SNOW

We have had a very cold December in Houston this year. In the short year and a half we have lived in Houston, it has snowed both winters and we have had 1 major hurricane. Maybe we should have stayed in MI!




As you can see... we did get some pretty big flakes coming down. There was even enough sticking in some places for people to make snow men, have snow ball fights ect. Lisa said her kids were going crazy.

School news:

I am now 6 days away from being done with my pre-clinical medical education!!! Our last day of class was yesterday, and now I just have 4 more tests before I am done. This mini block we have studied genetics and ARTS (age related topics = geriatrics and pediatrics). With the block only being 2 weeks long, it has gone by very quickly.

Genetics is interesting to me, but there are about 90 disorders we have learned, and each has quite a bit of information to memorize (inheritance pattern, gene involved, chromosome location, type of mutation, presenting symptoms, treatment options and so on). And even though our genetics professor is very nice and good at teaching, previous students have said the exam is something to be feared.

The ARTs class has two of the best doctors we have had as teachers. The material is really just explaining how, in many ways, old people's bodies are very different than adults and kids are not just smaller adults.

Then there is a PPS exam covering the things we have learned about the basic physical exam (this is in addition to the clinical skills exam with standardized patients we already did). This test should be not too hard, but the problem is it covers hundreds of pages of reading in our text, so preparing for it in such a short amount of time will be tricky.

Then the last test is the dreaded end of basic science exam, or EBS. It is made by the NBME (national board of medical examiners), who also write the STEP board exams. It covers everything we have learned over the past 1.5 years, although we only have 2.5 days to study for it after our other exams are done! I have been preparing somewhat already, but it is a very different test than the kind that we are used to. It is 200 questions in 4 hours, and the format is all "clinical vignettes," or short clinical presentations followed by multiple choice questions. I guess that some students have trouble with time, because there is so much to read before you get to answer any questions. So although it is supposed to be a knowledge exam... it seems like test taking skills will play a big role, as they usually do.

Finally, I have received my schedule for rotations for the entire next year! We were able to submit 4 different choices for our schedules... and mine looks nothing like any of my submissions. They did it by a lottery system, so I must have been picked at the end. However, I am still fairly happy with what I got. As of right now, I have neurology in January, family medicine in February, OB/GYN for March and April, pediatrics for May and June, 2 weeks break, Surgery for July - September, and Internal Medicine for October - December. I am thinking about putting family medicine off for later and instead taking an elective for that month in pathology or radiology. I have heard from many older students that the family medicine shelf exam can be very hard if you have not had internal medicine yet, so doing an elective instead might be a good idea. Plus I might be interested in radiology, and path is a good review before the step.

Anyway, that is the scoop with me. I'll be home for Christmas... in one week!

Thanksgiving in Texas

Our Thanksgiving break has been great! Sara came down on Monday night, and we put on a Thanksgiving day feast for three. We weren't entirely sure how much food we were making, but it turns out there was tons! We probably could have fed 9 or 10 people if we had a slightly larger turkey. You can see all of our pictures by going to the my photos link on the right.



On Friday, we went to go get a tree, although in Houston that means picking out a pre-cut one at Home Depot. Still on the agenda is the Ballet tonight, and lots more studying for me.



I am in the home stretch now for my pre-clinical curriculum. I will be totally done in less than three weeks now! I took endocrine and GU/GYN exams last week, and now we have two weeks of classes left for genetics and something called ARTS, which is geriatrics and pediatrics... I think. The third week is for the genetics exam, the ARTS exam, the PPS exam (over physical exam stuff), and then finally on Friday the end of basic sciences exam. That test is a standardized exam that covers all of the things we learned in last 1.5 years. It is made by the same people who make the STEP 1 boards, and it is meant to be used as a pretest. It doesn't affect our grade at all, but we have to pass it to go onto clinics. Oh and during the second week of the genetics/ARTS classes I have my PPS practical exam with standardized patients. So it will be a very busy three weeks, but after that I will never be a full time "classroom" student again.

Brussel Sprouts

As I was reviewing a pathology lecture about thyroid diseases, I found out why I hate brussel sprouts. Apparently spouts and other cruciferous vegetables are goitrogens, that is they contain compounds that interfere with thyroid hormone synthesis. Now theoretically this is only an issue in places with endemic goiters, but I am not going to take any chances. No sprouts for me!

Murmurs of Discontent

Part of our Patient, Physician, and Society course this fall is doing a few "special sessions" where we learn the particulars of a specific kind of physical exam. I was introduced to the male genital and rectal exam a few weeks ago (yikes!), and this week I did both my neonatal and pediatric sessions. The neonatal was the most fun, because we basically got to play with a newborn baby (about 12 hours old), while a neonatologist showed us what we should be doing. Babies can be cute (when they aren't crying), but this one promptly made a mess of himself, so we had to skip a few parts of the exam. In the pediatric exam, I had a good day. I was able to really see his optic nerve with my ophthalmoscope, which I think I've only done once before. Also, when I listened to his heart, I correctly discovered a systolic murmur without the doctor first telling me that it was there.

