Tomorrow is Hash Bash Ann Arbor

I won't be attending, but was intrigued.

Here are some photos from my sister Liz's visit last weekend:
These were taken during a walk over the Argo dam and along the Huron River, on a very sunny Sunday afternoon. On Saturday Liz and I attended a conference in memory of Sujal Parikh, a fourth year Michigan medical student who was tragically killed in a traffic accident last year while doing research in Uganda. The conference was called "The Social (Justice) Network"and it featured talks by professors and students on efforts to bring health care to disadvantaged people around the globe. The keynote speaker was Peter Mugyenyi, founder and director of the Joint Clinical Research Center in Kampala, Uganda. He talked about how the recent economic recession has led PEPFAR and other aid agencies to drastically reduce funding of ARVs for the treatment of AIDS in the developing world. The conference organizers hope to make it an annual tradition.

Liz's visit coincided with the final exam for our Central Nervous System Sequence, which was mostly neuroanatomy. The anatomy practical exam was especially tough, but fortunately it was the last anatomy exam ever! Our next sequence, starting Monday, is infectious diseases. This past week we learned how to do the neurology, ear nose & throat, and oral physical exams. We also learned a little about the in-depth mental status exam that psychiatrists do, and we had several interesting lectures on the Tuskegee experiments, child abuse, and LGBTQQ patients. On Thursday, our interpretive projects for the Family Centered Experience curriculum were due. My partner Kellianne and I made a video based on the everyday sights and thoughts of patients with chronic illness (my patient has type I diabetes, Kellianne's has multiple sclerosis). Kellianne happened to have knee surgery to repair a torn ACL several weeks ago, so I accompanied her to surgery to get some hospital footage. You can watch our video here. Our video project will be presented along with many others at a special reception on April 20 for the FCE families.

I'm starting to become very busy with the heap of extracurriculars I've taken on for next year. I'm a student coordinator for the Delonis free medical clinic, co-coordinator of the Students Teaching AIDS to Students program (med students teaching local high schoolers about HIV/AIDS), an editor for the Hippo med student magazine, and one of the leaders of the MedRunners group. Most exciting of all, I'm leading a group of 8 student rappers on a performance at the spring Biorhythms show May 14!

Spring Arrived Today!

Buckminster Fuller and Avalanches

This is the most un-springy spring break--it's snowed pretty much every day this week. We still made it out on Thursday afternoon to the Henry Ford, a massive museum in Dearborn, MI that chronicles American politics, art, and culture. There are many fascinating exhibits at the museum, from the Rosa Parks bus to the rocking chair President Lincoln was sitting in when he was assassinated in Ford's Theater in Washington, D.C. One of my favorite exhibits was the Allegheny locomotive, a monstrous steam engine built in 1941 that pulled coal-carrying trains more than a mile long.
Another exhibit I enjoyed was the Dymaxion House designed by Buckminster Fuller in the 1920s. Buckminster Fuller was not the man who first synthesized buckminsterfullerene, or C60 (that distinction goes to nobel laureates Harold Kroto, Robert Curl, and Richard Smalley of Rice University), as I originally thought. No, Fuller is most famous for inventing the geodesic dome. He's also well-known for his Dymaxion House, a cheap, sustainable, and virtually indestructible home. The house looks kind of like a big bag of Jiffy-Pop right before you take it off the stove. It's made of cheap and light aluminum, giving it a very shiny futuristic appearance. The house is suspended by one central post, so the whole thing can swing back and forth in an earthquake or storm. The round shape of the Dymaxion House maximizes living space while minimizing building materials. There are also rotating shelves and closets operated electronically to maximize space. Sadly, the Dymaxion House never went into production, even though it seemed pretty livable and cost about as much as a high-end car--I don't think I would mind living in one, if it was a little spruced up.
Today I attended a Winter Wilderness Medicine Workshop at Kensington Metropark about 30 minutes north of Ann Arbor. The workshop was taught by some very knowledgeable instructors--including emergency medicine residents and attending physicians. Most of the docs had been on mountaineering expeditions and had some amazing stories to tell. I learned about the Gamow bag, a simple but ingenious and effective piece of equipment for treating patients with altitude sickness. Patients crawl inside the bag, the medic closes a super strong zipper, and then someone uses a foot pump to pressurize the bag. The pressure in the inflated bag can reach the pressure at an altitude over 5,000 feet lower than the actual altitude.

