My fourth decade

This year I embark on my fourth decade on the planet. Wow, I'm a lot older than I thought. I have to admit I don't remember much of the '80s, although apparently some bad stuff happened, like the Exxon Valdez crash in Alaska, and some good stuff happened, like the release of Michael Jackson's Thriller. The '90s might be my favorite decade so far; my finest moment was winning the MVP award in the 8 and under all-star soccer game--it's been all downhill since. The '00s were a lot of work, and I don't see that letting up anytime soon. And here we are, in the second decade of the 21st century. If we just make it past 2012, we only have to worry about teeny issues like rampant population growth, food and water shortages, nuclear war, economic collapse, and the catastrophic consequences of global warming, to name a few. Sorry, I'm usually not this pessimistic. To make up for it, I'll humor you with a picture of what happens when you cook eggs at the lowest temperature setting on an electric stovetop for 45 minutes:
You might be asking why I cooked an egg like this for New Years brunch. The answer is that I was attempting to make the egg "cheese or cream-like" according to the method of Jeff Porter, author of Cooking for Geeks. Mr. Porter claims that cooking an egg slowly at 160 degrees F allows one to achieve smooth and delicious eggs. I ended up with a rubbery, sticky, inedible mess. Without an infrared thermometer, I cooked the eggs for too long at too low a temperature, causing them to dry out. I'll need a few weeks of rest after this traumatic experience before I try again.

Over winter break I started reading The Big Payback: The History of the Business of Hip Hop by Dan Charnas and discovered some rap gems made by old school groups like the Sugar Hill Gang and Run-DMC. In the 1980s, rap was just some guys singing clever rhymes over rock music beats--no synthesized voices, gun shots, or vulgar language every other word. These guys were geniuses. Fun fact from the book so far: How did record scratching originate? In the late 1970s DJs wanted to extend the instrumental breaks in songs so that b-boys (called break dancers today) could get their groove on. At that time the breaks were short, less than a minute. To extend the breaks, the DJs would spin identical records simultaneously and alternate back and forth between the breaks of both records. In order to match the beats during transition between records, a quick "rub" was often required. Once people discovered these rubs sounded pretty cool, the rub was expanded to the "scratch." Today there are scratching competitions for DJs.

Below are some pictures from break:

Keeping it Real with Sam the Squirrel

If anyone would like to know what a New Zealand accent sounds like, watch this about one of the world's more ridiculous bicycle accessories:
http://www.youtube.com/watch?v=bLeBHI3LYAo&feature=player_embedded#!

I am currently practicing with a bhangra dance group in preparation for a performance next month, and am having a blast. My procrastination method of choice is now to watch videos of bhangra on Youtube. Here is one of my favorites:
http://www.youtube.com/watch?v=RnL9sEherR0

Finally, here is an essay I submitted to the Michigan medical school literary magazine, called "The Hippo."

Keeping it Real with Sam the Squirrel

I don’t know how I was persuaded to write this--I hate hippos. People make hippos out to be so adorable, like the hippo girl in Fantasia they dressed up in a tutu. Sure, put a tutu on a hippo, but it’s still a hippo. Just the name hippopotamus sends shivers up my spine (but I may be biased due to hippopotomonstrosesquippedaliophobia—for those of you with a weak vocabulary, that’s a fear of long words containing “hippo”). I also avoid octopuses, because I never trust suction cups, and platypuses because they’re just mini-hippopotamuses. And before you call me a pusist, let me tell you I had a good friend who was a xenopus who tragically had all of her offspring taken by a molecular biology lab. Anyway, this kid representing the Hippo told me they were having trouble getting creative writing out of medical students, who allegedly lost all artistic inspiration somewhere between Bayesian statistics and the extensor carpi radialis longus. So here I am.

My name is Sam. I’m a squirrel, the common variety with light-colored fur and a big bushy tail. Right now you’re probably thinking “Oh, that’s nice, but squirrels like you are everywhere. They’re boring. I’d rather watch apple slices turn brown than talk to a squirrel.” Well here is a list of things that are everywhere, yet increase happiness substantially in the right time and place: money, coffee, IKEA furniture, body lotion, blueberry muffins, Michigan med student women wearing furry boots, Michigan med student men wearing blue collared shirts, pornography, burritos, bicycles, and squirrels. Yes, squirrels can be just as exciting as pornography. Look, I’m already naked.