We are now studying endocrinology and genito-urinary + gynecology (GU/GYN). The lecturers so far have been pretty good, and the material is fairly interesting. One gyn lecturer has brought us warm Shipley's doughnuts every day!

Again, if you don't play games, skip the rest of this post.

So I had been thinking about COD4 MW2 as a game I might want, but I think I have decided not to get it now. I really enjoyed the single player campaign of the first one, but it was way too short. I did play the multiplayer a bit too, but now I don't know many people who will be playing it for PC. Also, they have decided to change the PC version's multiplayer so that it does a peer to peer match up system (instead of dedicated servers), similar to battlenet. This sounds like a terrible idea to me, and this chart on digg explains why. Besides the lag and smaller game size issues, the inability to add mods or custom maps is really a slap in the face to the PC gaming community (there won't even be developer's console access). It seems to me that this just gives them a way to control 3rd party development and possibly release map packs later on for money like they do for consols. The greatest strength of the PC was its devoted fans who generate extra content for games at no cost.

The sad thing is the game is already on track to sell tons of copies for the 360, so Infinity Ward probably will just ignore the PC crowd, since there are much fewer of them anyway. Now I don't really care about MW2 that much, but it sets a poor precedent for future games. The way Valve updated TF2 over time and released new map packs for it was great (some control over content is good), but it would stink if they started charging 15 or 20 dollars for each upgrade. And other companies will undoubtedly do a much worse job than Valve of taking care of their games. Plus, open development gave us games like TF2 and Counterstrike in the first place! What does everyone think... is this a good idea or bad idea?

What to play?

GI exam is over, and it was very hard. Luckily, these feelings were prevalent among my class mates, so maybe some questions will be thrown out (though not likely). I think I passed, but otherwise it was not my best exam. HST is on Wednesday, so after this post I have to stop procrastinating and start learning about all those things that Dermatologists consider important... zits and warts mostly.

If you don't play games... ignore the rest of this post.

It seems that I have developed a routine where around this time of year I start looking through gamerankings.com, bomb, and other sites to get myself caught up on what has happened in the world of gaming. I don't follow the news as thoroughly as I used to, probably because I have less time to play games now. So instead of waiting eagerly for anything decent to come out to fill up some empty time, I now have to carefully pick out what games are actually worth spending my precious free time on.

One thing I noticed this fall is that my PC is now two years old. When I first built it, there were a lot of exciting PC titles coming out. Bioshock, COD4 modern warfare, Crysis, and the Orange Box (with Portal, Episode 2, and TF2) all came out around that fall and kept me busy for my entire senior year at Hope. Two years later, I am looking back and noticing that PC releases have been SLOW since that time. Left 4 dead was good but I didn't play much beyond the demo. While most games are multiplatform these days, the games coming out for PC lately have been ones that I would rather have on a console (Braid, RE5, ect). I kind of ignored Far Cry 2 and Mass Effect, but neither seemed like must play games from the reviews I read. I hope that Starcraft II, Diablo III, and HL Episode 3 will come out (among other good games, hopefully) and give me a reason to fire up the PC and get windows 7, and maybe a new wide-screen monitor.

My first year at Baylor I found time to play Crysis in the fall (which I had put off due to TF2), and I played Super Mario Galaxy and Metal Gear 4 in the spring. I am currently playing Metroid Prime III, and GTA4 is still sitting on my shelf, waiting for me to give it another shot. I was so bored the first hour I played that I put it down and haven't gone back, but everyone says it is so good I feel like I should try again sometime.

Here is a list of games I am considering for this year. I'll order them roughly by how excited I am to play them:

- Uncharted 2: among theives - PS3
- Infamous - PS3
- COD 4 modern warfare 2 - PC
- Flower - PSN
- Final Fantasy VII - PSN (I have never played it before)
- RE 5 - PS3
- R & C: a crack in time - PS3
- Braid - PS3/PSN or PC
- Trine - PSN or PC
- Batman Arkham Asylum - PS3

Uncharted 2 seems to be getting fantastic reviews from everyone and looks like a great game. Infamous didn't have perfect reviews, but the game looks awesome. Flower and FFVII are cheap and both seem like something fun to do. And the first COD modern warfare was such a thrilling single player campaign, I might replay it and then move on to the sequel. From about RE5 down I am not sure if I should waste my time. Let me know what you think, especially if you have played some of these before (or are currently playing)!

Mint

Good for more than just Mojitos...

About a month ago I was reading slate.com and ran across this article about mint.com. The article is really more about the success of "web 2.5" companies, but when I read it I was curious what features the website had to offer. Lisa and I did budgeting the old fashioned way, with an Excel spread sheet and online banking (irony intended for you old folks). After exploring the website, I decided to give it a try for a while and see if it could replace our normal budgeting process.

