RE(a)DFRUIT

This is why you are fat!

2010-03-12T16:28:00.002-05:00

Well not exactly. But that title sounds a lot better than "this is why you're still hungry after that huge pile of lettuce". Apparently the reason why is all due to the lack of ingested fats. After a fatty (and delicious) meal of say, Texas-style brisket, the small intestine needs more time to fully digest the fats that have been consumed (as compared to carbs or proteins). If that time isn't provided and fats aren't digested, then voila, out comes stinky, floating, fatty diarrhea. Ew. To prevent that disgusting outcome, the arrival of fats in the stomach stimulate CCK, a protein in your small intestine, to slow stomach emptying. Thus, fatty foods biologically make you feel full! So, I wonder if we are inclined to eat more fatty foods because they, compared to say brussel sprouts, are what ultimately satisfies our tummies. I guess the moral of this story is that the reason why my salads at home don't taste as good as those $15 bistro salads is that I'm too cheap to add in the really good cheeses and dressings and bacon bits and grilled meats and what-have-you's. It also defeats the purpose of staying on a diet. Oh well.

Medical dramas don't prepare you for reality

2010-03-11T15:13:00.005-05:00

While shadowing at the hospital yesterday, I saw a man undergoing chemotherapy treatment. This was my first time seeing someone undergoing that process in real life. It's not at all comparable to what I've seen on popular TV/movies. The man's cheeks were sunk in and his cheekbones extremely prominent. His skin was so pale as to be paper-white. And although I've seen people in and out of hospitals who are far skinnier, he looked more under-nourished. Most of all, there was an aura of sickness and fatigue. Nearly all of his energy and emotions and willpower appeared to have been leeched out of him. He looked like he was trying to move mountains with every word and action, but the result felt like the dry-crackle of dead leaves in the breeze.

Is it medicine
or is it poison? Only
stats and time will tell.

Living Bone is Beautiful

2009-10-31T16:43:00.010-04:00

Have you seen living bone? I always thought that our bones were the bleached white, rock-hard stuff with some amorphous composite of marrow in the center. The (dead) bones of the skeletons are amazing in their stark beauty and the fact that without them we'd sit like lumps of dough (Pillsbury Dough Boy anyone?). But living bone, the stuff that is right now inside all living creatures is a completely different story of wonder. While browsing through wikipedia to supplement my orthopedics pathology course at HMS (and yes, does that send little shivers of fear down your spines?), I came upon this gorgeous photograph of a living femur head. The bone is like a juicy fruit, bursting with life. Look at that intricate vascular network within the trabecular bone. Just beautiful. Everything within us is really really really honest to goodness alive.

Section through the head of the femur, showing the cortex, the red bone marrow and a spot of yellow bone marrow. Source: Steven Fruitsmaak, Wikipedia

An epic battle...

2009-10-18T21:23:00.003-04:00

...between man and nature. Well, more specifically, between me and the spider mites that had infested my basil plant. This August, I had the grand vision of having a year-long supply of basil. I even bought miracle grow potting soil! During the warmer days, I put the plant outdoors to enjoy the sun. I noticed as the days progressed, my plant developed a white-ish "covering" that won't rub off as well as some "cobwebs". Then there were black dots all over it. It just didn't look healthy. Several days ago, I was amazed to find several stalks swarmed by this little black dots steadily moving from leaf to leaf. I picked some up with a tissue and indeed the dots were alive and when squished, left a disgusting yellow brown streak. I remembered that a favorite bush in my family yard once died from "spider mites." A quick internet search confirmed my suspicions. Obviously, I was very unhappy that the pests were killing my plant. So for the past several days, I have been diligently spraying my plant with a 1:1 isopropanol-water mixture that kills the bugs instantly. Hopefully, I will successfully get rid of them with a week's more of spraying. My room really smells like alcohol wipes now...

Restaurant Review: Fugakyu

2009-09-30T23:41:00.004-04:00

Fugakyu is a chic Japanese restaurant with the standard array of chic sushi plates and popular Japanese entrees. From the amount of business it had on the Friday evening that we dined there, the place certainly doesn't lack customers willing to spend large sums for chic food in a chic atmosphere. We however are a group of medical students sitting on a large nest of loans whose appetites are just a smidgeon larger than 6 pieces of fish/cucumber/carrot slivers rolled in rice. There's a saying that one would rather have a poor loving man for a father than a rich uncaring king. Well, I'd like to have a cheap, unassuming and filling meal rather than an aesthetically arranged, overpriced platter of little nothings. Give me a bowl of Gyudon anyday. Fugakyu, I can't believe I paid you nearly $3 per piece of sushi roll, even if it was delicious and pretty.

Quality of food 4/5.

Ambience 3.5/5 - Eastern style waterfalls by entrance. Shoji-esque doors. Stone benches with stone Japanese snow monkeys carved in the sides. Kimono clad waiters and waitresses. AND two giant flat screens playing a loop of beautiful Japanese scenery. I'm tempted to give it a 4, but I can't help but feel that they are trying too hard to impress... non-Asian customers.

Service 3/5 - Very very long wait (~45min) for sushi! Honestly, did you go to the ocean and fish for it? There were also some hot towels. That was nice.

Overall, 3.5/4. I would only go back there if someone else was paying... and willing to pay for a lot of food.

Location:
621 Boston Post Rd
Sudbury, MA 01776-3306

I might become a neurologist

2009-09-30T20:22:00.003-04:00

I think the question mostly frequently asked of medical students is "what specialty are you going to". Personally, I think it's rather akin to asking someone what they are going to be when they grow up... the effect being the kid generally names something that just recently captivated their interest (supah-star!!) or some polite reply that can be translated to "I have no clue whatsoever and it shouldn't surprise you since when you were at this stage of your life you probably couldn't answer so why are you asking me this ridiculous question". As an aside, this is by far one of my most despised medical school interview/essay question. Honestly, can't you people think of a more thoughtful question?

Although I have no clue what I will ultimately end up choosing (for once in my life, I would like to be pleasantly surprised about the destination I reach), I have been mulling over what specialty might suit my personality and talents. Since I fancy myself an amateur artist and do quite enjoy hands-on activities, I have considered plastic/reconstructive surgery, trauma surgery and transplantation surgery. Transplantation surgery is very exciting now that David Sachs' group in MGH has shown that kidney and bone transplantation can be performed successfully without long term immunosuppressants. The research is super cool and involves the temporary creation of human mixed chimeras. The paper can be found online at New England Journal of Medicine. Anyway, it's one of the rare topics that both interests me clinically and could possibly return me to research. I've also considered Emergency Room medicine, mostly because a ER doc gets to see all walks of life and disease (even if it's mostly strokes, heart attacks and broken bones...). Also, one of my best instructors at HMS is an ER doc (he was voted one of best instructors last year but sadly has left us for a better position somewhere else). He cracks the whip like a slave-driver, constantly challenges you intellectually, and builds up your confidence while simultaneously drills in humility. Anyways, even if I don't go into Emergency Medicine, I want to be that kind of highly effective and intensely caring teacher to my med students in future.

Finally, getting to the title of this post, I've recently decided to add another specialty to the list. Neurology. Ever since Dr. Bernard Chang lectured on the thought process of diagnosing a neurologic disease, my little "food-for-me" radar has been beeping. The diseases that we have learned so far are extremely fascinating and peculiar. So much can go wrong in very small area. There's also something particularly attractive about being able to localize a physical problem to a certain site along the nervous system. It's remniscent of my favorite childhood logic game: given a set of statement of several people, can you figure out their relations to each other? Actually, although the topics are very dissimilar, Neuroanatomy is kind of like my favorite course at MIT: Organic Chemistry. Both requires a deep well of fundamental knowledge that once mastered opens the door to a magical new world of fun puzzles. Huh. Makes me kinda wish that I majored in Course 9 at MIT. Haha Jenn, I'm just joking. :) It's probably good that I didn't wear myself out with neuroscience in undergrad so that now the topic is fresh and fascinating. :)

But seriously, I might become a neurologist. Watch out brains of the world.

Restaurant Rec: The Juice Bar

2009-09-05T18:36:00.004-04:00

Ok, to start off with, The Juice Bar is not a restaurant; it's also not a bar, but it does serve juice. Yummy juice. Fresh-squeezed juice and bubble tea, grass jelly tea, milk tea, milkshakes, etc. My litmus test for any bubble tea/juice place is to try their watermelon juice. It's an especially effective test during the winter because you know, watermelon aren't in season in Boston in the winter. If the place doesn't make it from fresh-cut, red-ripe watermelon, it's no goood. The Juice Bar passed that test. In fact, it had more than a dozen "fresh" juices to choose from. We'll see next time if "fresh" really means fresh. A friend of mine tried their almond milk tea with boba. She was kind and allowed me a sip. It was very almond-y and milk-y. Quite a kick. I'm not expert on the quality of boba since I don't actually enjoy it much. However, I do find the boba today to be decently chewy (sound effect: nyah nyah nyah) and much better than Lollicup in Boston.

So in terms of the quality of the drink, I would give a tentative 4/5.

A comment on everything else about the Juice Bar. The service was quick and the cashiers were very nice. Their prices are fair. The interior decoration is very asian hip chic. You known, brightly-colored, funky-shaped lights. Metallic countertop with bar stools. The space was very small, but I have a feeling that the Juice Bar is more of a walk-in, walk-out kind of place. The interior is certainly clean and well-air conditioned. As mentioned above, they have an extensive menu of milk teas and juices. There are also some small eats like curry fish balls on a stick and Vietnamese spring rolls. We were on our way to Gourmet Dumpling House (which is so incredibly popular nowadays) so we didn't sample their treats.

Overall, I had a good watermelon juice that was just what I needed after a long pleasant walk to Chinatown. I will definitely come back to try their almond milk tea hot and their red bean shake. Then, we'll see if The Juice Bar might be replacing DK as my #1 top juice/shake/tea place in Boston.

Location: 40-44 Harrison Ave, Unit 1A, Boston, MA 02111. For those with some knowledge of Boston Chinatown, it's right next to Eldo Bakery. Hmm, I forsee that this combination could lead to a rapid rise in BMI and diabetes among the young Asian crowd...

A voltage-gated channel mystery solved...

2009-09-05T18:19:00.004-04:00

Guys, this is a monumentous discovery for me. All of you with basic understanding of neuroscience will probably stand aghast at the depth of my ignorance, but seriously, this is one of the top questions that have bothered me since first learning about neuroscience in Dr. Byrne's Clinical Approaches to Neuroscience course in my sophomore year at MIT (BTW, does he still teach that? I learned a whole ton of cool random stuff from him...). So anyway, one of the big mysteries to me was did voltage-gated Na+ channel inactivate because of voltage or time? Obviously, if I had paid attention to any neuro text or even displayed some intelligence by pondering on the channel name, I would have known it is the former. So let it be forever inscribed in the white noise of the "interweb" that voltage-gated Na+ channels activate/open following a depolarization and is also signaled to inactivate/close by that same depolarization! It's just that the door which opens the channel responds a lot faster than the door to close the channel. Isn't that interesting? There are two separate components needed to open and close the channel rather than a single component aka one door. Nature, your logic never ceases amaze me.

Myelin and Plasma Membrane Capacitance

2009-09-04T12:55:00.011-04:00

I spent a long long time yesterday trying to understand myelin's role in propagating conduction along axons. It was a very painful experience as most sources clearly reported that myelin reduced the capacitance of the axonal plasma membrane but it was unclear how this phenomenon would influence conduction. Below is a recap of the wonderful explanation given by my tutorial leader, Dr. Edwin Furshpan. I hope that it will help future frustrated HMS students and of course, anyone else confused by the topic. Enjoy. It's really a miracle of nature.

Let's begin by explaining cellular capacitors aka the plasma membrane. The membrane is thin, only two phospholipid layers thick but it has a large surface area, particularly in the case of long axons. The function of the membrane is to create compartments, the inner cell and outer environment. Part of the separation also includes separating ions which create the electrical potential across the plasma membrane. In this manner, the plasma membrane acts like a capacitor: it's fatty phospholipid bilayer is an excellent insulator that separates positive charges from negative charges. The thinness of the bilayer allows a lot of charge to be stored because the attractive forces between positive and negative charge can still be felt over that short distance and neutralizes the repelling force between ions of the same charge.

Figure 1. A thin plasma membrane capacitor

Red positive charges are separated from blue negative charges via a thin plasma membrane. The blue field (3) around the negative charges repel negative charges while attracting positive charges; likewise, the red field (1) around the positive charges repel neighboring positive charges but attracts negative charges. When the blue field meets the red field, the field is neutral (purple, 3) and thus positive charges can be stacked next to each other on one side of the membrane. Likewise for the negative charges on the other side.

Great, so the plasma membrane is a capacitor. But what does it have to do with conduction velocity of an axon? Intuitively, the propagation of a signal down the axon is in part influenced by how fast the sodium ions leak out of the axon. However, the signal is also lost because the charged ions of the signal are snagged by the plasma membrane capacitor as they travel down the axon. The large action potential and the very nature of the plasma membrane to store charge leads to the decrease of current within the axon and an increase of "induced" current through the capacitor -- I(capacitor) = C*(dV/dt). Thus the plasma membrane creates a poor environment for signal propagation even though it is absolutely necessary to generate an action potential.

Nature has (at least?) two ways to increase conduction velocity. First in the giant squid, the axon diameter is huge to take advantage of the relation that a wider conduction path leads to a faster current. We can't all be giants. In humans, myelinated axons are 10x to 100x faster unmyelinated fibers. Myelin which consists mostly of lipids is a better insulator around the axon, thus preventing charge leakage. In addition, myelin reduces the capacitance of the plasma membrane. The short way to explain this phenomenon is to imagine each layer of myelin as a capacitor. The total capacitance of a series of capacitor is less than the individual capactitors (1/C[total]=1/C[1]+1/C[2]+1/C[3]+...).

I prefer the following visualization. Imagine that the myelin and the plasma membrane as a capacitor with a lot of insulation between the plate, creating a lot of space between the positive charges and the negative charges on each side. The attractive forces between positive and negative charges cannot span that distance. What is left behind is the repelling forces felt between negative charges on one side and the positive forces on the other side.

Figure 1. A thick plasma membrane capacitor
	In section (3), the negative charge on the right is repelling the two other negative charges. The distance between the positive and negative charges is too large (2) to create a neutral field where charges of the sign can be packed close to one another. Thus, the charges are spaced far apart (3) and not as much charge is stored in a thick capacitor versus a thin capacitor.

Now, the plasma membrane is no longer such a good capacitor and does not store as well the charged ions that are part of the signal down the axon. The result is a signal that can travel fast and long distances. Amazing huh?

Now add in the Nodes of Ranvier, the short unmyelinated portions of the axon which contains the sodium and potassium channels needed to generate action potential. The end product is a structure that can quickly generate action potential while quickly and energy-efficiently propagate that signal to the next action potential regeneration point. Repeat as many times as needed to reach the end target, pre-synaptic terminal. Viola. You can now run from bears, pick fruits from trees, and of course, go to medical school...

P.S. - My friends of the electrical engineering, computer science, physics and other "hard science" pursuits do try not to wince too hard at my improper usage of terminology. Let me know if some of the details need to be fixed. Thanks.

Sportsmanship and Bitterness

2009-05-10T19:35:00.004-04:00

This past Friday was the annual HMS Society Olympics. Think of it like a mini-Harry Potter House Cup competition. Upon entering HMS, students are divided into 4 society (Holmes, Cannon, Castle, and Peabody) or they self-select into the 5th society: HST/London. HST is like the Slytherin House of HMS; there is a lot of bad blood between HST and the rest of the society thru the years due the fact that HST is seen as "different": geekier, too hard core, really into molecular research, lack empathy, off doing their own thing. The last is pretty true as HST students are horribly busy and there isn't much outreach between the students of HST and NP. I count myself as one of the few who is close to HST in so far that 1/3 of HST consists of MIT students whom I've know for most of my MIT undergrad years, that I had to make a very tough decision between attending HST or NP and that I really really dislike making fun of "others" in bad taste. However, this Friday during the Society Olympics, I felt my heart clog with bitterness towards HST: the great divide between "them" and "us" never seemed more obvious.

I think the bitterness stems from a clash of ideologies. I viewed the Olympics as a situation to build camaraderie not just among my own society but across society; it was a time for fun, humor, an exhibition of talent, where everyone pitches in and even if you don't have an inherent talent for the event you can still join in the fun. It was never really about winning. This was why I wasn't frustrated or angry as I could have been when our banner and our cake came in 4th place. I was happy to have spent time working with my teammates on the events. I was happy to get to know people outside of academics. I was happy that my society members appreciated our efforts and how they were motivated by our hard work. I was happy with what we had accomplished no matter the outcome. But as the day progressed, I felt that the atmosphere was more and more about winning. The team captains became furious and vicious. There was name-calling and spite. Everyone in NP seemed to rise against HST. Why? I think because never before today has HST seemed more obviously not "one of us". Their ideology seemed the exact opposite: win, at all costs. Their strategy ruthlessly maximized the arrangements of their teams for success and it was highly effective. The competitive side of me can admire that. But the competitive side of me also rail against it. We did not start on the same grounds; we came in friendly spirit and it was not met. The bitterness in me rises up and up. Bitterness towards HST for exacerbating the great divide, towards my NP peers for their jeers and animosity towards the HST team, towards myself for not being able to control these petty emotions. I realized then, oh of course, this is where it goes wrong, year after year; the boiling festering resentment among NP towards HST renews itself on this day and it seems like it will never end.

All this darkness really makes me marvel at the Cornell-MIT Tae Kwon Do relationship. How does Master Chuang cordially face his teacher at each tournament, each trying to best the other with their teams? How is it that each year, despite the intense rivalries, the tears, the injuries, the unavoidable bad calls, the teams do not degrade to dehumanizing each other and still end on friendly terms. I wish I knew how to brew this phenomenon and bottle it and spike all the water fountains on HMS campus with it so that all this senseless bitterness can finally end. Sportsmanship, I think, must be a miracle.

Adulthood

2009-05-04T11:56:00.005-04:00

Sometimes I think that I will never be grown up. Sometimes I think that I am still 14 and a freshman in high school with my eyes closed to the wide wide world. Sometimes I think I will never leave dorm-style living, never own more than some clothes and shoes and this semester's textbooks, never charge big purchases on my credit card, never make the big decision, never sit at the big people table. Then I remember, oh yeah, I did actually fly across the United States and half of the Pacific Ocean by myself. Then I remember, oh yeah, I've been cooking for myself for the last five years and I know that bananas cost 30 cents more in Boston than in Mason. Then I remember, oh yeah, I can read a map, plan a route via Google and MBTA, still get lost trying to find that clinic in the middle of Boston surburbia but have the courage to ask questions and keep on walking until I find the darn place.

Somewhere on this journey "growing up" just crept up behind me. All of a sudden, I have juniors who trust me on advice about life and wait for me to take the initiative in public situations. A weekend ago, I visited a woman in her late 30s who teasingly told her 7 year old son that there are two adults in the room so now you are outnumbered. Two adults? Oh yeah, the second one would be me. This morning, after I met with my mentor, I realized what we talked about: death and end-of-life, scientific and medical progress measured in centimeters and proclaimed like giant leaps, money, obstacles and bureaucratic tape... a sharing of truly "adult" matters, "adult" sentiments because we trust that each other had the maturity and the experience to understand.

