Monthly Archive for December, 2006

happy new year!

Happy new year, everyone!  Hope it's great!

P.S.  I'll be back on Tuesday. 

i’d rather be studying for the usmle step 2

Yep.  That's right.  My husband stumbled upon some Kaplan Step 2 materials and started quizzing me.  And surprisingly, I got all but one of the questions right.  And it was way more exciting than studying for my quals.  I wanted more questions, but he refused to quiz me anymore because it was distracting me from my real task of studying for my quals.  It's sad when I would rather study for something else to avoid studying what I really need to study.  But it also reminds me that my love for medicine far outweighs my love for research.  Sorry, I don't like to think.  I just like to memorize.  I've been fighting this truth for a long time now, but it's true.  I don't really like research because it requires me to…think outside of what I've been given, which I'm just not really that good at.  I'm much better at accepting facts that are given to me without question.  That's why I'll definitely fail my quals if most of the questions consist of, "So how would you test such and such?"  Because, really, I have no clue and I've had no training on such things. 

Sad that it's come to this.  Back when I was an eager and un-jaded undergrad, I loved to present my research.  In fact, for a research conference for one of my fellowships, we had the option of doing poster or oral presentations and I was the only one out of 15 or so students to choose oral.  That's how confident I was and how much I believed in what I was doing.  Not only that, but I was actually good at it.  Even at answering the random questions that I got peppered with.  So good that the person in charge of the fellowship praised me for being able to "think on my feet." 

I just hang my head in shame when I think of those days compared to now where I'm totally dreading this qualifying exam because somehow I've lost that ability to "think on my feet."  What happened in between?  Med school.  And some grad school.  Did med school make me dull?  Or did the years I spent lazing around the lab being my major professor's secretary/slave with no intellectual stimulation whatsoever do it?  Probably a little of both, or more like 15% med school and 85% major professor.  Med school required a whole different mentality of simply accepting and memorizing facts.  Grad school taught me otherwise and started to undo my med school mentality, but my major professor undid and then some all of that by not nurturing my intellectual development.  His refusal to let me speak my own thoughts without fear of major humiliation/tantrums led me to just become a drone who does not speak up or question his ideas (unless they're just WAY too wacky and even then I find it hard to say anything for fear of the repercussions).  I became a blind follower because of him.  I lost the ability to think because of him.  Not only that, but he has not given me a single day off so far to study for my quals AND insists on bothering me time and time again about the stupidest things while I'm trying to study at the lab.  It's as if he's trying to make me fail.

But it'll take a lot more than that to make me fail.  I'm not one to let other people screw me over.  That's why despite all that I have going against me and despite the fact that I really hate this, I'm quite proud that today has been my most productive day in a month.  A little late to start being hardcore again, but at least I've managed to pull myself out of that funk.  So instead of wondering if I'm too late, I'm going to look forward and hang on to the hope that I will pull this off now that I've started making progress again.

do not resuscitate?

Otherwise known as "DNR."  My husband and I had a discussion about DNRs because of the recent headlines about the man who was operated on and saved by a procedure he developed for repairing dissected aortic aneurysms.  Supposedly this man had signed a DNR and something else refusing surgery to repair his aortic dissection.  But after much ethical debate, the operation was performed anyway, successfully.

My husband thinks that there shouldn't be DNRs.  He thinks that people who are dying aren't of sound mind and that even if they do sign a DNR, that it's shouldn't always be upheld.  I can see what he's getting at, but I don't agree.  Short of being depressed or psychotic or demented, what makes a dying patient any less sound of mind than one who is not dying?  And who exactly is the judge of when a DNR should be upheld or not?  He believes that a person facing their own mortality cannot be of sound mind.  I don't think that it's the dying patient that isn't thinking straight, but rather that patient's family and friends.  Because it's usually these people who are fighting the DNR if there is one.  Often, people with DNRs are those with terminal cancer or other conditions in which they know that their death is imminent.  At some point, these patients probably come to accept that they are going to die and then choose to not prolong the process with unnecessary measures.  This is when they sign those DNRs.  For the people around them who are not dying, this act may be seen as giving up rather than acceptance.  They often cannot understand why their loved one wouldn't want everything done.

