Quote of the Day

Everybody needs beauty as well as bread, places to play in and pray in, where nature may heal and give strength to body and soul.  

John Muir

Berry Falls Hike, Big Basin State Park

Today, around noon my dad and I decided we'd tackle the 12 mile Berry Falls Hike. After an hour of driving we reached the lovely Big Basin State Park around 1pm, leaving us just about 4 hours of light to complete our task.

Luckily, it turned out to be one of the best hikes we've ever been on. Vibrant luscious flora, banana slugs, newts, birds abound, and spectacular waterfalls. We may have needed to trot the last few miles, but it was still amazing and we managed to make it to the car by dark!

Picture with Santa

Knotts Berry Farm

Abbey and I went on the silver bullet 3 times already! Going to be a
fun day

Happy 79th Birthday Grandma!

Running in the Rain

Finally no school, unfortunately it has rain nonstop since...Here I am
coming back from a tempo run, completely soaked!

Good News!

I have officially completed my first quarter of medical school. Now time to relax and NOT think about anatomy!

Quotes of the Day

Once you say you're going to settle for second that's what happens to you in life, I find. —JFK, 1960

 

We were to try harder than anyone else. We might not be the best, and none of us were, but we were to make the effort to be the best. After you have done the best you can, the hell with it. —RFK, 1965

Two hundred years from now, will people ask, "What was wrong with us?" We had exceptional prosperity, exceptional bounty, exceptional resources. Will they say, "They had the opportunity to do something about hunger, and they refused to address it"? —EMK, 1975

 Read more here

Pizza finished!

We were out of pepperoni so we used bell peppers, tomatoes, broccoli, carrots and sweet potatoes instead. YUM!

Pizza making!

Study buddies

Me, Felipe, Danny, and Skeleton Man...

December 14: Something You Need to To Do

Go watch Living in Emergency, the first uncensored documentary about Medicins Sans Frontiers (Doctors without Borders) to bear witness to the extreme conditions of wartorn countries. It is a one-night event, find out where it is playing by you here



I just went to a lecture this morning given by Dr. Sherry Wren who shared her experience in the Congo over the last two summers. We must be better, we must do more.

Opthamology

Yesterday I volunteered at the Opthamology Specialty Clinic at the Arbor Free Clinic. Most of the patients we saw were there for a diabetic retinopathy screen, if you have diabetes, you should have your eyes examined once a year to check the blood vessels in your retina, because if there is any sign of early hemorrhages or extra vessel growth, you can have surgery to avoid blindness in the future. It's one of the modern miracles of medicine. Previously, diabetic retinopathy was able to be diagnosed, but there was no treatment, now with early diagnosis and surgery people are able to retain their vision before it is even impacted. Opthamology is neat because so many gadgets are involved, I had a great teacher, Dr. Shahinian.

Now back to the library to study the derivatives of the ectoderm, somites, and limb development....

Scrubbed in to my first surgery!

Luckily it wasn't "my" surgery. I got to scrub in on a lap chole this morning at the VA (laparoscopic cholecystectomy aka removal of the gallbladder). To say the least, it was AWESOME. I got to maneuver the camera for most of the time. Surgery went smoothly, patient should be out of the hospital in time for Thanksgiving dinner tomorrow. Now THAT is something to be thankful for!!!

Sad day

I shadowed rounds in an inpatient oncology ward today. It was so sad. My heart absolutely goes out to all the individuals and families battling cancer. I had the unfortunate opportunity of witnessing a death today, she had fought breast cancer for 5 years and that battle ended this morning. Life is not fair, nor just.

Humans: Are we like differentiated cells or stem cells?

Disclosure: Yes, I'm studying over Thanksgiving Break. I must. I spent too much time working on cool projects rather than studying the last month and now my break is paying for it. At least what I'm learning is interesting!

Humans as differentiated cells
Do we start out all equal, capable of anything and everything? Then, over time, progressively restrict our goals, hopes, opportunities and dreams?  Does every little choice we make steer us towards our final destination, in sequential order? Meaning that if we didn't make choice A and B first, then we couldn't arrive at C?

Or...

Humans as stem cells
Not only do we start out with the world at our feet, but we have this ability throughout our lives. Are we constantly capable of reinventing ourselves? With the right mix of opportunity and timing, can we become anything we want to be? We can self-renew, be bold. But we need might need the right environment, the right parents, the right nurturing in order to have this ability.

I love biology metaphors. I think we might be something in between. Mostly differentiated cells, but under the right conditions we can be changed into stem cells, like inducible pluripotent stem cells!

PS. I shadowed Dr. Verghese today, it was pretty much totally awesome. Tomorrow I'm going on oncology rounds. So thankful for these learning opportunities...

Schools out!

Sort of. I still have my final exams the week of December 6th, BUT I have no more classes until January!!! How lovely :) This week I will be shadowing in the OR, catching up on Dev Bio, shadowing some hospital rounds, and making sure I know all my anatomy. And of course, celebrating Thanksgiving!

Since I've finished up my classes for the quarter, let me reflect:
Anatomy: The smell got worse, not better, over time. I think I like real people a lot more than dead people, which is why I'll take surgical anatomy next quarter (unfortunately still dead people).
PoM: Brushed up on my quant skills, feel more comfortable analyzing the statistics of research papers. I have my basic taking a medical history skills down, but still need a lot of work!
Genetics: Still want to get my genotype sequenced, all the fear-mongering didn't work on me.
Dev Bio: Development is just really cool and fascinating
Cost Effectiveness Class: Presentation completed! I can't get away from approaching all topics from a cost benefit or cost effectiveness perspective now that I know about it.
In all: I don't feel like I am now 1/6 prepared for the boards or my clinical years, but I am much more knowledgeable of my ignorance, and much more exciting to dive in to more shadowing and volunteer opportunities. I look forward to working with patients every single day. I still believe that this is 100% the path I'm supposed to be on. I still love medical school but am very thankful for the break!