Four years ago when I was a college freshman and a friend was a college senior, I asked an extremely naive question, "How did you become an adult? How did you know?" I expected a Ding! a moment, a gateway opening and closing. But there is nothing I can pin down. Life and time is interesting like that: still frame images and a continuous flipbook, never knowing how we got to where we are now and where we will be a few pages later.

A Citrusy Chocolate Scuffin

2009-04-18T10:52:00.005-04:00

I was in the mood to make some scones. Well, to tell the truth, I was in the mood to use up my milk before it expired... ever since freshman year at MIT, I have been just horrible at finishing milk before the expiration date even the super small sized ones. Anyway, I decided to be adventurous and not go with my usual awesome cream scone recipe from Joy of Baking but instead try to recreate my favorite Au Bon Pain Orange Scone with Chocolate. The good thing is that what I ended up baking was absolutely citrilicious. The bad thing is what I ended up with was actually a cross between a scone and muffin, thus a scuffin! Actually, without any of the "accessories", I think the base recipe is perfect for muffins in general. Well, muffins ain't so bad for breakfast either.

Dry Ingredients:
1 cup flour
1/4 cup sugar
1/2 t baking powder
1/4 t baking soda
1/4 t salt
6 T chilled unsalted butter

Wet Ingredients:
2/3 cup milk
1 egg
1 t vanilla
1 t orange extract
2 t lemon juice

A handful of chocolate chips

1) Mix flour, sugar, salt, baking powder and baking soda together.
2) With a spoon, cut in pea-sized pieces of the butter. With your hands, mash the dry ingredients until a crumbly mixture forms.
3) Whisk together the wet ingredients.
4) Pour the wet ingredients into the dry ingredients. Mix well.
5) Toss in the chocolate chips and mix well.
6) Spoon into cupcake tins.
7) Bake at 400F for 15 minutes.

Makes nine small scuffins.

Art: Smile My Love

2009-04-04T16:30:00.004-04:00

Title: Smile My Love
Date: 4/4/08
Time: 6 hours - 2 hours sketch + inking, 4 hours watercolor

I like:
1) My awesome Tombow ABT N15 brush. The ink flows so smoothly and provides great versatility in line thickness.
2) Shadowing: I usually have trouble with painting very flatly so I wanted to develop as much highlighting and shadows as I could here. Amazingly, I actually did not paint into my white highlight spaces. Although I with great trepidation started with a purple shadow foundation on the skintones, the purple actually did add a lot more depth... that side, the skin color was much darker than I intended.
3) Teeth: I feared drawing the teeth... there's just so many of them and done incorrectly, they just end up looking like horrendous grids. I'm actually pretty proud of these teeth. :)

To Improve:
1) Mixing colors. I can't mix colors at all! I wanted to develop a pink-ish skin color but instead ended up with the orangey-jaundiced color. Admittedly, I became very lazy after finishing the skin and so I skimped on mixing correct colors for hair and clothes. Before I paint anything else seriously, I need to make a color wheel to explore all the different colors I can mix.
2) Hands: I have a long sad history of battling with hands. I love hands: the many joints and bones and the wide array of emotions that one can express, the stories that can be extrapolated by looking at someone's hands. I just can't draw them well...
3) Wet on wet technique: Today's painting was very dry and didn't come out looking quite like the watercolors that I admire most: Masha D'Yans.
4) I need to get access to a scanner. Digital cameras skew the perspective of the painting.

Please leave suggestions for improvement! Also, H and J if you don't want your likeness posted here, let me know and I'll take the painting offline. Thanks for being my muses.

The tools: Tombow ABT N15 brush, Staedtler triplus fineliner pen, Flat shader 4, Stroke brush 3/4", Liner 4, watercolors from Marie's

Back to my roots

2009-04-04T16:12:00.003-04:00

Before my life was consumed by academics aka attending MIT and HMS, I spent a lot of my time drawing. My art was always a two-faced topic in my family. On one hand, my parents were exceedingly proud of my work and always showed them off to guests. But on the other hand, they never encouraged my development. Aside for one art class back when I was 5 or 6 to establish my basics, everything I know now is learned on the sly: copying from books and online tutorials when my parents weren't around to pester me about why I wasn't studying more if I had the time to draw. But art was one of the few entertainments available to me when I was younger and I loved and still do love it. So, it really bothers me that nowadays I maybe touch the pencil and brush once every six months or so. What happened to the days when I filled my class notes with elaborate art deco seals? I miss the road trips where R and I would "art jam" (completing one another's doodles) in the backseat. We started out with childish scrawls but through the years of practice (if it is fun, is it still called practice?) and exchanging tips with each other, we grew closer and closer to the artists that so inspired us at the beginning. We had ambition; we had a vision (pardon the pun) of the what we would eventually do. These days at HMS, despite all my classes and the relative straight path I'm on to my career, I feel the most restless and directionless. Maybe it's time to step off the straight path for a while and pick up the brush again. Time to go back to my roots.

Movie Review: Parineeta

2009-04-03T23:48:00.003-04:00

Parineeta is the first and only Bollywood movie that I have watched, and it defied my expectation. Sure there was choreographed dancing, melodramatic singing, and flashy costuming but somehow all the theatrics blended so smoothly with the acting and filming that I wonder why we don't all burst into song in real life. The movie starts with a series of shots painting Calcutta in the 1960s. Shekhar, the heir of one of the richest men in Calcutta, is getting married. But admist all the pre-wedding celebration, something is amiss. Who possesses the voice that haunts Shekhar, still calls out his name, even on his wedding day?

Parineeta is not by any sense a serious reality-based romance (as it does follow a quite dramatic and tense plot) but neither can it be dismissed as a standard chick flick. Instead, the director creates a romance and tragedy that can only exists in a beautiful, artistic, idealized world on film. Think Moulin Rouge. Think Romeo + Juliet (the modern version with DiCaprio). Think even of Disney's Enchanted. The movie should come with a warning label: this is a fairy tale, a fantasy, a story and not real life - no, don't even think about it. Yet at the same time, when I finish the movie, I can't help but think that the movie, like all fairy tales, reflects back the morals of the "real" world: of the meaning of fidelity in love, the debts we pay and owe, the way women are (mis)treated, the way boys grow (or not) into men, the foolishness of love.

Parineeta is well-suited for a night's in with the girls/guys/mixed. If you watch it enough times, you'll probably finding yourself singing along.

A final note: Watch out for the wall. Trust me, you'll know when you get there. :)

Oahu, in 17 snapshots

2009-03-30T21:48:00.002-04:00

I spent my the last Spring Break of my life in Honolulu, Hawaii. I could write pages upon pages of how beautiful, diverse, wonderful and exciting a trip it was. Instead, I think, some things are just better described by seeing. Here is my Oahu adventure, in 17 snapshots and a few words.

Japanese festival dancers in traditional costume

View of Honolulu from Mt. Tantalus lookout

Drive on 'til morning: On the road to the North Shore

Lana'i Lookout on a clear day looking at Hawaii, Lana'i, Maui, Molokai

Makapu'u Lookout: we are living in a postcard

Hunt for your dinner: catch-of-the-day for a spear fisherman

Heaven in a bowl: Yorgutland

Nature is the best painter: Eucalyptus Deglupta

Serenity: Turtle under the Plumeria Tree

The Day of Peace: On board the USS Missouri where Japan formally surrendered in WWII

A Good Offense: Guns of the USS Missouri

Boat-house living: Sea sailing

Loco Moco, a meal of ginormous fatty potential

Yellow hibiscus

Into the tangled woods: the path to Manoa Falls

Sunrise over Oahu from Diamond Head Crater

Blossom of the Rainforest

Restuarant Review: Zoe's

2009-03-29T00:06:00.006-04:00

I was craving Sichuan food. The honest to goodness ma(2) la(4) that tingles your mouth and makes you want to stick out your tongue and pant. Basically I wanted to revisit Lao Si Chuan but alas, I have no car and the people with cars didn't want to drive all the way out to Framingham. Thus, we decided on Zoe's. It had good reviews (even a personal face-to-face rec!) and someone in the group thought it was yummy on a past trip. Alas, this time Zoe's proved to be a sore disappointment (except for the waitress' awesome water-pouring skillz). Generally, the food was incredibly salty (and this is coming from a heavy sodium eater) and the spice was a 3/10 and certainly not ma(2)! Eck, sorry Zoe's, I must cross you off from my list.

What we ordered:

Dan Dan Mian - Tastes like warm dry noodles with soy sauce. Barely spicy.

Sesame Noodles - I couldn't taste the sesame at all. In fact, tastes like a cold version of their Dan Dan Mian.

Xiao Long Bao (XLB) - sadness! The skin was too thick. There was no juice. NONE. Can't say the meat inside was that great either...

Shui Zhu Niu (Beef in Spicy Broth) - There was not that much beef but it was tenderly cooked. However, the broth which often is often the best part was overwhelmed with saltiness.

Tea-smoke Duck - The duck was not particularly fatty which I suppose some people like but I prefer a nice juicy and thus fatty duck. I think they over-cooked the duck as the meat was drier than I'm used to... also, they included a lot of bony pieces. I'm a little disgruntled about that. It's ok to have some bone with the meat, but don't just serve bone with a bit of skin!

Hunan Style Fish Fillet - eh, breaded fish with green peppers... actually one person from the group actually didn't recognize that it was even fish!

Double-cooked Pork - eh, pork with green peppers.... sigh.

Mapo Tofu - is not ma! I make a better ma than they do... cries.

Yuxiang Eggplant - hmm, the best dish of the night. The eggplant was smooth and silky although the fragrance was once again overpowered by the saltiness.

Apple/Pear/Strawberry Crumble

2009-03-27T22:10:00.004-04:00

I bought too many pears and strawberries at Stop and Shop because they were on sale. What to do what to do? Make Apple/Pear/Strawberry Crumble of course! The pictures are not the most appetizing but it sure tastes yummy. Next time, I need to add a bit of cornstarch to the apple/pear/strawberry bottom mixture so that the liquid from the cooked strawberry solidifies a little.

Vienna Teng: Not another Love Song

2009-03-27T20:54:00.003-04:00

I have a favorite new artist and a favorite new song. To some, the name Vienna Teng, must come as old news. She does have a solid fan base although certainly not a big time pop star and that is all right by me. Unlike the radio top pop hits, Vienna Teng doesn't just sing the same old song about falling in love, falling out of love, lust not love, lust and love, love blave blah blah blah. Sometimes, I just get sick of the sappiness, angst, and sexuality that goes around. Sometimes, I would like an artist to think of the meaning of the words she sings and not trivialize the topics in her lyrics. Sometimes, I would like a beautiful mellow voice with beautiful good ol' fashioned (none of that synthetic stuff today) instrumentals. I have found her in Vienna Teng and her wonderful collection of songs ranging from non-tranditional topics like corporate whistle-blowing and moving into new apartments to more familiar but still uncharted territories of (serious!) homosexual love and filial love (or what sometimes feels like lack-there-of).

Here's some links:
1) Whatever You Want - that is until you say good-night

2)1BR/BA - don't mind the neighbors ;)

3) City Hall - a couple and a mayor at a seaside town

4) Daughter - years from now I'll cry to remember

City Hall is by far my favorite right now because of the power and beauty of the lyrics.

me and my baby on a february holiday
'cause we got the news
yeah, we got the news
500 miles and we're gonna make it all the way
we've got nothing to lose
we've got nothing to lose

it's been 10 years waiting
but it's better late than the never
we've been told before
we can't wait one minute more

oh, me and my baby driving down
to a hilly seaside town in the rainfall
oh, me and my baby stand in line
you've never seen a sight so fine
as the love that's gonna shine
at city hall

me and my baby've been through
a lot of good and bad
learned to kiss the sky
made our momma's cry
I've seen a lot of friends
after giving it all they had
lay down and die
lay down and die

10 years into it
here's our window
at the vegas drive-thru chapel
it ain't too much
for 'em all to handle

oh, me and my baby driving down
to a hilly seaside town in the rainfall
oh, me and my baby stand in line
you've never seen a sight so fine
as the love that's gonna shine
at city hall

outside, they're handing out
donuts and pizza pies
for the folks in pairs in the folding chairs
my baby's lookin' so damned pretty
with those anxious eyes
rain-speckled hair
and my ring to wear

10 years waiting for this moment of fate
when we say the words and sign our names
if they take it away again someday
this beautiful thing won't change

oh, me and my baby driving down
to a hilly seaside town in the rainfall
oh, me and my baby stand in line
you've never seen a sight so fine
as the love that's gonna shine

oh, me and my baby driving down
to a hilly seaside town in the rainfall
oh, me and my baby stand in line
you've never seen a sight so fine
as the love that's gonna shine
at city hall

One backpack at a time

2009-03-13T20:20:00.001-04:00

Airline prices get you down? Well, not much to do there (short of inventing your own teleporter). But you can thumb your nose at the airline big cheeses by not paying their ridiculous check-in luggage prices. By the way, the stingiest airline in my opinion is United Airlines. Not only do they make you pay for any and every piece of check-in luggage, there's not even a meager bag of free peanuts! So to get around the luggage fees, travel lightly! It's amazing how much you can put into a duffel bag or even better a comfortable backpack using the amazing invention known as packing cubes. They come in several sizes and can be purchased rather inexpensively at ebags.com or for a slightly higher price at REI. I'm very proud to say that when I went to Hawaii this past spring break, I packed 5 days worth of clothing, a pair of sandals, swimwear and toiletries into my small JanSport backbag using these marvelous packing cubes. There was still room to spare for souvenirs. Happy traveling, one backpack (and no check-in luggage fee) at a time!

a Eagle Creek medium sized packing cube

Inauguration Day

2009-01-20T14:02:00.002-05:00

I suppose it is quite appropriate that my first permanent post of 2009 would be on President Obama's Inauguration. This also happens to be the first inauguration I've ever watched in addition to the first election I've ever voted in. I hope that not only would this event mark a moment of national change but also personal change - to stay in engaged in the political world, to step outside of the ivory tower. One of President Obama's messages that reverberated with me is the message of duty and service, reminding me of the idealism that I possessed just last year during my medical school interview. To learn knowledge not for the sake of having knowledge but to use it for the good and welfare of those around me. How wonderful would it be to know that others are doing likewise? We are not depending on someone out there to save us (President Obama is not the savior) but we are depending on each other, that each small contribution will take us forward to some place better. I think some might consider President Obama's speech to be a bit too dark given the occasion, but I think that there is hope (the kind that you pile on like overly-sweet supermarket icing) and then there is the hope (that you built out of opportunities, faith and ingenuity). It is the solid kind that requires sacrifices and places limits on our desires. It is the kind that will see us through.

Mistakes in Chocolate

2008-12-18T21:09:00.004-05:00

Things to consider when next making a layered chocolate cake.

1. Wait until completely cool.
2. Cut both layers together and make sure that the top and bottom circle have the same diameter.
3. Put only a thin layer of whipped cream filling otherwise, layers will start slipping and fall off...
4. Put only a thin layer of strawberries in between otherwise the strawberries will fall out...
5. After "crumbing" the sides with icing, place in fridge to set.
6. After pouring the ganache icing place in fridge to set.
7. Add strawberry on top after ganache has solidified otherwise strawberries will fall off and take a lot of the icing with them....

Conclusion: MISSION FAILED.

Edit: The key is apparently patience and refrigeration. Ganache and whipped cream filling finally solidified after 2 hours.

Conclusion: MISSION PARTIAL FAIL.

The Oath of Maimonides

2008-12-17T20:51:00.004-05:00

Because no one is perfect, least of all me. Because no one is pure of sin and bias, least of all me. For the patients I have and will wrong in future because such actions are unavoidable, I ask not for your forgiveness but your understanding and faith that my intentions are good and that I will continue to strive to improve myself for you.

The Oath of Maimonides

The eternal providence has appointed me to watch over the life and health of Thy creatures. May the love for my art actuate me at all time; may neither avarice nor miserliness, nor thirst for glory or for a great reputation engage my mind; for the enemies of truth and philanthropy could easily deceive me and make me forgetful of my lofty aim of doing good to Thy children.

May I never see in the patient anything but a fellow creature in pain.

Grant me the strength, time and opportunity always to correct what I have acquired, always to extend its domain; for knowledge is immense and the spirit of man can extend indefinitely to enrich itself daily with new requirements.

Today he can discover his errors of yesterday and tomorrow he can obtain a new light on what he thinks himself sure of today. Oh, God, Thou has appointed me to watch over the life and death of Thy creatures; here am I ready for my vocation and now I turn unto my calling.

Believe

2008-11-26T00:24:00.002-05:00

I have to believe that I made the right decision to be in New Pathway and not in HST. I have to believe that I made the right decision to go to Harvard and not WashU. I have to believe that I will become the doctor that I dream of being.

One Pot Vegetarian Pasta

2008-11-19T12:22:00.003-05:00

A week ago, my friend made some wonderful quesadillas with peppers, onions and mushrooms. I tried to recreate her recipe but ended up with a soupy mixture as the mushrooms released all their water content into my pot. Oh sadness. However, I remembered my Kraft Food magazine days that one could feasibly cook pasta with the sauce in the pot. Thus, I tossed in rotini and cheese and voila! easy, delicious and healthy pasta for those oh-so-cold Bostonian nights.

Ingredients:

1 sweet onion, sliced in strips
1 yellow pepper, sliced in strips
1 container of white mushrooms, sliced
1/2 tomato, diced coarsely
1/2 cup Parmesan cheese, in small cubes
Rotini enough for 4
Salt and pepper
Oil

1. In a large pot, heat oil on medium and then add onions. Cook until translucent.
2. Add peppers and cook until tender.
3. Add mushrooms and place lid on pot. Cook until mushrooms start releasing water. 4. Add pasta and enough water to barely cover all ingredients.
5. Add tomato and cheese. Cook with lid on until sauce thickens. If pasta is not done by then, add more water. Repeat until pasta is done.
6. Add salt and pepper to taste.
7. Enjoy while the cheese is still melted and gooey!

26 y.o female with metastatic osteosarcoma

2008-11-17T18:10:00.003-05:00

"I'm feeling pretty crappy now; I mean who wouldn't with the tubes being stuck down my throat and tubes up places I don't want to think about. My right leg is broken. I can't walk. I CAN'T WALK. And the pain, it's so bad that I have to be on medication which I hate. You would think that after 8 years of chemo that I would be ok with drugs... but it's just the thought that I'm not myself when I'm all the drugged up and I'm not myself when I'm in pain. It's just another thing in the long of things that I can no longer control about my body."

"Don't get me wrong, I love my parents and I know that they love me. But giving up on someone can be something other than just abandoning them or shoving them out onto the streets because my parents did just the opposite. They took me back in when the cancer spread more to my lungs and kidney. They probably wanted me back when I lost my left kidney. But you can be in the same house, eat at the same table with the food that mom made just for you, and know that they just gave up on you, on your life, on you having a life beyond the next few days. There you are, their dying daughter, not simply their daughter. They just accepted that you are not going to be there, that there's no cause worth fighting for anymore when you know that it's not over yet. It can't be over yet."

"What are you saying?"

"I know that I'm not doing all that well but I'm done fighting yet. My body might be failing but my spirit isn't."

"So you're just going to stop? Stop the treatments?"

"Isn't there anything else we can try? I'm ok with anything new!"

