A Look Ahead

To all 2 of you who read my blog, i'm back :)

Since I last wrote, I've finished up basic pathophysiology of a few more organ systems (let me know if you want to know how to do a digital rectal exam), taken a few more tests, crammed for a cumulative exam that determines whether I can go onto clinical rotations or not, and generally enjoyed learning medicine.

On a personal note, I've been hanging out with 2 and 3 yr olds on sunday mornings, which has been tiring, humbling, and fun. They remind me how little plasticity my mind has, and that's been pretty depressing. I've also gone on a retreat, learned some things about faith, and read a few good books, seen some family.

Importantly, I've missed writing (don't worry though, I've got something big cookin' and I promise I will unveil it when the time is right) and I'm enjoying the down time and the freedom to just sit and write when I want to. I promise to write more, but for now, here's a short peek into my next few months, for all of you I've accidentally (or not) neglected.

Now - 12.25.09 - Houston

I will be in town tying up some loose ends, writing, reading (let me know if you want a good book suggestion), working out, and generally reflecting on Christmas without trees and stockings. Scintillating, I know.

12.26.09 - 01.01.10 - St. Louis

Going to STL for a few days to hear about all the different things God's got going on in the world. I still don't quite know how I feel about all of it, especially because I hear that it's a lot to take in. We'll see. I'm going to try to make a vlog about the trip to give me some perspective so keep an eye out for that. I'm also thinking about running under the arch in STL - the only thing that is noteworthy in STL, from what I've heard so far - but I'm scared I will freeze my butt off. Maybe I'll coerce someone into doing it with me.

01.02.10 - 01.03.10 - Houston

Recovering, watching Texas lose to Bama in the title game, getting my "student-doctor" game face on

01.04.010 - End of February - Texas Children's Hospital, Ben Taub General Hospital

Starting my first clinical rotation (!) in pediatrics. I will get a chance to see the coolest, and perhaps most annoying, sides of kids. But I am pumped to get out of the classroom and wear my far-too-short white coat and walk around with instruments I don't know how to use yet. And I'm still keeping on open mind about what I go into, so we'll see.

I'll cook up something semi-interesting to post before I jet for STL. Until then, I hope this entry finds ya'll well.

A Month of Music

In the last few weeks I've had the privilege of hearing some quality music live: not only did my boys Rick and Peter come through Houston, Snow Patrol also made a stop in on their 2009 tour as well. Solid.

Lyricks & Manifest: 09.25.09

New Life Fellowship

I've been following Rick (Lyricks) and Peter (Manifest) for a while now, ever since my brother showed me their youtube clips, so it was a treat to see them at my church friday night. Most people were like "who are they?" and I was running around like a total weirdo all amped about it. For the most part, I think 'christian' is a better noun than an adjective, and tend to be wary of christian rappers, not to mention korean-american christian rappers (sorry, my korean chingus).

But what I appreciated about Rick and Peter is that their faith doesn't seem to overpower their style or get distilled out of it either. They didn't start out as "christian rappers" per say or even really build their craft on top of it; you can tell that their faith was blended into their rhymes as it grew. I'm almost sure that they didn't plan it that way, it gives an organic, textured feel to their rapping, one that avoids two pitfalls at the same time: they don't revolve around money and fame, unlike those of so many modern rappers, and they also avoid a cliched christian feel that tends to crowd individual styles. They definitely carry their own sounds, which you can check out in the link below:

The Gift Remix (generated a lot of buzz for them a few years back):

http://www.youtube.com/watch?v=ZzNL0A6sWLc

On a very brief side note, since we're talking about it, my favorite rappers are essentially Nas and Mos Def. I have to think hard about their lyrics sometimes, and that makes me happy.

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Snow Patrol: 10.05.09

Warehouse Live

Snow Patrol @ Warehouse Live.

For those of you who missed this concert . . . you definitely missed out. As some of you may know, snow patrol is pretty much my favorite band ever, and I really wanted to catch them this time they came through Houston. I missed them the last time (3 years ago!) and promised myself I wouldn't again. And even though I heard all kinds of things about how they are horrible live and give the crowd an arrogant feeling, I was not disappointed. Don't be a hater; Gary has a soothing, affable stage presence.

