I used up my one allotted dumb question in med school today.

A family of patients with myotonia came to speak to us today. They have a problem with muscle relaxation and occasionally freeze up after using their muscles. The son described playing ultimate frisbee and being unable to let go of the disc. The baby girl cries with her eyes closed because she can’t relax the muscles in her eyelids. The mother is afraid to drive because her foot could get stuck and unable to brake. We watched as the squeezed their hands in a fist around a bar and struggled to let go. Interestingly, the condition worsens in the cold but improves with muscle use.

The disorder is inherited in an autosomal dominant fashion. Autosomal simply means not sex-inherited, that is, the gene does not lie on the X chromosome. Dominant means that one copy of the gene (we have two copies of every gene) is enough to cause the disease symptoms.

The family tree looked something like this:

You can see that there is someone with myotonia in every generation. Now, I was confused and asked why were there some children who did not have the disease even though their parents did. 

So, pretty much any high school or even middle school student with basic biology course can tell you the answer: Each diseased person has one disease gene and one normal gene. Thus, 50% of their children will receive the disease gene and 50% will not.

And here I am, with my biology undergraduate major and medical education asking a stupid question like that. We took our genetics final only two weeks ago and I passed with a 94%. I’m embarrassed to even go to class. I deserve to be kicked out of med school.

So yeah. No more stupid questions from me.

5/4/2

I’m not posting a new article today because I am wasting my life away playing settlers online. If you have no idea what I’m talking about, read on.

5/4/2

I made two mistakes in college that I vowed to not make in med school.

1. I emphasized academics at the expense of forming social relationships.

2. I spent all my free time and fulfilled my social needs by talking to my boyfriend freshman year. We broke up sophomore year, and I found myself with no social contacts.

Once I realized the importance of social relationships for my health and happiness, it was too late. Most people had already formed their social circles and weren’t too welcoming of newcomers. College students aren’t much more mature than high schoolers in that way. Now I’ve come to realize that med students aren’t much better (or at all better).

My med school class is 170 people. Large enough that I’m not going to adore everyone, and small enough that I have to spend a significant amount of time with those very people. Every day. Eight hours a day. I’ve been here for a month already, and everyone seems to have already formed their cliques, while I have no friends. So maybe it’s not just that I missed my golden opportunity in college. It’s probably just that no one wants to be my friend.

I had dinner and a beer with a classmate of mine after a long day of school (I knew her from undergrad, so she doesn’t count as a new friend). I asked her how she gets to know people and what kind of activities she does with them. Unfortunately, her answer was that she hangs out with her MD-PhD cohort. I don’t really think four extra years of school is worth it to make some friends, so that plan won’t really work for me. I live in a house with third year students who are too busy with clinics to hang out with me, and in a part of the city far away from most of my classmates.

In the past, I instantly knew who I could become good friends with. Now it seems like there is no one here for me. And that is why I am stuck here, telling my thoughts to a computer instead of to my best friend.

One of the tacky activities my med school requires of us during orientation is to describe our core values. As it turns out (and this is an off-topic preamble) I apparently didn’t think it was worth my time to complete beforehand. During the summer, I was swamped with work for my internship that I flagged the initial email and completely forgot about it. I figured they would send us a reminder as the time got closer. During the entire summer, I received no emails from my new school. Absolutely zero. I had to look up what day I was supposed to show up. “Wow, they don’t do a good job communicating with their students,” I thought.

Upon check in at orientation, a staff member asks me for my Core Values assignment. I hadn’t done it.

“Why not?”

“I must’ve missed the email”

“You mean you missed every single one of the FOUR emails I sent you?”

I had no clue what she was talking about. She hands me a pen and paper and asks me to write an essay about my top core values on the bus to the orientation. “You’ll need it today,” she explained.

It wasn’t until the end of orientation week that I realized I had a new school email address, and that all of the communications from my school were directed there. When I signed in for the first time, I encountered mountains beyond mountains of email. Among those were these two from the staff member above:

—–

Hi

As of this morning, we have not yet received your core values and/or your retreat consent form.  We must have these in had by noon today.

Please make every effort to send us these documents ASAP.

——

Then a few hours later…

Hi again-

We REALLY need your core values within the next hour.  (we have some administrative work to do with them before tomorrow).

Please make every effort to send them to us ASAP.

—-

Other emails I had missed included multiple notices of social gatherings of my classmates with subject lines “Happy hour tonight!”. And here I was thinking the whole time that everyone else was invited to these events but me.

In any case, that was a long preamble. Let’s return to the core values.  Of course, everyone groaned at this activity, but I actually found it insightful. Then again, I am into introspection. Here are my core values as written in 20 minutes on a bumpy bus ride:

1. Acceptance: to whole-heartedly accept another person with their positive and negative aspects. To withhold judgment. To really look past the exterior of a person and see their core values that narrate their life. To give all that I can to another. To forgive others of past wrong-doing. To accept that I am unable to influence others and that they ultimately make their own decisions and are responsible to themselves.

2. Diligence: To strive for excellence in anything I set out to do. To put my entire attention and effort into an endeavor, no matter how small. To have a high standard for my actions, so that if anyone entrusts a task to me, they can be sure that it will be done and done well.

