Polluting the Pond

"There's always more fish in the sea."

Except if they're dead floating in a pond. Even Chuck Testa can't revitalize them then.

Of course I’m talking about that risky choice to reveal who you like which becomes known to an entire group of mutual friends. Much like buying a car or jumping off a ledge, the opportunity to step back and re-assess the alternative options once you have made the initial leap of showing your feelings is long gone. As soon as you have clearly expressed interest, you may as well bag your chances with any of that person’s friends too unless they’re apt to be a second option.

And who wants to be a second option? People want to be cherished, special, and selected above all others.

Picture this: You are a fisherman equip with poisonous harpoons. Your fishing territory is a collection of ponds separated by rocks much like a tide pool. Some of these ponds are colossal and swarming with fish while others contain just a few. Every time you feel like hunting you search for a desired fish within a specific pond, take aim and launch your harpoon downward. Whether you strike the fish or not, your weapon pierces the aquatic floor and exudes an insidious poison that soon makes all of fish in the pond croak and float to the top. Sometimes, you pull out your fish and other times you miss, but regardless, you pollute the pond. If you want to hunt again, you'll have to find a different pond because even if there were other fantastic fish in the polluted one, they're dead now.

This is what happens all of the time when people pursue other people.

Boy likes girl a and kinda likes another girl b who also likes the boy. Girl b knows girl a and knows that boy has first chosen girl a. Then things fall apart with girl a so boy then wants to be with girl b. Girl b hates being the second choice and floats away from boy. Girl c (if she exists) does the same and talks with girl b about how terrible boy is. Girl b and c bond and become best friends.

Ok, I made up the last part, but the point is that by selecting girl a, the boy just polluted the pond. In the pond was girl a, b, c and possibly more awesome fish too. Maybe he didn’t care that he forwent his chances with girl b and c by choosing girl a, but he should at least known he would kill the other fish.

So what can you do? Your best bet is to shoot for a smaller pond.  A pond where just a few other fish are swimming. If any hesitation of which fish to choose exists in a large body of water, you would be wise to wait to keep the water pure and the fish swimming. So next time when you go hunting, go small or you might go home disappointed. And also, aim away from bottom feeders.

*Disclaimer: This scenario has no relevance whatsoever within Jersey Shore much of the greek sorority and fraternity ponds.

How to Change People/(Social Norms), Part 2

About 3 months ago, I attended a global health conference at UCSD. I had seen a listing of the presentations before hand and this workshop was one of the main reasons I wanted to attend the conference was for a workshop called “Changing Social Norms. Ending Female Genital Cutting (FGC).” I didn't know much about it, but really, when else do you hear about these things?

It turns out that FGC is extremely common in Saharan Africa. The WHO even estimates that 100-140 million women are living with it’s consequences and over 92 million of them in Africa [1]. This was a far bigger number than I thought. Can you imagine being a part of a society with a disgusting ingrained practice in that causes unnecessary pain, infections, and permanently diminishes pleasure?

What’s the method to stop it? Most experts turn to the process by which foot-binding in China ended for a good example of how persisting social norms can change quickly [2]. Just over a hundred years ago, millions of female babies had their feet bound and broken for the sake of beauty. But this 10th century practice changed within a several decades and was eventually banned in 1912

So how did they do it? The successful method could hopefully be carried out to ending awful practices like female genital cutting. Oddly enough, after reading the blueprint for abolition, I was reminded of fundraising for a canned food drive or for magazine subscribers in Boy Scouts. According to Politial Theorist, Gerry Mackie PhD who has written several lengthy articles on social norms, it goes like this.

Step 1 “They [organizations] carried out a modern education campaign, which explained that the rest of the world did not bind women's feet.” (Canned Food Drive: There are starving people outside of your doorstep)

Step 2 “They explained the advantages of natural feet and the disadvantages of bound feet in Chinese cultural terms.” (Canned Food Drive: With each can, a child is fed for a day...you might not use the cans but others would.)

Step 3 "They formed natural-foot societies, whose members publicly pledged not to bind their daughters' feet nor to let their sons marry women with bound feet." (Canned Food Drive: Can you pledge to bring X number of cans on this day? There are many others who are doing it also.)

This is what a movement within UNICEF does called the Tostan Community Empowerment Program. And the results training women in villages within Senegal are astounding. “Immediately before the programme began, 7 out of 10 women stated that they wished to have their daughters cut. At the end of the programme, this proportion had fallen to approximately 1 in 10 among women who had participated in the programme, and 2 in 10 among women who had not participated directly, but lived in the same village.” [3]. The most surprising statistic to me is that 2 out of 10 women who didn’t even participate in the program changed their beliefs. Obviously, most members of the community were just practicing because everyone else was. Probably something similar to fashion trends US (without the same consequences).