Ominous skies around Hoover Tower

Today was a fabulous day

I love my life. Today was a great example of why that is. I start class at 8am, to hear about the history of Exubera, the first inhaled form of insulin, from Rob Chess. Then I work on a project to understand the costs and benefits of IVF with blastocyst or two, for several hours, arguing over what the analysis is sensitive to. Then I race over to the Palo Alto VA to shadow my E4C mentor, who is Chief of Internal Medicine, get to see the amazingly cool VA electronic medical record in action as well as meet with a patient and learn about a bladder ultrasound. From there I race back to campus, singing to the country music on the radio, to grab a quick lunch and meet up with my group to discuss Project Easy, an initiative to include patient safety and quality improvement into Stanford's medical education. Then I get free, delicious dinner, learn about Stupak's abortion amendment that is currently in the House Health Care Reform bill, listen to my British anatomy professors tell stories of their experience caring for women in Britain who took the choice to have an abortion into their own hands before medical abortion was legal, and write letters to my senators, Harry Reid and President Obama urging them to allow the public option and insurers taking part in the national insurance exhange to receive government funding for safe abortions. Today was a fabulous day.

Knot Tying Skillz

I learned how to do a surgical square knot today, one-handed and two-handed. It's really fun, and very similar to cross-stitching and needlepoint.

Got a New Book in the Mail!

My Amazon.com order came in, my new nighttime reading is Walking Out on the Boys, a true story written by Dr. Frances Conley about her days as a neurosurgeon at Stanford and what lead her to resign from her tenured faculty position.

Time flies

I'm in disbelief that there are only 6 more days of class in my first quarter of medical school. Does time really past that quickly? Will I really have learnt 1/6 of what I need to learn before starting clinical rotations (answer: no, they take it easy on students during the first quarter!). I still haven't figured out an adequate schedule, a way to continue running, to study effectively, to not go crazy but also not get behind. But, I am enjoying all my classes still, I love getting to know my classmates, figuring out all that there is at Stanford. Stanford is amazing, there are so many opportunities, areas of research, talks, seminars, volunteer opportunities, it will take me at least a quarter to figure out all that is going on here before I can start to hone in on what I would like to work on, devote myself to. Tomorrow I get to learn knot-tying, Saturday I'll learn how to "scrub-in" to surgeries. Now when I look at someone's arm, I can imagine all that lies beneath, but when I look at someone's face I just see it as a normal person would see it. I'm both humbled and nervous that this ability to view the body as a "normal person" does is leaving me, week by week because of anatomy lab. It's getting chillier here in Northern California, but boy do I like it when "chilly" is 50 degrees and not 30!

SketchyMed.com: A Cartoon Guide to USMLE Step 1

This is a shout out to one of my dearest friends, Lilly Zhang, who recently created a website to help medical students prepare for the USMLE Step 1 Exam (giant standardized exam taken at the end of 2nd year). Check it out!!! Let me know what you think!

SketchyMed.com

Oh boy

Med School final exam #3 is tomorrow morning. Up to Bat: Biochemistry, aka Hyperammonemia, Hyperglycemia, Myoglobinuria, Lactic Acidosis, Methemoglobinuria, ketogenesis, Glycogenolysis, Gluconeogenesis are all on the brain tonight! I think I like biochemistry after all, it's really interesting to learn how all the pathways intersect and the ways in which different diseases present (and now I can understand why that is!)

Can you tell I'm having a little too much fun learning all these long funny sounding medical terms?

Did you know?

That double hand transplantation is possible?

...and that it restores feeling, strength and dexterity to each hand? To the point that someone can sew again, drive again, eat with a fork again?

HOW AMAZING IS THAT?! I got to hear about this firsthand from Dr. Dubernard, whose team performed the world's first successful face, hand and double hand transplants. This type of innovation is what makes medicine incredible. He gave people their lives back, and continues to help make people whole again, and he thinks we should be able to transplant any part of the body in the future. His advice: dream.

BreastCancerTrials.org makes MSNBC news

Here's the link to the article, check it out!

Favorite quotes:

"Users joke it's like match.com for breast cancer patients"

"Suddenly I get choices, I have decisions to make, I can decide what I want to do and what's best for me. It's a very empowering feeling," said Valerie Gardner, a user of the site"

"Everything we have ever learned about breast cancer, every advance has come out of clinical trials," she said. "I think that we can very soon see a time when we don't have to worry about dying from breast cancer.""

Monday morning

Hit the alarm 5 times, jump out of bed with 5 minutes to spare, grab a diet coke and race to class. Right now I'm learning about diagnostic testing for coronary artery disease, how to figure out the most efficient method of analyzing if an individual has coronary artery disease. We're analyzing how initial diagnostic tests impact QALYs (Quality Adjusted Life Years) of a person, life expectancy, including test costs (including the cost contribution of a false negative and false positive test), and cost of downstream treatment based on initial test result.

After this I race off to biochem, developmental biology, learn about the role of a hospitalist at lunch, then 4 hours of Practice of Medicine, learning about cohort studies, psychiatry, and clinical skills on giving information to patients. Then I meet with my advocacy group to discuss how we will incorporate patient safety/quality improvement into the med school curricula, then a townhall meeting to discuss clinical grades, then a study group, then...DINNER!

Spilled Milk

I really liked this story, its written by Jack Canfield and was in the HuffingtonPost today...

"One of the best stories I've ever heard about "spilt milk" and the lessons of making a mess comes from a famous research scientist who made several very important medical breakthroughs. A newspaper reporter once asked him why he thought he was able to be so much more creative than the average person. What set him so far apart from others?
He responded that, in his opinion, it all came from an experience with his mother, which occurred when he was about two years old. He had been trying to remove a bottle of milk from the refrigerator, when he lost his grip on the slippery bottle and it fell, spilling its contents all over the kitchen floor--a veritable sea of milk! (Thankfully, no glass shattered, but the milk kept flowing out like a river.)
When his mother came into the kitchen, instead of yelling at him, giving him a lecture, or punishing him, she said, "Robert, what a great and wonderful mess you have made! I have rarely seen such a huge puddle of milk. Well, the damage has already been done. Would you like to get down and play in the milk for a few minutes before we clean it up?"
Indeed, he did. After a few minutes his mother said, "You know, Robert, whenever you make a mess like this, eventually you have to clean it up, and restore everything to its proper order. So, how would you like to do that? We could use a sponge, a towel or a mop. What do you prefer?" He chose the sponge and together they cleaned up the spilled milk.
His mother then said, "You know what we have here is a failed experiment in how to effectively carry a big milk bottle with two tiny hands. Let's go out in the back yard and fill the bottle with water and see if you can discover a way to carry it without dropping it." The little boy learned that if he grasped the bottle at the top near the lip with both hands, he could carry it without dropping it. What a wonderful lesson!
This renowned scientist then remarked that it was at that moment he knew he didn't need to be afraid to make mistakes. Instead he learned that mistakes were just opportunities for learning something new, which is, after all, what scientific experiments are all about. They are simply that--just experiments to see what happens. Even if the experiment "doesn't work," we usually learn something valuable from it."

