Monday, December 26, 2005

Poor poor misunderstood horny giant ape

Saw "King Kong" tonight. Liked it, didn't love it. It was clearly a labor of love, and there's no questioning the commitment or the passion. But there is questioning some of the choices. Now that I have a scotch to drink, and I've played the Steve Miller Band's "Jungle Love" to get it out of my head, here's a few random thoughts:

* Naomi Watts is pretty. Pretty excellent!
* Adrien Brody: Mostly Harmless.
* Three hours, and they couldn't bring several of the plot threads to satisfying (or any) conclusions? Stand by for the five-hour director's cut, or else maybe the two-hour fifteen minute one.
* CGI in general was not awesome; several times it was obvious that people were green-screened. CGI for Kong was, as has been detailed elsewhere, awesome.
* Hey, you know, a stampede of brontosaurs would be pretty impressive all on its own. We don't necessarily need them to be a mobile rugby scrum which then turns to break-dancing.
* Jack Black: not just for comedy anymore.
* The natives; yes, racist. Any culture capable of building and maintaining those elaborate mechanisms of sacrifice-delivery would be capable of getting the fuck OFF the island. And we saw no reason for them to stay, like for example Kong-delivered fresh kills for the big village BBQ.
* Ape versus dino: yeah, that's what opposable thumbs can do for ya, beeyotch!
* When you bring a chick over to your place, you might find that she feels more at home if the bones of your ancestors aren't just lying about in plain sight. Unless she's gothy.
* For as wonderful as Watts is, seriously, somebody should have helped her learn to juggle for real. CGI rocks is Lucas-level indulgent.

...and in a word, that's my summation of the film. It was wonderful in spots, pretty solid overall as an entertainment in that Saturday-serial kind of way. But so very indulgent.

Thursday, December 01, 2005

Name-checked on Velcrometer. Sweet.

M. Giant said this, in a recent post about his offspring M. Small (aka Cuter Than Your Favorite Internet Kid)...

Screw the biological clock; the main reason you want to have a kid before a certain age is because you want to be young enough to be able to stand the levels of random cacophony that can burst forth at any moment.

Sigh. I am soooo boned. I already holler "get outta my yard!" at my traditionally-college-age friends, and it's only funny because it's true.

But thanks to RealAge.com, I can now confidently say that what I've suspected for years might be true: I can take back seven years. The calendar might talk some wack-ass jive about me being 35 and a half; but my diet, exercise, and other habits contribute to my being a lot more like 29.

(Between the ears, of course, I'll forever be a precocious 15. Ehhh, whatever. I've learned to accept it.)


SPECIAL BONUS NOTE: Blogger's spell-check applet doesn't recognize 'Velcrometer,' and suggests I replace with a list that's headed by "belligerent." Heh.

Thursday, November 17, 2005

Blog Niblets

Just because I like the idea that people I know sometimes read this, and I sort of love the idea that people I don't know might also read this (maybe, a little, sometimes) I figure I should keep on going even if I don't happen to have a 10,000-word essay in me every day. So this is really just the blog equivalent of pulling slips of paper out of my pockets and sharing them.

Wow hey, now that I put it like that, I'm struck by two things: one, that's a pretty damn fine description of most of the blogs I read. Two, it's mind-boggling that anyone would actually want to read that kind of thing. I'm allegedly sort of intelligent, and I adore people's brain-lint if it's in blog form. But hey. It's the Internets. They's weird.

1. Pooper
In honor of my young nephew, whom I am told has recently conquered the diaper barrier and become potty-trained, I find that I actually have something to say about poop. It occurred to me today, strolling across the pitted gravel that passes for a commuter lot here at good ol'
Hampden College, that one of the ways I know I really feel at home in a place, one of the signals that I've become "of" a place, is when I can mentally catalog a short list of nearby restrooms, and come up with the best place to take an impending dump.

Hey, the more I study the whole human biology/ anatomy/ physiology thing, the more I appreciate the simple side of life, sometimes.

The restroom in the big common building is okay, but something about it makes it a far better stop for your basic quick
micturition event, rather than what my housemate calls "dropping The Deuce." It's not a sit-and-stay sort of a room; it's narrow and long, and since it's a single-occupancy room despite its size, there's no stall. Yet it's more busy and crowded outside in the hallway than it would be in a typical private home. The Dung Shui is wrong, is what I'm saying.

So, full of big dreams, high hopes, and a double serving of pasta from lunch, I wound up hitting the default pooper in the science building. Which is okay, but upon further reflection I should have gone to the one upstairs by the lab, rather than the one on the first floor. The downstairs one has but one toilet, as does the upstairs, but the crucial difference is height. The downstairs one is in a quasi-handicapped stall, and it's just slightly higher off the floor than a normal one. It's not that my legs dangle or anything -- I'm middle-sized, dammit, not short -- but it's sub-optimal. Easy to imagine the whole apparatus is on stilts or pilings. Like you're poopin' off the dock of the bay.

Okay, cool, so now I've used my blog to
talk about pooping. Excellent. That should clear the karmic debt (or Midwestern guilt, or whatever) that I've been feeling since M. Small's birthday, when I suggested that the kid from Dooce.com is less cute than he is. Moving on, then.

2. Potter
It's movie time again. I watched movies 2 & 3 over the last couple days, and it's really true: the third movie is so much better, the first two films (relatively speaking) suck like a wood tick on Ecstasy. Happily, the early word on the new one is that it continues and even deepens the additions that movie 3 made (things like darkness, humor that's funny, magic that's magical, and characters with character). So, y'know, yay.

If there were a midnight show tonight within 30 miles, I'd be there elbow-checking fifth-graders for a good seat, but sadly, the town cinema doesn't feel a need to have a preview. All is forgiven, though, because our beloved college is having a midnight movie night Saturday/Sunday, and this means I can see the new one with the mass of drunken nerd-balls I share classes with, sans tiny tots who maybe shouldn't see this one until their parents can get a reliable friend to tell them how freaky the scary parts are.

As an aside: in this town, people who want to get the hell out of the house so badly they'd bring a squalling toddler to the movies far outnumber the more cautious, judicious types. To be fair, and to the credit of obviously superior parenting abilities, I saw Serenity with an 8-month-old not 20 feet away, and we all survived quite well. I hear the kid is already writing fanfic.

Besides, it's not like someone is going to spoil the story for me; I can wait a couple days. In addition, I think I mentioned the drunken nerd-ball nature of my classmates.

3. Partner
Teslagrrl is coming for Thanksgiving. Thank Jeebus. All the "how to not totally detonate your long-distance relationship" books and well-intended phone calls in the world can't compare to just one afternoon actually being in the same place. I think she would think it's amusing (or maybe I already mentioned this, and she did think it was amusing) that I once referred to her trips out here as 'conjugal visits,' but beyond the obvious benefits, her proximity has an agreeably civilizing effect on me, and I could probably use some of that as well.