Mint is a start-up company that runs a website where you can manage your money and use their tools to set up a budget. One neat thing is that you can give Mint your login information for your online banking and online credit card sites (they use the same encryption that the banks use, so it is secure), and Mint will automatically connect to those sites and pull over information about recent transactions each time you log in. This makes it useful already because you can go to one website now to see any recent purchases, whether from your bank account or any credit cards you might have, all in one list. It then lets you set up budget categories, and it will try to assign each transaction you make to one of the categories. It often messes up, especially if you make custom categories, but it is very easy to look over recent purchases and assign them correctly. Also, individual categories can be set up to "roll over," so if we don't spend all of our clothing budget one month, the extra will be added to the next months budget (this makes Lisa very happy), and if you overspend there will be less for next month.

Also cool is that I have student loans administered by three different entities (actually that is not cool), and Mint can login to those web sites as well and keep track of how deeply I have signed my life away. Currently the service is free and I hope it stays that way, but so far it has been so useful I might even consider paying if that is what happens.

Now budgeting takes all of 3 minutes a week, and we can check to see how we are doing anytime we want. I have never used Quicken, and it might be better for those with more complicated finances, but Mint.com is a neat, free tool to check out.

In Med school news, I have tests coming up is less than a week. The new schedule keeps them coming at a rapid pace. Dermatology has been completely unappealing so far, and it has been neat to learn what rheumatologists actually do besides rheumatoid arthritis. GI has been somewhat interesting though more complicated.

I heard from faculty talking at the curriculum committee meeting yesterday that hospital volume is VERY high right now due to flu season. Regardless of what Glen Beck and Bill Maher may tell you, flu vaccines (including H1N1) are safe and effective! Get them if you can!

Disappointment

I recently read an article about the Kindle which got me thinking that it could be a good Christmas present. Especially since the next Wheel of Time book is coming out this October!!! The author who is taking over the series has decided to break the last book into three smaller books (thank God) with the first coming out on the 27th this month. I thought it would be neat to have a Kindle, where I could get the whole series on one device and maybe start doing a read through of the series.

However, I noticed that the Kindle store has no Robert Jordan books at all! In fact, I also discovered that none of the Harry Potter books or LOTR books are available for Kindle either. I thought by now that Kindle's library would include such popular novels, but I guess not. I know that in Harry Potter's case, the lack of e-book format has something to do with JK Rowling being against electronic publishing for some reason. I am just worried that if books like these haven't been converted over yet, then there are probably going to be other titles that i can't find for it. And while the price has dropped to $260, that is still a lot to pay for a device that can't display all the books I want to read on it.

Retention

Well my AT&T saga took a few more twists and turns, but I think it ended up well. I decided that I didn't want to pay $80-100 for a new AT&T approved modem that would probably overheat and die in a year again, so I called AT&T with the goal of arguing them into giving me a free modem. I was on the phone for 2 hours, and was transferred to 6 different departments before ending up at Retention, which is the place you want to be. The conversation each time involved me saying my story, and that I wanted a new modem, the person responding that they didn't have the authority to do that at this department, but that the ___ department did, and they would transfer me over there. Each time the next department would say that they in fact didn't have any authority, and finally the person in Orders knew I needed to go to Retention.

Retention is the magical department where they have the authority to give free upgrades to people who are trying to quit their AT&T service. I told my story, and the guy told me that he would send me a free modem, or i could upgrade to U-verse internet for the same monthly fee, which would also up my speed from 3 to 6 Mbps. Also, he waived the installation fee and the U-verse box comes at no charge, so i didn't have do pay anything. So two hours of complaining got me double the internet speed for nothing... not bad. They came out on Thursday, a week and a half after my internet first went out, which is WAY too long to go without internet.

In medical school news, we just finished respiratory and renal exams, which went well. Now i have had 1 week of classes of our new block which covers GI and "hard and soft tissues." The hard and soft tissues course is a combination of dermatology, rheumatology, and bone diseases. GI has been surprisingly interesting so far, and dermatology has been predictably boring.

Quick Post

So I have my renal exam in about 9 hours, so this will be a quick post, but I wanted to link to this article in the Houston Chronicle about the Rice-Baylor merger talks. I went to one of the town hall meetings that our president gave, and it was very interesting. Pretty soon I could be attending Baylor College of Medicine at Rice University.

Also, I am posting this from the "business center" at our apartment, because our internet has been down since Monday. Living without internet is terrible. However, this week, it turned out to be a great thing. I found that while studing in the apartment with no internet to distract me, I am much more productive! I think even after it is fixed, I will be shutting off the modem and router (which are downstairs), and then going up to the loft to study.

AT&T has decided that their lines are fine and told me that most likely the DSL modem that they gave me for free on sign up is broken. Oh well.

