Just a quick jaunt through my thoughts this morning:

Within the world of academic medicine and scientific research, I often find myself surrounded by individuals who have large egos.  They think a lot of themselves, and sometimes not much of anyone else.  And a lot of times, it could be argued, it’s justifiable.  They’ve done great things, and they’re great at what they do.  But just because you can have a big ego doesn’t mean you should.

So I wondered: do these people realize that most of their students and “underlings” only seek their approval to the extent that it serves their own personal interests?  People don’t like the big-headed people because they’re fun to be around; they pretend to like them because they have power to influence their futures.  This is the definition of kissing someone’s ass.  And I wonder if those whose asses are frequently kissed realize that a large proportion of the sucking up isn’t because they are truly that good at what they do, but because they have the power to influence others’ futures.  Seems to me like that could be an important concept to which someone in power should be fully aware: the concept of “yes-men”.





My life of limbo:

I’m a Mormon.  But I’m pretty liberal on most issues.  I don’t have many Mormon friends.  I absolutely don’t fit in with traditional Mormon culture.  But I also don’t fit in well with non-Mormons.  I don’t drink coffee.  I don’t drink alcohol.  I generally don’t fit in with most of my friends in social situations.  Therefore, I live a life in limbo between two worlds, not quite fitting in with either.

I’m an MD/PhD student.  Grad students think I get a “diet” PhD (which is not the case in my program).  Med students think I’m weird for liking basic science and research.  I don’t quite fit in with either group.  Hence, again, I live a life in limbo between two worlds, not quite fitting in with either.

These are only two examples.  Limbo can be a lonely place.  But at least its quiet, sometimes.


Pardon me while I write about something that has nothing to do with MD or PhD life.

I remember when I was small I was taught about Native American culture.  They taught us the differences between their culture and the culture of the White settlers, and how such differences were a source of tension and conflict.  I don’t remember much detail because I was very young.  I do remember, though, that what happened to the Native peoples was taught to us as being truly sad and tragic.  There was the story of the Trail of Tears, ambushes and massacres, and the general view that “Indians” were savage and uncivilized.  They were often seen as animals, and frequently treated worse.  It was obvious that the White settlers of the time were the villains of the story.  White government agents signed treaties and broke them.  Finally, tribes were expelled from their lands and moved onto reservations, many of which remain to this day — a legacy of the White man’s cruelty.

I remember my teachers describing the dichotomy of values toward the land: the settlers sought to own the land, while the Natives sought to be a part of it.  The White man saw the land as property to be claimed, and the Native saw the land as a life-giver to be respected. One felt compelled to dominate and tame the wild places; the other felt compelled to protect and harmonize with the wild places.  One viewed bison as a stupid beast to be killed for sport and wasted; the other viewed bison as a fellow dependent of mother earth to be used with great respect and efficiency.  One thought of bears and wolves as dangerous, scary, and a nuissance; the other saw them as powerful, magnificent, and respected.  One felt his destiny was to rule over the earth and its creatures; the other felt his destiny was to achieve balance and harmony with the earth and its creatures.

Of course, much of what I learned was an oversimplified generalization.  I’m sure that much of the story was romanticized, making White men seem evil and Native Americans seem saintly.  But what strikes me today is how similar we are now to the negative traits (fictitious or not) in those White men of old.  The writing between the lines of what I was taught was, “yes, our ancestors did bad things, but we’re better now”.  I now think of that idea and question it’s veracity.  We still seek to dominate and own the land.  We view animals more as property than as coexistent beings.  We seek to develop the few remaining wild places of the country under the guise of making them more “accessible”, building highways through forests so that semi-trucks can give deer, raccoons, porcupines, and any other animal a traumatic and unnatural death.  (I have hit a deer with my car once before, and nothing about it felt right or good.)  We continue to expand our population, and where there are wild grasses or groves of trees on a bought-and-paid-for patch of land, we often raze it to lay down asphalt or concrete to either park upon or build upon.  Our cities further encroach upon wilderness, and we wonder why there are deer and other animals in our suburbs.  And many still look down upon the Native Americans who live upon the reservations and we judge them for having problems with alcohol, violence, poverty, and education — we think of them as uncivilized.  In fact, we do the same thing about any number of groups of people.

