Back in black!

We're back! Back in black! Back in black baby! Ok I think that's enough. By the way, what does back in black even mean? If you ponder it hard enough you realize it makes absolutely zero sense. Thanks AC/DC for popularizing this meaningless term. Speaking of, here's an enjoyable AC/DC tune to keep you company (and no, it's not 'Back in black' - that would be way too obvious):



Moving on. A little update on what's been going on lately. I finished second year of med school literally yesterday. And now I can operate on your brain and remove complicated pancreatic tumors. No, clearly not. But I can tell you 10 random facts about 'Chronic granulomatous disease' or 'Paroxysmal nocturnal hemoglobinuria'  - two insanely rare conditions. So I guess that's an achievement of sorts.

In less than 4 weeks, most of us will be taking an eight hour long test, the USMLE Step 1. Your score on this test marks the price of your soul is a crucial factor in ultimately deciding where you go for what specialty. Competitive fields like neurosurgery or dermatology traditionally require higher scores than others.

Most of my classmates will then go on to the hospital to do clinical rotations, while I will head over to the greener pastures of basic science research, spending time amongst pipets, gels and ELISAs. Interesting times lie ahead.

College basketball is boring and other random stuff

• I am coughing a lung out over here in sunny Southern California, but I must soldier to feed the insatiable urge of my dear readers. The show must go on, as they say (btw who the hell comprises this murky "they"? Why don't they ever reveal "them"selves?)

• For the first time ever, I deigned to fill out a bracket for march madness. Why, I don't know. Just wanted to get a taste of, I guess. Quite frankly, I am completely baffled by all the attention and hype. Let's be real here people: college basketball sucks. The level of play is obnoxiously abysmal, and the games are so boring and slow, even espresso shots can't keep me up. These teams get a 35 freaking second shot-clock and two 20 minute halves and yet games end with shitty scorelines like 64-60. What the hell are these people doing? It's an insult to the viewer. I would rather watch a far more superior product, the NBA. Meanwhile, feel free to clog up my facebook newsfeed with your inane complaints about bad coaches, bad referees and your desperate analysis of a sub-par sport.

• Just finished a block of exams. One more block to go. Infectious diseases was the biggest class of this block, and definitely had the most amount of stuff to learn/memorize. Which makes sense I guess, considering the myriad bacteria and viruses and badass worms have it in for you. And oh man, the cats. So many diseases transmitted through cats. Moral of the class: stay the hell away from cats. They are cute little furry monsters of death. Speaking of which, here's a picture of a cute kitten:

Patiently plotting world domination

                                      

That's it for now. Have a Happy Easter. 

Ascaris: the subtle, understated badass

Nature is full of badasses. They come in all sizes and shapes and flavors. Some are big, obvious and downright terrifying: your leopards, cheetahs and other their ilk. Some are ruthless, relentless and overwhelm by the numbers. Army ants fall into this category. Never cross the path of an army ant. Some prefer to take the subtle approach. They display their badassery not by devouring you whole or laying eggs in your dead bodies or ripping you systematically apart. Nope. They believe in the power of invisibility.

The badass on display is from this camp.
It looks like this:

Ascaris: all-around badass

Blisters, diarrhea and giants - an accurate roundup of med school

Merry (slightly belated) Christmas to you all.

(Happy Festivus if you are into that sort of thing.)

Meant to write pretty much everyday this month, but real life intervened in the form of OMG FINALS. If you spent the last three weeks frantically refreshing this page or kept re-reading past gems from this blog, I apologize profusely and sincerely. I am back now with fresh material to ensure this venerable little corner of the vast internet will not go unmanned (Or un-botted. You have no way of knowing if I am a highly proficient AI).

Recently concluded block numero tres of second year of med school. Only three more blocks to go before most of my classmates get shipped to the hospital wards and get presented with real patients with real illnesses.

This block's material explored interesting material and answered some critical questions. Like: what do you blame when your "hormones act up"? Is the pituitary gland really the "master gland"? Is there more to diarrhea than inconvenient trips to the shitcan? (Hint: yes) Can a skin rash be both macular and papular? Read on to find out.

This week in ranting: why is the pancreas so presumptuous?

Welcome to the second installment of "This week in ranting". Here is first installment: The lung is a noob .

A little background before we get started: today we had a small group session devoted to breaking bad news. Usually these small groups are a colossal waste of time. People sit around holding hands singing the kumbaya and nothing of any significance gets done. This small group session was an exception. Delivering bad news to patients is a critical skill and although teaching it this early might not have terribly important retentive value, at least they are exposing us to these things. Long story short, we were supposed to deliver a diagnosis of pancreatic cancer to actors pretending to be patients.

