Neurologist

Today I met with a neuro fellow at my institution. It turned out that I had actually seen her before, and she remembered me from one my neuro rotations over the past few years.

She does health services research in neurology, specifically on dr-pt communication with patients and families with neurodegenerative illnesses. Her experience with her department was consistent with my impression -- that most of the faculty here do basic science, or maaaayyyybe translational research. A lot of them didn't really understand health services research. That being said, they seemed to be at least somewhat supportive of her career path. She also said that her area of research was growing, even if most neurologists here didn't "get it" and that sooner or later they probably would.

I guess we'll wait and see. She enters the job market this year. I'm not sure she's going to end up pursuing a research career, or even a career in academic medicine. A lot is up in the air for her, and I got the sense that she isn't exactly sure which way to take things. I wonder how things will go for her given that she's a little different than your typical neurologist.

She also recommended specific people to talk with in her department who shared her interests.

In any event, she was completely awesome to talk with (as have been almost all neurologists I've met here at [my institution]) and made me miss neurology. It was also really interesting to hear her perspective on the field she researches, on the hospital hierarchy, and on different pathways that people take in neurology. She also made me think that neuro- critical- care might really be a viable option for me. At very least, these patients don't die *quite* as often as they do in the MICU.

I'm really curious to see where her career takes her, especially considering how unique her interests are in her specialty.

Batch

Today I learned how to run a batch job in SAS.

This means that I can run a bunch of time consuming programs in the background on my computer for HOURS while I pursue other activities.

In this case, I am watching tv. I don't think I can stand to look at another statistic for at least a few hours. My head hurts.

Water for Elephants

Whoever recommended Water for Elephants to me a few months back: Thank you. It was the best book I've read in a LONG time. Actually, I can't remember one I've read in the past 5 years that I've liked as much.

Too bad you can't humanely destroy certain people.....

Today was the last day of really beautiful weather that we're going to have here for a while (mid-90s next week -- YUCK!!) so I decided to take the Boo for an extended run around the cemetery this morning. Technically, no dogs are allowed, but people are almost always in there in violation of that rule, and I always keep the Boo on leash at the perimeter so she doesn't go shitting on someone's great aunt's grave.

Unfortunately, not everyone else does the same. There's something about the outdoor spaces + West Philadelphia mentality that makes people feel like they don't have to keep their dogs on the leash, even though it's the law.

But anyway.

As I was making my way around the perimeter of the cemetery, I saw a thin white man with curly white hair and a disheveled looking woman walking around the perimeter with their three dogs. All off leash. And they were big dogs too. They looked like Rottweiler-Shepard mixes. And of course they swarmed me and the Boo, wagging and sniffing, failing to recall as the owner called them. Fortunately, the Boo isn't one to freak out in situations like these, but many dogs would have.

I said to the guy, "What if my dog weren't friendly? This could have been really dangerous."

And he said, "What if MY dogs weren't friendly."

"Um..... if they had attacked me or my dog, I would have probably sued you, and potentially fought to have them humanely destroyed as dangerous dogs," I said.

"Yeah, YOU WOULD do something like that," he said (bear in mind -- I've never seen this person before in my life).

"Your dogs really need to be on a leash," I said, running away, "What you're doing is unsafe."

"Oh yeah? F*** YOU!!!!" he bellowed after me.

So I get to the dog park later, and I'm talking with one of the members about what happened, and he said, "Hey I know that guy. Was he tall, thin, with white curly hair and a disheveled looking woman following him? That guy is a professor at [your institution]."

"Really?" I said, "I wonder if he's a physician."

So folks, I'm taking guesses. If he were a doctor, what specialty do you think he would be?

Yesterday Sucked

Here's hoping today is better:

1. One of the geriatric dogs at the park didn't like having the Boo within 3 feet of him and snarled repeatedly (Boo wasn't really even that obnoxious -- didn't make direct eye contact, hump, or even sniff). This didn't go over all that well with the Boo. We mostly just take her to do obedience and play on the agility equipment these days anyway, but it's a reminder that we have to be really careful with her. Everyone does with their dogs, I guess.

2. Then I found out that the person who is in charge on the T32 I'm on might try to prevent me from getting off of it before 1 year is up should I actually get this F30 that I got the perfect score on. This could force me to decline the F30??? I don't know. It would really F me, since the F30 would fund (part of) me for 3 years, and the T32 gets renewed year by year....