...just not until after the boozing and bowling scheduled for tomorrow night, and the boozing and movie happening the next night. Yes, it's true: I'm becoming an undergrad. Hey, if the work is done and the grades are good, I tell my inner child to go to bed and give my inner 7th-year senior the keys. Seems to be a decent system so far.

Wednesday, November 02, 2005

falling in love

I frequently fall in love. Intense, sudden, gratifying, silly, humbling, often temporary, though the temporariness turns out to be a help most of the time. I fall in love with ideas, images, words, inanimate objects, and occasionally, people. The people part tends to last a whole lot longer (hi, sweetie!).

You could dial back the language a little, and simply say I'm a fan of lots of little things and events, or I'm enthusiastic about the experiences I have, and the way I process stimuli. Or you could go basic, and say that I'm generally very happy with how things are going; that I love life. But as true as all the above is, saying it like that would leave out the sense of immediacy, and the messy, evanescent poetry that I feel when I'm, say, driving on a twisty mountain road, with the iPod playing something good and the warmth shining through the sunroof. That's the setting, and the action is I'm shifting from fourth to fifth while the road settles down under it all and reclines, finished with its few moments of the gyrating, swaying hippy dance some of the roads do here -- bam, that's the instant; I'm a little bit in love with life. The thing with me is that I fall just a tiny bit in love with the moment, and thus with the car, the weather, the trees, the music, road, the sun. Man, I love the sun. And I'm even more smitten with the moon; so much so it's damn near to monk-drowning levels. Don't even get me started.


So one of the great things about being here in New England pursuing this program is that I have opened up exponentially both my opportunities to fall in love in this way, and probably my capacity to do it. Sure, I worry sometimes that I may be extending my adolescence to an unhealthy degree, but then again maybe I'm holding on to that poetic side, in a very smart and useful way. Maybe this will become a core skill as I get into my chosen profession, and meander ever deeper into the responsible, focused, more complete kind of adulthood.


Heck, maybe the fight that broke out on the sidewalk outside the local bar where Teslagrrl and I were singing karaoke a couple weeks back was just a spilling over of that kind of love. It's my theory that more people want to be expressive than know how to be, so when the John Cougar is flowing as freely as the beer, things can happen. Fuses get lit, ya-yas come out, steam gets let off. Eventually shakin' your doughy butt, nodding your baseball cap, and yelling "yeah!" isn't enough anymore; you need something more powerfully poetic. Sadly, the most poetic and expressive tool in some guys' repertoire is throwing a punch. I suppose that does, technically, count as making a connection with someone. So there you go.


I'm going on about this now thanks to a recent post* on Diablo's blog, with a sweet and generous devotional to her hubby (who by the way, is a frickin' rock star not just literally, but figuratively). Is that too sincere? Shit, I mean it's a soppy and clearly Jaeger-fueled mash note. Some might say Diablo being sweet is surely some manner of evil plot, but I know better. In her singular style, the writing is frank, funny, and disarming, and then makes a face at you and grabs its crotch. Or yours. Basically her prose is, in my universe anyway, Terri Garr in a leather catsuit -- and that is just about the BEST COMPLIMENT POSSIBLE. Okay, maybe I'm a little in love with the writing now too. Put it on the list.


So, yes. New England autumn. Driving. Love. Things like that. It's by no means comprehensive, but to give you a better sense of what I'm talking about, here is a list of some of the things I have fallen in love with recently: my wool topcoat, Atmosphere's new album, stovetop percolator coffee, about 50% of the designs in the student fashion show I saw on Monday night, about 75% of the models in the fashion show, the normal standard distribution (a Statistics thing), White Russians mixed and served in pint glasses, my midterm grades, winning at Scrabble, and the crisp snap of November air.


I am also in love with my girlfriend, which I have to say is a very good thing indeed. As I mentioned, she was here a couple of weeks ago. I can't even remember what we were talking about, or why we were laughing, but we were. I'm sure it was very funny. Actually, screw that, we don't even need a reason, but the point is I'd said something funny in response to something she'd said that was funny, and her explanation of whatever goofy thing it was that she had said was to say "hey, I'm in love." And that's when I forgot what she'd been talking about, and just sort of marvelled at the whole thing.

Today, it strikes me that this is what I miss most, and what I miss out on the most, owing to our being 1000 miles apart. I lack for opportunities to fall in love with little things that have to do with her. This seems horribly unfair. It's fine when we do re-connect; we just pick right up where we were. But in the meantime, dang. Distance, boy. I don't know. What you gonna do?

Hey, that may have just become relevant to the ongoing saga of the non-traditional educational process. Sweet! If I just throw in the words "long-distance relationship," this post might even come up when med students and pre-med students search. Though PA students are, of course, better-looking and more fun, I have to make sure to put that in there as well.

* The slatternly fishwife should fix the photo in the post, because I've seen it and it's adorable.

Wednesday, October 26, 2005

A modest manifesto

We had a little bit of weather out New England way last night, ayuh. A Nor'Easter, they call it. About two to three inches of snow fell, out at the homestead. The sticky, snowball-fight type stuff. Interestingly to this flatlander, the slightly higher elevation we have on our ridge was enough to keep the town itself from seeing much more than on campus, where they only got a dusting.

We'll see about how my Midwestern sensibilities handle the wool-wetting squalls of a proper Upstate NY/ SW Vermont weather system. I can tell you that about two solid weeks of dribbling grayness has left me unimpressed and with a fine head start on my latest bout of Seasonal Affective Screw this, I'm Going to Take a Nap disorder. I did find a fine woolen topcoat at the local Goodwill for $12.99, so the "wool-wetting" thing above is not just an artful phrase.

Speaking of artful phrases, I said I'd divulge the reason I'm so happy-go-lucky lately, and as a matter of fact I did make time to squeeze in the watching of a four-hour Shakespeare documentary over the long weekend (as well as The Big Lebowski and Ninja Scroll). Meanwhile, my classmates slaved like beaten dogs to prepare a stack of work for their courses. And say, come to think of it, I haven't adequately explained why I'm not in those same courses, nor how it is I'm nonetheless their classmate if that's the case.

So, dear reader, sit back for another lengthy story. Not that it's a complex or difficult thing to explain. I'm just so much more laid-back about my pre-med stuff now... or, to be more precise... (needless pause)... my pre-PA stuff.

Yes, these days I've been tooling around the winding mountain roads, the back seat loaded with books on not Organic Chem but Human Anatomy & Physiology. Not Calculus, but Statistics. The weather guy has been predicting rain, the Kaiser Chiefs have been predicting a riot, and I've been feeling like finally instead of "potential," I have a future I am excited about, and a way to get there.