In the midst of this session, it suddenly struck me that the pancreas is a freaking presumptuous organ. I mean look at it. What other non-paired, singular organ in the body presumes to seem and sound plural?

Ever hear the heart calling itself the "hearts"? No! Because that would be stupid. And arrogant. How would you feel if the brain woke up tomorrow asking people to call it "brains"? The brain is a pretty important organ, right? Yet you don't see it letting all this important get to it. You don't see its ego swelling to the size of a dirigible.  Look at the liver - the humble little organ that could (well actually the liver is one of the largest organs in the body, but let's roll with it). It sits there patiently and meticulously filtering out all the toxins you and I brazenly dump in our bodies. But you will never hear it saying it prefers to be called the "livers."

Why the pancreas then? This gnarly (no, literally. The pancreas is pretty tortuous) piece of tissue with the texture and feel of a giant chicken tender is a fairly crucial organ. It spews out digestive enzymes and also releases important things like insulin and glucagon so your body doesn't all of a sudden go into a coma due to swings in glucose levels. But unlike the vital organs like the heart, liver or the brain, this punk slab of cells swaggers around wanting its name to seem plural. An obvious case of plurality envy, if you ask me. It is clearly jealous of the lungs, the kidneys, the testes, the ovaries, the eyes, the limbs and so on.

So I looked into this a little bit more. Turns out some ancient Greek idiot named it the pancreas (meaning "whole flesh"). The plural of pancreas is pancreases or pancreata (yuck). Here's probably what actually happened: some Greek anatomist was looking at this yet-unnamed organ and was preparing to call it something sensible and singular. But this punk probably threw a tantrum and threatened to dissolve all organs around it with its enzymes. Faced with such daring thuggery, the Greeks promptly called it the pancreas.

So here I am, seething with rage and incredulity, while the pancreas prances around holding us hostage.

This week in ranting: the lung is a noob

Exams on Monday - heart, lungs and kidneys.

The more I learn about disease processes in the lungs, the more incredulous I get. Simply put, the lung is such a noob at fighting infections. I mean look at it. Almost every insult to the lung ultimately results in irreversible fibrosis and some weakass exudative stuff going on in the alveoli which ends up doing more harm than good anyway. All the reactive immune responses in the lung end up causing harmful granulomas. Every kind of terrible lesion seems to happen in the lungs. Pus? We got it. Abscess? Ooh we have multiple kinds of abscesses. Which one would you like? Necrosis? Again, such a wide variety to choose from! Unresolved, persistent infections? Check. 

You would think the body would do a better job at protecting such a vital organ that literally keeps you alive by dumping out CO2 for O2 and by sweeping out all manner of gunk that gets in. 

That's my rant for the week. 

Random stuff

Random stuff that I want to talk about.

• I have made no secret of my intense passion for bikes and biking. I have blathered about the topic several times, like here and here . This week my days as a glorious and proud outlaw came to an end. I surrendered my gritty, badass ways and agreed to abide by society's repressive laws. That's right. I finally purchased a helmet. For 10+ years I rode around unfettered, like an untamed majestic beast of the wild. Now after months of persistent pushing, both by friends and family, I am a rebel no more. Here is the heinous object that made it happen:

"Even if I am a school of medicine professor..." - showdown at orientation

Howdy. Our serene and mostly peaceful school has been recently hijacked by hordes of eager, goggle-eyed first-years. The firsties started orientation yesterday and a majority of them spent last week getting to know each other and the great city of St. Louis by participating in a community program.

Yesterday wise second years who are involved in various student-run groups were invited to give brief presentations (and by brief, I really mean brief. We were told not to exceed 45 seconds) to the firsties. Yours truly grabbed the opportunity and gave a smashing presentation. Standing ovation and all. Nah just kidding.

Anyway, that's not the story. The story is something that happened right before the event. Our benevolent school always provides enough Pappa John's pizza to feed an army regiment at most events like this. Since the welfare of students is priority numero uno, a bunch of stern guards admissions staff guards the pizza with great zeal and pride.

Perhaps tempted by the sweet aroma of the sausage pizza a faculty member stopped by. Now I know quite a bit about this dude, and he is a baller. Baller with a capital B. He is young, charismatic, creative, and insanely smart. He sauntered up to the lunch table and the following scene ensued:

A few thoughts on anatomy

In my last post providing an overview of med school and classes and such, I promised a separate post just for anatomy because I like it so much. So here we go.