Blood

Well I haven't posted much in the last three weeks, but that is because not much has been going on. The "mini" block I am in now is very short, and the rest of the remaining test periods will be short as well. I have had classes on respiratory and renal diseases over the past three weeks, and now I have tests next Wednesday and Friday. This will mark the real end of block 7, then my last pre-clinical block starts the week after. Block 8 is three "mini" test periods, two with three weeks of class then a week of exams, then one very short one that is only two weeks of class then a week of exams. We cap it all off with our end of basic sciences final, which is supposed to mimic the step 1 in terms of content and format. We have to pass it to go on to rotations.

Respiratory has been interesting, and we have a good course director for it. Renal has had some very good professors, but it is just hard to get excited about the kidney.

One fun thing Lisa and I did a few weekends ago was go to a friends house and play a new game called Munchkin. I linked the regular version but we played a wild west themed edition of the game. Our experience with the game was good overall. It is a turn based card game that kind of resembles Magic + RPG elements. It becomes very political like Settlers, as people can gang up on others or help each other out.

It seems online that people have very mixed feelings about the game overall. The game has a very silly theme with cool artwork, but I could see how the novelty of it would be gone after a game or two. Plus, the deck costs $20, which is a lot for what is essentially a deck of cards. Also, you need level counters, which don't come with the game. Probably the biggest problem we had, since we played with 7 people, is that the game does not have a good mechanic to push a conclusion. You can very effectively gang up on whoever is leading, and you can actually lose levels which sets the game back. So I would be interested to see how it goes with 4 competitive players.

The only other interesting thing that happened over the past few weeks is that we did have a session at Baylor where we learned how to draw blood. The girl who practiced on me had already been drawing blood at Ben Taub for her work study, and she did fine. She had really good veins (which makes a HUGE difference), so I was successful on my first try. It is still a weird experience to stab a needle into someone's arm and take their blood. Skin is thicker than you might think.

The Spiderman Ride.... at Disney???

It appears that Disney has bought Marvel... Does this mean there could be a Spiderman ride at Disney and Universal?

Cardio test is done, and it wasn't too bad. Now I have to blitz to get ready for Heme/Onc, which should be the harder of the two by far. Only two days left.

The end of an Era

No I'm not talking about Ted Kennedy. The PBS show Reading Rainbow is going off the air after 26 years, which is longer than I have been alive. A sad day for us all.

Moving Along

My first "mini" block is almost over and I am gearing up for tests next Monday and Wednesday. Cardio has been a great course, mainly because our instructor is excellent. Heme/onc... well lets just say it is hard.

One year into medical school, I have essentially become a professional multiple choice test taker. One thing you must learn is how to grind through, and exploit, poorly written test questions. In medical school, most of the professors are NOT full time teachers. They come in for a month or two out of the year and teach their material. The questions they come up with have taught me that multiple choice test writing is a skill that comes to some naturally, and others not so much.

My friend Patrick found this sarcastic quiz online that highlights what I mean.

Can you answer these 6 questions about multiple-choice questions?

Posted in Instructional design, Writing tips by Cathy Moore on 27 August 2007

1. I opened a course on a topic I know nothing about, clicked through without reading anything, and took the assessment. I passed! What does that suggest?

1. I am a genius!
2. The assessment was too easy.
3. Maybe the course was too easy, too.
4. Maybe the course didn’t even need to be written.
5. b, c, and d

2. In a multiple-choice question, when is the longest answer the correct answer?

1. Rarely
2. Sometimes
3. It’s almost always the correct answer, and it’s often stuffed with new information that should have gone in the main part of the course but we forgot so now we’re putting it in the quiz because we can’t possibly leave out the tiniest detail
4. Occasionally

3. When is “All of the above” the correct answer?

1. With alarming regularity
2. When we try to cover too much in one question
3. When we use a question to teach instead of assess
4. All of the above

4. When is it NOT a good idea to avoid negative questions?

1. Never
2. Sometimes
3. Always
4. What?

5. How often is the correct answer a?

1. Usually
2. Frequently
3. Often
4. Almost never, because if a is the right answer, then the learner doesn’t have to read all the other options we spent so much time writing and revising, and where’s the ROI in that?

6. We can confuse learners when we:

1. fail to actually complete the sentence we started in the question.
2. inconsistent grammar in the options.
3. sometimes we veer off into another idea entirely.
4. wombats.

My tests are filled with questions like these, where half the battle is making sure you understand what it is you are being asked. Oh well... 4 months to go!

Source: http://blog.cathy-moore.com/2007/08/can-you-answer-these-6-questions-about-multiple-choice-questions/

Back to Work

As most of the people who read this blog know, Lisa and I were back in Michigan for almost all of the month of July. We spent half the time with Lisa's family, including a week at a cottage in Holland on Lake MI. The other half of the time we spent with my family, including a week in Disney World. Lisa and I had tons of fun back home and were happy to get out of the Houston heat for a while. The best part of the trip was getting to see family and friends, since we haven't had many chances to get back to Michigan since we moved down a year ago.

