Happy Mother's Day

HNHM 2005

Telephone call at 11:30 a.m.

S: Hi Mom! Happy Mother's day!

M: Ah, I knew it was you. Samantha called at 10 a.m. this morning and Jeremy thought it was you.

S: [mentally: Crap, I'm the last kid to call] Oh...

M: Yeah, but I knew it couldn't be you because you never wake up until noon.

S: Yeah...Oh, and I'm sorry that I forgot to send you a card this year!

M: That's okay, your brothers gave me two pink roses and signed a cute pop-up card with all of your names. And Samantha sent me a card and signed your name too, so you're covered.

S: [mentally: Oh, crap, I'm the only kid who didn't send a card] Oh, okay, that's cool. Well, give me a call if you want to chat or anything.

M: Okay, and I know that if I ever want to check up on you, I can always read your blog.

S: Yeah, okay.

M: We're going hiking now, bye!

S: Bye Mom!

Wow, I'm officially the "slow" kid on Mother's Day.

Whenever you get around to reading this blog, Mom, I just want to say, "I LOVE YOU!"

Only a Scientist Would Say

Mystery Baby

Today in lecture, our professor had a cute computer desktop image of his baby son. As members of the audience "ooh"ed and "ahh"ed, our professor blushed and said:

"The author of that baby is sitting in the audience."

A classmate named Alex turned around and said to me, "Wait, does he mean like the first author?"

How many authors could there be?

The Perks of Being a Blogflower

DJ Axel's new album, "Breaking the Law"

Last month, I blogged about going to a mash-up, Bootie SF, at the DNA Lounge.

Here is my excerpt:

"Attended a mash-up called Bootie SF with some friends from medical school. A few weeks ago in Vegas, a girl accidentally burned my right index finger with her cigarette while clubbing at TAO. It was an accident, but it was bizarre. Saturday night, while dancing at Bootie SF, DJ Axel from LA was throwing copies of his new album into the crowd. I raised my arm to get one, and he threw one at me, but the CD hit me in the face and cut my left cheek. And I STILL didn't get the CD. Yet another entertaining nighttime injury. I'm going to be like one of those biker pirates with a leather eyepatch and a story behind every scar. Chicks dig scars, right?"

I wasn't mad or upset, the anecdote was more along the lines of "Why do I suck at life?" and other such self-deprecatory musings.

Later...to my GREAT surprise, I found a comment attached to that entry from none other than DJ Axel!

"Hi Stephanie,I just came across your blog. Sorry about cutting your cheek with my CD! Email me your address at axel@djaxel.com and I'll mail you the CD. Thanks for coming out to Bootie! -Axel"

You know those days when you say something to no one in particular like "Gee, I wish I had a donut," and then a big yellow donut falls out of the sky into your hand? Imagine my surprise that this little medical school blog attracted the attention of...a really famous DJ.

So I emailed DJ Axel my mailing address and I received this album this afternoon in the mail! He is so incredibly nice! I love it! Yay for DJ Axel! -HUGS-

Medical Scholars Program (MSP)

MSP handout

As always, SO MUCH has happened between this week thus far. Most of my Sunday, Monday, Tuesday, and Wednesday was consumed by the Medical Scholars Program (MSP), which is a tutoring program run by mostly by fourth and second-year UCSF medical students to help first-year UCSF students with anatomy and basic concepts. This quarter, the new MSP leaders are practicing their teaching skills by preparing lessons for BMB, and my first MSP lesson was this week on the amazing brainstem. It was an experience similar to Clinical Sciences Journal Club, in that you prepare intensely on a particular topic and present it in a public speaking forum to your medical school classmates, but it was also more didactic and had a different approach, using chalkboards and xeroxed handouts and whatnot.

At the beginning of the year, Albert asked me how I would prioritize seeing patients in the clinic, research, and teaching. I told him that I would rank 1) seeing patients 2) research and 3) teaching as a distant third, because teaching did not really appeal to me at the time. However, somehow, I was bitten by the "teaching bug" by watching the incredibly talented and inspiring MSP leaders this year who helped me so much and by realizing in our daily small group discussion sections that it was genuinely fun explaining medical concepts and factoids to peers (um, when I actually read and sometimes when I actually didn't). "Teaching" first-year medical students (peers) and 4th and 5th graders through MedTeach (with Craig and Sarah) this year has really given me a lot of joy. Nowadays, I might rank 1) seeing patients and 2) a tie between research and teaching.

So anyway, most of this week was consumed by preparing for my first MSP lesson, presenting it in a practice session to my fellow MSP leaders, and then giving the lesson last night in front of some 6-10 peers. I was particularly touched to see Paul and Albert there, because I know that Paul doesn't bother to attend MSP (this is taken by me as a fact of life) and Albert occasionally drops in.

Yesterday was so busy! Besides class from 8-12, there was basic science journal club, a meeting, an amazing UCSF Iraq Teach-In (check the UCSF Synapse page next week for more coverage), and then MSP.

Today, there was class from 8-12 (an exam review in the morning), a Synapse meeting, a session to learn how to use otoscopes and ophthalmoscopes, and then a few wayward medical students and I walked over to Japantown to eat some mochi, crepes, pearl milk tea, and go shopping at a Japanese market.

Busy month!

Reasons Why You Should Come to UCSF

Second Look Weekend for the incoming first-year class at UCSF occurred last weekend, but it doesn't mean that I shouldn't launch my own private blog campaign to bring would-be premedical students to our hallowed institution. Look out for more reasons to come in the near future...I will list the reasons numerically as they occur to me.

Reason #1: UCSF is a vibrant institution; you will never be bored. When I was checking my email over spring break, my mother glanced at the unread messages in my inbox and gasped...she asked me if I always had 20 new emails advertising different charity events, seminars, organizational meetings, social events, free food events, bake sales, journal clubs, protest rallys, tutoring sessions...you get the picture. Having grown accustomed to cleaning out my inbox every afternoon as a matter of survival (to avoid being crushed and suffocated by a swollen electronic inbox), I never realized how privileged UCSF students are to be able to have SO MANY activities and events available each and every day. Although I try to take advantage of everything offered, it's impossible to participate in everything that interests me!

