.mantracity

Guy catches an alligator while barefooting

2008-03-22T22:38:00.004-05:00

Not everything is what it seems...

2008-02-09T20:09:00.001-05:00

A great example how easy it is to change the meaning of things...don't take anything at face value!

Brian Day is hardly alone: Amen

2008-01-19T12:41:00.000-05:00

This editorial correctly summarizes some of the implicit disadvantages of our current health care system. Yes, Jack Layton you love our current health care system, as long as you don't need it. And, NO, our current system is not fair, it's just not money that dictates the inequalities.

I can speak from personal experience. I had a referral to a specialist - despite repeated voice mails and faxes from me and my GP's office, the specialist's office DIDN'T even call
me back. Finally I was given an appointment by fax to my GP's office 2 days before the opening, and then it took over a day for my GP's office to let me know. By this time I was completely booked and could not attend. I finally just went to the clinic. The fellow glanced at my medical school bag and saw me right there.

I'm not saying privatization is the answer, but we need to somehow make our health care system service oriented. Imagine if a telephone company didn't call you back for a month? And this is your health care.

Goldman Sachs CEO gets $67.9 million bonus, $67.9 million too much

2007-12-21T20:29:00.000-05:00

Goldman does not cause high profits but is merely associated with it.

Yes Goldman has done well in a credit crunch and put up big profits when the other banks have faltered, but is it because of him? No. In fact, it's not even the talent of those around him. All Goldman has to do is not screw up royally...and just ride on the brand recognition. It's sad really.

So much for a meritocracy and market efficiency.

Read a softball article here.

Snowkiting?

2007-12-20T21:10:00.000-05:00

My preference is definitely the water, though I'm thinking of giving this a shot.

Now that's a kite

2007-12-20T20:57:00.001-05:00

This is cool. When I saw the picture I thought it was doctored. These Germans have actually designed a $750,000 160 square meter kite that can save as much $1,600 in fuel a day. Hmm...~470 days to pay it off, not including repairs and maintenance. My question is - how do they launch that thing?

Motorolla S9: Bluetooth headset and stereo headphones

2007-12-09T00:10:00.001-05:00

I'm surprised these headphones haven't caught on. There I am on my run, no cord dangling by my face, volume/stop/play/forward/back buttons at my fingertips, listening to the music of my choice. Then the music fades, and I hear the sounds indicating a call is coming in. It's my mom. We chat for a while, then hang up and the music resumes. I just don't Motorolla has advertised them enough for what they are. The only downside is that when you use them as a bluetooth headset people think you are talking to yourself...though with the amount of schizophrenics walking around where I live I blend right in.

Pros: sufficient volume (though not enough to give you hearing loss), stay put while running, all in one, price ($70 new on ebay), stereo bluetooth

Cons: built as bad as most motorolla products (I already snapped one of the arms), 1.5 hours of battery life, red inside, ear buds fall off easily (though motorolla provides an extra set), not as light as regular headphones

I bet the plantronics version is better, though they are big.

(Young) Canadian students top world rankings

2007-12-05T23:20:00.000-05:00

Turns out Canadian 5th graders ranked 3rd in the world on an international test of science ability.

Yet, does this play out later on, such as in University and beyond? Are Canadians known for their intelligence by their global peers? I don't think so, though there's no reason why we shouldn't be. We are like the small quiet kid in the corner - noone dislikes us because we don't do anything to provoke them, yet noone really likes us either because we have minimal impact in the world (yes we are small, though our impact is less than 1/10th the impact of the US). Why aren't we forging ahead? We don't have political strife, wars to fight, or anything else to distract us other than some Anglo/Franco issues. Yes we came up with the Blackberry, but why can't we create google?

Getting googly and yes HIV is bad...but Hep C may be worse

2007-11-13T19:57:00.000-05:00

Sad case...people infected with HIV (and hep C) from organ transplants.

Though c'mon media. Yes, it is definitely too bad that 4 people contracted HIV, but why did the author just mention the hepatitis C as an aside? If I had to choose one of these chronic diseases, I know which one I would choose...many co-infected patients are now dying from the Hep C complications (liver) not the HIV (antiretroviral treatments are getting better). HIV is bad, but let's not let it overshadow other contractable diseases. How many people know that there is only a 0.3% chance of contracting HIV from a infected needlestick injury versus a 3% and 30% chance from Hep C and B respectively?

And after my tough week last week, I saw this article:

I graduated university in 2005 - some of my friends went to work for Google. I think they made about 80K base (similar to investment banking base pay) and may have received a modest bonus. What's crazy is the value of their options now:

I won't lie...I'm jealous. Perhaps there is a certain amount of money for which I would forego becoming a doctor (hopefully not out of sheer greed, but rather to do cool charitable things with it).