Gary Lightbody.

A little history: D actually turned me on to this concert through her internet search; without her I probably would have missed this one, found out about it post facto, and then summarily cried myself to sleep. Instead, we got to enjoy a great show - although Plain White T's opened, and that part was pretty suspect - packed into a small venue. We were probably only 20-some feet from the stage, so that was pretty dope.

the blokes behind us, taking in the tunes.

some highlights from the night (besides the company):

* hearing "lightning strike" live, which was glorious. I mean, really. expansive, strong, and glorious

* singing "shut your eyes" with Gary and the rest of the crowd until I lost my voice (see facebook video for more)

* having Gary mistake us for "Austin, TX" and then hearing him apologize profusely by singing "Houston" into some of his lyrics (did not expect that when I bought the ticket)

* getting snow patrol's set list (!!!) and pick, courtesy of D =)

* nabbing plain white T's picks, even though no one really cared about them

If it's possible, I left liking snow patrol even more than I did before. Which is saying a lot, since I once looped "chasing cars" for 3 weeks straight. no joke.

I ❄ snow patrol.

PS - I am framing the set list and pick, in case you were wondering. Come visit and check it out! but don't touch =)

September Update: School

September has come and gone, and it feels like my second year is going by even faster than the first. Things have been busy and it's been hard to find time to write, but here is a snapshot update of some high points over the last month:

School

just finished another round of exams and closed out a block on cardiology, hematology-oncology, pulmonology, and nephrology. Now that things are more clinical, and more related to pathophysiology, I'm getting a better feel for the different fields, what they do, and how much I like/dislike what I see. This is tentative, of course, since I haven't done my rotations. But I decided to weigh in and grade the courses anyway (note: these are the subjective scores I am giving the specialties, not the all-too-objective grades I got in the courses).

cardiology: A

very clean, very intuitive. if you like connecting dots between pressures and flow and volumes, this is a good one. also if you like plumbing. but i think they teach this first for a reason, namely because it's the easiest to get because the pathology is pretty much what you would expect it to be. common sense reigns supreme, and there's not a lot of abstract thinking. to be fair, it can get borderline boring, but there's probably enough patient interaction to get you through the dry seasons, i suspect.

word to describe cardio: clean/pristine.

hematology-oncology: A-

i thought the course wasn't taught brilliantly, but that the material itself was pretty interesting. Once you get a handle on it, it's pretty cool. Obviously things like anemia are common and useful for physicians to know, but even the blood disorders and malignancies have their own charm once you become facile with the terms and classifications. And regardless of taste, there tends to be more variation in patient presentations than other fields, and you don't have to touch pee! (see below) word to describe hem-onc: flavorful/variety-ful.

pulmonology: B

big fan of the way the course was taught, but not a big fan of lung pathology. maybe it's because the pathophys isn't very nuanced, and maybe because treatment seems so broad and general (you seem to hit everything with steroids and/or bronchodilators). i think i'm also bothered by the fact that there is no good screening for lung cancer, so the vast majority of cases end up presenting clinically when it's too late and when their 5-year survival rate is super low. tends to depress and make you feel like you are just trying to keep them alive and functioning, necessarily ignoring degrees of morbidity.

word to describe pulmonology: functional.

nephrology: C-

the kidney can be complicated, and nephrology is mathematical and abstract. there is a certain beauty to it, imagining thousands and thousands of nephrons. but it can also be a headache to imagine mechanisms for parts of one single nephron and then expand that to cover the whole kidney. and then remember there are two kidneys. I have great respect for skilled nephrologists because i think it takes a lot of thought and "art" to practice . . . the diagnoses are heavy on science, the management on art. but definitely not for me - at least at this point - because the feedback loop is so weak. you can treat and manage pts for months/years and see minimal changes (compared to other fields). plus, the main modality is the "poor man's biopsy," aka pee in a cup. I have never met a nephrologist who doesn't have a story about spilling pee somewhere. think about it.

word to describe nephrology: cerebral/abstract.