A side note... true, technically I might be able to say I'm a pre-med or I'm headed to "med school" and be correct, because I do plan to apply to a mess of schools, and many at of the top of the list will be schools where the PA program is part of a med school that also trains young MD's (and if I can have a Scrubs moment, going someplace where Young MC is on faculty would be a bonus. Bust a move!). But let's be clear: in this day and age, in the good ol' US of A, the bare fact of it is, you don't gotta be a doctor to practice medicine. And I'm not talking about some 'alternative' thing either. Good old paternalistic, ego-driven, Western know-it-all medicine can be done, and done very well indeed, by Physician Assistants. For dudes like me, that's a concept that is just brimming with intrigue and attraction.

I would have been remiss not to seriously think over my options, once I got on the road and discovered how well "the system" used for training future doctors and I get along... or don't. I might have been too proud or too stubborn to consider the advantages of finding another way... but I wasn't. What sealed it was my thinking long and hard about what I want to do, how and where I want to practice, and then combining that with what I don't want to do, and the things about the job I frankly don't want to have to deal with. It all adds up very nicely to exactly what the PA profession is (according to one way of looking at it). It's practicing medicine without a lot of the intervening stuff that makes docs crazy.

Now, sure, absolutely, you want your doctor to be someone who could conceivably pick up the nuances of Orgo (or Physics or Calculus), sufficiently well to get a decent grade in a course. But having worked in pretty much exactly the place we're all trying to get to, I know how far down the list of important characteristics that really is. You want smart, yes. You want quick-thinking. You want knowledgeable, even encyclopaedic. You want 'able to talk like a person.' You want a lot of things, and so few of them have anything to do with academic achievement, after a while it starts to become scary to think that such a large proportion of doctors started out as kids who got great grades in science courses.

This is not to say that poor achievers have any better shot at becoming good doctors, or that they should. Getting good grades usually means working your ass off, and you need people who can work their asses off, both to be decent students and to be decent actual working physicians. But the thing is, the PA way of doing things isn't all that different, in terms of the things that matter to people (meaning practitioners and patients, a group often overlooked in this whole training thing). Before I get into the guts of it (literally!) in PA school, I'll have to prepare with some of the things pre-meds don't see until med school year one: a buttload of anatomy, physiology, statistics... hey, waitaminnit, those are my courses now. Hmmmm.

I anticipate an objection here: No, it wasn't because I had an academically bumpy Summer. It wasn't even because more terms like that one would assuredly have helped me get lost in the pile, kept me from getting interviews, and made it unlikely I'd get the shot to get into med school in a year, or two, or maybe more. Nor was it any doubt about my ability to get through med school (and do it damn well, as a matter of fact). It's more that I already know what it's like to slog through something that's almost what you want to do.

If the going is tough, that's fine. If it's circuitous and time-consuming and expensive and stressful, that's fine. But only if where you're headed to is where you really want to be. So if you're smart about it, you think a lot about where you want to be. And you don't stop thinking about it, now and then, just because you're on the way to someplace people respect and think is cool. So, I thought about it.

I don't want to own and run a small business. I don't want to head up a department. I don't care (that much) about huge piles of money, or my name being synonymous with a maneuver or a weird-shaped surgical tool. I don't want to pay malpractice premiums higher than my income was when I worked in the corporate sector. I don't want to set policies. I don't want to call all the shots, just those that constitute care for my patients. I don't want to be the only guy within 50 miles who can do something. I don't want it to ever be considered a weakness if I feel I want to consult somebody.

I want to teach a little, write a little, do a little research into things that interest me, and mostly just practice medicine. I want to work on a team, as one of its leaders. And oh yeah, I want to have a life. As a PA, I will be "limited" to practicing, and I'll have to do it as part of a team. I honestly don't see the down-side here.

So around Labor Day, I made the decision. My pre-reqs are for PA school, and the classes are much more directly applicable, which is nice for an impatient and energized student like me. Hey, I like understanding things for their own sake, I really do. But I have a tough time being graded on things when I can't see the connection, and because of limitations of the system I can't be given time and space to find my own. I have a tough time believing that academic performance is an indicator of smarts or ability.

Oddly enough, I'm currently on track for A's in everything. Hmmm.

Wednesday, October 19, 2005

Hi to Joanne

Gadzooks, I didn't know I had "real" readers! Okay, okay, I'll make sure to say something concrete next week. Right now, school's going on a long weekend hiatus, and TeslaGrrl is coming to visit. I may or may not have time to write.

The preview version is basically this: there's been a slight adjustment in the career trajectory. Everything I've obsessed and fretted about is still relevant, and my vision of what I'll be doing in 10 years is similar, maybe even identical (at least in all the ways that matter to me). Also, my vision of what I'll be doing in five years is about 1400% better than it would have been if nothing had changed.

Knowledgeable pre-meds (and people who followed me here from SDN) already know what I'm talking about, but casual readers will be getting the first of potentially many fireside chats from me about the future of health care, and how to be a clinician while maintaining some semblance of sanity. As of recently, it looks like someone even asked for it.

Seeya next week.

Saturday, October 15, 2005

ah, yes, dear reader, the plot thickens...

I am writing (the first draft of this post) from the 'reading room,' which is to say the lounge-y area in the science building which is the semiofficial headquarters for those in my program. I haven't written about school, or anything else, very much lately, and for that I apologize. There must be at least two people who know about and read this thing. Which, come to think of it, makes "dear reader" more apt. The silence will be broken soon, but I'll just ease into it for now by saying that on this particular rainy evening, all my school-type work happens to be caught up. I went to the gym this afternoon, and even sat in the sauna for a bit. Then I got some food, and here I am.

Yes -- I'm caught up with schoolwork, I'm exercising, and I'm writing in this thing again. Clearly there have been some changes.

It's been good to have this time to reflect on the big fat decision I recently made; for a while just after it, every passing day was another chance to celebrate my being so intelligent and self-aware to make this particular judgement call... but it was also that glorious feeling of no longer being stuck. So from here, weeks, nay months, later, I trust it much more. And wow, I was really intelligent and self-aware.

But the telling of this one will take some background, plus I like to imagine there's a sense of drama to these things. Plus I like to believe that more beings read this than merely sp*m-bot$ and part-time workers doing the jobs of said bot$... and and so I'll tease it out a little more. Long story short, everything I've said below about what I'm doing and why is still true, and still the same. The difference is, what I am doing and why has simultaneously changed completely. It's kind of a quantum thing.