Read more at: http://www.huffingtonpost.com/jack-canfield/raise-children-not-flower_b_268607.html

American East

I watched the movie American East last night. It was about a Muslim-American family living in Los Angeles post 9/11. The main character was a widowed father struggling to make ends meet holding down multiple businesses, restaurant owner, taxi-cab owner, hair-salon owner. This movie had a bittersweet ending, and definitely makes you think about many different issues from a different perspective. In all, I really enjoyed it.

Confused and Awestruck

As I am reviewing my lecture notes from my developmental biology class, I am feeling simultaneous feelings of utter confusion and complete awe. I just can't believe so many of us turn out so normal looking, given how complicated it is to make a functioning fetus from an embryo. IT IS AMAZING! We have neural cells that are able to migrate all over us, make up our skin pigment, gut nervous system, eye color. Our heart starts working after 3 weeks and is a single tube that somehow develops into 4 chambers with valves and the rest of our beautiful circulation system. Our stomach actually internally rotates and ends up on our left side even though it rotates to the right first. To top it off, our intestines actually LEAVE our bodies because there isn't enough room to contain all of it and enter an extraembryonic cavity in the umbilical cord before deciding they want in on the party and excitement that is embryonic development.

Seriously, thank your body, it's amazing. Don't mess it up. Treat it well.

3 Things About Today

In my Healer's Art class, the class begins by asking 3 questions, and I thought I would share my responses with you today...What Inspired Me: In my CPR class, hearing Dr. Smith-Coggins talk about the Good Samaritan Laws in California and other states, and then subsequently sharing with us her own views, when she feels that she has a personal responsibility to help, and thinks there is a good chance she can help, she always does so.

What Moved Me: As I was running from the Student Lounge to CCSR, I saw a big, stunningly beautiful bluebird land and perch on a bike rack. I stopped running, admired, smiled, and had to run a little faster the rest of the way to be on time to my meeting.

What Motivated Me: I had an optional Anatomy midterm today, British Style, meaning that you have 15 minutes with a TA or professor and they quiz you. I had the pleasure of being quizzed by one of our professors, Dr. Whitmore, and did well, a "comfortable pass" as he declared, and I'm now happy with my study habits and motivated to learn more anatomy!

How to Save a Life

I get to learn CPR this week! Finally!

A -airway
B -breathing
C -circulation
D -defibrillation

Anatomy Update!

I love anatomy lab. Where else in the world do you get to touch bile, feel gallbladder stones, and sift through the fat apron (more properly coined the "greater omentum")? We're deep into the gut right now, which means I can identify the liver and stomach (if you have a pain on your right side, its NOT your stomach), the many arteries that supply your stomach with blood, and a few veins to boot. I kind of miss working with lots of muscles and tendons...the good old days of the "upper limb". Maybe this is a sign that I should be an orthaepedic surgeon?

Rain drops keep falling on my head...

Today was the first day, in 5 months since my car's convertible roof was slashed that it rained. It really rained. I was soaked to the bone after walking to class from the parking structure. Unfortunately, the inside of my car was soaked too. I guess my waterproofing job didn't quite make the cut...

Oh Freak Out

I love Stanford, I really do. I really really do. But this whole needing to figure out my life sooner rather than later thing--not really feeling it. In fact, at least once a week I plan my entire life to a T, only to realize the next morning that X, Y, and Z probably won't work, plus I have zero real world experience about that specific area of medicine and am just conjecturing. Talk about daily freak outs.

Every mentor, role model, successful person that I've talked with, or read about, has said that their paths have been full of surprises, spontaneity, unexpected turns of events. Well that sure doesn't help me! How am I supposed to plan a scholarly concentration around that? Or figure out what to spend next summer doing? Or decide which PoM project to work on? Bah humug!

But then, time and time again, it is SO TRUE. It's always the unexpected turn of events, the one thing you never would have even thought of. Me work at UCSF after graduating college? Never predicted. Me end up at Stanford? I would have just laughed at you. Me throw the javelin? Now that is just plain absurd.

But I would argue that it's not all chalked up to spontaneity or serendipity. You have to WORK HARD to put yourself in a position where things seem to magically fall into place. It's really about pursuing the scent of your goal. I may not know what my end-all goal is (except that its going to be BIG!), but I've got to use all of my senses all the time to smell it, and then follow that scent like a mad-dog. Just saying, "hmm that's interesting and forgetting about it" is not going to cut it.

So the next time I'm freaking out, you can settle me down by asking what scents I've been liking lately, and what I've been doing to follow them. I would really appreciate being brought back to earth. :)

Quote of the Day

Medicine is Hollywood for ugly people. Every time you enter a room
you're a star.

-hilarious quote by an ER doc just now

Sharing Grief and Honoring Loss

Tonight in my Healer's Art Class we had a conversation about dealing with Grief and Loss. We talked about ways in which we liked how other people have responded to our personal losses in the past...and ways we didn't like very much.

When we deal with grief or a loss, a lot of people tend to intellectualize it, devalue the loss, be in denial or ignore the loss, we get angry, we blame people, we rationalize it, we spiritualize it.

A lot of times we try to be helpful when someone else experiences a loss by saying things like "it's going to be okay", or asking if there's anything we can do, or giving advice, or filling up air space by talking. But really, most people probably just want a show of compassion, a hug, and someone to really listen to them.

This class is a really nice change of pace from my other classes (Quick what are the symptoms associated with 45, x? Trisomy 21? What are the steps of fertilization? Which one is the ulnar nerve again?!), and helps me think about some of the issues I'll be dealing with regularly. As it was put tonight, this class is prophylaxis against the transition from the precynical years to the cynical years...I also love my small group, a lot.

Update:
Here is the quote we were presented with at the start of our session: "The real voyage of discovery lies not in seeking new vistas but in having new eyes" -Marcel Proust

Ways Med School is Making Me Crazy

• When I eat, I now think of the TAC cycle, ETC, and fatty acid synthesis. Fatty acid synthesis is bad news.
  
• When I run, I think about oxygen, hypoxia, and all my muscles of respiration
• When I type, I see my extensor carpis and extensor digitorums moving on the back of my hand.
  