I'm sorry/

For 1.5 hours this afternoon, I role-played Jackie, 26 y.o. female with metastatic osteosarcoma (along with a plethora of complications due to the cancer). I don't really know if these are the words the real Jackie said but these words are those that I would imagine someone of her fighting spirit to say. Someone so desperate to live, to have a chance at owning her own apartment, marrying, having children, growing old. Someone who knew in the tightly wound core of her heart that death might be waiting a few paces around the corner.

I am learning to ask a lot of difficult questions during patient interviews. At first it starts out with just getting to know the patient... what do you do for a living? how is life at home? life at work? how old are you Mrs. X? Then there are the more personal questions: what has your support network been like? Are you sexually active? are you sexually satisfied? And now, after sitting in a room with 10 other doctors, I learn about the hardest questions of them all, how are you dealing with your (terminal) illness? Can we talk about the road in the future when we no longer have viable treatment options? There are so many questions about death, dying, relationships that fracture and gel during those times that I can't even shape into being... Sitting in the room, I am really amazed by those doctors abilities to probe my feelings and thoughts while staying gentle. I am also amazed by how rapidly fear can escalate from even the smallest of words, how easy for the patient and the doctor to be stuck in a futile loop where the patient is becomes increasingly hostile as the panicked doctor probes ever deeper into forbidden territory... How do we explore that uncharted land? How can we (doctors) retain our sensitivity and clear-headedness in an increasingly tense and frightening situation?

I am amazed today that doctors whom I perceived as old, wise, well-established, still struggle to answer these questions or rather address these question. But isn't that one of the major complaints currently that more people are dying in the hospital, feeling isolated, frustrated, frightened, abandoned and simply not cared for by their doctors? I don't look down upon my doctors today for their struggles because I know now from my own patient interviews that there is no magical formulaic question and that finding the right way to address these critical (but often taboo) subjects are so so so uncomfortable... like nails down the chalkboard. Instead, I feel so incredibly glad that these doctors are so sincere in their efforts to improve themselves for their patients. I am so so so happy that they are willing to look at their weaknesses, their wrong actions and remedy them. This is the way that our health care system will change for the better. Not because of relatives of dead patients suing hospitals. Not because of public humiliation at the hands of the press. But because there are good people like the doctors whom I met today who want to work together to find a way to address tough issues to discuss with patients instead of ignoring said issues or assuming a paternalistic, omniscient role.

One piece of advice that I heard regarding finding a medical specialty is to find a field that is populated with people that you admire and would want enjoy working with. I don't know much about Palliative Care right now but from interactions with today's doctors, I feel that these are the people whom I want to work with. I can endure the next 1.5 years of my nose in a book so that I can meet these good people again.

Aparagus Parmesan Omelet

2008-11-05T19:25:00.004-05:00

4 eggs
20 thin stalks of asparagus
salt and pepper
Parmesan cheese, grated
olive oil

1. Snap the ends of the asparagus and wash. Boil for 5 min. Drain and then wash with cold water. Drain and set aside.
2. Whisk eggs. Add salt and pepper to taste. Add grated Parmesan cheese to taste (I used about 2 tablespoons).
3. Chop asparagus into 1 inch pieces.
4. Heat olive oil in skillet. Pour in half of the egg mixture. When eggs have solidified on the bottom but still runny in the center, add 1/2 of the asparagus chunnks. Add more Parmesan cheese. Fold the sides towards the center. Flip the omelet. Take off heat when eggs are no longer runny (no liquid comes out when you press the top of the omelet with a spatula).
5. Repeat with remaining ingredients.

Serves 2.

Little epiphanies

2008-11-03T17:21:00.005-05:00

Two brilliant thoughts that amaze me in their simplicity...

1) Perfection often hinders actions - I've been taught all my life to seek perfection; after all, it is the road that leads to self-improvements. But somehow along the way, perfection has become an excuse for inaction. For example, I suffer major writer's block for any assigned writting topic simply because I want my first draft to be perfect. So, I keep rolling the thoughts in my brain searching for that perfect phrase, the perfect introduction, the perfect adjective even! The result is of course predictable, instead of perfection I get a very last minute, often-times poorly written paper. And often times, I use perfection as an excuse to push the deadline until eventually the task just never gets done. Today I read an article by Dr. Berwick, a leader in health care improvement research and implementation, regarding how perfection is also two-sided blade in health care. On one hand, we want our doctors to be perfect or at least constantly striving for perfection (because it's our lives on the line!). On the other hand, we risk viewing perfection as a road block to change. We might become so bogged down by conducting the "perfect" experiment, obtaining the "perfect" results, discovering the "perfect" solution that in the end, everything is the same old imperfect system. No change. No progress. Just another waste of time and resources.

So I know that this might sound a little strange, but I want to learn to be ok with less than perfect as long as I am actually getting closer to my goals. Life has passed me by so quickly as I keep on looking for the perfect time to do something, the perfect person to share my life with, the perfect cause to devote myself to. It's time that I set one foot in front of the other and walk onwards without my fear of imperfection.

2) To live is to change constantly - just a couple of years back, I thought that I would one day reach that age when I am suddenly very wise, when I would learn the secret to balancing all aspects of my life, when I would be always confident and not scared of anything, when I would become this magical, all-powerful adult figure. Well, I've since realized that I will never reach that plateau. Indeed I hope that I won't reach it because well, a life in stasis is pretty much... dead. The fact is that life is constantly changing. New stresses come into our lives. And new joys. We find that we were able to achieve some sort of equilibrium with various forces that demand our attention only to realize that 3 weeks later, things are thrown into chaos and we have to reestablish ourselves all over again. Just as I was getting comfortable at MIT, I am thrust into this brand new medical school environment. New challenges. New frustrations. And as I work through them, new friends, a new niche and new opportunities to explore and discover myself. Dr. Berwick also spoke that not all change is improvement, but all improvement is change. But I think we can all try to ensure that change become an opportunity for improvement in every step of life.

Darius Goes West

2008-10-30T23:23:00.005-04:00

Darius Goes West is a documentary following the 3 week trans-America journey of a 15 years0old African American boy with Duchene Muscular Dystrophy. Duchene Muscular Dystrophy is a X-linked recessive disease, meaning it is only manifested in males. When a mother is a carrier for the disease, her son has 50% of getting the disease. As it's name implies, Duchene Muscular Dystrophy is a muscular degenerative disease with loss first appearing among the limbs (causing loss of walking ability), followed by paralysis of the body and finally loss of the heart's muscular ability to pump blood. There is no cure and the average life expectancy is 30 years. Darius's older brother Mario died of the disease at 19.

This is the story of a boy who is older and wiser beyond his years because of his and his brother's disease. It is the story of his dream to let the nation, the world know about Duchene Muscular Dystrophy. To let mainstream America see that there is suffering in our own American backyard and that the things that we take for granted, traveling to the Grand Canyon, rest stops on a road trip, swimming in the ocean, visiting a friend's house, getting into bed, can only by accomplished through the greatest of efforts on these boys' parts and often not at all without a lot of outside assistance. But this is not a story of despair or finger-pointing. Darius's story is one of life, of all the great and beautiful things there are to experience in life. Of the friends and family we have and had. Of the friends we have yet to meet. Of the goodness that shines in the dark.

Sometimes in our lives, especially because when we are students stuck in our books, we tend to fall into the deep dark tunnel of self woe. It is during those dark lonely times that we need some fresh perspective. Trust me, Darius Goes West will provide that perspective.

Find out more info regarding Darius and his documentary at the official Darius Goes West website.

Some lovers try positions they can't handle...

2008-10-30T23:05:00.004-04:00

Sex apparently figures pretty heavily into medical school mnemonics... that and alcohol. Is it because in the good ol' days, the male students were studying so hard that they neither had time for beer or sex and instead spend their hours in the library fantasizing about both?

That's theory number 1 regarding anatomy lab. Theory number 2 is that anatomy lab doesn't actually teach anatomy. Ok, before people start screaming for my head, let me clarify that Netter's Atlas teaches anatomy and therefore someone out there before me must have learned all the parts from actually dissecting the cadaver. However, I know that I and several classmates have found that the actual dissecting portion of the class to contribute very little to actually memorizing the names, functions, attachments, innervations and blood supply of the structures... All these things can be taught via the atlas and the now high-tech computer graphics technology. But I didn't say that we were not learning anything in anatomy although the majority of time when we are hunting for that elusive inferior epigastric nerve we do feel like we aren't accomplishing anything except getting flecks of fat onto our aprons.

We are learning, just not anatomy. We are learning how to repress emotions, to set aside the visceral reactions of digust and horror. We are learning about the power we hold with our scalpels and soon with our titles. We are learning to think about the human body as, well, the body, the meat, the flesh, the fat, the neurovascular bundle, the bones and ligaments. We are learning to compartamentalize, so that the human soul is somewhere else when we probe the human body, so that our lives from inside and outside of the gross lab do not cross. We are learning to break taboos, to accept our place outside of society. We are learning to deal with the frustrations of not knowing, of not being guided, of learning as we go and making mistakes. You know, hazing is technically banned at Harvard Medical School, so gross anatomy is as close as we are going to get. Through this trial of fire, or rather of scalpels and formaldehyde, somehow we will emerge as certified members of the good ol' club of medicine, complete with the secret handshake and door knock.

Included in my intro packet to the course was a letter from one of the donors. Reading it at the time, I was incredibly moved by the faith that she had in us, of the goodness in her heart to help the next generation of doctors. But I wonder... if she could see us today in the lab, is this what she had in mind when she donated her body? Are these the lessons that she thought she was going to teach us? If she knew, if she could see, would she still have said yes? Now that we know, now that I know, could I ever be willing to donate my own body for the next generation?

Science is not one size fits all

2008-10-21T19:31:00.005-04:00

Dr. Von Eschenbach, you asked during your talk tonight for us to consider the arguments you made; thus I am going to write down my visceral reactions to get them out of my system in order to calm myself enough to write my social medicine essay.

Cancers are different histologically but the same genetically/molecularly - I beg to differ. I know that you have worked as a primary investigator at MD Anderson for longer than I have known about the existence of cancer but I must say that there must be different classification of cancers. Let's just look within one type of cancer, not even specifying what kind. There are the cancers that are late-stage, metasizing which have reactivated the genes that allow them to cross into the bloodstream and then to re-enter distal sites and re-establish cellular junctions. Then there are the cancer cells that have not yet been achieved such genetic or epigenetic modifications but have upregulated genes for the recruitment of angiogenesis. Thus, the gene profiles of these cells are different and we cannot seek to target them with one drug.

Furthermore, in a systems biology overview, different types of cancer may activate oncogenes or lose tumor suppressor genes in the same pathway but I do not believe that they can all share identical mutation profiles. Fundamentally, we must ask why despite some shared mutations do some cancers develop preferentially in the lung? in the brain? in the liver? in lung and liver? or in some other combination thereof? I do not question that some drugs might target more than one type of cancer (Gleevac) but the cancers are still not the same, they simply share crucial pathways. Also along that line, there are patients who don't respond to Gleevac because the cells that constitute their cancers have commandeered a mechanism that cannot be stopped by Gleevac. It's going to take many more drugs besides Gleevac to treat the broad arrays of cancers out there.

And here is a point that I will agree with: cancer research is not a vacuum. No research is a vacuum and if new discoveries in angiogenesis of the eyes can be relevant in the cancer field then by all means such information should be shared. However, simply because the eye and cancer both need blood vessels to survive does not make them equivalent. When problem arises in the blood supply to an eye or cancer, researchers may be able to design a drug that can target both tissue types, or a drug specific to the eye , or a drug specific to the cancer type, or a drug that has effects to the eye, cancer and many other tissues of the human body that also need blood supplies. And that Dr. Von Eschenbach, as many Gleevac patients can tell you, is called side effects. As far as I know, that has been one of the time-honored challenges of cancer therapeutics: finding a drug that can differentially kill cancer cells.

There are some more things mentioned today such as how scientific advances will transform the way that we will practice medicine. I agree, because scientific advances have already led to changes but I won't be so optimistic to say that all changes are good. Even if they are good, I am no longer sure how large of an impact they will provide especially if they are not accessible to the people who need them the most.

A gentleman, a student and a neuron walked into a bar

2008-10-09T22:58:00.004-04:00

There are great days. There are bad days. Then there are days where the great and the bad intertwine to illuminate in a flash the expanse of universe and reveal how small an area I occupy.

Yesterday afternoon, I was feeling crummy because I had just gone through a rather shameful performance of interviewing a patient. This gentleman I think is the type that most medical students dread interviewing... nonono, not someone with some horribly debilitating disease or a story that will make the emotionally strongest of us weep like babies... but a rather normal man who unfortunately simply did not trust (dare I say respect) the first year medical school student's skills. As you can imagine, my unease and slight panic only made me feel even more awkward leading to even less skillfully questions which exacerbated the situation leading to some frayed nerves on both sides. I think in some far flung field, this situation would be labeled a death spiral. On a medical school application essay, I would write this up under then "tell us about a humbling experience" section. If I ever needed a sign of how much farther I still need to travel, then yesterday afternoon would serve a good reminder. After all, my ego has been getting amazingly spoiled at HMS. I'm afraid that the faculty and administration think we have egos like spun-glass and thus need delicate treatment and daily polishing. Well, thank you Mr. X for reminding me that the world is a tough place and my chosen road will be full of unexpected potholes and hey, that generations of doctors might really be onto something when they say that the most crucial piece of medicine is the patient doctor relationship. Thanks Mr. X for teaching me that medicine is an art and please forgive my blunders as I experiment with my brushstrokes.

Later that night, I was chatting with a friend of mine who is currently experiencing the torturous process known as the medical school interviews. As I was helping her prep for the interviews, she told me that she just didn't understand the question how would a future where doctors could only work in HMOs affect her decision to pursue medicine. Immediately, I thought of all the instances when I heard doctors express dissatisfaction with HMO and managed care; indeed, I know students who have been discouraged from pursuing medicine because physicians have told them that had they known beforehand how bad the situation would get, they simply wouldn't have gone to medical school. So I was really surprised when my friend asked, is this a trick question? The restraints on physicians shouldn't effect our ultimate bottomline: providing care for patients. Whether we are in a single-payer system or an employee based or in resource poor or in technology advanced area, we are physicians because we care about our patients and we "can't ignore [our] patients, right? [We] gotta keep seeing them" because that actions defines who we are. It's been a long time since I or anyone else at HMS has explicitly reaffirmed that mission and I am so indebted to my friend for shaking me out of my textbook and anatomy lab haze. A thousand thank yous.

Finally, tonight, I was struck in moment of breathless beauty. I've been rather frustrated with anatomy and histology recently because HMS does a rather great job of giving students some tools, books and instructions to "go get them!" As wonderful as self-exploration is on paper, it's rather frustrating and despairing when nothing is familiar and no road map. However, as I reached the middle of the section on nerves in Netter's Essential Histology, I gazed up an EM of a fractured axon. In the center of the page, I "saw" the three dimensional mitochondria within the axon and it was as if for a brief moment the universe opened a secret door to a treasure trove of understanding. And though the door is now closed, that stolen glimpse has imbued each subsequent histology slide with new beauty. Medicine is suppose to entail a lifetime of learning, so I look forward to many more of these joyous occasions.

Our Naked Dead

2008-10-07T17:05:00.008-04:00

I've read quite a few first-time anatomy lab reflection essays. I read them like a crystal ball, peering in my future through the distorted lenses of others' eyes. But their eyes are not mine and just like how slicing the cadaver is never the same as cutting a breathing person, reading their stories is not at all like what I experienced this morning. So, this is my story.

We officially became medical students today. There was the brief, fleeting memory of the white coat ceremony. Of feeling like an impostor, of wearing "grown-ups'" clothes. But today we scrubbed in and we all looked like we were supposed to be in these loose blues among the locker-lined corridor outside the anatomy rooms. There are five or six rooms in total, each with four or five "beds" lined against the parallel long walls. Sunlight streamed in though a stretch of large windows that covered much of one of the long walls. The room looked similar to those ancient pictures of hospital wards 50-60 years ago. The floors are clean. The counters were clean. With the black bags zipped up, there was almost no odor. It was a strange mixed atmosphere of the clinical and the sacred.

How to describe unveiling my, our cadaver.... It was simple. C pulled off one edge. Perhaps gingerly. I didn't watch her face, I was intent on what was revealed beneath. Pale yellow skin with some dark brown mottling. It looked dry; not like dry leather but maybe like thick dry plastic. The back was quite visibly a human back yet certainly not a real living human back like the ones you would see on the beach. Looking from the side, I thought she had large breasts. I didn't know her age but I thought she might have been a grandmother hugging grandchildren to her bountiful chest. I looked at her hands and I remembered Pauline Chen's description of her cadaver's manicured fingers. Our cadaver has nice nails too. Much nicer than mine. I did not imagine her holding her husband's hands at the time of the dissection but I think about it now. I don't know why I didn't dream up the story; maybe because at the time, she looked so much less human than she does now through the fuzzy, softer lenses of memory. We were however looking out for any abnormalities on her skin in preparation for our meeting with the pathologist at the end of the course. Our cadaver had a small puckering of her skin vertically along the center of her lower back. Maybe, S said, she had undergone surgery.

We left the shroud at the junction of our cadaver's thighs and buttocks. The head also remained shrouded. There was still no smell. No one fainted. Although I think C and S might have been anxious. I was excited. Somehow, I must have realized that the first cut into our cadaver's body was like the cut that sliced away our pre-medical life from our current life in the medical culture.

I made the first cut. S and C were reluctant. M, I think, shared some of my own excitement but she was kind and allowed me. There was no ceremony. But then again, what would you do? So I pressed down on our cadaver's skin to find her vertebral column and sliced down. It was a good solid slice I think. The scalpel was fresh, not yet dulled by the constant slicing of fatty connective tissue. The fat underneath is yellow. It felt greasy between my gloved fingers. As we sliced away at our cadaver's back, large amounts of formaldehyde drained out. Surprisingly, I still couldn't smell the "typical" formaldehyde smell yet. Surprisingly, we fell to work easily despite M and C's initial concern.

We sliced through fat with impunity; indeed soon, we would become frustrated with the amount of "connective tissue" that shrouded our target muscle groups. Instead of referring to the full names of the muscles, we called them "lats", "traps" and "delts". We were soon chastised by a senior faculty. He must be from the long-ago school that focused on finesse, respect for authority, control, propriety. I think everyone felt like they were in grade school again. But although he might have been insulting and never answered our questions, he made some good points about our pride, arrogance, and of course, lack of experience regarding dissection. I think that I will never forget to hold my scalpel like a pen. Don't hack away at it, he says. And suddenly my frustrations at the offending piece of tissue obstructing the L4 vertebra dissipated. It's not our cadaver's fault that I can't find the facet joint. It's not her fault that 30 minutes ago I cut too deeply into the upper back and missed the rhomboid major muscle. It's not easy cutting the correct anatomical information out of her back but most of that is due to my inexperience with the tools, my lack of understanding of the road map. And it won't get any easier by recklessly cutting away at her body.

