doc w/ Pen

journalist + medical student + artist

Tag: books

Uganda: Learning to live with limits

So much in the United States is unlimited, like our wi-fi access. Not so in Uganda, as I was reminded after a thoughtless frenzy of downloads.

Living in a foreign country means making adjustments. To respect the conservative dress code here in Uganda, for example, I wear a skirt that falls below my knees, and cover up my sleeveless blouse with a lightweight shrug.

There are technological adjustments too. The wi-fi here at Naggalama Hospital only works three weeks out of the month. By the fourth week, they’ve used up all their data.

That’s the general principle here, for technology, and otherwise. Resources are limited.

To make sure I could access the Internet for my entire four-week stay, I have a “Uganda phone.” It’s an iPhone from the United States, but with a Uganda SIM card inside, and a Uganda phone number. When I arrived, the phone was loaded with 10 GB of data, and what’s called “airtime.” Airtime can be used to call within Uganda, any phone carrier, and also to call internationally. Airtime is not to be confused with “minutes,” which can only be used within Uganda, and only with people who share your same carrier (in my case, MTN).

I didn’t plan on doing anything crazy on the Internet while here, mostly checking e-mail and writing blog posts. But I hate using the Internet on a cell phone. So mostly what I’ve been doing is using the phone’s data to set up a hotspot for my laptop, something I’ve never done in the United States (because I never had to). I’ve been religiously keeping track of my data usage, dialing the MTN “data usage” number to find out my balance every few days. After more than a week, I hadn’t even used 1 GB. Then I checked this morning. 3.5 GB gone. Somehow, over the span of a couple of days, 2.5 GB had … disappeared. How did this happen? Was there a data monster lurking somewhere, biting into my bytes while I slept? I inventoried my Internet use over the last few days, trying to account for the missing many megabytes.

An hour later, while I ate breakfast, it dawned on me. The day before, while waiting at Masaka Hospital for someone to pick me up and drive me back to Naggalama, I’d downloaded a half-dozen audiobooks from the New York Public Library. I did it without thinking. Because at home, I’m almost always on a wi-fi network. In my apartment, at school. And when I’m using my data, I’m only checking a handful of websites, maybe Google maps, or looking at e-mails. Not exactly high data use activities.

I’d downloaded so many books — hours and hours worth — because I’m picky about my narrators. Their voices, that is. So many grate on me, rub me the wrong way, for reasons I can’t always articulate. And I can never tell by the brief sample they give you. I need 15 or 30 minutes to decide whether I want to invest myself in the story, and in the voice. My dad used to read aloud to my family every night when I was a kid, and he set a high bar, it seems.

I know streaming and downloading eats up your data like nobody’s business. I know that. But I clicked the “download” button a half-dozen times with nary a thought because that’s what I always do. In the United States, data is dispensable, limitless. Like so many things.

Not so here.

I really should have known. Because after three phone calls home, I suddenly ran out of airtime last weekend, my phone call cut off mid-sentence.

Well, I have the books now, 2.5 GB later. They’re checked out for three weeks. By then I’ll be home, back to limitless wi-fi.

Lesson learned though, for while I’m here. Hopefully …

Looking for books

Usually, I use this space to share my thoughts, feelings, and experiences. Today, I use it to ask for advice.

I discussed in a recent post about how I’ve rediscovered my love of reading books. It started innocently with rereading A Wrinkle in Time, which my sister had offhandedly mentioned to me. I’m now almost done with the fifth book in L’Engle’s Time Quintet. And I’m chafing for more.

I’ve got ideas. I have some cherished authors whose books I want to catch up on. I bookmarked the website listing the National Book Awards going back to the 1950s — lots of gems there, I know. But as with music, some of the best creations never win prizes.

So if you’ve read a book lately and loved it, or have a short list of favorites (or a long list) — of any fictional genre — please do share.

I’m all eyes.

 

My post-medicine to-do list: An update

Ten days ago, I wrote about “My post-medicine to-do list.” Now that I’ve really had a chance to catch my breath and find a new rhythm on this research rotation, I thought I’d write a follow-up on my progress.

Ironically perhaps, given the title of that post, I’ve decided that to minimize my stress level, I will minimize the items on my daily to-do list. These three essential goals, though, are at the top of my list every single day:

  1. Humanity. Have meaningful contact with someone (not just about work) by text, phone, or in person. This reminds me of what’s really important in life: people.
  2. Creativity. Do something creative every day. It could be anything from doodling on a notepad to drafting a blog post. This feeds my spirit.
  3. Movement. Any intentional, anti-sedentary activity counts: going to the gym, taking a walk around the block, stretching on my yoga mat. Just something to get me out of my desk chair, to get the blood flowing. This keeps me in shape physically and psychologically.