Wednesday, October 12, 2005

To Young M. Small, on the Occasion of His First Birthday

Kiddo,

You are going to have just the most 21st-Century scrapbook ever. Your whole life thus far, or at least bits of it, has/have been the subject of your dad's writing. And although I'm sure someday this will totally mortify you (and send you to some manner of psychotherapy that we losers in 2005 can only imagine), some other, later day you'll be glad because it's really good writing. But whichever way it goes, or when, hey. He's your dad. Can you blame him? At least it's not, say, a closet jammed to the rafters with M. Small crop art.

I've known your dad for approximately 20 years, and your mom for not much less than that. I say 'approximately' partly because I honestly can't recall the exact dates or really years, and partly because it's too freakin' weird to contemplate being this old. Someday you and I will almost certainly talk about the stupid stuff your dad and I (and to a much lesser extent, your mom) said, thought, and did when we were "your age." These stories will not be exclusively for your amusement -- because we did learn a thing or two, here and there -- but I promise right now that I won't be mad if you totally miss my point and just laugh yourself stupid instead. That's some quality uncle-style fun for me, right there.

Anyway, soon enough you'll be able to wield a computer yourself, and whether your money is on genetics or environment, your kung-fu will very probably become very mighty. Please use this power for good, as we have tried to, and not for evil. That said, feel free to even the odds. Post whatever stories you can about your pop's misadventures and weird habits, or any photos you have of him mowing the lawn in black socks, loafers, and bermuda shorts. I can help, if you want.

Also, and don't tell the Internet I said this, but you're way cuter than the kid over at Dooce.com. Happy Birthday, electro-boy!

Wednesday, October 05, 2005

I heart technology

If you have a blog, you know about this fancy new form of annoyance where a bot will post a 'comment' that's actually spam. If you don't have a blog, there's this thing... that I just described. Give me a break; I'm drinking my morning coffee.

So, it's nice to be obscure and a-visitor-ic enough that I have seen maybe three of these on this blog in the time it's been up. But it's unbelievably sad that I got an email to alert me of the new comment, and even I, who ostensibly see a reason to put stuff here, was surprised.

So, dear reader, I'll try to change that. There's no shortage of stuff to comment on, and as I've mentioned this thing will be a scattershot but hopefully complete record of a process that's interesting to me, anyhow. Not to mention important (to me, anyhow). We'll attempt some more writing soon. I have a raggedy-ass text file on my laptop that serves as a sketch pad, and somehow not having the Web at home (I know! It's just like in pioneer days!) makes it easier to think of and organize stuff for the blog.

Wednesday, August 10, 2005

Five-Star

For the first time I can remember, I have completely used up a three-subject notebook.

The first day of classes was two months ago, on June 9. I started out by making a note about the fact that water molecules are "polar," whatever that meant. And there was some stuff about hydrocarbon chains. Soap was described as a "functional (and big-ass) molecule," with a hydrophillic head and a hydrophobic tail. And there was some parenthetical stuff thrown in about how I thought it would be cool to look at what magnesium sulfate is, and why it helps with migraines. Then I settled down to some problems (I guess there were not too many notes that first day) and the next day we started with the lab. Real notes started the following Monday, with Dalton and Rutherford and atomic theory.

This notebook ends with a back page where I'm finding a bunch of resonance structures for C5H12 (there are three, by the way). The organized part ends with yesterday's notes about the molecular orbitals in CO2, using SALCs to show which combinations of SP2 hybrid orbitals work, and where the sigma, sigma*, pi, and pi* bonds are in relation to the original energy levels of the MOs in the molecule. The chart looks like crap, but the info is correct.

We are not in Kansas anymore, people. I complain about the truncated, compressed, five-week Summer courses. It's just enough like Keanu getting an eight-inch RCA plug through the back of the neck to be unpleasant, and regrettably not as fast (not to mention, the kung fu I know now is arguably not as cool). But it's getting clearer that what appeared impenetrable is now, four to nine weeks later, nearly easy. This occurred to me after I sat down and whipped out some stuff today that I need for a project, and remarked on the foreign language I've been learning.

See, a water molecule is polar because the electronegativity of oxygen is 3.5, versus the 2.1 on hydrogen, plus the structure is bent, which puts the net dipole of the O up on its own end. I can create a nifty graphic in Gaussian, or run a sample through the UV-vis or the NMR to show you more about it, but really all you need to do is see how the boiling point of water is way higher than that of, say, methane. The mag sulfate thing will be more thoroughly explained in Biochem, I'm sure. I think that's in Spring term.

Another nice thing about today was that Dr. Fargo, a friend from back home who finished his EM residency
at the Center of Excellence and now works in the 'burbs, sent me some notes he says he plans to use when he writes the letter of rec he will be sending to my program here. It'll be part of the committee letter, or maybe accompany it, when the time comes for me to work on the big med school application. He doesn't have to do this, and in some ways I'd rather he didn't, but hey, if a guy asks how many "l's" are in "excellent," what are you going to say? (No, that didn't actually happen, but I'm saying he's writing it, not me.)

Sure, my grades so far do nothing to boost my soggy GPA and the faculty is probably worried I'll go completely sideways on the day of my MCAT, but the letters are looking good so far. Fargo says some things about me that make me go "gawsh" and look at my shoes. But at the same time, it's a nice reminder of "hey, yeah, I know what this is all about; these ain't just pajamas I'm wearing" and "ohhh yeah, that's why I've volunteered for this absurd adventure." And I will cheerfully own anything that helps me do that.

Monday, August 08, 2005

Best song lyric of my life (this week)

P-p-p-"pneumothorax" is a word that is long
They’re just tryin’ to put the punk back into "punctured lung"

The Kaiser Chiefs rule.

Monday, July 25, 2005

Worst. Summer vacation. Ever.

The truth is, I love being here, in the abstract but also in the quotidian details and the busywork. I love learning this stuff, it's very cool, and even the most odious of tasks, which loom unpleasantly on the "to do" list, become something interesting, and even fun, once I'm actually into the work. What's new today is that the anaesthatizing thrill that came from the newness of it all has begun to wear off. Now this is my job, just like I knew it would be. And I'm at work at quarter to nine in the evening.

I have a junior migraine with big ambitions, more than I myself feel just now. I have some oddball lower GI deal going on. I have a sleep debt running from the weekend. But I have a huge paper due tomorrow. All things being equal I'd rather be in bed, at home. If I listen to my inner voice, I hear the Miami-tinted voice of one of my EM resident cohorts, good-naturedly saying "enjoy it now, bee-yotch, because it gets WORSE." And then laughing. I guess you'd have to know the guy; he somehow makes that seem encouraging and sympathetic, because he's right there with you.

This is just a momentary break. The paper is actually not such a huge project; actually, whittling it down to ONLY five to seven pages might turn out to be the tough part. And the PowerPoint for Thursday will be very much in the vein of those med student lectures I sat in on, so many times. Booya.