One of the instructors used to work in alpine search and rescue in Utah and had done extensive research on avalanches. He told us about all the factors that affect avalanche risk, such as slope steepness, the direction the slope is facing, the type of snow that has fallen, the temperature, the wind, tree cover, and more. We got to play with avalanche rescue beacons used to find people buried in the snow, and we also practiced a fine probe search, which must be done when the victim is not wearing a rescue beacon. In the probe search, a line of people each carrying a twenty foot probe walk step-by-step over the avalanche field, every step pushing the probe in the snow on their left, center, and right. If someone thinks they hit something under the snow, the probe is left in the snow and another line of rescuers with shovels is responsible for digging to the bottom of the probe. Behind the probe line, specially trained dogs sniff for human scents wafting up through the probe holes. It is a painfully slow process. In fact studies show that if avalanche victims are not rescued within 15 minutes, their chances of survival are very slim. So by the time the search and rescue time arrives, they're usually hunting for the dead body. However, a device called an Avalung can buy the victim time. Although there is usually plenty of air mixed in with the snow that is burying an avalanche victim, the victim typically asphyxiates because the warm air he/she breathes out melts the snow immediately surrounding their face, and then the snow refreezes, sealing their face in a tiny air-tight compartment. The Avalung is just a tube that channels expired air behind the victim's back so that the area around their face is not iced in. When the Avalung is used properly, the limiting factor in survival becomes hypothermia rather than asphyxiation.

Here is a video of an avalanche:

Avalanche (Video)..Incredible! - Click here for more home videos

Spring Break!

These snowy pictures were taken twelve days ago, but it's already spring break! (Fortunately it has gotten above freezing the past few days.)
The walkway over Argo dam that I take on 50% of my runs.
Looking at the downstream side of the dam. A dam was first built on this site in 1830 to provide power for a mill. That mill burned down and was replaced in 1914 with a power-generating dam. In 1959 power generation was ceased, but today the dam still backs up the Huron River to form Argo Pond, a small recreational lake used by over 600 rowers from Huron and Pioneer High Schools, the University of Michigan, and the Ann Arbor Rowing Club.
A diver descends into the icy water from the Argo Dam walkway to clear out a dam intake valve in early February (picture from the Ann Arbor newspaper).

Argo Pond, frozen solid.
This is Barton dam, the next dam upstream from Argo (Ann Arbor has 4 dams total on the Huron). It was originally built in 1912-13 and generates 4.2 million kWh of electricity per year for the city of Ann Arbor.

I wonder how much electricity it generates when it's frozen.
Ice climbing, anyone?
Ducks and swans apparently don't mind the cold.

In the last month and a half we completed the GI, endocrine, and immunology sequences, all of which were challenging due to the large amount of new material. But to be totally honest, medical school so far has not been tremendously intellectually stimulating. I'm thinking back to college math problem sets or biology journal clubs or even writing political science papers, where I actually felt like I was problem-solving and thinking logically, rather than blankly staring at my notes, trying to squeeze one more fact into my brain that I will likely forget ten minutes after I take the test. What's more, college assignments usually resulted in some kind of finished "product" I could call my own, whereas in medical school we just file into the library at the end of each week, log on to a computer, choose one of five options a couple dozen times, and hit "submit." Fortunately we have a "Clinical Foundations of Medicine" Week after spring break where we will learn some more physical exam skills, which I also enjoy. Then we have a three-week sequence on the central nervous system, which I know will be fun because the brain is an endless, fascinating frontier.