Here is a recent email to give you an idea of what happens at UCSF every week:

May 15, Noon - 1pm N225 (Parnassus) How to Start And Manage a PracticeYou’re preparing to be a brilliant practitioner, but will you be ready to be a brilliant business owner? Get the jump on what it takes to successfully start and manage a health care practice. The issues, the concepts, the language are all novel for UCSF students but will be increasingly important to understand as you contemplate your future professional options. This session offers a basic overview of financing, staffing and managing a healthcare practice. Presenter: Kevin Mc Namara, Student Loan XPRESS Cosponsored with Student Financial Services

::Passport to Wellness:: Through May 24. Attend events. Get Stamps. Win Prizes. Be Well http://www.ucsf.edu/passportStudent Activity Center: MU108W, 502.2442, MConway@ucsf.edu_____________________________________________________________________::

PLUS info you need THIS WEEK ::TOPICS FOR NEXT YEAR’S STUDENT ENRICHMENT SERIES: FIVE QUESTION SURVEY, PLEASE!Two minutes, 5 questions and you will send us off in the right planning direction for Tuesdays at noon next academic year. Your opinion is the only one that counts. http://www.surveymonkey.com/s.asp?u=808233821751

WALK THE LABYRINTH: YOUR MOVING MEDITATION EXPERIENCETODAY Wed. May 9, 10am - 3pm, Saunders CourtLabyrinths have been used over centuries as a tool for moving meditation and spiritual practice. They are not connected to any religion and lend themselves to any personal belief system. Use this unique opportunity to fuel your soul and move into relaxation. Sponsored by the UCSF Spiritual Care Program. *Passport to Wellness!

THE HEALTH EFFECTS OF THE IRAQ WAR: UNINTENDED CONSEQUENCES
TODAY Wed. MAY 9, 2-5 PM, in Millberry UnionWe are at UCSF to learn about the alleviation of human suffering. We have been at war for 4 years now, and it is our role to learn about, and to teach about, the suffering involved. What can we do? The symposium will feature invited guests along with speakers from within the UCSF community. Plan to participate in this important, interesting, and exciting event. Arrange your meetings, lectures and classes so that we can join together during the teach-in. We look forward to taking action and learning with you on May 9th!

AFROFUSION RETURNS: A CELEBRATION OF THE AFRICAN DIASPORAFriday evening, May 11, 6:30pm, Millberry GymThe African diaspora is the story of how Africans, though scattered and dispersed, managed to retian their traditions and reform teir identities all over the world. Dance performances, fashion, food and so much more! Free. Black Student Health Alliance

NOTES OF CHANGE BENEFIT CONCERTFri May 11, Milk Lounge, 1840 Haight @ Stanyan, 8-10pm, $5 at the doorSponsored by the Asian Health Caucus to benefit the San Francisco Women’s Shelter

VOCAL CHORDS ANNUAL SPRING CONCERT Friday, May 11th, 7pm-8pm. Location: N-225.Sit back and enjoy a performance by UCSF's A Cappella choir: Vocal Chords Singing jazz, doo-wop, modern rock, ballads, and everyone's favorite old-school songs. FUN, LIVE, and FREE entertainment! Open to everyone. Free Refreshments. Vocal Chords is comprised of UCSF students, post-docs, residents, and staff. Passport to Wellness stamp!Contact: Lillian.Hsieh@ucsf.edu

KaBooM FIREWORKS FROM MISSION BAY GARAGE TOP: GET A PASSPORT STAMP!Sat May 12, at dusk, Meet on the roof of the Bakar Fitness Center parking structure KaBoom is an all day event sponsored by KFOG that features an expanded fireworks display synchronized to a World Class Rock soundtrack and the exciting, fun atmosphere that Fogheads make happen every year. For great viewing and destressor, gather at the top of Bakar Fitness Center and get a Passport stamp from Suya Colorado-Caldwell. Look for the woman with the silver jeep serving chocolate chip cookies. She’ll be looking for you.

UCSF DEPT OF DERMATOLOGY: FREE SKIN CANCER SCREENING May 12 Sat May 12, 9am to 4pm, 3rd floor Med Center Mt. Zion, 1701 Divisadero
Worried about a change in your skin? A sister’s mole? Your dad’s sun damage? May is designated as Melanoma/Skin Cancer Detection and Prevention Month® One in five Americans will develop skin cancer during their lifetimes, but through early detection, it can be highlycurable. UCSF and community dermatologists will participate in the screening and will provide informational material on self-examination for skin cancer. open to anyone, free, and no appointment. For more information about the screening, please call 415/353-7800.

FRIDAY NIGHTS AT THE DE YOUNG MUSEUM ARE BACK!
5:00 PM - 8:45 PM, DeYoung Museum in Golden Gate Park, Wilsey Court and Kimball Education GalleryFriday Nights are back! The popular series returns, offering live music, poetry, films, dance, tours, lectures, cocktails, food, artist demonstrations, and interactive art projects. Enjoy a variety of musical performances; performance art; artwear demonstrations; art works made from recycled clothing; student designers and more for free. The galleries are $10. The calendar: http://www.thinker.org/deyoung/

PASSPORT TO WELLNESS: 16 DAYS TO GET 6 STAMPS
Check out the Passport website http://www.ucsf.edu/passport for all 14 events between now and May 24 where you can relax, get a stamp and be well! There are endless visits to the gym possible. Get your name into the raffle hat by getting 6 stamps before the 24th. Be Well!It is all free and brought to you by your campus wide student services.

OUTDOOR PROGRAMS ARE PASSPORT PROGRAMS!:
Introduction to Rock Climbing:Sa 5/12, Sa 5/19, each class is $55 and is 9am – 12pmThis three-hour entry-level climbing class is designed to get you up and climbing on the new outdoor wall at Bakar Fitness Center at Mission Bay. You’ll learn and practice basic climbing skills, proper use of equipment, and belay techniques. Successful completion of this course will qualify beginners to take the skills test and safety orientation at no additional charge.

