Thursday, June 30, 2005

A Milestone

Mikey's First Beeper.



Like wow. Back in the day, owning a beeper pegged the carrier as a physician. Nothing wrong with that, but it didn't help my father when he was trying to negotiate with the car dealer. Nowadays, almost everyone carries a pager, yet the medical student's first pager is still somewhat of a minor milestone. Perhaps it is because its importance may lie in its ability to convey a level of competence and/or professionalism where there is none.

Tuesday, June 28, 2005

Phat Tuesday

Wow. Everything is falling into place all at once.

First, I won't make it back into the third year curriculum on time to start my surgery clerkship on July 5th. However, thanks to our MD/PhD Faculty Advisor, Mud/Phuds now have an option to move a fourth-year elective into our third year schedule, and count it as research credit. That way, I have plenty of time to finish writing and defend my dissertation. As a result, I had to move the surgery clerkship to somewhere else during third year, and schedule one of the shorter clerkships for August. But for that rescheduling to happen, I had to petition the Promotions Committee to allow me late re-entry into the third year curriculum. This petition took a long time:
  • Monday, June 20: I write a letter to the Promotions Committee Chairperson.
  • Tuesday, June 21: A reply from the assistant states that I need to be more specific about my request, i.e., "Why do you need those 6 weeks off?" My second letter is more specific, giving the date of my most recent committee meeting, when my committee officially gave me permission to write my thesis. (This was flawed wording, as you'll see soon).
  • Thursday, June 23: The Promotions Committee does NOT approve my petition, saying that, with less than two months before the start of Block 2, they don't have the confidence that I can finish on time if I had just started writing my thesis. (What I should have stated in my letter was that I had been writing my thesis for almost two months already). Barb writes a note to the Promotions Committee Chairperson stating that my thesis is nearly finished, and I will have successfully defended well before Block 2.
  • Friday, June 24: no reply
  • Saturday, June 25: no reply
  • Sunday, June 26: no reply
  • Monday, June 27: no reply. I write another letter. Here's the first draft:
Dear Dr. C___,

PLEASE PLEASE PLEASE LET ME OUT OF THIS PLACE. I CAN'T TAKE IT ANYMORE. IT'S TORTURE, I TELL YOU! TORTURE!!!!!!!!

Sincerely,
Mikey
Wary that this first draft may sound a bit desperate, I have a friend edit the letter. As you may know, Kinjo is a fine writer, and transformed my words into something a little more professional-sounding:

Drs. C___ and O______,

I apologize if I'm being too forward, but I write to inquire about the status of my petition for reentering the 3rd year curriculum in Block 2. Any information that you could provide regarding when I might expect a decision on my petition would be much appreciated. I've written my letter explaining my intent, and my advisor, Dr. Barbara N________, wrote an email confirming my progress on June 22, 2005, as well. We are both very confident that I will be able to finish in time, and anticipate that my defense date will be in late July (pending scheduling with my committee and the Department of Graduate Medical Sciences.) To demonstrate good faith, I've also attached the latest draft of my thesis to confirm that I have not misled anyone regarding my progress. This part of the thesis has been read by both my first and second readers, and I will shortly be submitting the final Discussion section for review. (Please excuse its crude format; I will format the document to conform to the graduate school guidelines upon completing the dissertation.)

Please let me if there is anything else I can provide to help you with your decision regarding my petition.

Please also be advised, as far as scheduling is concerned, because I was initially scheduled for surgery clerkship in Block A, I needed to rearrange my schedule to accommodate reentering in August. I let C________, the surgery clerkship coordinator, know of the anticipated change, and she in turn has already removed my name from the Block A surgery clerkship. In essence, the ship has sailed. My understanding is that if I do not start Block 2, I will have to wait until July 2006 to begin the third year curriculum. I cannot stress to you how much I do not want that to happen. After spending over 5 years in graduate school, I am very reticent to delay my progress any further. I am sure that you can sympathize.

Thank you for your time and attention to my concern. I look forward to hearing from you soon.