We, as a people, are still much like the White man of those old stories.  We still seek to use the land for our own purposes rather than harmonize with it.  We view the Earth and its life as a resource to be exploited.  We see the Earth much in the same way that we see a convenience store.  It makes me sad that we haven’t learned from the past.  With our words we vilify the White man of the past as being greedy and racist and wholly cruel, but with our actions we continue down the same path that they did.  We justify ourselves by saying that we do it more respectfully, or that we do it with a greater eye for sustainability.  And in some cases that may be true.  We have, in truth, improved upon some things.  But the overarching theme of our culture continues to be one of domination, expansion, and exploitation.

I am, of course, complicit in all of this.  The very fact that I’m posting this on the internet is evidence that I am.   I wish I weren’t.  I should seek better ways to not be so.  But even being complicit in its destruction, there is a part of me that longs to abandon the city and live with nature, harmonize with this planet that provides us all that we need for life.  Inside of me is a little boy that wishes he could hear the wind blow across a quiet mountain meadow instead of the din of the city.  Not just on vacation, but always.  I hate that we have replaced the sound of crickets and natural night with the hum of artificial lights that blot out the stars.  At times I find it odd that we spend so much effort and money grooming and preening and pruning our lawns and rosebushes and flower gardens as if we somehow know how to improve upon nature.  The beauty of plant life isn’t enough, so we have to arrange it in neat little rows and cut every blade of grass so it is the same length.  Keep the hedges trimmed so they’re neatly and symmetrically shaped.  We take the massive and beautiful diversity of nature and strive to homogenize it.  We attempt to tame, to domesticate, and to civilize the wild.

I don’t pretend that this model of society has been wholly unsuccessful.  Our domination of nature has allowed us to do much.  I question, though, whether doing much should really be our goal.  I do lament the arrogance of modern humanity in its continuous pursuit of expansion and domination over mother Earth.  And I admire those whose values foster a respect and coexistence with Earth and nature.  We all depend on the Earth for life, and we share this dependency with every living creature on the planet.  In this way we can think of ourselves as brothers and sisters of the wolves, bears, deer, moose, trees, plants, and so on.  We all arise from, receive sustenance from, and return to the same dust, from the same Earth.  We are all connected.  In this way, I feel that protecting the few remaining wild places on this Earth is more important than just protecting species from extinction.  Finding a deep inner connection with the planet and its life brings greater meaning to being alive.  Nature has become a novelty for so many — a vacation destination akin to Disneyland.  And this makes me sad.  The true beauty of the natural world exists beyond simple aesthetics.  It is much more profoundly meaningful than that.  It touches something deep inside of me in a way that cannot be described with words.

always avoid asinine alliterations

An asinine alliteration?  Yeah, you know.  Those things that the worthy wordsmiths use.  Not that I would know.  Carelessly crafted crap!  C’mon!  Why would we want to read rankling repetitions?  Really!  Insulting, infamous, and incredibly infuriating.  Pedantic playthings for puerile people.  Henchmen of horrible haikus:

a rankling repetition
carelessly crafted


Copyright © 2012.  


The most recent rephrasing of the term “burnout” is “compassion fatigue”.  At least that’s what they’re calling it among medical professionals.  But I don’t think that’s exactly what I’m feeling.  In fact, I’m certain that it’s not, because I haven’t interacted with very many patients yet.  No, I’m just fatigued.  Compassion has nothing to do with it.

I feel like I could, right now, quit school and be adequately satisfied.  I just finished my second year of medical school and now I’m off to PhD-land to work for the next 4 to 5 years. Before starting in the lab, though, I have the USMLE Step 1 exam.  This is likely one of the most important exams of my life and I should be preparing more than I am, but I feel kind of numb to the urgency.  It’s as if I’ve accepted that a small improvement in my test score isn’t worth the quantity and rigor of the effort required.