Of course, I have many research goals as well. Some are flexible; others more time-sensitive. To both keep myself on track and to prevent myself from feeling overwhelmed, I group them according to must-do tasks (need done today) and can-do tasks (need done eventually, will try to do today if I have time but ok to shift to another day). This system seems to be working so far.

I have also made headway on the to-do list I proposed in that post from 10 days ago. My apartment is cleaner that it has been in months (I even mopped my kitchen floor). I’ve found some great new (to me) songs and musicians on Spotify, including Kidneythieves, Perfume Genius, and Gary Numan. Yesterday was a beautiful day, and rather than take the subway to do my various errands, I walked all over the city, enjoying hours of delicious sunshine. I’ve discovered that I prefer New England-style IPAs (which my new friend Nick at City Hops described as more “juicy,” with citrus notes), and that three of the varieties I’ve tried and loved are made at a local brewery called SingleCut in Queens. Definitely time for a field trip.

I’ve recently rediscovered my love of reading. I started with some childhood favorites: Madeleine L’Engle’s Time Quintet.

I’ve also rediscovered my love of reading. Last week, my youngest sister mentioned to me that she just reread A Wrinkle in Time, one of her favorite childhood books, in preparation for the upcoming movie. Her remark took me back to my own childhood. I was captivated by Madeleine L’Engle when I was a kid. I read everything of hers I could get my hands on, and even wrote her fan mail. In the flurry of clerkships, I’d forgotten that a movie based her most famous book is coming out next month. Clearly, I needed to be prepared too. So I immediately bought A Wrinkle in Time online, then proceeded to devour 90 percent of it in one sitting. Clearly, I could not wait, not even for 2-day shipping, to get the next book in this quintet. So yesterday I went to a real-live bookstore and bought the next three books in the series (the fifth wasn’t in stock, but I can wait for shipping on this one). I forgot how much I love fantasy novels, being transported to faraway worlds, bringing the vivid descriptions alive with my imagination — a creative endeavor in its own way. L’Engle said it well herself:

A book, too, can be a star, explosive material, capable of stirring up fresh life endlessly, a living fire to lighten the darkness, leading out into the expanding universe.

– Madeleine L’Engle

Tapping into that seems like a pretty good goal too, if you ask me.

This Book’s a Keeper

Reading immunology on the front porch on a beautiful day is rather pleasant.

A few days ago, I wrote about some books I *might* be using during my first year in medical school. I already know this one is a keeper: How the Immune System Works, by Lauren Sompayrac (Wiley-Blackwell).

Before I talk about this book, let me take a step back. It’s said (by people more knowledgeable than I am) that in addition to the required basic science classes in college, there are three upper-division courses that may help you in medical school: genetics, biochemistry, and immunology. I’ve taken genetics and biochemistry, and done well in both. But immunology is a world I know nothing about. To put it bluntly: I didn’t know my neutrophils from my natural killer cells (which is embarrassing, if you know anything about the subject).

Enter Lauren Sompayrac’s book, which is a “big picture” view of immuno designed to prepare you for more a complex course by showing how parts of the immune system act and interact at a very basic level. At only 132 pages of actual chapter material, it’s a short read. The writing is entertaining, with plenty of analogies and quips thrown in. From now on, when I think of the major histocompatibility complex (MHC) – a molecule that essentially serves as a billboard to tell what’s going on either inside or outside the cell it’s attached to – I will think of a hot dog bun. (Yes, there is a photo of a hot dog bun in the book. It works.) There are also plenty of astounding facts too which keep me engaged with the general topic. (Did you know that the area covered by the mucous membranes lining our digestive, respiratory, and reporductive tracts – part of our body’s perimeter that needs defended – measures about 400 square meters? That’s two tennis courts! Immune cells have to patrol all that!)

My goal isn’t to master the immune system before medical school. That’s what medical school is for. But since I have exactly zero background in this, I want to develop a basic understanding of the players before I’m expected to know the whole playbook.

Read All About It: Basic Science Books for Medical School

Note: This post is at the request of one of my readers, who asked me to share what books I plan to use in my first year of medical school. I will update as the year goes by to talk about what I actually used. But here’s the plan …

textbook stackDuring undergrad, each new semester meant heading to the school bookstore, dropping a few hundred dollars, and lugging a giant stack of heavy textbooks back to my dorm or apartment.

Things have changed. First, I’m in medical school now, not undergrad. In medical school, the prevailing wisdom is that you wait for your second year classmates to tell you what you really need before buying any books. Second, the trend across the publishing world is to use eBooks on your laptop or iPad rather than giant hardback tomes. And many medical schools – Cornell included – offer access to a selection of these eBooks through the school’s library. Cornell’s top-of-the-line resources mean that I have access to a LOT of eBooks this way, so I anticipate not having to buy many titles at all. Another bonus of these eBook offerings, which are usually accessed through an institutional subscription to part of a publisher’s catalog, is that in addition to the books there are related videos and self-assessments.

