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Monthly Archive for August, 2006

the dreaded phd qualifying exam*

I’ve put it off way longer than I should have. And it’s not my fault. Well, not 100% my fault. When I first started grad school still high from that adrenaline that pumps non-stop during those hectic first two years of med school, I wanted to take my quals as soon as possible so that I could finish my PhD as soon as possible. Then in stepped my major professor, who told me that I’d be committing suicide by doing so and that I should take the quals at the last possible minute to ensure that I would have enough time to study for it. Adding to his argument was the fact that one of the classes I wanted to take was only offered in alternate years and not that particular year. So I really had no choice but to wait until this fall to take my quals.

So I putted along with my grad school classes (none of which could even come close to matching the difficulty of a single med school class, by the way) and dutifully met with my advisor at the end of the year. I had listed out the courses I still needed to take before being done with the required coursework, including the I-put-off-my-quals-to-wait-for-this-class one. When he saw this course listed, he told me that it had not been offered for awhile and that he didn’t think that it was ever going to be offered again and to confirm with the professor. I emailed the professor and found out that what my advisor had said was true. Which meant that I tacked on a whole entire extra year to my grad school coursework for absolutely nothing! And that I had to find another class out of the extremely pathetic available classes in my graduate group to take in its place. Exercise physiology—whoo-hoo…

I was angry about this issue for awhile. If I hadn’t listed that course in my little-list-of-courses-to-take-before-quals section when I met my advisor, then I wouldn’t have even found out that the class wouldn’t be offered until the quarter I was waiting for came along and I got a rude awakening! And what are advisors for if they can’t even prevent me from making such a fatal-yet-easily-avoidable-had-someone-only-told-me mistake? And why have my graduate group’s class listings not been updated since 1962?! I slowly got over my anger as I accepted that there was nothing I could do about it at that point and because I thought that I would be able to speed along my research because of my very light courseload. Well, I got nowhere with my research and am still nowhere one year later thanks to my good for nothing lazy major professor.

And I never got around to taking my quals when I said I would either. First, I told myself spring quarter (i.e., three months ago). Then I said September. But I didn’t schedule that either and I can’t imagine how I would have studied had I scheduled it with those pesky freeloading kids around. So today, I finally managed to pull myself out of that rut, and drumroll please, emailed all the members of my qualifying exam committee to see if they’re available in December (which is the latest I can take the exam before someone notices that I haven’t taken it yet). Just the act of contacting them makes me want to faint. I purposely contacted them today so that I’ll have all weekend to recover from emailing them and to prepare myself for their responses.

But I’m angry again. At myself because I failed to schedule and take the exam sooner. For being lazy and all sand-people-like. And at my major professor and my graduate group because they did not guide me and push me in the right direction. I was all gunner-like when I started grad school and now I just want to be done and almost even regret doing it. And all because I’ve felt that all I’ve done these last two years is flounder without any guidance whatsoever. Abandoned is the word for it, I believe.

But all I can do now is look forward. There’s no point in regretting what I did or didn’t do or the fact that I’ve become such a lazy bum. So I will pause my whining for now. Look for it to continue when I receive those email responses on Monday.

*For those of you who are not familiar, the qualifying exam (also known as the PhD oral) is the big scary test a grad student takes after completing all required coursework that determines whether said grad student will advance to candidacy (be allowed to finish their PhD) or be sent home with a “thanks for trying” sticker. I imagine it to be an interrogation, super nerdy scientific style—five faculty members grilling one poor grad student about random esoteric things just because they can and because they like seeing grad students squirm.

inspirational music for the medical student 1.5

Gaaaaaaaaaaah!!! I hate my website hosting place! My site keeps going down at the most inopportune times, like right when I’m pressing the “publish” button on my inspirational music post last night!!! And it stayed down, so my apologies for not having a post yesterday. Here it is now.

It’s time for another edition of inspirational music for the med student. My song of choice for today is: All American Rejects – Dirty Little Secret. Why you ask? Because we all have dirty little secrets that we hide from each other, patients, professors, and admissions committees! These secrets can be as harmless as the fact that we’re obsessed with Pokemon, as annoying as the fact that we’re closet gunners, or they can be downright ethically wrong such as cheating on exams (sorry, I know we all want to think that doctors are morally superior people, but the reality is that not all of them are). So here’s to dirty little secrets and the med students who have them!

By the way, the album that this song comes from is quite awesome too, much better than their previous album.

As always, feel free to submit song suggestions through the contact form.

no parking!