WOMEN'S HEALTH RESOURCE FAIR
Monday, May 14th, 11:30-1:30 pm, City Lights/Golden Gate Rooms, Millberry Conference CenterGet informed, check out your own health status, take care of yourself all free. Check your bone health: get a free bone density screening. brought to you by the Women's Health Organization at UCSF. A Passport to Wellness program.

NUTRITION TO STAY HEALTHY: DO I NEED VITAMINS?
Tues. May 15, 5-6pm, SHS Parnassus clinic, MU-H005A small group workshop emphasizing the latest research on foods and vitamins to fight stress and disease, be energetic, stay healthy and maintain your weight. Refreshments. Sign up: shs@ucsf.eduOr in person at the SHS clinic. A Passport to Wellness program!

ASIAN PACIFIC AMERICAN CELEBRATION WEEK
MONDAY, MAY 14, 12noon, HSW 303, Parnassus Keynote Speaker, Preston Ni. on Communication and Culture at UCSF
TUESDAY, MAY 15, 6pm, Mission Bay Apartments Community Room
CHPSA's Dumpling and Tea Night
WEDNESDAY, MAY 16, 12noon, UCSF Library Lange Reading Room
The Music in the Library featuring Benjamin Sun, a Passport to Wellness Program
WEDNESDAY, MAY 16, 12noon, Genentech Hall, Cafe 24, Mission Bay Steve Espaniola, Hawaiian slack key guitarist
THURSDAY, MAY 17, 12noon, The View, Laurel HeightsSteve Espaniola, Hawaiian slack key guitaristTHURSDAY, MAY 17, 6pm Genentech Hall, Mission Bay"China Blue" screening FRIDAY, MAY 18TH, 12noon, Millberry Union Gym
Filipino Cultural Show:: PLUS info you need

UPCOMING & ONGOING ::
CALL TO ACTION: DON’T LET SACRAMENTO GAMBLE YOUR FUTURE AWAYUrge Your legislators to Make a Safe Bet for Higher Education during the UCSA Week of Action May 7th - 11th @ www.ucsa.org UCSA is calling on ALL students and families to fax a letter and make a call May 7th - May 11th urging Sacramento to BUYOUT the UC Fee Increase and RESTORE Academic Preparation Program funding to $33 for info: http://votervoice.net/target.aspx?id=ucsa:15185334

CHECK OUT THIS FREEBIE TO BEAT ALL FREEBIES If you have a Bank of America card, many SF museums are FREE for you and a friend in May. Really. No more excuses. http://www.bankofamericapromotions.com/museums/

MUSIC IN THE LIBRARY: BENJAMIN SUN MASTER OF THE ERHU
Wed May 16, noon – 1pm, Lange Reading Rm, UCSF Library
The Erhu is a traditional Chinese two-stringed musical instrument that became popular during the Song Dynasty. Sun has received many awards for his music and has been honored at command performances in Beijing with the Central Ballet Orchestra of China. Free! A Passport to Wellness program!

UCSF STUDENT ADD-ON: $20/MO FITNESS & RECREATION CENTERS
The Fitness & Recreation Centers at UCSF have adjusted the standard membership monthly rate for any additional adult household members of a UCSF Student. This Standard Membership package is called UCSF Student Add-On. Dues have been discounted to $20.00 per month. Any UCSF Student Add-On who enrolled on or after July 1, 2006 is eligible for a credit to the UCSF Student’s membership account. Eligible UCSF Students and their Add-Ons, contact Member Services for more info: Millberry 415.476.0348; Bakar 415.476.5646

EARTH FEST
Thurs. May 17, 11 – 3pm MU GymOver 50 information and product tables, Free raffle tickets for eco-gifts and more. Shop, samples, learn green choices. Very popular last year so come early. A Passport to Wellness program.

BIKE TO WORK DAY
Thurs. May 17, all morning at key routes into campusGet a Passport to Wellness stamp for riding and leaving the other options at home!

THE COST OF A TICKET: CHECK OUT THE RANGE OF OPTIONS!Have some time on your hands? Here are some good options for high- and low-end entertainment. There are some freebies, too. http://www.sfgate.com/datebook/ticketcost/

SF ZOO PASSESThe passes are available for 24 hr. check out at the Student Activity Center, Millberry Union 108W. Must have your student ID to check out the pass. Passport to Wellness stamp when you check out the zoo pass!

EARN A PASSPORT STAMP: CLIMB THE STAiRS OR HILL FROM IRVING TO PARNASSUSCome in our of breath but thrilled with your success to the SAC, MU108W, and get a Passport to Wellness Stamp! Get six and enter the raffle. http://www.ucsf.edu/passport We are open 7:30 am to 5:00pm M-F.

9TH ANNUAL INTEGRATIVE MEDICINE FORUM: COMMUNICATING ACROSS CULTURES OF HEALING May 18 & 19, Parnassus Campus Pre-Registration: Student :$20, ($30 day of) Includes dinner, breakfast, lunch. Keynote topics include: “The Art & Science of Mind/Body Medicine”, "Indigenous Diets from Around the World: Ancient Cures for Modern Plagues", “Guiding People for Self-Healing Across Cultures: Reducing Dependency” and workshop topics: Herbs & Weight loss, Integrative Medicine and Cancer, Ayurveda, Holistic Healing, Homeopathy, Yoga, Energy Healing, and more! To register and for more info: http://www.ucsf.edu/imn/ A Passport to Wellness program!

WOMEN’S SELF-DEFENSE MAY 19 @ MISSION BAYMay 19, 2:30- 5:30pm, Bakar Fitness & Recreation Center, Studio 1, Activity Code: 2434.45, $55Women, get the essential skills needed to defend yourselves and maintain confidence in any situation. Practice and train in a series of safe, but realistic scenarios and learn how to program your mind and body to respond automatically, day or night. Taught by IMPACT Bay Area , www.impactbayarea.org. 415-514-4545 for questions about registration. A Student Passport to Wellness program!