I myself have felt this way before.  When my mom was dying from cancer, I found a DNR form stashed away in one our desk drawers.  I was 17 and had no idea what it was, but after reading it, I got the point.  It wasn't filled out or even signed.  So she didn't opt for it.  But the mere existence of the form freaked me out (and this was compounded by the fact that I didn't even know that she was dying at the time).  I seriously doubt that my mom was the one to decide not to sign that form.  I picture her maybe wanting to, maybe considering it, then my dad convincing her otherwise.  He was nowhere near being able to let her go.  But I think my mom was.  In her last days, she was calmer than I had ever seen her, serene even, as if a great weight had been lifted.  I was not there to witness her death, but I have to wonder how traumatic the resuscitation attempts would have been for me had I seen them.  And I wonder if my mom really had to go through that one last trauma when there really was no hope at all anyway.  I wouldn't change anything, but such cases are what I think DNRs are for: when a patient has already gone through enough and accepts that they are going to die regardless of what measures are taken.  Patients should be allowed to choose when to say enough is enough.

Back to the story that started it all.  This heart surgeon had a DNR and believed that his condition was fatal.  However, it turned out that it wasn't.  So had they upheld his DNR, he would be dead today.  And I guess that's why my husband is so against DNRs.  Because if there is even a minuscule amount of hope left, he believes one should fight.  Because who knows…you just might beat the odds.  Maybe you won't, but at least you tried.  I understand that mentality, but what we still need to consider is what the patient wants.  What if this heart surgeon didn't care that he was saved and resented his family for not allowing him to die and prolonging his low-quality-of-life life (which is not the case here)?  Maybe the patient thinks that they have lived long and fully enough and doesn't really care if they live another month or year.  Then it should be okay for them to say DNR.  But my husband doesn't agree with that.  If his mom were to have a DNR, he would fight it, regardless of her reasons.  Which brings me back to my point that it's the patient's family and friends who aren't willing to accept death.

Our collaborators on my thesis project were discussing this very notion during my last experiment: people are now living longer and longer due to advances in medicine, but what kind of life are they living?  Many of these people are miserable and are merely shells of themselves.  At some point, these people should be able to say, "enough."  But they're not allowed to because medicine can help them and because their families cannot let go.  At least let them have DNRs when it is their time to go.  At least that's what I think.  It's not an easy thing and I can't say that I haven't been guilty of not being able to let go.  Nor do I think that I would be brave or mature enough to be able to sign my own DNR come time.  But I can respect the decision of those who are.  And their family and friends should learn how to respect their decision too, even if they don't necessarily agree.

i should be in full-on freakout mode

But I'm not.  And I sit around debating why I'm not instead of freaking out and studying.  I think about freaking out and studying but I just can't quite get myself to do it.  Let's put it this way.  Everything is not going to be okay.  My qualifying exam is in less than a month and I have yet to:

1. Make my Powerpoint presentation of my thesis project.

2. Study everything that I was told to study (I conveniently ignored all the broad topics and the hunt-for-papers topics).

3. Think about all the holes in my project and how to plug them up.  Especially statistics.

4. Know anything and everything about my project backwards, forwards, sideways, and upside down.

5. Read my committee members' papers. 

6. Memorize everything that I supposedly already studied.

Can I really do all of that in less than a month?  Probably not, even if I didn't sleep for that whole time.  And yet what have I been doing?  Let's see.  Today, I slept in until noon.  Then I ate.  Then I watched an episode of a Japanese drama.  Then I surfed the web.  Then I opened my notebook.  Read less than one page.  Surfed some more.  Then I found some sweet online after-Christmas sales and wasted a good chunk of time.  Then there was dinner.  More online shopping.  Put Santa hat on my dog just to annoy him.  Memorized two lines on anesthetic mechanism of action.  Made ringtones for my husband's cell phone.  Cleaned the house because my husband's friend is visiting tomorrow.

What can I say?  I need a really loud wakeup call.  Because I can't seem to do it myself.  What's it going to take?  I wish I knew so that I could start studying again.  This is just bad.  Really, really bad. 

holiday hangover

Oops.  Too much holiday-ing and not enough blogging (and studying *groan*).  Extended the stay in the land of no internet because of a storm, but I'm back now.  Just too tired to form a coherent thought so I'll spare you.  I'll be back tomorrow!