Some things, like knowing where to start slicing and what muscles to reflect, are not easy. But some other, much more crucial to her, to my humanity, are too easy. It is so easy to puncture through the fat and skin flap, to insert the pliers through for a better handle to life the flap. It is so easy to turn the muscles to a mess of shaved of meat, to drop yellow, greasy lumps into the large white container sitting conveniently under the table. Oh it is so so easy to think that it is just meat, bones, tendons and fat underneath me. It is so much easier than opening the mice I have sacrificed in lab. Then, I could still feel and see their beating hearts. Their bodies were still warm and blood spurted from any wrong incision. Here, everything is cold, so bloodless - like pork shoulder just thawed from a long storage in the freezer. I wonder now, if it might not have been better if I felt even slightly ill. But no, I won't paint myself in a rosy picture; whatever discomfort I felt rose from not wanting to accidentally sever some anatomically important part of the body.

We got through the lab all right although I imagine that for a while, none of us will be eating lunch with our bare hands that smell like our cadaver's insides. I didn't eat meat tonight - not because of anatomy lab but because I have been trying to eat less meat for a healthier diet and healthier Earth. As I chewed and looked over the dissecting schedule this week, I briefly felt that visceral disgust/horror at my task for the next eight weeks. Did I feel repulsed at the violation of our cadaver or by the rather unpleasant-looking organs that will be revealed? I can't tell. All I know is that I don't want to hack my way through our cadaver's body. I want to learn to wield the scalpel like a pen so that at the end of November, the lessons of her body are drawn out like art and not left as a mess of shredded muscle and naked bones.

Memories and musings

2008-09-17T20:47:00.004-04:00

Four summers ago, I was a wee lowly undergraduate researcher at Baylor College of Medicine. That summer was among top two summer experiences I have had. I think I grew up a lot then (living as a rising sophomore among rising seniors does that to you); I also received a solid intro research training (I will never forget to ask about experimental controls); and of course, for the first time in my life, I found a role model, my first mentor. Tibor is one of the kindest and most thoughtful medical student I have yet met. The way that he treated me during the time that I worked with him really influenced my behavior towards underclassmen and my students in subsequent years at MIT. He should be in his residency program right now (unless he took more time for research) and I really think his patients will love him.

I haven't reflected about BCM and Tibor for a while (although I get pretty worried whenever Texas gets hit by a tropical storm because I remember the huge floodgates at the entrance of my research building)... however, today, I immediately thought of him when I read the following question in my Patient-Doctor I course manual: "One of the main skills you will be learning in Patient Doctor I is to use "open-ended" questions. Consider practicing this with your partner, beginning with a question lie, "Can you tell me about yourself?". If memory serves me correctly, the day that I started to think of Tibor as a friend and mentor instead of an intimidating 3rd year medical school student was when we were lysing cells for western blots and he said, "So tell me about yourself." Clever clever Tibor! I'll have to try the trick sometime and see if it will help me overcome my social awkwardness.

P.S. I am also amused by the course title Patient-Doctor because in addition to learning about patient-doctor relationships, we are also indirectly learning to be patient doctors! Get it?? Hehe, I have such clever course directors!

In another life...

2008-09-16T00:04:00.004-04:00

...I would work in Google; have breakfast, lunch, and dinner supplied as part of my job benefits; enjoy on-site massage chairs and massages; play Mario Kart Wii after lunch; and sit in super comfy ergonomic chairs with giant LCD monitors for my computer screen. Ah life... Where/when in my life did the fork appear, to choose between the safer, more approved career of medicine and the secret secret culturally frowned upon desire to be one of those really geeky people who play Magic: The Gathering, write code for graphics calculator games, and of course, draw concept art for video games??? I don't regret my choice to pursue a career in health care but I think... in another life, I might have had the courage to choose the road less taken.

Closet biology lab geek

2008-09-12T16:09:00.003-04:00

Ok so maybe I'm not that much of a closet biology lab geek, considering that I have worked in a lab since junior year in high school. BUT I did "renounce" wet lab and chose New Pathway rather than HST so I guess I feel just a smidgen of embarrassment in admitting that I can't run away from my past. This afternoon, I was in (optional... I know I'm hopeless) journal club and we read about the coolest article ever (next to the article by Egli et al. that reported somatic cell reprogramming in mitosis-arrested zygotes)!

The first geeky item that brightened my day was re-learning the Yeast 2 Hybrid Assay, which my dad so excitedly informed me about earlier in August. Unfortunately, I had a really screwed up perspective of it (but I thought it very cool at the time). Having learned it accurately, I still think it is the coolest.

Basically, Yeast 2 Hybrid (Y2H) asks the question, do two proteins bind each other? To accomplish this, one protein is used a bait to fish out binding partners among a library of potential proteins. The gene for the bait protein is fused to the DNA binding domain of a yeast transcription factor, Gal4. The gene for potential binding partners are fused to the activator domain of Gal4. A reporter gene is constructed from LacZ fused to a promoter that is recognized by Gal4. The bait-fused-DNA binding domain binds to the promoter of LacZ. When the bait interacts with a binding partner, the activator domain fused to the binding partner interacts with the DNA binding domain fused to the bait. A functional transcription factor is completed and transcription of LacZ occurs, which can be visualized by addition of X Gal.

Isn't it awesome??

Item 2: Now we move on to the article by Dong et al (2004). The authors show that Gag, a protein that directs HIV particle assembly, interacts with AP-3, a protein that helps assemble the coat of vesicles directed to multi-vesicular bodies. It is assumed that HIV, once in the multi-vesicular bodies, can leave the cell in a coat made from the plasma membrane of the host cell, enabling it to more easily infect other similar cell types. Sneaky sneaky. BUT that is not the coolest point.

What truly lit my match is the strong evidence that HIV does not make it to either the plasma membrane or the multi-vesicular bodies in the presence of engineered AP3 that only contains a Gag binding domain. This artificial AP3 "soaks" up the Gag and prevents it from leaving the cell. Now, I think it would be amazing if someone would look closer into whether this phenomenon can be repeated in vivo with the T cells and macrophages that HIV most commonly invades. AND THEN find out whether this modified AP3 could be developed as an effective HIV anti-retroviral drug (by sequestering HIV withing cells).

So, it's been 4 years since this paper has been published. Does anyone know if there is investigation into my question? I seriously think it's super cool and it almost makes me want to go back to wet lab. If there isn't any research out there about this (probably there is; come on, there should be), then people are free to work on my idea as long as I am credited and that any potential therapeutics be made available at very low cost to patients. Because come on, what kind of sad sad sad person are you to enjoy making a profit out of other people's miseries?

Loss

2008-09-11T16:05:00.005-04:00

Today is 9/11. I'm sorry that I didn't realize it until three minutes ago when I went to NYTimes and saw the feature article on McCain and Obama calling a truce on political advertisements to honor this day. I don't know what saddened me more: that I almost went through the whole day, caught up in my own small troubles, without remembering the horror and terror of the not so recent past (is it so easy to become complacent?) or that only through a tragedy as great as 9/11 would 2 presidential candidates put aside their own egos.

Despite being obtuse enough to forget today's date, I have been thinking about loss quite a bit. As I am as ego-centric as the next human being, a lot of my thoughts have centered on my own feelings of loss, specifically regarding the transition from MIT to HMS. I suppose the old saying is true, you don't realize what you had until you have lost it. But I won't bore you too much with the details of this loss, as it has simmered down to a point where it rises up from the depth to strike only when I become un-vigilant. Looking back on my life, I think that MIT (and everything/everyone that comes with it) might possibly be the biggest loss that I have ever sustained. So I'm lucky, sheltered, or maybe deprived. Whatever. Point is that, I don't have that much experience to relate to the losses of some of my future patients.

The other day, a patient spoke to us about the tragedies in his life. His disease, multiple myeloma (cancer of plasma cells), led to the degeneration of his vertebrae. Median survival, according to Wikipedia, for Stage I disease is roughly 5 years. His most recent treatment regiment causes numerous side affects, not the least of which includes neuropathy, or in his words, "feeling like you are perpetually wearing icy cold wet socks". We can't quantity this feeling but I'm pretty sure it's much worse than my own 'heart ache of not having close friends nearby to talk to on a rainy day'. But that's ok. I can deal with not winning this competition. The issue that I am grappling with is what to do, what to say to such patients. The other day, I learned apparently the most important phrase in my medical career, "that must have been hard for you." Does anyone think that it sounds a little shallow? But what else to do, to say? I remember that on the afternoon of 9/11, I gave out a lot of long hugs. Maybe I could if I were sitting next to the patient, in a one-on-one session. But what to do and say in a lecture hall setting, where a grown (and very macho) man had to gather his strength, emotion, and dignity to confess his greatest pain - of losing his adoptive daughter-to-be because of his diagnosis - to 170 strangers?

I don't know. I don't know. I'm going to stop now because I have nothing novel to offer as solution. I don't know what to do and I don't know if what I can do will ever be enough.

With great power comes greater responsibility

2008-09-09T21:28:00.002-04:00

Case: H is a man who was diagnosed with late stage AIDS and speaks only Spanish. He was given prescriptions for an 18 drug regiment and instructions to follow with a HIV clinic. Although he was committed to fighting the disease, he missed his appointment and had difficulties filling his prescription due to health insurance complications. He relapsed twice with intervals of 2 months and 1 month respectively. Both times, he was treated in the ICU for seizures and other life-threatening conditions. Treatment plans following discharge was the same as his first visit.

Q: What if anything is wrong in this case? Could anything be improved?

Last week in tutorial, a classmate suggested that the person who is responsible for a patient's treatment and recovery process is the patient himself. In one sense, this statement very much agrees with the first fundamental principle that ethically guides medical practice: respect patient autonomy. The patient (if of legal age) is considered an independent individual who has to right to decide what kind of treatment to pursue, if any is to be pursued at all. Just as we cannot force a terminal cancer patient to pursue chemotherapy, we cannot force H to make an appointment with the HIV clinic and to follow his anti-retroviral regiment. The choice is ultimately his.
The flip side is that the consequences are the patient's to bear as well. If a patient ends up in the hospital for recurrent neurotoxoplasmosis because he did not follow his doctors' recommendations, then who was at fault but himself? Yet in tutorial, we all agreed that H was not completely at fault; something was wrong in a more systematic manner. H might not have been able to keep his appointment because he couldn't take time off of work or maybe he had a family emergency or maybe he simply misunderstood the time of the appointment since he only spoke Spanish. Choices are not made in ideal conditions, free from the constraints of time, money, cultural taboos, family obligations, etc. The cultural and socioeconomic context of H's daily life influenced his actions regarding his health and shifts some of the responsibilities away from him. If H were an educated, middle-class, English-speaking male who was well-acclimated to American culture, would he “naturally” have a successful outpatient treatment? I cannot conduct an impromptu research study into the question; my best guess would be that he still has some risk of not properly following through with the treatment recommendations. After all, several classmates have mentioned that they sometimes had trouble adhering to a simple treatment of antibiotics despite their education level and sincere willingness to become well. This example is not intended to discourage societal improvement measures. The government (at all levels), conscientious citizen groups, AIDS prevention/treatment groups, and even socially conscious businesses would do much to improve health care quality by helping to educate people like H regarding HIV/AIDS, guiding them through the health insurance system and even setting-up AIDS clinic appointments outside of the normal workday hours.
Should the health care system also shoulder some of the responsibility for ensuring that H follows through with the recommendations? I believe so. The principle of autonomy seeks to redress the power differential between physicians and patients, to prevent physicians from controlling patients' actions “for their own good”. However, it should not be used as an excuse of the powerful for shifting the majority of their duties of healing the patient to the patient himself. Inside the doctors' office, diagnoses can be made, treatments prescribed; however, much of the healing process occurs outside of the office. A patient does not cease to need healing once he steps out the door. True, H would make the final decision on whether to swallow his medications but a doctor would do well by him to work with H to ensure that the treatment plan has a high chance of success. Otherwise, I feel that the doctor becomes a prescription dispensing automaton who may just as easily be replaced with a more efficient machine that churns out a standard treatment plan upon patient input of symptoms.
The doctors who should share H's responsibility for ensuring successful treatment includes his PCP, the surgeons, the neurologists - basically all who were involved with his care. The patient whom I “interviewed” during my first week at HMS listed some qualities that she really appreciated in her doctors. On the top of her list is her cardiologist's promise that he would stay with her until she was fully treated; even when she was in the hospital waiting for a heart transplant and was seen primarily by her surgeon, her cardiologist still kept in touch with her regarding her condition. I know that physicians are overworked these days, with a tight time and budget constraint that interfere with thorough follow-ups. However, as one classmate has already mentioned, the time and money needed tofollow-up with H or hiring a medical translator would be far less expensive than the resources consumed during H's two relapses. Thus, hospitals and insurance companies should really recognize the financial incentive for follow-up, for improvements in communication among doctors in and out of hospitals, and for other measures that would help H fight his illness at home. I also wonder if it is truly necessary to keep doctors on such a short time leash. Certainly, if physicians truly do not have the time available to minutely monitor patients such as H, then there should be another important position created in the health care profession that serves as a bridge for H from inpatient to outpatient visit. H was assisted by an aggressive outpatient treatment program for his TB but why has there not been a similar program set for HIV/AIDS and other diseases where patients often fall through the health care system cracks?
I wonder if the principle of autonomy and the spirit of individualism is sometimes taken too far and consequently, hinder the care for patients' health. It is easy to lay the blame on the patient's shoulders without seeing the flaws in the social/economic/political structure and the healthy care system that contributed to the disasters like H's. While doctors cannot guarantee successful treatments because the outcome is influenced by the above factors, we can work harder at finding ways to increase the likelihood of treatment success inside and outside of hospitals.

Square dancing rocks

2008-08-29T21:30:00.003-04:00

I just came back from two hours of square dancing with members of the first year Harvard Medical School Students. It was awesome. Who knew that in this day and age of booze, clubbing, wii, and facebook that young people would actually get to together to swing their partners and promenade. Tonight was my best night since arriving at HMS even if half the class returned back to the modern age of flashing lights in dimly-lit, sardined packed bars/dance floors. Here's to show that people can actually laugh, act silly and have good old fashioned fun without inebriation.

On another amazing note, Harvard has a Figure Drawing class every other Tuesday. Woot. Now to see how much my drawing skills have deteriorated in four years.

A further amazing note: Paul Levy, President and CEO of Beth Israel Deaconess Medical Center in Boston has been blogging about his experience running a hospital. Sweet.

A mere comma

2008-08-28T00:08:00.003-04:00

Today, I "interviewed" my first patient at BWH. I tried to remember the recommendations laid out from an article on medical etiquette that I had just read the night before. Dress impeccably (I had worn my white coat but had not ironed it because I lacked an ironing board). Knock on the door (and promptly forgot that I was also supposed to ask the patient if I could enter the room). Introduce yourself. Give a firm handshake and maintain eye contact. But the article never addressed the proper etiquette for when the patient's husband is present. And for a few uncomfortable minutes I listened to the patient describe her condition while feeling horribly guilty that I was ignoring the husband. Eventually, introductions were made and when the daughter arrived in the room, somehow those introductions were also made. Despite their present situation, the family was incredibly kind to share some of their most difficult experiences with me and my partner. When I shook their hands at the end, I felt that my first interview went quite smoothly yet I could not shake off the feeling that my performance was unsatisfactory.

From the moment I entered the patient's room, I was in doubt regarding my abilities. Just the acts of knocking on the door and apologizing to the nurse and patient about interrupting revealed to myself how little I knew about the medical field (and how low I was in the hospital ladder). I knew very little about the tri-cuspid valve failure that is causing heart failure in my patient. I knew very little about long-term hospitalization, about the administrative and surgical procedure of a typical heart transplant. I knew very little about transitioning from a casual conversation to questions regarding patient histories. What is the polite way to ask a middle aged woman about her age? About her emotions when we've only met 5 minutes ago? I felt that I was standing on terra infirma. Where do I stand in the patient-doctor relationship? In that polar scheme, there is little room for the doctor-to-be.

Thankfully, the patient treated us kindly; she gave us sound advice to retain our humanity. She graciously allowed us to be young and clueless. However, I couldn't help but be disturbed at how useless I was to her. We were not friends talking to friends, consoling each other in a moment of grief. We were not parent to child, bonding in an intimate moment of revelation regarding the cruelty of nature and life. We were not doctor and patient, struggling together to postpone death. Instead we were strangers who happened to engage in an one-sided exchange of deeply personal dramas. Although my fellow medical student and I tossed jokes to keep the atmosphere light, there was still a sense of a high barrier. We could not be allowed into the patient's life like their cardiologist or transplant surgeon. At the end, I felt that the patient was slightly anxious to reach the end of the conversation. Perhaps the emotion was due to the fact that her lunch had remained uneaten while she was speaking. But I sensed also a feeling of a duty completed, of a favor done for the hospital/doctors. I feel a little sad that in the book of her life, I probably merited a mere comma. However, the image of her, a delicate yet strong willed blonde woman with a thick cord of tubes plugged into her right arm, will stay with me for many many years. She is the official first page of the chapter of the rest my life.

My white coat

2008-08-19T23:58:00.005-04:00

...is a bit loose on me. The sleeves are a couple inches too long and I know I will start forming the bad habit of worrying the sleeve edges. But we had to go a size up because the smaller size was too tight around my chest. That would most certainly not do. One certainly wouldn't look doctor-ly with the buttons of one's coat ready to pop off with one deep breath.

I can't help but think that this slightly ill-fitting white garment is quite appropriate to my current status. Who am I right now? What am I? As the students traveled back from the Brigham, an administrator cheerfully cried out, "Here come the new doctors!" My upperclassman friend text messaged me at the reception, demanding to meet the new Dr. Ouyang. Did this white coat of mine suddenly convey upon me a status/degree that I assumed would only come after 4 years of intensive training? Have I become Athena, born from Zeus's head, armed and fully grown and ready to perform miraculous deeds? I wonder if by the time first year is through I will (like the admin and the upperclassman) have been indoctrinated into the belief that possession of the white coat (regardless of the size and fit) equals being a doctor. But as I hear the title "doctor" over and over, I know I am not yet prepared for the ramifications of this role; Dr. Ouyang knows very little about doctor-ing and she wishes that you would realize it too before any disasters happen. In truth, she walks in her over-sized coat with a confidence she copies from her peers and doctor-teachers...

Does that walk become easier every time that the coat is worn? When will it no longer be "copied" and simply becomes part of the white coat? Will the white coat and doctorly confidence (and all the intellectual and emotional maturity that comes with it) eventually to possess some transitive power? Perhaps yes; the white coat does seem to convey a sudden measure of confidence and doctor-liness. Perhaps not. It is really only pieces of white fabric which cannot teach one how to operate, how to diagnose, how to comfort and heal. It is stiff and stuffy in packed auditoriums and definitely over-sized. It is uncomfortable and new, like my new title. But like all things new, it will with time, be worn and comfortable as I travel and re-travel down these (and many other related) thought avenues. In time (perhaps as soon as one year!), I will grow into my title and my responsibilities and eventually into my white coat. I just hope that I will remember my initial feelings of discomfort and confusion.

The beginning of an era

2008-08-18T22:29:00.003-04:00

...slips right by me. Orientation at Harvard Medical School was earlier today. Like all Orientations, there was the usual line-up of somewhat un-inspiring but relatively important speakers. I missed the introductory speech regarding the promise of our brilliant medical futures, the hope and power we hold in hands (probably regarding both patients and society), of the hard work ahead of us but of great rewards.... Most people I talked to didn't think that I missed anything which rather pointedly indicate the usefulness of such things hmm? The time spend trying to (awkwardly) talk to these not-strangers-only-friends-I-haven't-yet-met passed much less painfully than I expected; not much was truly accomplished except the exchange of a few names that I have already forgotten and whose associated faces will tease me with unplaceable familiarity during the following days.

