21/01/2011
My love affair
I love science; it describes so elegantly the universe around us. I can see why people see it as lists of dry, arcane facts with no real application; but what science describes, allows not only our life, but our enjoyment of it. Physics describes wave motion through gas, which our brains interpret as music, or words. Light activates chemical groups in your eye that allow you to see the world around you, and through billions of years of evolution, biology describes the process by which the entire world lives. The waste you breathe out is used by plants to grow, and every breath we take in is full of vital oxygen because of plants. Our oceans exist as liquid because water is a bent molecule, allowing ice to float instead of sink; preventing a frozen wasteland from forming. There is so much beauty around us, when you stop to really contemplate what is in and around us, a sense of sublime humility washes over. The components that make you up, allow you to think, and feel, have existed always, have been on this earth for billions of years, and for this blink of an eye, you have the opportunity to utilize a wondrously complex make up of chemicals to experience life. To make it better for those around you, to bring joy and beauty into the world. Before our earth was even a molten lump, a star emitted a photon. Every time you look up into the night sky, streams of those photons end their journey as beauty in our minds.
From a series called Symphony of Science
17/01/2011
Protons and other things I’m working with in physics
Today is one of those red-letter days because it marks a turning point in my grasp on physics and the material we are working with. Last quarter was grueling, and my understand of the material was hard-earned and not as stable as I would have liked. But sliding into this quarter and a huge volume of new material, its astonishing how much translates from classical mechanics into electricity. We haven’t hit magnetism or optics yet, which I’m both excited and nervous about, but so far I’m happy that this quarter is fitting together so well conceptually. I’ll share my epiphany below, if you don’t care about math/physics you can stop reading here, even though you’ll be missing the best part.
I was asked to find the speed of a proton after it passed through an electric field with a potential energy difference of 190Volts.
So dredging up constants & formula I listed out these things that we hold as true.
Mass of a proton: mp = 1.673×10-27kg
Charge of proton: qp = 1.60×1019C
Law of Conservation of Energy
Classical Mechanics: mgh=(1/2)mv2
Electricity: potential energy difference: qV (this is the equivalent to mgh above)
Here’s where the insight happened, and for anyone who has spent time with physics this is probably on par with a toddler figuring out how to open a door, so its good for where I am.
I substituted potential mechanical energy with potential electrical energy, which works because the force of static charge is many powers greater than the force of gravity, but you can still find velocity from kinetic energy. For our purposes V=volts and v=velocity, an unfortunate reality of notation here.
qV = (1/2)mv2 -> v=(2qV/m)(1/2)
Solving for v we find that v=1.9×105m/s
And now you know. Victory.
08/01/2011
’11 – My changes
These aren’t resolutions. I didn’t resolve really to do anything, and the timing is a genuine coincidence. But in the spirit of that, and because I get to write, I’ll convey the changes that this new quarter brings.
Winter Quarter 2011 Changes
-Minimize driving/use public transit: I bus now, I bought a pass, I use it almost any time I am going somewhere downtown and other people aren’t with me. I drive to work still because I need to be able to work over time, and parking is free on the weekends. But generally I minimize my time spent in the car. To supplement my driving, I offer to drive friends if we are both going somewhere to offset the vehicle usage. This is beneficial in personal fiscal terms, as well as trying to lessen my personal consumption of fossil fuels. An added benefit is that I get to see another side of my city because the buses I take go on routes I normally wouldn’t. I feel this is true for almost any new form of transit I’ve tried, be it walking, biking, or busing.
-Dress for the occasion: I love my t-shirts. I have too many of them, and most of them have my favorite cephalopod on them. As a plug, I’ve purchased most of these from either http://shirt.woot.com/ or http://www.teefury.com/. These sites are my guilty pleasures, its pretty unhealthy. That all being said, I did the t-shirt and dirty jeans college experience once, and I’m trying to treat it in a more serious and professional way. College is my job now, its something I love but it is in fact by a very real extension the base of what I hope to make my career. I wouldn’t show up to that job like I did to my freshman English class, which translates into making a more concerted effort to dress professionally on campus too.