Unfortunately, my break came to a quick end. The Monday after we got back I started Block 7, which for right now involves Cardiology and Hematology/Oncology. One good thing about school this fall is that they have changed our test schedule in a way that I think will be less stressful. Baylor classes in previous years have had 10 weeks of classes in block 7; the first four weeks were dedicated to cardio and heme/onc as I have right now, with the remaining time mostly devoted to respiratory and renal. Then they would have a big week of exams over all of the subjects after the 10 weeks. This was hard because you finished taking cardio and heme/onc classes a full 6 weeks before the tests, and then you had to dig that information back up and get ready for a test in a very short period of time. The same thing would happen again in block 8, except it was even worse because the block ended with 10 exams over the course of 3 weeks, including the big end of basic sciences exam which you had to pass to move on to clinics (and several people did fail every year).

So, because of the wonderful complaining of the students above us, they changed it so that we have a test after each individual class, instead of just at the end of each block. So my cardio and heme/onc exams will be at the end of August, instead of mid October. I think this will encourage us to work at a more consistent pace and relieve stress during exam periods, even if there will be many more of them.

My new preceptorship for this fall is actually in the hospitals instead of at the Baylor clinic. While the cystic fibrosis patients I saw last year were very interesting, being in the inpatient setting is a good change. In the first week I saw a patient with diffuse/systemic scleroderma, and a very sick patient with newly diagnosed HIV/AIDS. The emphasis for this fall is to make sure we are comfortable enough with the physical exam to be somewhat useful on rotations and learn more of the abnormal findings that we should be looking for.

I think that this semester will be challenging but fun, and with only about four months to go before rotations, the light is visible at the end of the tunnel.

Lisa has one more week of break before going back, and I think she is excited for this coming year. Her program has been completely restructured, so instead of having a big group all at once for several hours a day, she will be pulling kids out one at a time or even going into the gen ed class rooms to work one on one.

Sorry for the long post!

Catch Up

Sorry about the long delay since the last post! I am playing catch up in school and my exams start in less than a week. This will be the end of block 6, my 11th straight month of medical school with only 2 weeks off for Christmas. Needless to say, I am ready for a break and thankfully it is coming up soon. For the month of July Lisa and I will be flying back to MI on the 6th, leaving with my family for Disney World from the 11th until the 19th, and then staying around until we head back to Texas on the 1st of August.

Besides the fact that vacation time is almost here, some other good news is that I just found out yesterday I was chosen for a spot on Baylor's Curriculum Committee. This is a group of administrators at the school who consider changes to the curriculum, organize feedback from students, and sometimes even advise the AAMC on what should be required course work for pre-medical students. There are two student representatives from each class, and I was picked out of the maybe 14 students who applied. It should be a fun thing to do, and the time requirement is really not too bad.

I also have posted some albums to my picasa site (click the my photos link on the right). There are a bunch of pictures from the graduations and a few shots of when Lisa's parents came down to visit.

One thing I discovered when we went to Galveston is that the octopus water slide thing at Moody Gardens is gone! This was one of the highlights of visiting Houston each summer growing up. Some of its arms were stairs leading up to its head, and others were water slides. Underneeth there was a sub marine with cool stuff inside. Now they have replaced it with a silly, generic looking water slide. Sad.

Paying for Health Care

I just read an excellent article in the New Yorker by Atul Gawande, one of my favorite doctor/writers (his previous two books, Complications and Better are both fantastic). He explains that the question that is being debated right now in Washington, who should pay for health care, is the wrong one. Whether a public plan exists or not does not solve the real problem, the ballooning cost of delivering medical care. An expanded medicare-type system might save some money through administrative efficiencies, but the real problem, as Gawande outlines, is over-utilization of services by patients and doctors.

Gawande shows in his article why McAllen, Texas has one of the highest per-capita spending rates in the nation, but doesn't necessarily deliver higher quality care. It turns out that the doctors in that area have developed a culture that creates high volume, high profit practices that generate much of their income from ancillary services. When doctors own testing facilities and equipment, they tend to order more tests and recommend more surgery because it augments their income. Plus, most patients still believe more is better when it comes to health care, so they agree to whatever battery of tests their physician orders (and their insurance pays for all of it too).

I agree that reducing health care consumption by restructuring the way physicians get compensated would do more than anything else to reduce health care costs. However, Gawande didn't really outline a detailed way in which this might work. Defining what a successful outcome is for a given patient and then coming up with a way to compensate appropriately is a very difficult thing to do. The team model, where a group of doctors is held accountable for the quality of their work and given a portion of the money they save by reducing over treatment would probably save lots of money, but who wants to go see a doctor who makes more money by giving you less care? The pendulum would swing towards under treatment, which Americans would never tolerate.

It is a very complicated topic and it will be interesting to see what Obama's health care bill will look like once it is done.