Everything I am assigned to do for class turns out to be cool. (Ask me about my slime mold!) But there's just so damn much of it, sometimes. Plus, the super-compact five-week version of the courses that comes with summer term is a hell of a way to get started. It's like, muscle fatigue sets in after the cells run out of energy from ATP stores, and after respiration has shown that can't make enough available quickly enough, and on top of that the anaerobic route is running out of glycogen from fat stores. It actually takes quite a bit of exertion to do it, but once you're there, you can stimulate that cell all you want, it's not doing anything.

Come to think of it, I'm nowhere near that point yet. And my paper is obviously calling me. I should go.

Oh, and the reading room is in the wireless cloud for the computer lab. Which very kindly has half a bazillion songs on their iTunes. So I'm fine. I'll sleep when I'm dead. Thank you Cell Biology, may I have another.

Sunday, July 17, 2005

Harry Potter and the crappy AMCAS application

So, there's the "Ultimate Workout," there's my not-excellent first official letter grade here in postbac, and then there's Harry Potter. I'll try to keep it intelligible, but I need to be speedy too.

Many many thanks to my dad and family for the gift card from Wal-Mart; this is a way for me to obtain goods without so much giving the big nasty mega-retailer my own money directly. And thanks to the mega-gigundo-chain for having a big stack of HP6's when I walked in, looking for a nice pair of $25 running shoes.

See, there's a lake in town, about 2 or 3 miles or something from the house on campus where we live this summer, I really don't know, and some of my housemates have been doing this thing where they run to the lake, jump in and splash around for a while, and then run back. This has been dubbed the Ultimate Workout 2005 (I suspect there may be exclamation points involved), and eventually I have to go along, because there's a fat guy inside me just dying to get out and, y'know, basically eat a lot of stuff. Hence my need for shoes, hence my being in the store I have decided I will now call Volde-Mart.

Hence my buying "the book" today, even though not 48 hours ago, I had been lamenting the idea that I would have a tough time staying spoiler-free, what with the very real and immediate need for me to study. To study a lot, actually. And more than that, to study in some way (yet to be figured out) that is more effective than what I had been doing that first five weeks, which seem so long ago but actually ended last Friday.

Mostly because if you get one grade on one course like the one I just got, it's no big deal, really, especially if it's for the first course and besides, you haven't touched chemistry or algebra for, no shit, about 15 to 20 years (shudder). But if you get a whole raft of grades like the one I got in this one course, you don't so much get invited to interview with the Mayo Med School, now matter how nice a guy you are or how flat your abs are supposedly going to be.

Anyway, staying spoiler-free will still be rough, because now my studying is going to work something a little more like this: get as far through Chapter 7's Chem problems as I possibly can, having read Chapter 7 but not yet having been to the class where we will be talking about it. Then, read some Potter. Re-read the Bio stuff we covered last week, since it's going to be on Tuesday's test. Then, read some Potter. Go through all the little figures in the Bio book and re-draw them myself, as a way to get more familiar with what stuff is and why I care. Then, read some Potter. Oh yeah, plus eat and sleep. Sometimes.

Thursday, June 30, 2005

Addendum (plus whining)

NB: this is actually being written much later. But I like an organized blog, and this is too long for a comment on June 21, yet it makes no sense as a contemporary post. Anyone who gives a crap about this will want to see it here. Logical progression and such, you know.

For the record, when we got back our phthalate papers, The Prof pretty much hated the comparison to cyanide. I thought at the time I read her comments that hey, they're both ingestible/ ingested, and allegedly both poisonous, so if I were writing for TIME magazine's health section, they would totally let me argue from that perspective. And it's a powerful statement of what's being asserted, plus a nice punchy way to illustrate that there's a way to come at the issue and derive some facts. I liked it; I believe I did mention that she freakin' HATED it.

I have since learned something important. The key idea is, as much as that whole cyanide thing might be totally true and valid, strictly in terms of its being a helpful way for the non-scientist to come toward the ideas, here in Chemtown we don't cotton to that sort o' talk, mister. There are sufficient differences in the two chemical processes that I look like a dweeb if I try to talk even a little outside the scope of the problem under consideration. And it's my own fault for even going there, because I had a perfectly good science paper without it*. Cue head shaking and uncapping of the red pen.

Which is cool, and helpful to someone like me who's a parallel thinker, and a right-brain interactive learner, working to establish a contextual framework and hang a shitload of information from it. I appreciate the chance to bump up against things, make mistakes, and learn from them. It's good to work these things out and arrive at an individualized, personally meaningful understanding, one which will stay with me as I continue my studies. It's great to have a supportive, nurturing environment for these little bumps in the road to come up, without a need to freak out because every tiny little thing is under scrutiny and a potential source for bad grades, or the cocking-up of otherwise good grades...

Oh, crap.

Yeah, as will shock no one who knows me well: this style of learning, interacting with my own historically-favored style of thinking, is maybe not the best combination for this particular... um... life. I am sitting here for ten weeks at an all-you-can-learn buffet, and at times I've been trying to eat soup with a fork.

It's happened several times. I mis-typed "cytosol" as "cortisol" and got busted for it. Unlike out there in the world before, my knowing how to correctly spell both words gets me no points. In fact, with that instructor and in that instance it actually made it look like I meant to use the obviously wrong word; presumably the thinking would be that they're totally different things, but both exist and are within the realm of the topic. Again presumably, it never occurs to the evaluator that it was just a mental misfire, a neuron over in the verbal section grabbing the wrong term. Science people are, like, so literal, dude.

Plus people with PhDs can sometimes seem as though it's been a long time since they skied the bunny hill. Mixing the metaphor, newbies like us would prefer a quick sketch of the big picture, and a little arrow saying "YOU ARE HERE." This is not something that is often thought of as an advanced skill, but trust me, my experience on both sides of adult education confirms it is. One instructor said, on more than one occasion (and this is paraphrasing) "yeah, I realize this all makes no sense to you guys, and for the moment it's a litany of vocabulary words without meaning. But it'll make sense soon, trust me, so hang in there." The implication being, work on the information now, and find the knowledge later, on your own time.

The good news is things have already improved dramatically on that front. The material is different, the instructors have changed more than once, and most importantly, we are learning. We're not non-science students anymore. I'm surviving the Summer term well, and really have absorbed a lot. Plus I've been continually improving my own storage and retrieval system.

My war is not with The Man, and it's not with The System, and actually it's not even a war. It's an aggravating disconnect between how well I'm internalizing what is in many ways an excellent understanding of the most important points of the material, and how poorly I'm performing on certain measures, which are widely considered to show learning.

Okay, the gripe session is amusing but it's done now. Moving on, just after I say this. There are days I'd like to go back to some of the instructors I had in my arts education, who stressed the "flail until you fly" method of learning, and I swear to god just punch 'em right in the nose.