3. THEN my Access database became corrupted. Fortunately I had a backup, but still.

4. Then our programmer told us that he miscalculated one of our main predictor variables that we're using for our analysis.... and he still hasn't gotten us the corrected dataset.

5. And then I discovered a leak in our shower. Water was dripping onto the living room floor.

I eventually did have a pretty productive day, but MAN the first 1/2 was pure suckitude!

The plumber came today. We will be retiling our bathroom and getting a new pan for the shower. Bye bye $$$$!! (Ah the joys of homeownership.) Though I will add that it was incredibly cute when the plumber was explaining what they were going to have to do with the shower, and Boo crawled into the shower and curled up next to him. Hee.

At least today is better. So far. I guess every so often a sucky day is necessary to keep the good ones coming.

Oh. My. God.

So the bike drama continues.

I finally met perpetrator #1. She seemed pleasant enough, and was very apologetic.

But then perpetrator #2 appeared. He decided to lock his bike next to the handrail to the stairs leading up to our properties. His bike was IN my garden.

So I rang the bell and asked him to move it.

So he moved it. To the other side of the handrail so it was blocking the stairs.

So I rang the bell again.

"Are you obtuse?" I asked. I know, I could have been more polite.

Then the MOM came outside and said, "Well, you know your DOG WALKER leaves her bike there."

?!

Seriously?

The MOM is defending this BS?

Anyway, I said, "Well I'm not here when she does that." I dropped a note to the dog walker suggesting other locations to put her bike -- including inside my house if necessary -- in case they decide to make a stink about it to her.

The guy then walked around for about 10 minutes trying to find someplace else to put his bike that was not attached to someone else's property. Finally I poked my head out and said, "Hey maybe you can put it in your garage." Since, you know, they don't keep a car in there or anything. "It'll be nice and dry when you ride it home then too," I added since it was raining. And it's about 1000x more secure than it is attached to some handrail in the ghetto.

Gah!!

Will the drama never end????

I mean, you'd think that the mom at least wouldn't have given me the back talk. Perhaps this is where the child learned the behavior, however.

:-P

Fun times.

Ok, I feel better now that I've vented. Back to work for me!

What a good dog!

Boo did AWESOME today at her evaluation!!

Sit, down, come. All on the first try. Then she ran around off leash in the agility area. Did the tunnel, A-frame, and a bunch of jumps. We got her to do the see-saw even though it made a loud noise when it thunked on the ground and scared her the first time. AND Luca had her do the dog walk, which she'd never done before. She just trotted on up and across at the full height!

She did her mommy proud. Even the dog trainer said she was surprised The Boo did so well.

We were given clearance to do either Foundations for Dog Sports, or Basic Agility. Woohoo!! No remediation for her!

(yet - she still hasn't seen Boo in a group of other dogs when she finds them irresistible to go say hi to)

Yay! What a good doggie!

Baby

A friend of mine was pregnant last year, and due to give birth during March -- right in the middle of a semester. Fortunately, she was finished with most of her coursework, and was only enrolled in one class that semester.

So, at the beginning of the semester she decided to speak to the teacher about the fact that she was likely going to be giving birth in the middle of the semester.

"Are you planning on videotaping the lectures so that maybe I can watch them from home the first few weeks after I deliver? I would really like to be able to keep up, and that would be a great help." she asked him. It was not an out of the ordinary request. Many students in my program are forced to miss lectures from time to time due to -- among other things -- clinical obligations, and consequently many faculty members videotape their lectures as a courtesy to them.

But instead the teacher was an ass to her. "I'm not making any special accommodations for you," he said. "It's your responsibility to make up the material, and if you can't cut it, too bad for you. It was your choice that put you in this situation to begin with."

Such is the environment women in academic medicine often face. My friend swallowed it and took her B after missing three weeks of class. I was impressed at her restraint. I can imagine that I might have been unable to prevent myself from telling him to go F himself, and where he could go shove his class (and his paunch bellied balding ego). And then I would have complained about him to everyone in the department who would have listened. For good measure, perhaps I would have followed that up by bringing my baby to class with me, nursing, and then pinching her so that she cried, interrupting his precious lectures.*

Her question was not unreasonable. Where do jerks like that get off?