“As of December of 2004, these meetings have led to public declarations by 1,527 communities, or approximately 30 per cent of the population estimated to practice FGM/C in Senegal in 1997.” FGC is still common in certain places in the globe, but at least we know we know eradication is possible and organizations are working to stop it.

Citations
1. WHO factsheet.
2. Footbinding in China.
3. UNICEF. Page 24.

How to Change People, Part 1

For some time, I’ve been thinking about how people change. How do people come to value new ideas ignite passionate for causes? I’ve always been fascinated by how people become themselves whether by their own ambition, family, friends or society. All play a role, but some influence people to greater degrees, especially whichever one a person spends more time with. Whoever you spend time with, you will become like without even knowing it sometimes. Studies have shown that “emotional contagiousness” exists and that your level of happiness is directly proportional to the happiness of your friends and their friends. [1] Whether you like it or not, you will pick up on some of the things people around you say and think as well as their attitudes and emotions. Sometimes, I even catch myself speaking with the same tone and jargon as friends I know or teachers I’ve been learning from recently. Even now as I write this, I’m writing under the influence of Atul Gawande, just because I’ve been reading one of his books today (I would definitely recommend Checklist Manifesto).

Now lets say you want someone to change. What if you want to make a person to lose weight or stop being so critical? One way would be to ensure that the people that surround them behave in a way that aligns with the change. Habits can change quickly around certain groups of people. I’ve seen, on multiple occasions, people who ordinarily cuss, but when they happen to be around people who don’t they follow suit. It would be too awkward otherwise. But you can’t always make someone go into a certain environment all of the time. There has to be other ways to make change intentional.

I’m sure psychologists have dozens of guidelines for how to change and motivate people, but here are two that I’m sold on.

1. If you want a person to change, never directly tell them that their beliefs are wrong. Also don’t tell someone that they NEED to change or else bla bla bla will happen. The “your wrong and this is how you should be” approach is tempting because it’s honest, logical and to the point. It might work with certain personality types, but in most cases, it’s bound to fail. You want to out argue the person, but most of the time, the person will become defensive or/and shut down. Then, future attempts will automatically be prone to further unwinable battles.

Instead, a person or group of people must (somewhat) independently realize that change is necessary and muster the motivation to do it. People feel most empowered to alter their beliefs or lifestyles when they have come up with the answer themselves. That way, they can take pride in their own intuition and ambition when positive change occurs. This route often involves a discussion of the topic. In this discussion, non-judgmental questions are crucial. At first, I was skeptical of this method since it feels childish to me, but any discussion can geared to the level of the individual. “What holds you back from losing weight?” “What’s fair in this situation?” “What do you think are reasonable goals for you?” These kinds of questions can help a person come to his own conclusions?

2. Accountability will help change and is sometimes necessary. For most, changing their ideology or lifestyle is extremely challenging. Something tantamount to waking up one day and swimming 10 miles or filing your nails on a chalkboard, at least at first. In rare cases, a person with incredible will power can stop an addiction, or habit just by wanting it away badly enough. But for most, it REQUIRES a SEISMIC environmental alteration or a PUBLIC declaration to do something differently. With accountability, you are constantly reminded that friends expect you to change. This makes failure a great embarrassment. And success stories from the flash diet show that peer pressure is one of the strongest factors in changing eating habits. [2].

Certainly, there are other big factors too. Cataclysmic events like a heart attack will often make a person serious about exercise and diet. Reward and punishments can work well too, but I believe only if a person establishes them independently.

How have you changed and why? What or who made you change? Did you know you changed when it happened?

1. Christakis, Nicholas and Fowler, James. SOCIAL NETWORKS AND HAPPINESS http://edge.org/3rd_culture/christakis_fowler08/christakis_fowler08_index.html

2. Flash diet. http://www.dailymail.co.uk/health/article-1052234/The-flash-diet-Taking-photos-meals-helps-slimmers-lose-weight.html

Tuesday Takeaway (Nov. 8th)

The gap between the rich and poor is partly due to the gap between the rich and young.

Three simple ways to gain energy without drinking coffee.

Like it or not, Facebook is becoming more and more about self-promotion.

NEW STUDY: Around 10% of college papers are plagiarized from wikipedia.

New clothing for establishing posture. Awesome, but hilarious.

"Suicide is not chosen; it happens when pain exceeds resources for coping with pain." A good article for anyone considering suicide.

Elections in Latin America:

Nicaragua's president Daniel Ortega is breaking rules to win again.

Bad news for Guatemala: Perez Molina, a high-ranked former military officer who was trained by the School of Americas will be presiding over Guatemala.

Tuesday Takeaway (Nov. 1st)

The challenges of Smart Phones

The 53%

What makes a Halloween Costume offensive?

Redesign a supermarket like a colosseum

Halloween Party Rock. Must have taken months to prepare!