Anatomy more or less dominates our first block of classes. We have three lectures a week, each followed by a marathon session in the dissection lab. There are four students per body, meaning there is plenty of work cut out for everyone. A dedicated brigade of professors (some of whom are reportedly renowned experts in their fields) and TAs roams around to provide assistance to floundering groups or to regale the idle ones with grand stories about exciting discoveries in the field of anatomy. The lab is akin to a bazaar, full of boisterousness and healthy chaos.

A month's worth of newness

Well it’s been more than month since I have posted anything here and it’s damn well about time I changed that. I have been incredibly busy and have been totally absorbed by medical school and all the burdens that go with moving to a totally new place and getting adjusted to living there. But now I have begun to settle down into a fairly convenient routine and can give a good retrospect of the month that just passed.

On August 8, I boarded a painfully early morning flight from Los Angeles to St. Louis to start medical school at Washington University. The founders of my school must have been fond of misunderstandings, since its name provokes a lot of confusion.

“Is it in Washington?”

“Is it in Washington, D.C.?”

These are the two most common follow-up questions I get whenever I talk to someone not in the medical community. No wonder that in 1976, the Regents of the university finally sneaked in the qualifier “in St. Louis” to the school’s name to make it “Washington University in St. Louis.”

Usually its shortened to either WashU or WUStL. 

BTW if you haven’t got it by now, the school was named after our first president.

Orientation was from August 9-12. I was at a slight advantage at meeting a lot of my new classmates because more than half of the class had arrived in St. Louis early to do a week-long community health program. First day went by fairly briskly, and I spent an awful lot of time shaking hands and smiling and introducing myself. The two most common questions following introductions – “Where are you from?” and “Where did you do your undergrad?”

If time permitted, these were usually followed by “Where are you living right now?”

That evening, the school rented out the entire City Museum from 6-9 and threw a lavish reception party, replete with an open bar and a generous dinner. This was the type of affair with waiters circulating in and out of crowds, carrying trays laden with delicious appetizers and some kind of wine. The entire top brass showed up, and the Dean of admissions was seated at my table. I was awestruck. This man was literally directly responsible for my admission to the school. He was my interviewer way back in November of last year, and he was the one I wrote to express my interest after being waitlist. And he was the one who called me the next day to announce the happy news.

There were four other students at the table, and the talk turned to California. My class has a lot of Californians. The Dean made a joke about it: “When the creator made the world, he/she took the whole North American landmass and shook it thoroughly, and all the nuts fell down to California.” 

Hey-O!

The rest of the orientation days were, sadly, neither as eventful nor as exciting. We were bombarded with lectures and protocols and forms. Orientation culminated in what has now become a standard practice among medical schools, the white coat ceremony. It is a fairly recent tradition (Wikipedia tells me it was first introduced in late 1980’s) that marks the initiation of new medical students into the medical community. Each student is given a white coat and the class as a whole recites an oath to uphold the principles of medicine.

WashU makes us construct our own oath, partly because the Hippocratic oath is terribly outdated (it includes clauses like "to live in common with him[i.e. teacher] and, if necessary, to share my goods with him; To look upon his children as my own brothers, to teach them this art." ) and partly because the school acknowledges that while the main tenets of medicine may not change, each new generation of physicians-to-be brings its own set of ideals. 

For that purpose, we were split into small groups. Each group, under the guidance of a faculty mentor, spent two hours brainstorming various ideas worthy of including in the oath. Two representatives were appointed from each group, and all the representatives met again to write the final product. If anyone is interested, here is the oath in full: Oath.

Now normally, I am faintly leery of such displays of solemnity because I think people take them for granted, thus diluting the significance of these events. However, I was very impressed with the gravitas and authenticity of the whole ceremony. Granted, we are all at a very young stage in our careers, but the boisterious idealism on display at the white coat ceremony is necessary to sustain the tough years ahead. Plus, everyone’s parents had a nice reason to feel happy and overwhelmed, which is always good. This post has grown too long already, and I will talk about classes, daily life etc. in my next post.

The multiple mini-interview: miracle drug or meh?

Multiple mini-interviews are all the rage these days among U.S. medical schools. Most Canadian schools already follow it, and last year UCLA, Stanford, UC Davis and a couple other places followed suit.

The concept is simple: there are 8-10 interview stations, each with a different question designated to it. Applicants are typically given 2 minutes to read the question at the station and then give a well though out answer for about 8 minutes to the interviewer at that station. After time's up, they rotate to the next station. The entire thing lasts about two hours. Questions mostly deal with ethical and moral quandaries one is expected to face as a physician.

The traditional interview format consists of one-on-one sit down interviews with faculty and/or current medical students (most schools do a combination of both).