-Exercise more; Classic right? But seriously, I had an experience over my holidays that really brought this home to me. I’m 26, and I’m too young to have experiences like that, so I’m in two PE classes, and I’m trying to hit the gym four days a week as well. Go cardio.
-Cut the crap. I love my hobbies and spending my free time enjoying myself, but I’m trying to pick between things that I enjoy AND are useful or personally enriching, and dropping things that fall into the pure hedonism category. I’ll still buy my octopus t-shirts, and read bad fantasy, but the less productive and obscenely time intensive things have got to go.
-Play the piano more. This one will be hard on a purely time basis, but I really want to try to fit it in soon. Wish me luck.
-Learn a language. See the above, though I’m having more luck with this one than the piano.
-Build the extracurriculars. I have a shadow experience lined up with a doc, and I’m working on more volunteer time. This again, comes back to time. Sleep may have to move over for some of these.
-Caffeine. On the sleep note, I’m dropping my caffeine intake significantly. This also falls near the health note. I know that the virtues of coffee have been paraded around, and I’m sure they’re legit, but taking in three to four 16oz cups a day isn’t necessary. I’m down to three cups a week or the equivalent and I’m doing fine. I haven’t even noticed a lag in my energy and I’m working harder than I was last quarter.
So there you have it.
31/12/2010
Fire
I spoke with someone this week about education, and career. For anyone who doesn’t know me, this is a very frequent point of conversation for me, so it normally wouldn’t be of note except that its tenor was contrasted so profoundly the following day.
To give a short background, I currently work at a local area university hospital as a registered nurse, and have been nursing for near four years now. I’ve logged near 7,000 hours across areas such as emergency, orthopedic, oncology, bone marrow transplant, cardiac, neurology, abdominal transplant, plastic surgery, general medicine, pulmonary medicine, renal, liver & GI. I’m by no means a seasoned veteran, but I’ve been exposed to a fairly broad range of conditions and procedures and am well past what is considered “new” in the field. I’m finishing year two of three of premed and will hopefully be entering medical school in 2013, though with some serious sweat I may be able to wrangle it to 2012. My stance is that this is a goal that I’m unwilling to budge on, and I’ll give up anything short of my ethics to get to where I want to be. Spend five minutes talking with me about it and you’ll see my fire, even if you don’t understand it. I don’t either, it just is. As a side note, nursing is not the way to go as a starter for medicine. I have no doubt that my experience will help shape who I will be as a physician, but I didn’t intend on this path when I took it. Nursing doesn’t need people who don’t want to be nurses, and nurses are by no means little doctors. They are their own body of highly qualified and trained professionals. If you want to go into medicine, go, but don’t use nursing as a stepping stool, you won’t be doing anyone any favors, including yourself.
The individual I spoke with expressed an interest in medicine and we talked about what they had done to take steps toward that goal. I’ll break down the general path so that people can get a quick view of what this would entail in general terms for your average under grad student.
Medical schools want the following items off a checklist:
Any baccalaureate degree (4 year) from an accredited school
Premed coursework typically includes
1 year of biology
1 year of physics
1 year of general chemistry
1 year of organic chemistry
Things that are good to have include volunteer time that demonstrates engagement and commitment, so longer is better here, not variety. Time spent shadowing a physician, and a letter from that physician. Research is a huge plus and required in some areas.
To be fair its daunting when it’s all piled up in front of you. But these are items on a check list, and we have nothing but time given us. But these checklist items weren’t the real issue, in my estimation. I had no doubt they could be taken care of quite handily by this individual. The missing component right off the bat was the fire to do it. The passion, drive, ambition, the indescribable feeling that compels you to work at something despite the odds. Having watched many people work toward it, and many walk away, it isn’t for everyone. That’s fine, it isn’t for everyone, and it isn’t a measure of someones worth by any means.