Sad race studies of Ebay.

Pythons and hearts.

Mindfulness in medical care.

Tuesday Takeaway (Oct. 25th)

Around Latin America.

Obama to send 100 soldiers to fight against LRA.

Lord's Resistance Army crisis tracker.

Diet is an outlet to express oneself and a make or break for dating.

Sheex: Bed sheets for performance. NY times.

U.S. dumping illegal immigrant criminals for fiscal reasons.

Could China take over the moon?

Facebook friends correlates with brain size.

Where can Libya go next?

Health and Medicine:

Parents and vaccines.

UCSD's technology is moving up.

The Medical School Mini-Rant

“Too much of a good thing is never a good thing.”

Let’s just say the past two weeks has been nothing short of spectacular. But like almost every week in medical school, it’s been a sustained, almost enslaving spectacular that makes liberation frighteningly revitalizing. I’ll explain.

Over the past two weeks, I’m convinced I’ve done, seen and learned more than the average person does in months. I saw multiple patients at the free clinic one night, then gave a tour of it the next. I shadowed a cardiologist and saw an EKG of a patient on the brink of a heart attack. I interviewed a pregnant actress who experienced physical abuse. I’ve memorized almost 45 drugs and their mechanism of action. I studied cardiac electrophysiology, anatomy and histology. I also cut a human heart out of a deceased person’s chest and examined it. I helped diagnose a patient with aortic stenosis. I housed an interviewee and a friend from another medical school. I scrimmaged in ultimate frisbee, and flag football, danced salsa and went to church. Interspersed with those activities, I studied my butt off for dozens of hours. Tomorrow will include an 8 mile hike and a football game and three days from now I’ll be shadowing a pediatric cardiologist.

And with the exception of some non-medical school fun things here and there, it has been a constant track meet. Every day must be planned to the hour in efforts to stay somewhat on pace with school and avoid burn out. Each fun event and study plan must be screened meticulously for it’s value before commitment is given. An hour that produces mediocre fun or sub par understanding in academic preparation is quickly thrown out.

When I visited with one of my non-med school friends tonight, I was refreshed by nothing more than simple dialogue. I stepped out of my medical school suit, and forgot about memorizing, and performing. We talked about random stories and funny situations. For several hours, our only goal was to laugh and have a good time. (Something I’ve become accustomed to doing in medical school within small, 1-10 minute pockets of time). He had no idea what I had gone through this past week. And I appreciated that.

I didn’t want to think about everything I had done. I didn’t want to regurgitate more information. I wanted to laugh and think creatively. To ask questions without a specific acronym with which to guide them. To drop my notepad and just live.

So that's what I did and it was spectacular.

Tuesday Takeaway (Oct 18th)

Buy slavery free candy this halloween!

Occupy Wall Street protests reach universities.

Uruguay gives more laptops to it's kids than the U.S.

Alabama bringing back slavery. This time to Latinos.

Hugo Chavez has just 2 more years to live say doctors.

Marathon runner goes the distance at age 100.

Landslides in Central America.

Rap Snacks.

How rich are you, relatively?

Biodegradable shoes.

"Remembering that you are going to die is the best way I know to avoid the trap of thinking that you have something to lose."--Steve Jobs.

The Dream Act comes to california.

Jerry Brown signs in a law against shark defining.

Healthcare and Medicine:

Magic Mushrooms. Was this written by a hippie or a scientist?

Technological analysis in Hospitals predicting outcomes with accuracy

Text messaging increases adherence to malaria medication in Kenya.

"The Kaiser Family Foundation released recently its latest estimate of what health insurance will cost in the future. By 2021, average family premiums are set to double, to more than $32,000. This year alone the premium is $15,073, up 9% from 2010" But...Don't blame doctors for high medical costs

ADHD can now be diagnosed and treated at age 4 :-(

California Medical Association looking to pass marijuana legalization.

Malaria soon to be eradicated in 1/3 of affected countries.

A new test for Downs Syndrome.

Tuesday Takeaway (Oct. 11th).

There are just a few readings for today. Mainly, I've been caught up on school work, playing frisbee and flag football. Ok, maybe just a bit more of the former. Today, for instance, I took a 2 hour final, went to cardiology class for 2 hours, ate lunch at the beach, and then went to the downtown clinic to see two patients. Tomorrow is more 8am class...brutal!

Tuesday Takeaway..here we go!

How many slaves do you own?

Churches filling in the gaps of underserved care.

Woman finishes a marathon and then has a baby.

Healthcare and Medicine:

Quantifying improvement and using peer pressure to induce health changes.

Most people believe the US is well off, and therefore neglect the families that are 'food insecure.'

Genetic testing for freshmen at UC Berkeley.

Peanut butter and Haiti

Tuesday Takeaway (Oct. 4th)

Hank Williams Jr. flagged for offensive Obama comment. Monday night football will never be the same.