Proponents think MMI is better because of two reasons:

1. It eliminates the subjectivity of the personal interview. At the end of each MMI session, each interviewer gives a score to each applicant. Since there are 8-10 stations, you now have that many scores for each applicant. These scores can now be compiled to create a list of the best applicants. Since multiple people are evaluating the applicant (as opposed to just one interviewer in the traditional format), subjectivity can be reduced.

2. The spontaneity cultivated by MMI will help "reveal" the true applicant and thus will help schools weed out poor applicants or posers. Each applicant at these interviews is made to sign a confidentiality form agreeing not to reveal any question to other applicants. In theory, this can prevent people from rehearsing questions beforehand. But just to be on the safe side, most schools also have two (or more) sets of slightly different questions they use each time.


The New York Times, in its curious, undying quest to define and implement the concept of the perfect doctor, latched onto this concept and did a lengthy article espousing its benefits. You can read the whole article here (provided you haven't run out of your 20 free articles a month quota or your subscription hasn't expired), but I will be quoting extensively in this post regardless.

First, let's let the good Times define what's at stake:

"Doctors save lives, but they can sometimes be insufferable know-it-alls who bully nurses and do not listen to patients."

Fair enough, but somehow the Times got this from the above:

"Even more dangerous is when poor communication becomes so endemic that the wrong operations are performed. A 2002 study published in The Annals of Internal Medicine of one such incident found that the patient, doctors and nurses went along with the mistaken treatment because they were used to being kept in the dark about medical procedures. A survey by the Joint Commission, a hospital accreditation group, found communication woes to be among the leading causes of medical errors, which cause as many as 98,000 deaths each year."

Whoa whoa whoa. I read the actual survey, and it cites "Communication" as a problem. Now that's a pretty broad term and it could include a lot of things, and I don't think the MMI alone is going to solve this problem.

But leave it up to the Times to tout this as the wunderdrug:

"The new process has enormous consequences not only for the lives of the applicants but, its backers hope, also for the entire health care system."

Look, let's not get ahead of ourselves, okay? I did two of these interviews last year, and I really really liked the format. It is very refreshing and unique. It definitely has its advantages over the traditional system. The pressure of coming up with a coherent response in a span of two minutes was very invigorating and it certainly helped polish my conversational skills. But to brand this format as the cure for all ills is a massive exaggeration at the very least, and a criminal lie at the worst.

For one, this system is not as fool-proof as the proponents make it out to be. It's kinda easy to fake being personable and all mushy-wushy when you have to do that for only 8 minutes. Furthermore, who is to say that personable people right now won't devolve into jackasses seven years from now, when they are attendings?

At a more fundamental level, I don't think bedside manner is as big of a handicap that can't be overcome . The Times has a new trend where it likes to create a straw man - arrogant doctor with no social skills and all the technical skills - and bash this to the ground. In reality, this is never the case (unless you are on TV and your name is Gregory House). Not everyone is outgoing and has the same level of rapport with everyone. But it is relatively easy to develop patient interaction skills through medical school. Of course, sociopaths must be weeded out but to predict someone's bedside mien seven years down the line based on a two-hour interview session as a pre-medical student is a gross mistake.

Just so you guys don't think I am all against this format, let me say that the spontaneity inherent in MMI is definitely worth it. The questions are thought-provoking and address real issues that physicians face once in practice.

Bottom line: It's a cute new format (at least for the U.S.), and I wouldn't mind if all schools adopted it. Use it to select students, but don't let it be known as the solution to communication and management woes down the line. Those issues are grave and likely have their own complex causes that are unlikely to be solved by a two-hour ethics-spouting session.

Is it the new penicillin? A big fat no from me. It's just a good interview format that probably has two or three advantages over traditional interviews.

Some random thoughts

On this wednesday, a lot of random thoughts are swirling around in my head, like a freshly stirred cup of good coffee. Allow me to share them:

• Pearls before swine is on my favorite comics. The absurdity of the cast and the pungent wit make it a very delightful read every day. Take a look at this one from last week featuring the Pillsbury dough douche boy (click to enlarge):

•  The other day I was driving around my hometown and made a stop at CVS. There was a tiny video store next to it called "Video Joy". Hmm, I don't know about you, but with a name like that, I don't think I want to visit that video store.

• It's med school rejection season right now. Most schools are done sending out interview invites so now they in the business of notifying the rejected candidates. Almost all emails are stiflingly formal but there are some unintentionally funny ones. For example, this one:

Your application, although reviewed multiple times, was not selected for admission.