3. Accountability: To be responsible and trustworthy on the issues for which others depend on me, and to be responsible for myself. Don’t be late. Complete tasks on time. And strive to the best extent possible if otherwise. Take care of personal needs, including health and social. Addendum: Strive for excellence but maintain a minimum standard of competency.

—-

It’s ironic that my last core value is to complete tasks on time and I clearly did not do that for this assignment. This beautifully illustrates the fact that my core values describe the person I aspire to be, and that is still a work in progress.

My first exams are coming up in two days. Looking through histology slides at 1AM in the morning ultimately means that I end up thinking less about the science and more about the “oooh… how pretty..”

I definitely want these as a poster print on my wall or even as the print on my dress. Ten points if you can guess what these are (I’ll reveal the answers in two days while either celebrating the end of exams or moping about how poorly I did).

This one reminds me of a area time-lapse photo of a highway…

I never thought that cooking was a worthwhile activity. All of that time that you spend cooking is just not worth it. And there are all the hidden costs too. There are the costs of utilities, kitchen tools, ingredients that are wasted because you didn’t manage your groceries and they all went bad. Then you invest the time to plan meals, grocery shop, clean the dishes, clean the kitchen, and manage your inventory.

But in the end, it’s still not as expensive as buying a meal. And when you’re living off of student loans, you have to think in your head that every dollar you spend is at least two dollars that you will have to repay in the future, then that $20 dinner comes out to more like $40.

The obvious solution would be to cook. Unfortunately, the only way to eat on a budget if you don’t know how to cook, is to eat lots of frozen food, which is exactly what I’ve been doing for the past week. A much younger version of me wouldn’t have believed it, but I can only have so much of hot pockets and pizza bagels. The problem is exacerbated due to time constraints. When you come home exhausted from a long day of class, the last thing I want to do is go buy groceries, make dinner, and clean it up. By the time that’s all done, it’s time to go to sleep. And even when I go through all of that effort, I can’t taste the difference between my meal and the burnt products that I made in chem lab.

Now that I see the importance of cooking skills for anyone who can’t afford to hire a personal chef, it’s too late for me to learn. I know that the initial reaction is, “It’s never too late”. But honestly, if I have an exam coming up then I am not going to spend hours learning a new recipe if I can just fry an egg in 2 minutes and eat it with a piece of bread.

Which brings me to the lesson I want all of you college kids to draw from this: learn to cook when you are younger and have time and can spend your parents’ money, and you will save money and time when it matters!

or

Date a rich boyfriend with a strong sense of chivalry. (If you opt for this approach, do not enter a long distance relationship with said rich boyfriend as I have.)

Did you know:

Genetic analysis of mitochondrial DNA of any two individuals can tell you how long it has been since they shared a mother.

Mitochondria are very ancient cell structures that were incorporated into the cell by engulfing a primitive bacteria. Although most of the original mitochondrial DNA has migrated to the nucleus, a subset of genes are still retained within the mitochondria’s own genome. Because the mitochondria is so critical for producing all the energy our cells use, it is super important that mitochondrial proteins remain stable and do not show as much variability as other genes. To accomplish this, mitochondrial DNA do not undergo the normal processes of meitoic recombination that nuclear DNA does. Therefore, mitochondrial DNA is highly conserved throughout generations, more so than the nuclear genome. Another interesting point is that mitochondrial DNA is passed maternally. For whatever reason, more mitochondrial DNA is present in the egg than in the sperm. So, one can trace an individual’s maternal lineage through looking at mitochondrial gene sequences.

Whew. So what was the point of all that? I’m not just trying to lecture you about science. This got me thinking… If we go back far enough, we all came from the same mother. Somewhere up in heaven is an old African woman looking down at all of her great great great great (great)^n grandchildren. And that woman is wondering, “What they hell are they doing?”

Yesterday, I was so angry at random strangers for small actions. But maybe they had a bad day. Or maybe they’re just jerks. But hey, I have three brothers who can be jerks but they’re still my brothers. It’s not just my personal life, but larger conflicts around the world. The front page is full of war in Libya or suicide bombings, or just last night my classmate heard gunshots at a basketball court in the shady part of town – six people were wounded with one in critical condition. Maybe world leaders and gang leaders alike need to learn a little something about mitochondrial genetics.

So yeah, I think I can forgive those jerks. Because we all come from the same mother.

And they say you don’t learn anything useful in the first year of med school..

The first semester of med school here is pass/fail. No one fails. That means that really, this semester is meant as a cushion for those of us who either cruised through undergrad or took relaxing gap years (or both) to get our act together. With all of the information thrown at us, we really need to find a way to handle it now, because upperclassmen have told me that it only gets worse.

Mistake #1. I strolled into lab on the second day to find that I was the only one who couldn’t remember the names of the cell types and structures we had just heard about in the previous day’s lecture. Turns out that everyone had gone home and reviewed.

Mistake #2. The next day, I slept in and missed four hours of lecture in the morning. As a result, I kept watching lectures online days behind my classmates who were going to the live lectures. It took me well into my weekend to catch up.

