Tuesday, November 18, 2008

Please, for the love of all that is reasonable, stop quoting Dostoyevsky.

I've been watching a fantastic debate between Christopher Hitchens and Rabbi David Wolpe. I was enjoying at least the hope that this debate would follow with solid intellectual honesty and some concessions would be made.

Unfortunately, midway though Wolpe's opening statement, it occurred to me that he hasn't read a single letter of Dostoevsky.

This is clear when he utters a statement I've heard from many who clearly haven't read 'The Brothers Karamazov': Wolpe says, "Ivan Karamazov says in Dostoevsky's novel, famously, that "without God everything is possible (sic)." Except Dostoevsky feared that eventuality".

Read the Brothers Karamazov. I have. You might be surprised to find that Ivan Karamazov never says such a thing. Ivan, one of the two aforementioned 'brothers', was an atheist and did declare (early on) that there was no such thing as immorality. But the sort of immorality that Ivan admonishes is the very divine command argument that I think we all can agree is wrong. Is it not pernicious to do something only because of promise of reward when you die or (conversely) threat of punishment if you don't?

Isn't it simply better to be good for the sake of goodness? Or for the sake of your brother? (hint, hint)

Ivan's philosophy cannot be diffused down to this completely fabricated quotation. To do so would be to rob the character and the author who created him the credit he deserves for encountering, before even the philosophers that defined the school of Existentialism, existentialist though. I see much more uncertainty with Ivan as the novel progresses, instead of uncertainty, and the suggestion that this reduction is at all valid robs the literature of vast meaning.

Furthermore, to suggest that Dostoevsky himself shared this view is perhaps more deleterious. Now, not only is it suggested that a main character draws such simple conclusions, but the author of one of the greatest literary works of the 20th century is portrayed as "fearful of its eventuality", as though the Brothers was some warning against atheism!

This sort of intellectual dishonesty is poisonous.

Shame on Mr. Wolpe. And shame on those who continue to misquote Dostoevsky to advance their theism.

Monday, November 17, 2008


So sad that for many, this is TRUE.

Tales of the Perineum

Pictured here is one of many different views of the Pelvic Floor and Perineum. This is the region of the body that has, well, all of those bits that you need to finagle around during your history and examination without *actually* talking about them.

At my medical school 'Abdomen, Pelvis, and Perineum' (APP) is the last large anatomical section covered before the comprehensive final exam. The faculty, wisely, threw us into Perineum first, as though to get out of the way.

You see, this section turns every driven, focused, sometimes married medical student into a Twelve-year old-- if only for a few minutes during a supplemental study group session.

My moment came this past Thursday when our Supplemental Instruction, an elective review group that meets twice a week to review lecture and lab concepts started reviewing the features of external genitalia. For the vast majority of the time, we sift through the slides, label diagrams, and look at Netter diagrams that are just contrived enough, without sacrificing accuracy, that one wouldn't feel uncomfortable.

Avoid eye contact, crack a little one liner, and keep labeling-- Rinse repeat.

Our group leader, Christine, thought we should go through and check our answers as a group. Usually this is a portion of the class where a few of the students, typically bright, type-A's tend to dominate the conversation and turn each question-answer session into a competition. I joined in at the beginning of the year, tasting the same prospect they must have to set themselves apart from a group; but I've since chilled out and filled the niche of "that guy who follows up what people say with some witty retort". I figure, let's save the frustration and stress of such competition for when we have to impress someone.

Christina pointed at a structure using her handy-dandy overhead and we mumbled out an answer (or sometimes a few different answers). We began on the external female genitalia: mons pubis, labia majora, etc.

Finally her pointer landed smack dab on the glans clitoris.

Well, in the rush to answer first my good, and married, friend Steve (one of the competitive types, but with a good sense of humor) blurted out, "External urinary meatus....uh..err." He strained, quickly realizing the gravity of his error.

I couldn't resist. Before Steve could correct himself I loudly responded, "So Steve, how's your marriage?"

The group erupted in laughter for a good moment, and a few people chimed in with various un-professional-but-hilarious comments they seemed to have bottled up. It was as though we performed some fasciotomy on the compartment syndrome-like tension.

After getting that out of our system we continued with the review series and went on learning.

Wednesday, November 12, 2008

Why is Science Ed. Important?

Why is science education important?

Well, if only to relieve the fears of this woman, who would feel much better if she only knew what light refraction was.