Man opens fire on the San Diego 805 Freeway.

Bank of America to charge for debit usage

Getting kids excited about reading
"Teachers and school administrators might want to consider this: in many schools, there's a tendency not to reward boys for reading books like "Guinness World Records" or "Sports Illustrated Almanac" or "The Rolling Stone Illustrated History of Rock and Roll." Too often, boy-appealing books are disproportionately overlooked on recommended reading lists.
Big mistake. Tragic mistake. Avoidable mistake. It's all about attitude. If your kids' school library isn't a boy magnet, the school probably needs to check its attitude"

A practical step by step guide to setting up your own business.

From the Limits of Empathy: "Nobody is against empathy. Nonetheless, it’s insufficient. These days empathy has become a shortcut. It has become a way to experience delicious moral emotions without confronting the weaknesses in our nature that prevent us from actually acting upon them. It has become a way to experience the illusion of moral progress without having to do the nasty work of making moral judgments....People who actually perform pro-social action don’t only feel for those who are suffering, they feel compelled to act by a sense of duty. Their lives are structured by sacred codes....They would feel a sense of shame or guilt if they didn’t live up to the code."

Twitter study suggests that our "moods are driven in part by a shared underlying biological rhythm that transcends culture and environment."

Income taxes by country

The moment of revolution video of the protests in Wall Street.

More on the protests and mass arrests

Arrested Development coming back!

Amanda Knox can FINALLY breath a sign of relief.

Healthcare and Medicine:

Sometimes achieving global health goals is as easy as taking turns

Hi, I'm a doctor (of nursing). Why physicians are angry.

The battle between health access and overspending in Washington

Making women with cancer feel beautiful

Staging breast regression Hilarious.

The autism and vaccine rumor went a little too far...

Quotes that Move Me

Below is a collection of my favorite quotes. Some of them are inspirational and others just make me think or reconsider my perspective on certain aspects of life. Although most of these people are famous, some of the names you won't recognize at all. I took a few of them from blogs and articles from common people like you and me. I like the idea that anyone can make an impactful statement regardless of notoriety or reputation. Read them and use them as your circumstance lies.

“Meals embody the principles and the disposition of the person who eats them. Food means choices and choices mean a chance to fulfill our principles.” --Ryan Holiday

“Our greatest fear as individuals should not be of failure but of succeeding at things in life that don't really matter.” Francis Chan

"Weakness of attitude becomes weakness of character." --Albert Einstein.

How will someone know you love them if you don’t tell them that you love them too? --Spongebob.

"If everything seems under control, you're just not going fast enough."
- Mario Andretti

"Not everything that counts can be counted, and not everything that can be counted counts." -Albert Einstein.

"Find something you love to do and you’ll never have to work a day in your life." --Harvey Mckay.

“Whenever you find yourself on the side of the majority, stop and reflect.” --Mark twain

“The best means of benefiting the community is to place within its reach the ladders upon which the aspiring can rise…forms best calculated to do them lasting good.” – Andrew Carnegie

“Neither the individual nor the race is improved by alms-giving.” – Carnegie

"Dancing is silent poetry."
- Simonides

“When we strive to become better than we are, everything around us becomes better too." - Paulo Coelho

“It’s the possibility of having a dream come true that makes life interesting.” --Paulo Coelho (The Alquimist).

“Whatever you do, work at it with all of your heart, as working for the lord, not for men.” Colossians 3:23

"We cannot become what we need to be by remaining what we are." - Max Dupree

“We don’t beat the Reaper by living longer. We beat the Reaper by living well.”
-Randy Pausch (1960-2008)

“Religion that God our Father accepts as pure and faultless is this: to look after orphans and widows in their distress and to keep oneself from being polluted by the world.” -James 1:27

“If you are insecure, guess what? The rest of the world is too.” Tim Ferriss

"Life was always a matter of waiting for the right moment to act." - Paulo Coelho

"Education is a progressive discovery of our own ignorance."
- Will Durant

"It takes a long time to grow young." - Pablo Picasso

"Everybody is a genius. But if you judge a fish by its ability to climb a tree, it will live its whole life believing that it is stupid." - Albert Einstein

"You need to find a way to live your life, that it doesn't make a mockery of your values." - Bill Ayers

"Enjoy the little things, for one day you may look back and realize they were the big things." - Robert Brault

"It's never too late to be what you might have been." - George Eliot

Tuesday Takeaway (Sept 27th)

4% of the photos ever taken-->Facebook.

Today's racist bake sale at Berkeley.

Could public biking outcompete the subway and bus system?

The great school depression...SAT lows and spending highs.

Could you live on $30 a week of food?

Time Banks. A way to exchange time and help people.

