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More Biology love from my homies over at MIT. This is a picture of new research on the chemotactic factors that allow axons (those lovely little things that are growing) to follow certain paths, or to even grow at all. The cell on the right is a mutated cell that doesn't express the Ena/VASP proteinsthat appears to be necessary for the growth of the axons. Cool stuff.

Prompted by yet another story on NPR about Oprah's 20 Favorite Things Show and how well it promotes certain products, I've decided to make a list of the 20 things that are the most important to me this holiday season.

20. Greybeard (even though he pisses me off sometimes....ok most of the time)
19. My Little Special Friend
18. My First Love
17. My Med School Mentor
16. My Awesome Little Sister in Small Group
15. The Ritmos and Med School Salsa Crew
14. The God Squad and Potluck Crew
13. Hispanics - thanks for all the culture and food
12. My childhood friend out on the East Coast
11. My old roomate and constant source of comedy
10. My Free Spirit Mountain Town Roomate
9. My Awesome Little Sist"a" in Small Group :)
8. Chuck Norris (had to throw it in there)
7. The sweetest little Inuit you'll ever meet
6. My Med School Roomate
5. My adopted Ma and Pa
4. My High School Best Friend and Mentor
3. My Wonderful Family
2. Mom and Dad
1. She Knows Who She Is

You are all precious to me (including you Chuck). Have a happy holidays

I was listening to a story on NPR the other day about conditions down in Guantanamo Bay. They were doing a report on the medical facilities down there which naturally peaked my interest. It started off fairly tame with Dr. GMO (general medical officer) talking about the new cardiac catheterization unit that they had flown down to take care of a patient. The doctor was complaining that it cost a lot of money to fly the unit down here and now the patient was refusing to allow the procedure to be done on him.

Then the reporter asked about the hunger strikes that were occuring. Apparently there have been as many as 50 prisoners on a hunger strike at any one time. With a tired tone in his voice, the doctor described the procedure. After 8 days without food, the prisoners were put on a "medical watch" and if they still refused to eat, then they were brought into the clinic, strapped to backboard, drugged, and a tube was threaded through their nose, esophagus, and into their stomach to start enteric feeding.

I listened with horror and revulsion as this doctor described the procedure being done on someone who was perfectly competent to make their own decisions and would obviously resist if given the choice. There will probably come a time in my life when I'll have to strap somebody down and perform a procedure on them because they are out of their minds or an immediate danger to themselves or someone else. But that threshold will be pretty high. The prisoners pose a danger to themselves, but they are not hunger striking because they are crazy or drunk, they are hunger striking because they have no hope of ever escaping from their prison cells. They have no hope, no recourse, no trials, no friends and family to come and visit them...in short no reason left to live and nothing that attaches them to any scrap of what makes us human. But these physicians are keeping them alive, locked up in their holes, with no control, no hope, no joy, living but not really alive.

This is an immensly powerful education that I am receiving. I will always endevour to use it for good, but imagine the horror a doctor would be able to inflict if he turned his education toward pain and suffering. Picture yourself strapped to a table, IV in one arm, a slow drip of paralyzing medication leaving you completely immobile. But you can still sense, you are able to feel the air forced down your throat every time the ventilator compresses air into your chest. You can feel the hole the monster has poked in your abdomen to insert the feeding tube that is keeping you alive. You can still hear and he stokes your fear and anguish with chilling words. How long before you would want to just die?

There is no doubt that medical school is stressful. There is no way that any human being could absorb this much useless information as fast as we are being taught it. It's how people handle that stress that says a lot about their person. I think this is a general rule and applies to everyone. How you handle stress reveals the most about your inner character.

People are so rarely severely stressed that it's difficult to see that true character. I think that's why I like the people I encounter in medicine so much. I would say the vast majority of people become monsters when they are severely stressed. They get angry, petulant, whiny, and are just generally people that you would not want to hang out with. They might be the nicest people in the world when you encounter them anywhere else, but in a stressful situation, they just suck. I woudl say I actually fall into that category too, but I am working on it.

Then there are the people who seem to somehow rise above the circumstances and realize that there are not really that many things in life that are worth getting stressed out about. Every once in a great while you will encounter a patient whose illness seems to have transformed them into an angel. These are people with life-threatening illness (the ultimate stressor) who seem not to have a care in the world. They are kind, patient, and willing to help in any way that they are able. These are the people that I latch onto in my environment. I am constantly trying to learn from them how to combat stress, and to learn how to be a better person. They have forged their soul into something beautiful and strong and I would like to emulate it.....

But since I am still a little snot who likes to complain, here is my rant against the characters that have emerged from the pressure cooker that is med school:

1). The Vampire
These people stay up until the ass-crack of dawn studying because they think they can cram the information into their heads simply by staring at it for a pre-determined number of hours. They also like to brag about how late they stayed up to make everyone think that they know so much simply because they were stupid enough to stay up all night. This places more stress on students that are dumb enough to fall for the ploy and like the bite of a vampire, they transform into more vampires. The only way to stop these creatures is to stab them through the heart with a wooden stake.

2) The Bitches
These are the girls (and some guys) that you knew would inevitable crack under the pressure. They have these really high, whiny voices and walk around bitching all day about how unfair the last quiz was, or how unfair it is that we have to learn all this info, or how they don't have time for anything anymore. They tend to get really angry almost all the time about the stupidest things. "What!!! The anal sphincter is going to be tagged on the test? That's so unfair." The only way to stop these creatures is to stab them through the heart with a wooden stake.

3) The Stress Balls
These people have STD (Stressful Test Disorder). They walk around talking really fast and asking all kinds of questions without really waiting for a response. They are very pushy and seem to hover around the teacher at all times asking really annoying, pointless questions. Unfortunately, their disease is contagious as I have seen perfectly normal students go into a group with a Stress Ball and come with STD. They come back saying, "OMG I don't know that. I need to learn that. Do you know that? Where can I find that? What are the attachments? What innervates it? OMG!! OMG!!" You get the idea. I have no idea how to stop the spread of this terrible disease. We might have to quarantine it. That would actually be an interesting experiment. Put a bunch of Stress Balls in a room and see how long it takes before all of them have heart attacks.

4). The Geniuses
Somehow these people seem to hold it completely together and yet know everything about everything. It is pretty funny to watch the Stress Balls and the Bitches bounce off them.

5). The Slackers
These are the people who waste a valuable hour the night before the test typing a rant against their fellow students. They are impervious to STD and vampirism although they can still be bitches. Long live the slackers.

Economic Look at Bush Policies

What $611 Billion could buy

I'll give it that it's a little baised, but it's all true, and it's time for America to wake up and realize just how stupid we are acting. We are headed for an economic crisis of biblical proportions. I'm not talking about just the Iraq war or anything like that. Medicare is going to double it's rolls in about 10 years and we're going to be so far in debt that there's nothing we're going to able to do about it. The rest of the world knows this...hence the plummeting dollar. The prospects don't look good for the American economy. Let's elect somebody next year with a little saner economic policies and a little more decision making acumen.

Update:

Warren Buffet agrees with me.

He just says it a little more eloquently and with a lot of decision making acumen backing him up.