It turns out squirrels have a lot of fun. In fact, every day my friends and I get higher than the chairs at a Jewish wedding. That’s right, us squirrels smoke marijuana. And unlike for humans, it’s actually legal for squirrels to smoke marijuana. Usually me and my buddy Terry, who’s a black squirrel (not related to Obama, as some local school kids claim), we go down to the Jolly Munchkin for some smoking and poker. Mostly it’s just birds and grass snakes at the bar, but occasionally some real interesting characters come. Like last week this aardvark showed up. Usually I avoid playing poker with anyone whose name rhymes with “card shark” but this aardvark turned out to be all right. I figured he’d be devouring insects left and right, but actually he’d converted to Jainism five years ago. “So what do you eat?” I asked him.
“I usually get Vegan VegAnts from Trader Joe’s; they’re right next to the Tofutti Tootsies” (vegetarian pig’s feet, apparently). As long as no one tofutizes my acorns, everything’s cool.

So I hang out in the Arb quite a bit, and I see lots of couples walking on the trails. It’s always interesting to observe the varying levels of PDOA. For those of you unfamiliar with the “lingo,” or for members of the Providers of Doughnuts to Orphans and Albinos (God bless you), I’d like to remind you that in this case PDOA stands for Public Displays Of Affection. By far the most common PDOA is Hand Holding (HH), followed closely by Laying On Top Of One Another Just Far Enough Away From The Trail To Make It Unclear Exactly What You Are Doing (LOTOOAJFEAFTTTMIUEWYAD). Because HH is so common, there are several subcategories, including the “finger interweave,” the “four finger wrap” (preferred when wearing mittens or if you have syndactyly), “sporadic hand fondling,” and pattycake (advanced HH technique). The other main PDOA, kissing, is highly controversial among PDOA experts. Some claim that kissing is a perfectly respectable expression of love, but others think kissing looks like two people trying to eat each other and may cause children to grow up to be cannibals. Personally I enjoy watching people kiss, although all that cheek movement makes me hungry for nuts.

The great thing about being a squirrel is you can pretty much do whatever you want. I mean, no one is going to try to exterminate squirrels. City parks advertise their “rich and vibrant flora and fauna,” and if you take out squirrels, your fauna component is down to pigeons, and everyone knows pigeons are dirty. So I get away with a lot of shenanigans. Like one time last summer in the Arb I saw this girl sun-bathing face down with her top unhooked, so she could maximize her risk of skin cancer. I crawled up next to her cell phone, so that I could maximize my cancer risk, and a half hour later the phone rang and she grabbed me around the waste. The girl shrieked as she jolted up sans top, some 12-year-old boys gasped, someone yelled “Oh come on, haven’t you seen Titanic?” and then I was chucked into a pricker bush. But it was worth it.

In the Arb I see a lot of runners, and running styles. Some people run by bounding in the air two feet higher than necessary, some people run like they have a stick up their butt, and some people don’t actually run but pretend to by swinging their arms madly, stomping their feet, and looking exhausted. As a squirrel, when I run I look like I’m on crack. People think squirrels make jerky movements because we have primitive neurologic systems, but actually it’s because we like to ensure that people driving cars have no clue which direction we’re planning on going. Seriously though, the world would be a better place if people didn’t run with iPods. First of all, if you’re listening to Metallica’s Enter Sandman while you’re running there’s no way you’re appreciating how charming us squirrels are. Second of all, listening to music on your iPod is selfish. If you’re going to get fired up with Eye of the Tiger, I want to get fired up too. Why not tape speakers to yourself so everyone can listen? Maybe you’ll inspire some overweight dude on his way to fill his Big Gulp, and suddenly you’ll be leading pigeons, squirrels, and fat people on a glorious exercise crusade. You can do it; trade in your ear buds for shoulder-mounted subwoofers, and be an American hero.