*I wouldn't have actually done that, but it's fun to fantasize, isn't it?

Remediation

Tomorrow Luca and I are taking the Boo to the Y2K9 Dog School in order to have her "evaluated" so that we enroll her in the appropriate class this Fall.

We want to enroll her in either a) an intermediate obedience class, b) an introduction to dog sports class, or c) recall bootcamp so that we can try doing agility with her at some point in the future. You see, in order to do agility, she is going to have to be able to remain focused on us -- OFF LEASH. I'm not convinced this is ever going to happen.

I just KNOW that Miss. Boo is going to forget everything she knows and we will have to remediate basic obedience. Again. I am tempted to bring photographic evidence of her doing the see-saw, tire, jump, ramp, tunnel, and table at the dog park, and a possible video of her actually obeying me..... but I fear that this would be lame, and viewed as a pathetic attempt to prove that my dog is actually better than she is.

As in, "I swear she knows how to do a down-stay!! Just look here on the video!! Please don't make her remediate basic obedience!"

So this evening (and this morning), we are going to be practicing. A lot. Miss. Boo -- Please don't let me down!

I wonder if this is what having kids is like (x1000).

Which brings me to another point

My coffee meeting with the IM person this week went really well. Nice guy. Interesting career trajectory.

Invaluable advice: When you're a fellow, figure out what you're interested in, and define that interest clearly and articulately. Then sell yourself and your idea to your department chair. Even better if you can get a grant doing what you want to do first.

He said that at first he'd been waiting for people to take interest in him, to give him things to work on, but that ultimately things started going his way when he began trying to sell himself and his ideas.

Really useful advice for us aspiring clinician scientists!

She rips her hair out in frustration

I am supposed to be starting "clinical connections" as a way of figuring out what kind of residency I will apply for, oh.... 3 years from now. This can involve the dreaded shadowing (kill me now, please), or other activities like going to conferences, having coffee with people who do what you think you might want to do, doing a shift in the ED, working in clinic with a dr you know. Things like that.

Later on, I'll be able to use clinical connections to bone up on those clinical skills, which become inevitably rusty after 3-4 years of non-use. In theory.

Anyway, I'm considering doing clinical connections-type activities in the following specialties:
-Internal Medicine
-Emergency Medicine
-Neurology

I had coffee with someone earlier this week who does IM, which was very useful, and I'll probably do something like that next week too.

So on to neuro. Where to start. They don't seem to understand what I do. Most neurologists who do research do basic science and, how to put this delicately.... they think what I do is bullshit. I'm not going into a field where most people think my research is bullshit because it will be that much harder to find a job.

You get me?

Anyway, I was talking to one of the fellows about this yesterday. However I quickly realized that this was a mistake for several reasons.

1. It turns out she never came up with her own research idea this past year. Buh bye research career! She's probably going to end up doing 100% clinical when it's all said and done. Nothing wrong with that, but not at all what I hope my career trajectory is going to be.

2. She started suggesting that I offer my services to various attendings to do their research for them. Um no. I am at the point at which I am designing MY OWN studies, getting MY OWN grants, collecting MY OWN data, coming up with MY OWN analysis plan. No offense, but why am I doing this just so I can be some attending's -- who knows less than I do about research -- data-slave on some study that I can have no input in the design of. I would be happy to offer my services as a consultant, to collaborate, etc. But seriously, I just don't need bs publications from collecting data for some poorly designed research study. Also, I don't have time for that. You see, I have this thing called a DISSERTATION to work on that I would like to finish sometime this century.

3. Then she suggested shadowing a variety of doctors who, incidentally, I have actually worked with in the past. As in worked with as a medical student where I actually CONDUCTED THE H&P MYSELF, wrote the note, and come up with a differential and a plan (with help). Why would I want to shadow these same people now?

4. And she only suggested outpatient options, increasing my impression that if I did Neurology, I would be mostly an outpatient doc. Which I don't want to be. Sigh.

5. She then referenced the two people in the department who have Masters degrees and do clinical research "like me", one of whom has told me in the past that a Masters degree is equivalent to a PhD. And neither do health services research.

So apparently not only do the neurologists I've talked with not understand what I do, but this one also doesn't actually understand that the career trajectory of a med student is not the same as that of an MD-PhD.