* No fun to read, if you ask me, but I'm a pre-med student now, and fun is calculating the formal charges on atoms in a molecule. Fun is naming alkenes. Fun is blowing stuff up in the lab (actually, that one really is fun). Anytime flair, style, or expression comes into it, that's great but it's probably not helping me.

Tuesday, June 21, 2005

Procrastination Theatre Presents

(first in what I am sure will be a series)

WHAT I SHOULD BE DOING: Writing about the questions of safety surrounding phthalates as additives to PVC plastic, especially in toys babies and kids chew on. It's due tomorrow, sleep or no sleep.

THE VERY BRIEF BLOG THING I'LL SAY NOW: Life is good. I've never worked so hard, and yet this sure beats working. Also, I'd like my financial aid money now, please...and so, a gaggle of students from the school where I worked would be sooooo amused. Then again, I have savings and know how to budget, so [impolite gesture #14a]. (That's the two-handed V-chop, sharply inward toward the groin. I saw someone do that last weekend and it was way funny.)

CRYPTIC BONUS: I think that was #74, who sort of accidentally stole a bike for a minute.

SNIDE REMARK IN CLOSING, AS I GET TO REAL WORK: Sodium Cyanide starts getting dangerous at 0.05 mg/ kg/ day. That would be 50 micrograms. Mean exposure for the 12-to-23-month olds in one 2004 study was 0.08 micrograms/ kg/ day. 99th percentile was 2.4 mcg/ kg/ day. Is this stuff 30 times more deadly than cyanide?

So, in short, my argument might be
[impolite gesture #14a].

Got to go write now.

Saturday, June 11, 2005

tinkering

Messing with the fonts, layout, and colors. Fun for a humid Saturday here in the farmhouse. I'm looking for something that fills the space better, in terms of width. Lots of these templates seem made to mimic newspaper columns, and I use this more like letters or essays.

More changes will come, but for now I changed some colors and fonts I didn't like, from an otherwise excellent template. Yay for Blogger that I can do that in the first place.

Now I need to figure out the link issue, and maybe get some traffic back n' forth from friends with better sites.

Friday, June 10, 2005

So, Here We Are

I live in Vermont now.

My backyard is a ten-acre meadow.

The place next door is a big stone mansion. It's the music building when regular school is in session, and it was also the inspiration for Shirley Jackson's The Haunting of Hill House.

I have eight housemates, and they all seem interesting and cool and impressive in their own respective ways.

We nine have the entire campus nearly to ourselves, until Fall.

Today I held a little chunk of pure magnesium in a flame, and as advertised, it glowed and sparked and totally burned right the hell up under the fume hood. This is my job now; playing with (and thereby learning) science.

There's much, much more, but I need to go put 24 beers into a cooler because there's a barbecue starting in about half an hour.

Friday, May 27, 2005

yarrrrgh

Yes, I still intend to update this, when there are things to talk about.

Yes, there are plenty of things to talk about. But there's no time, yo! I have, like, six entries half-written in the Drafts section. Someday they'll blend in and make it look like I wasn't actually blog-free for 8 weeks or whatever it's been. Sigh.

Hey, is it completely normal to have five days left before the lease is up, a burning need to reduce all of your worldly possessions to one carload and some limited storage space, and then to not really have started preparing at all?

Yeah, I thought not.

The plus side for right now is that housing is set until August, books are paid for and should be waiting for me out East, we're visiting the Leinenkugel brewery on the way, and everyone I know is happy and encouraging about my whole deal.

One quick observation from tonight. In my last shift at the ED for a while, a bunch of patients called me 'doctor.' Must be the appearance of smarts and skills. Which is nice, but I always correct people.

The calm and poise come from not worrying about it -- because my duties and responsibilities are well within my comfort zone. I guess people assume optimistically that said zone includes all the stuff they wish someone would hurry up and do, and I get swept along in the expansion of expectations. If I really were this cool while being tasked with (and trained to) reading C-spine radiographs, diagnosing heart problems, or evaluating a tendon repair post-op, then I guess I would be The Man after all. But I'm not, so sorry folks, you'll need to wait. Can I get you a warm blanket?

Also, tonight I heard Metoprolol called "Metropolis." Awesome.

Finally, extra bonus points to me, because I spelled the drug name right the first time. Okay, I'm going to bed now.

Thursday, May 05, 2005

What Occupies Me

At the bottom of the tax form, after your signature, you're asked to list your "occupation." I have always wondered, where does this information go? And where is it supposed to come from?

Recently, getting ready for the big move, I had a look at my tax forms from the past few years. Sure, job titles are good, but I don't always stick to them. The year I earned a $100 honorarium for being part of the "guest ensemble" (that's "chorus" to most of us) in a 3-month-long production at my favorite theater, I was also starting my job at the cool company (the one I just left after 7 years to go out East, back to school). That year, I listed my occupation as "Actor."

2004 was the year I started working at the hospital, in November. I was an "EMT" that year, and the next, if I'm remembering correctly. All of which is true, but maybe not entirely descriptive of where I spent most of my working hours. I was happy to be associated with the cool company, but as the years went on the day-to-day enthusiasm ebbed and flowed over time. Toward the middle there, I might have put "hapless cube-monkey" if I thought I could.

So I guess I will be a "student" soon, and that's both clear and accurate. It feels good to have no conflict to resolve. Just one more indicator, I guess, that it's time to do this.

Friday, March 18, 2005

Web-headed happiness

Things I Love about the Spider-Man 2 Game for PlayStation2 (in no particular order):

* Jumping off the top of the Empire State Building, free-falling until the closest buildings are low enough to shoot a web at, and then swinging out over Fifth Avenue.

* Approaching a citizen in distress and hearing Tobey Maguire's voice say, "Hi, my name is Spider-Man, and I'll be your superhero today."

* Bruce Campbell as the game's narrator/ tutorial voice. Helpful, yet sardonic.

* Knowing it's possible to stick a web to the bottom of a helicopter and hitch a ride out to Liberty Island (and I shall, oh yes, I shall).

* The unexpectedly poignant videogame moment when I went to the financial district and saw a big vacant lot with a dozen big spotlights pointing straight up, at the site of the World Trade Center towers.

* To buy upgrades for Spidey's web-slinging and combat powers, you walk into what is pretty obviously the Midtown Brooks Brothers. And all the little virtual people go about their business as if it's completely normal. Heh heh.

* Hot dog carts dotted around the island, including one in Battery Park. (Game designers missed an opportunity to make them do something, but that's okay.)

* They named the neighborhood with the fictional Daily Bugle building "Flat Iron."

* Random New Yorkers shout out to Spidey as he swings through the city. About a quarter of them say something obnoxious.