Tuesday, November 11, 2008

The Medical School Interview: Some Advice

So, I haven't posted in a while and I thought I'd post some of my musings.

I work as an admissions ambassador at the medical school I attend. It's a nice extracurricular and gives me a chance to show off the school that I'm proud to be attending to prospective students. I also like helping applicants feel at ease through what is a very nerve-wracking experience.

My favorite part of the job is conducting the student interview. I really get excited when an applicant gives well-thought responses to the very ambiguous and often intellectually difficult questions that the admissions board dreams up. However, after conducting a bad interview or two, I thought I might post some suggestions for any pre-meds reading this.

What not to do during an interview:

1. Do not ask the interviewer what he or she thinks about the question.
I've thought about the question, I've probably answered it in my interview. The idea of the interview is for me to get a better idea of you as a candidate, not the other way around.

2. Name dropping isn't impressing anybody.
No, I'm not interested that you share Schopenhauer's opinion on the subject. That is, unless you explain what Schopenhauer's idea was and why you agree with it. Asking me if I've "read Schopenhauer" and stopping when I say that I have doesn't make you a better candidate.

3. Don't bring weaknesses up unless asked.
I make it a point to ask what applicants think their biggest strengths and weaknesses are. However, don't start the interview off by telling me why you got that "C" in Physics. I didn't even know you got a "C" in Physics until you told me. And now I have to listen to your awkward excuse. If you are going to say things without a prompt, make them positive things.

4. Speaking of weaknesses... be honest.
I wasn't the strongest candidate for medical school. I wasn't the 4.0, 15 extracurricular, 42 MCAT student either. But when I ask you a question that requires some honest introspection, don't give me a weak answer. For instance, if I ask, "How do you think you won't be a good fit for medicine as a career?" a bad response will be, "I care too much. I will have a hard time if I don't get the tests I need when I want them." Or when I ask what you think is a character weakness, don't reply, "I am too compassionate. I would spend all of my time on every patient so they receive the best care I can give, at the expense of my own time."

Give me a real weakness and a real solution. I will give you points for self-examination.

5. Don't ignore the strengths and weaknesses of each program

I chuckle when I read the U.S. News and World ranking of medical schools. You know how they make their lists? They rank schools based upon faculty bias, the credentials of entering students, and the number of applicants that the school rejects. I'm serious, check out their methodology.

The fact is: latissimus dorsi, glycolysis, Trisomy 21, dermatomes, H&Ps, and all of the details that a med student are expected to learn do not change from one medical school to another. Every student is expected to demonstrate the same proficiency on the USMLE and every school will likely prepare you.

So don't ask me about my schools rank.

Instead, tell me the aspects of the program you are applying for that you like or don't like (if you care to). For instance, my school puts an emphasis on developing globally minded physicians who have a concern for the underprivileged. My school also wants to create doctors that will stay in state. My school has one of the best Primary Care programs in the country.

Telling me you are a future Dr. Meredith Gray hoping to go into CT Surgery out in suburbia will not earn you points.

Yes, our students pass the USMLE at higher than the national average (which is already 90-ish percent). No, I don't know our exact score. Yes, you will likely place your first or second choice residency if you try hard enough. Yes, even programs like Mayo and Mass Gen. No, I'm not impressed that you went to Darthmouth.

6. Choose your examples wisely
One thing that impresses me is when an applicant supports his or her answer to my questions with an example from his/her clinical experience. I'm aware that not everyone has clinical experience, but I can guarantee it will make a much stronger applicant out of you if you do.

If you don't have clinical experience, talk about some sort of experience that might be equally significant, such as volunteering at a charity or following a family member through a medical problem.

The reason I say this is because I find it hard to believe that your experience at Best Buy working on the Geek Squad taught you as much in terms of interpersonal communication. I'm sure it was a difficult day for many of the people who came in with broken computers and software. But I doubt the experience was as life changing as you are describing it. Besides, I don't these people are having nearly the "bad day" that they could be having in, say, a cancer ward or emergency room.

Hope the advice helps. Or at the very least, amuses.

Tuesday, November 4, 2008

Election: My predictions.

My “day of” Predictions for the Election. I’ll be liveblogging this.

In 2 hours, approximately, polls close in parts of New Hampshire, lots of Kentucky and lots of Indiana.