Or that I may know more about research now than she will ever know in her entire life.

Or that I would rather lobotomize myself with a pencil through my orbit than shadow. EVER. AGAIN.

You know, I do appreciate her talking to me about this..... but it's so disheartening when people just don't get where you are, and give generic advice that doesn't really apply.

Joy.

To Do

My To Do list has gotten more manageable. That is to say I now have ONE project I'm working on right now, and no class. It's a rare luxury that will end soon, as this Fall I am taking not one but TWO statistics classes, plus the doctoral seminar, plus or minus (I'm hoping minus) this seminar I'm supposed to take because of my funding source.

Then I'll also have all the work I'm currently doing on top of that.

But for now, the bliss of having only ONE thing to do.

And I have to say, the project is going well. About a month back, I switched from STATA to SAS, and my life has gotten so much easier since, it's not even funny. Ah the joys of being able to have more than one dataset open at once. Ah the joys of not having pull-pull down menus, and actually being able to write a program that doesn't F with your data. It's fantastic, if you really must know.

So now, I present to you my to do list for the next week or so:

1. Finish building database
2. Read articles sent to my by biostatistician
3. Figure out correlation between potential confounders we may include in the model
4. Figure out how to use nlmixed command in SAS
5. Continue reading and reviewing stats from last year
6. Figure out missingness of potential confounders

I think that's it for the time being. To celebrate, I slept 30 minutes later than usual and hung out at the dog park for an extra 30 min. I think Boo enjoyed herself. I know I did.

Oops

Do you have friends who you like, but who posts status updates on facebook constantly? I usually hide these people's updates because really? I don't care about your damn goldfish. Or that you just bought a new pair of shoes. Or ate at the Reading Terminal Market for lunch.

Then you run into them, and they start speaking about some event that they posted a series of status updates on, and they expect you to know all about it. When you look like you don't know what they're talking about, they say, "Didn't you see my status updates?"

AAAAAHHHHHHHHH!!!!!!!!

Of course you can't tell them that you blocked them because that would be mean. :-P

I usually just say, "Oh I haven't been checking fb all that often. Tell me about what happened?"

I knowI'm not the only one with this problem.

****

The other thing I've been doing to procrastinate lately is culling my fb friend list. Can't remember who you are? Wouldn't recognize you if I saw you? Wouldn't want to talk to you if I did? I unfriend you.

But then there are people in my med school class who fall into that category. Part of me worries that if I unfriend them they will find out. And then what if in a few years from now, they become my attending? And maybe having that connection could be useful in a few years since they ARE in my field.

As a result I have a sh*t-ton of "friends" whom I barely know -- just because they are doctors.

Gah! I do wish I could unfriend a few of my most annoying classmates without repercussions, but that just seems like a bad idea, now doesn't it.

Relationships in Med School: Will it Work Out?

4 years ago this past week, my husband had an interview at the company he works for now. He was still living in Chicago, while I was starting med school in Philadelphia. He was looking for his first position as a scientist after finishing his post-doc.

The job market was bad, though not as bad as it is now.

I remember many people telling me that our relationship would never work out once I started school. That ALL pre-med school relationships failed once med school started, and that we would be no exception. A friend who had just gone through a divorce during her third year of med school was especially negative, perhaps understandably.

Another girl I knew (Hi Jenny!) asked me how it felt to know that Luca had chosen the city of Chicago over me. How was it, she wanted to know, to be rejected for a city?

A few days after today, one week or so into med school, Luca received his job offer. He moved here shortly after, and the rest is history. We've been together almost 6 years now. We'll have been married 4 in November. And I have to say that I have one of the most awesome supportive husbands out there.

Looking at stat counter, I see a lot of searches for "long distance relationship in med school doomed to failure" or "divorce in med school." Apparently this is a concern for lots of first year med students.

Will your relationship survive med school? I don't know. Does your man want you to prepare lunch for him everyday before he goes to work? Does he want you to keep an immaculate house, cook dinner for him every night, bear him multiple children, and still get that derm residency?

Does he resent that you want a career, and that this takes time away from him?

Then, your relationship might be in trouble.

But even if it doesn't work out, the majority of my classmates whose relationships fell apart during the first year of med school are now in new and better relationships now. Largely with people who are with them in part BECAUSE of their career aspirations rather than in spite of them. Even my bitter divorced friend has a new bf.