San Antonio

Lisa and I celebrated our first wedding anniversary last weekend (May 24th) in San Antonio. We decided we needed to get out of Houston and see some of the rest of Texas. We drove over to San Marcos first on Saturday, where we went to an outlet mall that was unbelievably huge. We both needed clothes and Lisa likes to shop, so it seemed like the thing to do. We then spent the rest of Saturday and Sunday and part of Monday in the city. Some highlights of the trip included the Mexican market, exploring the river walk and taking a boat tour, and stopping by the Alamo just to say we had been there. Our hotel was a Westin on the river walk and was the room was nice. Mom and Dad spoiled us with flowers and treats too!



The Mexican market was interesting because Mom and Dad apparently took a trip San Antonio about 20 years ago, where they bought some home decorations that I remember dusting many times during my stint as "key-tay." I saw the exact same vegetable hanging thing that is still in my parents kitchen (the one with the corn). Lisa and I bought a pepper one of our own for our kitchen.


You can check out all of the pictures from the trip by clicking the my photos link off to the right and looking at the San Antonio album. I apologize in advance for the quality of the photos. We forgot all of our cameras, so my cell phone's horrible camera had to record all of the memories for this trip.

White is not my color

Lisa and I are going to get some new clothes this weekend as we pass by a big outlet mall on our way to San Antonio. Earlier, we were talking about the trip to Disney this summer, and I realized that I might need some new clothes to wear in the scorching Orlando heat. I looked through the drawer of t-shirts I wear to exercise, and I found a bunch of white shirts that I have had forever. Out of curiosity, I looked up pictures of Disney 2004, and I have all of the same shirts!!!





I still have every single one of those shirts, and the swimming suit in the last picture is still my main suit. This tells me that not only have I not grown an inch since well before I was 18, I must not wear these shirts very often or they would have disintegrated by now.

I show Lisa these shirts, and she tells me I can not wear them to Disney 2009. I say this is crazy. I never wear white shirts, so it would make no sense to buy more. Also, who cares if I am wearing old shirts when everyone is going to be sweating and running around all day anyway? Weigh in on this important topic! Should I be allowed to wear them or not?

To make this fair, Bryan and Phil's votes count double.

Good News

Good news this week for two reasons...

I finished my block 5 exams last week and had a good two days off. The exams went well enough, but I won't find out my grades for a few days still. The better news is that our noise problem has been solved! If you haven't been down to visit, I will explain...

The apartment tower next to us has a single air conditioning tower for their entire building, which was built at the end of their parking garage. This building is about 25 stories high and its air conditioner is huge. Later, our apartment building was constructed such that our apartment is within 50 ft or so of this huge air conditioning unit. We picked out our first apartment without knowing that it was there, so it was quite a shock last summer when we first moved in and heard this thing running. We eventually got used to it, so much so that we decided to move to an apartment on the same side of our complex even though we know how loud the noise is. In summer, we have our windows shut anyway, and in winter the thing shuts off completely for a few months.

After we moved, a new person moved into our old unit and was shocked with the nose as well. We know this because a manager at our complex asked us what we thought about the noise when the guy wanted them to pay for him to move across the complex. I guess he decided to stay put and a few weeks later he slipped a note under everyone's door on our side of the complex. Apparently, he had called the police and they did determine that the air conditioner violated the sound limit for both day and night time by more than 10 decibels (5 times louder than legally allowed). He filed complaints with the mayor's office and wanted all of us to do the same.

We decided we did not care enough to call and complain, but a few days ago I saw some guys doing work on the air conditioner, and now it has become substantially quieter! It is now quiet enough for us to use our balcony, and we can barely hear it at all when we are inside. It turns out that the squeaky wheel does get the grease.

Viral Videos

Mom noticed that when I posted pictures of the apartment before, I forgot to put up any good ones of the kitchen. So here are a few pictures showing the new space.


Despite the rest of our apartment being smaller than the last one, the kitchen is now bigger! Now when dishes are drying we still have enough counter room to cook.

Unfortunately, my tests have arrived and I am doomed to spend the next week and a half studying like a madman. Of course, anyone who knows how to study hard also knows how to procrastinate. So I offer this website I stumbled upon while browsing Digg.com, a compilation of the 100 most iconic viral Internet videos. In case you aren't really up with the whole "Internet" thing, these will help give you a glimpse into its pop culture, and what a weird culture it is. I remember most of these videos by the year in college that they were made popular. I recommend:

1, 2, 3, 6, 7, 8, 10, 14, 15, 16, 18, and 30.

If you can only watch one, the "David after dentist" came out at the beginning of this year and is quite funny. The commentary on this site for each video is good, as it explains why each one became popular and adds some extra insight. While each of these are kind of fun to watch the first time, I promise you that after everyone around you has been saying "charlie bit me" or "I like turtles" for a few weeks, they get old.

Ok back to the brain.