• I now check people to see if they have a palmaris longus, and wonder which people I know have a 3-lobed left lung
• When I cook, I look for the nerves and blood supply in the chicken or meat
• When I bowl, I complain that my interossei and lumbricals are sore
• When I sleep...oh wait, I don't really sleep.

I'm sure this list will get longer!

Bowling

Last night I went bowling at Palo Alto Bowl and it was a ton of fun. For not bowling in 3+ years, I did pretty well. 4 games in an hour, and I scored 115, 166, 149, 148. For the second game I actually bowled a "4 bagger" which means I threw 4 strikes in a row! It was awesome! If I could get a spare for the life of me, I might have been over 200 that game. However, my left lumbricals, doral and palmar interossei, flexor carpis and extensor carpis are quite sore today after all that bowling!

Quote of the Day

The most important thing to remember is this: To be ready at any moment to give up what you are for what you might become.

~W.E.B. Du Bois

Q1 Begins!

With my mini-quarter now complete, I am diving into my first "real" quarter of medical school. Here is how my class schedule is shaping up so far:

Biochemistry
Medical Genetics
Developmental Biology
Practice of Medicine
Anatomy
Costs, Benefits, and Risks of Health Care
Healer's Art
PALS

It's a jam-packed schedule, but I'm excited about all my classes. There are also several lunch time seminars I'll be sitting in on, including Intro to Surgery, Intro to Internal Medicine, and Intro to Emergency Medicine.

Also, another ANATOMY UPDATE:
You can now quiz me on the thorax and upper limb. So basically the hand, arm, shoulder, heart, rib cage and lung. I know how to test if you have carpal tunnel syndrome, whether your dislocated shoulder caused nerve damage, and make sure you have a corotid pulse.

My Evolution into an AM Runner

It's come to this. I have finally given in to the pervasive idea that only by running in the morning can you ensure you will get a run in. For the mini-quarter I attempted to run after class, to workout at the gym at night, to run once I got home. Fail. Fail. Fail. If it ain't working, change it. So this morning I woke up, went for a light run, and voila, I fit my run into my day, before my 6 hours of class, before the evening OB/GYN interest meeting, before the interventional cardiology lunch time talk. I ran, I feel great, and I'm happy.

I also realized that it's not so much that I don't like running in the morning, it was pleasant today. I just HATE getting out of bed in the morning. There is nothing more satisfying then hitting the snooze alarm 10 times to me. This too can change, and today I only hit it twice and was out the door by 7:30. Desperate times call for desperate measures. I will only do well in medical school if I run regularly, thus my entry into the world as a newly minted AM runner.

Novel H1N1 Virus

Today I learned how to give a flu shot, I vaccinated someone and got vaccinated in return (with the seasonal flu vaccine). I learned a lot about the Novel H1N1 Virus. Right now the US government is prioritizing vaccination to certain groups who are at high risk. It appears that most of the public health community is on alert, ready to start vaccinating as soon as we get enough of the seasonal flu vaccine and the novel H1N1 vaccine.

Here at Stanford, all 1st and 2nd year medical students are being enlisted to vaccinate the entire Stanford community, all 30,000 or so that want the vaccine. I will let you know how it goes once we get started.

I also learned of the 3 key signs of influenza-like-illness (ILI): people must have a fever, and they must have either a cough OR a sore throat. If you're worried about catching the flu this year, stay away from people that cough (within 6 feet of them and you'll probably get the virus), and wash your hands regularly. Most importantly, don't touch your face! The best resource if you're concerned is the Center for Disease Control's website. They have weekly updates and more than enough information.

Survived Exams

I'm still alive. And I think I passed!

Sent from my iPhone
-Julia

Hey Mom, Look What I Can Do!

On Wednesday in my Practice of Medicine class we learned how to:

• Draw blood
• Give a PPD (TB shot)
  
• Give a shot into the muscle (IM injection)
  
• Measure blood pressure
• Measure glucose levels

I feel so doctorly after learning all of these, I love it! I practiced on my fellow med students, and in turn they practiced on me. It wasn't too bad at all, besides the fact that getting an injection of sterile water into the skin really stings. Please don't ever do it.

Limited time offer: Free blood pressure screenings for life to the first person to buy me my very own sphygmomanometer.

Anatomy Update

As you can infer from my previous posts, I really enjoyed the first few anatomy labs. Then came our past lab on Tuesday. In this lab, we needed to turn the cadaver over so we could access the back, and investigate the trapezius and latissimus dorsi muscles and various other things. I was very disturbed by the act of turning over our cadaver. For some reason, seeing the legs, seeing the body so lifeless, and needing to put so much force into moving it, made me acutely aware of what we were doing, that this was a real person. A person who walked, talked, maybe ran, told jokes, worked, had a family. Up until this point I have been able to trick myself into thinking of the corpse as a "cadaver", as "it", as a thing to be investigated and explored. At lab on Tuesday, the last thing in the world I wanted to do was explore. I think another part of it is the fact that we had to cut through so much skin. The last few labs we have been deep in the thorax, its much easier to dissociate from the humanness of the cadaver when you're holding their insides, and seeing organs in ways you never saw before. Skin is something very human and real, and I think I struggle most when I have to cut through the skin. I'm very grateful to have this opportunity, and today I was fine during anatomy. But I think I like working with living people a whole lot more than I like working with dead people.

Quote of the Day

"It's like studying human behavior in a burning building"

Dr. Brown on why it's bogus that so many of our cell culture studies are done in serum, which is cells taken from clotted blood, and is chosen so exactly because it is basically the universal signal for cell growth, and is something that normal cells almost never see.

A Startling Assertion

Dr. Krasnow finished his lectures today with the following statement:

"You now know more about molecular biology of disease than all the physicians you will work with"

Subsequently he encouraged us to take the lead in asking the difficult questions that link clinical presentation of disease to its molecular mechanism and cause.

Kind of awesome. Good thing I'm studying hard!

The Dish

The Dish is a 4 mile trail on the outskirts of the Stanford Campus. From the southern entrance, it is characterized by the Never Ending Hill, the Glorious Downhill, and the MoJo Hill (as named by yours truly). You can find deer (as we did today), lots of squirrels, bluejays, hawks, snakes, and mice.

The Dish owns me. It is a tough run, but I feel like each week I run it, I'm tackling it a bit more than it is tackling me. I thought it could be entertaining to share some of the thoughts that crossed my mind during my run this morning...