DISABILITY VIDEO SERIES: ARE THE KIDS ALRIGHT?Wed May 23, 12 – 1pm, S172 (Medical Sci Bldg.)This searing documentary examines the crisis in mental health care for children and adolescents at risk and the catastrophic decline in the availability of appropriate service for young people. Info: alice.wong2@ucsf.edu

SCHOOL OF PHARMACY: 9TH ANNUAL COMMUNITY SERVICE SPRING AUCTIONThurs May 31, 4:30-7:30pm MU Conference CenterSave the Date! This auction serves to benefit pharmacy students’ community service activities. Funds raised through attendants’ bids enable School of Pharmacy service groups to continue to provide health screenings, disease-state management counseling, and informational health fair presentations to Bay Area communities. There will will be a Silent Auction followed by a Live Auction and Raffle. Appetizers and light refreshments will be provided. Check out our website http://www.ucsfspringauction.org/ See you there!

8TH ANNUAL UC SYSTEMWIDE BIOENGINEERING SYMPOSIUMJune 15-17, Mission Bay Campus, call for abstracts and registration now open http://www.bioengineering.ucsf.edu/UCBIOE.vp.htmlKeynote speakers include Tejal Desai, PhD on Micro and Nanofabricated Interfaces for Therapeutic Delivery and Joe DeRisi, PhD on The Virus-Chip: Pathogen Diagnostics and Discovery. All are welcome to this open symposium. Register now for the early bird rate of $75. MARK YOUR SUMMER SUNDAY CALENDAR:

FREE STERN GROVE CONCERTS
Sundays, 2:00 p.m., June 17 - August 19, 2007, Stern Grove - 19th Ave & Sloat BoulevardStern Grove Festival is San Francisco's celebration of community, nature, and the arts. World-class performing arts has attracted hundreds of thousands of visitors every summer in one of the country's most beautiful and unique natural settings. Check out the performers http:// www.SternGrove.org--

Student Activity CenterUniversity of California, San Francisco415-502-2442Maureen.conway@ucsf.eduhttp://student.ucsf.edu/sac/

So Fun It Should Be Illegal

Reflex Hammers from Steeles

Yesterday we learned how some basic neurological physical exam skills, and we finally got to play with NEW TOYS (read: tuning forks, reflex hammer). Imagine eight medical students sitting in a classroom banging away at each other with tuning forks and "queen's square" reflex hammers (which, in one of those cruel mysteries of life...are actually circular rubber disks on a stick) or "tomahawk" reflex hammers.

My favorite neurological maneuver is the good old fashioned patellar reflex. Just bang the tendon below the bony patella and PRESTO! Your leg shoots up like it's been possessed. For some reason, this trick never gets old. In a manifesto on humor, the philosopher Henri Bergson mentioned how one type of humor, exemplified by the Jack-in-the-Box, amuses us as children because it pops out at you unexpectedly. It's paradoxical because you fully expect it, even relish it, but when it actually happens --- you are no less surprised and delighted. Every time I see a leg shooting up in the air due to the patellar reflex, I giggle with the maturity of a toddler playing with a jack-in-the-box toy.

Also, today in small group, we learned about the mental status exam (MSE). One of the criteria is arousal/alertness, another one is speech patterns, thought processes, etc.

At one point, in order to comment on a recent patient presentation, one of my classmates started off the discussion by saying: "She seemed pretty aroused."

You don't have to tell me...I have the maturity of a 5-year-old.

SF Int'l Film Festival 07

"Once" - good film - thanks Kim!

I will try not to get too frou-frou on you, but I like how the center of this picture is empty...

it's just the space between a guy and a girl and somehow it says everything.

Back from Spring Break

Don't worry, I know that you've missed me. ;-)

"We See into the Life of Things"

Studying anatomy has led me to believe more and more that the human body is a reflection of the earth. The three comparisons shown here demonstrate a sample from neuroanatomy and how it reminds me of an equivalent in nature.

Shown above: cross-section of the human spinal cord.

Shown below: black and white image of a sand dollar seashell.

Shown above: cross-section of the brainstem (midbrain).

Shown below: photo of a moth (notice the two spots on both photos).

Shown above: drawing of a neuron with many dendrites.
Shown below: Painting, "The Red Tree," by Piet Mondrian.

Ads Say the Darndest Things

Google ads have always interested me. Especially the ones that pop up in your Gmail windows and on the top of this webpage, because they select ads that target for specific keywords. Since I have been posting about the brain so often, there are "brain"-related advertisements at the top of this page. If you actually start reading them, you might become very amused and confused.

See below for an informal analysis of four Google ads based on three categories:

Relevance of Need - Is there a demand for the product or service?
Literary Value of a Two-Sentence Ad - Is the ad coherent and persuasive?
Website - Does the website address inspire confidence?

All categories will be judged and awarded "brain points" on a 0-5 scale (5 highest).


Brain Cancer Treatment
Leading-Edge Research & Innovation From Cedars-Sinai Medical Center
Cedars-Sinai.edu

Relevant Need: 5 brain points - cancer patients and families need to find treatments for life-threatening diseases.
Literary Value: 5 brain points - "High-impact" words like "leading edge research and innovation" capture your attention.
Website: 5 brain points - Cedars-Sinai...almost as cool as UCSF...

This normal ad has been included as a "control."


Neuroscience Lab Manuals
Sheep Brain Dissection Guides Stereotaxic Surgery Manual
www.ajkirbyco.com

Relevant Need: 1 brain point - Why does the general public need sheep brain dissection guides? What is "stereotaxic" surgery?
Literary Value: 2 brain points - Interesting but totally incoherent words explode like dizzying Pop Rocks on my prefrontal cortex...is this a whole sentence or two nouns pasted together? "Sheep Brain Dissection Guides" and "Stereotaxic Surgery Manual"?
Website: 0 brain points - Exudes "scam"...I mean "spam."