I'll be sticking around Ann Arbor for the one-week break, catching up on some reading for my summer lab rotation and writing a rap or two for the spring Biorhythms show in May. Meanwhile, the Smoker--the musical in which students lampoon the medical school faculty (it's been occurring annually for nearly 100 years!)--is coming up in two weeks. I have a small acting part and am in one short dance.

Michigan hockey won a 5-4 thriller in overtime tonight versus Western Michigan. Go Blue!

GI Rap

The "peacock" maneuver to finish off our bhangra dance.

Here's a link to the GI sequence rap: http://www.supload.com/listen?s=B75TNW#

With all this humor writing, ethnic dancing, and rapping, I almost feel like I'm getting a degree in music and arts rather than medical school. In fact, last week was the first week of rehearsals for the Smoker, an annual musical put on by the medical students to satirize the faculty. I'm playing Dr. Abrams, a wise white-haired pathologist. My part was originally cast with only two "guffaws" but a lot of standing around, so I added in two lines for myself. I get to dance a little bit too.

On Monday last week I went to a poetry recitation to celebrate Martin Luther King Day. This featured Angel Nafis, a former Huron High School student who is now apparently studying and/or writing poetry in New York city, and Val Gray Ward, an internationally-known actress. Nafis was introduced by her high school English teacher, who noted that she struggled in his class but was quickly becoming a famous young poet. Nafis's poems were powerful and witty, written in stream-of-consciousness style, about what it was like to be black in America. For example, one poem alternated between the word "black" and things she associated with being black. The word "black" resonated in the audience's ears, so that we couldn't escape it, just as African Americans cannot escape their skin color and all that goes along with it. Val Gray Ward recited stories and poems, like the story of Harriet Tubman, with an improvisatory style, moving freely from one piece to the next. Sometimes it was a little hard for the audience to keep track of where she was. Her accent and voice changed to match the character she was playing, and one part in which she portrayed the suffering and helplessness of slaves was particularly moving.

On Wednesday I went to a talk on the business of pharmacology by Rajesh Balkrishnan from the Michigan Center for Global Health. His talk was on "Pay for Delay," a concept I had not heard of previously. By the time a typical drug gets on the market, the big pharmaceutical companies have about ten or twelve years before their patent expires. Because drug development is such a costly process, the companies have to make the drug very expensive during that ten or twelve year period in order to recoup research costs. In Pay for Delay, a strategy that has become increasingly common in the last few years, big pharmaceutical companies like Pfizer and GlaxoSmithKline will pay millions of dollars to the generic drug companies not to produce their drug once the patent expires. The big pharma companies do this because they can still make massive profits on their expensive drug even if they are paying off the generics, and the generics are happy because they get money for doing nothing. The big losers are insurance companies and patients, who have to keep paying ridiculous prices for the drug. This is obviously a major problem, and one that requires congressional intervention to fix.

And yes, I'm still in medical school as well. We just finished up the gastrointestinal sequence, which was heavy on anatomy and biochemistry, but also had some pharmacology, which is my favorite subject. I've also signed up to coordinate the Delonis Clinic, the free clinic that Michigan medical students can volunteer at. Right now the volunteer opportunities are frustratingly small in number (students are lucky if they can volunteer one night per year), so my number one priority is to get more slots for med student volunteers, either at Delonis or another clinic in town.

Biorhythms 2011

Below are videos from the dances I participated in at Biorhythms 2011, the U of M semi-annual arts performance. These are just two of about twenty acts total, including a capella, violin solo, hip hop dances, modern dances, and more. I had an incredibly fun time learning, practicing, and performing these dances, and I'm definitely planning on participating in Biorhythms again. If you want to watch the other acts, a quick search for Biorhythms 2011 on Youtube will do the trick.

http://www.youtube.com/watch?v=vpoe6zDuW_Y

http://www.youtube.com/watch?v=P62Sn6veIb0

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: