Musings: Med School Seating Chart by Maturity Level

Musings: Chinese Restaurants

David and Kevin's Musings - A Visual Series

Comic: Hard of Hearing

David quantifies his inanity

To those who know me, it's probably not a big surprise that I waste a lot of time talking about things that are completely meaningless and most likely offer zero benefit to anyone. To illustrate, I offer the following example. Recently, we have been studying childhood development. One important topic in the study of infants and toddlers is a milestone, a certain ability a child acquires at a certain age which is important in his or her development. Some one of these milestones involve how many blocks a kid can stack at, say, 20 months versus 24 months (only four at 20, but a whopping 4-5 at 24). This is important because it indicates the child's motor and cognitive skills are progressing appropriately.

Instead of taking this concept at face value, my friend and I launched into a 30 minute discussion about how exactly these block values are ascertained. Is there a block laboratory where babies perform thousands of stacking trials? Are there internationally standardized blocks sold by Welch Allyn? If there aren't, what's the point? A toddler might be able to toddle his way to a stack of 10 really stable blocks, but if one weighed 5lbs he probably wouldn't be able to add number two. What exactly is the limiting factor? Is there just an increasing error accumulation that is insurmountable once four blocks are reached? And perhaps most importantly, how much more awesome would we be at block-stacking than those little kids? If we had a crane and a really tall indoor space with virtually no airflow, couldn't we be an unstoppable block-stacking force the likes of the which the world has never seen?

As sad as it seems, I have at least 2-3 of these sorts of conversations per day. This one was sort of long, but if we assume I have 2.5 conversations at 15min per, and take about two weeks of vacation time to rest my rambling muscles, I waste over 9.1 full days on this nonsense annually ((15/[60*24])*2.5*350). That may not seem like a lot, but since I plan on saving at least 300 lives per day as a doctor, and the economic value of a statistical life has been argued to be about $5million*, my inanity will cost the world billions by the time I die. Good to know I'm making a difference...


*This is actually true, but don't expect me to cite any sources here.

Comic: Oops

David wins epic battle against co-walker

(Kevin recently contracted bird fru, so I will become the prolific scorer I always knew I was and continue to pick up the slack.)

Yesterday, I was walking towards my car with a jaunty spring in my step after managing to stay in class for two hours before calling it a day. A few minutes away from the parking lot, another random guy (RG) started walking alongside me, and initially I thought nothing of it. Normally, I’d give RG the patented Dave speed burst and launch ahead on the way to bigger and better things. Alternatively, I could’ve played it Mav style, hitting the brakes, letting him fly right by, then switching immediately to missile lock (or guns, if he remained too close). For some reason, I opted against either go-to strategy. The path was pretty wide, I was still happy about all the learning I’d just done, so I decided to let things play out naturally.

After a while, it became painfully obvious to both of us that we had been walking almost side by side for several minutes. Still, as is the case with 99% of my choices, inertia won out and we remained in relative lock-step. By the time we reached the parking lot, which is pretty large as public parking lots go, more than a few awkward side-glances had been exchanged, yet still no one made a move to take the lead or fall behind. And based on his body language, I’m almost completely certain he was thinking about our strange traveling dynamic as well. About fifteen rows in, we approached my car, and I veered off to the side appropriately. RG, seemingly confused, shifted almost instinctively in my direction before stutter-stepping and then finally grinding to a complete stop. Clearly disoriented, he looked around awkwardy and then started walking in the other direction. In my car, I watched as RG backtracked a few rows and proceeded to walk up and down each of them searching vainly for his car. Perhaps you had to be there, but watching him wander about for several minutes, potentially aware that I might be watching since I hadn’t left yet, was oddly mesmerizing. At one point, it appeared as though he was contemplating exiting the parking lot entirely so he could return with tabula rasa and try again. Or maybe he was thinking about giving up entirely and taking the bus home or buying a new car. In any case, after another minute or so, I finally forced myself to leave. Needless to say, I emerged the clear victor…

David rants about Dishes-it-out-yet-can’t-take-it-back Syndrome

When I hang out with my good friends, there is a lot of back-and-forth joking. It is generally good-natured ribbing, and each participant typically takes about as much flak as he or she dishes out to others. Perhaps this isn’t the most mature friendship dynamic, but I enjoy joking around and almost all of my friends do as well. Some topics are clearly over the line but, for the most part, everyone knows the humor isn’t serious and gets a kick out of the back-and-forth.

Now, not everyone is particularly jokey. Some (most?) people are orders of magnitude more mature than I am – which should make you extremely happy that I’ll be treating patients in T-minus 12 years – and may not trade similar barbs with their buddies. I have several such friends with whom I exchange mostly light-hearted or topical banter, without engaging in person-specific comedery or ever venturing into the purely golden “that’s what she said” domain. On the other end of the spectrum are friends with whom normal conversation has nearly no humor restrictions. We don’t seriously insult one another, but the phrase ‘yellow-on-yellow’ crime would apply with significant regularity.

The golden rule governing this intricate humor interplay, an unspoken law that most people find intuitively obvious, is that one must be able to take approximately as much as one dishes out. If Robert makes a joke about how long it takes Kevin’s mother to cook Minute Rice (Note to Robert: it’s not that funny if she’s really smart and cooks it in 25 seconds), Robert must be willing to endure a similar barb from Kevin’s humor repertoire.

To illustrate this issue, a simple 45-degree line will suffice. On the x-axis, we have “out-dishing;” on the y-axis, “back-taking.” Thus, the more you dish it out, the more you have to take in order to meet the perfect 1-for-1 Repartee Ratio. Now, it’s no good to make fun of someone who’s polite/mature/nice enough not to dish it out. Nor does he/she deserve it. Thus, that friend is forced to take little back in return. Moving along the line, your obnoxious buddy that makes all those ridiculous jokes better be willing to feel the heat.



The problem occurs when people are disproportionately over-sensitive; they love to make inappropriate, callous jokes about others yet become defensive or upset when someone sends a yo’-mamma missile their way. This is one of my big-time pet peeves, a common pathology I’d like to call Dishes-it-out-yet-can’t-take-it-back Syndrome (DS). People with DS put a serious strain on one’s humor game, completely throwing off the mostly well-meaning, tongue-in-cheek vibe that brings me so much joy. Each one of you knows someone afflicted with DS. You can all recall an otherwise awesome social situation where DS made everything end in tears.


Well, thanks to my burgeoning biotech firm, the solution is finally here in the handy, dandy, Rx-only Getoveryourselfafilnoprene. Only 50mg nightly before bed has been shown to yield clinically significant reductions in DS symptoms. Stay tuned for our next pharmaceutical innovation in the treatment of Always-make-everything-about-them Disease…

David takes a step back to reflect...

Do you ever stop to contemplate the little things that change the ultimate paths of our lives, those almost indefinable moments in time that can alter who we become or the impact we have on the world? I know I’m normally so caught up in the hustle and bustle of school and life that I don’t take the time to stop and smell the roses. Everything becomes such a whirlwind of tests, stress, drama, and hate crimes…I get so turned around I don’t know what’s important anymore…

A while back in this space I mentioned going out to lunch with a friend and how a bird pooped on him on the way back. I sort of made light of it at the time, but it’s been eating away at me ever since. If only we had stopped a moment longer to wait for the light to turn on the previous street, the bird and my friend would never have crossed paths. If I had noticed my shoe was untied, how would things have turned out differently? My friend wouldn’t have ruined his new coat. He wouldn’t have missed class to cry it out. Or maybe, just maybe, that bird impeded our path just long enough that we avoided something far worse...like being pooped on by a larger bird, or by two smaller birds whose cumulative poop volume exceeded that of the one average-sized bird.

So maybe that bird was meant to poop on him…if it hadn’t, we might’ve walked in front of a bus a couple blocks down. I might never have realized my ultimate dreams: saving African babies, walking on the moon, making it rain hundys at Club Isis. When I stop and consider the interconnectedness of our universe, I am overwhelmed. It’s beautiful, but, at the same time, it’s scary....................

