doc w/ pen

a journalist becomes a doctor before your eyes

Month: January, 2012

Building A Scientific Cathedral

cathedralA woman came across three men working at a construction site. She asked the first man what he was doing. He replied, “I’m making bricks.” She then asked the second man the same question. His reply was, “I’m making a wall.” When she came to the third man and repeated her question, he said, “I’m building a cathedral.”

Clearly, all three of these men were doing the same thing. But they had different attitudes, different visions, and a different sense of pride, about their work.

stone wallSo why am I telling this story? I think that there is a parallel to basic science work here (and I’m not talking about the chemical reactions involved in solidifying bricks and mortar). Like bricklaying, basic science involves a great deal of “manual” labor, which is sometimes repetitive and tedious. If that’s all you see about science, though, you’re not going to be very satisfied doing it – much like that first bricklayer. If you can make some connections, put the work in context, see it as the second bricklayer did – that you’re creating a wall – then it will be somewhat more fulfilling. But if you can continue to do your work while maintaining the sense that you are a part of something greater, that every discovery is built upon the work of so many other people, that you are constructing a “cathedral” of sorts along with other scientists, then the discipline becomes so much more.

I’m not going to lie. That repetitive work? I know that in my future as a physician-scientist, I may not always feel like doing it, or find it “fun.” But there will be a point to it, a greater goal, both within the context of my own particular research and within the larger context of science. And I find that thrilling.

Like the greatest cathedrals, our body of scientific knowledge has been built brick-by-brick. I look forward to laying a few of my own someday.

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Excel-ling

I’m no stranger to Excel. I’ve made plenty of graphs and charts throughout school, especially in the science courses I’ve been taking in the last two years. But the formulas and functions that spreadsheet programs can do? Not so much. I’ve always done that work by hand. (Correction, with a calculator.)

Now that I’m taking statistics, I’ve got a LOT of calculations to do. So doing them one by one, cell by cell, would simply take forever. Luckily, last Friday my stats professor showed us how to do a number (no pun intended) of basic calculations within Excel itself. (Although at home, I’m not using Excel – I’m using Apple’s Numbers program, which is an Excel numbersequivalent. And I’ve found that the calculations work pretty much the same, thankfully.)
This is just a basic stats course, and it’s the beginning of the semester, so we haven’t gotten to anything too complicated yet. But using a spreadsheet program to compute the sample mean (i.e., average), variance, and standard deviation is so handy. I was even kind of having fun doing my stats homework … really. It was almost like magic. After entering my data points, I’d go to a new cell, hit the “equal” sign, and then do my thing. Multiply, divide, square, you name it. Then click-and-drag to do the same operation down an entire column. Of course, the program is only as smart as you are, so you’ve got to input everything correctly. And that can take some getting used to. But I think I’ve got the hang of basic operations, at least.

Now, the question is, what am I going to do with all the time I’m saving?

Lovely Larvae

On Thursday, I started my work in the Genetics research lab. Granted, this may not be everyone’s cup of tea, but given that I want to do an MD/PhD, this is the perfect way for me to spend six hours each week (10 a.m. to 4 p.m. every Thursday).

Before beginning any actual “research,” my professor had me read two of his own published articles as background information. Both had been published in the journal Cell, which, if you’re not familiar with it, is quite prestigious. So his work has gotten some attention from the scientific community. He and his colleagues have been looking at olfaction (sense of smell) in drosophila larvaeDrosophila melanogaster larvae. In the first paper, they identified a set of genes responsible for olfaction in the larvae (previously, it had not been known which genes controlled the sense of smell in the larvae). This was really quite an accomplishment, and the methods they used were pretty amazing. (Don’t worry, I won’t go into the details unless someone asks!) In the second paper, they looked at behavior of the larvae in response to different organic compounds, both attraction and repulsion. I will be doing an extension of the second work, performing behavioral assays with the larvae and testing their chemotaxis response (that is, movement in response to chemicals). By the end of the semester, I will (hopefully!) have generated quite a bit of data, and will write a formal lab report about my progress.