Designers Accord

It's refreshes me to see people doing some pretty innovative things to promote sustainability with design.

I'm not an expert on this, but it seems pretty obvious that integrating sustainability principles into the different areas of design - at the level of consumption, or somewhere higher in the pipeline, like those of education or production - is no small task. But that's exactly what Designers Accord - an organization in the design community that is trying to "change the culture of the creative community from bottom to top, and with it, the way everything is made, from toothbrushes to airplanes" - is attempting, and from what I read, doing well.

The concept is simple enough: take the wide potential in design, and add an emphasis in sustainability to it. See what happens.

I'm not sure that these efforts will really change the way everything is made (maybe airplanes, don't know about the toothbrushes), but I like the spirit behind it. It seems predicated on the idea that social issues - climate change, social justice, civic improvement - aren't just confined to public or non-profit sectors, that there is a place for those emphases in the creative design, marketing, distribution, and consumption of products. Couldn't agree more.

There have already been some very cool advances; whether this continues into affordable, everyday products and services remains to be seen. But either way, the movement is one to watch.

An example:

Frog Design's lichen-based paint that changes colors with Carbon Monoxide exposure; a simple protective measure to prevent CO poisoning. Using biology to detect rising chemical levels? I like.

image from http://www.fastcompany.com/blog/valerie-casey/networked-culture/case-studies-sustainability-designers-accord-introduction

If you're interested, check out some designer accord case studies - spotlights on companies making waves in the field, hand-picked by fastcompany. check it out here: http://www.fastcompany.com/tag/designers-accord.

Digital Friction

I recently read a great post by Seth Godin about what he called "friction."

Friction, as you might already know, is the force that opposes the movement of a body against another, or as Merriam Webster puts it, the "the force that resists relative motion between two bodies in contact."

Godin's friction is the force opposing the flow of ideas; it keeps ideas and movements from spreading to people and through populations. He gives the example of the friction associated with mailing something by snail mail: the cost of stamp and shipping. He then discusses how there is friction in e-mail also (no matter how free it seems to be). That friction, Godin maintains, is not the physical cost of sending the e-mail, but rather "the cost of all the people you'll lose."

His idea is that if you're reckless with your emailing, people will either be trained to ignore your emails and/or block your address. Worse yet, they might get annoyed enough to badmouth you to others (this would be added friction). He concludes with an operative example of how this kind of friction ruined the movement of Drugstore.com's ideas/products for him:

Drugstore.com made two mistakes with their relationship with me. First, they bought the lie that opt out is a productive strategy. They unilaterally decided that I'd be delighted to get regular emails from them, merely because I bought some shaving cream.

The second mistake? They didn't bother to be selective about what they sent.

I've never purchased diapers online, since my diaper purchases predate online diaper shopping. And my hope is that I won't be buying Depends for another fifty years or so. Drugstore.com should know this. And yet, because it's apparently free to email me, some lame brand manager says, "sure, do it!" Except then I unsubscribe and an asset that is worth ten or a hundred or a thousand dollars disappears, probably forever.

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I think this kind of friction pertains to most group work also. I'll use ministry as my example, although this could apply to student organizations, non-profit work, etc.

If you've ever led a small group or hc you know what I'm talking about. You know the feeling of emailing your group only to get little/no response, to your frustration. You might even re-email with reminders, in the hopes of getting a response. Then you might get one. Or you might not.

While I'm not saying that everyone fails to e-mail back because of this kind of idea friction, I am saying that it has a large part to do with many of these outcomes. Think about it - do you read every event, prayer meeting, donation, update, and church forward sitting in your mailbox, waiting to be opened?

If we're honest, we'd realize that at some point, we condition ourselves not to read the emails from high-volume e-mailers, from people who we know are going to bury us under paragraphs of dreary agenda and/or complicated prose. We could also become so annoyed that we start complaining to our friends about it, leaving the bad taste in their mouths also.