Regards,

Michael
Not bad, not bad. I regret not having Kinjo also write my dissertation. Ah, well.
  • Tuesday, June 28: An email from the Promotions Committee Chairperson:
Hi Michael,

You should get an email today from Susan N_____ approving your petition. The formal letter will follow. Take care.
Awesomeness. I ran around campus quite a bit today gathering the appropriate signatures, because I needed all of the following forms signed:
  • A form dropping Surgery from Block A.
  • A form adding Surgery to Block D.
  • A form dropping Psychiatry from Block 7.
  • A form adding Psychiatry to Block 2.
  • A form dropping Obstetrics & Gynecology from Block 8.
  • No, I'll not be explaining the Block system in this post.
To summarize, my third year schedule is shaping up, I'll be defending near the end of July, and I'll have about two weeks to rest before beginning the Psychiatry clerkship on August 15.



I also picked up the course materials for Third Year Orientation, which BEGINS TOMORROW!!! (Cue "What a Feeling" from Flashdance, performed by Irene Cara). I'm a bit nervous, for a number of reasons:

First, my sleep schedule is off again, as I'm going to bed around 4AM. Orientation starts at 8:30AM. Just in case, my friend John is going to call and make sure I'm up and about.

Second, orientation is where we start to learn an advanced set of skills: Advanced Cardiac Life Support (ACLS). I took a refresher course in Basic Life Support (BLS) a year ago, so I do know basic CPR, but ACLS already looks quite daunting. I remember precious little pharmacology from MED YEAR 2, and ACLS definitely requires us to know everything that needs to be done when someone's life is hanging in the balance.
We are also scheduled for a couple sessions on phlebotomy. As far as I can tell, physicians fall into one of three levels of blood-drawing aptitude.
  1. Expert. The needle stick feels like a pinch, and the duration of the blood draw is painless.
  2. Average. The needle stick hurts, and the blood donor is reminded of the presence of the needle in his or her vasculature with every blood-spouting pulse.
  3. Inept. The physician can't find the vein on the first try, requires multiple sticks, and in general, should be forbidden to handle a hypodermic needle.
My father, my boss at NCI, and most nurses I've met fall into the Expert category. I'll be satisfied, but not happy, if I end up an Average blood-drawer. I really hope I can become good at it, just like my Dad. Oh, great. Pressure to live up to my father.

Finally, I'm joining a medical school class in which I know virtually no one. I'm a stranger. And with that, I will carry the gamut of social anxieties with me into orientation this week. (Cue "Creep" from Radiohead's Pablo Honey.) This is complicated by the fact that it is entirely possible that my new classmates will be brandishing bruises of deep purple hues due to my attempts at blood-drawing.

Still, I have to say that I'm feeling very hopeful at this point, and that's great - because I haven't felt that in quite a while.

Tuesday, June 21, 2005

Someone Stop The Ludwig Van

...I wanna get out.



Mikey is working hard today on the discussion section of his dissertation, and therefore needs a relief pitcher1 to come in and help him keep you well entertained. Or perhaps, well, entertained. Regardless of punctuation issues, I am sadly low on content of late (although I have plenty of ideas bouncing about in me head meats, most of them just aren't Mom friendly - hi Mike's mom!), so I'll need some help from England's The Guardian newspaper.

That is, I am enlisting the help of Dr. Dylan Evans, a senior lecturer in intelligent autonomous systems at the University of the West of England, and general fuddy-duddy killjoy, to explain why it is when Mikey plays Beethoven in the background while he writes his productivity declines and he descends into a pit of personal despair and inutility.

You see, apparently Beethoven was a narcissistic hooligan:
Beethoven certainly changed the way that people thought about music... for the worse. From the speculations of Pythagoras about the "music of the spheres" in ancient Greece onwards, most Western musicians had agreed that musical beauty was based on a mysterious connection between sound and mathematics, and that this provided music with an objective goal, something that transcended the individual composer's idiosyncrasies and aspired to the universal. Beethoven managed to put an end to this noble tradition by inaugurating a barbaric U-turn away from an other-directed music to an inward-directed, narcissistic focus on the composer himself and his own tortured soul.