I guess what I’m saying is, live while you can. Laugh out loud and don’t pay attention to who’s watching. Stumble once in a while, it’s OK. I know I’m going to try and follow this advice too. Maybe I’ll look back on this post when I start feeling blue and it will remind me to stop holding my breath so I can get oxygen again. I know there are still important things I need to learn about myself, but hopefully, this is a start…

The shadows surround me
Gripping
At
My soul.
No, Darkness, please
I have so much more to
Give.
Light. Peace. A second chance.
Thank you.

David is outraged by senseless krill murder

I am shocked and appalled that Kevin has condoned senseless krill-killing in his investigative report on the Little Mermaid. He quickly excludes the possibility of a Flounder feast or Sebastian sauté – on the basis of their demonstrated sentience – yet throws krill to the sea-wolves without a second thought. Why? Because they’re small and don’t crack the starting lineup for “Under the Sea.” That is unacceptable. I am taking a stand.

First, watch this video of arguably the finest impromptu-underwater-point-making-ensemble-musical-number ever:



Now, two things are painfully obvious. First, Sebastian is a frickin’ rhetorical genius. “The seaweed is always greener” is persuasive gold. That effeminate crab just knows how to sell it. Second, and far more importantly, there is established video evidence that shrimp are sentient. At 3:03 in the video, right after we learn that “each little snail here know how to wail here, that’s why it’s hotter under the water,” we see a bevy of shrimp, smiling, dancing, and jumping in a glorious air bubble cascade that would make anyone want to drown in a tide pool. The shrimp display obvious, visible emotions in their heartfelt attempt to keep Ariel from going above water, all the while maintaining admirable balance atop slippery bubbles in an impassioned jig.

Clearly, the shrimp have a lot going on upstairs. And krill, as everyone knows, are basically just mini-shrimp. Even Wikipedia – which will have been responsible for at least 29% of my medical education by the time I’m done – describes them as “shrimp-like.”
   
                                         
                                                     Can you tell the difference? I can't...

Adding two and two together, we realize that Triton and his Mer-peers are basically eating 1000s of conscious beings every day. Murdering countless krill families and destroying countless krill dreams. Stopping krill doctors from seeing krill patients and devastating krill adolescents worldwide by preventing krill Jessica Alba from reaching the level of irrelevance that would inevitably force her to do a nude scene to get back into the public eye. And all based on the shaky premise that, somewhere along the continuum between krill and shrimp, there is an arbitrary Eat Me line that makes it OK. Outrageous!

Triton, is that any way to lead your people? Shrimp, how could you pander to the princess whose father murders your cousins day after day after day? And you, Kevin, I am most disappointed in you. You’re just like Harry Potter, standing idly by, ignoring the problems of another world while you keep the platypus down…

Kevin Contemplates the Diet of the Little Mermaid

Following David's intrepid exposé of Harry Potter, one can't help but wonder what questions remain unanswered from the movies our beloved childhood. Should Aladdin go to jail for stealing bread? Is Winnie the Pooh's honey addiction merely a stepping stone to black tar heroin? All the signs point to yes. But one question has dogged me until this day.

What did the Mermen eat in the Little Mermaid?



What a hottie

Looking at Ariel’s heroin-chic physique one might guess a subsistence of cigarettes and self-loathing but of course we all know you can’t smoke under the sea. The next thing that comes to mind is the wide assortment of aquatic plants at their disposal. So are the Mermen a bunch of kelp-hugging vegetarians? You might think so but looking at King Triton that simply can’t be true. Without the necessary high protein diet, a person simply cannot maintain such a physique without the help of BALCO.



Ladies, got your tickets to the gun show?


Thus, Triton must eat meat. While the film features a wide array of oceanic fauna, most of them appear sentient. Can you sink your knife into Flounder or toss Sebastian into the steamer? I didn’t think so. Finally we come to krill. While technically an animal, this tiny Sebastian is far too small to be capable of sentient thought much less performing spontaneous yet surprisingly well-coordinated musical numbers. Looks like we have a winner (or loser if you’re the krill.)



Common fare at any seafood restaurant


To find out how much of these tiny critters Triton must wolf down on a daily basis, I did a little digging into the daily diet of Blue Whales. According to one article, a single Blue Whale eats roughly 40 million krill per day (about 7715 lbs) to satiate a recommended 1.5 million calorie a day diet. With these figures, I surmise there’s about 0.00357 Cal/krill and each krill weight approximately 0.000192 lbs. Then assuming Triton maintains a 2000 Cal/day diet (pretty low given his body size), he would need to eat 10.28lbs of krill per day. A pretty ludicrous amount given that a single human being eats less than half of that (4.7 lbs). But I guess it’s not outside the realm of possibility.

Comic: Romance

Kevin Realizes Mistakes Happen All the Time in Surgery

For those who don't know, I'm in a surgery preceptorship this quarter where I get to watch a surgery once a week. This is quite an amazing experience since I'm literally standing shoulder to shoulder with someone who is wrist deep into someone's heart (not metaphorically either, although im not sure what that metaphor would imply). Of course this intimate glimpse into the OR is not without its surprises...

Just last week, I was observing an ascending aortic composite graft procedure when out of the corner of my eye I noticed the scrub nurse engaged in a muffled conversation with the circulating nurse about something.  Then the  circ nurse suddenly drops to the ground and starts crawling around.  5 minutes of her best illegal immigrant maid impersonation later, she comes up and  seems to wave a "Negative" to her sterile compatriot.  The scrub nurse then turns to and asks:

"Kevin, can you look around for a needle, it should be attached to some blue suture."
"Uh... sure," I said, fumbling around my little section.  By the way, the universal "fumbling and patting the pockets" motion when pretending to look for something makes you look retarded while gowned up in an OR.

After 5 more minutes of my fumbling, I was forced to give a negative as well.  So finally the nurse tells the surgeon: "Doctor, we're going to have to x-ray this guy after you're done, I can't find a needle."  Oops.

Kevin and David Present: The Top 10 Things We've Learned in Med School

To commemorate the completion of our first half-year of med school, we present the top 10 things we've learned so far:

10)  Experts tell us having kids and being married both suck.

9)    Experts consist of random 38 year-old "young" adults.

8)    Eighty percent of future doctors are brunette white women.

7)    Kevin wants to learn, David wants The Truth.

6)    (Kevin doesn't really want to learn, but David really does want the Truth.)

5)    You can teach an entire lecture with inspirational quotes alone.

4)    We have something in common with a football player from Duvall (pronounced "Dooooo-         vuhl").

3)    Kevin is 1/32nd cardiothoracic surgeon but he's pretty sure he's ready now.

2)    David still thinks he's in business school. 

1.5) Your patients won't care how much you know until they know how much you care.

1)    Never donate your body to science.

Comic: Bad sign for the future

Inspired by Linda's adventures with electronics:

I had just gotten the coffee maker, and I made coffee almost everyday. It was exhilerating[sic]. Then one morning, while I stood in the kitchen and Penny sat at the dining table, I was horrified to find that when I pressed the on button, nothing happened. No coffee.

NO COFFEE.

Shit! I said to Penny. Look! The coffee maker's broken.

She told me to check if it was plugged in. Oh, I said. So I picked up the white plug behind the coffee maker and plugged it in. But still, nothing happened, no red light. Now I was really scared; I started to panic.

I frantically pulled and replugged the cord into the wall socket. Oh no! It's broken! It's broken!

Then I looked emphatically back at Penny to see why she was not also panicking.

She said, Linda, that's the rice maker.

Apparently she had been sitting at the table watching me freak out while the light on the rice maker went on and off, on and off.

So I changed plugs, made coffee and we both went back to studying.

David Anticipates an Unexpected Consequence of Kevin*

After reading Kevin’s latest post, one can’t help but envision the following probabilistically inevitable scenario:

Kevin tells me his name is quite common amongst immigrants from the motherland. A quick Google search for “Kevin*” confirms this to be true, returning 22,800 hits. Given this high number of Kevin*s running around and the extreme virulence of the aforementioned disease, it seems likely that there might come a day when one of those countless Kevin*s was…wait for it…infected with Kevin*. How exactly would that doctor-patient interaction go?