The current course, Introduction to the Profession, has the promise of being both embarrasingly boring and ethically profound. The professor so far does not appear brilliant so much of the outcome lie in the hands of my 150ish classmates. I know that I should not already be judging people based on their appearances but I have a hard spot in my heart for people who wear evening/clubbing types of clothes to the first day of medical school. But they seemed nice enough people and this class is supposed to help me learn to break down the barriers of my prejudices/assumptions of Others-not-like-me.

Despite the absolute blandness of today (which like the first days of my high school years will be lost in a few months - so much of medical school seems to smell faintly of high school-ness to my horror/distate since high school was just a step short of disaster), I did seem to make some headway in establishing if not friendship than good acquaintanceship. Let's hope that I shall do better in the next days.

On a final note, I have once more heard about the notorious non-teaching-ness of HMS New Pathway. If they insist in not teaching/teaching poorly, then I suppose it is a sign that I should look into studies in Medical Anthropology to actually stimulate my brain cells.

What is a mishrack?

2008-07-29T00:37:00.027-04:00

This is a mishrack, a term that I feel would adequately describe this mumble-jumble update of a post. It will tackle such important issues such as 1: Where is the new layout, 2: What have I been doing lately, and 3: Where did all the thinking go? I just love it when things come in threes.

Item 1: This is not the new layout I promised. The new layout is now the ex-layout, the scrapped layout, which has not quite made it into my trashcan, but has lain dormant in the proverbial desk-drawer for a month. For weeks, I tweaked and adjusted it. But I could be satisfied with the product. The color was wrong; the columns were not balanced. It frustrated me so much in the end that I just decided to ignore it. And then I thought, well, why in the world am I doing this for? Who am I trying to impress with my Photoshop-ing skills? So now, I come up with this. A strange yet wonderful combination of colors that I came up with the help of an online generator. Expect to see some of these colors to show up at my far-in-the-future wedding. I'm not amazed by the design but hey, I'm content and it only took me a hour so that now I actually have energy left to write.

Item 2: I have been doing quite a lot which really means I did many things in a short amount of time but otherwise did nothing during the large span of time. Of the most recent and most important is my shadowing experience with several Wisconsin physicians. A small-town hospital is decidedly different from a large urban teaching institute. While the schedule is still filled, there is none of the rush, of the get-in get-out, overwhelmed with paperwork feeling that I felt distanced some of the teaching institute's physician from their patients. The facility was not visibly inferior. The feel of the staff was humorous, close-knit and fun-loving. Ultimately, those qualities will determine where I will go. Regarding specialties, ER, ob/gyn and surgery are still in. Radiology is out because I can't be in a job where I don't feel like I'm doing anything. Certainly if I am going to part of the generation that helps improve the cost and productivity inefficiencies then I will not take a job that pays so much while encouraging physicians to thoughtlessly use expensive machinery whose often-times inconclusive results are read at a time when the results were no longer truly useful. I'm sure we'll still need radiologists just not at the current number, doing the current jobs. Surgery cons - long and hard on my feet, often employs brute strength, lead aprons are heavy. Ob/gyn cons - slightly repetitive office work. ER cons - very busy at times resulting in juggling of many cases.

Item 3: The gears are still turning, I'm just too lazy to put them to words. Here are some topics that I have thought about.

1 - Book rec: Lilith's Brood by Octavia E. Butler. Honest to goodness Science Fiction is meant to extrapolate current scientific principles to creative future endeavor. Writings should open the mind of the reader to great and terrible possibilities, especially posing thought experiments regarding the impact of such technologies on human life/culture, on the biosphere, on what it means to be human, on the creation of new ethical dilemmas... In short, science fiction asks the readers to think and explore the unexplored aspects of their lives.

2 - Same-sex marriage is legal in California. For now. There is an initiative to constitutionally ban same-sex marriage via the ballot. That thought still sends shivers down my spine although at an earlier time I was quite close to convulsion. Plainly, I support same-sex marriage because I support love in all its forms. Comment if you want more details or if you want to discuss, but please, provide arguments other than same-sex marriage destroys family values or sodomy is the work of Satan. If you don't feel like commenting, please do think about your stance on same-sex marriage; this really is a pivotal point in the evolutionary of the human race. And lastly, if you live in California, PLEASE vote ESPECIALLY if you need to cast an absentee ballot. Yeah, you know, who you are. Save us from the extremists (from all groups) and actually have the law reflect what a true population majority.

3 - Movie rec: Wall-E. It's great: graphics, story, sound, the whole-shbang. Go see it (and stay for the beautifully drawn credits). I was going to write a detailed rec but then NYTimes stole my thunder.

4 - Book rec: Next by Michael Crichton. This is his best book thus far not just because of the masterful suspense but most importantly because it is a HONEST TO GOODNESS science fiction work. It explores a broad range of ethical dilemmas in bioengineering, medical science and pharmaceuticals today. And it is dark dark, ethically-twisted world out there in Crichton's universe, but the darker message is that it's not altogether an inaccurate mirror of our current world. I hope you will all be deeply deeply disturbed after this one.

5 - Book rec: Uncle Tungsten by Oliver Sacks. A magical, sometimes light-hearted, incredibly poignant account of Oliver Sacks' boyhood in England during the time surround WWII. Dr. Sacks is a man of incredible passion, a broad range of interests/accomplishments, humor and wit, and that now rare delight in exploring the mysteries of the universe simply for the joy of it. As Richard Feynman once flung open the door to physics for the masses, so has Dr. Sacks with the door of chemistry.

Arrrgh, blogger!

2008-06-17T12:52:00.002-04:00

grrrr... I am trying to cipher the blogger template file in order to create my new layout. The design is completely finished but translating it into blogger language is hell for someone whose only knowledge of coding comes from self-taught html/css and high school java... gah, sometimes I wish I had taken some coding classes at MIT. Oh well, I guess I just have to hack and chop at the code until something reasonable comes out. Oh the sadness. Sometimes I wish I could just have someone do the coding for me.

Movie Review: Kung Fu Panda

2008-06-17T00:34:00.002-04:00

What a hilarious little film. As a warning, I have to say that I love animated films, especially of the light-hearted kind. Kung Fu Panda, despite its warm fuzzy messages about perseverance and hope and trust and believe in yourself, really boils down to light-heartedness and humor. The artwork is amazing. Digital animation never ceases to amaze me with how realistic semi-realism can be. The lighting effects are simply amazing; the colors are extremely vibrant and despite all the gravity/physics defying moves, it all looks like it could possibly happen. Technicalities aside, I really enjoyed the clean good fun that the movie displays. So often these days, humor seems to need to be lewd in order to attract a good audience. However, most humorous scenes are witty (though a little corny); there are even some cute original moments. Of course, being Chinese, some of the more "Asian" aspects of the film really makes me cringe but overall they didn't butcher my culture too much. The martial arts in there is really not that accurate either but the "special effects" are pretty nifty to see. Finally as a critique, I think that the ending was too abrupt; nothing really gets (satisfyingly) resolved.

Warning: This film is not intended for people looking for something serious. Duh. Or for people looking for intense battle scenes and overly melodramatic endings... There are NO epic wars (that really disappointed me). Finally, Lucy Lu and Jackie Chang and whatever else other famous star (except Jack Black and the guy who plays the master) whom you wanted to listen to will not speak more than 5 lines in this film... otherwise, go see it and have a few laughs, man!

Layout under repairs

2008-06-14T22:41:00.002-04:00

The layout is under repairs right now. Expect a niftier one up in a few days. Right now, please bear with this standard blogger template... >.<

Restaurant Review: Lao Si Chuan (Sichuan Gourmet)

2008-06-14T00:06:00.005-04:00

Name: Lao Si Chuan (Sichuan Gourmet)
Category: Si Chuang aka extra spicy :D
Location: 271 Worcester RD. (Rte.9),
Framingham, MA 01701
Price: $ - standard Chinese food prices
Yumminess: 4/5 - best Chinese food I've had in a long long time (outside of mom's cooking of course)

Appetizers
Chengdu Spicy Dumplings (8) - 3.5/5
Pork wontons (no soup) with spicy chili oil dressing. These were not the greatest; certainly not comparable to the ones I had at Yeah! Shanghai Deluxe in NYC Chinatown. The wontons meat was soft but unremarkable. The wrapper looked and tasted like the store bought variety. The chili oil lacked a spicy spicy kick.

Rice Noodles w. Chengdu Spicy Sauce - 4/5
Glassy rice noodles in a scarlet soup of chili and garlic. The spiciness is 8/10 on my scale which is pretty darn spicy considering my Hunan background. I couldn't get enough of the soup base even though it's really more of a dipping base and probably would send me into immediate liver failure if I had more than two spoonful...

Steamed Bacon w. Fresh Garlic Spicy Sauce - 4.5/5
Chinese-style thin strips of fried fatty pork wrapped around spicy and slight fermented crumbly tofu. HOLY CRAP is this good. My friends, this is no crispy oily American Bacon. Nonononono, this is fat. This is soft slightly chewy slightly buttery fat. I personally am not fond of the fermented tofu (dofuyu) so I could not give this a 5/5 but duuuuude, this artery-clogging dish is amazing (however should only be consumed in teeny portions otherwise I am not responsible for any cardiac failures).

Roast Beef & Tendon w. Chili Sauce - 4/5
Slow-roasted beef strips and tendon in a five-spice and chili sauce with garlic and cilantro. Tastes like mom's cooking except spicier. :D It was soft and moist and juicy! Personally I think if they drizzled the rice noodle's chili soup base over it, it would be have been a 5/5.

Entrees
Old Sichuan Chicken - 3.5/5
Crispy crunchy (fried) chicken chunks rubbed with chili and other spices. Tasty but the crispiness is not at the level that I expected. Kind of like it wasn't served straightaway but was allowed to sit so that the crispy outsideness became a little meal-y. Anyway, not as good as the one I had at that place that Sam took me to in the outskirts of Boston. No not Wang's. Another spicy place. I can never remember name... Oh by the way, the crispy cabbage cole slaw is absolutely delicious. It's sweet and slightly vinegary dressing is the perfect accompaniment to all the spicy dishes. Plus it crunchy. I like crunchy.

Beef w. Spicy Chili Sauce - 3/5
Thin slices of beef in a spicy soup with cilantro. The meat was superb. Very tender and moist. Did they pound it with a mallet? Did they coat it with baking soda? Maybe the later because despite the texture of the meat, it was bitter. I don't like bitter dishes, even if they are really spicy. Especially if they are not supposed to taste bitter.

Fresh Whole Fish & Tofu w. Special Sauce - 4/5
Seriously, the name says it all. It's whole fish. With head. And tail. And bones. But happily, large bones that are easy to pick out. The meat was once again superbly cooked so that it was tender and flaky and almost melts in the mouth. I unfortunately didn't get to sample the tofu but it looked good and of the fried variety. The special sauce? I don't know what went into it but it was surely a special mixture of chili and sugar and top secret if I told you I would have to kill you. The sweetness was a good complement to our already extremely spicy array of dishes.

Tea-Smokey Flavored Duck - 5/5
Crispy skinned, fatty duck with bone. Served with a side of the superb cabbage cole slaw. It also happens to not be spicy. However, it is most excellent in that the fattiness is preserved without been overwhelming. The butteriness of the fat is also not clogging or extremely oily. I'm not quite sure what tea-smokey means but the duck meat did have a certain smokiness. It is certainly not roasted duck with sometimes too-soy-saucy taste... hmm, I believe I will have to order it again to discern this special flavoring :D

Overall, a great night of spicy foods. I would love to return many times if only I had a car and if I can persuade people with cars to take me - I mean, us - there. Our waitress was wonderful, full of recommendations and re-filled water when I was barely half-finished with my glass and I drank a lot of water than night... by the way, if you ever order General Tso's or egg rolls here, I might have to beat you with a seal. Also, there is a restaurant across the street that specializes in xiao chi (um, little dishes? dunno in English). Let's try out that place someday too!

What I would like to try next time:
Sliced Cumin Flavored Tender Lamb with Chili Sauce
If this tastes as good as it smells.... I might be tempted to never leave Boston. Do you know how many nights I have hungered for that special cumin flavored lamb kebob sold by Chinese Muslim in rickety and probably below standard hygiene levels street stands??

The Beginning and the End

2008-05-08T17:40:00.004-04:00

Next week will be my last week of classes at MIT. It will essentially be the end. The end of an era? Of a wonderful (and sometimes horrible) four years; of pain and love; of friendships made (and I hope kept for a long long time); of discovery and adventure.

On a September weekend in 2004, I gazed up from the base of a staircase in a restaurant in Chinatown. What was is called? I don't know. Can I describe it? Nothing except the cool darkness of all indoor dining areas. No smells. No memories of who I was with. Nothing except this feeling that here is the beginning of the greatest adventure I have ever undertaken. Nothing except the sentiment that oh what a glorious four more years to explore this new city of mine.

And now? One day after my 21st birthday, I know there must be so many things left undone, so much more time I want to spend with my friends, so many more events to attend at MIT... four years was not enough... I will be here next year, and the year after and at least 2 more afterwards. Yet that too will be different. People closest to my heart will have moved away, moved into different chapters of their life. What adjective can describe the sorrow and loneliness that shrouds this beautiful spring? I am so proud of who we have become, of the peace that we have found for ourselves, of the ambitions that we now pursue after... yet I want to plead that we never forget the camaraderie that can only be forged here at MIT...

This is the end and the beginning, merged as one. I want to reach out and hold you all in my hands but everything is quickly slipping away. Time will not stay; we cannot stay. Soon, all that will be left are these inadequate words and the echoes of what was once a vivid reality.

I'm feeling a little defensive

2008-04-12T23:09:00.004-04:00

I think many of my friends are angry right now; some at me and some at other stuff in their life. The other stuff, well, I can't really help with, so I'll just stay out of the way until their anger dies down. But I think that there are some that at angry at me because I haven't told them that I have been admitted to Harvard and that they found out about it through other means, or that they feel like I waited really long to tell them. Well, compared to other people, I think I do have a tendency to talk about important things later. It's a rather bad habit I suppose and kind of ironic since I purposely don't tell people because I don't want them to have a negative reaction. I guess I sort of grew up with this habit my whole life; my parents and I are very private people and we don't like to discuss our successes very much. I mean we do share a lot of news with each because we're kind of like one entity except composed of 3 people. But I think it's hard for me to tell other people immediately of major important steps in my life. So when I got into MIT, we never announced it outside of the family. I never went up to any of my friends and said, OMG, I just got into MIT!!! In fact, I think my mom was more excited than I was about the admissions. Many many many days late, I told the few teachers who wrote my recommendations and from there on it spread by word of mouth.

So, it's the same way with Harvard. I found out about my acceptance to Harvard the Friday before Spring Break so there wasn't much of chance to tell people before we left for Aruba. But at the same time, I really didn't want to tell anyone. I just wanted to keep it close to me for a while, to sit on it and think about what it meant and what it felt like. And I certainly didn't want people to start jumping up and down and congratulating me and everything else that people normally do when I partially felt like I didn't deserve it or when I didn't feel like celebrating. Not that I'm not happy that I got into Harvard, but I really wanted life to be quiet now that I got through this step. I think that now it's over, I feel like it's not so important and crazy as I thought it would be. I thought I would be really stressed out. I thought I would be really excited. I thought and thought it would be great deal of other things and instead, it almost was a little disappointing. Sure, I felt that knot of anxiety for a few moments when I opened up the email. But by the time I had finished talking to my parents, I had already stepped into the quiet mode. I realize that for a lot of other people, this would be very very important and super cool, which didn't make me feel that much better about my own reaction. I didn't want to tell other people when I was trying to deal with these emotions within me. I actually really really really didn't like it when some people on the Aruba trip found about my acceptance accidentally.

However, I do admit that I need to get a better method of revealing to people about important news. It makes me equally unhappy when people tell me accusingly, hey why didn't you tell me about this earlier and I can't believe that I heard it from this person... I feel like a really bad person - I know that according to their expectations, I've probably done something hurtful. But it's not that I don't think they're important or that I don't love them enough, it's just honestly, I have to say that this is still early for me. It's because I have this don't ask don't tell policy; so I'm really sorry that I've hurt people's feelings but I'm not sorry that I didn't say it early. There are still tons of people at home who probably don't know about my acceptance and I don't think I'm ready to tell them until I get back home or if I don't go back then at the beginning of summer. I haven't told any of my recommendation letter writers yet either and I don't plan on telling them until the end of this week when my life is calmer and I feel more sure about myself. It is strange how I can feel comfortable writing about the news on my blog but not feel comfortable about telling people about it straight off. I think maybe it's my way of trying to slide things under the radar but I think that it backfires? At the same time, I don't feel that my blog is very public; in fact, I honestly believe that I can count the number of people who read it with my right hand. I often feel that it is my space to free-think, to associate and to discuss the different emotions and philosophy that coursing through me. That I don't write for other people but I write as a record of my memories, I write so that I can organize my thoughts for me. I don't examine life because I feel other people want me to; I do so for myself and if the end product changes me and shapes into a better person, then I am thankful for it...

But anyway, this is all talk and not the resolution I need right now. What I should work on is that for my next big news, I suppose is the time when I have a boyfriend or something, I should really tell people earlier... I can deal with my conflicting thoughts on my own time without hurting the people who are really precious to me. In short, I shouldn't be this selfish.

18 + 1 thoughts on life during and after Aruba

2008-04-08T01:08:00.005-04:00

18. That if I am a fire-element based person and lacked one of the elements when I was born, then I must have been missing the element of air... 90 degrees Fahrenheit feels like heaven with a constant, good, strong wind.

17. That although I'm in another country-island, it still feels like the USA when living around downtown... there's pizza hut, wendy's, ralph lauren even Ben and Jerry's! Everyone speaks English and at least 5 other languages. And even though I'm on an island, the idea of traveling to another, smaller nearby island is quite tempting...

16. That my dream house would be based on Aruban architecture: a) brilliant hues of yellow and blue, a splash of lavender or green or pink instead of the standard stuffy vinyl boards, b) dark red tiled roofs, c) rounded gateways with open air kitchen/patio/dining, d) low walled courtyard filled with useful plants and trees NOT a lawn e) columned veranda

15. That the western Aruban white sand beaches and turquoise waters is beautiful like roll cake or some small fluffy woodland creature - safe and calm and lulling but that the eastern shores carved from the union of raging waves and cooled lava is beautiful like tragedy, like chicken vindaloo extra spicy. Standing on the edge, watching spray after spray, tasting the salt on the air, the chill of occasionally being splashed, listening to the roar... the untamed wilderness, the power of unbreakable resolve for some reason is far more attractive than that idealized western beach... Jenn says that I need to move to NorCal; if it's like eastern Aruba then I think I agree.

14. That my favorite moon hangs low in the sky, glows a warm gold, is full and fat like a gluttonous child after too much sweets.

13. That I am very much an introvert. That my patience grows short and temper grows sour when surrounded by too many people for extended periods of time and where I can't withdraw into myself or merge into the environment.

"I WILL arise and go now, and go to Innisfree,
And a small cabin build there, of clay and wattles made;
Nine bean rows will I have there, a hive for the honey bee,
And live alone in the bee-loud glade."

