Final Count

Pending revisions, the final Thesis Progress Graph:

I thought the trajectory was such that I'd hit 25,000 words with a rather verbose Discussion section, but it was not to be. As theses go, I feel a little self-disgust that this one's a little on the shorter side. Even with references, the volume only comes out to 118 pages. My committee chair mentioned that I also needed to throw in my curriculum vitae. Whoopee! That brings the page total to a WHOPPING 120 pages.

Even though my experience in research (as an undergraduate, a technician, and a graduate student) says otherwise, it's hard to escape the thinking that correlates the quality of one's research career by the quantity of data generated. We're so hung up on quantity these days. More words, more figures, more publications, more grant money equals bigger, badder, and better.

Yet, most people that I know in science understand that research isn't so simple. Experiments fail for any number of reasons: equipment failure, bad reagents, difficult/poor project, bad luck, wrong electron spin. Grad students can go months, perhaps more, generating piles of 'negative data.' Negative data is important, no doubt, but it's kind of like proving the sky isn't chartreuse. It doesn't necessarily move the project forward and gives answers no one really cares about. I knew one graduate student who spent years obtaining negative data on a number of research projects. Despite her lack of success, you couldn't find anyone who would claim that she wasn't a competent scientist. In fact, her committee finally let her go, realizing that she really had nothing more to prove.

I've spent five years in graduate school so far. The first two-and-a-half years I spent with an advisor that couldn't care less about my training. What data I generated with him didn't carry over into my new lab with Barb. What to do? Start from scratch? Generate a quantity of data on the new project that will satisfy even the most hardened critics? More data more time more years trying to prove my worth in science to these people? No, I don't think so. Anyway, my approach to things is that "it" is more about the journey than the destination, and I concluded quite a while ago that staying in graduate school wasn't going to make me any better as a scientist. If science is in my future (which it isn't), there will be other opportunities to continue growth in that area.

Yet I can't shake this feeling of inferiority with the volume of data I've generated. When I took the thesis drafts around to my committee last week, a younger graduate student, "Jess", scoffed at the fact that all five copies fit into one box. As if I should need a truck to deliver these things. Yes, I'm positive "Jess" is the next generation of academic scientist, beating down her own graduate students and lab personnel, sometime in the near future. Whatever. Whatever helps "Jess" sleep at night, she can believe what she wants. She and her ilk are just another reason why I won't be anywhere near academia if I can help it.

So what? I won't be remembered as a Graduate Student All-Star. I'll let people like "Jess" claim that accolade. I'll leave it to someone else to tell her that's almost like winning "Jagoff of the Year", only less prestigious.

*******

What I'm listening to right now: "Alive and Kicking", Simple Minds

Frist's Reversal

...isn't really a reversal, as I'll point out later. But....there are those who don't consider medical doctors to be real scientists. And really - could you blame them considering the misinformation that the Senate Majority Leader has dished out?

Let's look at the most recent gaffes:

• Spreading misinformation about the spreading of HIV-1, Senator Frist backed up the claims of several government funded abstinence programs, which claimed among other things, that condoms are ineffective in preventing the spread of STDs, and that AIDS can be transmitted through contact with sweat and tears.
• Being able to openly question the diagnosis of neurologists' diagnosis of Terri Schiavo, merely by watching videotape for 1 hour in his office.

After these incidents, the American public is absolutely right to question what sort of physicians that medical schools are turning out nowadays. Rest assured, there are quite a few bright people in medicine, and I am confident in thinking that Dr. Frist's positions on the above issues have more to do with his need to further his political career by catering to the Religious Right.

Supporters like to point out Dr. Frist's yearly trips to sub-Saharan Africa to provide free medical care to the needy. Which is great, but I'm not sure if one can justify that tradeoff. Save hundreds of people in Africa and you get to misinform thousands of young people about HIV transmission? Where's the logic in that???

Then there's the videotape 'diagnosis' of Terri Schiavo. Never mind that Dr. Frist trained as a cardiothoracic surgeon, not as a neurologist. I've yet to complete the clinical part of medical school, but I don't think that this "remote video diagnosis" is part of the curriculum. Actually, I think it requires no training whatsoever. It's easy! After watching videotape of the first Presidential debate between Senator John Kerry and President George W. Bush in 2004, I was pretty certain that President Bush was mentally retarded. See? Anyone can do it!

Anyway, I'm cautiously optimistic about the news that Dr. Frist is reaffirming his position in expanding support for stem cell research. He has differed (quietly) from the Bush administration on this issue, but deferred to the wishes of the President in recent years. Perhaps, after pushing conservative Christian views only to achieve laughable results, Dr. Frist is trying to appeal to a more moderate base. It should be interesting to watch.