If we struggle with this as a reader, how can we expect anything different from our followers? I know from personal experience the disappointment that can arise when I send out encouragement, reminders, and meeting recap/agendas, and I can tell no one reads them. No one replies, and you wonder if your effort meant much at all.

So as a leader - and as a person who wants to spread ideas and encourage spiritual growth, interest in service work or passion for social justice - remember friction as you email. Choose wisely. Don't email everyone with everything, although in theory it should work. Not everyone is interested in everything, and in reality, most people are interested in less than you'd think. There are other ways - blogging, voluntary subscription to newsletters, in-person meetings - to update those who are interested in what's going on without being burned by the friction of people who really aren't.

I've learned to send directed emails, and to send short emails. I only send them to people who I really think would benefit from them. Yes, it's meant more thought on my part, more editing of the content, and a tough divorce from the idea of sending stuff out on huge email lists. The (wrong) instinct goes something like this: "Why not CC the whole group on this new update or idea? It's free, easy, I can just type their name in, and it's better that they have it than if they didn't."

The truth is that many times it's not better that they just have it, it's actually worse. So my best advice is to be thoughtful and as Godin suggests, recognize and "embrace the friction." The cost of not doing so is too far too high.

A link to Seth's "friction" post: http://sethgodin.typepad.com/seths_blog/2009/09/friction.html

Home Grown

I recently went to Seattle to visit a friend, and I discovered that a good number of people grow their own vegetables in their yards/on their balconies. It's probably not enough to sustain most people, granted; its more a supplemental source of food.

But it got me thinking (and excited) about what I could grow on my balcony back in Houston. I did a little digging, and turns out that this horrendous Houston weather is - despite being so bad for so many reasons - good for something: growing vegetables, including my favorite, tomatoes. The humidity and sun make the environment great.

Roughly, here are the steps I need to take to get this done:

* decide if I will buy the feeder/bins for the plants, or if I'll build my own

* finalize the list of things I want to grow

* get smart about how to take care of those vegetables

I am open to ideas, or help, or even co-gardens if some of you want to "invest" a few dollars and share in the "profit."

More on this later.

The Road Home

Charles straightened, stretching his back and letting out a brisk sigh. Craning his head upward, he rubbed his neck in deep circles. His memory of the last few days were like the mile markers streaking into dirty green across the windshield, blurred and patchy.

After the offer was made, he’d packed his things and gotten the rest of his business in order: Letters were written, gifts were bought; he had even remembered to change mailing addresses and cancel his classes. He’d even had a few meals with friends.

But on the road now, he didn’t know how to feel. Tinges of sadness and regret lingered; the imprints of hope and possibility too. There’d been pressure from parents, and from within, followed by waves of doubt and uncertainty. But their memories seemed to flutter over his mind only briefly, scattered quickly by the busyness. Perhaps he’d kept himself busy on purpose, to avoid his dense emotions. He couldn’t remember.

* * * * *

The hours passed, and Charles drove. His mind wandered slowly, from Houston to Los Angeles, and back. He remembered long roads like this, traveled with friends and broken only by forays into blue bonnet fields.

He wandered into memories of long, quiet streams - the soft trickling water, the steady sound of oars, the quiet conversations traded across canoes.

He startled at the memories of good jokes, of friends bent over in laughter, shaking so hard they couldn’t breathe.

Charles grinned softly at the memories, watching the people and events return slowly, one by one.

As the hours passed, Charles drove. Ahead, the sun was finishing its slow dive beneath the clouds. A distant windmill cut the dimming light into sprays of purple.

And as the light faded, Charles felt a small wave of anticipation well up within him. It came lightly, without warning or announcement; without defining moment or epiphany. It approached fragile and soft, like the purple rays draping the hills, moving as a light breeze against his heart.

Charles checked his mirrors and switched on his headlights. As another road sign approached, he swept his hair aside and squinted through his glasses. A wide smile spread across his face as he found the white letters, flashing brightly now against the fading light.

Houston: 326 miles.