Facebook's newest target: Music

Creating business sectors in impoverished areas that did not exist before. "The best of philanthropy and capital coming together." Skip to 9minutes in for the meat.

Sad reports and studies from border control mistreatment.

Are our bodies restricted by exhaustion or a mental barrier?

Why our government isn't working.

The world's rudest hand gestures.

Development is often constrained by tradition. Persistance rules over grants and alms giving.

Foods in the shape of flags.

The power of forgiveness. "One of the great secrets of this life is that when we are hurt, we have all the power. We have the power to hold onto the offense, grasping it like a thumb screw in a torture device. But we may, if we choose, unscrew it; we may release the one over whom we have power."

Philosophy of Quirky: Using regular people to innovate.

How to execute your $1,000,000 idea. Check out the tips "Find your (profitable) idea."

Health/Medicine:

Virtual advice from 5000 doctors.

Drug shortages in hospitals.

Incredible cyborg devices could allow for patients with Parkinsons and other debilitating diseases to regain abilities.

Are our bodies restricted by exhaustion or a mental barrier?

Using vinegar to treat HPV.

Tuesday Takeaway (Sept 20th)

World:

Pictures from the gold rush in Senegal.

Drug cartels in Mexico are using social media to promote fear.

Hip Hop: The music of rebellion and justice in Libya.

Building toilets to stop sexual assault in South Africa.

Random:

Tuition for UC Universities might increase by 81% over the next 4 years! Most staggering statistic: Average tuition at a UC in 2000: $4,000. Average tuition at a UC in 2015: $22,000.

Brad Pitt confessions

I am a photic sneezer. are you?

Why whiners don't win. "According to a new CareerBuilder survey, 71 percent of human resources managers say they place more emphasis on emotional intelligence -- a person's ability to control his or her emotions, sense the emotions of others and build relationships -- than they do on IQ. Fifty-nine percent of employers even said they wouldn't hire someone who had a high IQ but low EI."

Is Hillary Clinton back for 2012? Polls say so, but Clinton will not.

What would you promise yourself?

A free text by Epictetus. Go stoicism!

The CIA pitches to Hollywood.

The exodus of 'primary caregiving' women from prisons in CA. Lawsuits in the future?

So this is where blond jokes come from.

Raising awareness in Boulder about Homelessness.

Healthcare and Medicine:

Gates Foundation: Reinventing the toilet...swapping water for fertilizer.

What do you know about Celiac Disease?

Gamers solving scientific quandaries.

Patients like me: Finding a disease based support group...virtually.

The man who was cured of HIV.

U.S. healthcare taught by Dr. Seuss.

Does extra safety as a physician mean bad medicine? It certainly means unnecessary costs.

The Tuesday Takeaway (week 4)

Obama’s target on Rural Community growth.

Obama is pushing Congress on the American Jobs Act. His quote: "stop the political circus and actually do something to help the economy"

Computors>Textbooks.

Using Wordle to remove redundancies in foreign language writing.

Breaking U.S. temperature records in the summertime.

A documentary on Hair in the Sikh community.

Discovering more time and yourself without porn.

How contagious are emotional states? “We pass emotions back and forth all the time, as part of every interaction we have with another person,” notes Daniel Goleman, author of “Leadership: The Power of Emotional Intelligence.” “It’s usually subtle, but sometimes all too obvious.

A distressing report from Somalia from the president of Médecins Sans Frontières

Some things are hard to believe.

Tweeting from Tipoli.

Chile’s September 11th: A U.S. backed coup in 1973.

Only Humans shed emotional tears.

Christionizing Reality TV shows. Jon Acuff is the man.

Written with a Hint of Jealousy

Today I confirmed an epiphany that I had prior to starting my blog. The mix of writing and fame can produce a powerful potion. A potion that has the ability to bring giants to their knees, convert seeds to redwood trees, and even doctors and swamped medical students to a state of silent, devoted attention. Just kidding about the first two.

Picture this: A group of medical students are bombarded by classes, readings, electives sign ups, lockers, buying supplies, moving in, and socializing. We've been receiving thirty to forty emails a day from interest groups, organizations, social events, deans etc. But we push it all aside to sit in silence for a few hours.

Just beyond them are the busy clinicians and scientists with nationally recognized research projects and dozens of patients to see and surgeries to do.

At 1pm everyone gathers.

An brief speech is given by a med student to introduce a famous UCSD physician who has the privilege of introducing national best selling author of Cutting for Stone, Abraham Verghese. I've never seen a introduction to an introduction to an introduction before, but today was a novelty.

There is a hierarchy of big fish in the medical community but only one will be heard today.

For a full hour, not a single whisper is heard, nor computer open while Verghese lectures about meaning, physician suicide and his experiences as a bedside doctor. When Verghese's voice is not audible, it's so silent that the rythmic beeping of a a construction truck can be heard just outside.