Simple Physics

I saw an interesting article (with videos) in the WSJ today about how small cars really do in crash tests against larger vehicles. Sub-compact cars like the Honda Fit, Toyota Yaris, and the Smart Car were tested against a full size sedan, in this case the Mercedes C class, Honda Accord, or Toyota Camry. The results are predictable for anyone who has taken high school physics, but were still visually amazing. This makes me wonder what happens when you put a mid sized sedan up against a full size SUV, which are ubiquitous in the city of Houston. So drive safe, or buy a bigger car!

Easter

We went to Mike and Linda's for Easter this year and had a great time. We got to see Nancy and Jason, and it was fun to spend a day out at the lake. We even got to color eggs, and continue one of my oldest traditions (mocking Phil via Easter egg).

Lisa was nice and hid candy filled eggs around the apartment while I slept in on Saturday, so even though it was my first Easter without a basket, it was still great.

I have one more week of class, then two weeks of exams including neuro, infectious disease, medical ethics, and behavioral sciences. Neuro has been a fun course. It is very visual with lots of pictures and pathways to memorize, and the clinical correlations are like solving puzzles. Infectious disease has been less fun. The material is interesting, but it is simply lists and lists of facts which is not much fun to learn. Next block we get to do more neuro and more ID, as well as a bigger section of behavioral sciences including psychiatric diseases, which should be interesting.

Finally!

Today I finally finished collecting all 120 stars in Super Mario Galaxy. Technically I could go on to collect them all again playing as Luigi, but I feel like this is a good place to stop. It took me quite a while to get those last couple stars, mainly because I had not played much since mid February when I started studying for block four exams.

I would say Galaxy that it is the best Mario game of all time, hands down. I found the game easy in some parts, but thoroughly challenging in others. However, unlike some of the other Mario games, I never felt like the platformer "jumping" puzzles were an exercise in futility. I always was able to get the star and move on after a solid effort, which made the game very fun. I think the next game on my list is Metal Gear Solid 4, then either GTA 4 or Metroid after that. I also want to get and play Resident Evil 5, even though some reviews have said it is good, but not great. I really enjoyed the last one, and I trust Brad Shoemaker's review more than most other sites anyway.

In the OR

Last week Monday I followed a pediatric surgeon around for a day and observed my first "real" surgeries. I say real because I have seen ophthalmology surgeries before, but they tend to be very different.

There were three cases scheduled that day, and the first one was kind of a big deal. The pediatric surgeon I followed was working with the chief of Baylor's adult bariatric surgery program to perform a roux-en-Y gastric bypass on a 17 year old boy who was almost 500 pounds. There was a news crew from channel 11 to interview the surgeons and film the procedure. The whole thing was done laproscopically, and it was quite neat to watch.

The second procedure was to perform an excisional biopsy on an enlarged inguinal lymph node in a young infant. They weren't sure initially if it was a tumor or an infection, but upon cutting into the mass it oozed lots of pus, so they had their answer pretty fast.

The last procedure was to remove a thyroid adenoma from a young teenager. He was playing football and was injured a few months ago, and when he had an MRI done to look for head injuries, they noticed he had this small benign cancer growing on his thyroid. The procedure is relatively straightforward, except there is a nerve near the thyroid that controls vocalization and respiration, so almost the entire surgery is spent finding the nerve and making sure it does not get cut.

Overall I thought that surgery looked like a lot of fun. General surgeons (and pediatric surgeons) do a wide variety of procedures, and most have a balance of clinical days and surgery days. The downside is the ridiculously intense five year residency. Fellowships after general residency get even more competitive and even more time consuming. I'll have to see what it is really like when I rotate in about a year, and check out if it is worth the sacrifice.

The New Apartment

As promised, here are some photos of the new place.







As you can see, we now have a loft space that replaces our second bedroom as my study space. The kitchen is actually a little bigger than before and has a separate island type counter. However, just about everything else is smaller than before. One of the challenges was figuring out what I was going to do when Lisa comes home from work and starts making noise in the living room while I am trying to study up in the loft. Our solution was a small, $25 desk from IKEA that fits nicely in the corner of the bedroom, and so far it seems to be working out well.

One thing that is better now is the view. Being up a floor we look out over the ugly parking garage a bit more. In fact, we can now see that on top of the garage there is a set of tennis courts and a pool. Also, we get a better view of the park and can even see the med center skyline a bit.

We still have plenty of room for guests to come stay, so you are welcome anytime!!

So much for posting more...

I just noticed that the month is over half-way over and I have yet to post. The reason... we moved! We decided to start looking early for living options for next year. After the first week in March, we started looking at other apartment complexes in our area, and we were not very impressed with their deals. We were looking for something a little smaller than the two bedroom we had before, and something much cheaper.

We discovered that the complex we live in right now has a great 1-bed + loft plan, but they have a 4 person waiting list for this summer already. However, a unit came up as of March 10th, so we really felt like we needed to snatch it up while we could. Did I mention that it is $400 less per month than what we payed before!!

Luckily, Lisa had spring break and Sara was coming down anyway, so the move went very well. However, the whole thing has left me a bit behind in school, and very behind in blog posting. I'll try to get some pictures of the new place up soon.