While conquering the Never Ending Hill:
"Kill kill kill the hill. Shoot, I think my chest is tight, maybe I have hypertrophy of my left ventricle. It would really suck to have a heart attack right now. Better be safe and walk. The nurse checked my heart the other day but I don't trust her. How can I weasel my way into an ECG? Maybe some cardiovascular studies need healthy volunteers. Need to check into that. Oh stop being a wimp and just run.

While coasting on the Glorious Downhill:
OMG is that a hawk? Nope, just a rock. Wow, I'm seeing things. I hope I don't have a retinoblastoma. Nah I don't. Downhill is my favorite, I love running, I feel so free. Oh shoot, there's the steep hill. Why am I doing this again? At 8:30 in the morning? What is wrong with me? Whatever, I can do short hills, just nail it.

While climbing the MoJo Hill:
Get your mojo. Go mojo go mojo go. Almost there, last hill. I love the last hill. I'm owning this. BOOYAH.

Today: 3 Firsts

1. Took my first patient history ever (I heart the Pacific Free Clinic)

2. Did my first blood draw ever

3. Chased by ferocious dogs on a run for the first time ever

Veins, Ventricles, Arteries, Oh my!

Are you a future cardiologist or cardiothoracic surgeon? If so, the following terms will just slip off your tongue... Today we got to cut through the heart, see the valves (amazing!), cut through the veins and arteries, saw through the rib and clavicle. A little gruesome, but an incredible learning experience. I now give you permission to quiz me on any of the following terms:

Left subclavian vein
Phrenic nerve
Thoracic duct
Coronary sinus
Atrioventricular Node
Mitral valve
Right internal jugular vein
Left common corotid
Great cardiac vein
Atrial appendage
Papillary muscles
Hemiazygous nerve
Brachiocephalic Trunk
Circumflex
Tricuspid valve

It's like learning a new language! I love anatomy.

Asha Medical Foundation

This evening I had the good fortune to listen to a talk by Dr. Kiran Martin, the Director of the Asha Medical Foundation, which is an organization that delivers health care to slum communities in India. Dr. Martin is a remarkable woman, she speaks with passion, has a clear understanding how to get results, and is motivated to make the most impact possible. She challenged all of us in audience (as we enjoyed the delicious Indian food), to do more to improve situations of those less fortunate than us. She spoke quickly, so I'll have to paraphrase her challenge:

"You can be the people with the inspiring vision, the credible vision, the moral authority. You can use your gifts to see that the shame of child poverty will not have the last word. This is my challenge to you"

In the last 21 years, Asha has been successful in creating a sustainable model that is not expensive, but gets results. They train community health workers (selected by those in the slum community) to do the majority of the medical work, health prevention, promotion, mid-wifery roles. They connect the communities to excellent referral systems to meet with medical specialists when needed, and focus efforts on education folks to take an active role in getting clean water, electricity, housing rights, sanitation for their community.

You can learn more about ASHA here.

Russian Ridge Hike

Natalia, Anne and I went on a hike in the Russian Ridge Open Preserve late this afternoon. It was awesome! We could see the Pacific Ocean, a panoramic of Stanford, and all of the peninsula. We saw a cute little mouse too.

Fresh produce rocks

One of my favorite things about living in Northern California is the fact that every weekend there are Farmer's Markets, overflowing with a variety of fresh cheap produce from the Central Valley. It is so much fun to go, try the samples (I had a pluot for the first time today!), and then come home and make some deliciously fresh and tasty lunch. Sarah and I pulled together a really tasty grilled chicken salad today with fresh lettuce, carrots, and heirloom tomatoes, we topped it off with strawberries for dessert. YUM!

For those who have never seen or heard of a pluot before, it's a cross between a plum and an apricot and is really tasty!

Stem Cells, Humans, and the Importance of Local Neighborhoods

I had an epiphany as I was sitting in my Cells to Tissues lecture earlier this week... See, when you learn about what goes on inside a cell, you realize that almost all stem cells have the same DNA inside of them, which means that technically they could be any other type of cell. What makes a stem cell unique is the environment it is in, its niche. There are certain characteristics of niches that turn on certain genes to make certain proteins, which makes a blood cell a blood cell, a skin cell a skill cell. We're realizing that we can manipulate the environment of the cell and change cells into different types of cells, which will no doubt lead to amazing therapies in the future.

So as I was sitting in class, I realized that if our cells evolved to be changeable and malleable, it reasonably follows that this could be very helpful too humans too. If you were to clone me, and put the two me's in two very different environments, families, ways of living, you would probably get two very different me's. In terms of my goals, values, beliefs, I would bet they would turn out to be much different depending on which "niche" I was put in.

Just like a blood stem cell differentiates into certain types of cells depending on which part of the bone marrow neighborhood its in, I think by and large we are who we are because of our local neighborhood, our families, communities and where we grow up.

H1N1 Rap

Awesome doc rapping about H1N1

Vintage Book I Want:

The Cell in Development and Inheritance.

Written by Edmund Beecher Wilson in 1911. He was the first person to recognize and understand that tumor cells have abnormal chromosome divisions by looking at cells under a light microscope. He's really the founder of cellular biology, and we still use his concepts and basic findings ALL the time today. How cool is that? I think this book would be a nice addition to my small but loved collection of old books, including a recent find at the Mt. Zion Medical Library earlier this spring (a copy of William James' seminal work in psychology, "Principes of Psychology").

Insane in the Pericardium

Today I cut out a human heart, and held it in my hands. I've never felt like I was on more hallowed ground. Very few people in the world are granted this opportunity to study true-life forms for the sake of some day hoping to save and improve the lives of others...Most people whose blog posts start with, "today I cut out a human heart" would be marked as serial killer status...Seeing the real deal makes me so motivated to study and make sure I know everything inside and out. It also makes me realize that our bodies are amazing, sophisticated rockstars.

Things I learned about the heart:

• It's big! At least in most people, its bigger than my hands folded together. One cadaver had a super tiny heart
• It can have things in it! Our cadaver had a pacemaker going through the superior vena cava
• Everything that surrounds it (muscle, pericardium) is very strong

I also ran intervals today: 800, 400, and 3 200's. It's a start. I will not divulge my times because they are embarrassing. But on the bright side, the Stanford track is beautiful!

PS. Follow me! I added a "Followers" gadget to the bottom right hand of the screen.

Hearing More than a Hearbeat

Check out this article (I'm quoted in it!) from Stanford School of Medicine about our recent Stethoscope Ceremony. The video is great too, it features Katherine and Duy, who were both on my SWEAT trip.