My neighbor across the street from me has a problem. Their entire family is so sedentary that they call walking across the street exercise. That’s the only explanation I can think of for why they insist on always parking their ugly SUVs in front of my house even though there are spaces aplenty (and by aplenty, I mean that there is not a single car on their side of the street) in front of their own. Bad enough when it was a Nissan Pathfinder. But now it’s a flaming red Hummer. Which they bought right when gas prices began soaring. Are they trying to show off that they are rich and can afford it? Or that they don’t give a crap about the oil crisis and want to spend more than their fair share of our precious limited resources? All that I know is that I simply cannot stand it when they park their gas guzzler in front of my house. You can’t even see my house past that monstrous thing! And I’m green, darnit—I don’t want anybody thinking that I drive such a thing. I’d seriously buy a Prius if I could afford it and if it were really worth it in the end. My husband and I carpool to work/lab even though doing so means I’m stuck in the lab (from hell) at least an hour longer than I have to be. I like to think that I’m at least trying to do my part.

My distaste for SUVs goes way back to before such a monstrous thing as this Hummer was introduced—they’re huge, they drink gas, most people who have them don’t really need them (and the bigger they are, the more obvious it is that the owner is trying to make up for something he’s lacking, if you know what I mean), they’re unsafe, and I simply can’t see past them when I’m stuck behind them on the freeway. So you can imagine my ire when I ended up with neighbors with SUVs who simply cannot park their cars in front of their own house. The next time I buy a house, I’m definitely going to stake it out at night to see who and what parks in front of it because this problem is seriously driving me up the I’m-so-tempted-to-key-their-flaming-red-Hummer wall.

Apparently, there was a movement against SUVs in Brooklyn back in 2001 in which people posted “No SUV parking” signs on streets and issued prank tickets to SUVs that they found parking on the street. The tickets had such things as increasing US reliance on foreign oil, compensating for lack of manhood, and holing self up in two-ton metal fortress as violations. They’re quite amusing. I wish I could put a copy of such a ticket on the flaming red Hummer parked in front of my house, but these people aren’t exactly decent and I’m afraid of retribution. Here’s the link to it in case anyone reading this has more guts than I do. All I can do is sit here and stew over it and maybe stare daggers at them every time I see them.

my first letter of recommendation

Ah. The power. All I could think as I was penning (or more accurately, typing) it was, “Mwahahaha. You’re going to wish you never destroyed my bathroom and acted like a complete ass at the lab that I had to sell my soul to get you into, passive-aggressive cousin-in-law.”

But leave it to my major professor to put a nice kink in my plans to tell the Special High School Science Contest committee members exactly what I thought of this kid. “As much as he was an ass, it just makes you look like an even bigger ass if you tell them that he was an ass,” he said, much to my chagrin. He must have noticed the evil gleam in my eyes when I agreed to write my cousin-in-law’s letter of recommendation for him (because he was too busy surfing ESPN again). Either that or he knew something was up because I would never agree to do such things in the first place.

“So how do I let them know that he thinks he knows everything, doesn’t know his place here, and did a crappy job because he put everything off until the last minute?” I asked, quite put off that I was going to participate in helping the good-for-nothing skate by yet again.

“Well, you can’t put it that way,” my major professor said. “You say things like, ‘Like other high school students, he needed to learn how to budget his time more effectively.’ You have to qualify your statements to lessen the blow and not make it seem like you have a personal vendetta against him.”

“But I do have a personal vendetta against him,” I thought to myself while saying, “Okay” out loud to my major professor.

Then I set to work on this letter of recommendation that had turned into much more of a chore than I had thought when I agreed to do it. But as I wrote the letter, I understood what my major professor meant by beating around the bush. I realized that in my failure to say certain things, such as, “Mr. X was the greatest person to ever come through my lab” would speak for itself and that I did not have to stoop down to the level of saying outright, “He was a passive-aggressive ass” to get my point across. A mediocre letter of recommendation is just as bad as a bad one because these committees are used to seeing glowing (and by glowing, I mean radioactive-I-need-sunglesses glowing) letters. So, even though I didn’t get to write exactly how I feel (think Homer strangling Bart here) about passive-aggressive cousin-in-law in his letter of rec, I still tossed the letter in the mail quite smugly, knowing that he won’t be winning any of these Special High School Science Contests any time soon.

In closing though, before I get carried away patting myself on the back for achieving some level of revenge on the poor kid, here are some tips for getting good letters of rec for those of you who want to learn from my cousin-in-law’s mistake of asking for a letter of rec from someone who was not at all impressed with his performance.

