The other day I decided to go ahead and choose a specialty.  I narrowed it down to orthopedic surgery and cardiology.  Not only do these two areas seem so different, they are the extremes in terms of residency programs.  Orthopedic surgey is typically reserved for medical students that score in the 99th percentile on Step 1 of the Boards.  On the other hand, cardiology begins with internal medicine which is one of the least competitive programs.  Others take me as the equivalent of an undecided freshman in undergraduate school when I tell them these two areas.  It's hard for some to see a connection.  The connection comes in that I am an engineer and problems that occur in cardiology and orthopedics are engineering problems.  This is not true for dermatology, opthamology, emergency medicine, or pathology.

In any case, those plans are again up in the air after my two meetings today.  

12:15 pm. My first meeting was with a administrator from the Drew program who was checking in on how students were doing in medical school.  Surprisingly, she gave me high praised and practically called me a genius among medical students.  Her only concern was that I might become lazy.  She said I could become lazy and still pass medical school, but would hate to see that happen.  She then went on to praise my critical thinking and noted that I would be a great researcher that could change the way research is done.  I tell her thanks and walk out.

1:30 pm. I go meet with my PBL (Problem Based Learning) instructor to discuss my performance so far in PBL.  I express that my weakness in class comes from my lack of in-depth knowledge of techniques we encounter in journal articles.  I fully understood the mechanism of the techniques but knew not their shortcomings and how to criticize them.  This is especially true when researchers have designed a completely new experimental method.  He responded by saying that this was because of my wanting to learn everything in great detail, which was not needed for our class.  He then went on to say that I had immense potential as a researcher.  He commented that he knew not my career goals but that I would be a great researcher.  He then opened his office for whenever I might want to talk about my future goals.

Needless to say, I was not expecting so much praise today.  In addition, the research cloud has again been thrust upon me.  I am the student who did research for two and half years as an undergraduate.  I am the student who turned down Boston University which has the oldest MD/PhD program in the United States.  My graduate work would have been in Biomedical Engineering where Boston University is ranked in the top 3 or so.  Boston has the highest concentration of intellectuals in America as well as the highest concentration of biotech firms in the world.  After I thoughtfully turned down Boston University, I only had slight feelings that I might regret not doing a PhD.  I admit that I think like a researcher.  Not all medical students, even those that do research, think like a researcher.  Months earlier, I did dispel the notion that just because I was good at doing research that I had to do research.  After today, it seems like others seem to think not just that I could do research, but that I belong in research.  Considering that the option of doing a PhD here at UCLA is just a matter of if I decide to or not, I now have to again deal with the research issue.

The first lecture this morning covered cell injury.  The process can be reversible but can reach a point of no return if a cell is severely injured leading to cell death.  Students kept simplifying different enzymatic pathways and inquiring about the universality of all that was presented.  The obvious answer is that everyone is different and whether something is fatal in one individual might not be for another.  Yet, some students couldn't seem to grasp this and continued to ask questions that would get them no where.  This prompted me to stop paying attention to lecture.  Instead, I pondered the concept of individualized healthcare.  Contrary to anyone's claim (that includes doctors, politicians, and media), there is no individualized healthcare.  Whenever you present yourself to a physician, all of your symptoms are combined with the doctor's experience.  The concept of 'you' doesn't exist.  A doctor develops a course of action based on his/her experience.  This seems to be ok for the common cold, but is well-known by patients with more serious health issues.  There are select doctors that are seen as the best neurosurgeons, plastic surgeons, and oncologists.  The reality is, they are the best.  But they still don't provide individualized healthcare.  They have greater experience and are successful more often than not with procedures.  Whether a person has a cold or a failing kidney, no doctor can tell the patient what their outcome will be.  Doctors are playing an odds game based on their experience.  With computational modeling such as those I created as an undergraduate, we can move towards individualized healthcare.  For example, we could model bypass surgery and quantify for a patient exactly how much more blood flow they can expect with the surgery.  This is individualized healthcare.  It is not saying, "Mr. John Doe, most patients have better coronary flow with a bypass" and then hoping Mr. John Doe fits into the 'most patients' group.