         

          The subtext here is "you were a loser each time your application came up...hahahahaha"

• Some human genetics research papers have more than 50 authors on them. We read one for a class last week that had 55 authors from 39 institutions, representing 7 countries. Talk about the summer olympics sheesh.

Hey Lakers, you do know the object of this game to win, right?

(Not)On the road - 9: The Homefront - You. See. El. A

Last installment of the series
Part 7(Harvard, Boston) is here and part 8(WashU, St. Louis) is here.

So as you can see from the title, not really a on the road post. Well technically, I was on the road. For 12 minutes, which is about the time it takes to walk from my apartment to the admissions office at the David Geffen School of Medicine at UCLA. That's quite a mouthful. You'd think a guy donating hundreds of millions of dollars to have the naming rights to a medical school would be kind enough to call it by something short and sweet. Like Dreamworks school of medicine.

The medical school, for those not in the know, is located in one of the nicest parts of Los Angeles in an area called Westwood. The famed beaches of Santa Monica and Malibu are not very far, which in LA parlance could mean anywhere from 30 minutes to 2 hours. Bel-Air hugs one part of the larger UCLA campus, and Beverly Hills is a stone's throw away (if you are Michael Vick). Pretty safe neighborhood and unless you do something incredibly stupid, you can walk around freely even at odd hours of the night. I have done it, with no problems (the waking around, not the doing something stupid, obviously). If you are into that sort of thing, you can spot multiple celebrities from multiple fields. A lot of my friends brag about seeing the Chicago Bulls or Adam Sandler in the gym playing basketball.

Now it is no secret that the med school building is nowhere as fancy as some of the others across the country. It is located in some cramped corridors of the ancient Center for Health Sciences building, sharing space with the dental school. To compensate for this, the spanking new Ronald Reagen UCLA medical center opened up just across the street a couple of years ago.

This much, I knew. What I didn't know was the med school has a first-class top-notch A-grade student lounge that looks like a boring arboretum from the outside. This swank piece of work boasts multiple flat screen TVs, a Wii console and ping-pong tables. Our tour guides touted its exclusivity and its opulence quite a bit during the tour. The library is equipped with an exclusive study lounge as well. The school has the added benefit of being surrounded by multiple research buildings. Keep your friends close, your research closer - as the famous saying goes.

All in all, a damn fine med school.

Anyway, that's the end of the on the road posts. Hope you (and I mean my one and a half readers) enjoyed them. As the looney tunes used to say: That's all folks!

On the Road - 8: Wasssss(h)up!

Second of the final three installments in the series 

Part 7 (Harvard, Boston) is here and part 9 (UCLA) is here.

St. Louis doesn't get much to boast about these days. The city used to be a glamorous, busy hub back in the day, even hosting a World's Fair and the olympics in 1904. But that was then. Nowadays, it is in the news for the wrong reasons, like for being named the most dangerous city in America.

Which is really a shame, because St. Louis is a nice idyllic midwestern city. Absolutely would not mind living here. Plus it has the gateway arch. Can your city boast a giant arch that leads into Illinois? St. Louis is home to Washington University, whose undergrad campus is right next to Forest Park, that is 50% larger than Central park. Take that New Yawk! Someone from my interview group raised the crime question and our gracious tour guides told us that was because the numbers were skewed by East St. Louis, which is actually in Illinois. Oh right, let Illinois take all the blame.

The university and the med school are located in an area called Central West End, which is, by all accounts, a typical college community. The public transportation is pretty easy to use (LA, I am glaring at you yet again) and I had a swell time visiting the city. But I bet y'all (my one and  half readers) want me to skip to the fun part where I visited the arch, right?

Well here you go. Most people don't know you can actually go all the way to the top of the arch and gaze out at the city skyline or, if you so choose, look imperiously over Illinois on the other side. The top is all closed up (obviously) and the windows are tiny, but it is definitely worth the view.

The gateway arch: facing Illinois since 19

They like to tell you exactly how high off the ground you are

 

St. Louis: standing tall

Now if only the Rams had a better season this year...But one must not be greedy, right?

On the Road - 7: Har-Har(vard) in Bahstun

Due to a proper lack of time last month, I have decided to publish three final installments of the On the Road series today. All the trips I describe here were made in the month of November.

Post #8 (St. Louis) is here and post#9 (UCLA) is here.