Update: For those too lazy to click on the link, here's my few sentences of fame:

“It’s a wonderful gift to receive as we’re starting out,” said Julia Pederson, 24, one of the new students who immediately took her stethoscope out of its box to listen to the heart of her 10-year-old sister, Abbey, sitting next to her at the dinner table.

A Harvard biology major, Pederson has spent the past two years working at the UC-San Francisco Breast Care Center helping to facilitate decision-making between breast cancer patients and their physicians. That work set her on the course to becoming a doctor.

“A lot of times I was working with patients when they were first diagnosed with cancer. It’s a time when people are so vulnerable,” Pederson said. “Making them feel like they are getting the best care they can helps with that fear and vulnerability. Being that first line of support is an awesome thing.”

Gross Anatomy

I hate the smell of anatomy lab, but I love anatomy. It is so novel, I do something new and learn so much each time. For example, today I sawed through the ribs, cut through arteries and veins, and held lungs in my hands (my double gloved hands, thanks to Naila's advice).

...Sure I cut off part of the lung that I wasn't supposed to, nicked the outside lining of the heart, and had to re-saw through the bone because I didn't cut it all the first time, and keep calling the internal thoracic artery the internal thoracic nerve, but that's the fun part, and now I know better. I am so thankful for this unique and slightly nauseating experience. The 3-hours in anatomy lab fly by, much faster than any of my other classes (though I'm enjoying them too).

Given my kindergarten-like cutting skills, and lack of knowledge of anatomy, I am even more impressed at the surgical skills of some physicians. How some doctors can do a heart bypass by integrating the internal thoracic artery into the heart is beyond me. Infathomable. Beyond belief. But I will get there. One day.

The Weight of Med School

Today I felt the weight of med school. It's just day 3, but we had class 9am to 6pm straight with just an hour for lunch (and an optional review from 7-8:30 that I decided to postpone until Wednesday)

Now I come home, hungry and dazed, with a plate full of studying ahead of me. Oh and preparing a journal club presentation for tomorrow (another day of 9am to 5pm straight class, followed by as much studying as I can handle in the evening).

It's a lot. I'm doing the best I can to review each day's material and prepare for the next, but I can already tell that it will become overwhelming fast, and this is mostly review material for me!

I'm going to do the best I can, and hopefully just hang on. Most importantly, I think running every day after class will really allow me to relax and clear my mind before another night chalk full of studying. Anyone with tips for remembering the development stages of erythropoeisis, please send them along!

My place

My apartment is almost set. I really like how it's turned out so far.
Here's my living room:


and my workspace:
I still need to frame a few photos, clean up the dining room, and tidy up, but then it will be set!

Stethoscope Ceremony

Tonight I received my stethoscope and recited the Stanford Affirmation with my class as my official induction into medicine.

Here is an excerpt of the Stanford Affirmation:
"On my admission to the Practice of Medicine I pledge to devote my life to the service of humanity. The care of my patients will be my first consideration.....I will hold all life dear, and let knowledge, wisdom, courage and compassion guide my therapy. I will use my medical knowledge to promote human rights, social justice, and civil liberties...."

It was a wonderful evening and I'm so happy my family was able to be there. As I dive into my first preclinical year, full of molecular biology, genetics, and basic science courses, I hope to remember why I'm here, all the women and families I worked with at the BCC, and hope to begin to personify the quote Dr. Probe gave at the end of the night...

Cure sometimes
Relieve often
Comfort always

First Day of Medical School!

It's been a long time coming. Today was my first day of medical school. It was interesting, fun, and not too overwhelming. Anatomy was interesting. My cadaver had cancer, I know because she has a port in her for chemotherapy delivery. I took the first cut, from the manubrium all the way down to the xiphisternum, one clean cut. Dead skin is not my favorite thing in the world, in fact, it might be my least favorite thing next to fat and fascia. I love muscle, and finding the long thoracic nerve, (stems from the brachial plexus and innervates the serratus anterior) was really neat. As for reflections, It struck me that I will learn more this year than I can possibly comprehend, my synaptic connections might triple. I'm really thankful Stanford is pass/fail. Tomorrow is my first histology lab, we'll be using microscopes to look at bone marrow and blood cells.

In other news, I FINALLY went for a run today. It was tough, not because I was going fast, but because I'm so out of shape. I am definitely going to run every day during med school, I think it's the only way I'll get fresh air.

PS. After vigorous hand washing and a long shower, I still smell like the anatomy lab.

Pearls of Wisdom from the 3rd and Final Day of Orientation

"Whenever I see a medical student on the wards cry, I am delighted because I know this means they will be a wonderful physician" -Abraham Verghese

"To be a good physician is to walk in your patient's shoes as best you can" -AV

"It means you haven't yet transitioned from your precynical years to the cynical years" -AV

"Don't be afraid to look stupid now, it's bad to be stupid later" -Gill Chu

Regarding the Health and Human Disease course: "You gotta be encyclopedic about medicine"
___
Tomorrow is officially my first day of medical school. I have a full schedule starting off with Molecular Foundations of Medicine, moving on to Cells to Tissue, and then finishing off the day in anatomy lab. I will do my best to follow Gill Chu's 3 pieces of advice:

1. Your first obligation is to yourself
2. Your second obligation is to your patients
3. Ask for help and get in the habit of asking for help because you never want to wing it on the wards.

Wish me luck!

Orentation Day 2 and a new theme: Stay Focused

One of today's themes at orientation was Academic Development. Stanford is really cool in that there are so many options and areas for academic development! Lauren Baker aptly described Stanford's resources when he said "it's like there are $20 bills lying all around everywhere all the time!". Exciting and overwhelming. Hmmm, this sounds like a repeat of Harvard undergrad.

The difference is that this time, I'm focused, and my theme is to stay focused. Professionally, I am starting to visualize the path through the forest of how I would like to spend my time here at Stanford. My primary goal is to become the best clinician I can be (duh). My secondary goal is to set myself up with the skills and knowledge to become an effective and innovative leader who can help make health care dramatically more patient-centered, safe, and efficient.

Here's the sketch of my plan:

The next 2 years: Work really hard to do my best during the pre-clinical years. Take many surgery electives, shadow many doctors, and look out for really innovative and inspiring physicians who could potentially be mentors, teachers, and advisers. Try to get involved in some kind of project by next summer that has a clinical focus, and work on a project the summer after that has a healthcare delivery focus. And can't forget the biggie: definitely rock Step 1 of the Boards.