I quickly killed that thought and accepted that there wouldn't be standardized healthcare anytime soon.  This came from the rather large number of students talking about meaningless topics outside of medicine.  Others were paying even less attention.  One of our PowerPoint slides was of a finger that had been cut off.  One student decided to draw on it and make a dinosaur out of it which he showed to students immediately after lecture---none of which laughed at his drawing.  It would be great for future patients if these students were already at the top of their game.  There are quite a few students who know their stuff, but they are deeply focused with the lecture.  I happen to know these students aren't that bright by the level or lack thereof in their many questions.  They hold up class because they are stuck on slides when they do attention.  The lecturers always pretend to not know their question so they repeat a couple words about the slide and move on.  Occasionally they'll say, "I think I will answer that question by the end of this lecture, and if not, come see me."  Who knows what type of doctors these particular students will be.  Their level of responsibility, however, lets me know that in fifteen years there will still be top doctors, good doctors, mediocre doctors, and bad doctors.  They are probably sure of what specialty they will go in and think they have no incentive to learn anything outside of that specialty.  These will be the doctors that have malpractice issues later on.  I wonder how many 'medical mistakes' are actually made in medical school.

I realize that I too don't pay great attention in lecture.  Yet, I know exactly where I stand as a medical student.  I am the one that makes other students fill uncomfortable because I actually know the material we go over in histology and anatomy.  I am the student who asks the great questions during doctoring/interviewing patients.  I am also the student who studies much less than everyone else.  (I see it as if I learn a topic, then I will never have to study that topic.)  The difference has nothing to do with me being smarter than everyone else.  Memory is the lowest form of intelligence.  Even patients with severe mental retardation can memorize.  Animals can too.  

Perhaps they aren't that motivated.  It's hard for me not to stay motivated when somewhere walking around Los Angeles is a healthy middle aged man.  While I was in class, he was at work.  While I was in anatomy, he picked up his kids from school.  He is now buying some groceries before he heads back home.  He is going to watch television for the rest of today.  I am still deciding what to do for the rest of today.  One day, he won't be middle-aged.  He will be in a hospital.  When I go in to see him, he won't be wondering if on Sept. 2, 2008 I watched television the entire evening.  He won't be wondering how well I did in medical school.  He won't be asking if I was a marginal pass at a medical school with only a pass/fail grading system.  He won't be drilling me with questions to gauge my knowledge.  He won't be doing any of this......and he shouldn't.

Where do I start?  I woke up.  Watched some of LSU vs. Appalachian St.  Bought groceries.  Played guitar.  Took some notes from lecture.  Played guitar.  Watched some of USC vs. Virginia.  Ate some frozen pineapples.  My family knows I love frozen pineapples --they're so good!  Then I watched Alabama destroy a preseason top 10 Clemson football team.  Fortunately I'm at UCLA where no one cares about football or else I might be running around crazy with the masses in Atlanta.  God help me if I happen to find people who actually care about football!  I might not ever be able to focus on medical school.  Today has  been such a good day.  Not perfect though.  I am sweating.  My room just gets so hot.  Staying cool has been my hardest challenge so far in medical school.  I gotta do something about this heat right now.

Adios.

What a day.  I had a meeting at lunch time where students were expressing how stressed out they were and how hard medical school has been.  I feel so out of place because I have near zero stress! Some students were mentioning how much time they were spending on tests.  Their figures were in the multiple hours.  I had to restrain myself from telling them that I get both my tests done in less than 45 minutes at the same time I eat breakfast and listen to music.  I would for sure be the most hated student if I had also mentioned that I bought an electric guitar and amp yesterday.  But oh well, what they don't know can't hurt them.  I'll do some work tonight in addition to playing with my amp blasting throughout all of the Weyburn apartments.

What a day! First I didn't go to my 11:00am class.  Instead I chose to study for a histology quiz which I aced--(the grade doesn't count btw).  After breezing through my histology class I went and bought an electric guitar.  A Yamaha Pacific 012 and a Line6 15-watt amp!  I keep meaning to spend more time studying, but I keep coming up with more things to occupy my time.  Why do I do this?  So now, I will be jamming out and everyone will hear me due to my room location.  There are great acoustics for sounds from my room to permeate everywhere outside.  Unfortunately I'm not so great on the guitar, or rather, I play the same songs.  I pity the fool who has to walk outside my room.

In any case, I've been MIA from this blog.  I apologize to those who have been suffering from days of boredom without an update of my life.  I will spend more time updating this blog in the next coming days.