Clutch move...I felt like this is what happened to me this week

2007-11-10T14:02:00.001-05:00

It is not suprising to me that doctors have so many mental health issues.

What I learned today...

2007-11-09T23:40:00.000-05:00

It doesn't matter what a person's crudentials are....if you don't have presense you just don't have presence. Funny why lawyers are always so short.

Our future health...

2007-11-08T23:40:00.000-05:00

Toddler struck by drug-resistant bug improving

These events are so much more real now when I spend time in the hospitals in which they are occuring. Parents make sure your children finish their antibiotic regimens!

Study Finds Carcinogens in Water Near Alberta Oil Sands Projects

Does anyone in Alberta (other than the residents directly affected) care? Perhaps someday the honeymoon in Alberta will be over.

Beauty in the Eyes of the Beholder...

2007-11-05T12:49:00.001-05:00

Very enlightening...

Sextuplets - who's in charge?

2007-02-03T11:02:00.000-05:00

Sextuplets born to devout Jehovah Witness couple in BC in need of blood transfusions

"The B.C. government got court orders in the past week to seize three of the surviving sextuplets born in Vancouver earlier in January and ensure they got blood transfusions if necessary. Two of the sextuplets have already died.
The babies were part of the group of of six born at B.C. Women's Hospital into a family of Jehovah's Witnesses, a religious group that prohibits blood transfusions."
-From B.C. intervened to save 3 sextuplets after 2 died

These are the kind of issues that really scare me. Makes me wish I had chosen my alternative career - doorman. That way I could still help people out, yet get much more reading done and not have to worry about such complex issues.

As a somewhat religious person myself, I am trying to be sympathetic to this couple. Yes, to me giving blood to these babies seems more of a gift than a violation, but can I not defend their position as well? Is mortal death really the worst thing that can happen? Obviously not - they could have aborted these babies days before birth, and may have been praised by some for protecting the mother's health and not biting off more than they could chew family size wise.

Learning to become a doctor (hopefully)...

2007-02-03T10:29:00.000-05:00

I have a confession to make. I often find my pre-clerkship classes boring. I tell my parents it's interesting. I sit mid to near the front. I seldom sleep. Yet sometimes, sitting there listening to some phD drone on about another biochemical pathway I think to myself - how could this possibly help me help patients? Yet I continue on. I even memorize this stuff (not the concepts and their clinical significance, but rather ever minute detail). Why? Because it's on the next exam.

There are those in my class who are in denial, as if the slightest insinuation of boringness implies they faked their way in med school. They don't just lie to their parents, they lie to themselves. I imagine they will be the same people who will be in charge of the curriculum in the future, who will continue the rite of passage of having med students memorize laundry lists of facts void of clinical relevance.

I quite enjoyed That Med School Guy's soul searching post Somewhere Along the Line. He explores his apparent fixation on the test over preparing to help patients. He's pretty hard on himself. Below is my comment, where I discuss possible reasons for his test vs. patient centered mentality:

Great Post! I highly doubt you were one of those “who happen to fall through the cracks,” at least judging by the sincerity of your post (and blog in general). Can you blamed for studying for the test? That’s what ultimately got you into med school, how you’ve been hardwired over your premed years. You've been forced to develop an addiction that is hard to get rid of. What’s worse, that is also currently your main evaluatory measure of whether you’re doing well in medical school. At least from an evaluatory sense, you are being told the addition is still okay. Why is that? True, med students need to look past the multiple choice tests at the big picture, though why can’t the big picture and med students’ current reality be aligned? Sounds like it would make the Professors happier as well! [Reference to earlier comment by Med Prof. Dr. K]

I have an idea. Let’s deemphasize multiple choice tests asking us what enzyme is used in the 4th step of heme synthesis (uroporphyrinogen III synthase in case you are wondering). Let’s emphasize how we do in the scant time we get as preclerks with patients practicing clinical stuff. And let’s introduce a new evaluatory measure. Hold on to your seatbelts. Let’s ask the patients how we are doing. I know it sounds crazy – let’s ask the person we are trying to help if they have been helped. I enjoy the blog.

Rich Without Money

2007-01-28T09:50:00.000-05:00

In contrast to my Goldman post I found this article very refreshing.

"...At the age of 36, Bob gave up his career as a quality control technician, went to medical school and set out to improve the quality of the planet. He opened his office in a neighborhood where most doctors wouldn't open their car door [poorest part of Albany, NY], and welcomed in all the people mainstream medicine would rather ignore..."