And then there are the classmates whose relationships did survive med school and are still doing great starting off residency. A lot of these folks are married now.

So my advice? Take a deep breath. You will be fine. You will be fine whether or not your current relationship survives med school. Better than fine. You will be great.

And Jenny? You can blow it out your a**.


Anybody have med school relationship success stories? Crash and burn stories? Advice? Please share!

First Year

The first year medical students start medical school at my institution today.

I can't believe that was me 4 years ago.

These are the kids who will be graduating with me -- if I in fact graduate in 8 years total.

Scary thought.

Today at the park

The SeeSaw


The Ramp


The Little Jump


The Tire


The Tunnel


The SeeSaw (Again)


The Begging (and Sitting)


The Tub


The Ferocious Pit Bull


The Tongue


The Aftermath

Teeth

Last night Luca watched the movie Teeth on Netflix. It was pretty decent. I mean, horror is not really my preferred genre, but the black-comedy aspect of it was appealing. And it was decently done.

It was about a girl with the vagina dentata mutation, and well, I'll leave the rest to your imagination.

Luca and I read its reviews posted on Netflix later on that night, and I was amused to see that most of the negative reviews commented on how unfair it was that "all men" were portrayed as jerks, or that they didn't approve of the "abstinence message." I figure, if the only people criticizing it are getting their panties in a bunch over silly things (it's a campy horror movie, people. Any "message" it sends is by definition not to be taken seriously), it probably was pretty good.

*****

In the same vein, we saw Waitress the previous night. And all I have to say is, Man. What a disappointing movie.

Keri Russell plays a waitress who makes amazing pies, who is trapped in an abusive relationship with her husband. She then discovers she is pregnant, and proceeds to have an affair with her Ob-Gyn. Incidentally, the Ob/Gyn doctor is cheating on his completely adorable wife, who is a resident at the hospital. What does he find attractive about her? Her delicious pie.

Ew ew ew ew ew ew!!!!!!!!!!!!

I really don't understand how anybody could find this NOT creepy. Or romantic. Really? An affair with your Ob/Gyn? Really?

Say it with me again: Ew!!

Of course in the end she is rescued, but I won't say by whom.

*****

Well anyway, that's what Luca and I have been up to this weekend. Maybe at some point I'll get around to reading some Epi.

Apparently

Apparently the bike chained to my fence DID belong to my neighbors. Even though when I asked them, they denied it.

This is the house with the obnoxious loud graduate students whose mommy bought them a house for $310,000 cash. Over the summer, before the obnoxious grad students moved in, there was a couple living there who seemed reasonably nice. They were quiet, anyway.

The couple told me last week that one of the girls who is going to be living there this year had just moved in. They are moving out themselves in 2 weeks or so. I guess the daughter is moving in in a few weeks. God knows when the rest of her friends will arrive. God knows how many of them there will be. It's like a freaking commune over there.

Anyhow, I am guessing that the bike was the new girl's. Now it is chained to the gutter on the front of THEIR house, partially obstructing our common walkway. I think I am going to let the air out of the tires tonight after it gets dark.

If only I'd acted more quickly with the bolt cutters.

:-P

Bang the Drum

They used to play this song every night on the radio at 5PM on 101.5 FM when I was a teenager. Yes, I listened to the classic rock station. Of course, pretty much every station that we got in the NW corner of CT was classic rock.... except 104.7 which played things like Mariah Carey. I pretty much gave up on that station when I went to high school, and it was no longer cool to like pop. At prep school, all anyone ever listened to was Phish and the Grateful Dead.* I never really got into either of them. Maybe because I didn't smoke huge amounts of weed.

Ironically, one of the things Luca liked about me when we first met was that I knew the lyrics to almost all the random classic rock songs that would come on the radio. Ah, to be able to remember pathophys like one can remember song lyrics.

Anyway, I thought this was a stupid song at the time, but now I totally get it. That's how I happen to feel THIS lovely afternoon.

Enjoy!




*Do they even exist anymore?

Bike

A few days ago, someone locked their bike to the fence that divides our property from our neighbor's property. This actually took some effort on their part, as they had to carry the bike up our front stairs and walk by our garden in order to put it there.