* The digital Guggenheim confirms my long-standing suspicion that the thing is right at home in a comic-book world. I fervently wish that at some point in the game, it's revealed that there's some arch-villain's secret base in there. (The game's been out most of a year, and I well know there isn't, but a guy can dream.)

* And finally, here's a game with the expansive open-endedness of the Grand Theft Auto games (which I also dearly love, don't get me wrong), but without the misanthropy and nihilism.

* Swingin' on a series of webs, you can get from Harlem to SoHo in, like, five minutes.

Friday, February 25, 2005

Mortality and morbidity, with garlic bread on the side

On a recent weekday, I had the day off from the office job, so I went to the 7:30am trauma room conference. The conference is a review of a handful of the more interesting critical cases that came through the most acute part of our emergency department over the most recent week, grouped around a theme -- one week there will be two different head injury cases, for example, plus maybe a seizure case or another "altered mental status" case, if the general theme is level of consciousness. Conference takes place in a basement room that is all very hospital-white. There's coffee, and bagels show up at some point during the hour.

I like going when one of the a cases covered will be one I worked on, partly because I like to know how things came out for the patient. This can be good news or bad, of course. Speaking of head injuries, I'll never forget the one where someone I'd been there for was presented, and after the head CT and a report from our EM resident (assigned to Neuro at the time) came autopsy photos of the same massive brain clot, this time frankly visible within the exposed top of our former patient's cranium, with a report from the medical examiner.

I also go to conference because it's a chance to feel connected to the learning part of the process; to take advantage of the fact that I work at an excellent academic center, and I am encouraged to attend. I also like to imagine being able to call on these experiences later on, as a helpful memory. Not so much for clinical info, although surely I'm picking some of that up, too. I like the idea that because I have the chance to do this now, settings and situations like the conference won't ever be foreign to me, and thus less intimidating. It's part of the whole 'non-traditional' student thing. Many staff physicians are close to my age, but the residents are only younger than me by a factor that's about the same as how far behind them I am in education. Thus, I tend to gravitate to the resident part of the room.

Today I also stuck around for the med student lecture, something I do most days I attend the conference. As I said to the 3rd-year resident I was sitting next to, this is an unusual time in my training -- there would be no consequences at all if I decided to ditch the lecture, since I am "invited" and "encouraged" to attend the conference, but the lecture is pure bonus material. Somehow, this seems to work out to having the kind of attention span for medical education I fear I might be lacking later on, when things are going to get a lot more compulsory and/or graded.

It helped that while this lecture was unusually well-organized and presented in a more academic, true lecture-style way than some of the lectures I've attended, it was also really good. It amuses me to think that if I am asked to strap a blood pressure cuff to a patient's ankle in the next few weeks, I'll know exactly what's up. (Actually, I would have been able to suss it out on my own, strictly in terms of "what does that tell us?" But this way, I'll know it's because the resident and I attended the same lecture.)

Something I've never done was hang around after the lecture, for the Mortality and Morbidity conference. Having checked my voice mail, and knowing that lunch with the gf was not happening as planned, I was curious about what's next. The residents were not entirely sure at first, so I soon found myself with a very narrow window to decide if I would stick around. Turns out it was indeed M&M.

Would this be interesting? Totally. Educational and helpful? Sure. Would I just be there out of prurient interest? Not at all. Would it be okay for me to be there, or was this a doctor-only kind of thing? Uhhh.... well, I took a look around. The RN's had taken off already after conference, since they tend to have, y'know, lives, and of course nobody from other services was still around. But med students were still there.

One of the big things I've learned is that med students are nothing special. And I say that even as I make huge personal sacrifices in the fervent hope that I will be granted the opportunity to be one.

Some are of course wonderful, and brilliant, and it's obvious to see the future doctor just beneath the surface. Many are studious, well-intentioned young people, who with some time and effort will be great. Many are exactly what you'd think, if you watch a lot of Scrubs. Seriously, I have never had what I've felt was the requisite awe and respect for medical people; that's one factor that kept me from joining up earlier. But most of my experience has not yet shown I was wrong. Students are just regular ol' people... some moreso than others.

So it was staff, residents, med students, and me. But what the hell. The boss-doc who was running things saw me, we made eye contact, he gave no indication it was weird or inappropriate for me to be there. And it turned out to be really fascinating. For those who are unfamiliar, the "M&M" is the big meeting where we talk about what went wrong.


First was a discussion of things that get screwed up, in general, in the practice of medicine. There was a big long list that the group had been working its way down, over several weeks or months. The boss-doc presented some examples of issues culled from several years' worth of cases, pointing out where studies that had been read as normal were truly not, asking difficult questions of the residents, and applying hindsight to point out things not to be fooled by.

Then, specific stuff from the week at our hospital was presented, by various people who had been connected with the issues. None were huge problems, most were not even noticed by patients, but all were important because the team chose to make them important. Here's the situation, here's how it might have been prevented, and here's how we make sure it doesn't happen.

How come every industry, business, and institution doesn't do this?

From TV and film portrayals of the M&M, you'd think it was a big auditorium with stone-faced old guys frowning down at a trembling young doctor in the hot seat. It's actually a discussion peppered with horrifying but comical stories from 25 years ago, when the gray-haired sage who now runs the show was a skinny little geek prone to rookie mistakes just like anyone, and chances for newbies to demonstrate the ability to learn from mistakes during, and even prior to, their commission. It's the healthiest, most honest, most real-life-no-BS-helpful way to make things better I've seen.

And that's sad, because I've been in the business world for what, 12 years? "Continuous quality improvement" sounds great, guys. Thing is, we've been doing it since Hippocrates. (I commented to GeekSpice once, more than a few months ago now, that I had found the word "we" coming out of my mouth when referring to medicine, and the way things work in that world. I did it again, just a couple of paragraphs ago, when I said "our hospital." Yep, I'm committed, now.)

As M&M wound down, food was brought in. I was ready to go home, and really, the next thing on the agenda was prep for board exams. If all goes well, I'll be getting ready for my USMLE Step I board exams at this time of year... six years from now. So, not so practical. But hey, free food. So I stood in line, where I talked a little with some staff docs about an issue that the M&M had addressed, then ladled up some ziti that had a nicely zippy sauce, one good-sized meatball, and then sat back down. Dammit, board prep started immediately. I was trapped.

And then came the best surprise of the day. The way the oral part of the boards is done is extremely similar to the way my EMT class had been run, as we practiced cases for patient assessment. There is an examiner, who guides you through a scenario, and you need to verbalize what you would do, what you would look for, etc. Bedside manner counts, following the standard of care counts, doing the steps in the right order counts. There are things you need to do and things you should not do, to earn full points or avoid failing the scenario altogether. The scenario is timed.