Indiana, the crossroads state, the “South of the North” if you will… is sort of a conundrum. I always know when I’ve crossed the border between Michigan and Indiana. Country music infiltrates stores and gas station. Drawls and drawn out syllabic stresses leak out of people’s mouths. And “yee haws” spring up randomly from large enough crowds. Pollsters have Indiana listed as a “swing state”, however it has voted Republican in the last 10 elections. Gary and Indianapolis will definitely go blue, but given our electoral college system, I suspect that Obama won’t be able to take enough from the otherwise massive landmass occupied by the rural poor who, paradoxically, consistently vote for the candidate that is least likely to help them. I’m going to predict that McCain will take the state.

I think recent polling has Kentucky pegged Republican. I think that the 6-7% undecided voters will likely split down the middle. Some polling shows many of these undecided as already setting up camp with McCain.

New Hampshire will go with Obama. The reason I think this is because if we look at their history, they have aligned with the more charismatic candidates in the election. Also, NH voted democrat in 2004, obviously sick of Bush policies. With McCains alignment with the GOP home base, he’s consequently “aligned” with Bush. This will play against him. Cheney’s endorsement of McCain can’t help him, either… honestly I don’t see how Cheney endorsing anything would help…

At 6:00, Obama will have 4 electoral votes and McCain 19.

At 7:00 we’ll find out if I’m right about NH, KY, and IN. Polls start closing at Florida, Georgia, South Carolina and Virginia.

I don’t think we’ll see too many surprises. Here’s my prediction:

Georgia will go Republican.

South Carolina showed some promise for Obama in preliminary polling. But more recent polling has shown the gap to close and McCain to take a slight lead. I’m not very confident about my predictions in this state, but seeing as they voted Bush in ’04, I don’t think the southern conservative nature of the state will turn it Red on the election maps after the polls close.

Florida is definitely a swing. Palm Beach, Miami, and most of the southeastern state are typically democrat. However, I’m confident that Obama will take the state despite Florida’s strong conservative constituency in the panhandle and among a large population of elder voters. I think they are going to support Obama’s social policies. Conversely, they could be scared off by comparisons of Obama’s positions to socialism or drawn to the fact that McCain is likely older than they are.
I think today will be the first election in 40 years (the last 10 elections) that Virginia votes Democrat.

So, current count:
Obama has 44 electoral votes, and McCain has 42

A word about “swing states”.
Current polling shows that Obama will win even if he loses the swing states. So some upsets will need to happen for McCain to terrorize my future with fear of his impending death and Palin’s rise to power.

As it stands, Missouri, North Carolina, Ohio, North Dakota, Montana, and Nevada are “swing” states that I’ve not mentioned yet.

Of these, I think Obama will take Nevada (he won strong in the primaries) and Missouri.

McCain will likely take Montana and North Dakota. These are based on historical best estimates.

That leaves Ohio and North Carolina.

Ohio is a unique state, and fits in a bit of a political crossroad. It has a higher distribution of urban centers than Indiana, which suggests to me that it is more likely to gravitate towards Obama. However, the regions that are Republican are some of the most conservative districts in our country. Ohio voters are aware of their influence and potential to direct elections following 2004. So, there has been a lot of work done by both political parties to gather support in the state. However, even though the gap was closing with recent campaigning by the wildly popular Palin, I think the 1-5% lead by Obama will stick.

Call my optimistic, but I really hope he takes Ohio, that will really suck the life out of McCain’s run.

Virginians haven’t voted Democrat since LBJ… I really feel like the large urban growth and support through local politicians (popular politicians) in the area for Obama will swing it for the Democrats. This would also be a fairly big victory for Obama.

Now, I’m going to take a break until the first results come in and study for Anatomy. Take care, readers!

Update: 7:01 PM.. Looks like the predictions were solid. McCain takes KY and Obama NH. So far, it's almost neck and neck in Indiana, however, Obama is taking some of the rural (and typically Republican) districts. Polling hasn't even closed in the larger population centers.

A final note on the Election:
Obviously I couldn't liveblog as studying comes first for medical students. However, I was pleased to see Obama take a massive victory in this election. I can't help but feel hopeful despite my natural skepticism and cynicism when I hear him speak.

We learned that Virginia can vote Democrat when the man has the degree of character that Obama does.
We learned that young people can go out and vote and actually change the election.
We learned that in Michigan, we support science and research as well as making relatively harmless drugs one step closer to decriminalization.
We learned that there can be a massive voter turnout, overall.
We also learned, importantly, that our country is ready for a man that won not by the "color of his skin but the content of his character."

A happy day for America.

Monday, November 3, 2008