~ John Keats, Lake Isle of Innisfree

12. That real coconut flesh is not as coconut-y as the canned stuff but the chunkiness it adds to pina coladas is superb.

11. That parasailing above Aruba might be closest I will ever get to flying - I swear I saw a turtle rising from the aqua depths of the ocean.

10. That kayaking is great fun but that kayaks which have holes and fill up with water are no fun... swimming back after being swept far away by the wind would have been a disaster if not for life-jackets.

9. That I have a one-track mind (food, certain people, certain types of clothes, elves).

8. That sunblock must be applied continuously during the day or else you will burn. When the feet are starting to get warm while sunbathing, I should not ignore the pain and keep on sleeping. And yes, it is possible to be sunburnt on the scalp. When the dry skin sheds, it looks like extra-large dandruff and is extremely difficult to remove. The skin is not smooth but is instead spotted with many holes of varying sizes for the hair follicles. In short, I get fascinated with the weirdest things.

7. That food in Aruba is outrageously expensive but the one night of Aruban cuisine (mmmm, seafood and chicken with cheese melted on top) and of Argentinean steak (fatty, slightly burnt beef!) is soooo worth it.

6. Huzzah! Hazella! The imitation Nutella!

5. That sunrise over the beach, behind a curtain of clouds could possibly make me believe in Helios, Hyperion, Ra, Amaterasu, Eos and other sun deities. I am reminded of a chorus line in Homer's Illiad: when dawn spread her rosy fingers....

4. That the stress of schoolwork, the future, of failures and dreams after a week of relaxation and half of year of lying low hurts like a dull throbbing wound that never healed correctly. These days, I am amazed that I managed to survive this far through MIT without serious trauma; that I can still smile and laugh and not shrivel into a dry husk of anxiety and disappointment.

3. That I am home-sick for my parents; for my bed; for my mom's cooking; for the flowers that have bloomed in our gardens but I have not seen for the past 3 summers; for my dog's warm body and cold nose; for the sweep of Ran's hair and the sharp angles of his fingers; for David's bear-hugs and his cheerful yet slightly egotistical humor; for Hana's quietness and non-judgement; for bacon, pancakes and hot tub on a cold January night at Coryn's; for randomness and craziness with Krissy; for the unconcerns of childhood.

2. That I want to learn to use the fly-wheel.

1. That I have learned many types of -do (Tae Kwon Do, Cha-do, Koh-do) but the one -do which I have been following all my life and until the end of my life is yet unnamed: the Food-from-love Do - how do I love thee, let me count all the dishes savory, sweet, spicy, and mild, crunchy, crispy, creamy, a soup or stew, grilled or baked that I can make for you...

0. That falling in and out of love is mysterious; that what is love (platonic or madly deeply truly), what degree of love is unfathomable; that who or what to love is unexpected - the randomness of me knowing you, of picking your face among the crowd - how does it happen? I am happy and thankful for chance to have loved and continue loving all of my important people.

Tae Kwon Do, UPenn Tournament

2008-04-06T04:13:00.003-04:00

Today was my second to last Tae Kwon Do tournament of this academic year and it is the third tournament that I've been to. The team left on Friday at 3pm but I stayed behind in order to finish grading exams for 7.05 Biochemistry. The Tufts team kindly picked me up at 1:30am Saturday and we arrived without trouble on UPenn campus around 7:00. The Sabumnim of Tufts is a wonderful, kind man who cares deeply for his small but close-knit team. He did most of the driving to Philadelphia (Augi (sp?) their black belt drove part of it - he is extremely nice too; helped with my bags and tried to make me as comfortable as possible in the small bus) and treated me like I was part of the team. During matches, he carries around this spray can he uses to spray cold stuff on his student's injuries - he's really conscientious regarding his students' well being! Plus, he let other teams borrow the spray can (Jenn got sprayed and I really think it helped give her that push to fight so well during her last finals C match and her B match).

One of my professors this year commented on how desperately humans search to find communities to fit into now that we are so mobile and leave our previous communities to follow our careers, families, etc. He made a joke about this guy who whenever he settled somewhere new, he would seek out the people who had the same model of (a rare) car as he does. These would be people that he trusted immediately, despite the relative superficiality of their connection. Basically, my professor was poking fun at the groups that we find ourselves in today. While I think the car example is somewhat ridiculous, I do agree that some hobbies/favorite items make a poor basis for a stable relationhip.... however, I think that Tae Kwon Do has gone past for me than just a simple hobby.

I might never love the sport as much as Steph (who would have been willing to take the 2am Chinatown bus if there was no other way to get to UPenn) or Jenn (who really really wants to make it to the last tournament), I feel that this is nation-wide (world-wide) community that I can find myself slipping into regardless of where I am. I think about Tufts' kindness yesterday; of cheering ourselves hoarse for Women's B4 and B3, Men's B2's finals match... I'm no fool; I know that it's not possible that every dojang or club team is as wonderful but from the tournaments that I've seen, the the strength of each community is real regardless of how large the team is or how advanced their members are. So if I go to WashU next year or if I'm at Harvard, TKD would be the support group that I would seek out. And I don't think that the relationships would be superficial. I might not be best buddies with everyone on the team (the energy barrier to bf status, even just f-status, is pretty damn high for me), but I would be able to trust in their strength and in their knowledge.

That being said, I would like to reflect a little on my own performance at Tournament. It was disappointing at best. I totally blanked out on my forms - so badly, I had to stop twice. That has never ever ever happened..... *sigh* I know it is because I didn't practice enough! There are three weeks to Nationals and I am definitely putting forms practice in high priority. As for sparring... *sigh* I really really really don't know if I'm getting it or not. Last tournament was great in that I felt I was really learning and improving. But today I feel like I really lost it. I kept on clashing and now there is horrible bruise on my left knee that I can't bend very well. What I really need to lean is to block and then kick. I need to learn to push my opponent around. I need to learn to go in and out fast. *sigh* I really feel as I regressed. I didn't even try to clinch and short-kick even though she was taller!!! So, overall, not happy with my performance. But what is done is done and now, it's time to look to Nationals. Ganbatte yo!

Short update

2008-04-03T17:37:00.003-04:00

A lot of interesting stuff has been happening in my life right now. I'm also learning about some really thought-provoking topics in my bioethics and drugs class right now. If I have time this weekend, I'll post some of those thoughts. But I thought it might be about the right time to make some news public.

Medical School Status

University of Cincinnati: accepted
University of Michigan: accepted
Washington University in St. Louis: accepted
University of Pennsylvania: waitlist tier 1 - application withdrawn
Case Western: interview offer - application withdrawn
Northwestern: interview offer - application withdrawn
University of Chicago: interview offer - application withdrawn
Baylor College of Medicine: interview offer - application withdrawn
UCSF: interview offer - application withdrawn
Duke University: waitlist
Harvard HST program: accepted
Harvard New Pathway program: accepted
Johns Hopkins University: interview - waiting for a letter (did it get lost in the mail???)
Stanford: rejected

The fact that Harvard accepted me to both programs and Duke waitlisted me boggles my mind. Perhaps I didn't give them the correct answer to their ethics question? Well, if that's the case, then I'm sorry but I'm going to change my answer. I answered as I believed right and maybe 10 years down the road, I might learn more to change my mind, but I'm not going to compromise my standards by shaping myself to another person's opinions. If there is one thing that I learned this semester from my classes, it's that ethics, morals, whatever, they're only opinions. Sorry to burst your bubble.

On a completely different subject, I'm going to UPenn this weekend (I think) to spar. Anyway, I think I'm leaving with the Harvard/Tufts team but I still need a confirmation from them. Master Chuang for some reason has decided to put me as an alternative heavyweight for b1-b3 teams. OMG. I really don't want to think about what would happen if I actually had to stand-in for one of the girls. So girls, I'm cheering for you and hoping that you don't get injured!

Where I am going?

2008-03-20T00:14:00.002-04:00

I'm in a weird part of my life right now... it's hard to become motivated and I'm sleeping a lot. No, I'm not depressed, I'm just feeling very lethargic yet tense. I feel that I have so much to do, to accomplish and I am just shoving it all off elsewhere. Why am I not doing the important things in life? Where am I going? Now that I am not interviewing with med school anymore I should have plenty of free time to work things out. Yet I find myself being distracted in so many ways, and not very confident with who I am or even knowing what I want right now. I think the path I am on right now is, hmm, self-destructive (not in the way of alcohol or drugs, but I am still weakening myself). I think I want a new hobby (I felt very good making teacups earlier this week). I think I want to do more of things that make me happy. I think I want to feel better about my body and behavior. I think I am tired of going to class and doing things that no longer really matter to me. Writing papers, doing lab-reports, these things feel so small yet insurmountable. Yet if I can't get myself motivated to do such things, I feel somewhat like a failure, like as if I should have enough control and strength to be able to such tasks like these even if I don't derive joy from them.

Oh, I think it is time to wake up now. I've been thinking that for a while. Let's wake for real now and find out where I am really going...

On a slightly happier note, Monday night was nice. It was funny and happy and we were all together as friends. That was what mattered; not the tests and papers and other assignments but being with people whose lives somehow often accidentally became intertwined with yours.

I think I am going to start to learn pottery-making. I think it is truly something I would enjoy do; the hands, the art, the quietness of thought... here is a list of some of the things I would like to make:

2 sets of rice bowls for Jenn
1 freeform clay piece (a very very big vase?) for Mary
1 pitcher for Samantha
1 set of teacups + saucers for Afsah

and as a gag piece (it might take me a life time to do this), a bust of myself for Sony.

Banana Cream Pie

2008-03-15T21:37:00.011-04:00

I made 2 banana cream pies for Pi Day on Friday, 3/14. They were delicious and well received, especially the one where Jenn persuaded me to add strawberries in addition to bananas. However, I think that the cream is more like a custard in thickness and texture so maybe I should rename it to banana custard pie?

Ingredients
1 pre-made graham cracker crust

1/3 cup sugar
1/3 cup cornstarch
1/4 teaspoon salt
1 1/2 cups whipping cream
1 1/2 cups whole milk
3 large egg yolks
2 ripe bananas, peeled, sliced cross-wise
sliced strawberries (optional)

Add sugar, cornstarch, and salt to saucepan. Gradually whisk in whipping cream and whole milk, then egg yolks. Whisk over medium-high heat until custard thickens and boils (custard starts "burping"). Remove saucepan from heat when custard starts "throwing up" aka splattering a bit from boiling. Cool completely, whisking occasionally.

Stir custard to loosen, if necessary. Spread 1 cup custard over bottom of prepared crust. Top with sliced bananas, then 1 cup custard, covering bananas completely. Repeat layering with remaining bananas and remaining custard. You may add sliced strawberries as well. Chill banana cream pie until filling is set and crust softens slightly, at least 8 hours and up to 1 day. Cut pie into wedges and serve.

Tae Kwon Do Kick-a-Thon + Tea Ceremony + Avenue Q

2008-03-13T01:11:00.003-04:00

Today was the MIT Sport Tae Kwon Do Kick-a-Thon where each member kicks 1000 kicks and break boards for sponsors. Half of the proceeds go to Special Olympics. I felt really really good about our cause today because I wasn't just collecting money, I was also honestly working for it.

I will try to recall our repertoire: axe kick, lifting leg, inside-to-out, out-to-inside, turning, fast, back double, front double, triple, back kick, nah al bam (spin backwards turning kick), side kick, cut kick, double and trip cut kick, jumping front kick, reverse turning kick, 100 alternating front kicks, 100 walking alternating turning kicks, 100 running turning kicks. It was awesome. It was super tiring. I think it might have sorta helped cure my cold.... then I broke boards, very thick, hard to break boards. My heels hurt alot from trying to do a jumping front kick multiple times..... ugh, I wanted to break with my forehead but decided not to in order to preserve brain cells; same with the finger break... I did learn to do an elbow break which if you don't do properly will result in a bruises or a pain similar to a rug burn. Overall, very fun night. I am proud of everyone who participated. Also, if anyone has any use for pinewood or know of any ways to recycle it, please tell me. We have boxes and boxes of them!

Also, just a quick note about the Tea Ceremony I participated in on Monday. So I've always wanted to be part of a Tea Ceremony. While this one was not very formal, it was more of a learning sessions, it was still very cool. The Sosei came to present about his various pieces, many of them are antique. There was an intricately carved incense burner pot. There was a prized scroll, inside a prized scroll container, inside a prized box for the container, inside another box.... which is tied together in the most curious fashion... Two ribbons were attached to the two adjacent sides and through Sosei's skilled movements came together again as a perfect bow. There was an ingenious water boiler that looked just like a small scale of those big burners found on the grounds of Gu Gong (The Forbidden City) in Beijing. Wood is added to the lower chamber to heat the water on the higher chamber.

The Sosei made koi-cha (thick tea) and usu-cha (thin tea) for us. Before the thick tea, we had orange mochi that we picked with gigant toothpicks/skewers made from a spicewood bush. I swear that the toothpick smelled of some incensy like smell but Jenn thinks I'm crazy. Koi-cha was shared by dipping small rice wafers into the bowl. It was a beautiful deep grass green, very thick, and deeeelicious. I wish I could've had more but the tea is very expensive (a special gift from a distinguished family in Japan) and there was a lot of us at the table (because 13 people can't fit onto the standard 2.5 tatami mate room). The tea tasted of seasalt or seeweed with a hint of roasted rice or barley. The process of making the tea was a silent ritual. Every movement I felt like was practiced >100 times, with grace and concentration. It was a little akin to watching someone perform their Tae Kwon Do form. Sosei is apparently known for the froth in his usu-cha, but unfortunately I did not partake because I was sick and did not want to contaminate the communal cup. Apparently, 4 people is the maximum number to share a cup of tea. Before drinking usu-cha, we ate a piece of pressed brown sugar. The candy was molded into chrysanthemums, pine trees, sakura, a daisy-like flower that I can't name and something else that I can't quite remember. I was tempted to pick the chrysanthemum but decided not to because of the association with the royal Japanese family. I went with the pine tree because it is seasonal and also because I felt very drawn to the principles of the pine, steadfastness and longevity. Along the lines of pine, Sosei said that the best water for tea is that when you add cold water to the tea kettle, the soft boiling hissing dies down for a few seconds and then rises up again. This phenomenon is called matsu-kaze, or pine wind. Apparently, when you hear the wind though the pines, then it is time for tea!

Sosei was definitely a performer; that is the whole ceremony was akin to the theater where there are certain ways that you smile and talk, like a special script. His actions was a little stilted and his humor was hard to get; perhaps he was acting correctly if he were a man from the pre-Tokugawa period (Sosei follows Zen Rikyu school of tea)? Anyway, the atmosphere was definitely a bit awkward especially when he does his special little chortle. Also, I didn't like how he was very being very snobbish and better than thou to his assistant (who was an extremely nice, senior gentleman). He kept on saying, get this or that, in the most condescending manner, and then he would say, oh forget about that, it's complicated, I'll take care of it, in this annoyed manner. Ugh, I hope he is not really like that outside the ceremony. Both men looked to be in their late 50s to mid-60s (lots of white hair). I wonder how often they perform the ceremony, who they perform it for, and when they first started learning? Can you make a career out of the tea ceremony?

Finally, I went to see Avenue Q. It was hilarious and totally non-PC. Christmas Eve's wedding outfit as a light-up optical fiber Christmas tree was a hoot. Very glad I went to see it! But if you want to see it, make sure that you are very very very open-minded; the show insults just about anybody and everybody.

Type rest of the post here

In the eye of the beholder

2008-03-09T00:19:00.003-05:00

"Beauty is truth, truth beauty," - that is all
Ye know on earth, and all ye need to know.
~Ode to a Grecian Urn by John Keats

I saw a girl wearing a beautiful dress today. I think she was pretty but I wasn't focusing so much on her face as on her body, which wore the dress pretty well. But in truth, the dress was really the focus point. It was white and long, cut in a V to 2 inches above the waist in the back. There was a band of smooth white satiny material around the waist but the dress was otherwise pleated (kind of like the white dress that Marilyn Monroe wore in her infamous dress blowing up in the wind picture) The best however was the drape of the dress, which unlike other dresses that drape straight down, makes a U loop from the from one side of the waistline to the feet and then up again. It was gorgeous. The grace of the folds, falling like ripples in the water. From the side, the tiers of softly curving was sheer classic elegance.

I thought of ancient Greece; I thought of Athena and Artemis. This is the way I see beauty in the world. In the lines and curves, the drapes and folds, the lamp post light glittering on the rippling, shadowy river, the transition of bumpy knuckle and smooth finger bone, the balanced proportions of the leg, torso and neck... yet sometimes I feel like a voyeur.

With nature and landscapes, it is easy to stare longingly, lingering on especially inspiring features. But with people, I always feel rude, like I am intruding, offending them. Or maybe they think I'm perverted because I focus so much on their body. What I wish I can explain is that it is not sexual. Well, maybe it is a little sexual because sexiness is part of beauty and beauty quite sexy. What I mean is that just because I look at you doesn't mean that I am attracted to you per se, but I am attracted to the form that you present at that certain moment that I am seeing you. I am attracted to the texture of your hair, the way light glints off your glasses, the certain angles formed when you are crossing your ankles or the silhouette of your standing pose. It is in these moment when I realize that everyone can be beautiful even if it is just a little part during a little time of the day. And when I see people whose very forms are so well balanced, so elegant and graceful or so powerful and striking... I think oh, oh, oh, this is truth, this is perfection. And I want to share that with everyone, tell them, look here, here is beauty and truth, appreciate it and savor it, if we are lucky it will stay for a while but maybe it is fleeting (which sometimes partially contribute to the beauty) and we must catch it now or lose it forever. Most times when I tell people what I see, they don't take me seriously or they look at me like I'm a total weirdo... and it makes me really sad, that they are not seeing the beauty. And sometimes it is very lonely, having a perspective that cannot be shared.

Beauty is in the eye of the beholder. Perhaps more so in my case than others.

My first ever sports medals!

2008-02-25T22:38:00.010-05:00

Yesterday was the NYU Tae Kwon Do tournament. It was awesome and it lasted a really really long time. Most of the day flew right by as I was constantly floating from one ring to another, on deck for my upcoming matches. I sparred 3 times and lost 3 times but each time was a learning opportunity. I found that I was less tired, more focused and scored the most points during my last match (0-3, 3-5, 5-12). None of my opponents were very tall, but they still kicked harder and more accurate than I. Must work on turning my hips and kicking higher! Also need to work on side-step + kick + follow-up, short multiple kicks, cover-punch + multi kick, step forward + multi kick. See the prevalence of multi kicks? Yeah, I need to build up my stamina. On the good side, my last match was against a Cornell C1 heavyweight who was also on a B team and apparently everyone thinks I did pretty well. Multiple people said I moved at the fastest speed they've seen me yet. Yay. Remember to also work on speed.

Now for the medals. I placed 3rd (out of 25?) in Women's Green Belt forms and my C2 team placed 3rd for Women's C team sparring. yay!