One first-year and one second-year resident were being quizzed by a third-year, in front of the group. Staff offered comments and gave pointers about the way things are structured. Sitting in our seats, my friend the third-year and I whispered about the food and he (correctly) diagnosed the problem in about 15 seconds. Me, I wasn't ready to go that far, but I knew what to do. I was shocked to find that not only would I probably not kill this imaginary patient, I might actually get a decent score on this scenario.

Now, this in no way means I would not wet my pants (figuratively or literally), if faced with a real situation. It doesn't mean I'm as smart as an intern. It just means I am on the right track, and the preparation I have done so far will directly relate to what I will be doing later. As someone who is racked just about daily by a very reasonable-sounding inner voice that questions the wisdom of all this, I appreciated the boost.

This is long enough, so I'm signing off, but that reminds me -- sometime I need to talk about that EMT class, and the imaginary patient I killed in one of those scenarios. She's the only one I've lost so far.


And I still think that even if I had asked about it, she might have denied taking the damn Viagra.

Thursday, January 20, 2005

Surgical Deep Thoughts, part 1

The femoral head is the round bit at the top of your thigh bone, your femur. It's the ball in the ball-and-socket joint of your hip.

In a total hip arthroplasty (a hip replacement, in other words), a titanium rod gets inserted a little ways down the center of the femur*. That part is meticulously measured and the rod is planted solidly. After the rod fits and the artificial socket up on the cup-shaped hip bone fits (that's the acetabulum, by the way), then the last bit in is secured to the top of the rod; this is the artificial dealio, made of titanium or ceramic or some other space-age material, that will become the de facto femoral head.

The femoral head is (on most adult people) slightly larger than a golf ball, smaller than a cue ball. Sitting there in a little metal tray, it can look awfully bewildered. Even, dare I say it, a little sad. A minute ago, it was an important body part, and now it's been replaced by some fancy-schmancy bionic thing. It's suddenly become medical waste. Hard to preserve your dignity in that situation, but the femoral head is nothing if not practical. It does retain some of its natural poise and beauty, despite being totally irrelevant at this point in the operation.

I thought it was sort of like the way a pitcher looks, when the manager walks out to the mound in the bottom of the fifth, with only one out and two of their guys on base, and says "nice work today, kid, but we need more juice out here right now. Hit the showers, willya?"

Except with more awe and respect. Not enough awe to make my brain seize up, though. Too much musing on the thin gossamer thread of every human's mortality, or the sacred yet profane work of we the blessed healers, can get in the way of people doing their jobs. And people doing their jobs is worthy of respect and awe, right there.

So, uh... yeah. I've had the chance to do some shadowing. Surgery is very, very cool. It's interesting to be aware of myself as someone barely scratching the surface. I know the names of most of the parts, and I understand much of what's going on. Yet outsider-style ideas and observations still bubble up. I'm hoping that I can hang on to some of that, along with all the actual knowledge and skill I'll be needing, when I'm standing in one of those other spots.

Total hip info (complete with gory photos) can be found here:
http://www.wheelessonline.com/05/4971.htm


* Some marrow gets sucked out to make this work properly, and for some reason that part wigs me out more than all the rest of it -- including the part where the surgical team gets to be standing there in the first place, looking down into an open wound at the bones of a live person, like a bunch of guys eyeballing the half-disassembled transmission from a 1993 Ford Escort. And also, shaping the bones so they'll fit snugly with the implant. Shaping them with a saw. And a hammer and chisel. Ortho is cool as hell, and that's partly for the way it is not at all glamorous. It's clearly science and art, and one of the specialties that can make a person perspire from the physical effort of practicing it. As an Emergency kid, this is something I can respect.

Saturday, January 08, 2005

Welcome to the Backwater

I recently commented at SpaceWaitress' place about blogs, and how they provide a skewed prism of a person (a persona, really). There's a discussion there about people "in real life" who get ahold of one's writing, or stumble across it subsequent to the ending of the actual acquaintance, and use it to build a mental bridge that allows them to think they know the writer. Not unlike fans who have "connections" with famous people.

Sometimes readers actually do know the writer, so friends and family who read a blog can participate in one more way in that person's life. This is undeniably cool. We've learned that Spacey's mom is even cooler in her head (and via her keyboard) than she's always seemed at those brief times when we've talked in person. We've seen evidence of why people are such good friends to one another, and it's always heartwarming (or, since it's kind of an intellectual thing, maybe it's "brainwarming") to see an affirmation of people who get one another so well. I had been impressed by Spacey's group of friends, and their loose-knit ability to stay connected and in synch, but now I have another view of that quality, and I have a sort of observer's affection and respect for it.

My contribution to the thread over there was the awareness that as I plod through the process of various applications -- to postbac (done!), med schools (the plan is for the 2007 app cycle) and eventually, residency programs (2011, god willing and the crick don't rise), I'm going to be asked to write and talk about a lot of stuff... which in many ways, I am thinking and writing about now.

Part of being a good tech is anticipating the need, and having the whoosit ready by the time it's asked for. The ambulance is due to arrive in five minutes; we're all gowned up standing around the cart and saying hello as though it's the first time (which it sometimes is). We're looking at each other's name tags. The ultrasound is right behind you, doc, and it's booting up now. The nurse's documentation sheet has the Hollister sticker and my signature on it, and it's in the bin ready for other paperwork to join it. Empty blood tubes are arranged like a multicolored pan-pipe by the phone, and my gloved finger will jab any speed dial you need. We're all set.

So, okay. Is this mental processing here at the humble little pseudo-blog going to be useful later on? Or will it just be one more thing I can be evaluated on later? And, if it makes me look like a clueless tool with delusions of competence, wouldn't that evaluation actually be more like what in the liberal arts we like to call "judging?" Ay, there's the rub.

But you know what? This is public, but it's primarily for me right now. Convenient, that, since almost no one else comes here. Still, that may change with time. The work so far is not on my own C: drive because I do want some elements of a conversation. I don't want to talk only to myself. And in the long run, even though it might bring some of the complications that Spacey notes now, giving over the ability for people to jump in to this place from various points in the future or past, I think it's worth it. There could be value in helping other non-traditional students get on the road. It might be amusing or interesting. There could be some worthy insight. And best of all, there's the chance that it might help establish a pattern that corroborates something positive a decisionmaker thinks they see in me at some point.

And really, everybody else has a blog. Maybe in the 2007 application cycle, it will be weird not to have one. And you gotta believe that a person's true colors show over time. Whether this is a footnote or the Lake Itasca of one segment of my eventual doctorhood, welcome to it. It might provide clues about letters to the editor I'll write in 2024, or things I'll argue about at national conferences, or how I'd give feedback as chief resident.

At the very least, yeah, it proves I am actually like this, and not just at interviews.