When asked why medicine was the career they wanted to pursue the answer given was noncommittal and unconvincing. Fortunately I’m not an admissions committee, and to be fair when I started this my answer would have sounded a lot like that. If you read on school websites you’ll notice a consistent theme. Aside from scholastically sound and ethical individuals they want leaders. They want people who are self motivated, who can pick themselves up by their bootstraps and keep going, because patients don’t deserve fragile clinicians directing their care. They also want people with emotional maturity to take criticism, to grow, and to recognize that healthcare is driven by teams, not individuals. Medicine isn’t about the doctors, it’s about the patients.
I’m sure that given the time and thought applied they will figure out why medicine is or isn’t for them, for their sake I hope so.
The contrast came the next day. I met a colleague of mine from the university I attend to recount the year and update each other on life. When two people hungering for knowledge meet they know it. It’s an energy you can’t miss. It was of a quality I haven’t found in a long time, and was easily the finest way I can think of to end the year (thanks again). I find it in people from time to time, and the last was from a professor I shared a drink with on campus.
Their energy & passion are palpable. The “why” has been answered and burns inside them. Whatever it takes. It helps they have a realistic grasp and clear direction, but the key is there. There isn’t a question in my mind they will succeed utterly, because each fall is learned from, each lesson marked and synthesized, and each success cherished.
I’ve walked away from things in my life that I will probably always receive some measure of criticism for, but its a price only I know and that I’ve judged fair. People don’t want their loved ones cared for by those who are semi committed. Clinicians who know what their doing fairly well, they want the best. If giving up parts of my life means that I can return a thousand people home to dinner safely, I’m happy to. Our reasons for entering medicine are entirely unique to us, our sacrifices only measured inside our own life stories, and our drive only truly known to ourselves.
As I’ve said, none of this is intended to make an estimation of the worth of a person. Really the message can be applied to anything. To get where you want to go intentionally, requires commitment and foresight. You should know before you step over the edge what you’re willing to give up, and what you aren’t, and why.
One of the key revelations I had, was that success in any area is marked by long lonely hours of work, and short moments of social or professional praise and reward. In many ways learning is its own reward, and that can be gained from the people around you as well as the books in front of you. But for every public success you see, the work that went into it can never be fully appreciated by those who haven’t been there.
Reveal
The last month has been unlike any other I’ve lived through. Most of it was fairly mundane, but punctuated by pockets of worry or discomfort. I knew as each moment hit that the pain was passing, and that one foot in front of the other was the best way to pass through. Not sage wisdom, ants know that standing still isn’t the solution to moving from under the magnifying glass.
Then on Thanksgiving Day a call came in that someone very dear to me, Sharron Francisco, was in the hospital, and over the next month a weekly call came that she was back in. She passed December 22 at 1615 surrounded by those who loved her, the closing of a beautiful life. I’ve never sobbed so uncontrollably; or more deservedly. Aside from the unconditional love she radiated to those around her, the greatest gift she gave was demonstrating that against any odds, life is to be lived. At her memorial each picture that came across the screen showed someone who was in love with life itself, and that energy spread to everyone around her. To her life is a gift to be treasured and used, not buried and forgotten about.
Everyone who comes through our life touches us in some way, bumps and nudges our course in varying degrees. Who we are can largely be gleaned from a third-party by the people we surround ourselves with, and anyone she crossed paths with could be judged better for it. At birth reality places a contract, that we achieve life in exchange for death. That someday what we are must give way for something else. I can’t speak for her, but the price we paid in her passing was well worth the benefit gained by knowing her.
The pain of the month is lasting, just as the loss is. However the joy she brought to my life is without question a trade I would make ten thousand fold. Thank you Sharron.