Epiphany on the road to my "doctor" identity

2008-02-24T00:58:00.003-05:00

While writing my paper for one of my medical anthropology classes, I arrived at a shocking epiphany. During the early days of my application to medical schools, I had griped about how disturbing and frustrating it was to constantly fit into this "pre-med" mold. One must do certain activities, have certain attitudes, enjoy certain pastimes, etc. Yet of course, the school also encourages you to have your own personality, your own story, your own unique pursuits. Is it even possible to reconcile these apparently contradictory demands? I still do not know the answer, but I am one step closer to understanding the application mentality. You see, the "doctor" is a social construct. Medical schools are searching for the students that can assume the mantle of a physician, which includes the proper behaviors, attitudes and beliefs. From here on until the end of career, I will be constantly in that battle to retain some aspects of myself and still wear the "doctor" identity. So the application process is actually not as broken as I had perceived it. If I was no longer willing to subsume myself in the quest to become the kind of applicant they want, the kind of applicant they know who can survive the "re-construction" process, then I would longer follow this path and of course, the schools wouldn't want me anyway. I really have no idea how I feel about all this... amazement at the cleverness of the system, disgust at the oppression of the applicant's individuality?

Well, at least this verifies what I have always suspected... I am rather good at molding myself to meet other people's expectations. Ugh.

February 14th

2008-02-14T22:22:00.003-05:00

Today is February 14th. The only significant fact about today is that it is one week from my legal birthday. Rather than talking about the many couples out there doing couple-y things, let's talk about Durkheim and what humans want most in life.

Durkheim's argument, my version:
Take today for example, with all the "love" in there, perhaps we can argue that all humans want love or to be loved. Well, suppose you are loved by your significant other; is there anything else you want? Perhaps a diamond ring, a fancy dinner... Perhaps love from your parents, your children, your friends, your peers, even the entire world! As a person "fulfill" each of these wants, she will find that there eventually will be something more out there. "Wants" unlike "needs" are unlimited and as we fulfill particular "Wants", they become "Needs" and we later seek new "Wants" to replace them. A woman who likes shoes wants more shoes; a guy who likes video games wants more video games. What we (mostly pertaining to a Western individual) "want" most is really just More.

Think about how this philosophy has influenced American culture. Capitalism itself propagates our individual "Rights" to more. Corporations want more profit and more marketshare. Consumers want more (duh) products; think Wal-mart; think the wide-spread usage of TVs and computers; think of the American Dream - no matter how low in the socioeconomic status you are, you are encouraged to envision a limitless future where you can have anything (sex, money, fame) and do anything you want as long as you work hard and smart. So high school students take more AP classes, participate in more extracurriculars to get into more elite schools. Multibillionares don't just retire, they look for more ways to earn money to bear the cost of their ever more thrilling and more exotic adventures. When will it ever stop? When will it ever be enough?

Perhaps it shouldn't stop. Perhaps we should never stop striving for more; after all isn't that progress? Here in the Massachusetts Institute of Technology, the philosophy of more technology, more research, more knowledge, more innovations drive students, faculty, staff and administration alike. We imagine that our "wants" for more are really for the benefit of society. If we don't strive for "more", families in Africa will starve, the energy crisis will ruin the earth, etc. If we don't strive for more, wouldn't society be filled with total bums who never push for better and better things?

Yet, do you truly believe that we can have it all? This is a concept that has bothered me throughout my tenure at MIT and I bet, this is a concept that has depressed most of the freshmen even sophomore population... we come here and we find that we are limited. We find our previous conception of ourselves as geniuses, our previous dreams of being the best of the best, our previous ideal of pushing our boundaries were false. Our life becomes a string of negatives: we can't do this problem set; can't pass this test; don't get enough sleep; don't have any time to be with friends... We find that we can't have it all. The limit surrounds us, suffocates us, degrades us... is it any wonder that there are suicides here? In this world filled with limits (on your job, on your looks, on your status), is it any wonder that there are deeply sad and unfulfilled people?

Durkheim offers a solution: that we need to limit people; that society's duty to the people within it, is to the set recognizable boundaries: you can only be this happy, you can only have this much... yet doesn't this feel awfully against the "Truth", our fundamental "Right" to have more? I am not going to explore this tonight. Instead, I want to go onto the application of Durkheim's philosophy to medicine and American healthcare.

The current popular American philosophy regarding healthcare is this: I want the best technology that I can afford or that insurance can give me or the government can give me (More treatments). As the patient, I want those MRIs, CT scans, any and all diagnostic measures to determine my exact illness (More Tests). If it is "regular" disease, I want those brand-name prescription pills, the newest ones I heard on TV (More Pills). And if it is a severe disease or goodness-forbid a fatal disease, then I want all the doctors in the world to keep me alive in the highest quality of life possible (More Doctors). I want all the researchers in the world to work on my disease; to invent more treatment options if not a cure (More Technology). Even if I don't have a disease, I want a longer life (More Life). As a patient, I want more... (please note, that I do understand that there are people out there who draw the line and say no more (that's the debate on euthasia, reserved for another night), but right now, I am representing the view point of the majority of patients and patients' families and even doctors in US).

However, in medicine, the limit on "more" is bitingly clear. There is not enough for everyone in the United States to constantly ask for more when they are in the hospital. There might, MIGHT, be enough for one person but not for everyone. There is a limit, but we, the American, insured healthcare consumers, simply don't see it, don't comprehend it. We don't because it is so easy for the middle to upperclass to get healthcare; so easy to say, "I can't believe that I waited over an hour at that clinic, I'm transferring to another, better doctor now." There always seem to be more doctors to turned, more hospitals, more medical machines... No limit, we think but there is limit that depends especially on our financial status, on our race, on our gender, on the geographic area which we reside... so many limits, yet never considered; buried under our cultural philosophy for "more"...

So my question: is this why, American healthcare consumers are so unhappy as compared to our British or Canadian counterparts? Because we have no "visible" limits on the healthcare system, we want more and because we can't always get more, we say that the system is flawed? Because we cannot change the system to suit our fantasy of "limitless medical supply", are we doomed to despair*? Have we been looking in the wrong direction for the solution to the healthcare problem? Perhaps, we are the problem not healthcare itself? Well, I'm never fond of a situation with two extreme, dichotomous choices... so I'll say right now that of course, I believe that both the consumer philosophy and the current healthcare system is flawed.
*despair is not the precise word that I would use, but I cannot think of a more precise one at this moment so you will have to bear with me

Now, let's move onto a even more disturbing medical application: Atul Gawande mentioned in his book, Better, that it is our medical duty to always push the envelope for better. This spirit for improvement is what led me to MIT and has propelled to medical school and research and drew me to Dr. Berwick. Yet, didn't we cover before that better is just another expression for "more"? Is our pursuit for better medical technology making us more unhappy? In the old days before heart transplants, there was a limit on what a person can expect in terms of life span after a heart attack. A patient simply accepted he was going die. Now, with our rapidly improving technology, a person can hope to live longer and longer. A person wants to live longer and longer. A person is unsatisfied when medicine and technology cannot deliver fulfill that want; either in the case of a shortage of heart transplants or the ineffectiveness of a pacemaker... So is it wrong to hope and want? Is it wrong to focus on more research and more technology? Is it wrong to do better?

When I first discovered this thought within me, I was scared. I was chilled. I cannot describe the despair, the feeling that my very foundations were crumbling. Is my research fueling our society's insatiable hunger for more and better healthcare? What if in my quest to do better for my patients, I in fact harmed them? Is civilization really better than the hunter-gatherer days? Should we, as one health care reformer suggested, abandon our hunt for more treatments, more pills, more technological research? I don't know. My soul is still rests on shaky grounds.

I am held together by one bandage... the other night, while in the shower, I thought, oh, to do better, doesn't necessarily mean to do more. Didn't Dr. Atul Gawande write in Better, of the nurse who cried out, you doctors are all the same, you don't know when to stop! I had been rushing straight ahead without stopping to think, oh, to do better sometimes means to to do less. Not necessarily to provide less caring in the form of sympathy, understanding, kindness... less of technology, or drugs, or life-sustaining measures that are no longer "better" for the patient. Yet here, we return to Maysun's argument: what if the patient does not want less technology? What if she wants more when it is not better for her? How do I know what is better for me? How do I know when to stop? Where is the limit; how can I determine the line that defines when to push for more and when to not?

Dr. Atul Gawande offers this answer: "In the face of uncertainty, wisdom is to err on the side of pushing, to not give up. But you have to be ready to recognize when pushing is only ego, only weakness. You have to be ready to recognize when the pushing can turn to harm." (Better, 164)

A week ago, I whole-heartedly agreed with this answer. I thought I was ready to recognize ego, weakness and harm. Now with my half-ruined pillars and my one bandage, I am recognize just how unready I am...

"In a way, our task is to "Always Right." But our fight is not always to do more. It is to do right by our patients, even though what is right is not always clear." (Better, Gawande, 164).

I wanted to end this incredibly long post on a happy note, but I find I can no longer do this. Writing about this subject has solidified some concepts but much of my insides are still sloshing around as I search for way to rebuild myself.

*On a slightly tangential point, I was at Duke last week where the Associate Dean told us that "we don't come to medical school to find ourselves, that's what college is for." Well, I find that I don't agree with the concept anymore because while I have found much of myself in college, I know now that there is much still left to discover; new parts of myself are being discovered all the time. My ethics, my philosophy is constantly changing. Therefore this task of "finding myself" or "examining my life" will stay with me forever.

On "Zen" and love

2008-02-13T23:47:00.003-05:00

As I walked out of TKD practice today, I felt a supreme sense of calm, of detachment from the worries of the world despite that I was actually not kicking as well I should or could have been. I was also more awake and invigorated despite the sweat soaking through my dobok. What a rare and miraculous feeling. When I, in the future, consider not going to practice because of too much work or feeling tired, I think that I will recall tonight's incredible "Zen-ness" - rejuvenation - and hope that the memory will spur to attend practice despite my materialistic concerns.

On another TKD note, I voiced today some thoughts regarding Master Chuang that I have tossed around in my cranium for a few months now. For those who don't know Master Chuang, he is an incredible man. He coaches us 3 nights a week for 2 hours without pay (I believe) yet he is so incredibly dedicated to the club/team, so encouraging of beginners, has expectations and goals for all of us regardless of martial arts background or capabilities. He is funny yet intense; the man whose skills we all look to and yet can bridge the age gap (admittedly, he is at most in his late 20s) with a few well-intend but awkward statements. Obviously, I have been silently admiring his devotion to TKD and to the club/team for long time. However, I also feel guilty when I compare the extent of his love for the sport with mine. I know that I don't the passion like he does and I wonder if there is some that I could or whether I even should... There are days when I am not willing to sacrifice time and energy for the sport; he, on the hand, is there consistently unless he is coaching someone at Nationals or if there are matters at the CW dojang. He sacrifices leisure time, time with his wife and same-age buddies, work-days when away for tournaments, so much for us, for a group of college students not related to him in any way except that we are all students of Tae Kwon Do. It is mind-boggling. It is inspirational. And in the end, I am forced to ask the question... is there anything that I love like that and am willing to sacrifice so much for that love? Am I even capable of loving that much?

The Patient Dictatorship

2008-02-10T18:36:00.000-05:00

Last night, I was deep in argument with Maysun regarding patients' and physicians' rights. What is the role of the physician? Are we, merely as Maysun suggests, a "tool" for the patients to use to enhance their health? Should we sacrifice our autonomy in deference of the patient's right to how she wish to treated? Should we spend as much time with a drug-user or a person who is obviously abusing the medical system than with patients who have serious and real issues? Can we decline treatment to these "bad" patients? The argument lasted until 3am and was frustrating yet paradoxically, invigorating. I wonder how many people out there share her views? I was going to write up a detailed rebuttal, but I don't really have enough time so I will only sketch out my rough idea.

1. Physician as a "tool" for the patients
A. While it is true that physicians provide a service, this doesn't mean that physicians are servants. We are especially not slaves, subject to the whims of patients who may or maybe not be mentally competent. Years ago, physicians had the last word, e.g. the surgeon will perform a mastectomy, the geriatrician will stick tubes into you to keep you alive, etc. That was not physician autonomy; that was physician tyranny because there was no regard for the patients' desires or beliefs. The physician "knew best". Now, medical students are encouraged to talk with their patients, and discover what is the quality of life the patient wishes to purse, how much treatment, what kind of treatment, what are their fears and doubts and misconceptions about the medical system. Now, physicians "might know better". We serve as a guide through the healing process. We are providers of information as much as we are providers of medicine and medical exams. In the ideal situation, physicians and patients work together to hammer out the ethics of tough cases. However, the world is not ideal... sooner or later in one case or another, someone is going to set down his or her foot on a hard decision. Is that someone the physician or the patient?

In a world where the physician is only a tool, then the patient has the last word regardless. This world is the opposite of our previous age of "physician tyranny", now healthcare is a dictatorship under the reign of the patients. Mastectomy to save your life or keep your breast to save your vanity? If the patient is exceptionally proud of her breasts, she could override her doctor's attempts and die in pain despite having a treatable condition. A man hallucinates that his perfectly healthy leg is festering and demands an amputation. An eighty year old woman seeks increasing doses of morphine on a weekly basis and begins to show obvious effects of addiction. Should we, "tools of the patient", obey these requests? Should we bow down and say that the patient is always in the right? Should we become automatic pill-dispensers, autosurgeons, machines, slaves?? In this dictatorship, the physician no longer uses her brain, her medical training, her own sense of morals or ethics. She is only a projection of her patient. In this dictatorship, there is no such thing as the "physician" because each and every patient is her own "physician". Each and every patient has the "right" to heal AND abuse her body as she likes.

Would you be willing to live in this world as a patient? For myself, the initial joy of controlling what my doctor can or cannot do would fade away fast. When I go see a doctor, I want answers, I want to be treated or cured, I want to be reassured that I don't have disease and that I will live a long good life. I want someone who is highly trained, who has the authority and knowledge to advise me if I need surgery or radiation. If I shall ever become insane from pain or disease, I hope that my doctor would ignore my ravings demands for harmful substances or procedures; I would hope that they have the guts, the autonomy, the intelligence to figure out what is wrong with me and then apply the appropriate treatment over my very loud and irrational protests. I would want to live in a world where my doctor acts in my best interest armed with my knowledge and experience than me.

Would you be willing to live in this world as a doctor? No. If someone shows the future, written in stone, is a future of a patients' dictatorship, then absolutely no, I don't want to be futile, spineless, robot. I wouldn't want to be the woman who kills her breast cancer patient by misplacing more value over her patient's vanity than her patient's desire to live. I wouldn't want to be the woman who cuts off her patient's perfectly healthy leg because he irrationally believed that it would rid him of his hallucinations. I wouldn't be able to live with myself as executioner and torturer when I clearly had the option of being a healer. I wouldn't be able to live as a traitor to that fundamental principle of physicians in every nation: first, do no harm. In this dictatorship, I wouldn't be able to avoid doing harm. Ironically in this world, I am obligated to do harm by obeying the commands of my patients.

So now, we have established the falseness of both extremes: neither the patient nor the doctor can always be in the right. There are times when the physician acquiesce to the patient's desires, to not resuscitate, to not undergo more rounds of chemotherapy. But I hope these decisions arise not from the irrational, impromptu emotional moments of weakness, spurred by fear or doubt or pain or anger or mislaid hopes. I hope that in these situations, we are acting in the patients' best interest and not out of defeat, not out of fear of being sued later on, not out of a pride-filled urge to "show off our stuff", not out of greed to earn or save more money... If we physicians must become "tools" of our patients, then let us be more knowledgeable "tools", more competent "tools", more thoughtful tools so that we can honestly and reasonably say, I acted against your wishes because I believed that my actions would result in a healthier and happier you.

Wish List

2008-02-09T19:22:00.008-05:00

I'm taking a leaf from Justin's blog and starting my own wishlist. This list will be updated as I acquire new wishes and fulfill old wishes. Happy shopping.

*Fashion

~~Jewelry book/tree, specifically for dangling and non-dangling earrings~~ So apparently, a nice sponge (like watercolor sponge) or other foamy material work great as a cheap substitute. I have a circular one with the dangling earrings on the outside and studs in the middle.

A beautiful watch, stainless steel links with gold embellishes and actual numbers on the face

A dark grey, well-tailored, warm pea-coat that ends 2" above my knees, maybe with double-breast buttons or a high-waist belt

Being invited to the TV show, What NOT to Wear

*Creature Comforts

A comfy body pillow

*Cooking Gear
+ thanks to everyone who helped purchase my dream kitchen gear for my 21st bday!

~~Knife sharpener~~+

~~A high-quality, stainless steel chef's knives and small paring knife~~+

A high-pressure cooker

~~A small slow-cooker~~

~~A grater for cheeses, veggies and fruits with a comfortable handle~~+

~~A food processor~~+

~~A wok with a lid or a large lid for my current large frying pan~~ I bought a small but deep saucepan instead. It will do until I have my own apartment or until I have someone else to cook for consistently.

*Books

Japanese Cooking for Two by Kurumi Hayter

Chinese Rice and Noodles: With Appetizers, Soups and Sweets by Su-Huei Huang

*Music

Piano scores by Jim Brickman and David Nevue

*Technology

~~MP3 player, preferably inexpensive but durable with only the essential features!~~ - Thanks Dad! For those who are curious, the MP3 player is indeed the cheapest one we could find. :)

~~Some EECS person to give me some good guidance on the next computer that I purchase...~~ So I didn't exactly find a guide but my parents did just purchase me a new computer... beggars can't be pickers I guess!

Elderscrolls IV: Oblivion

DDR pad
Palm pilot/blackberry/other searchable reading device that contains a medical dictionary with ETYMOLOGY (to satisfy my inner Latin and Greek geekness)

Bluetooth wireless earphone for my cell phone

*Fun Things to Do

Visit Japan and China/Hong Kong/Taiwan, New Zealand for LOTR, Italy, Morocco - particularly the countryside, Greece or some other Mediterranean islands

Learn salsa or tango

Tubing

Zip-lining in Costa Rica

Snorkeling around some nice reefs

Eat delicious Barbeque at the National Barbeque Competition in Memphis

*My Garden

Zucchini plant (bush?)

Chang Do Ya

WATERMELON

1 small-ish tomato plant

Basil shrubs

Salad cucumber plant (vine?)

Chives

Green onions

My name means morning reminisces

2008-02-08T16:38:00.000-05:00

I have recently began obsessing over writings - essays, poems, books - by various doctors. I am currently reading through an anthology, This Side of Doctoring: Reflections from Women in Medicine, given to me by Dr. Etta during my sophomore year. It contains some beautiful writings but this poem that I am posting touched me in some deep dark place and I am overwhelmed by how much my own past resonates with the topic. I read it and recall all the wonderful stories of my parents' and grandparents' tragedies and joys. My father asks me to keep an archive of all my writings so that one day, he can collect them into a book. I think I would like to keep an archive of all of my parents' and grandparents' precious memories so that my children and grandchildren can get to know them in the future...

A Doctor in the Family
Bhuvana Chandra

My father walked barefoot to
the municipal school
with no money for lunch
and torn, fourth-hand books.
And every day his feet stung
from giant spider bites.
His friend had a mother
who squatted on street corners
and fried snacks in hot oil
so her son could have slippers
My father was motherless.

As a child, I heard him
mutter at beggars, those
who swarmed at the entrances
to temples and stores.
His eyes gave him away.
"Go on," he'd say, slipping,
coins in a trickle into each of their hands.

Once, near a bookshop
where he bought me
my first Thomas Hardy,
I saw him reach down
to stroke this old cow
that blocked the pavement.
People stared at him while
he talked to the animal.
I looked away, pretended
I didn't know this mad man.
I was fourteen. He only smiled.