I arrived in Boston (or should I say Bahstun?) on a chilly Monday night. I jostled my way through the crowded Logan airport (Hey Boston, mind expanding the restrooms a bit? The lines were Disneyland long, man) to begin the first of three legs of the public transportation-assisted journey that would take me to my gracious host's house. You see, a family friend, who is a first year dental student at Hah-vahd, was kind enough to put me up for the night. All hopes of getting a glimpse of the Charles river ("Charlie") were destroyed, however, when the Silver line bus got a massive influx of people. Thirty five minutes later, I was all aboard the Green line subway, en route to the Red line subway. Which reminds me: why are all these subway and bus lines always named after boring colors? How about the Cyan line? Or the Fuschia line?

My friend lives right across the street from the Medical-dental-public health-pharmacy-Harvard hospitals megasupercampus, so I didn't have to worry about waking up early the next morning and scrambling to get there.

Before  my trip, an acquaintance of mine, a resident physician in SoCal (whom I had run into after a long time on the morning of my flight) had told me to savor my interview and take lots of pics because the main admissions building looks like the White House. And boy was he right. Even the damp morning air couldn't put a damper on it (zing wordplay!):

Clearly, Harvard likes to protect its lawns

At the risk of sounding pedantic, let me describe the area a little bit: the medical school is located (along with a host of other professional schools) in an area of Boston called Longwood. Two major Harvard teaching hospitals are adjacent to the med school (BIDMC and Brigham and Women's), as is the Dana-Farber Cancer Institute. If Longwood were a solution, it would be a supersaturated one. Security is pretty tight around here. Every building has a guard at the entrance and it is impossible to get past them without having valid IDs.

The Biomedical library, located right behind the main building, is a pure nerd haven. They had an ongoing display on the life and times of Oliver Wendell Holmes, Sr., famous intellectual from the mid-19th century. (His son was more famous then him for, among other things, supposedly telling an incognito Abraham Lincoln to "duck, stupid" at a charged Civil-war battlefield and for becoming a supreme court justice).

They even had a portrait depicting the first surgery under ether (a crude anesthetic used in the late 19th century):

Quite surprisingly, a few in the audience look positively bored

The crown jewel was this exhibit of Phineas Gage's skull. Gage was a railroad worker who suffered a truly bizarre injury when a steel rod pierced his frontal lobe and came out the other end. Miraculously, he survived, but his personality altered irrevocably.

Phineas Gage's skull: educating Neurosci 101 undergrads for generations

It was only later that I noted a tiny sign at the top left that said: "No pictures." Oops. Sorry Harvard.

Up in the air, down on the ground - a veteran sure and proud

A while ago, I saw the 2009 film Up in the Air, starring suavemeister George Clooney. It was your typical Clooney film, meaning it was slightly quirky, used a lot of close shots of his improbably perfect stubble, and exploited his prodigious talents in making mundane dialogue somehow seem interesting.

The movie has an interesting plot. Basically, Clooney plays this high-flying executive whose only job is to "consolidate" badly performing firms. If you haven't figures it out yet, it's just a nicer way of saying his job is to fire people. See, the company he works for specializes in this sort of thing (a repo agency for firms, if you will) so anytime a firm is not doing so hot, it will hire Clooney and Co. to come clean up. Clooney is your seasoned veteran: he has a gazillion frequent flyer miles (towards the end of the movie, he gets a special gold-plated card by American Airlines for becoming one of the very few people to accumulate ten million miles), and an equal number of club cards, credit cards, hotel discount cards and so on. Long story short, he has a change of heart, one predictably disastrous love affair, and decides to change his life for good.

The reason I brought up this movie is that lately I have been feeling like a veteran too. I may not have the same number of frequent flier miles that Clooney does, but I have certainly done more than a fair share of flying. Medical school interview sure have familiarized me with a LOT of airports that I would otherwise never have gone to. Since all of my interviews usually end around 4 pm in the afternoon, I end up taking the late evening flight back to LAX. That means I get to my apartment by 11 (on a good day) or midnight (on a mas o menos day).

And let me tell you something: no matter how much I hate the ridiculously long lines, no matter how irritated I get at the byzantine security procedures (I am severely glaring at you American for moronically counting my garment bag as a "third carry-on" bag), I definitely breath a nice, long sigh of joy and relief when I get down the escalator and see the giant pic of our esteemed mayor giving a wholesome grin. Damn it feels good to be back each and every time.

To round this off, here are some interesting tidbits from today:

• God I had this kid patient once and he had severe foot odor. He had sweaty feet! - overheard at Northwestern med school. 
•  My faculty interviewer was roommates with noted neurosurgeon Keith Black at the University of Michigan med school. He also partied hard with Magic Johnson when Magic was at Michigan State. Best quote from him: "We needled Keith a lot when he appeared on cover of Time." Medical celebrities!