This was a ghastly inversion that led slowly but inevitably to the awful atonal music of Schoenberg and Webern. In other words, almost everything that went wrong with music in the 19th and 20th centuries is ultimately Beethoven's fault. Schoenberg was simply taking Beethoven's original mistake to its ultimate, monstrous, logical conclusion.
[Emphasis added]
Dr. Evans continues on and claims that it is Beethoven's morbid self-obsessive "darkness" that has spoiled music, wrought untold figurative and literal violence upon the world, and done more to destroy the culture of life than any other human effort ever. Okay, maybe that's an exaggeration of Evans' thesis, but I'm not too far off the mark.

The point is, Mike, turn off the Beethoven and let Bach's "exuberant commitment to the Enlightenment values of clarity, reason, optimism and wit" wash over you and write you magnificent bastard, WRITE LIKE THE WIND!


I am mindful that I feel: sullenly adolescent, dark and frenzied
On the iPod: Nurse with Wound - Soliloquy for Lilith



1
This and "end run" are the only sports metaphors I can use or understand with any accuracy or comprehension. Before you think less of me as a man, understand that I am great with war metaphors and double entendre.

Thursday, June 16, 2005

Mikey's Thesis Committee Meeting #3: A Recap by Hank

Hi,

Hank here. Well, Mike's a little comatose, having pulled an all-nighter plugging away at his dissertation. Probably not such a good idea, considering the committee meeting scheduled for this afternoon. Apparently he thought he could handle it, getting to the gym at 6AM this morning, and somehow, despite a 3-week absence from cardiovascular exercise, avoiding yet another heart attack. Obviously he got a little cocky, as I caught him cat-napping in front of his laptop around 9ish.

Mike's preparation for the meeting was minimal - he was able to put together his presentation in about 10 minutes, but just in case, he decided to print handouts for his committee. Of course, the printer failed. Again and again. Don't know how that could happen. Wasn't me.

By the time he finished printing, everyone on the committee who could attend was there. Mike presented his data. The committee nodded, made some suggestions, then formally told him to start writing his thesis. Yeah, I know. Could you imagine the state of this blog if Mikey truly started to write his thesis just now? Anyway, he should be able to hand in his final section on Monday the 20th, then give the entire dissertation to his second reader by Thursday, June 23rd.

Yeah, I didn't think it would happen either.

*******

Right now I'm listening to: Mikey talking to himself in his sleep.

Wednesday, June 15, 2005

Old habits die hard

Which means, that despite everyone's helpful advice, I find myself too often just staring at my dissertation, trying to form that perfect sentence. Making a smooth transition from one topic to another. Making sure I avoid passive voice, colloquialisms, and run-ons. Before I know it, hours pass by with minimal progress.

SO - I made myself an on-screen reminder to stare me in the face as I work:



I think this little trick is gonna put me over the top.

*******

Right now I'm listening to: Introducing Brad Mehldau, Brad Mehldau

Brad Mehldau is one of the most amazing jazz pianists I have ever heard. He mainly plays in trios along with a bassist and a drummer, and comparisons to Bill Evans follow, except the musical structure seems to differ quite a bit from many of the pieces that the Bill Evans Trio performed. It seems that there's less freedom for each and every member in Mehldau's trios to improvise, so most of the work showcases Mehldau's piano-playing skills. That's not to say that he's a self-centered, selfish musician, as one can easily appreciate the skill of his accompanists, only don't look to Brad Mehldau for the second coming of the Bill Evans Trio. Some of my favorite pieces of his are jazz adaptations of Radiohead's "Paranoid Android", "Exit Music (from a Film)", and "Everything in Its Right Place."

Recommended albums of his: Anything Goes, Live in Tokyo, and The Art of the Trio, Vol. 3: Songs.

Not PhinisheD...yet

Quickie post.

Well, obviously - Lia's right. Feeling angst about struggling to finish up is, well, not so unique. I found a website dedicated exclusively to discussion and support of those students who are struggling to finish their dissertations or theses.

Not that I have time to go on there and commiserate with everyone, but, just so you know it's there...

*******

Right now I'm listening to: Symphony No. 5, Ludwig van Beethoven, Carlos Kreiber, conductor, Wiener Philharmoniker

Tuesday, June 14, 2005

It's gettin' hot in herrre...