In his growing-up days, long
before I, his only daughter, was born,
my father's notion of a feast
was a handful of rice, an onion slice
and one chili, searing hot, green.
I never knew how it felt
to go hungry for days and
simply accept.

My father made a bookcase,
repaired clocks, planted flowers, among other
things. His fine surgeon's hands
painted oil pictures and watercolor words,
made kites that I flew with my brothers.
He brought in a dog, a mongrel, one day,
that had one fiery eye, seemed half dead.
My father named him first. Cyclops.
Lucky stray. Then nurtured him to health.

When I graduated, my father said -
his face almost expressionless -
"You are the first doctor, ever,
on my side of the family."
His eyes gave him away. He
saw in me the dreams of that
boy, too poor to practice the art
of medicine. My father was wrong.
I simply followed in his footsteps
where I'll always belong.

End of the last first week of classes

2008-02-08T13:47:00.000-05:00

Well, the end is finally here. This is my last first Friday of classes at MIT. Technically, I didn't have class today because I'm just sitting in 7.05 as a TA but oh, hearing Professor Yaffe joke about "tweptophan" and asking the kids whether HAc is protonated or deprotonated at pH 9 brings back joyful memories of my younger days. I will be cliche and ask, where did the time go? In late April of my freshman year, I looked back and said, "man time sure flies..." and bit back the last part of that phrase, "when you're having fun" because at the time, fun was taking a backseat to stress, hell weeks and horrible weather. One of these days, I'm going to read over my blog from those darker days... Now, I look back and think, yeah time sure does flies and ain't it been pretty fun despite some awful days?

Of course, today has been a source of stress, at least in terms of paper work. Kids, don't put off asking your concentration advisor to sign your concentration completion forms. That's just asking for trouble. Also, remember, if you want to graduate, without paying the $40 fee, you need to fill out a form before the end of your first last week at MIT. Ugh, I narrowly avoided the second fate this morning and will be heading back to the Literature Program to get my form signed... thank goodness I complete my PE requirement during Sophomore year.

I put my flowers in 2 make-do bottles this morning. My rooms smells wonderfully fresh. I think I'll get some flowers regularly now because my room looks so much brighter and smells much better. Anyone want to contribute to my flower fund?

Happy Birthday and New Year

2008-02-07T18:36:00.000-05:00

Happy Chinese New Years everyone. Also happy birthday to me. I have turned 21 on paper... am I old now? Well, I've been feeling older ever since the medical school application cycle started. Yesterday was what I thought to be my last ever interview. I was in Duke, visiting the medical school, an old old old friend Yaqing (who is much shorter than I remembered) and a not quite so old friend David (who is much more courteous than I remembered). David and I celebrated my 21st early with a shot of Kahlua each. Apparently, I have inherited my dad's genes for turning very very bright red. Ellann came over today to give me flowers for my birthday. She is the only person who remembered that it is my birthday today; granted it's not the one that I celebrate but it was very sweet of her to remember especially since my own parents don't remember. Usually I'm not disturbed by this general lack of un-memory but because my estrogen level is at its lowest, I've been pretty emotional about a variety of topics that normally don't unnerve me. We're going out this weekend to celebrate with Frappes and 27 dresses. On a brighter side, I received a birthday e-card from the University of Michigan medical school. It was very cute: 4 surgeons are operating what looks like a life-or-death case but it turns out that they were actually cutting a birthday cake. ^___^ I think sweet gestures like these really distinguish the school.

Back on the med school track, I thought the interview season was over with Duke, but JHU sent me an invite today. I was contemplating not going because its the Friday right before the NYU TKD tournament but my parents are really excited and they are paying for the plane ticket so now I think I am pressured into going... we'll have to see. I think I need to make a decision by Monday.

Finally, I want to recommend a book: A Three Dog Life by Abigail Thomas. I picked up the book at Hudson News in the RDU airport and finished by the time my plane lifted off from New York LGA. It's a touching, sincere, and just beautifully written memoir of a 50-some years old woman who struggles to live and find purpose in her life after her husband suffers from permanent brain surgery. Plus she loves dogs. Absolutely wonderful.

The Food that is just Right for Me

2008-02-04T01:41:00.000-05:00

Looking back over the years of my life, I wonder, was I so naive, so aimless? I wonder, what did I ever know? How could I have been trusted to make such important decisions about my life. As we wander down the road of life, we discover that there are so many paths, popping up unexpectedly and without any labels. Which road do I go down? Having gone down that path, will there be a day when I retrace my steps because I went down the wrong path?

Why am I asking these questions? Well, mainly because I am trying to define the next chapter of my life. I feel often that I grappling at smoke or at least trying to wave aside the smoke that is masking my purpose. I am also going to my Harvard and Duke interview this week so it would be a good idea to understand what I trying to do with my future. Thankfully, miraculously, over this winter break I think I have discovered the first steps to that future.

There are two "things" I want to pursue right now (in addition to medical school). One, I want to learn more about my "invention" or rather the invention that I thought I invented but has already be invented by some big pharma or another. But I want to learn about it and perhaps even use in a potential research project. Someday, I will clarify my intent. Two, I want to learn more about Dr. Don Berwick and his Institute for Health Improvement. I think this might be the closest thing to a calling that I have ever felt. One day too, I will talk about how I accidentally discovered Dr. Berwick but suffice to say that right now, I think I would like to stay in Boston this summer and work for the Institute for Health Improvement. Maybe at the end of the week, I will be able to tell you about the Institute and about how I can accomplish my plan.

Finally, I want to jot down an interesting analogy I came up with while discussing these issues with Steph. It goes something like this:
In my life, I have always eaten good, solid, filling food. I am content to eat this food, indeed grateful that I am able to eat such food. However, I also know that this is really normal food, mediocre at best. All my life, I feel that there might be an even better type of food, a great food that's just right for me. But I'm not sure that it exists or that I will ever find it so I keep on eating this normal food because I don't want to eat crappy food or no food at all. Then one day, I smell a gorgeous smell and I think, wow, this could be the smell of that elusive great food.

I have arrived at that special day.

The great food is an analogy is what I am looking for in my career, in my future, in my purpose. I think I have smelled it. Let's hope that I will be able to follow that smell to my great food that is just right for me.

A bit of sadness

2008-02-02T15:58:00.001-05:00

Medical School Status

University of Cincinnati: accepted
University of Michigan: accepted
Washington University in St. Louis: accepted
University of Pennsylvania: interviewed - awaiting notice
Case Western: interview offer - application withdrawn
Northwestern: interview offer - application withdrawn
University of Chicago: interview offer - application withdrawn
Baylor College of Medicine: interview offer - application withdrawn
UCSF: interview offer - application withdrawn
Duke University: interview 2/6
Harvard HST program: interview 2/5
Johns Hopkins University: awaiting news
Harvard New Pathway: awaiting news
Stanford: rejected 2/2

I was hoping and hoping that Stanford might want me. The program sounded great but the school is so small (86 seats this year) so I knew getting accepted would be a stretch. But I though I would at least be offered an interview.... ah, there goes my sunny dreams of California.

Vegetarian Chinese Meal

2008-01-31T23:25:00.000-05:00

I unintentionally created an all veggie based meal today. It was slightly on the spicier side with plenty of garlic. However, the edamame, or soybeans, provided the protein and the noodles provided carbohydrates so I think the meal was very balanaced. I only wished I had taken some pictures to post. I'll try to remember next time but for now, I hope the recipes shall suffice.

Recipes for each dish.

1/31/08 Dinner menu:
Re gan mian (hot dry noodles)
Smacked cucumber salad
Xiu cai mao do (Pickled vegetable with edamame)

1) Re gan mian (hot dry noddles) - a popular dish eaten during the breakfast in my hometown, Wuhan, China. But it's equally filling as a lunch or dinner dish. The key ingredient is tahini, or sesame paste. I was so shocked to discover that tahini can be readily bought in large quantities in American grocery stores!

Sauce:
Garlic cloves, minced
Sugar
Soy sauce
Hot chili oil
Sesame oil
Water
Tahini (sesame paste)

Mix the sauce ingredients to taste... which I suppose is very difficult if you have never had the sauce before. However, like most Chinese cooks, I don't keep track of the amount that I put in for each ingredients. Let's just say that the sauce should be slightly viscous but not runny or a paste. It is sweet yet savory with a slight spicy kick.

Noodles:
La mian
Cooking oil

1) Cook la mian in boiling water.
2) Drain and then lightly fry the noodles.
3) Set aside overnight and then quickly poach before serving the next day.
4) Mix noodles with sauce.

Smacked Cucumber Salad
Dressing:
Soy sauce
Sesame oil
Brown Sugar
Rice wine
Rice vinegar

Mix ingredients together to make a salty and tangy sauce with a slight sweet overtone.

Salad:
Cucumbers
Salt

1) Wash cucumbers.
2) Smack the cucumbers with the wide part of the blade on a cleaver or butcher knife. After you have smacked the cucumbers all around, the cucumbers should split lengthwise into several pieces.
3) Cut cucumbers width-wise, 3 inches apart.
4) Place cucumbers into a coriander.
5) Sprinkle salt on cucumbers. Toss. Taste to make sure that the cucumbers are not too salty. Set the cucumbers aside for at least 1/2 hour.
6) Pat dry with paper towels.
7) Add dressing.

Xiu Cai Mao Do
Ingredients:
Edamame
Xiu Cai (Chinese pickled rape)
Olive oil

1) Heat a bit of olive oil in wok.
2) Lightly stir-fry edamame.
3) Add xiu cai. Mix.

I hope that you will enjoy these dishes. They are all simple to make and are relatively healthy. Well, at least the veggie dishes. I'm not quite sure how healthy sesame paste is... ^^;;

Tomato and Eggs for Dinner

2008-01-24T23:47:00.000-05:00

Tonight was the second night of our cooking group. Tejia made a delicious tomato and eggs dish. She had added a bit of sugar so the dish was a bit different from what I was used and what I had posted previously. We also had an excellent spicy aubergine dish. I won't call it exactly yu xiang because she didn't use a yu xiang sauce. Lastly, Tejia's "la shou" dish is her cucumber and meatball soup. Very light refreshing considering that the only flavoring for the soup is the crispy freshness of cucumber and the juices from the pork meatballs. Eating it made me slightly homesick because my mom's "la shou" dish for the recent Christmas holidays has also been a meatball soup. Her meatballs are incredibly airy and spongy! I think it is because she forces me and my dad to spend at least half an hour mixing the ground chicken and egg white and other secret ingredients. Anyway, she also adds plenty of yummy foods such as enoki mushrooms, winter melon, large elephant mushrooms and ginger and scallions to flavor the soup base. I think I will have to ask for the recipe next time I feel the need for soup.

Tae Kwon Do, Food and God

2008-01-24T02:29:00.000-05:00

Considering that I was feeling quite sick, today has actually turned out to be an eventful day of firsts. There was my first Tae Kwon Do practice in a while, the first night of my re-instated cooking group, and my first attendance to a MIT Asian Christian Fellowship event.

Today is my first day back to Tae Kwon Do practice after leaving for winter break. I think I was secretly dreading going back because I am emotionally insecure regarding my physical abilities aka I was afraid I was going to get my butt whipped. Of course, it doesn't help that I am very very very out of shape. Anyway, practice was surprisingly a lot better than expected even though I was sick and had to blow my nose at every resting opportunity. We were able to purchase new mats for the dojang... a rather exciting event although new mats are horrendously slippery and made the warm-up exercises quite difficult. My feet felt like they were being waxed. However, I survived all the running and not being able to breathe very well... and I learned my next form. Also, Master Chuang gave me my green belt today and that was pretty awesome.. because one, the belt was finally long enough and two, I never thought I would ever be a green belt martial artist. Granted, I don't think that I am a very good one, perhaps sub-average at best but I really think that learning Tae Kwon Do was the best thing that has ever happened to me. And it could have possibly been the worst thing to happen if not for my super-supportive teammates and Master Chuang. Everyone just believes in everyone else sooooo much. For example today, Nathan almost killed us by ending class with 20 push-ups, 20 bicycles, 15 push-ups, 15 crunches, 10 push-ups, 10 suitcases, 5 push-ups and 5 leg lifts... and if I were to do this on my own, I would have given up at the 15 push-ups. However, because all my teammates expected me to perform and do my best, because they were cheering me own and counting with me and doing the same for everyone else, I felt that I was riding on all of this great energy to accomplish this near Herculean task. Granted, I wasn't doing any of the exercises very well at the end, but I made it and everyone else made it and it was pretty darn awesome.

Speaking of awesome, tonight's dinner was just that. This past summer, I had many nights of great food with my friends as we took turns cooking our favorite dishes. We are briefly resurrecting this tradition for IAP (but perhaps will extend to the spring semester?). Tonight, Kenny cooked his "la shou" dishes: dong pou rou and shrimp with eggs. Very delicious. I will have to ask him for the recipes. Sadly, unlike a very similar previous menu, we did not have bacon with broccoli. Justin's spinach was very good nonetheless. Remember kids, do NOT add ketchup to your stir-fried spinach... that is just plain nasty.

Lastly, I will touch upon a quite serious issue: religion, in particular Christianity. I went to a Doubters Anonymous session tonight, hosted by the MIT Asian Christian Fellowship. I went because I think it might be a good time for me start delving deeper into my perceptions of religion and spirituality rather than keeping by my initial rejection of both. I listened to two pastors(?) try to answer some questions such as 1) is there a true religion, or should there be? 2) how can we believe that Christianity is a true religion given that we can cast doubt on the verity of other religious texts, especially the Koran as mentioned specifically tonight? 3) isn't immoral Christians an oxymoron? 4) isn't it good enough to be just a good person and not a good Christian? The answers that were given were not satisfactory to me and perhaps put me even further away from Christianity.

I did share some similar views with the speaker... 1) that there is a truth out there, perhaps not a religious truth, but a moral truth where for example, it is good to be kind to people but evil to murder someone in cold blood. But have we reached that truth, I don't believe so... but that doesn't stop us from constantly searching for it and redefining our meaning of "truth" and "good" and "evil". 2) Just because that people are Christians, doesn't necessarily mean that they are good. People are people, imperfect with all sorts of nasty and impure motives. Some turned to Christianity because of the power that religion holds over other people and even nations. Some only pay the moral concepts of Christianity lip service. This is all very sad because they are the ones who give religion a bad name... Does this mean that I shouldn't convert to Christianity because some people have done bad things in its name? Of course not, because in doing so, I should also renounce my Chinese heritage, the American culture I have adopted and nearly any other organization I am a part of... there is a lot more to be said on this particular question, but I will save it for another day.

Here are some points that really irked me during the session: 1) A person cannot be moral without subscribing to a religion, particularly Christianity. More specifically, if people believe that the world is without purpose, then logically we should disregard the rights of the people around. There is no human dignity, no golden rule... what total and utter crap... Do you expect me to believe that Confucius' teachings of morality is pointless because his students does not believe in God? My moral and honor code rests not on the fact that I want to serve God or that I believe that the purpose of the universe has something to do with God or that there is even a purpose to the universe. I believe in goodness and kindess and respect and forgiveness and all that jazz because it makes the world a better place and I would much rather live in that better place and have my friends children live in that better place. This is another topic that I will have to explore more in depth. 2) A reason for why Christianity is the truth is because it survives the test of time (since its conception) and has spread to so many religion. Hey, I'm not a great student of history but I'm not quite sure how many of the followers today would have believed Christianity if not for crusaders and missionaries and the dual yoke of Christianity with Western technological supremacy. Finally, 3) which puzzles me more than irks me... How do you have a relationship with an omnipresent and omniscient God? When He or She or dare I say (It) knows your next thoughts, your flaws and temperaments, the buttons to push and not push.... where is the room for growth in the relationship? How are such conversations held? Why do such conversations need to be held if they and the outcomes are already known?

So, it seems that I still have a lot of work to do regarding the topic religion. And please don't think that I am picking on Christianity... it's just the only religion actively trying to recruit me at the moment. Some day, I'll have to turn my thoughts other religions as well. However, I think I've made a little progress today and definitely welcome my readers' civil and constructive comments. After all, as Socrates once said: the unexamined life is not worth living...

2 Movies and a Dinner

2008-01-23T02:35:00.002-05:00

Today was overall a pretty good idea despite the fact that I was sick and couldn't sleep very well due to the lack of ability to breathe while lying down. I finished a second draft of my scholarship for Washington University School of Medicine. I think the I'm not writing it very well, that is to say, I am not writing very ambitiously. There are some descriptive parts that I feel need to be replaced with concrete proposals for my goals as a future physician. Unfortunately, I don't think I have anything concrete right now... I will see how tomorrow's draft turns out.

For the evening, I hung out with Patricia and we had an adventure ordering food and watching movies. First we wanted to watch Crash but couldn't get the DVD player to read the disc. Then we wanted to watch Zatoichi but instead watched the first half hour of Sonatine before realizing that we had the wrong disc. Apparently Sonatine was the bonus disc with Zatoichi and Tang Hall has misplaced the actual Zatoichi disc... ^^;; Anyway, it was very slow and we were both very confused. There was also a lot less blood than we expected from a film about the yakuza. BTW, never cross the yakuza. They will beat you up or drown you... anyway, I might try to watch the movie again on my own. We finally ended up with Queen of the Damned after the food arrived. It was a sub-average movie with interesting costume designs of metal, fishnets and lots of eyeshadow. I think they also must have synthetically altered Lestat and Akasha's voice. Akasha sounded amazingly like Tia Dalma... ugh, why do ancient Egyptians have Caribbean accents?

The food we ordered from Chili Duck was excellent, as expected. Patricia ordered Mango Chicken Curry and I ordered Duck Drunken Noodles. The curry I thought was a little to mild but then again I am a spice-eater. The duck was succulent and I even ate most of the vegetables. For appetizers, we ordered Crazy Rolls and Shrimp Tod Mun. Patricia adored the Crazy Rolls, probably because she likes veggies more than me. But the peanut sauce for the rolls was deliciously thick and despite its crispy yet chewy tempura exterior, the rolls were quite light. The Shrimp Tod Mun although deep fried actually wasn't so oily and I was quite fond of the combination of spices. Anyway, I'm happy because now I have a second (and far less expensive) dish to order instead of my usual Chili Duck.

Recipe: Tomato and Eggs

2008-01-21T18:19:00.000-05:00

Salt
Oil
3 eggs
2 tomatoes, medium sized beefsteak is good
green onions

1) Whisk eggs in a bowl until uniform.
2) Add salt to the eggs until the color changes from pale yellow to a light orange. Be careful with the salt or you could end up with super salty eggs!
3) Dice the tomatoes.
4) Chop a handful of green onions into large 1 inch pieces. Cut another handful into very fine pieces so that they look like rings.
5) Heat some oil in skillet on medium heat.
6) Fry the large piece of green onions until fragrant but not brown!
7) Fry the tomatoes until the juices come out and they feel a bit mushy. Add a sprinkle of salt to taste. Either scrape the tomatoes to the side of the skillet or take them out. You can leave a little of the juice in the skillet.
8) Scramble the eggs in the skillet until just a bit runny.
9) Mix tomatoes with eggs until eggs are cooked.
10) Garnish with finely chopped green onions.
11) Eat with white steamed rice.