And I find myself feeling a bit annoyed. I feel somewhat irrational about it, since really the bike isn't bothering me, and it's not as though I need the fence for any purpose other than as a fence.

But they didn't ask. And it's on our property. And it's been there for 3 DAYS now. And it's an eyesore.

I really really want to cut the lock and dispose of it.

Of course, this may be ill advised, since the person who locked it there? Who knows who they are. They could angrily accost me and demand that I compensate them for their stolen bike.

Of course, I could also deny knowledge of the bike's missingness. And anyway, it's on MY property.

So dear readers, two questions for you:

1. Exactly how long do I need to give them before I dispose of the bike?
2. What kind of tool do you need to remove a bike lock? It's a flexible coil lock, not a U lock.

(See, I really AM a b*tch.)

Nice

I was reading an article today on how to be a successful clinician investigator, and the following sentence caught my eye:

I assume that no reader will seriously posit that being a nice person is a prerequisite for academic success.

Phew!

It's good to know that between making 4 year olds cry, and bitching my husband out today (loudly and in public) for locking me out of the house (unintentionally -- don't ask -- you really don't want to know), and then driving to work, I'm off to a great start in the "not-nice" department.

Even better to see that this in NO WAY will impinge upon my future success as an academic.

Small Victories

Boo did the see-saw this morning at the dog park BY HERSELF! I'd been holding it for her so it wouldn't move suddenly and scare her, and then I'd lower it for her. Today she moved it herself, and I let it drop to the ground with gravity. She was a little surprised, but didn't seem scared or jump off. Then she repeated the exercise 3-4 more times.



Admittedly, the above image is not Boo, but I didn't have my camera with me.

AND she did this all with other dogs in the park. Before she would have been too distracted to do any of this with me.

She also:
- Does a nice off leash heel in the park (not with other dogs there yet though, we're working on it)
- Recalled over a jump -- and didn't even try to go under it
- Runs through the tunnel to ask for a treat

We still have to work on better attention when there are other dogs around, but she's made so much progress. I am really proud of her.

She is so awesome!

I think I made a little boy at the park cry today

I was walking Boo, and he literally came running at full speed across the park to come pet her. Didn't ask. Parents didn't ask and weren't really paying attention.

He was so gleeful and exuberant, probably about 4 or 5. Totally adorable.

I saw him and said, "Don't even think about it. Seriously, do not pet my dog." Then I walked her out on the park.

He looked completely devastated.

I feel terrible!

The thing is, Boo is really great with people, even kids most of the time. But sometimes she gets excited and jumps up. Especially with kids. Especially when the kids move fast and don't approach her slowly, the way you're supposed to approach a dog. We're working on polite greeting, but that's what it is: a work in progress.

And plus, it's just a bad idea to run up on a strange dog like that. Not all dogs are friendly.

Still, it makes me feel sick inside to have made him cry. I really don't like yelling at other people's kids.

:-(

Dating myself

To finish up the MD-PhD retreat, we had a customary game of Quizzo. I'm not so fantastic at quizzo, but there was one question I got right:

What band was Richie Sambora in (or something to that effect)?

Would you believe that not a single person on my team knew he was part of BON JOVI! How can you live in Philadelphia/New Jersey and not be familiar with Bon Jovi?

Hm. Maybe it's because Bon Jovi was at their most famous when my tablemates were around 3 years old. :-P

I suppose at least being "old" is worth something SOMETIMES. Maybe if I'm nice, my classmates will feed me watery gruel when I'm in the nursing home too.

vocab

My husband and I just tallied the number of words The Boo now knows. She's come a long way since we got her in December!

sit
down
stay
come
square (i.e. go to the blue towel on the floor)
crate
go to bed (same as crate)
wanna come up (onto the bed)
here
find it
watch
hey! (used on walks, it means slow down, look at me, and pay attention)
wait
leave it
stay
heel (working on this in various settings)
tunnel
ramp
jump
tire
table (as in the one at the DOG PARK agility section rather than the dining room)
see-saw (just learning this one)
tub
get it
dinner (din)
pee pee
poo poo
excuse me (get out of the way)
clean up
wa (water)
doggie
Marley (her boyfriend next door -- she'll go to the window and start to whine if we say his name)
target (as in, go put your foot on this round thing on the floor)
upstairs (i.e. go upstairs)
all done! (most important)

That's 35 total. She even does some of the simpler ones in Italian. Maybe we'll teach her roll over this week.