And after an hour of talking, his advice and words of wisdom are solicited from both practitioners and students. We wanted to know about his opinions on the use of hands as a doctor, of smell in his book, and the relevance of the characters in his book.

Never mind what the accomplished dean sitting in front of him may think of hands and patient contact.

We are the congregation and he is our pastor.

Forget the emails, the medical school planning, our families, and all other activities.

The man has come. The man who placed words on a page and became widely recognized for it.

And we all look on, starstruck with great admiration of our poetic hero.

Now, Abraham Verghese is more than a great writer. He is a physician born in Ethiopia who has lived a marvelous and inspirational life. And, although I doubt he has much time to attend to patients while touring the U.S. after writing his book, I know him to be an articulate human being with sound advice.

But what makes our faculty, and deans and two hundred other busy students take three hours out of their days to offer undivided attention to another human being?

Can writing really be THAT powerful?

Can fame make us sacrifice THAT much of our day?

Is Abraham Verghese part SuperGod or just another physician?

Well done, Dr. Verghese, you have captivated us all.

The Tuesday Take Away (week 3)

Since I begin medical school today...dramatic pause...gasp...and CHEER! I’ve been reading up on a few more medically related topics. Still Muslims, Marijuana, and Finland snuck their way in.

Hockey enforcers are turning to alcohol and other addictions to soothe problems while paying in deaths.

Teachers are highly regarded in Finland. This fuels the jealousy (or admiration) of American superintendents and education activists.

Supposedly, people only wash their hands 60% of the time after using the bathroom. This statistic is even lower for doctors between seeing
patients. Sick. Just sick.

Argentina is on the up from 2001’s 100 Billion dollar default and this article says why. Love the title on this one: “The Turnaround Tango.”

NY Times on the Health Care Crisis
"American health care tends to divide the population into insiders and outsiders. Insiders, who have good insurance, receive everything modern medicine can provide, no matter how expensive. Outsiders, who have poor insurance or none at all, receive very little. To take just one example, one study found that among Americans diagnosed with colorectal cancer, those without insurance were 70 percent more likely than those with insurance to die over the next three years."

Mapping Marijuana in the USA: Where it’s expensive and where it’s dirt cheap.

David Carreon on questioning the framework of food banks and blindly giving money. Based on an essay by the world’s all time 2nd richest person, Andrew Carnegie.

There’s now hope for the shaky handed phlebotomist.

A hilarious video on 1st year diagnosing a patient as a 1st year medical student.

A great article by Steven Koll on why many Muslims are angry with the U.S.
“The United State props us autocratic governments on the basis that they are relatively more progressive - according to the assumed Western narrative - than what the people would do if they had their way. When the Algerian military in 1991 overturned the results of a democratic election when it appeared that an Islamist party would prevail, America and other Western governments turned a blind eye. When democratic forces arose in Tunisia and Egypt, Muslims perceive that the United States only joined the parade when the outcome was irreversible.”

Learning and Memory. Way more than you ever wanted to know, but very insightful material!

A beautifully written article by the author of Cutting for Stone, Abraham Verghese (who I will meet today) on the irreplaceable patient doctor relationship and the importance of physical examination. I take refuge in articles that confirm the ability of humans to perform as technology cannot.

Medical School Update!! (Although it hasn't officially started)

First, a side note: When I created this blog, I promised myself that I would NOT write a single entry about my day to day events. Frankly, it's a little egotistical and boring. Instead, I would share stories, special experiences, interesting articles and whatever else not involving the day to day updates. But, I am just entering medical school and since it is a once-in-my-lifetime event, I will share you a bit of day to day happenings.

I've been attending orientation for the past week. This means an 8am-4pm activity time which includes lectures by the deans and medical student panels to pump us up, tours, and activities to make us crack our shells. Every day, there are also optional social events afterward from usually 5:30pmish to the night. The other night, I stayed on campus from 7:30am-5:30pm and then headed to the beach until 9pm. All for orientation events and socials. So far it's been overwhelming, interesting, fun and exhausting.

On the first day, the medical students and staff surprised us by giving us a tour of the new 70 million dollar medical building ( 35 million dollar over budget). It is BEAUTIFUL and completely surprising to me since I have not stepped on campus for over a year. Some of the highlights are:

1. Our lecture hall is about one thousand times nicer than any place we took classes in the undergraduate campus. Each student has a desk similar to that of the senators in Washington D.C. They are all wooden, and spacious with brand new office chairs and include a personal lamp in case we need more light. The room is like a massive opera house with reverberating acoustics.

2. The practice operation room inside the building includes new state-of-the-art equipment including a micro-optic camera, and all of the technology necessary for laperoscopic (key-hole) surgery. The technician said they will probably bring in live pigs to do operations.