Pictures from the Arb (and a couple from DEN)

Med school, first semester

I'm well over halfway through my first semester of medical school, and having an absolute blast. Our curriculum is divided into body system sequences, rather than semester-long classes, and right now we are on the musculoskeletal sequence, having already completed cardiovascular/respiratory, "cells and tissues," and "patients and populations." The musculoskeletal sequence is very heavy on anatomy, specifically of the upper and lower limb. There are four main types of structures in the limbs that we are studying: bones, muscles, blood vessels, and nerves, and it's important to know not just where the blood vessels and nerves are located but which muscles and areas of skin they innervate. Besides anatomy we've learned a fair amount of muscle physiology (how sarcomeres work) and energy metabolism (glycolysis, Krebs cycle, fatty acid oxidation). We're also going to learn a little radiology this week.

Our afternoons are filled with either anatomy or histology labs. Dissection of human cadavers made me nervous at first, especially after I read that some medical schools do not tell donor families what exactly students will be doing to the bodies (and some medical schools still use unclaimed dead bodies). But at Michigan we had a thoughtful memorial service for the donor's families and while I don't know precisely what is on the informed consent form, I'm assuming the anatomy program tells donors and families what dissection is. My enjoyment of anatomy increases with each lab as I get a little better at cleaning nerves and muscles and have a better general structural understanding of the human body. I still have no ambitions for surgery though. In histology we study digital microscopic slides of various human tissues ranging from respiratory epithelium to articular cartilage. Even though histologists and anatomists are friendly rivals, the two disciplines complement each other well. It's often surprising looking at a tissue under the microscope after I've dissected it, and it always blows my mind how these tiny cells can organize themselves into such complicated macroscopic body parts.

Here are two very silly attempts at injecting fun into studying:

Cardio Rap

Anatomy Comic

In extracurriculars (if you don't count the above as extracurriculars), I'm participating in a Chinese drum dance and a Bhangra dance that will be performed in the medical school Biorhythms show in January. I have no dancing experience whatsoever but am having a great time with this. The best cycling days of the season are behind us, but I've been running several times a week and went geocaching last weekend.

Today there was a very enlightening "Coming Out Panel" at lunchtime in which a number of medical students, residents, and attendings who were part of the L(esbian) G(ay) B(isexual) T(ransgender) Q(ueer) Q(uestioning) A(llied) community told their coming out story and discussed prejudices or biases they've encountered. To my knowledge, unfortunately no one in my family is gay and I've had very few gay friends, so I haven't thought much about these issues. It was really eye-opening to go to this panel and see my friends talk about their experiences, as I was completely oblivious to how they identified. As example of my ignorance, a few weekends ago at the annual medical student Fall Ball, I remember being very surprised when one of the guys on today's panel told me he had arrived late to the ball because he had been speed dating with undergrads. I couldn't understand why he had been speed-dating with undergrads when there were hundreds of single girls our age at the Fall Ball. I'm very glad I attended this panel because I want to be a physician who supports the LGBTQQA community, not one who makes assumptions about someone's spouse or is shocked to learn their patient is gay.

AMA Conference

Last weekend I attended the American Medical Association-Medical Student Section interim meeting in San Diego, California. There I presented a resolution stating that the AMA should support designed incompatibility for medical tubing such that it is physically impossible to connect tubes intended for different functions. Medical tubing misconnections have caused serious injuries and death; for example, in 2006 Robin Rodgers and her fetus were killed when a feeding solution meant for enteral delivery was accidentally pumped into her veins (http://www.nytimes.com/2010/08/21/health/policy/21tubes.html). This resolution was one of only two resolutions that was passed without amendment and referred to the main AMA, probably because the Nevada delegation of the AMA had recently proposed a very similar resolution. About a dozen Michigan students attended the conference, and we presented four additional resolutions on lengthening drug expiration dates, opposing mandatory treatment of patients with government-funded health insurance, sending unused surgical supplies to the developing world, and enforcing strict rules on medical students participating in medical clinics overseas. All the resolutions either passed with amendment or were not passed but led to reaffirmation of previous AMA policy.

Overall I had a great time at the conference and learned more about how the AMA works and a little about parliamentary procedure. I also attended a couple talks on research by medical students and a talk on HIV/AIDS disparities, particularly in the African American and Latino populations.