In addition to doing the behavioral assays, I will also continue to read scientific articles, which will be great – I love getting exposure to more scientists’ work, techniques, etc. And there will be some freedom in the work I do as well – if I want to take the work in a particular direction not previously explored, I have the ability to do that, under my professor’s direction. Which is pretty amazing.

All in all, I look forward to this semester’s work. Who knows what we may find? That is the beauty of science.

Just Read It: eBooks

I will admit. I love the feel of paper, of a tangible book in my hands. Flipping the pages, scribbling notes in the margin, highlighting and underlining … it’s a great sensation. After all, I was a Journalism major, with a focus in News Editorial, and I wrote for newspapers, magazines, and textbooks for years.

But. I must say, I am totally into the eReader thing these days. So many books are available in electronic format, and it makes them incredibly portable. Not to mention searchable, in a way regular books are not. Don’t get me wrong, I don’t think “real” books are going the way of the dinosaur. I believe – and hope – that there will always be a market for them.

ereaderThere are, however, a lot of positives about eBooks. Besides the portability and searchability features, there is the cost factor. I’ve heard that some eBooks are more expensive than the hard copy, but my experience has been the other way around – that the electronic versions tend to be cheaper, on the whole. (I got an incredible version of Charles Darwin’s Origin of Species for $2.99.) And some are even free. I recently discovered, via a dear friend, that you can “check out” electronic books, by downloading them, from your local library. Yes, for free. The selection is somewhat limited, but not bad, considering the price. You just enter your library card number and password, click on the title, and if no one else has it checked out – just like a regular book, only one person can have a title checked out at a time – the book goes directly to your Kindle app. Pretty cool. I’m glad to see libraries are keeping up with the times.

You can always buy electronic books, of course; iBooks (Apple’s digital “bookstore”) and Amazon.com are the go-to places these days, it seems. One thing I really like about Amazon’s Kindle books is that you can send a free sample to your device (which includes my iPad) to test out the book before you buy it – just like if you were to go to a bookstore and read the first few pages. Here are a few Kindle titles I’ve downloaded to sample:

  • The Selfish Gene by Richard Dawkins
  • Genetic Medicine: A Logic of Disease by Barton Childs, MD
  • On the Sparkling Nature of Human Origins by Talessian El-Wikosian
  • Watson & DNA by Victor McElheny
  • Genetic Twists of Fate by Stanley Fields and Mark Johnston
  • Inside the Human Genome by John C. Avise

Of course, reading even samples of books requires that you have time … which, in my life right now, is in short supply. But I hope to check out some of these titles, at least. Who knows what I’ll learn?

A Great Tutoring Opportunity

purple-diatoms-527157-gaMy goal, eventually, is to go into academic medicine. In that capacity, I hope to do some teaching. This semester, I will be getting some experience doing just that – by being a tutor for General Biology 2.

I received an e-mail about a week ago from my former Gen Bio lab professor, telling me that because I did so well in the class last spring, she was inviting me to be a tutor for the class this spring (along with some other students). Dominican University offers drop-in biology tutoring at its Academic Enrichment Center, but this will be different – it will be an “invitation-only” small tutoring group for students who did not do so well in General Biology 1, and who might otherwise slip through the cracks grade-wise.

I’m really excited about the opportunity. It will be great teaching experience, and will (hopefully) help these students do better in class. Part of the tutoring will be helping students with concepts, of course. If they come with questions, great; if not, I am supposed to be prepared to lead a discussion about what was covered in lecture that week (no problem there). One of the nice things is that they will be covering basic genetics in the course – meiosis, Mendel, Punnett squares, etc., and I excel at that, especially just having taken an actual genetics course. So I will definitely be prepared for that material. I also made flashcards for the entire Gen Bio 2 class when I took it, so that’s another resource I can share with the students. Some of these students may also have issues not only with the material, but with general study skills – how to study, and how much to study, for this class. That’s another arena in which I can definitely be of some assistance.

I will be attending all of the Bio 2 lectures (a total of 3 hours each week), and then leading a 1-hour tutoring group one afternoon a week. I even get paid for all 4 hours, which is a nice bonus. (It doesn’t pay much, so the monetary part certainly isn’t the main reason for my wanting to do this.)