1. Only get letters from people who know you. Like I said above, it’s never good to have a mediocre letter of rec. And that’s what you’ll get if you ask for one from someone who doesn’t know you outside of the classroom. All they can say is, “My class is extremely difficult and Mr. X did well in my class, ranking 2 out of 150 students, which means he will do well in medical school.” Your letter writer needs to know you as more than #2 of 150 and convey that to the person reading the letter or else the person reading your letter will just toss your file into the little round receptable under his desk, otherwise known as the graveyard of broken premedical students’ dreams. Okay, maybe I’m being a little dramatic here.

2. Only get letters from people who know you and like you. Obvious, isn’t it? But you’d be surprised how many people can’t tell when someone doesn’t like them. It’s okay to be oblivious to the invisible daggers people might be throwing at you, but it’s not okay to be so oblivious that you ask one of these people for a letter of recommendation. People who don’t like you aren’t going to suddenly pretend they like you when given the chance to ruin your life. You might as well throw your own file into the little round receptable underneath the admissions committee member’s desk. That way, you’ll save him the trouble of having to do so himself and maybe he’ll give you a chance after all. Or maybe not.

3. Make sure you did well in whatever it was you did with the person you’re getting a letter from. Obviously, a letter that says, “Mr. X was an average student, who was rank 80 of 150 in my class…” isn’t going to work too well. Neither is one that says, “Mr. X burned my lab down.” Pretty self-explanatory, right?

4. Give your letter writer appropriate notice. Nothing pisses off a letter writer more than being bombarded with requests for letters of rec from 1,000 different premeds that all need to be done tomorrow. And you don’t want to piss off your letter writer. For why, see point #2. Doing so also helps prevent you from pestering your letter writer every other minute to see if he has sent it in yet, which will also serve to quite effectively piss him off.

5. Give your letter writer everything he needs to write your letter. Everything. Don’t make him work to write your letter because that will only serve to annoy him. Yes, that means having your personal statement ready, along with your CV, and anything else you think helpful (please, no bribes). Oh, and an addressed stamped envelope would be good too.

6. And don’t forget to thank your letter writer. He didn’t really have to write you a letter but he did. He took you in even though he knew you were only going to use him to get a letter of rec. And he humored your incompetent undergrad ass (sorry, it is in the nature of undergrads to be incompetent no matter how smart they may be and yes, you really don’t know anything) and even took time out of his busy schedule to teach you, even though he knew that you would hightail it out of there faster than a premed to the front of the room to ask questions after lecture once you got what you wanted. So thank him!

Well, that’s all from me on letters of recommendation. Hope it was helpful!

grand rounds 2.48

Don’t forget to check out the 100th edition of Grand Rounds this week at The Examining Room of Dr. Charles.

will the real valedictorian please stand up?

This article is old, but brings back fond memories of my moment in the spotlight at my high school graduation as one of two valedictorians. At the time, I was only a little peeved that I had to share this honor with him because at least he was a nerd too and not some cool kid. I had been competing with him since junior high for the top grades, so it only made sense that we would end up sharing the honor, even though I believed that he “cheated” a little bit to get there. Let me explain. There was a certain calculus teacher at my high school, who was well known for being hard to understand and for giving difficult exams. My fellow valedictorian took calculus at the local community college to avoid this teacher for fear of blemishing his perfect GPA. I didn’t. And I got the A. But I was annoyed that he still got to share the honor with me even though he had used underhanded methods to ensure that he would maintain his GPA. But at least there were only two of us and we both had perfect 4.0 GPAs while taking the hardest classes my high school had to offer (except for that calculus class I mentioned on my co-valedictorian’s part). So there were two speeches and I would like to think that mine was better, of course.

The following year, there were eight valedictorians at my high school. Perfect GPAs too, I believe. But they were the cool people, not the nerds. Turns out crazy Asian parents figured that if their kids didn’t take the hardest classes, they would be more likely to get straight As and be valedictorian. But how is that fair to the rest of the people who chose to challenge themselves and still got the As? Or worse yet—the people who challenged themselves and didn’t get the As? Not only that, but it’s just not possible to have eight speeches given by eight valedictorians at graduation, so what’s the point of such an honor anymore besides to look good on college applications? This trend has not changed, at least not at my former high school. The number of valedictorians per graduating class has increased over the years to I believe 16 for this year’s graduating class. I don’t know about you, but I just wouldn’t feel special anymore if I were one of 16 valedictorians, especially if I’m sharing this honor with people I know full well cheated the system to be there while I got there the honest way. And quite frankly, I don’t know how these people live with themselves, knowing that they used sneaky underhanded methods to get to where they are. And I guess that’s what really bothers me, especially on the heels of pesky passive-aggressive cousin-in-law’s horrendous performance in my lab: the people who just skate by and cheat the system who still end up getting what they want and indeed end up in the same place that I, who worked hard the honest way, ended up. How can these sand people be considered just as good as me when they’re not? And why should I work so hard if I can be like them and skate by and still get what I want?

