Sunday, June 29, 2008

I can do it

Pressing the "submit" button on my primary application for medical school was difficult, it meant that this year will cost an inordinate amount of money, and will be full of more applications and most likely many rejections. But - this I am okay with, and will do my best to remember why I want to be a physician and that I have the capability of being a good one. The following quotations are two of my favorites and I will continue to remember them throughout the year....

If I have the belief that I can do it, I will surely acquire the capacity to do it, even if I may not have it at the beginning
- Mahatma Gandhi

You may be whatever you resolve to be - determine to be something in the world and you will be something. " I cannot," never accomplished anything. "I will try" has worked wonders.
- J. Hawes

Friday, June 27, 2008

Proper treatment

Here is an article that was published in the SF Chronicle recently, about patients, and doctors fighting insurers over denied payment of treatment. This article makes me think about "evidence-based medicine" and makes me question who is using that evidence and who is making that evidence. doctors vs insurers. In this article, it seems like the evidence-base is being used to go against the individual physicians best-judgment. My question is whether this is a good thing or a bad thing for quality of care?

I agree that if a women is a diagnosed with breast cancer, she should receive the standard treatments, and if not, should be placed on a clinical trial so we can ethically and honestly monitor her health and safety and quantify her response. Doctors should not be using drugs that have not been vigorously tested in diseases that enable such testing.

The problem becomes more complex when you start dealing with diseases that are extremely rare in the population. Li Fraumeni syndrome for example. The number of people with this gene mutation is so little that there is not enough statistical power to ever conduct a clinical trial, to make "evidence" about effective treatments or therapies.
In these more rare cases, I am concerned and would rather have care dictated by thought leaders and experts, rather then for-profit insurance companies.

Wednesday, June 25, 2008 Preview

If you want to learn a bit about what I've been working on the past year, check out this tour of We will be launching our site soon and I will be sure to post about this when it happens.


Elevators are great places to study social dynamics, it comes as close to the "deserted island" scenario as you can in this day and age, cell phone generally don't work, no food or water, dependent on others outside to find you...

I go up and down 10 floors in an elevator every day I take the shuttle to work, so I consider myself an "expert" elevator rider. I know exactly when to push the close door button to maximize efficiency, I know which corner I like to stand in, I know when the doors will open according to the bell ring.

I love studying the ways people fill up space on an elevator, like a subway, in elevators people like to stand as far away as everyone as possible. It's a great example of social magnetism, if you think of each person having the same polar magnetism, then we all want to stand as far away from everyone else as possible, thus the following scenarios occur:

two people: diagonal from each other, against the wall.
Three people, fill up the three corners, a triangle
Four people: 4 square
Five people:
* *
* *
and so on, until we reach the 8th floor and you just cram in, completely violating each others personal bubble we had so happily managed for the 7 floors below us.

It always amazes me when someone violates this polarity principle. If friends board the elevator, this dynamic changes, friends are allowed to stand in the vicinity of each other. But-the other case is so unusual, and always makes people nervous. When there are 5 people in the elevator, and 2 leave, the other 3 sort of rearrange naturally, pulling away from the other 2 folks in the elevator. But this doesn't always happen, and one person doesn't pull away -it is very rare that this happens, maybe once every 100 elevator rides? In my experience, it has been a foreigner, who I guess does not yet understand the physics elevator principle of us Americans!!!

Sunday, June 22, 2008

Zoo Days

Today I went to the San Francisco Zoo for the first time. It ended up being a great day at the zoo. The giraffes were picture perfect. The lion was awake and strutting around with his big mane. The siberian tiger was meowing (the whole zoo could hear it). In Grizzly Gulch, two grizzly bears were play-fighting. The South American penguins were eating. The silverback was certainly doing a good job of guarding his house. AND no tigers escaped!

I was completely fascinated with the uniqueness and industry of each species. The tapir was especially awesome. It has a body of a bear, and the snout of an elephant/ant eater. To think of the conditions that required this specific capacity is beyond me, but something I would love to learn more about. I was struck by the color patterns and variations of the animals too. At one point, I nonchalantly joked, you wouldn't think loud black and white stripes would fit in on the savannah would you? (in reference to the zebra that had its back to me). Someone pointed out that many animals are colorblind, so this might be an explanation. (I still need to look into this though, I'll believe it when I see it)...I also noticed a few abnormal behaviors that I don't think most wild animals do, like the anteater pacing in a circle repeatedly in her small cage.

I definitely want to go again, I could sit and watch animals all day!

Wednesday, June 18, 2008


This weekend Jon and I went on an overnight backpacking trip in the Sequoias (Redwood Canyon Trail in Kings Canyon N.P.) It was an amazing hike. The first 4 1/2 miles took us through 2 huge Sequoia groves in complete solitude. When we weren't in in the shadows of the gentle giants, we were surrounded by the spring wildflowers, dozens of species of blues, purples. reds, pinks, yellows, oranges. When we made it down to the bottom of the canyon there was a soft-flowing stream that we hiked by for another 4 miles before climbing our way up the stream bed (way harder then that sentence makes it out to be) and finding 2 30' waterfalls. We were lucky our packs weren't ransacked by bears before we got back to them....

The next morning we woke up to the sunlight shining through our tent and the sounds of dozens of birds singing to each other across the forest canopy. For whatever reason, it was much easier to hike with our packs on the second day, even though our calves were killing. After taking down camp, eating some PBJ for breakfast, we were on our way. A mile into our hike, I stop in my tracks, seeing a big black bear (he was actually brown-colored) on the trail about 45 feet ahead of me. We start talking loudly and he notices us and nicely scoots off our trail into the meadow to our left. Of all the times to not have my camera out! It was an exhilarating encounter and really made the trip. Such a big bear, but so innocuous that morning. We kept going, enjoying the cool morning air, the sounds of woodpeckers and songbirds. After our final stream crossing we started our ascent up the canyon to our car. It turned out to be much more moderate than I expected, and we passed through several Sequoia groves again. The Sequoia forests are so incredible, the sheer size of the tree canopies create a lot of space on the forest floor, allowing beautiful ferns to thrive in the shady environment. It is so quiet and shady. You really do feel tiny when every tree you pass has a 15' diameter and soars 200' in the air...

Tuesday, June 3, 2008

Obama '08

Just busted out all my Obama gear. Smiles all around!