So suffice it to say that my first week didn’t go too well. But that’s ok, because I’m caught up now and this week is a new week. It’s ok to hiccup a little at the beginning, as long as I find my groove. Here is the study plan that I’ve realized works pretty well for me:

1. Day before lecture (or during live lecture if necessary): Pre-read lecture notes and take handwritten notes. I really need to process new information on my own pace or I get very lost for the rest of the material. Also, handwriting everything is essential for burning it into my memory. (~1 hr per lecture)

2. Day of lecture (1 hour after live lecture ends): Watch lecture online at 2x speed to reinforce concepts and fill in handwritten notes. Note any questions I have to email or ask during small group sessions. Being able to speed up or slow down or pause as necessary is key so I have time to write things down. Also controlling when I watch lecture so that I am the most alert is a plus. (~ 45 min per lecture)

3. Review problem sets and labs after completing them in a group on my own to make sure I fully understand everything.

4. Every weekend: Transfer handwritten notes into an electronic outline with only the main points that I need to study. Especially focus on understanding the big picture rather than detailed pieces of information

5. Before exam: Study from the outline, answer practice questions, and reinforce main points

Yes, I realize that this study plan requires a certain amount of discipline, which I lack. However, one of the traits needed to be a doctor is discipline, so hopefully I will develop that skill sometime in medical school.

P.S. I was so bored while reading my embryology lecture notes until I came across an amazing realization. An ex of mine had told me before that he was born with his head tilted and required surgery. I now know that this is called “congenital torticolis” or wryneck, which is a result of shorterning and fibrosis of the sternocleidomastoid muscle on one side of the body. Cool, right?

They weren’t kidding when they said that medical school is like trying to drink from a fire hydrant.

We’ve only had three days of class, and already I am falling behind.

On the second day, we had a lab session based on material from the first day’s lecture. I had always seen medical students constantly studying, reviewing material the same night, or even right after lecture during lunch. Despite this, I still held on to the fantasy that I could get through class the same way I got through undergrad – slacking and gliding through. Of course, I was one of the only ones who didn’t review the lecture notes, and I looked like a fool in lab. There’s no better motivator to get my act together than to be the weakest link in a group effort.

Since I didn’t review the first day, I was already behind. And catching up is difficult. Even with working every waking minute I have, at the end of today, I have two lectures to review, and three that I haven’t even watched yet. I’ve spent more time trying to set up my computer to watch lectures at 2x speed than the time that I would have saved doing so. Then tomorrow we have class from 8am to 5pm, which means that in addition to the five lectures I just mentioned, I will have five more to review tomorrow night. I can’t even imagine how anyone would have time to pre-read the lecture slides. It just never ends!

And yet the biggest piece of advice that my fourth year tour guides had for me was that they wished they had studied less. I’m going to have to ask them again about how to do that in detail.

Please let the weekend come and never go away!

Mood: 3/Tiredness: 3/ Spiritual Tiredness: 3

Growing up, I cannot recall a single day when less than ten people milled about my house. There was Dad, Mom, Grandfather, and my three dogs I mean younger brothers, of course. But then there were also the visiting relatives, friends, enemies, traveling circus, hobos, and what have you passing through. In fact, our front door is never even locked. It would probably take a week before any one of my family to notice a drifter in our presence. And then my Mom would just set up a permanent bedroom for the guy. That’s the thing about chaotic households – they teach you to welcome friends and strangers alike with open arms. On a typical day I’d cook meals with Grandfather, discuss politics with Dad, gossip with Mom, and war with my brothers. Add a few extra bodies into the equation and I don’t even know how I found time to practice on my violin or do homework!

To top all that off, our house quickly became the popular hangout spot of my friends due to its kickback atmosphere. Look up the “No Rules House”, and you might find our house on a list of hottest places to visit in the area. Because I enjoy creating tacky opportunities for my groups of friends to meet each other, I have become (in)famous for my themed parties. We celebrated 2009 with “99 Red Balloons”, in which guests were forced to maneuver through rooms filled with – you guessed it – red balloons. My 21st birthday, “Murder Mystery Bash”, featured the murder of the mafia princess Cristal in crime-ruled New York in a role-playing story written entirely by yours truly. And for my boyfriend’s December birthday, I managed to lure 100 of his friends into my gingerbread house (luckily, they were able to escape as real boys and girls). Now my friends have become lazy about seeing each other, saying “We’ll just get together at Crystal’s party like every other year”. If I flunk out of med school, I think I will probably make a living as a professional party planner.

Not every moment in the No Rules House was fun and exciting, and the utter lack of privacy can be frustrating. Now that I’m living in a shared house with other medical students, I understand that it is not exactly the same as living with your family. Now that I’m all grown up, I understand personal boundaries and that you shouldn’t randomly punch the other people in your house just because it’s funny (although tasteful practical jokes in moderation are ok). But at the end of the day, I wouldn’t have it any other way. If there is one thing I’ve learned from living in a large household, it’s that every member contributes in a unique way to building a social, intimate environment. A warm, welcoming, and busy house brings out the best of everyone – including me.