On the the Road - 6: On top of the world

Quick post: I am in Chicago again, for another medical school interview - Northwestern(Citizen Lafayette has this theory that there is a collective midwestern conspiracy to lure me here because a majority of my interviews here have been in the area haha).

Staying with a medical student host. He graduated from UCLA, so I picked him solely on that criterion. He lives with two other roommates in an extremely posh high-rise (when I say high, I mean it. This place has 40 floors.) apartment complex. They live on the 36th floor and the view here is absolutely magnificent. Northwestern medical school is in the nicest part of the city, right by the Navy pier and practically right across from the lake.

I love Chicago and the culture here. Now if only it was a bit warmer this time of the year...

Just for gits and shiggles, read this statement:

I am the being which is in such a way that in its being its being is in question

That zinger brought to you by French existentialist philosopher Jean-Paul Sartre, perhaps the only person in history with enough cojones to decline the Nobel Prize.

On the Road - 5: Niceville

If Nashville were to play the role of superspy James Bond, it would perhaps itself like this: "Name's ville. Niceville." And order drinks thus: "One martini. Shaken, not stirred. Please."

People often say the south is a completely different place - almost like its own country. It doesn't take long to notice the difference. Nashvilleans are outrageously polite. So polite they almost me feel guilty.

Am I being nice enough? Is my smile wide enough? 2 millimeters more, perhaps?

I got a lot of honeys and sweethearts from elderly female cashiers and clerks. And it was 94 degrees outside! Nothing seems to faze these bubbling cauldrons of joy.

With a population of about 650,000 (1.5 million if you count the surrounding areas), Nashiville is the second biggest city in Tennessee. It enjoys prominence owing to its status as the state's capital as well as its reputation of brewing country music superstars. Music city, USA, as Nashville is often called, is home to the country music hall of fame, and boasts having an entire area devoted to recording studios. Nashville makes it obvious that it takes music seriously. Get this: the airport features a live band! The musicians kept playing merrily as amused travelers (like this blogger) walked by.

LA: meet your country music counterpart.

Nashville is also home to Opryland, the largest non-casino hotel. And here I thought the frat across the street from my apartment owned that dubious record. Speaking of dubious, the Tennessee Titans and NHL non-powerhouse Predators play in Nashville as well.

Vanderbilt University is the major research university in the city. How do we know it is important? Why of course because it has been called the "Harvard of the south". I wonder how the fine folks at Harvard would feel if their institution was called the "Vanderbilt of New England."

Vanderbilt, or Vandy, was founded by legendary shipping and railroad mogul Cornelius Vanderbilt in March 1873. Good ol' Cornelius was born in a solidly Dutch family in New York and worked his way (the good ol' American way) to become an immensely rich and influential figure in the country's history. He operated steam ferries around the New York area, eventually branching out to ocean lines as well. His shipping prowess earned him the nickname "Commodore." Beginning in the 1850's, he began investing in railroads, adding considerable amount of wealth to his already large fortune. When the civil war erupted, he donated his flagship Vanderbilt to the Union navy.

Think this is all boring history? Well, here is something interesting: fashion empress Gloria Vanderbilt is one of his descendants, and so is CNN News honcho Anderson Cooper (Gloria V's son). Tycoonery seems to run in the family.

Vanderbilt University takes its historical roots seriously. A giant statue of the Commodore greets visitors at the front entrance. Even the school's mascot is called the Commodore. No Falcons or Wildcats for these folks.

The Commodore, standing tall and proud

The campus extremely scenic, full of lush lawns, intriguing modernist sculptures and quaint 19th century styled academic halls. Walking around the campus felt like walking in a cherry orchard (zing! Chekhov reference). Definitely the most scenic campus I have visited.

                                                                                                                                              

                         
Various sculptures seen around the campus        
The VUMC (Vanderbilt University Medical Center) is quite extensive and has a VA, a Children's Hospital and a host of research buildings. You know the Children's Hospital is good because they have a giant, intricately designed model train set for kids (and their parents) to play with.

For the kids and the kid within you

 Lastly, the student newspaper is called the Hustler. Yeah you read that right. No banal names like Herald or Tribune for these Commodores. Vandy's finest get their news from the Hustler. Pretty badass. The hustling commodores. (name coined by my friend RPN)

I certainly loved Nashville a lot. It's cheap (many students choose to buy condos) and despite being a big city, it is mercifully free from the accompanying traffic troubles. Although I didn't get a chance to taste it, I can always train myself to like grits.

The grand to-do list

I have been doing a lot of thinking lately (you should try it too - it's good for your health). I dusted off the cobwebs, oiled the creaky rusty brain and put it to work. And I realized that despite being in LA for the last three years, there are quite a few things I haven't had a chance to do. I have one more year before I graduate and leave the bubble, so here is a list of things I would like to do/accomplish before the year is over.