I do have a list of books I plan to use as necessary, most of which I can access as eBooks. This list was developed with the help of a dear friend, Dr. Hoffheimer, who is now a third year internal medicine resident in the Detroit area. I thumbed through the books she had used, and selected those that seemed to best fit my learning style. Most of these are not traditional textbooks, but review-style books, offering a bigger picture of the concepts rather than excessive minutiae. I have these bookmarked in my web browser, ready to go.

 

LIR biochemIn terms of the basic sciences, I found I preferred the Lippincott Williams & Wilkins series Lippincott’s Illustrated Reviews. From what I’ve seen so far (I’ve spent some time with the biochemistry title), the LIR series does a good job of giving you an overview, while also providing enough detail – but not so much that it’s overwhelming. These eBooks also offer online self-assessment, video/audio components, and a print feature (great for reading offline, if you print to PDF and throw it on the iPad). I have bookmarked the following through the LWW Health Library website. I’ve linked the titles to their Amazon.com pages if you’d like to read more about them or see customer reviews.

netter's atlasFrom Elsevier, I bookmarked:

From McGraw-Hill, I bookmarked three titles that I haven’t ever flipped through, but looked promising. What I like about these is that there are interactive self-assessments for each, with USMLE-style questions. So even if I don’t use the books, I’ll likely use the test prep component.

metabolism at a glanceI did buy four books in advance, titles I felt confident I’d need, were worth the price, and I wanted as tangible objects instead of eBooks.

  • First Aid for the USMLE Step 1: Highly recommended by people I trust. And I know I’ll need to start doing USMLE-style questions pretty much right off the bat.
  • Neuroanatomy in Clinical Context: An Atlas of Structures, Sections, Systems, and Syndromes: Neuroanatomy has a reputation for being a tough block, and this book looks amazing. I do have access to this as an eBook, but there are some writing components that made me want to buy it in print.
  • Metabolism at a Glance: This large-format book puts all the pieces of metabolism (Krebs cycle etc.) together in an integrated way, rather than looking at them separately.
  • How the Immune System Works: This title presents a high-level view of the immune system, which should be great to have before I dive into my medical school block. I felt I needed this background since I’ve never taken an immunology course.

How many of these titles I use remains to be seen. But I felt it was important to have them bookmarked ahead of time so that if I get to a topic where I need more information, I have a trustworthy source to go to – and by “trustworthy” I don’t mean Wikipedia.

Thanks to Dr. Hoffheimer for her help in developing this list. And thanks to Varia for prompting the post.

Library Access: A Lab Job Perk

PubMed is a great resource. For those of you who aren’t familiar with it, PubMed is an online resource hosted by the U.S. National Library of Medicine and the NIH. It has more than 22 million citations to biomedical literature. Some of those citations have links to full text articles. But unfortunately, many of the more prestigious journals charge for their articles (often as much as $30 or $40 per article). Given my current broke status, I can’t exactly afford to buy article access.

So I recently e-mailed my PI at the UIC lab where I work asking whether I could get journal access through UIC (major universities usually provide this type of access to their students and some employees). He told me that all I needed to do was plug my laptop into the UIC network (via a network cable at the lab) and I would automatically get access to everything.

A few weeks ago, I spent a little downtime getting some of the articles I wanted. When you download an article from some of these publishers’ sites, a little window will pop up with “recommended readings” based on what you just looked up. I noticed at some point that not a journal article, but a book chapter, popped up as one of those recommended readings. I hadn’t thought about book chapters. But as I did think about it, the idea appealed to me. A book chapter would provide a great deal of background, which is what I am looking for right now. So I wondered, “Could I get the whole book?” The answer: “Yes!” Then my follow-up question: “Are there more available books on my subject?” The answer, again: “Yes!”

From home, I used the UIC library’s Web site to find available eBooks. Then while a gel was running at lab, I downloaded them, chapter by chapter (you can’t download the whole book directly). Back at home, I put them on my iPad.

Granted, I’m not going to read every single page of every single book I downloaded any time soon. But I want to be able to skim them, to decide what I want to read and not read. So getting entire books made sense.

After I had finished getting my books, I was curious – how much would all of these books have cost had I purchased them? Being the absolutely nerdy person I am, I made an Excel spreadsheet to calculate the cost of buying the hardback book directly from the publisher, the eBook from the publisher, the hardback from Amazon.com, and the eBook from Amazon.com (yes, I actually did this). I was amazed – the hardback books from the publishers would have cost more than $2,000 (eBooks and Amazon.com hardback prices were somewhat less). One more reason to be affiliated with a major research institution, and to be grateful for my lab job!

Here is my lovely spreadsheet:

library savings

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?