My husband believes that these people will get what they deserve in the end or that the fact that they just skated by will eat away at them inside or that they will eventually be found out. But I don’t see the world as being so just and I don’t see these people as the remorseful type. So all I can do is gripe and be glad that at least I was a real valedictorian and that I shared that honor with someone who also deserved it. Maybe when I infiltrate those med school admissions committees I can start trying to do things my way (at least until they kick me out for having too high standards). So all of you who plan to sneak your way into med school, you better do so before you run into me as your interviewer or as a member of the committee reviewing your file.

the cost of living

How much are you willing to pay to extend your life? Does it depend on how long it will be lengthened? Would you be willing to spend your life savings to live an extra six months? One month? Two weeks? Does the quality of your life during that extra time make a difference? Would you still pay that much money to live that extra month if it’s going to be an extra month of pain?

These are all questions that were painfully brought back to mind when I read this article about how much certain maybe life-extending treatments cost. That’s the thing about some of these ridiculously priced treatments. They’re maybes. There’s no guarantee that this treatment you’re sinking all your money into will actually work. Yet most of us would jump at the opportunity, when faced with a terminal illness, to try these treatments at any cost if only we can afford it or perhaps even if we can’t.

But is it worth it? The answer to that question is really dependent on the individual. Even I don’t know what I would choose myself if I were to face such a decision tomorrow. But countless people face this very decision each day. One such person was my mom, who was diagnosed with Stage IV lung cancer (<5% five-year survival rate) and told that she probably had six months left to live. Typical stubborn Asian immigrant that she was, she had been feeling unwell for awhile, but refused to go to the doctor until her symptoms could no longer be ignored. And she had too much to do, too many responsibilities to be sick. So she put it off. I know very little of what happened because I was in high school at the time and my parents did not tell me much. I didn’t even know that she had lung cancer until very close to the end when my dad was no longer emotionally strong enough to keep the secret from me. But I do know that they were given the choice of palliation or treatment with little hope of it actually helping. And they chose the latter. It was incredibly difficult for me to watch my mom go from the strong woman who kept our household together and functioning efficiently to a frail woman seemingly beaten by her radiation and chemotherapy treatments. I knew she had cancer (and only because I knew that chemotherapy was used to treat cancer, not because they actually told me anything), but I didn’t know which one and I didn’t know how bad it was. I naively thought that since she was being treated, she was going to be okay, especially because neither of my parents told me otherwise. It is hard to explain their reasoning, but they were afraid that if we (the kids) knew, we wouldn’t be able to handle it and we would flunk out of school. And that’s the one thing my mom did not want—she wanted more than anything for us to excel in school so that we would have brilliant careers and futures, something that she and my dad did not have because of their struggle to survive as immigrants. As time passed and she got worse instead of better, I think she finally realized that she was going to die and that realization seemed to defeat her. She became only a ghost of the mom that I remembered and that is when I also realized that my superhero mom wasn’t going to win this one. But in her final days, she became more of herself, so much so that I tricked myself into believing that maybe she was not going to leave us after all. Only after her death did I realize that she must have finally come to terms with her mortality and that this acceptance allowed her to be herself again, which is something I am glad she was able to experience again before passing on.

So my mom, when faced with this decision, chose to try. And she obviously can’t say whether it was worth it or not. The medical bills almost did us in and she suffered greatly except for that last week of her life. Would it have been different if she had not gotten any treatment? I really don’t know. What I do know is that the decision whether or not to try ludicrously expensive treatments that might not work is not an easy one to make. And that not everyone can afford these expensive treatments even if they want to give them a try. And how much extra time does one need to gain in order for it to all be worth it? In the end, all I can do is emphasize the importance of patients making informed decisions regarding their end-of-life care. If they want to try the last ditch expensive treatment, they should know what it entails and that it might not work. I don’t think my parents fully understood this (probably because of language issues) when it came to my mom’s case and their hopes were falsely raised because of it, leading to a more painful and prolonged acceptance process than would have occurred had they fully understood exactly what they were getting into.

kids (season 1, episode 19)

D’oh. What I was hoping was going to be a relaxing weekend is turning out to be anything but. Didn’t have time to write anything, so here are some House-isms.

Sorry. A lot of sick people here. I might catch something.

That’s right. I’m subjecting a twelve-year-old to a battery of dangerous and invasive tests to avoid being bored.

You wouldn’t know Prada if one stepped on your scrotum.

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