*******

What I'm listening to now: Astro Lounge, Smashmouth

Punctuation - Does It Really Matter?

While I'm sure that Lynne Truss would emphatically say "Yes" to the question in the title, I wonder if anyone else really cares. The reason I ask is because of the degree I'm pursuing, the dual "MD/PhD." That slash bugs me. I've only understood the slash to be used for the following functions:

1. In arithmetic, it's used for fractions or as a symbol of the division operator.
2. Shorthand for dates, so "July 26, 2005" becomes the more convenient "7/26/2005". I prefer using periods in my shorthand (7.26.05), as it looks cleaner and there's no possibility of confusing the slash with a "1".
3. In written prose, the slash can be shorthand for "or". Of course, I find this silly when used in the phrases "and/or" or "either/or" as it is redundant.
4. An annoying yet necessary component of website addresses, I suppose. Computer programmers operate under a whole other set of rules.

A brief survey around the web finds roughly equal usage of "MD/PhD" as opposed to "MD, PhD". So what does it mean to me when I see my degree written out as "MD/PhD"?

Arithmetically, it really makes no sense. You don't divide one degree by another, although, talking to some people, the presence of one of those degrees somehow dilutes the strength of the other. You hear that from both MD's and PhD's. We are considered neither good clinicians nor competent researchers. We get no love from either.

From a written perspective, I assume that most people would apply the "either/or" usage of the slash whenever they saw "MD/PhD". "Well, which is it?" they would ask. "What - you got into medical school and couldn't decide?" Explaining that it's a combined degree, and that we have training in both clinical practice and laboratory science, most people tend to understand at that point, but in discussing that with other people in the medical field, we end up rehashing the "degree dilution" argument (see above).

I would prefer the punctuation in "MD, PhD" because the comma tends to insinuate the presence of both, rather than either. Of course, were I to list that properly, I'd have to include periods and all of a sudden the abbreviation becomes a cumbersome "M.D., Ph.D." and quite the headache to read. I wonder if there's some sort of limitation on how I list this degree - do I have to print it as it will be printed on my diploma, which is sure to display the less desirable slash, or do I have some degree of self-determination?

Perhaps this obsession with the slash is merely hiding my anxiety that no matter how one punctuates this particular combined degree, one can define it by the following quote:

"You spent how long to get the "MD, PhD"?.......DUMBASS!"

An Enemy at the Gate

Yesterday was a big day, although it didn't feel like it for the most part. The dissertation is entering its final stages, and I distributed drafts to each member of my thesis committee. The other big event was this:

WE HAVE A DEFENSE DATE!!!

Yes, the Day is approaching, and August 4, 2005 will be my final day as a graduate student.

In the meantime, I have some paperwork to submit to the graduate school office, and with that, I must deal with the guardian that lets me pass through that glorious gate that leads out of graduate school. Just for the sake of this narrative, we'll call said guardian 'Ellie'. Ellie's job description, I would predict, reads something like this:

Ellie, Registrar, Graduate Medical Sciences

• Directs the daily operations of the Registrar's Office.
• Recommends and participates in the development and implementation of university policies and procedures regarding student registration, records, etc.
• Develops and publishes major University information documents including, but not limited to, University Catalogs and class schedules.
• Creates a ridiculous number of forms, the purpose of which is to obfuscate the purpose of the Office of the Registrar.
• Depresses the morale of the graduate student body.

I'm not sure what it is, but Ellie seems to enjoy making students' lives rather difficult. It's like we walk in there to take care of whatever business is necessary, and she tries to pick a fight. The only way to deal with her combative attitude is take some sort of non-threatening posture and pray that you make it back outside with very little bleeding. Also, she'll usually force some other bureaucratic maneuver upon the student, requiring more running around obtaining more signatures. My task came as Ellie was checking to make sure that the list of thesis committee members I'd provided was legitimate. As if any student would try to pass off a fake committee member:

Ellie: Okay, I'm checking your thesis committee members with our list of approved faculty.
Mikey: Okay.
Ellie: Wait a minute. I don't know this person.
Mikey: He works in the Pulmonary Center, which is just down the hall from you.
Ellie: What?!
Mikey: Nothing.
Ellie: He's not on our list. You're going to have to fill out Special Form Number 624D then get it back to me attached with a copy of his CV. Until then, I'm not processing your thesis defense paperwork.
Mikey: Okay.