This tutoring project certainly adds to my plate, but in a good way. I’m looking forward to giving back to the Dominican community, a community that has given so much to me.

Background: These are marine diatoms, specifically Pleurosigma angulatum, at magnification x200. Diatoms are unicellular organisms often characterized by a silica shell. This image is from National Geographic. Diatoms, along with other unicellular organisms, and their phylogenetic classifications/relationships, are some of the things I will be helping students with in General Biology 2. 

Spring Break!

dros confOK, so maybe it’s a bit early to think about spring break, given that the semester just started yesterday. But I have exciting plans. So I want to share them. No, I’m not going to Aruba or Cancun – I’m going to the 53rd Annual Drosophila Research Conference, to be held right here in the Windy City, March 7-11, 2012.

I first heard about this conference last year, when my Research Methods professor, Dr. Kreher, attended it (it was in San Diego then). When I met with him this morning to talk about working with him this semester on his fruit fly research, he brought up the conference … and I immediately decided I would go. It will be a great learning opportunity, first of all – dozens of scientific posters and talks to attend, all about Drosophila genetics. It will also be a great networking opportunity, especially since I’m applying for my MD/PhD this June. You never know whom you will meet at events like this, and what kinds of connections you will make.

I will, of course, post more about it after I attend the conference. I’m sure I will have lots of exciting fruit fly news to share.

And who knows? Maybe some day in the future, I’ll be one of the presenters …

Another Diploma …

When I started my post-baccalaureate program at Dominican University, it was a certificate-granting program. That’s not the reason I chose Dominican, though (a certificate is certainly not necessary for applying to med school). I don’t even think I would have completed the certificate because it required you to take classes I just didn’t have time for. But thanks to the hard work of our program director, Dr. Louis Scannicchio, as well as Dr. Hughes (she teaches Clinical Behavioral Medicine in the program), I now have the opportunity to earn not a certificate but an actual second degree.

It’s called a “Bachelor’s of Medical Science,” or BMS for short. As with the certificate program, there are some specific course requirements, but because I’m a second-year student and already have my courses set, Dr. Scannicchio has agreed to waive a couple of those requirements for me (and other current students, depending on GPA and other considerations such as additional courses you have taken). I met with Dr. Scannicchio this morning, filled out my paperwork, and submitted it to the registrar. The only major decision I had to make was how I wanted my name to appear on my diploma, which I will receive when I graduate in May of this year. I decided that because I’m a big fan of all three of my names, I’d display them all: Lorien Elisa Menhennett. Other than that, all I had to do was sign on about a dozen lines and hand the papers in.

So what will this degree do for me? Well, as with the certificate, it isn’t a make-or-break thing for applying to medical school. That said, having a second degree with both the words “medical” and “science” in it can’t hurt, and might give me a leg up in terms of applying for MD/PhD, given that most of those applicants have hard science degrees such as biology or chemistry. I’m also hoping that this degree will give me additional credibility when I apply for jobs during my “gap” year.

lab workerI am applying to medical school in June, and will (hopefully) have interviews during the fall and winter in order to matriculate in the fall of 2013. That leaves me with an empty year, which we in the non-traditional pre-medical community refer to as a “gap” or “glide” year. Some people take classes, some people work. I can’t really afford to take more classes, and I have rent to pay, so a job it is. Given that there are less than zero writing/editing jobs out there, and that’s the field I’m exiting, I’ve decided I want to work in a lab. I have looked on job search sites (mainly Indeed.com, which is my favorite, and seems to be the most comprehensive), and have found quite a few. Of course, I won’t be able to apply for jobs until the spring, but it’s nice knowing they seem to exist. I don’t need to make a lot of money; just enough to pay for my rent, car, insurance, groceries, and the various and sundry other items that come along. But with the economy the way it is, I’m guessing those jobs are pretty competitive to get. So having this “science” degree will, hopefully, lend some credence to my claims that I know my way around a pipette and PCR machine.

It’s kind of nice, really, to be “getting” something out of the two years (and tens of thousands of dollars) I’ll have spent at Dominican, something that aims to help me get into medical school and get a job. I know Dr. Scannicchio and Dr. Hughes put their hearts and souls into making this happen. So here is a shout-out “thank you!” to them.