Activate your Brain & IQ
Lab proven to amplify IQ, brain functions & intelligence. It's easy
www.iMusicSeries.com

Relevant Need: 5 brain points - people are always looking for quick and easy ways to get richer, smarter, and thinner...the rationale behind this ad makes sense to me.
Literary Value: 5 brain points - At first, I was confused because the ad didn't specify how it would activate my IQ...but the website address suggests through music? Never mind that -- IT'S EASY!
Website: 4 brain points - iMusic?

Brain Pictures
Browse a huge selection now. Find exactly what you want today.
www.ebay.com

Relevant Need: 1 brain point - This advertisement REALLY confused me. Why do people need brain pictures so badly? WHY do we need to PAY for them? Are people looking for specific brain pictures of OTHER people? Do they have something "exact" in mind?
Literary Value: 0 brain points - Two sentences have left me even more confused. This is an ad for "Brain Pictures," NOT audio CDs or DVDs? But it says, "Browse a huge selection now. Find exactly what you want today." Unless there are hundreds of people out there with a fetish for brain imaging, I'm not sure why the vendors even bothered paying for this advertisement.
Website: 0 brain points - EBAY? Let me get this straight -- EBAY is paying to advertise the large selection of BRAIN PICTURES that people are selling on the website?

Workaholic

You know that your life needs more balance when you get annoyed at the UCSF library for closing at 8 p.m. on Friday and Saturday nights.

The first BMB midterm is on Monday, but I have two side assignments that are due that same day...an interesting assignment for "Synapse" on a recently published study showing no association between induced abortions and breast cancer (super-interesting considering the recent Supreme Court decision and the suggestion that "an abortion procedure could be banned if it posed a risk to a woman's health" NYT 4/24/07) and an extensive literature search on prostate cancer and nutrition. I feel like there's not enough time to do a great job on these fascinating projects!

Dreaming of D.Lo

Dan Lowenstein

It finally happened: I had a dream last night involving our BMB course director, Dr. Dan Lowenstein. With all of this talk about brains and dreaming, I just knew that our brilliant academic leader would somehow find his way into my unconscious. It was a really weird dream, however, in which D. Lo was giving a lecture on the history of literature and he was so unbelievably articulate, insightful, and compelling...the lecture was somehow on the difference between the male and female narrative...or something like that...

I must be a lot smarter when I am asleep.

Crushing the Dreams of Budding Medical Scientists

A few months ago, my classmate Albert received a call from the UCSF MSTP office regarding a young student in middle school who was interested in writing a career report on being a "medical scientist." It was yet another reincarnation of that annoying report in junior high school that forces you to think of a random occupation and to interview a reluctant role model to get the "inside scoop" on being a puppeteer or a test pilot.

Anyway, it was obvious to Albert that the young boy was not particularly interested in being a medical scientist; he was probably encouraged by some well-meaning adults into contacting the MSTP office, which took pity on the boy and forwarded his information to Albert, a nice person. The boy asked Albert a few rote questions that were clearly being cribbed from a piece of paper, such as "What special skills are necessary for your job?" To which Albert responded, "JOB? I don't have a job, I'm a student." The boy asked a few more questions, and Albert later swore to me that for some reason, he received the impression that the boy was Asian. Later on, the boy sent Albert a "thank you" card, but Albert discarded it and forgot the boy's name.

Flash forward a few more months, until a few weeks ago when Albert received a message titled, "JohnnyIsAzn (name changed) has sent you a Hallmark eCard." Of course, Albert thought that it was spam and automatically sent it to the trash box, but since he rarely receives junk mail, he decided to risk the safety and security of his computer by opening the card. A colorful website popped out with the following message:

"Thank you for your time and cooperation during my interview with you, i have learned a lot more than i expected. Due to your knowledge of this career, i have earned a B- on my project."

Several minutes passed before Albert could figure out what this card was referring to, but by then the damage was done.

Our conclusions:
The boy is either...

a) genuinely happy with his project grade, it was well-deserved and an improvement over his previous work. We entertained the remote possibility that he may not be "the sharpest stick in the pile."

b) a junior high school genius with a refined literary wit to rival Jane Austen, whose nuanced expression of sarcasm and irony seeks to rebuke Albert for his lackluster interview.

Whatever the case, this short e-mail message is a masterpiece in its own right. The short, obligatory pleasantries, leading up to the witty and caustic phrase, "DUE TO YOUR KNOWLEDGE OF THIS CAREER," which seems to emphatically place the credit/blame on Albert's shoulders, collides at just the right moment with "earned a B-" The deliberate ambiguity of this boy's gratitude and satisfaction is the greatest punchline to a story that has spanned months.

What also makes me laugh is Albert's exceptional mentoring capabilities and his memory of the whole incident. It's heart-warming to consider that Albert's inspirational interview may have launched the academic career of yet another budding "medical scientist" at UCSF (class of 2034).

A Grape-Sized Tumor Called "Sonoma"

Visited Sonoma Valley last Saturday with Albert and Joyce, his friend from Amherst College. We had a late start, eating lunch at In'n'Out (Joyce has never been to the West Coast), before proceeding to Benziger Winery. Took a $10 tour at Benziger even though it was a rainy day, saw the beautiful vineyard, rolling hills, agrarian hillsides. Proceeded to the presses, wine caves, and the nice tasting room. Overall, we came away with half a case among the three of us (4 muscats, 1 buttery chardonnay, 1 port). The muscat tastes faintly of honey. :-)

Proceeded to Kenwood Winery, free tastings, the wine was okay but the prices were great. I bought a gurwertztraminer ($14) and a sparkling brut ($10) to make bellini or something fun later. Last stop was St. Francis Winery, a tasting menu heavy on the dry whites and reds. The best wine was the cabernet franc varietal, but at $45/bottle, I happily settled for the claret ($22). For dinner, we ate at the Red Grape in downtown Sonoma.