31/07/2010
Then they’ll tell two friends
When you want to pass along a particularly juicy blog post you typically email it or post it to your favorite social networking site for connected public consumption, that way the love can be maximized. When you want to share a juicy new disease with your friends, it works best to play the role of a the vector and place the contagion in the most public place. To truly take spread the good word though, finding groups with few breaks in the chain will get the job done the fastest.
One doctor Offit, a professor of pediatrics at the University of Pennsylvania School of Medicine & the chief of infectious disease at The Children’s Hospital of Pennsylvania, posits that it is not only a wise choice for parents to vaccinate themselves & their children for their own good, but also for the wellbeing of the people they come in contact with. He certainly isn’t the first to make the argument for the strength of herd immunity, but it doesn’t hurt to hear it again.
Opponents of vaccines invariably cite the ill effects of vaccines like autism; but time and again it is dis-proven. Other’s will bring up Guillain-Barré syndrome (GBS) , and while it is possible that vaccines cause GBS, you can also get a vaccine AND get GBS, without the vaccine having caused it. The benefit of vaccines has historically been judged to outweigh the risks.
On a fairly basic level of logic, I would urge readers to read the articles referenced in news articles published by mainstream & corporately sponsored/owned sites. The more sensational the story, the more loudly it will be proclaimed, often omitting details that muddy the water. Forming opinions after skimming news headlines is ill advised, especially when those opinions have a very real impact. For more information I would highly recommend the following reading.
I’d welcome responses, as always, and will do my best to reply to them.
I can’t take credit for it; but it must be shared
This post was sent to me, and is an anonymous letter from an physician who performs abortions. It is well written and coherent, and is worth reading as well as passing along.
Thoughts from an Abortion Doctor
I’d like to share some of my thoughts with you regarding abortion. I’m a doctor who does both 1st and 2nd trimester abortions.
Although most of my practice is general OB/GYN, I’m something of an abortion “specialist” because most folks in my profession don’t want to be involved in abortions. I work for a large group where abortions are sent to those of us who will do them, so I perform literally hundreds of abortions a year.
First of all, I and most of my abortionist colleagues are women. Most of us are Jews, atheists, and other non-Christians. Almost all of us are mothers. I continued to perform abortions late into my own pregnancies, and you could literally see the appreciation in the eyes of my patients, knowing that I accepted and supported their reproductive choice.
I rarely tell anyone but my closest friends and family that I do abortions because I don’t want to risk myself or my family. Those crazies out there scare me.
Who Gets Abortions and Why?We all know that anti-abortionists aren’t really “pro-life,” they are “pro-forced birth.” They make huge assumptions about who the women are who actually have abortions. They think that all the women who have abortions are just young flaky women who have no concern for the life of the embryo/fetus they are aborting. They couldn’t be more wrong.
Most of the women seeking early abortion are either very young or in the late part of their reproductive life. The youngsters are often coerced into unwanted pregnancies by their partners, or they didn’t think or know that they could get pregnant. Some of the older women think they couldn’t get pregnant because they were “too old.”
The decision to have an abortion is an agonizing decision, that few women choose lightly. They will be criticized for whatever decision they make. What kind of terrible mother could kill her own child? What kind of terrible mother could give her child away to strangers? What kind of terrible mother would keep a child she can’t afford to care for?
Did you know that half of the abortions done in this country are done because of birth control failure?
The “pro-coerced birthers” think that these are immoral women who should be punished for their (sex) sins with an innocent child. Then they complain about “welfare mothers” who need money to support their children. Those “precious babies” become children who they don’t want to feed. Aren’t Christians supposed to provide charity for those who need it? Worse then that, they don’t want to use federal funds to provide effective contraception or abortions for poor women. They just want to keep punishing women. Of course, if it’s one of their own, she just “made a mistake, she’s really a good girl.” Abortions happen in the fundie community too, don’tcha know.
Did you know that 1/3 of women who have abortions had a partner who sabotaged their birth control method? This is true domestic violence.
Women who have abortions come from all walks of life. This is not a phenomenon of only the inner city. Many are educated, and most of them are just plain middle class people.