Until then, listen to the latest song I am playing.

My TB skin tests were negative.......that's a good thing.  The lady spent two seconds and just said, "oh, nice and negative, is that it?"  That was it.  I walked out.  Yesterday I ate at Roscoe's Chicken and Waffles for the first time.  I couldn't finish my waffles or the half-a-stick of butter on top of them.  I also went shopping at the Beverly Center yesterday.  I was surprised to see so many people at the mall in the middle of a Thursday.  All I could think was, "Shouldn't these people be working?"  I saw entire families at the mall!  Maybe they have some servants or something that was working at that time; these families certainly weren't tourists.  So much has happened but I'm too tired to mention them all.  I feel tired now that I bought the new Jawbone 2 bluetooth headset.  It makes me feel like I've been running errands all day and being productive.  *yawn* I might play guitar and go to sleep........sounds like LiftOff in the morning is in call.

What a draining day today has been!  I went to the Ashe Center for a TB skin test, a Hepatitis B shot, a Tetanus shot, and blood drawn for varicella/measles antibody tests.  The nurse botched the TB test and my arm started bleeding.  I'm certain I will fail the TB skin test simply because my skin is already red from internal bleeding.  After the other two shots I was about to pass out.  I had already told the nurse I would probably pass out.  Everyone in my family knows how sensitive my body is....ummkay...I then walked over to the recliners they have for people to get blood drawn.  Aside from the doctor and nurse praising the veins in my arm, they commented on my bleeding arm from the TB skin test.  Apparently, my arm was not supposed to be bleeding if the test is done properly and any blood should have been wiped off.

While leaving, I notice a guy that looks familiar and I go up to him and say, "Ey, you're Tiq's brother."  Of course he was and he knew I was from Stanford.  We exchanged contacts as he wanted to introduce me to some other people.......my celebrity just grows.

As I walked through the main campus I finally saw the first minorities that were students.  This short kid asks me if I want to buy some candy to support their football team.  I kinda doubt this kid plays football and asks if he's in highschool----nope, he's at a community college.  I guess there just aren't black UCLA students.  They're missing...In any case, he asked me if I played football.  Ten minutes earlier, a guy at the Ashe Center asked me if I played basketball...I didn't realize my body was in such great shape.  Maybe I was born with it, maybe it's Herbalife.

I am quite tired from today.  I'll start with the earthquake first.  I was in the hall on the 3rd floor of the Molecular Science Building reading the newspaper.  The earthquake began and I immediately thought, "oh boy, I'm not in the mood for an earthquake," and continued reading my newspaper.  Afterwards, I texted a few people then went to lunch with a professor at the faculty club.  My food was quite good and even better considering that it was paid for.  I later took a nap outside before my meeting with the dean of research  I was still tired but for some reason he talked VERY LOUD!  I wanted to tell him to calm down.  In the course of our talking, I remarked that research could be done on the use of parasites/viruses as potential vectors for somatic cells or cells of a specific type of tissue.  Surprisingly, he shot down my remark by saying it was more than a stretch: it was a huge 'leap of faith'.  I'm not one to throw out dumb ideas.  I admit that I come up with the hard questions and the hard research projects, but that's part of who I am.  I'm not a lame biologist or simple medical student that does the EXACT research as everyone else.  So I had to correct the dean of research.  There's quite a bit of weight in everything I say.  I told him my idea wasn't a 'leap of faith'.  90% of all types of cancers develop in epithelial cells.  And there are parasites/viruses that are specific types of tissues.  It would be arrogant for someone to think there isn't  a parasite/virus that is specific to epithelial cells.  I stopped there since I was in his office and he was the dean of research.  But I could've gone further and mention studies I know of and a professor I know at Cal Tech that is looking at a specific virus for targeted gene insertion/deletion.  Oh well, perhaps I just have too high expectations for people in higher positions.  It was a 'leap of faith' for me to expect the dean of research to not only know of perhaps the largest problem in genetics and the applicability of parasites/viruses.

Enough of that, voy a tocar mi guitarra.

Well, I'm back at UCLA. My time at Cal State Long Beach was a short one.  There were great times such as playing basketball with high school kids.  And there were not so great times such as eating in the dining hall every day.  The food was terrible.  I'd never seen such sad meals.  The mashed potatoes were made from powder, each type of meat was in a pattie form, the garlic bread was sliced bread with garlic on it...I had missed the fine cuisine from Stanford dining.