On a very different note, here is a rap that I made with a fellow classmate on the cardiovascular system:
https://mfile.umich.edu/?path=/afs/umich.edu/user/r/o/rogawski/Public/Cardio%20Rap.mp3

Pictures from two of my favorite places

Here are some pictures from Ann Arbor and Williamstown taken this fall.

The Michigan football experience

Today I finished my weekly quiz (this week's topics were biochemistry and anatomy) around noon and discovered that a fellow student was selling a single ticket to the afternoon season-opening football game at Michigan stadium against Connecticut. I wanted to get to at least one game this season and decided that no game was better than the first game. So I arranged to buy the ticket for $30, then headed to a store on State Street to pick up a t-shirt--I didn't want to be caught in the Big House without spiritwear, and I certainly didn't want to be mistaken for a UConn fan (of which I think I saw two the entire afternoon). I bought a yellow shirt with a straight "Michigan" logo so I could wear it to other sporting events. Then I coasted down the hill on my bike, past thousands of students playing dance music and drinking outside of frat houses, and relished the big-midwest-school-pregame-experience. I thought the partying we witnessed in Barcelona before the Madrid-Seville championship match was the most excessive I would ever witness, but the pregame celebrations I witnessed today may equal or surpass those of the European fans. For one thing, tailgates started around 7 am this morning for a 3:30 pm game (In Barcelona we witnessed dance parties at noon for a 9 pm game). In Barcelona there were two main fan zones for each team, relatively well contained by fences like a nice benign tumor. But in Ann Arbor the parties had metastasized, with many small and medium sized gatherings and tailgating over several square miles around the stadium.

I navigated through the throngs, parked my bike at the outdoor track, and joined the herd moving to the stadium gates. Everyone was decked in maize and blue, and there was palpable excitement for the first game of the season. It was partly sunny at that point, not too chilly, and I watched overhead as a plane drew an "M" in the sky with its exhaust; there were also a couple helicopters flying around the stadium at lower altitude. Unfortunately, when I got to the gate I was told that for a student ticket I needed a student ID, which I did not have on me, so had to squeeze through the crowds to a ticket office, wait in line for twenty minutes, and pay another $30 to get my ticket "validated" (i.e. make up the difference to a non-student ticket). As I was waiting in line some fighter jets did a flyover of the stadium. I made it into the stadium just after kickoff, went to section 29, and showed the usher my ticket. "Way down there," he told me and pushed me rather hard down the stairs. My ticket, it turns out, was from a med student who also went to Michigan for undergrad, so she had some pretty amazing seats. The stairway was packed with people and it quickly became obvious that there were way more people at the lower levels than who actually had tickets to be there. The row with my seat, like all the other rows, was completely full of students standing sideways on the bleachers. There was no way I was going to fit too, so I stood around on the stairs for awhile until a security officer told us to move out of the stairs and I sheepishly slid myself in between two screaming students. There I stood for the first half, both feet only half on the bleacher, back twisted, neck craned, watching Michigan score two touchdowns in the first quarter and nothing for Connecticut. I heard "The Victors" fight song, the lyrics of which are plastered all over med school posters, and some other cheers with arm chopping and key shaking. Connecticut scored a touchdown and a field goal in the second quarter, but Michigan also scored another touchdown. At halftime I was expecting everyone to leave to get a hotdog or something, but instead I was surprised that as the clock ran down everyone suddenly sat down on the bleachers around me. Before I knew it, I was trapped, surrounded by a sea of knees. There was no escape--so I just watched the marching band perform. They were good but not loud enough. Finally the third quarter began and I decided to exit the student section and explore the rest of the stadium.

I did a full loop, smelled the fried dough and caramel corn, and sat down in a non-student section on the opposite side of the field. There I watched as Michigan continued to demolish UConn (they won 30-10). The stadium really didn't look that big because it wasn't super high, but in the fourth quarter it was announced that the attendance was 113,090, an NCAA record for the best-attended college football game ever in America! That got the crowd really excited. The student section did some more cool cheers; for example they split into two groups and yelled "Go" and "Blue" back and forth for a minute. They also started a wave. Many fans started leaving in the fourth quarter, but all the students stayed to the very end. Finally the game was over and it was a reverse pilgrimage back into town, with many stopping at bars and restaurants. What a game and ritual!