off to spread holiday cheer

I'm off to parts unknown (in that the internet does not go there) for the holidays.  So I'll be back Tuesday (that is, if I'm not shopping :P ).  Merry Christmas! :)

rooster: 16, me: 0

My neighbor owns a rooster.  I never knew she owned a rooster until I heard it cock-a-doodle-doo-ing some morning or other.  At 4 am.  The sun's nowhere near to being up at that time!  I didn't really mind though.  People have animals.  Their animals make noise sometimes.  I know my dog barks at 7 am or earlier sometimes if I leave him outside.  But this damn rooster has been cock-a-doodle-doo-ing for over two weeks now. And it doesn't do it just once.  It'll start at 4 am and then keep doing it at about five-minute intervals.  Then it'll stop.  And then start again at 6 am.  And then again at 9 or 10 am.  See, I didn't care until one early morning, I was awoken yet again by his cock-a-doodle-doo-ing and in my half-awake-half-asleep state had an epiphany: no wonder I've been so exhausted lately…to the point where I literally cannot keep my eyes open come 6-7 pm (I never get so tired that I can't keep my eyes open)…it's because of this damn rooster!  It keeps waking me up so I'm not getting a goodnight's rest.  Not enough rest leads to me being unable to concentrate.  Which leads to me not being able to study.  So it seems that I will fail my quals because of a rooster.  Can it get anymore absurd?  I don't know what I can do about it.  My husband wants to find it and cut its existence a tad short, if you know what I mean.  I think it would be way too obvious to my neighbor when she finds a strangled rooster in her backyard.  I guess I can complain to her.  But what can she do about it besides get rid of it?  Sorry, lady, it's me or the rooster.  That'll go over real well.  I'm so screwed.  I'm being pwned by a rooster.  Yep.  That's what my life has come down to.  X_x

inspirational music for the graduate student 1.11

So I did another one of my experiments yesterday and since I haven't done a little happy dance, that means that it didn't work out.  Again.  Our model is still just a tad too lethal.  But I won't lament my failure to get results today.  I wrote about guilt yesterday and I want to continue that theme today.  What else do I feel guilty about besides not seeing my horrible, terrible in-laws for the holidays?  Well, these experiments…each one means I kill an animal.  And I like animals.  A lot.  Even experimental animals.  That stink.  I know that we need to do experiments on animals because we can't do them on humans.  And that they don't die for nothing.  But it's still hard for me not to feel guilty about killing these innocent animals.  One moment they're sitting in their cage.  And the next they're sedated and being cut open.  Never to wake up again.  And at the end of the day, they just get tossed into a biohazard bag in a bucket to be disposed of.  It gets to me after awhile.

Now before you call me naive, this is not the first time I've worked with animals.  I did so as an undergrad.  But I never saw the experiments from beginning to end.  I never saw the animal awake just minding its own business.  And I never saw it struggle and fight against being given a shot (to induce anesthesia).  I only saw it lying on the operating table covered with drapes with various catheters coming out of it.  Seeing them like that made it easier for me to not think of them as living, breathing things that we were killing.  But now that I'm behind the scenes and I'm there every step of the way, it really gets to me.  Especially when my experiments don't work.  Of course, it's not a waste because I learn something new every time.  But a part of me can't help but feel that way. 

How can I be a scientist who can't work with animals?  The answer is I can't unless all I do is clinical trial work, which just isn't basic science enough for me.  And I might as well kiss my PhD goodbye if I simply refuse to work with animals.  My major professor actually threatened to "fire" me for refusing to work with dogs as a part of one of his experiments that had absolutely nothing to do with my thesis.  I stood my ground there because he had no right to force me into that project anyway.  But I have no choice when it comes to my thesis.  I'm not working with dogs.  I'm working with an animal that we, myself included, routinely eat.  And yet I still have a hard time with it.  So hard in fact that I want to become a vegetarian, which is just crazy considering I hate vegetables and never eat them.  Just goes to show how much these experiments are wearing down on me.

Which is why I have to finish.  I have to work out this model and test my hypothesis.  Because I don't want to kill any more animals than I have to.  Really, I don't.  This PhD has taken its toll on me in so many ways from major professor hell to qualifying exam hell to stuck-in-a-rut-going-nowhere hell to now guilty-about-killing-animals hell.  I really need to finish before I go crazy from all of this.  Although I guess it could be worse.  I could be decapitating monkeys and harvesting their brains.  But still.

So in honor of the animals that have given their lives for research that betters our lives, I've chosen Elton John – The Circle of Life as my song for this week.  Hopefully it'll all be over soon.

Song suggestions?  Send them to me here