3. Our patient simulation room where we take physical exams and do patient interviews is also brand spanking new. There is also a sliding computer that is built into the wall outside of the room that is height adjustable. They said we could log into our account to begin a video inside the room, then practice our verbal tests, and watch ourselves later at home. Pretty advanced if you ask me.

4. The entire building is OURS for studying. We are the only ones with access to it which of course makes us feel special.

They also told us that they are doubling the number of available spots for the Free Clinic Project at UCSD. Our free clinic is nationally acclaimed, but the number of spots to work in as 1st years is usually very limited. The 2nd year medical students rave about their experiences at the free clinic so I’m getting excited about that.

We have 125 students in our class. It’s been very fun and a little overwhelming getting to know all of them in this past week. The questions of “where are you from?” “Where are you living?” “And what did you do in your year off?” continue to run off the tongue from everyone. So in a way it feels like going to college all over again, but the students are far more interesting. Most of them took time off between now and undergrad and traveled, worked, did Teach for America, a fulbright or some other unusual activity. One student worked in presidential secret service for around 10 years. Another helped win the NCAA national volleyball championships. One of our students is a woman with three children, the oldest of which is 13. Another guy grew up in Puerto Rico and did his undergrad there too. Overall, the class is on average 23, claims residency in California and did their undergrad at UCSD. Wait...I’m 23, A CA resident, and a Triton Alum. Guess I’m not such an oddball after all.

Probably, the most eventful day of our week-long orientation was the blood draw session. I always thought they would have us practice sticking bananas or some synthetic skin before poking patients. Turns out we had to be guinea pigs for each other :-o So with a 21 gauge needle and a shaky, novice hand, each student carefully stabbed his partner’s cubital fossa vein. Usually saying something like “Sorry, Sorry” when things did not go right. It’s a simple procedure, but requires gauging your speed. Poking too slow means more pain for the patient and going to fast could mean puncturing through both layers of the vein. To add a challenge, we had to keep the needle stationary in the vein while pushing a suction tube into the back of it. That meant pulling with one hand and pushing with the other and often times pushing the needle further in, or removing it completely. All said and done, we made it through and I walked away with a band aid on each arm.

Class starts Tuesday and the new curriculum includes 4 hours a week of a new approach called Problem Based Learning (PBL). PBL means more group discussions and application of what we learn in lectures to real life cases. It takes a bit more Sherlock Holmes mystery, but studies show that you will learn better when you can apply and relate to it. I’ve never been a fan of group work, but I think this could be ok. I will definitely make us more accountable and space out less.

Time will tell....

The Tuesday Take Away (week 2)

Here are my favorite articles from the week! From languages, to the NBA lockout, to an atheist who did AA.

Think you can’t learn a language for free? False. There are a number of sites and resources out there for language learners. My golden rule: ‘No hay verguenza.’ or “There is no shame.” Put yourself out there and practice and you might surprise yourself by how much you can learn. Scroll to the bottom of this post for some helpful links.

Nice guys finish last. Well, not really, they just don’t make as much money.

Long article on the NBA lockout. And a thought provoking paragraph at the end about the psychic benefits of art or ownership.

There are a million ways to fail in online dating. Here are some hilarious ones.

We are becoming more productive, but not being compensated appropriately.

Ignorance is bliss. Until it kills the environment, and you.

The US is the only developed country where citizens are not guaranteed paid vacation time. Check out the graph!

The flash diet. The only diet with no recommendations.

Are cholesterol numbers really that important? One doctor calls them ‘worthless.’

Depressing News is terrible, but depressing international news gets far less attention. Did you hear about the terrorist attack at a Casino in Mexico?

An interesting article written by an Athiest who went through AA. Her quote “I believe that the most important spiritual principle of AA is humility. The recognition that we are flawed, that we can and must change and that our purpose not only in sobriety but in life is to be of service to others.”

Sleep is to our brains as a disk fragmenter is to a computer? Studies are showing that sleep allows us to make synapses more efficiently and create room for more of them.

The Tuesday Take Away

Guess what...It's TUESDAY! Which isn't normally exciting, aside from Taco Tuesdays, but starting every Tuesday, I'll post my favorite articles here with a little side note about them. If you don't love 'em, then you are welcome to leave today and go to Wednesday Walk Aways!

jk I don't know what that is. But here we go.

New websites discovered:

KIBIN: A good business idea? Or a form of literary incompetency? Editing services are becoming easier and easier to find.

Verbling: Language learners should be stoked about this one! Chat Roulette has met Fluent Future. On this site you can talk to a foreign stranger in their language for 5 minutes, then speak in English for 5. You'll get cut off after that, but still allows for more than small talk. I've tried it three times and loved it. Always exciting to see who you will talk to.

Rescue Time: Ever wanted to see how you spend your time online? Rescue time tracks every place you go online and gives you a nice bar graph result revealing just how much time you waste on Facebook (or other sites.) Good for self-tracking and accountability.