3rd year: Go to the Business School to try to understand organizational behavior, ways to implement systems-based change, learn from other industries how we can make healthcare safer and perform at higher levels. Recruit all the b-school kids into health care reform and innovation.

4th and 5th years: Complete my clinical years, figure out exactly what type of medicine I find most fulfilling and want to practice. Work hard to hone my clinical judgement skills, work hard to make sure the folks I care for receive the best care for them. Actually be able to answer some of my family's medical questions.

This outline is really growing on me, and I see how I can make it work. We also had an Amazing Race all over campus, watched a really thought-provoking documentary called "Hold Your Breath" and then had a great dinner at Bucca de Bepo in downtown PA....I can't wait to see what our 3rd and final day of orientation will bring!

Best Advice of the Day

How to do well in med school:

1. 20 minute prep: Before the first day of every class, do a 20 minute review of the class. Review the syllabus, books, etc, determine what you will use and how you will study.

2. 20 minute closure: After the completion of the last day of any class you take, set a timer for 20 minutes and annotate your First Aid Review book.

3. Use the 2nd years: Ask 3-4 second years how to approach the class before you start it to get the inside scoop on study strategies and level of difficulty.

4. Q&A Blitzing: Each week, write 8-10 questions you think will be on the test. Meet once a week with a group of unlike-minded peers and blitz each other.

This advice was actually handed out yesterday afternoon, by learning specialist Sue Willows. It was too good not too pass on. I will do my best to follow it!

Reflections on my first day

In the morning, Dean Pizzo welcomed us to Stanford Medicine. He put our year in perspective by pointing out that 50 years ago, the year that Stanford Medicine moved to Palo Alto, the structure of DNA had been elucidated only 6 years prior, the polio vaccine discovered only 3 years prior, and now, our class will be the last to have courses in the old medical school buildings. He also shared several pearls of wisdom that I really appreciated:

1. "Bring the glow back"
2. "Become a champion"
3. "Make the U.S. number one"

1. In reference to his urge to preserve the moral high ground of physicians in the face of good clinical care and compassion competing with financial gain.
2. Ie. find your passion and pursue a path of medicine you really care about and want to improve
3. Improve health outcomes so that the U.S. is number one in more metrics of health care besides administrative expenditures (currently the only thing we are number one in).

Next came Dean Prober who gave a Top 10 list of reasons why we made the right choice to attend Stanford. My favorites included #10 (Geography) and #1 (Your Classmates). My 85 classmates (whose names I'm trying hard to learn!) are pretty cool folks, 20 countries are represented, 8 have PhDs, 12 have Masters degrees, 8 other were varsity athletes in college, and besides the stats, everyone I have met so far has been very genuine, interesting, and engaging. I think Dean Prober nailed it.

I feel so honored to be apart of this community and anticipate that medical school will change me in more ways than I can possibly understand at this moment. As I went to bed last night, I was thinking about quotations that encapsulated how I want to approach my education, here are a few that came across my mind:

"We are what we repeatedly do"
"Learn from others, learn from your mistakes, keep moving forward"
"Always do what you are afraid to do"

And, of course, my biggest focus: "Become the best damn doctor I can possibly be".

PS. What do you think of my new look?! :)

Medical School Orientation Starts Tomorrow!

Here I am, 1:30am, too excited to sleep the night before my first day of med school orientation. The theme tomorrow is "Leadership and Service", we get breakfast, lunch, and dinner, along with Welcomes and Introductions, a talk on "Advocating for Change", and a round robin discussion about community health and the Cardinal Free Clinics, with logistical stuff interspersed throughout the day.

I can't believe this day is already here. So much has happened in the past month since I finished my job at UCSF. I had a great week in Chicago, regrouped in Southern California, successfully moved in to my own place, and went on a 3-day hiking trip with other new medical students. The hike (SWEAT trip) was beautiful, we were in the Stanislaus National Forest, north of Yosemite and camped at a gorgeous lake (which I swam in!) for 2 nights. I really loved all the other folks on the trip and look forward to getting to know them better over the course of the year. Abbey and my Dad, and now my Mom too, have been helping me move in and get situated, which has been really helpful. I just need to get my internet installed and I'll be really set.

So, short story, I start orientation tomorrow and I'm stoked! And for a taste, here are two photos I took on the SWEAT trip:

BBQing up a storm

Scallop kabobs, chicken kabobs and corn on the cob. My mouth is
watering just looking at them!

UCSF Decision Services in the Wall Street Journal

In today's Wall Street Journal you can find a great article on the UCSF Decision Services program. The article, Weighty Choices, In Patient's Hands, delves into how and why providing patients with information and decision support, like the program I was apart of for the last 2 years can be better for all parties involved. There is even a photo of one of my very good friends, Alexandra (Jay) Teng, doing part of the service. Glad to hear this great program is finally getting some publicity.

Stir Crazy's famous banana wonton dessert!

YUM!

Quack Quack!

Saw this little guy at the Chicago Botanic Gardens today.

Quote of the Day

"The key to happiness is to own your own slippers, own who you are, own how you look, own your family, own the talents you have, and own the ones you don't. If you keep saying your slippers aren't yours, then you'll die searching, you'll die bitter, always feeling you were promised more. Not only our actions, but also our omissions, become our destiny."

From Cutting for Stone, by Abraham Verghese, the book I'm currently reading.

Watson's Drugstore for lunch

My Grandma and I just had lunch here at Watson's in downtown Orange.
It first opened in 1899!

Shopping in Santa Monica with Amy!

My very own place

It's official, I have my own place! It's a cute little 1-bedroom in Menlo Park, a little over a mile from the med school campus. So exciting! Not only is it my own place, but it has great amenities like a dishwasher and garbage disposal and laundry on-site. I'm super close to bike trails, downtown Menlo Park, and there's a Starbucks around the corner.

Menlo Park has a great history, rich in Irish heritage. It was founded by two Irish settlers in the 1850s. The word "Menlo" comes from their town Menlough, from County Galway, Ireland. County Galway is just south of County Mayo, where my relatives immigrated from. So you know I'm living in a good neigborhood, stepped in Western Ireland tradition. ( I heart wikipedia for making all of this information easily available!)

The weather is always beautiful, lots of hiking, a great golf course and I will definitely have room for visitors, so start planning your trip!

