunger, and unemployment.

Is it too much to give scientists the power to do something? What we have here is now the social version of the Heisenberg Uncertainy Principle:

The more you know about something, the less likely you are to be in a position to do something about it.

For example: scientist studying earthquakes measures a quake somewhere in the Indian Ocean seconds/minutes after it happens. Thinks to himself, "Hmmm...there may be a tsunami." Can't tell anyone. Can't reach anyone. 200,000 people die. Can we get this guy a freakin' phone? How about a button that tells people in BIG NEON LIGHTS to get away from the water?!?!

However, the cynic in me believes that giving someone such power eventually exposes them to forces that they can't control. Would they use the knowledge they have to make decisions? Take the case of Senator Bill Frist M.D. (R-TN). We in the medical community know very well how HIV is transmitted, yet Senator Frist eschews the scientific knowledge that we have accumulated, and gives the religious right party line (interview transcript here), about tears and sweat being able to transmit the virus. Unbelievable this man graduated from Princeton where he studied health policy then went to Harvard Medical School.

Perhaps scientists aren't ready for the responsibility. Or maybe we're just not used to seeing the forest through the trees.

Just a small bump in the road

One rite of passage for the graduate student is setting up the Thesis Committee meeting. The meeting itself isn't such a big deal in most aspects, but it's the journey getting there that is the uphill climb. Right now I'm trying to set up the ideal time for getting my five faculty committee members in the same room. This has not been easy as yet. It's been a week since I sent out the first notice, and we still haven't settled on a date. I'm pretty sure the faculty is readily accessible (what do they do besides sit in their offices and surf the web?), and they conspire together to make the graduate student sweat just a little bit:

Barb: Okay, did everyone get Mike's email about the next committee meeting? Good. Okay, what's the plan?

Jackie: Let's do the usual. I'll tell him I'm away next week. I'm available the week after, but after the second week of March I'm busy until the end of May.

Wellington: I'll tell him that I'm available on Tuesdays and Thursdays after 2pm, on Fridays before noon.

Cyrus: That sounds good. In my first email, I can make it on Mondays and Wednesdays before 1:30, on Thursdays after 4pm if there's a full moon the night before. Then I'll send him a second email and tell him that I forgot that I'm taking a sabbatical until August.

Greg (waking up): I'll just forget to reply to him, how's that? Are we done here? I'm hungry.

Actually, I'm quite fond of the people on my committee - it's just taking a little long to get this set up...