I’ve kind of checked out.  And my feelings are even further complicated by my final exam scores that I just received today.  I passed, which is all that matters in the end.  But my score was substantially lower than what I had expected.  This is more of an ego bruise than anything.  I felt like I had done reasonably well.  Getting a low score puts questions into my mind about whether I really know what I’m doing.  (But if you ask any seasoned physician they’d say that no second year really knows what she/he is doing yet.  Somehow that’s not comforting.)  It shook my confidence.  But despite the sting, this is probably good for me.  The last thing this world needs is more overconfident medical students.

Back to PhD-land…

I have a meeting this afternoon with my new mentor.  He’s a strong scientist, an MD/PhD grad, and a nice guy.  But I’m nervous that I have little to discuss with him.  I’ve set up email alerts for papers in certain subjects, but so far that’s as far as I’ve gone.  I haven’t really read any of the papers.  I have ideas, but they’re very broad.  None of them are appropriate thesis ideas.

Since I’m just venting, and this is terribly uninteresting to read, I’ll get to some point…

Bottom line:  I’m stuck in a difficult place right now.  The path of my classmates and friends is diverging from my path.  I’m uncomfortable with mediocrity (even when it’s adequate), but I lack the time, energy, and will to achieve anything more than the minimum required right now.  I guess that’s kind of what burnout is.  My passion for this stuff has faded from a bright flame to a tiny glowing ember.  I really need to find some gas to pour on and start up the fire again.  Tricky part is… if I throw too much on too fast it smothers the ember.  What I need is not too much, not too little, but juuuuuust enough.

That’s another phrase I’ve heard thrown around lately: the “Goldilocks effect”.  My, aren’t we clever.  (forgive the sarcasm)

what is a student?

Today I’ve been thinking a lot about this question.  Here are my thoughts:

A student’s job is to learn.  To try.  To make mistakes.  We are going to mess up.  And that’s the point.  A student needs to be given the space to think, to try, and to get it wrong.  That’s how we learn.

However, of course, this isn’t an all-or-nothing game.  Rather, there is a spectrum between perfection and failure on which each student can be found.  Realize, though, that I’m not referring to grading or performance here.  I’m talking about expectations.  How often is the student expected to reach perfection, or near perfection?  How often is the student allowed to miss the mark?

There is a balance to be sought in this.  The student must be permitted to make mistakes, just not excessively.  If the student is given too much latitude, they will miss out on needed correction and learning.  But if the student is given too little freedom, and is too severely corrected for every error, then the only lesson learned is that of fear — the fear of trying.

The student will learn that the best way to avoid failure is to make no attempt in the first place.  To prevent this, the student must be allowed to make an occasional mistake without the fear of failing an entire class, being held back, or expelled from school.  Only an accumulation of mistakes, or the repetition of prior errors, justifies such drastic punishments.

To use a sports analogy, what would baseball be without three strikes?  Who would (or could) play the game if one swing-and-a-miss was all it took to strike out?  And what would the game be like if one strike was sufficient to eject you from the remainder of the game?  That is why the game has three strikes: to accommodate less than perfection.

I feel like I’m rambling, but this is my point: students are students, and we will mess up.  We’re supposed to.  We need to be held accountable for our mistakes, but not to the same degree as the masters.  Because we’re not masters.  Not yet.  And if we’re not provided an environment in which we can safely attempt to become masters, then we might as well not even try.

At least that’s the lesson we’ll learn.

(Maybe another day I’ll rant about my philosophies on what a teacher is.  I’ll give you a clue: it’s not a simple holder or disseminator of information.  That’s a book’s job.)

HPV = human papillomavirus

Today the CDC expanded its recommendation for the HPV vaccine to boys and young men aged 11-21 years.