The 1st trimester and early 2nd trimester abortions are most frequently done as elective abortions for unwanted pregnancies. I don’t like to do elective terminations after 22 weeks because of the viability issue. Late 2nd trimester pregnancies are very different.
Virtually all of the late 2nd trimester abortions I do are for fetal anomalies, fetal deaths, and for maternal health reasons. These poor souls really wanted their babies. They are in deep mourning because of the loss of their children. They come in deep grief, many times feeling guilty because they are “killing” their loved and wanted children. They worry if the baby will feel the abortion, and they don’t want their child to suffer.
Performing AbortionsMany folks wonder what it’s like to perform abortions. First trimester abortions (dilation and curettage, D&C) are very unremarkable. Our patients are awake but sedated. The procedure is performed with a suction curette (hard plastic tube), and in the hands of an experienced abortionist, suctioning out the pregnancy lasts less than a minute. The “products of conception” come out as just a mass of undefined tissue about the size of a golf ball. No thunder and lightning. Most patients have worked themselves up to have it be a long, grueling process, but are shocked at how short the procedure is.
2nd trimester abortions are very different. The later procedure is much more difficult and riskier for the mom, hence the limited number of us who actually do them. They are also unpleasant, because the procedure (dilation and evacuation, D&E) involves pulling out the baby in pieces. That all being said, the procedure (in the hands of an expert) is much safer than inducing the delivery, and has a much lower complication rate that the induction does. Many of these poor parents don’t want to be awake for the birth of the child they are going to lose, and just prefer to lose the child under general anesthesia.
I’ve never done the famous “D&X” (dilation and extraction, “partial birth abortion”) procedure. This was the one that was outlawed because opponents thought it was too horrible of a procedure. The concept was to try to deliver the baby intact, but the brain matter was suctioned out to allow the delivery of the head through the cervix. This procedure was designed so that the parents of the child could hold an intact baby, back of the head covered up, after a surgical abortion. Not because we horrible abortionists love to torture babies and then kill them.
Why Do I Perform Abortions?
I would be the happiest person in the world to never do another abortion again. So why do I do them? Because pregnant women with unwanted pregnancies are willing to risk just about anything, including almost killing themselves, in order to try to end unwanted pregnancies.
I remember reading some statistics comparing abortions in the U.S. and Mexico, before they were legal there. About the same number of abortions were done in each country, just over 1 million abortions a year. In the U.S. about 10 women died as a result of legal abortion. In Mexico, about 10,000 women per year died as a result of illegal abortions. 10,000 women who were mothers, sisters, daughters, wives. Not pre-viable fetuses.
There’s excellent evidence that in countries where women control their reproduction, the families are more prosperous. Funny that, women knowing when it’s a good or a bad time to add a child to their family.
You would never pick out an abortionist in the crowd. We would probably be the last people you would figure. We are the kindest, most compassionate people you would wish to meet. We are, however, very passionate about protecting the lives and reproductive rights of our patients.
Last time I checked, abortion was legal in this country. But I can tell you that the people who oppose abortion have no feelings of any kind for the poor women who have to make the terrible decision to end a pregnancy for whatever reason. They want to end abortion because they love those theoretical innocent children.
Oh, yeah, forgot that we are all born sinners. Maybe they aren’t such great babies after all.
18/07/2010
Integration
This blog will be integrated into a larger primary site; in that spirit, the one post of any substance from another blog I have will be moved here to its new home. Stay tuned for more updates!
This site will be an ongoing project. Each week I’ll feature one or two specific pieces of anatomy and try to give a summary of its placement and function, as well as a short history of its name & other esoterica. If you like a post let me know, I’d like to make this as interesting as possible for everyone involved.
The first post will be on a piece of western medicines history, namely its iconography. It’s common to see a serpent and staff emblazoned on uniforms, facilities, and equipment. This well known icon, immediately identifies the bearer as a person or place of healing.