I didn't get the CV before the close of the business day, so I had to turn the special form in the next morning. And, of course, after double checking the graduate office database, another administrator found that this faculty member was indeed on their list. Ellie just either:

1. Hadn't updated her faculty database to the most recent version (if true, then she hasn't updated since 1999), or
2. She just gets a kick out of sending students out on inane little chores.

Me, I'm thinking it's #2.

Thesis Update: Do Not Pass Go

In Which The Drawing Board Hits Mikey Squarely In The Face

My plan to put in a half-assed effort to finish off my thesis failed. Perhaps I overstate my efforts - was it even a half-assed effort? Maybe a quarter-assed effort. How does one quantify effort with "asses" as a measuring unit, anyway? I mean, if we're talking quality, then perhaps we're talking 1/16th of Charlize Theron's-assed-effort. But if volume is the issue, then perhaps I put in a quarter-Oprah Winfrey-assed effort into the discussion section. I think I can put a positive spin on it by saying that I put in a full-Kate Moss-assed effort into the final section, however this may imply that I don't have much volume, and I was flying high as a kite to boot.

No matter the measure, the effort does not pass muster under Barb's gaze. Her remarks were remarkably dissimilar to her reviews of my other sections - most, if not all, corrections were largely for grammatical errors. This time, the grammatical corrections were at a minimum - not a good sign. No, this time Barb's notes were paragraphs punching holes in my logic. And at least eight - EIGHT!!! - notes stating that a discussion on such-and-such needs to be included. Not a couple of rinky-dink sentences, but full-blown multiple paragraphs that will force me to spend hours on PubMed looking for references and more hours staring at my computer screen coming up with some prose that will make it sound like I know what I'm talking about. At least I don't have to convince anyone that I care about the science, anymore. Anyway, so much for a laid-back, relaxing weekend.

Good morning, world. I SUCK.

*******

Playing right now: "Creep" from Radiohead's Pablo Honey.

ACLS Fun Fact (cont).

Forgot at least one:

• Pounding someone in the chest when they're in the throes of cardiac arrest doesn't do much good. Sure, it looks good in the movies, but in real life? Not the first option. See here for proof.

Third Year Orientation

Orientation for the third year of medical has drawn to a close. The thing that I thought was going to be a big deal turned out to be not such a big deal at all, that is, the ACLS training. Seriously - would you expect someone who has had three days of training to lead a Cardiac Life Support Team? Of course not - this is but training for the rest of our careers as health care providers, and we've got to start somewhere.

ACLS Fun Facts:

1. Apparently, we don't get to inject drugs directly into the myocardium anymore. So, those of us who want to re-enact one of the most famous scenes from Quentin Tarentino's Pulp Fiction, the one where Eric Stoltz rams a syringe into Uma Thurman's chest, are SOL.
2. Did you know that Viagra (Sildenafil) has shown promise as a treatment for pulmonary hypertension? Viagra can cause dilation of pulmonary blood vessels, reducing blood pressure.
3. Did you know that Viagra may be prescribed for children with pulmonary arterial hypertension?
   

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We also got to play dress up:

This is Greg, a fellow MuD/PhuD, who is sporting the latest craze in tuberculosis (TB) mask fitting technology. Here we are trained to properly sport these fashionable TB masks. The hood is worn to test the fit - a saccharine solution is sprayed into the hood and if we can taste it, then the mask isn't fitting properly. If Greg were to wear a poorly fitted mask into a TB patient's room, he could easily be exposed to the airborne TB particle. We wouldn't wish that on Greg, right? Right?

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Phlebotomy Training

Our first needle sticks were performed on these fake rubber arms. The obvious advantage to this is that we practice what to do with our hands on a subject that won't scream or recoil in pain.

Sticking a classmate or being stuck by a classmate was optional (when did medical school become so wimpy?) Here's me probing my friend John's arm for a decent vein:

So, my first catheter insertion went pretty well. At first, John's veins were easy to see, but once I wiped down the area with alcohol, the vein submerged, I SWEAR. John's only complaint was that once I punctured his skin, I hesitated a little, causing some discomfort. I certainly had to go deeper with the needle than I expected, before I saw the flash of blood appear around the base of the needle.

I returned the favor for John:

A successful catheterization by John. Again, there was no screaming nor any blood spurting. Oh, well - there's always next time.

*******

What's playing now: A Night in Tunisia, Art Blakey & The Jazz Messengers

Recommended by my high school friend Deej, the same guy who recommended ELP's rendition of Modest Mussorgsky's Pictures at an Exhibition. I think we both agree that A Night in Tunisia is the more solid work.