One of the best things about living in San Francisco and attending UCSF is the opportunity to visit Napa and Sonoma Valley. Wine country is good for the soul -- the beautiful landscapes, the peaceful vineyards, the delightful wine, the tasty foods.

It's a great idea that the UCSF MSTP admit weekend in early May will include a sojourn to Sonoma Valley. Sonoma is much less busy, commercial, and expensive than neighboring Napa Valley -- it's an interesting contrast and a fun place to visit if you like nature, plants, wine, fine food, and a dash of pretentiousness. Someday, I will write an essay on why I like wine so much, but for now, I just wanted to tell readers to ignore snooty wine drinkers and things like prices and ratings. The best rule of thumb is: "If the wine tastes good to you, then it's good." As in fine art, taste is always an individual and subjective luxury.

Is It Any Wonder?

Rat cerebellum from Nikon Microscopy U

Although Brain, Mind, and Behavior (BMB) has only started, this course already seems like it will be one of the most incredible courses of my academic career. At UCSF, we tend to study the body as organ systems, and for the longest time, our cadavers in lab seemed to reflect that piecewise academic philosphy. Our cadavers have always had their heads and hands wrapped tightly in white gauze, perhaps to obscure the most poignant and human aspects of the body until we medical students were more accustomed to working with dissection. Similarly, our courses on the heart, lungs, kidneys, and GI system have always shied away from the brain, the nervous system, and anything existing above the neck. Therefore, in my mind, the brain has existed as this black box throughout the first year of medical school, a topic that "we'll learn later in BMB."

BMB has already given me several mind-blowing experiences, but I will focus on two of them and they both occurred in the anatomy lab. The first one occurred when my anatomy group and I were inspecting the gross specimens of the brain, floating in buckets of formaldehyde. One of the brains was cut lengthwise, allowing us to see the cross-section. The cerebrum was interesting, but it was the intricate, leaf-like pattern of the cerebellum that caught my breath. Like parents amazed at how a little baby has dainty, perfectly formed fingers and toes...I was amazed at the precision and detail present on the inside surface of the cerebellum, patterns of loops and ridges that looked like perfectly sculpted branches of ocean coral or vivid fern leaves. Since I could not find a photo of a gross pathology specimen that could convey the beauty of the cerebellum, I had to settle for a fluorescent confocal microscopy image. In neurohistology today, we learned that early scientists called the cerebellum "the tree of life," and this reverence has also captured me in the same way.

The human body reminds me of the earth in many ways. A few months ago when we looked at the spinal cord, we cut a piece out and saw the nerve endings exiting the spine like little white roots (in fact the nerves are called rootlets). The white axons sprouting out of the brown, cakey flesh reminded me of seeing roots coming out of the dirt, and serves to remind me that we all return to the earth eventually.

My second epiphany occurred when I was watching the anatomy video in preparation for the second lab. It was 8 a.m. and I was sitting in my room at my desk wearing scrubs and eating breakfast and watching our professor pointing out different anatomical landmarks on a cadaver on my lap top. When I least expected it, the anatomy professor lifted away the skull cap and revealed a curtain-like dura mater. It was a whitish film. Then, the professor lifted away the dura to show us the BRAIN, and seeing that reddish, pinkish, purplish mass safely ensconced within the skull, finally exposed and radiant in all its brainy glory, made my whole mind stop in wonder for 10 seconds and I exhaled a long, breathy, "Wow." It was a moment of wonder, and I realized again medicine is the right choice for me. When we uncovered the skulls of our own cadaver during anatomy lab later that day, I was prepared to witness the brain's exposure, but it was still exciting to use a "brain knife" (ours looked like an oversized pate knife or butter knife) to cut our cadaver's brain in separate cross-sections. It was the best anatomy lab this year so far.

However, it was also the first lab in which we finally got a good view of the cadaver's face, which was a sobering moment because it makes me realize that every patient whom we interact with is a person with their own thoughts, emotions, and souls. Sometimes it bothers me that we have patient interviews with a "diabetes patient" or "mentally ill patient," because it restricts that person to the one dimension of their disease. Hence my internal battle between utilizing the utmost clinical concentration and the utmost compassion continues on.

Update on this Week

Monday - finished my application for the Dean's Summer Research Fellowship, did laundry.

Tuesday - watched as a classmate interviewed a patient with sarcoidosis in Foundations of Patient Care (FPC). the patient mentioned how she felt very isolated in the patient community by this rare disease, as though she were "in the chicken coop, and in the chicken family, but not exactly like every other chicken."

Wednesday - co-hosted a wednesday night dinner with 2 hosts and 12 guests (paella, banana cream pie from scratch, seared tuna/salmon with reduction sauce, virgin margaritas, apple spice cake from scratch, faux chicken, salad, mushrooms with avocado spread)

Thursday - completed a home visit for FPC with a wonderful elderly lady, took my first kickboxing class with my roommate at the UCSF gym

Studying has not yet begun for me, but Brain, Mind, and Behavior (BMB) started on Monday and it has been an intense ride ALREADY. My study habits are so ingrained in my behavior that I can't even bring myself to begin reading, I've become one of those ne'er-do-well kids in the back of the medical school bus. Actually, I think that I've always been in the back of the school bus.

However, someone joked to me that BMB is obviously coordinated by a group of men, because the competition is heating up. Now we have a daily "Case of the Day" at 8 a.m. sharp in the morning (we're technically not required to begin lecture until 8:10 a.m.) and we get to answer questions and email them to a special yahoo account until the 8 a.m. deadline the next day. Each case has a certain number of points assigned to it, and the student with the most points at the end of the course gets a T-shirt that says, "I am a HUGE NERD among nerds who likes to wake up early." Not really, the T-shirt says, "I won Case of the Day." But it means the same thing.