Here is my position:

  • HPV can cause cancer; HPV does not cause sex to happen. (If it did, it would be marketed very differently.)
  • Cancer can cause death, sex cannot. True, people can get diseases from sex (including HPV), and those diseases can cause death.  But transmission of those diseases can be minimized and prevented… by things like an HPV vaccine.
  • Therefore, If HPV can cause cancer, and if this can be prevented by a vaccine, then those at risk should get the vaccine if they want to avoid getting cancer.  Either that or guarantee that teenagers won’t have sex.  Good luck with that one.
Now, here are some details about HPV, what it is, and what it does.  This way I can count this as studying, kinda.
  • HPV = human papillomavirus
  • HPV refers to a group of over 100 non-enveloped DNA viruses that use skin and mucosal surfaces for replication
  • only some types (16, 18, 31, 33, 35) can cause cancer (i.e., have oncogenic potential)
  • there are two HPV vaccines: Gardasil protects against four types of virus (16, 18, 6, 11).  Cervarix protects against types 16 & 18 only.  16 & 18 cause about 70% of cervical cancers; 6 and 11 cause about 90% of genital warts.
  • more information can be found here:


I have heard that people like cats. Especially online.  There are millions of videos and photos of cats posted all over the interweb.

I can’t say I completely understand.  Nevertheless, this is my small contribution to the online cat conversation.

Truth be told, this is really just an attempt to get more people to look at my blog.

If I write about cats, and how they have soft fur, and how they like to jump and scratch, and how they can be so affectionate, and how they have cute little whiskers, and how they have the most adorable little babies, and how they sometimes bring you dead mice as presents, and how they really like catnip, and how they meow and purr and keep you cozy and warm in the winter while you watch Sleepless in Seattle all alone and snuggle up in a big heavy blanket that your dead grandmother made for you that time you had mumps and had to stay home from school for a whole week……. (big deep breath)… then I’ll be writing about something that people like:  CATS!

When people search for cat photos, they’ll find me. When they look for cute cat videos, they’ll find me.  When they want to find out about little kitty halloween costumes, they’ll find ME.  When they search for ways to give a cat a bath, THEY’LL FIND ME!

Ah, ha ha ha ha!  (villainous laughter… pause…)

At least… that’s one possibility.

I guess my little blog could just get lost in an ocean of internet cat pages, too. We’ll see, I guess.  Should be an experiment worth the 5 minutes it took to write this.

If I don’t see more activity, then I’ll rant about something less ubiquitous and post that.


who fits who?

You should know, this post has nothing to do with Uncle Sam.

Today at school we started a new “block”.  (Our curriculum is split up into segments of 8-9 weeks called blocks.  The last one was “Brain & Behavior, and we just started “Circulation, Respiration, and Regulation”.)  Each block is led by different physicians and scientists who specialize in the subject matter being taught, so inevitably there are changes in how things are taught each time we begin a new block.  The great thing about starting a new block, then, is watching a room of about 100 med students become very uncomfortable with the changes.  There are the vocal complaints and audible groans, then the pointed questions from high-strung “type A” personalities asking things like “Why are you moving away from a Board-prep style of teaching,” and “Why are you making it like that other block from last year that we hated so much?”

This got me to thinking:  Is the medical school supposed to alter their teaching style to fit the students, or should the medical students try to adapt to a changing situation?  Who should fit who?  Should the school bend to the student’s demands, or should the students accept it as a challenge and move forward?

My opinion:  the student should accept the challenge from the teachers.  Classically, that’s what education is.  The student has always been challenged by the teacher.  (That’s Socrates to the right — I admit that I don’t know much about him or his methods.)  Rather than complaining that the new way of doing things somehow makes it harder to succeed, the student should say, “Okay, so you’re making it more difficult — I’m going to do well anyway!”  Instead of taking that anxious energy and whining about the status quo, focus that energy and blow every test out of the water.  Look at it as a chance to prove that you can do well regardless of the circumstances; an opportunity to show your true mettle.  Prove that you are so destined to become a physician that you’re going to learn the stuff no matter what tries to get in your way!

I think of this kind of response as the “high road”.  Take whatever hand your dealt and make the most of it.  Take a less-than-ideal situation and do extraordinary things.  The “low road”, on the other hand, is just complaining about how it’s somebody else’s fault that things are hard for you.  Nobody likes a whiner.  And nobody is impressed by somebody who does well when everything is stacked in their favor.  But when somebody does well when it’s not easy, that’s impressive.

So what kind of “somebody” do you want to be?  Personally, I want to be the doer, not the complainer.