My first reaction is that we need more of these people in medicine. I worry, however, that the selection process weeds them out. It's hard to ace your classes, complain to your Professors when you don't, research, engage in other leadership and extracurricular activities, etc. when you're busy going around doing unrenumerated acts of kindness. Unfortunately there is no correlation between empathy and "objective" test scores (when they say objective, do they mean this person will "objectively" be a better doctor?), at least for the standardized scores currently weighted heavily in admissions. While I think the new MCAT Communications Skills project is a start, I propose a radically new admissions criteria. Somehow someway students need to be faced with a situation in which they must decide between helping someone in need and succeeding career wise. Maybe they could delay a premed student such that he/she was running late for an important premed exam, and then strategically place a seriously injured person in the path of that student as he/she was rushing to the exam. Pick those students who stop to help. Easy.
My second reaction was to stick my chest out ever so slightly with pride for being Canadian. Maybe I'll buy myself a Canadian flag doo rag and next time I hear the Canadian anthem put my hand on my chest. It would take over 100,000 Dr. Paeglows to serve those people in the US without medical insurance. If Dr. Paeglow lived in Canada, he could do what he was doing, get paid for it (he could just give the money to the patients if he is so inclined), and get the same kind of resources for his patients that everyone (theoretically) enjoys. I make such an observation not to criticize the US system but to glorify ours. In fact, I'm not a US basher at all. I try to avoid criticizing the US because I'm sensitive to the new found Canadian sensitment of moral superiority over our friends of the south. We'll save that topic for another post. The bar chart is from the Yes! Magazine article: Has Canada Got the Cure?

For high strung med people - time to relax

2007-01-27T13:19:00.000-05:00

Rising income disparity

2007-01-27T13:17:00.000-05:00

“…After making record profits, Wall Street giant Goldman Sachs Group Inc. reported that it will pay its workers an average of $622,000 this year.

That's more than three times the average salary of a Massachusetts surgeon; four times that of a Massachusetts chief executive; and nearly 12 times that of a Massachusetts high school teacher, according to the state's Department of Workforce Development…”

Read Article

Wow?! As a former Wall Street employee I just can’t comprehend why Goldman employees should make 12x a high school teacher. It’s too bad wages weren’t based on positive impact to society. How many of the deals these firms orchestrate are actually accretive in the med/long term (for shareholders, not the CEO and bankers that is)? And despite the increasingly commoditized nature of M&A deals and proliferation of M&A shops the lucrative 7% commission remains…

I was surprised with the B-School Prof’s justification of the excessive income. He said this despite knowing he’s probably smarter than a majority of the people at Goldman yet makes 1/5th what they do.

“…While the salaries on Wall Street can be outsized, they reflect risk that few other professions face, said S.P. Kothari, a professor at MIT's Sloan School of Management. Traders and investment bankers constantly have to meet the bottom line: One year they can make $600,000, the next year, lose their jobs…”

What kind of risk is there to cashing in on $600K in one year (a cool $30K/year return in safe investments)? How about being laid off from the most prestigious financial firm in the world? Not exactly a CLM (career limiting move).

To the brink and beyond

2007-01-26T16:23:00.000-05:00

Stuff happens, there's no doubt about it. However, this is taking it to the extreme:

"...Naum Ciomu, 58, was operating on the man to correct a testicular malformation when he lost his temper. Grabbing a scalpel, he sliced off the penis in front of amazed nursing staff, then cut it into three pieces before storming out of the operating theatre at the Panduri Urology Hospital in Bucharest..."
Read Article

Stress and personal problems have been forwarded as the cause. No one enters medicine thinking they would do something like this, and presumably, few people will. My worry is the negative personal changes that will occur over my med school training - the affects of busyness, stress, and dealing with the emotionally charged routinely. How could someone that was able to pass through all the hoola hoops to becoming a surgeon do such a thing? It's hard for a young, idealist, self flattering medical student to understand. Yet, I've already seen changes in myself. 4 months ago I would have told you that urology (assuming I actually knew what urology was) is disgusting. After meticulously dissecting a cadeaver, speaking to a few gleeful kidney transplant recipients, learning about emerging prostate cancer research, and general desensitization to anything anatomically private...it's suddenly become a specialty of interest. That's only 4 months.

I've witnessed a doctor uncover a sensitive area of an older woman without asking her. I've heard a pediatrician refer to a child as a FLK (funny looking kid). These things bother me...at least for now. In doctors' defence, I suspect one cannot deal with emotionally charged things all day. Could a doctor look at private parts all day comfortably if she saw them as private? Could a pediatrician sustain himself without depersonalizes the innocent suffering around him (treating children who could easily be his own)?

So what are some strategies to ward off the jadedness and remain emotionally balanced?

-hang out with people outside of medicine

-blog about stuff other than medicine; I hope someone comment slaps me if I become overly fixated on med stuff

-document my current idealistic euphoria regarding my future career in medicine

-complain about stuff that doesn't seem right

We'll see how it goes.