Goodbye to the BCC

Friday was my last day working at the UCSF Breast Care Center. It has been an amazing two years. I helped launch a national nonprofit website, BreastCancerTrials.org. I supported 68 women through difficult appointments and treatment decisions. And most of all, I learned so much from the amazing physicians, clinic staff, and all of my colleagues. These folks in the picture above have become some of my closest and dearest friends and are going to do amazing work in the field of health care and medicine. No doubt about it. The photos below are of me with my lovable supervisor and the BCT queen, Elly Cohen, at the AVON walk and me with my mentor and role model, Laura Esserman, the woman who makes this all happen... I have no doubt that the BCC has left a lasting impression on me and I look forward to doing the best I can at Stanford with such enjoyable and meaningful work under my belt. I may be leaving for medical school, but the BCC will always hold a very special place in my heart.

My Intern Presentation

2nd year of BCC Interns

First year of BCC Interns

Winding down at the BCC

I'm in my last week of work at the BCC. It has been an eventful and fulfilling two years and it's still a bit surprising to me that I only have 4 days of work left! I invested a lot of myself into my job, and I'm proud of my contribution. As I train my replacement, I realize how much I really learned. It humbles me to think about medical school and the pace at which I will be absorbing new material and subjects. As with most of my experiences, my favorite part has been all the wonderful and unique people I've had the opportunity to work with. I will miss the interns, my colleagues, supervisors, and the patients I worked with so much! Fortunately I'm just a drive on the 280 away. :)

SF MOMA

Yesterday I went to the SF MOMA with Amy and Hannibal to see the Ansel Adams and Georiga O'Keefe Exhibit, which was fabulous. Here is one of my favorite of Georgia O'Keefe's work that I had the pleasure of seeing first hand:

Quote of the Day

"Never forget that as physicians, we must always be advocates for our patients, not our specialties."

-Laura Esserman 7/6/2009

Regenerative Medicine

Imagine the world when we don't need organ donors.
Or prosthetics.
When organs invaded by cancer can be regrown/replaced with new organs.

How cool will that be?

I just watched a TED talk by Alan Russell that completely inspired me and made me see the potential for regenerative medicine. He asks, "if newts can regrow their limbs, why can't we?". He also showed powerful examples of how we already use regenerative medicine today.

The best thing about this is that Stanford is building the largest Stem Cell and Regenerative Medicine Center in the NATION and is doing their best to recruit the top-notch scientists from around the world to be part of the team. HOW COOL IS THIS?

We can't regrow limbs, replace cancerous organs, or completely repair heart damage



yet.

Clinical Reader

I'm trying to find an easy way to stay updated on recent medical news, events and publications that I should be aware of. I found Clinical Reader, a website that allows you to review all the major journals and also summarizes what they consider to be key findings. Let me know if you have better ideas or websites that you use or are aware of!

Must Read Author: Nevada Barr

A good friend recently clued me into the mystery author Nevada Barr. She writes amazing mysteries that are based in national parks and other scenic places. Her protagonist is tough-nosed middle-aged ranger Anna Pigeon. I finished High Country a few weeks ago and I couldn't put it down. I'm about to finish Ill Wind, another great read. I love the fact that she writes with such vivid imagery and gripping story lines that I can't wait to turn the page, but at the same time love to take in her amazing talent of describing the scenery, air, and feel of the location. These books are great for nightstand reading, beach reading, and definitely awesome if you're traveling. May be a bit scary if you're camping...(I am speaking from experience!)

Bluetooth!

Thanks to Andrea, I now have a bluetooth headset! This is so great! It means I no longer have to think up contraptions for holding my iphone while driving! This combined with the voice activation feature of the iphone 3GS is just ridiculously cool.

Quote of the Day

"It is better to have enough ideas for some of them to be wrong, than to be always right by having no ideas at all." -Edward De Bono

Quote of the Day

"The height of your accomplishments will equal the depth of your convictions."

Travel travel travel

It's so much fun! I have lots of photos to post from my last two weeks, between Hawaii, Seattle, and Canada. Rest assured it's been a blast. Most recently, on our ferry ride to Vancouver Island we saw baby orcas breaching, a bald eagle soaring right before us, and seals sleeping. On my run this morning I saw a little sea otter playing along the the shore. And of course, the vespa ride! It's been awesome to spend time with Nicole, Grandad and Laurie. I just wish I was staying longer!

Crossing into Canada

Enjoying the Peace Arch park.

Seattle

Good News!

On my last day in Hawaii, I got a phone call from the Dean of Admissions at Stanford Medical School letting me know that I was accepted!

I'm still a little in shock, what good news! Go Stanford!

And a fitting quote...

"I'm a great believer in luck, and I find that the harder I work, the more I have of it."

Thomas Jefferson

Happy Graduation Jon!

What a birthday extravaganza!

It started with a filling homemade breakfast courtesy of my Grandma...


Then, I decided to take advantage of the "Get in Free on your Birthday" deal offered by Disneyland...


With my 81-year old Grandpa. Yah that's us standing in line for Splash Mountain.

And we rode Space Mountain and the Matterhorn too (and many more!).

And then more family came and celebrated on Saturday.

I'm officially spoiled. Thank you to all!

Thanks!

Thanks for all the wonderful birthday wishes yesterday! I had a fun day at Disneyland with my Grandpa, and my Grandma spoiled me with a birthday breakfast and steak dinner! I will try to post photos of Disneyland on Monday.

Pizza Party!

Last night I had a pizza-making party to celebrate my 24th Birthday! I was so impressed with everyone's creativity and pizza-making skills that I have a few awards to give out....


Most Traditional: Kevin won the award for most traditional pizza, hereby called the "Kevin" pizza.

Most Unique Combination of Ingredients: Meghan won this award with her brilliant combination of apple, celery, and brown sugar toppings.

Most Creative: Hannibal and Jay won the Creativity award for their stuffed crust!

Troopers of the Night: Melissa and Audrey won the Trooper award for helping set up, slice and dice, and still making delicious pizzas!
Trailblazers: Amy, Eugene and Rajiv won the TrailBlazers award, for making the first pizza of the night!

Most Perserverence: Abi and Jay won the Perserverence Award. For making these two delicious pizzas even though they were already both stuffed!


Best Secret Ingredients: Yiwey won the award for best secret ingredients. He made a Hawaiian pizza with Spam and Pineapple!Thank you so much for everyone who came and were such good sports and fantastic chefs! I had so much fun and I hope you all did too.