A long time ago, in a state far far away

I noticed that Bryan was lamenting on his blog about how he only managed to post four times in February, and then I realized that I only posted once! I actually have had things to talk about, but my most recent round of exams were so hard I didn't even have time to procrastinate very much.

Since the beginning of January we have been in been in Block 4, which contains pathology, pharmacology, head and neck anatomy, and immunology. Path and pharm were not so bad, but head and neck had a lot to memorize, and immunology was the hardest subject we have had so far at Baylor.

With head and neck anatomy we finished up all of our pre-clinical anatomy classes. I am very surprised at how much I enjoyed anatomy. I came in thinking I wouldn't like it very much, and it turned out to be my favorite subject so far. Whether or not this means that I will enjoy a speciality that uses lots of anatomy (surgery, radiology) remains to be seen.

Earlier in February my mom was down in Houston helping Noni and Popi come down for the winter season (or at least the second half of it). We went to a Houston Symphony concert featuring the music of John Williams, which turned out to be a very well put together event. They played music from Jaws, Indiana Jones, Harry Potter, and lots from Star Wars. Apparently the theme music for the NBC nightly news was also written by John Williams and is a stand alone piece. Throughout the concert, they had various Star Wars characters come out do silly things, like Darth Vader stealing the baton and conducting for a while. Afterwards the characters were in the lobby, as can be seen by my poor cell phone pictures.




In other news, Lisa has to give her kids the Texas state assessment test this week, and she has been working had to make sure that as few of them fail as possible. I remember taking the MEAP every few years or so, and it was never as big a deal as these state tests are here.

Hopefully I'll be able to keep up better as I start block 5 this Monday. Many older students tell us that block 5 is the best block in pre-clinicals, so I might have more time.

A very dangerous place

Today there was an article in the Houston Chronicle of a brutal crime that was so awful, it was reported in the paper even though the city where it happened is not even in Texas! What city is that you say? New York? Baltimore? Philadelphia?

No! The dangerous city in question is... Kalamazoo, MI!!!

Apparently a group of 40-50 teenagers beat a 50 year old man who was riding his bike to the ground. They hit him on the head with a bottle and then punched and kicked him as he lay in the street.

Nothing like this has ever happened in Houston, so seeing such news in our small town paper was quite shocking. Lisa and I are just glad we got out of K-zoo before things really got bad...

A matter of perspective

I noticed something funny today:

If you want to see the difference in editorial slant between the Wall Street Journal and the New York Times, just read the articles I've linked to from each paper. They are both discussing the economic stimulus plan, and the ideas presented in each couldn't be more different.

Of course I have nothing of value to contribute to this economic debate, but then again most of the opinion articles I've read lately don't offer much either.

Texas is funny

Sorry for the super long interval since my last post. I really have no excuse except Mario Galaxies and 30 Rock. Lisa and I had a great holiday break, but we were ready to come back to the nice weather.

Speaking of weather, we have a breaking weather alert in effect for our area!!! Let me post some of what it says below:

FREEZING TEMPERATURES ARE EXPECTED FOR ALL BUT THE IMMEDIATE COAST TONIGHT AND INTO EARLY WEDNESDAY. FOR MOST INLAND AREAS AREAS... TEMPERATURES WILL BOTTOM OUT BETWEEN 23 AND 28 DEGREES AND REMAIN BELOW FREEZING FOR 6 TO 10 HOURS. FOR THE HOUSTON METRO AREA... TEMPERATURES ARE EXPECTED TO DROP TO 30 TO 32 DEGREES AND REMAIN BELOW FREEZING FOR 1 TO 3 HOURS. TEMPERATURES WILL CLIMB BACK ABOVE FREEZING AREA WIDE MID MORNING WEDNESDAY.

PRECAUTIONS SHOULD BE TAKEN TO PROTECT PEOPLE... PETS AND PLANTS THAT ARE SENSITIVE TO FREEZING TEMPERATURES. THE DURATION OF TEMPERATURES BELOW FREEZING IS CURRENTLY NOT EXPECTED TO BE LONG ENOUGH TO CAUSE A SIGNIFICANT RISK TO PROPERTY.

30-32 degrees for a whole 3 hours??? Good thing it won't damage our pets or property. We were worried for a little while. If it stays that cold until the early morning, Lisa might get a delay!! Of course, the high tomorrow is 62 and sunny, so we won't have to endure this arctic blast for too long.

On the med school front, we got to take the brain out of our cadaver last week, which was a pretty neat experience. Our donor theoretically died of late stage Alzheimer's disease, but the pathologist who was in our lab looked at the brain and did not think it could have been Alzheimer's. It might have been a severe dementia that was misdiagnosed, and I guess this is why doctor's order autopsies.

By the way, the electric bone saws we used to cut through the skull sound something like a dentist's drill, but with an awful grinding sound at the same time. Not a pleasant noise.