Where to begin? I still haven't finished my thesis. Not from lack of effort, mind you, but I've been burnt out for quite a while now. In five years of graduate school, I've taken two weeks of vacation. I'm tired. And even though finishing graduate school is quite the incentive, it just hasn't been enough to neutralize the absolute apathy I have towards this research endeavor.

But I'm cutting this really close:
  • Orientation for 3rd year starts June 29th.
  • My surgery clerkship starts July 5th.
  • I couldn't get my committee in the same room together for my (hopefully) third and final thesis committee meeting until this Thursday, June 16th. And even then, one of them is unavailable until after June 20th.
  • I still haven't submitted my official dissertation paperwork to the graduate student office because I've been waiting to meet with my committee. But this paperwork has to be read by my committee before I submit the paperwork, which is then submitted at least three weeks before the defense. THREE WEEKS?!?! There's a chance I won't be able to defend before I go back.
I'm feeling a little bit lost right now. I'll do what I can to finish, go in and beg the graduate administration for understanding, but I don't know how far that's going to get me.

Perhaps I'm still in denial, but I refuse to let this bureaucratic stuff get in my way. If it stops me from finishing, fine - I'm so ready to walk away from graduate school, anyway - and I SO want to yell "I QUIT" at someone it hurts.

*******

Right now I'm listening to: Amnesiac, Radiohead

You can keep the furniture
A bump on the head
Howling down the chimney
Release me
Release me
Please
Release me
Release me

Friday, June 10, 2005

Pot to Kettle: You're Black

Well, now that there is a study hinting of scientific impropriety as I posted yesterday, today I've been alerted to another potential case of scientific hand-waving, this time from the White House. EGADS! My confidence in the integrity of our elected officials is absolutely shattered.

It turns out that an EPA study concluded that 'global warming' is a real threat. I have not read the study, but apparently environmental scientists have characterized the data as a robust body of work. However, the conclusion of the study directly counters the political agenda of the current administration, which, as always, claims to be leading the battle for a healthy environment:
In 2001, President Bush withdrew U.S support for the Kyoto climate change agreement claiming that it would hurt the nation's economy. At Tuesday's news conference, Bush defended his strategy to combat climate change:

"In terms of climate change, I've always said it's a serious long-term issue that needs to be dealt with. And my administration isn't waiting around to deal with the issue, we're acting. I don't know if you're aware of this, but we lead the world when it comes to dollars spent, millions of dollars spent on research about climate change. We want to know more about it. It's easier to solve a problem when you know a lot about it. And if you look at the statistics, you'll find the United States has taken the lead on this research."

I cannot dispute the president's assertion that the United States spends the most money on environmental research. In fact, I applaud it. However, I can't applaud the fact that they've hired a former lobbyist for the American Petroleum Institute to edit the government-funded climate reports. Apparently, Philip Cooney "repeatedly edited government climate reports in ways that play down links between [greenhouse gas] emissions and global warming."

Perhaps Mr. Cooney's experience as a representative of the API resulted in the ability to critically review data from environmental studies. Perhaps I'm just falling into the trap of the liberal media and too easily believe that the current administration shrugs off scientific conclucions that don't jive with its agenda. But then, there this:
"[The] Guardian of London reported yesterday that the environmental group Greenpeace obtained documents which showed that President Bush's global climate policy was heavily influenced by ExxonMobil and other oil companies."
Of course, what's wrong with oil companies having a say in formulating environmental policy? They probably know better than the rest of us what exactly is being spewed into the air we breathe whenever we burn fossil fuels. It's genius, really. Kind of like letting Big Tobacco formulate health care guidelines for respiratory health.

I should note that in response to questions regarding the reports, White House spokesman Scott McClellan said the documents were all approved by government scientists and by an independent panel set up by the National Academies, the leading independent scientific body. President Bush's science adviser, Dr. John H. Marburger III, also approved the reports.

Thursday, June 09, 2005

Scientific Confessions

An article published in Nature describes a study finding that one in three scientists admit to having 'misbehaved' scientifically, some by ignoring 'bad' data to outright falsifying data.