A less well known detail is that the two commonly used symbols have very different and conflicting histories. The two symbols are truly seperate and polar entities, but they are often interchanged synonymously.
The Staff of Asclepius is one variation of the classic medical symbol. It is a depiction of the staff held by the greek god of medicine, Asclepius. He was the son of Apollo &Coronis, and was trained in the healing arts by Chiron, a centuar of uncommon intelllect & thoughtfulness. So great was Asclepius healing that it was even said he could raise the dead. A mortal with this capability greatly upset 
Zeus, who saw the physicians actions as breaking the natural order of things. Zeus killed Asclepius, but after seeing how much his healing had aided mankind, turned him into a god, and placed him in the constellation Ophiuchus.
The actual meaning of the snake around the staff isn’t actually recorded anywhere, but it is speculated to likely mean one of two things. In the asklepieion hospitals, non venomous snakes were left on the floors at night. The shedding of their skin was supposed to symbolize the renewal of the body, and its healing power. Alternatively, and not exclusively, the venom that many snakes possessed could be used as a healing agent, as well as a poison to cause harm, much like modern day prescriptions. This actually aligns closely with a passage in a modern version of the Hippocratic oath.
“I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.“
As a side note, Asclepius fathered five daughters, Aceso, Iaso, Panacea, Aglaea and Hygieia. This is where we pull our english words panacea, a curative or universal cure, as well as hygiene, though its real intent is to mean health.
The Caduceus of Hermes is often seen used in the same way that the staff of Asclepius is. Hermes was the result of the union between Zeus and the nymph Maia, and was the herald of the gods. In his own right, he was the god of shepherds, land travel, merchants, weights and measures, oratory, literature, athletics and thieves. He was well known for his cunning and shrewd nature, making him an apt deity for thieves and merchants.
So where is the link to medicine? Alchemists were the chemists of the day. The ultimate accomplishment of an alchemist was to find the philosophers stone, a recipe that could grant immortality, cure any illness, and turn any base metal into gold. Hermetic practices such as magic, alchemy, and occultism have all used some form of this symbol, and laid claims of patronage to this god, or a similar one.
In the above image, Asclepius, along with three of his daughters, are being approached by a groveling Hermes & one of his merchants.
02/06/2010
Unsettled
I’m not one for throwing my dreams out to others, since by and large they aren’t anything worth sharing. A few weeks ago though I had one that I haven’t been able to shake, and I’m hoping that maybe committing it to paper will let me stop thinking about it. Its significantly more macabre than anything I usually write about, so if you aren’t in the mood you may want to check back later when I put something more light hearted up.
As dreams go, it didn’t start out as anything remarkable. I was in a room with a small gathering of friends; I remember it being a fairly public place too, probably a small cafe of some kind. We were the only people in it, and my friends were in a semi circle around me. The stress was thick, and there was lots of hushed, and strained conversation going on. Suddenly a door burst open and a man walked in, think Rocco from The Boondock Saints, and started yelling. My back was to him and he made it clear I was going to stay beside him. Why had we not done what he asked? He had made it clear what he wanted. Then he pulled out his gun and pointed it down on my head and kept yelling, the barrel of the gun was cold and pushed painfully down into my scalp. My friends were panicked and yelling, he yelled back at them that it wasn’t enough. In a moment of panick I tried to jump out from beneath the barrel. Everything suddenly went quiet, and the dive to the side I had begun continued in a free fall, unable to control how I landed. People were screaming, at least their faces were painted in looks of horror, but I couldn’t hear the sounds I knew they should be making. I hit the ground with a painful, stunned thud, knocking the wind from me. Silence reigned, and I could feel something warm and wet pooling around my cheek, blood running out in front of me. Then I woke up.
I was totally unnerved; and from time to time I find myself sitting with the same cold fear I felt in my dream. I know it can’t compare to anyone who has actually been in a life and death situation, but the primal fear it evoked in me was terrible.