We love clicker training.

PhoQ and other awesome abbreviations

Yesterday, as I mentioned previously, was the MD-PhD retreat. It was actually fun! I got to catch up with a number of my classmates who I almost never see, since I work from home, and they work in labs. I even had to do a "poster" describing my research. Mostly it was just a talking point to show people that Epidemiology is AWESOME!

No, seriously.

Since I was on the planning committee, I decided this would be the year to invite clinical research people to the retreat. A) There are probably 10 of us in the program in total, and talking to basic science professors about their careers is not usually all that helpful to us, and B) because many of the basic science kiddos will end up doing clinical research in the end -- whether they realize it or not -- and many are interested in exploring those kinds of options as well.

My big fear was that nobody would sit at the clinical research person table. Except for us clinical researchers of course. But I was assured repeatedly by one of my basic science peeps that of course basic science people would be interested in talking to them as well. I shouldn't worry. I was being silly.

In the end, of course, it WAS just the clinical research people sitting together. Oh well. On the plus side, I got a lot of one-on-one time with two really fantastic potential mentors. One faculty member was one of the few women in my department who had gotten tenure. She is my new idol. She has so much fantastic information, and great stories. I LOVED her. Seriously. Talking with her -- ALONE -- made that retreat completely worthwhile in my book. I just hope she didn't feel that it was a waste of time to come out the the burbs to talk mostly to ME.

:-)

Anyway, the title of this post is inspired by several of the student talks this year. For some reason there was a preponderance of talks involving proteins/genes with dirty names. Off the top of my head I can think of PhoQ and fok, but I'm sure there must have been others as well.

Of course I seemed to have been the only one who picked up on this. All the basic science people sitting around me nodded piously as the speakers went on and on about signaling pathways. Or maybe they were just nodding off to sleep....

All in all it was fun, and a good excuse to not really do much work for an entire day. Yay! And now I'm back to the ole grind. I was told today that I needed to "hurry up" on this paper I'm working on at the moment. My mentor is afraid we'll get scooped. Yikes!

Keeping your dog away from stupid people

Today was the MD-PhD retreat, so unfortunately, we had to leave Miss. Boo locked in the bedroom (with a/c) all day. With a walk from the dog walker, but still. It was a long time for her by herself considering I usually work from home.

Anyway, we got home and decided to take her to the dog park. Our usual time is in the mornings, and she has a core group of 3-4 dogs that she plays with regularly almost always in a 1:1 situation. It's either one of those dogs or it's completely empty when we go. It has worked out really well for us. None of the usual dog park morons.

We do know that there are a couple of dogs to watch out for. They do not like Miss Boo, and usually snarl at her when we even approach the gate. Tonight one of those dogs was there, so we went for a walk around the block instead. When we came back, that dog was gone, so we decided to go in.

There were three other dogs in the park. Miss Boo didn't know any of them, and she went over to sniff, and politely greet. She was welcomed by this lab mix pup who immediately started shoving her around. Then another dog came over and simultaneously started humping her. Then the third dog joined in.

Within about 30 seconds Miss Boo had been rolled over onto her back and pinned there, and was clearly uncomfortable with the situation. I was there and I started shoo-ing the other dogs away. The dogs had her on her back, and kept nipping at her, all three of them, and wouldn't let her get up. This kept up for about 30 seconds or so.

She gave a warning growl. They wouldn't back off.

Then she gave a warning snap. They STILL wouldn't back off.

Then she gave a warning growl/snap/lunge. Then the dogs started growl snap lunging back at her.

I'd also like to point out that at this point only I and ONE of the other owners was anywhere nearby. The other two owners -- the ones that owned the lab pup that was the worst offender at keeping Miss Boo rolled on her back -- were casually sitting down chilling, telling their dog "No" from a distance.

I quickly had Boo by the collar. One of the other owners also got her dog quickly. These two idiots didn't. I was standing there, with their dogs continuing to lunge and growl and snap at me and Boo in the center of it all. There was little I could do given the circumstances. It was pretty scary.

When they FINALLY got a hold of their dogs (it seriously seemed like eons later), I said, "I think that's enough for tonight, we'll just go, guys," they got all up in my face about it.