The week ended with a White Coat Ceremony at Charles R. Drew University.  After the ceremony, I wore my white coat inside of Bed, Bath, & Beyond and Target.  I didn't wear it inside of Bank of America, but maybe I should have worn it today when I went grocery shopping.  Today, in Ralph's a lady just starts talking to me.  She swears she gave me a ride from Ralph's back to UCLA a while back.  I have to tell that she is wrong and that I've just only recently arrived in UCLA.  I don't want to get into race issues, but she said she thought I was the same guy because my groceries were the same as the ones this other guy had purchased....Why couldn't she differentiate my face from his?.....She didn't even say I looked like the other guy!.....I guess we all look the same and my set of groceries gave me away as some other guy.  This is what I bought: Guerrero flour tortillas, rice, beans, lettuce, tomato sauce, salt, garlic salt, a can opener, a light bulb, and some knives....No further comment about that lady.....I can only wonder what that other guy was going to prepare for dinner--there's just so many possibilities.

Since that lady has killed any desire of mine to cook tonight, I will have a Herbalife nutritional shake with bananas.  Later tonight I might end up at the In-N-Out I discovered that's a quarter of a mile away.

It's been awhile since my last blog, but I finally have my internet working.  So much has happened since my last blog.  I am at Cal State Long Beach for Pre-Matriculation Week.  Shout-out to my sister for making it from LA to Palo Alto in less than 5 hours.  I wish she had not done it, but she did.  I can't wait for my chance to beat that time.   Also, thanks for others who have left comments.  I was too busy going to the Long Beach Aquarium to respond....it was awesome!  This week has also been filled with intense instruction and informationals.  I go to sleep early and get up even earlier.....I guess that's like negative sleep.

These days the 2nd year medical students are trying to intimidate us.  The mantra of the week is "there's no time!".  The question was asked, "How do you plan to study?" and a student ( I swear it wasn't me) innocently replied, "re-write my notes."  And the instructor said, "there's no time to re-write notes!"  So now I have to plan on getting done with all of my stuff when there is no time.  I have to fit my lab rotations into my class and study time which apparently leave me no time.

Also, I'm doing Herbalife!  I think it's awesome, because of the large disconnect between medicine, nutrition, and exercise.  Herbalife has also changed the way I look at overweight individuals.  I now want to reach out to them and get them to join Herbalife, join a gym, and join a nutrition plan that suits them.  Once I get settled in I will go out and get people to make healthier life choices.  We all have choices.  We all have an optimal weight.  I'll be there to help people make the right choices to reach their optimal weight.  Thanks to Edgar for the above design.

I also moved into my graduate housing at Weyburn Terrace.  I have a kitchen where I now need to cook.  Please leave comments for suggestions in addition to simple cooking steps--simple because I don't have time!  I also brought my bike--thank God that it didn't fly off on the freeway.  My room is near awesome now that I have taken my brother's speakers.  I just found out that we already have cable with everything!  Now I'm going to go buy a nice television next week...perhaps I will buy a nice futon....nah, there's no time!

This is my last blog at Stanford.  I have packed my stuff and am ready to go in the morning.  No more grubbing at Treehouse.  No more getting ripped off at the bookstore.  Armando at PO Box 12495 is no more.  Leaving Stanford has been less glamorous than expected.  There were no fireworks, no celebration...nothing.  At the end of the day, I am alone with all my stuff, while all those I know are in dorms lounging about.  I'm not depressed.....not yet.  I'm just thinking about how long before they miss me.  Rolando needs someone to talk to about girls other than Drew (all respect to Drew though for his work).  Herba needs help with CS106B.  Israel needs someone to help him hate on people.  Elaine needs someone to tell her when she's....umm.....I'll leave it at 'inappropriate'.  Uri's still studying for MCAT without me!  Pavon needs someone to hold down Centro for awhile...I wonder what Brooks is doing.

They say tomorrow is inevitable, but being around to see it isn't.  That is so true.  Stanford is moving on and so must I.  I can only hope to be around to see what everything I know and what all I know become.

On a different note, contact me if you are interested in Herbalife products.