If I was Jay Leno (or David Letterman, pick your poison), now would be the time for the terrible in-house band to play some dramatic music and do a drum roll.


1. Get into a medical school. If that doesn't work out, the next best thing is getting a PhD in Computer Science.

2. Visit the USC campus. Everyone makes such a big deal out of the crosstown rivalry and I have never once visited the Trojan campus. Would be nice to do that.

3. Visit the Hollywood sign. You know the sign that every movie and TV show set in LA tries to get panoramic shots of? Yeah apparently you can hike up to that.

4. Attend a concert at Hollywood bowl. I have been to the LA Opera (cheap student tickets and an alert friend), but haven't been to the Bowl yet. It's quite expensive from what I've heard, but so is regret.

5. Spot a celebrity. Almost four years and one-and-a-half sightings (James Franco in Starbucks, Magic Johnson from across the street. Couple friends tried getting his attention, but he ignored them and drove away). Not enough, obviously. People reported seeing entities like Adam Sandler, Rajon Rondo, and a string of E and F-listers. I will make this happen this year, even if it means staking someone out and making them get a restraining order (I am looking at you Kim Kardashian. Nah just joking)

6. Publish a short story. Yeah it sucks that no one reads the pages and pages of stuff I write. But this year I am seriously going to try and get something published in the Westwind (the college literary magazine). Maybe I too will get discovered a la Justin "Look at my bangs" Bieber. 

Short list, but I am not too demanding.

On the Road - 4: Pittsburgh (Putting the 'It's' in It's Happening)

Pittsburgh, PA: The erstwhile steel capital of America. Andrew Carnegie's backlot, his sandbox. But that was then. When most people (including me) think of Pittsburgh today, they probably think it is a dump - a dying old steel town that outlived its usefulness, and is past its prime.

Imagine my shock when I looked outside my tiny AmericanEagle airplane (3 seats a row, a plane so tiny even reasonably tall people have to crouch to walk through the aisle), I saw thick plumes of lush green trees, a neat and dazzling array of skyscrapers surrounded by spectacular bridges over wide rivers. No surprise, then, that Pittsburgh was named the most livable city in America .

Pittsburgh, PA. [image:pbt.org]

The city of bridges has experienced a rebirth, and it is all the bit better for it. Everyone I talked to was immensely proud of Pitt's beauty and acted playfully offended when I expressed my surprise at finding the city so pleasant.

I stayed in a neighborhood called ShadySide, about 2 miles from University of Pittsburgh (which is located in an area called Oakland), in a nice little hotel called ShadySide Inn (a converted apartment building, where 50's era radiators are anachronistically juxtaposed next to flat screen TVs). The hotel is so nice that the manager mails signed thank-you notes to guests.

I took it as another mark of the city's confidence that it chooses to call one of its swankiest locales Shadyside.

Oakland is a very vibrant area, owing to the presence of two major research universities: University of Pittsburgh and Carnegie Mellon University. The two campuses are so enmeshed that buildings from both campuses are often located right next to each other. To avoid confusing freshmen, they label each building's name with the name of the school.

U Pitt, because of its medical school and its associated medical center, is a more forceful presence. Like in Ann Arbor, where Mich dominated the city, UPMC (University of Pittsburgh Medical Center) pretty much dominates the area. UPMC operates about 25 hospitals in and around Pittsburgh, making it the largest health system in the United States. Last year, the system generated about $8 billion in revenues, which gives you a sense of the extent of its multifaceted operations.

U Pitt is also, by far, the older of the two institutions. It was founded in 1787, when none of us were alive.

University of Pittsburgh: founded before you, your mother, your grandmother and your great-grandmother were alive

You can tell U Pitt values education by the fact that they have a humongous Cathedral of learning (I can hear Citizen Lafayette salivating at this factoid) right in the middle of campus. Magnificent and imposing at 535 feet, the cathedral is the fourth-largest educational building in the world, as my friend Wikipedia informs me (second, if you go by the tour guides at Pitt School of Medicine). The building is open 24/7, and its 42 floors house many classrooms and a quiet study room. I took a peek inside and the architecture is just so intricate and awe-inspiring.

The Cathedral of learning: bigger than ANYTHING on your college campus

People here were tactful enough not to mention the harsh winters (last winter's snowstorms virtually crippled the whole city. People reportedly skied down the hilly streets around the Med school.) Regardless, Pittsburgh is a very beautiful city.

Spread the word. Correct the misconception. Squash the rumors.