They wanted the dogs to all "work it out." I told them I thought it was a bad idea. That it was potentially very dangerous, that their dog was going to continue harassing my dog, my dog was going to continue not liking it (and telling her so), and a fight was bound to occur. Just a bad idea.

They then insisted that OTHER OWNERS had done this with their dog when she had this issue before (guess we're not the only ones....) and it had been fine. I was being unreasonable.

So I said, "Well, I have a pit bull, and if it did get out of hand, I don't want to imagine what my dog could do to your dog. It's just not a good idea."

I.e. Socialize your dog on someone else's liability policy, thanks.

Then they said it: "Well she's just a puppy!"

Well, I guess that makes it all right for your dog to harass my dog relentlessly, and completely ignore all cues that she is uncomfortable with that. And that my dog is "aggressive" for telling her to stop. Oh wait, no it doesn't mean that.

And then they said, "Well, I guess if you're afraid that YOUR dog might hurt OUR dog."

Actually, I was afraid that BOTH dogs would get hurt, that a person would get bitten, and that it would be a bad experience for all. But I just said, "Sure," and we left the park.

I just found the situation very upsetting. I don't like seeing my dog get bullied by other dogs. I don't like that the other people insinuated that it was all my fault (and the fault of the "aggressive pit bull"). And I don't like that they tried to pressure me into doing something with my dog that I felt completely uncomfortable with.

I think I handled it well..... I mean, I didn't curse, I didn't yell, I explained what was going on in my opinion. And then we left.

God. People are idiots. We'll go back to the park, but we're going to stick with our usual time -- EARLY in the morning when there's practically nobody there. And especially when the idiots are not there.

Gene Therapy

I think one of the few things that would make my days even more awesome than they already are would be if I could take Boo to school with me.

Alas, I fear that would be frowned upon.

I did bring her into my "office" last week for a few moments so I could pick up some dvds with data for my study. It was about 6:30 at night, so fewer people would be around. Nobody seemed to mind, but it must be noted that I ran into exactly zero MD-types.

So it was to my great pleasure that this morning I saw a canine celebrity being brought to work by one of the famous investigators at my institution. I inquired if she was bringing her dog to lab, and she replied that in fact it was a lab dog that she had adopted.

She said, "He used to be blind, but we performed gene therapy on his eyes, and now he can see."

I think they use an adenovirus vector to transfer the genes.

I thought that was just about the coolest thing I'd heard all week. It really warmed my heart. And he was an adorable, good natured pup too.

Now if only they'd let me bring the Boo in. I swear she'd be a perfectly mannered ferocious Pit Bull!

Remote Control

This post is inspired by Fizzy.

Before I started med school, I was talking to a friend of mine who was doing a joint MD-JD program.* He was telling me why he had decided not to do medicine, and to do law instead. I think it involved something about the hours and being afraid of killing people.

But anyway, then he got to his story about his friend Kim** who had decided to become a radiologist. Apparently this occurred during a month long ED rotation. Now, one of the things that's great about emergency medicine is that you get to help the great unwashed -- i.e. people who don't get to see a doctor very often due to a variety of reasons, poverty being the most common.

Of course, one of the major downsides of emergency medicine is the great unwashed, and the flora and fauna that come as a side to not bathing very often, not to mention the aromas.

And it's funny, it wasn't the cockroaches that came scurrying out of her first patient's shoes that day that turned Kim off to direct patient contact. That's probably because seeing cockroaches scurry out of a patient's shoes isn't all that uncommon in the ED.

It was when she was examining a patient, trying to listen to the patient's heart.

The patient was a rather large woman, with even larger pendulous breasts. Kim lifted up the woman's left breast to try to get the stethoscope nearer to the heart so she could actually hear it. Underneath the breast was an expanse of sticky, fetid skin.

And then a remote control tumbled out from underneath the freshly lifted bosom.

"Oh! I was wondering where that had gone!" the patient exclaimed happily.

It was at that moment, friends, that Kim decided that patient contact was not for her, and that she would live out her days in a dark room as a radiologist.

Exam room surprises aren't for everyone.




*I know some reader is going to ask me how this was possible. Answer: He was a Rhodes scholar, it was 100% paid for (+stipend), and I really really doubt you'd be able to do it too. For free anyway. It's really not worth it most of the time given the licensing requirements for both fields.

**Not her real name.