Another competition starting in BMB is to find typos or content errors in the BMB syllabus and have them posted on the online forum. The winner with the most corrections submitted will get a T-shirt that says, "I have OCD," and a dinner for two at a restaurant. If the class finds over 500 errors in the syllabus, the winner will receive a fancy dinner. If not, then the winner will get a meal at McDonald's, or something to that effect.

Even though I am not working too hard, I am getting anxious about being late in the morning, because D. Lo will stand at the door and give you disappointed/dirty looks and it makes me so scared! I respect D. Lo, and the incredible effort that he and his colleagues put into the course to make it phenomenal, so it's only fair that he ask for the same total dedication and fanaticism among his students. However, another part of me is also skeptical and wary of his mind games and unnecessarily complex competitions designed to whip us into an academic frenzy. That's just the paranoid conspiracy theorist in me.

Overall, however, BMB lectures have been AMAZING. On our first day of class, we witnessed an interview with a stroke patient and how he is physically affected...it was very powerful and moving. We have had TWO anatomy labs in TWO days. On the first day, we looked at brains in buckets. On the second day, we opened up the skull of our cadaver and removed the brain in sections. It was mind-blowing. Today, we had another patient interview with a psychiatric patient to described to us how her life unravelled when she began hearing voices and seeing faces and eyes. She described with perfect detail how this neutral voice would say "No" and hiss when she did something the voice did not approve of, and how it said "beautiful" on the rare occasions when she did something it did approve of. And she believed that her internal turmoil was responsible for external events in the real world, like tornados, and that if she moved the salt and pepper shakers a certain way, it would affect the state of the universe. This incredible insight into the experiences of this patient, who is now fairly recovered and living a normal life, was a precious opportunity. Everything in BMB leaves me speechless and astounded, because the human mind itself is so amazing.

Structured Procrastination

Procrastinator Mousepad

Paraphernalia from Structuredprocrastination.com

Read an entertaining essay on "Stuctured Procrastination" written by John Perry at Stanford. Please refer to the link to see the whole essay, but I will paste the gist of it here:

"This is the essence of what I call structured procrastination, an amazing strategy I have discovered that converts procrastinators into effective human beings, respected and admired for all that they can accomplish and the good use they make of time. All procrastinators put off things they have to do. Structured procrastination is the art of making this bad trait work for you. The key idea is that procrastinating does not mean doing absolutely nothing. Procrastinators seldom do absolutely nothing; they do marginally useful things, like gardening or sharpening pencils or making a diagram of how they will reorganize their files when they get around to it...

The list of tasks one has in mind will be ordered by importance. Tasks that seem most urgent and important are on top. But there are also worthwhile tasks to perform lower down on the list. Doing these tasks becomes a way of not doing the things higher up on the list. With this sort of appropriate task structure, the procrastinator becomes a useful citizen. Indeed, the procrastinator can even acquire, as I have, a reputation for getting a lot done."

Ah-HA. I must revise my earlier self-diagnosis...I am NOT an academic bulimic...I am a STRUCTURED PROCRASTINATOR/ACADEMIC BULIMIC. Because it is true that studying...like closet space...will expand to fill the space allotted to it. And so it is much easier to get things done and out of the way earlier in the academic cycle before school rears its head. Unfortunately for me, the important thing at the top of my list is always "studying."

A Game of Chess

From Winding Roads Visual Art

Dr. Daniel Lowenstein (D.Lo) told our class a story yesterday during our first day of Brain, Mind, and Behavior (BMB):

"Once upon a time, there was once a traveler searching for the meaning of life, and he heard that there was a great Zen master who possessed an especially deep understanding of the essential. So the traveler journeyed up the mountain and stayed at the monastery where the Zen master lived, and spent many years enjoying life there and learning. Many of the people at the monastery had never lived anywhere else, and the traveler was delighted to learn that one of the favorite pasttimes at the monastery was playing chess. Since the traveler himself was quite good at chess, he spent many days playing with the monks.

One day, the traveler finally meets the great Zen master. The Zen master invites the traveler to play a game of chess, but warns the traveler that whomever loses the game will be exiled from the monastery forever. The traveler agrees and the two begin playing. At first, the traveler finds himself with the upper hand, and realizes that he is very close to defeating the Zen master. However, he soon becomes lost in thought, wondering why the Zen master would agree to this game, how much the monastery must mean to him after all these years, and how the Zen master would live in exile. Before the traveler could finish these thoughts, he looked down at the chess board and realized that he was now losing. The traveler refocused his attention to the game and barely brought himself back from the brink of defeat, before those intrusive, worrisome thoughts again clouded his mind and he found himself losing again. However, the traveler was able to turn the tide of the game once again with enough concentration, and this cycle continued for several more hours before the Zen master used his stick to knock the chess board off of the table with a mighty "thwack."

'That,' said the Zen master, 'is the secret to living life with the greatest meaning...by living with both the greatest concentration and the greatest compassion.'"

D. Lo continued by saying that as doctors, we must live life with the greatest concentration and the greatest compassion. The dichotomy between science and the humanities has always fascinated me, because medicine is truly the intersection between science and society.

When people asked me why I wanted to be a doctor (usually during an interview), I said that it was the personal stories of patients that fascinated me and the idea that I could somehow intervene and change that story for the better.

An NG Tube, Fancy Soaps, and a Mash-Up...Not Your Typical Three-Day Weekend

Hydra soap from the SF neighborhood collection: Sunset

Hydra soap from the SF neighborhood collection: Golden Gate

I actually believed that the three-day weekend following the Metabolism and Nutrition final exam was going to be extremely boring. Since Paul and Albert fled to Canada after the exam (I'd like to think that it was caused by something glamorous like tax evasion, a federal offense, but it was really more like food tourism in Paul's hometown), I planned for three days of absolute bliss and nothingness...like those lazy childhood afternoons that were blissfully wasted watching TV in a small windowless room.

God, I was so wrong. But in a good way...