ADCOM Q&A: Problems in U.S. Health Care

stethoscopeIt is undeniable that we in the United States have access to all kinds of health care procedures, medications, and specialists that, in many other countries, are only a pipe dream. Well, some of us. One of the responsibilities of the future generation of physicians – and politicians – is to help shape a better landscape for health care in which all Americans have access to these resources. That, of course, is easier said than done. But recognizing the problem is the first step toward a solution, so it makes sense that admissions committee members would ask a medical school interviewee something like this: What are three of the greatest challenges facing health care in the United States today?

First of all, that’s not an easy question. I don’t think anyone would argue that our system is systemically broken. So there are quite a few “challenges” I could talk about. But I will talk about three that dovetail into each other. That is, they are all related to money. Of course, pouring money into a broken system is not the solution in and of itself. But there are three money-related issues in health care that I want to talk about here. I don’t have answers, perhaps only more questions. But asking those questions has gotten me researching these topics and learning more about the difficulties facing our health care system, and at least thinking about some possibilities for the future.

So here we go.

1. The lack of comprehensive health insurance for all Americans.

When I want to go to the doctor, I have to pay a small copay, sure. But the bulk of the charge gets paid by my insurance company. For an annual check-up, doing without insurance might not be such a big deal. But what if you have a chronic health problem such as diabetes, or wind up in the hospital for a week or two? You’re looking at some hefty medical bills, medical bills that many, if not most, Americans couldn’t pay out of pocket. So how big of a problem is this? Well, according to the most recent Census Bureau report, the number of uninsured Americans topped 50 million in 2010. That’s 1 in 6 people in the country. Obama’s health reform bill is supposed to help with this, but there is much controversy (and litigation) surrounding that bill. So while the number may have dropped some, it is still high. Too high. And that makes good health care – any health care – unaffordable to too many people.

pill bottle2. The rising cost of prescription drugs. 

Prescription drug costs have increased wildly over the last few years. If you have decent insurance and are taking a round of antibiotics for a mild infection, this is not much of a concern. And there are some drugs available at Target and Wal-Mart for less than $5. But there are a couple of big problems facing people today. One is for those lacking insurance all together (see issue 1 above). For those people, drugs can cost, tens, hundreds, even thousands of dollars, depending on the medication. Clearly, that can make some drugs unaffordable all together. For people who have insurance, the rising cost of prescription drugs is still a concern, even though you might only be paying a fraction of the actual drug cost. Insurance companies are charging more for drug copays, especially for newer, brand-name, “fourth-tier” drugs. If say, you have diabetes, and you’re on several of these pricier drugs (and a fixed income), that adds up to a lot of money, even with insurance. So why have these costs gone up? Well, for one thing, pharmaceutical companies charge a lot for their drugs. According to a study published on Kaiser.edu (a Web site associated with the non-partisan Kaiser Family Foundation), pharmaceutical manufacturing was the third most profitable industry in the country in 2008 (it was first between 1995 and 2002). Many argue that these high prices are necessary to encourage more research and development of new drugs, though … so there’s a dilemma there. Retail prescription prices have also outpaced inflation between 2000 and 2009, according to the same Kaiser Web site. Another issue is that most of the top-selling prescriptions are those newer, higher-priced drugs. And while hospital and other professional services have increased in cost, the growth rate for prescription drug costs is projected to overtake other categories of services between 2010 and 2019 (again, via Kaiser.edu). You’ve probably heard stories on the news of people having to decide between buying medicine and food. While these situations may not affect someone you know personally, they do happen. And that’s not right.