Articles worth reading:

Want to eat healthier? Food substitutes provide a solution with little change to your diet.

Also, an article on eating. Ever thought of eating philosophically? Me either. A good 10-15 minute read. Also some interesting research on self-control as a finite resource.

American Liposuction doctor flees to Columbia after being sued for using fat for powering his car. Weird weird story from 2008. I'd love to meet the guy.

The internet CAN help you be more productive. (at least in 10 minute increments.)

Will Smith getting a divorce?! Nope. That's how rumors start.

Decision Fatigue: It's no joke. Making too many decisions can cause you to take shortcuts and make poorer decisions in the future, or no decisions at all. It's part of new studies on ego depletion.

Imagining Obesity (A defense of overweight people)

After traveling in Europe for six weeks, I flew to New York and was ready to take off to the west coast of my beloved country, the USA. I took a seat in the back of the plane and soon a large American woman approached me from the aisle with four overweight children waddling behind her.

“Could we get in please?” the mother asked.
I stood up and let the mother-daughter combo slide in beside me. While the other three sat down behind me.

Loud bickering erupted from behind.

“You got the window seat last time!” One girl exclaims.
“NO, I was here first!” Retorts the other.
“But you can’t steal it from me!” Yells the first child.
“MOM!!” Cries the second.

Mom chimed in to settle the suits and soon the long five hour flight from New York to Phoenix began. Time for TV. The mother quickly slid her credit card for her four kids to gain access to unlimited movies, music and TV. The kids wined about not having headphones and exclaimed their excitement for Dominos Pizza that night. Then, the real kicker came.

Mom pulled out a jumbo-sized, crinkled bag of Mcdonalds. Digging her hand into the bag, an array of five packaged, greasy burgers and fries soon appeared.

“Here you go girls.” She exclaimed while handing out each meal.

My thoughts were then confirmed: we MUST be in America now.

Obesity might be the greatest killer in the United States. It contributes heavily to the top three leading causes of death in the US (Heart Disease, Cancer and Stroke, respectively) and to Diabetes as well (#7 leading cause of death) (1). Our nation is now crumbling beneath the weight of the problem (get it?), by the deaths of people and our finances.

It is estimated that healthier diets might prevent $71 billion per year in medical
costs, lost productivity, and the value of premature deaths associated
with these conditions (1).

34% of US citizens are now obese (up from 15% in the early 80s) (2).

One third of white children and one half of Latinos born in the 2000s will develop Diabetes in their lifetimes (and 80% of those with type II Diabetes are overweight). (3)

But what is it that’s making us so fat? And why can’t fat people start making good choices?

One of my old friends used to mention how he didn’t feel bad for overweight people because it was their fault. I find that the general sentiment from people who have their weight under control goes something like this:
“Fat people don’t HAVE to go eat fast food all of the time.”
“Fat people COULD exercise if they really cared about their bodies.”
“It’s THEIR fault for being fat.”

But for a second, imagine being one of these children on the plane. You’ve been surrounded your entire life by TV and quickly prepared and artificially preserved food. You have developed a strong desire for fats, sugars and salty treats that is reinforced multiple times a day by the food you are given. Mom works hard to raise you, but does not have the time to cook. You are overweight, but so is mom and so are your sisters. They are your support group and they don’t seem to mind at all.

At some point in your life, maybe Jr. High or High School, someone will probably laugh at you for being overweight. And someone else might offer suggestions for what you should do. But not only were you not raised to see it as a problem, you were never told to value anyone's opinions for body improvement or their recommendations for other health options. Your eating habits are so constrained by your family that you do not even have the leverage to change your eating habits. So you bounce off negative comments about your weight and lifestyle and find refuge in other peers who are like you: overweight.

You are obese, but is it your fault?

Or is it your mother’s fault?

Your grandmother’s?

The fast food corporation's?

The economy's?

Later in life, after much deliberation and listening to your well meaning friends, you might begin to want to lose weight. But how? What should you eat? How should you exercise? How do you maintain motivation for all of this when your family has none?

Your upbringing in this area has been somewhat of a stroll through a valley that has now reached a crux at a rocky mountain pass. Some of us were guided through the mountains and not permitted to stay idle in the valley. We find the upward climb to be at times difficult, but manageable. We think there must be a level playing field for everyone.

But we never grew up like you did. We were given low risk genes, positive life examples, ample money, and caretakers that made us be active (4). We grew up in families that did not smoke, and were encouraged to pursue education (I'm lucky to say this was my case).

We already endured trials that we had no idea were trials. And today our childhood serves as a template for our own healthy living and a hindering roadblock for our understanding of others.

Sources.
1. USDA data.
2. USA Today Article
3. Understanding Obesity (Obesityinamerica.org)
4. Obesity Risk Factors