Along with my transition to UCLA, I am starting a new serious workout/diet plan.  Monday marked the beginning, after which my entire body is sore.  I am officially on 'old man grandpa' status--stairs are killing me!  Surprisingly, today has been quite a productive one for me.  My TODO: list has now been halved.

Perhaps my best success so far has been with finding professors at UCLA to do research with.  I have about 10 professors who are eager to meet with me when I get to UCLA and allow me to do a rotation through their labs.  Technically, medical students don't do rotations through labs.  My mentor here at Stanford did it, so I will too.  I seem to be over my head a bit in rotating in labs that I know little about, but I seem to do better in environments where I know little.  In those situations my creativity and critical thinking are what set me apart from most medical students.  Por eso, I intend to do meaningful research in each rotation I do...I'm no longer an undergrad.

The next half of 2008 is going to be perhaps my greatest time juggling feat as I take on a bevy of other potentially important projects.........Why does it always seem that the next four months seem to determine what I will do with my life??

Happy Birthday Sarah Louise Whigham Jones.

I saw HellBoy II last night.  As expected, the good guys won, but I wanted to see more choreographed fight scenes with Prince Nuada and Celtic mysticism than HellBoy's drinking Tecate and singing love songs.  Overall, I recommend the movie to all.

On a completely different note, Stanford Football Coach Jim Harbaugh is silently putting together the best recruiting class Stanford has seen in many years.  On my routine trip to grub at the Treehouse, I saw Coach Harbaugh with a couple players and coaches with two recruits.  I immediately recognized one recruit to be Shayne Skov--the No. 3 Outside Linebacker in the nation.  I've seen this guy on video and he is a beast at linebacker.  I introduced myself to Coach Harbaugh and told him I thought he was doing a great job with his recruiting class.  The high point of our talk for me came when Harbaugh asked me why wasn't I playing football and if I had played in high school.  I responded with a 'no' but that I would've liked to be a corner/defensive back type player.  He then asked me what year I was.........Did you see what that was?  Do you see what he was doing?  He was recruiting ME!....or at least that's what I saw it as.  Unfortunately, I had to tell him I graduated and that I wished him the best of luck finding another defensive back as good as Armando.  Of course I didn't say that last part, but I thought of it and that's enough for me.  He did ask me if I wanted to eat lunch with him and the other recruits.  In all honesty, I would've loved to talk football with Harbaugh but realize that he needs to spend time with his recruits.  Hence, I settled to introduce myself to the other recruit who was Offensive Guard Khalil Wilkes who Harbaugh introduced me too.  I gave him a couple words about Stanford and that I'll be at UCLA Med this fall--only at Stanford do you recruit football players with talk of Law School and Medical School.

No doubt Stanford's future is headed in the right direction for years to come.  Let's see what happens with Oregon State on August 28th.  Go Card!

Day Two: Unfortunately my To Do List still looks the same...What exactly did I do yesterday?...I remember watching The Office, a little bit of the Chivas (US) v. LA Galaxy. I have to get used to seeing LA Galaxy since I will be moving to LA. Unfortunately, they never seem to win--last night was a tie. I need to make it out to a game at some point; my uncle lives right by the Home Depot Center in Carson. After the game, I watched Telemundo which was awesome for me as I got to work on my Spanish. This lead to my discovery of the First-Semester-of-Spanish Spanish Love Song on Youtube. (I need to figure out how to put the actual video up.) I think I have to add something medical school related to keep this posting appropriate for this blog--"Pathologic processes, genetics, molecular and cellular biology, basic immunology, and critical appraisal". That is from the First Year Curriculum: Block 1. There were comments suggesting I post about another topic. Who are these people??? And why do they keep listening to this song? I think I should get back to 'working', as I like to call it. Also, pay no attention to the visitor counter at the bottom of the page. It gives different numbers to different people. There should also be a '100,000,0' in front of whatever number you see.

This is my first post.  I am currently still on the Stanford campus and prologue for the CDU/UCLA Medical Education Program begins in 10 days at Cal State L.A....It's been less than a month since I graduated!  In these last days I need to turn in my P.O. Box key, get my mail forwarded, get my health records from Vaden Health Center, pack all my stuff, move to L.A., get my new room key, meet my roommate, upack all my stuff, and make it out to Cal State L.A in addition to another million little things....I had a much easier time leaving high school for Stanford.