3. The shortage of primary care physicians.

In the town where my mom grew up (the sleepy, 1,500-person town of Caldwell, Kansas), there was a town dentist – her father – and a town doctor. Everyone in town knew these two practitioners, because everyone in town went to them for their body aches and toothaches. These days, though, it’s becoming less and less common for those little towns to have a resident physician, or even one anywhere nearby. PCPThis also applies to many urban and low-income areas. In fact, Kaiser.edu estimates that 60 million Americans (that’s 1 in 5, folks) lack “adequate access to primary care due to a shortage of primary care physicians in their communities.” So what’s the problem? Again, in part: money. There is a huge income gap between a family physician or internist (we’re talking well under $200,000, says Kaiser) and the mugh higher-paid specialists (try around $400,000 for radiology or cardiology). With the cost of medical school debt sometimes rising to $200,000 or $300,000, that higher salary looks appealing in terms of loan payoff, not to mention lifestyle considerations. Fewer medical school graduates are going into primary care, in part because of these financial issues. Which stem from our payment system. You get big bucks for procedures, pennies for an office visit. And all those phone calls that your family doc makes? He or she doesn’t make a dime for that time.

Our health care system here in the United States is, in some ways, the best in the world. People come from all over to see specialists at places like the Mayo clinic, for example. But the system doesn’t work for everyone. We need to figure out a way to resolve that.

A British Take On the TV Doc

Flip (or scroll) through your local television listings and you’ll find all kinds of medical shows, both fiction and non-fiction. There’s House, Gray’s Anatomy, ER, Nip Tuck, and so many more. And those are just the dramas. (I will admit, I used to watch old-school ER, back in my high school days.)

These days, though, I’m pretty picky about my television. I simply don’t have time to watch much, for one. And when it comes to medical shows, I am not a big fan of the sappy, soap-opera-y ones either.

doc martin

Enter Doc Martin, a British medical drama a dear friend just introduced me to on New Year’s Eve. Doc Martin is a whip-smart, funny, and well-written show that takes place in the gorgeous region of Cornwall, England. The sheer cliffs, rolling green hills, and friendly fisherman are enough to make me want to go there. But there’s more to this show than the scenery. Here’s a bit about the show’s premise: Doc Martin was a prominent London surgeon who suddenly developed a phobia of blood (obviously, a serious problem for a surgeon). So he moved to a small Cornwall village to take over a general practitioner’s office. What you need to know about Doc Martin, and what makes this show so hilarious, is that he is absolutely socially inept. Which may be OK for a surgeon who spends most of his time with his patients under anesthesia, but is not so OK for a GP who spends most of his time with patients who are breathing (and talking) quite normally. There is, as well, a cast of colorful supporting characters (including a love interest of Doc Martin’s!) who round out the show.

I highly recommend checking it out. The first four seasons are available both on Netflix instant view and Amazon Prime video on demand. If you do watch an episode, let me know what you think!

Oh, and for a preview of what Cornwall looks like, here are two tantalizing photos …

The Unsilencing of a Gene

Rat neuron

Rat neuron

As many of you know, I love genetics. So when I was perusing Nature on my iPad this morning (working on my New Year’s resolution), I went straight for the article with the word “allele” in the title. (An allele is a version of a gene; we all inherit two alleles of each gene — one from our mother and one from our father. This concept is very important for the article I read.)

The article was about a drug that was found to “unsilence” an allele in mice, serving as treatment for a disease called Angelman syndrome, a severe neurodevelopmental disorder.

Normally, we have two potentially active alleles of each gene. However, in a particular gene called Ube3a, only the maternal allele “works” due to a process called imprinting. The paternal allele is effectively silenced. So if the maternal gene is mutated or dysfunctional in some way, then the gene product of Ube3a doesn’t get made — there is no functional paternal allele to take over. The result is Angelman syndrome, according to this article.

So researchers looked at 2,306 different molecules (yes, that number is right) to see whether any of them would “unsilence” the paternal allele. One — an anticancer drug called a topoisomerase inhibitor — did. The scientists eventually found another topoisomerase inhibitor that worked even better, and tested it in vitro (in culture) and in vivo (in living mice). In both cases, the Ube3a gene was activated in the target neurons.

While this type of treatment has a long way to go before it is approved for use in humans, this research study does offer hope to some people. (Angelman syndrome is estimated to affect 1 in 15,000 births, according to the Nature article.)

This article also contains many concepts that I learned in my genetics course. Which made it easier to understand, of course, and also reminded me that what we learned was significant and will be important in my future as a physician-scientist.