Brian Martinson of the HealthPartners Research Foundation in Minneapolis, Minnesota, and his colleagues mailed an anonymous survey to thousands of scientists funded by the National Institutes of Health. They asked the scientists whether they were guilty of misbehaviours ranging from falsifying data to inadequate record keeping.

Of 3,247 early- and mid-career researchers who responded, less than 1.5% admitted to falsification or plagiarism, the most serious types of misconduct listed. But 15.5% said they had changed the design, methodology or results of a study in response to pressure from a funding source; 12.5% admitted overlooking others' use of flawed data; and 7.6% said they had circumvented minor aspects of requirements regarding the use of human subjects.
I've witnessed some of these transgressions, and I will admit to fantasizing about doing something similar just so I can get out of this hellhole known as graduate school. (But I didn't - is thinking of sinning the same as the sin itself?) I wonder if this is a byproduct of the nature of the system - researchers are judged by the amount of money they can bring in, which could be thought of as an indirect measure of the quality of their research, the number of publications, etc. The stakes are high, especially because tenured faculty positions have largely gone the way of the dinosaur.

From their paper the authors posit some of the reasons why scientists resort to such behavior:

In our view, certain features of the research working environment may have unexpected and potentially detrimental effects on the ethical dimensions of scientists' work. In particular, we are concerned about scientists' perceptions of the functioning of resource distribution processes. These processes are embodied in professional societies, through peer-review systems and other features of the funding and publishing environment, and through markets for research positions, graduate students, journal pages and grants. In ongoing analyses, not yet published, we find significant associations between scientific misbehaviour and perceptions of inequities in the resource distribution processes in science. We believe that acknowledging the existence of such perceptions and recognizing that they may negatively affect scientists' behaviours will help in the search for new ways to promote integrity in science.

Little attention has so far been paid to the role of the broader research environment in compromising scientific integrity. It is now time for the scientific community to consider what aspects of this environment are most salient to research integrity, which aspects are most amenable to change, and what changes are likely to be the most fruitful in ensuring integrity in science.

Hence the dilemma - healthy competition (in this case, for research funds, prestige, climbing the career ladder) can result in scientific advances, benefiting society. However, with so many scientific mouths to feed, the competition becomes a frenzy and responsible scientific conduct sometimes falls by the wayside. Scientific advancement becomes merely a bonus, as long as the researcher survives to work another day. That's the mentality of my last several advisors - they see themselves as fundraisers so they can ensure the existence of the laboratory.

Where is the happy medium in all of this? Go ahead. Discuss. I have to finish writing this Discussion section of my thesis.

*******

Right now I'm listening to: Stop Making Sense, Talking Heads

Monday, June 06, 2005

Coming up with an appropriate title for this is impossible

The capacity to give one's attention to a sufferer is a very rare and difficult thing; it is almost a miracle; it is a miracle.
-Simon Weil
*******

I'm not a legal expert, so there's no way I can put forth an opinion as eloquently as our friend Kinjo. But today the Supreme Court put forth an opinion on Ashcroft vs. Raich, regarding the use of medical marijuana. Long story short, our beloved Bush administration believes that the state has no right to pass a law allowing possession of marijuana, trumping any federal anti-drug laws. Although Ms. Raich, who suffers from terminal brain cancer, has been prescribed marijuana by her physician to alleviate her pain, she can still be prosecuted under federal law, thanks to the Supreme Court. (The National Review puts it in terms of Federal vs. States' rights here).

/sarcasm
My reaction? Good thing they prevented this woman from using the rest of her life to set up a massive drug-trafficking operation. (5-year survival rate for brain cancer patients is less than 10%; life expectancy for patients diagnosed with glioblastoma multiforme is less than 1 year). I mean, WHEW! our nation really dodged a bullet there, huh? Because SURELY, the first thing a cancer patient is going to do after diagnosis of a terminal disease, is find a way to break the law. What better way to make use of the rest of your time on earth?

My advice to her: just sit there and deal with your pain! God meant for suffering to exist, now stop whining.
/end sarcasm

MP3 Players