So here is a blow-by-blow recap of an action-packed weekend:

THURSDAY (3 hours of sleep)

8 a.m.-12 p.m. Metabolism and Nutrition Exam

- Visited my PedPAL at the hospital, she is 14 years old, but she weighs only 60 lbs. because her mouth hurts from Graft-versus-Host disease (GVHD) and she has been unable to eat on her own. When I came to visit her today, bringing fresh irises and a teenage magazine called CosmoGirl (which I carefully screened before purchasing), she was sporting a new nasogastric (NG) feeding tube. It made me really sad, and she's getting a more permanent PEG tube in a few days.

- Took a shuttle to Mt. Zion to pick up a letter of support, then decided to walk to Fillmore St. to see the boutiques. The walk was longer than expected, but the weather was nice and it was fun to roam the city. The best new find on Fillmore was a fancy soap shop called "Hydra," which specializes in custom designs and scents. The gimmick that really won me over was their SF Neighborhood Collection, which has soaps named after each SF neighborhood and a corresponding scent (e.g. the Marina soap smells like the ocean, the North Beach soap smells like coffee, the Haight-Ashbury soap smells like incense, there's also soaps for Sunset, Castro, Twin Peaks, Fisherman's Wharf, Mission, SoMa, etc.).

- Came home, napped for 1 hour, before attending a merry medical school class get-together in the evening, went to bed at 1 a.m.

- Did I mention that this is a UCSF sponsored blog?

FRIDAY

- Woke up around 8:20 a.m. to the call of my classmate Craig and Sarah, fellow MedTeach volunteers. We traveled to Alamo Elementary School in the Richmond District (hmm, no Hydra soap for Richmond!) to teach 4th and 5th grade students about the cardiovascular and respiratory system. We brought real pathology specimens and taught them about heart attacks, listening to heart sounds with stethoscopes, looking at red blood cells in microscopes, the dangers of smoking, and how breathing through a hollow licorice tube is analogous to asthma. The lessons were so fun, and the kids were really smart.

Here are some of my favorite quotes:

Me: "What is a heart attack?"

Kid: "When something attacks your heart."

Me: "Almost."

Me: "The heart has a big room where it pumps out blood."

Kid: "You mean the ventricle?"

Me: "Uhhh, yeah."

Me: "Do you know what's inside a cigarette?"

Kid: "Marijuana!"

Me: "No. Where did you hear that?"

So we ended at 3 p.m., and after teaching 16 separate lessons to little groups of eager elementary school children, I decided that being a teacher or pediatrician is too demanding. It's not that I don't like kids, in fact, I LOVE kids, but the amount of patience, dedication, and hard work that goes into raising 33 kids simultaneously is something that gives me the heebie jeebies right now.

After MedTeach, I went home to change and nap for 30 minutes before going to a $20 dinner at Palomino's on the Embarcadero with my roommate and her friends. It was a delicious dinner. Then I went to get gelato at Holy Gelato on 9th and Parnassus with my college roommate, Kim. We met at 9:30 p.m. and decided to head back to my place after a proposed bonfire at Ocean Beach was postponed to a later date. We talked for FIVE straight hours, until 2:30 a.m. about EVERYTHING...I can't even begin to summarize the crazy ideas passing between us. We talked about life after death, the dichotamous nature of the world (why is it always good/evil, man/woman, life/death? Would our conceptual framework be different if there were three sexes necessary for reproduction...say, man, woman, and fox?), Maslow's pyramid of needs and the value of high art. Then we got creeped out by talking about souls and decided to watch the Top 20 VH1 countdown. One thing that was strange was that Kim has been reading the same news articles that I have been reading...the Post article on Josh Bell, the NYT article on perfect high school girls, another article on the Flaw-O-Matic...we didn't share any articles between us, promise.

SATURDAY

I fell asleep around 3:30 a.m. -- Woke up at 3:30 p.m. on Saturday.

Checked my email, ate some lunch.

Fell back asleep from 5-9 p.m.

Attended a mash-up called Bootie SF with some friends from medical school. A few weeks ago in Vegas, a girl accidentally burned my right index finger with her cigarette while clubbing at TAO. It was an accident, but it was bizarre. Saturday night, while dancing at Bootie SF, DJ Axel from LA was throwing copies of his new album into the crowd. I raised my arm to get one, and he threw one at me, but the CD hit me in the face and cut my left cheek. And I STILL didn't get the CD. Yet another entertaining nighttime injury. I'm going to be like one of those biker pirates with a leather eyepatch and a story behind every scar. Chicks dig scars, right?

Fell asleep at 4:30 a.m.

SUNDAY

- Woke up at 11 a.m.

- Visited my PedPAL again and we continued working on our Paint-by-Numbers project of a ballerina painting. We're running out of white pigment, but the painting is turning out nicely.

- Shopped in Union Square with Irene and Elaine.

Wow, so that was my weekend.

Academic Bulimia

Disturbing bulimia photo from lecture

Our final in Metabolism and Nutrition was today; it covered an interesting span of topics ranging from endocrinology, metabolic pathways (glycolysis, TCA, beta oxidation, ketogenesis, LDL, VLDL, etc.), diabetes mellitus, and obesity/weight management issues. Although I complained continually at first that these topics were completely unrelated to each other, there are links between each area (mainly insulin or lack thereof) that actually tie the curriculum together in a rather enlightened manner.

One of our later lectures on the theme of weight management involved discussions on eating disorders like anorexia nervosa and bulimia nervosa. Although nutrition has never interested me (the food pyramid can eat itself), I am fascinated by disorders in which perfectly normal girls (sorry for the sexism) starve themselves to death in a land of plenty.

Although I have never had any eating disorders, the cycle of binging and purging associated with bulimia seemed awfully familiar even as I was cramming that syllabus chapter into the small space between my ears. Periods of intense binging...and then a subsequent purging? Yes, ladies and gentlemen, I realized that I have been a lifelong ACADEMIC bulimic since preschool. Like a circadian rhythm dictated by exam schedules, my life follows a regular cycle of compression (pain, stress, angst) and decompression (happiness, denial, sloth).

Here are some interesting posters on the medical consequences of anorexia and bulimia.