------

Doctor: Kevin, I have some unfortunate news. You have Kevin*.
Kevin: Excuse me?
Doctor: Kevin*, you have it.
Kevin: Are you stupid? Have what?
Doctor: Who’s on firs…Err, there’s a disease called Kevin*, Kevin. Unfortunately, you’ve got it.
Kevin: You’re kidding?
Doctor: Actually I’m not.

Kevin: ...

Doctor: ... 

Kevin: ...

Doctor: What are the chances, eh? If you think about it, it’s actually kind of fun–
Kevin: Die.

------

One can only imagine what would happen if the original Kevin* was this Kevin*’s doctor, delivering the news and explaining his reasoning for naming the disease. Or maybe bad karma would win out and original Kevin* would get ALS.

These are the things I think about sometimes. Why does my brain hate me…

Kevin considers Infectious Disease

Back in the glory days of medicine when old white men ran the show and nurses wore skirts and paper hats, medical research was pretty egotistical. Whenever someone discovered a genetic disorder, he would inevitably name said disorder after himself. Thus you have your well known diseases such as Alzheimer's, Huntington's, Tay-Sachs... the list goes on. Yet, even back then, no one wanted to name infectious diseases after himself. Dumb. Infectious diseases are the crazier, flashier, version of their more homely genetic counterparts. The evidence is in the movies.  Infectious disease has given us adrenaline-pumping thrillers such as Outbreak, 28 Days Later, I Am Legend just to name a few.   Genetic disorders on the otherhand gives us Bubble Boy, a trainwreck I'm sure Jake Gyllenhal would like back.  


You decide

So that gets me thinking. Naming such diseases after the infectious agent is boring and predictable.  If I become an infectious disease specialist I will dedicate my life's work to finding the most dangerous virus/bug out there. But I wont name it something boring like Africanized AIDS (although that has promise). No, I will name it after myself. Why, you might ask. I'll tell you why. Imagine the headline possibilities.

AFRICA IN CHAOS AS KEVIN* RAGES ACROSS CONTINENT

Or maybe something more akin to the movie Outbreak:

CALIFORNIA UNDER MARTIAL LAW TO CONTAIN KEVIN*

"Oh my God his body is completely destroyed by Kevin*"

I'm pretty sure  that would cement my place in the medical as well as the history books.

*Obviously I would use my whole name to maximize my glory and minimize confusion, but for internet purposes, first name is enough.

David: Harry Potter and the Glaring Lack of Wizardkind’s Collective Social Conscience

Today during lunch, the conversation turned to logical inconsistencies in popular entertainment. All kinds of movies require the audience to take large leaps of faith in order remain engaged in the storyline and enjoy the show. Can dinosaurs really be made from DNA taken from the blood sucked out of fossilized mosquitoes? In order for me to realize my life-long dream of riding on a pterodactyl, I can only pray that they can. But to really enjoy the movie, we all have to overlook that potential snag and get ready for the people-eating. In the end, no one gets hurt from the suspension of disbelief. Science may suffer briefly, but people aren’t looking for old tree sap to clone another T-Rex. Everybody wins.

                                                   
                                                               If only…

Unfortunately, things are not always so harmless. Eventually, our lunchtime babbling focused on Harry Potter. (Harry Potter, for those who don’t know, is about a physically and emotionally scarred little boy who undergoes the trials and tribulations of adolescence. All the while, Harry fights some unspeakable evil that is really scary, yet somehow manages to be continually defeated by the power of love and unicorns and stuff. Forgive or correct me if that is wrong, but that’s the story as I know it.) Now, I am not entirely familiar with all of the rules of the wizard world or the guidelines J.K Rowling imposes on what wizards can and can’t do, but I’ve seen most of the movies, read some of the books, and have a general idea of what’s going down in Candyland. And as far as I can tell, Harry Potter is a terrible influence on today’s youth. Forget all of the religious conservatives that see the series as sacrilegious or anyone that may think believing in magic gives children false hopes or distorts their sense of reality. My major complaint is the blatant lack of a social conscience displayed by witches and wizards to those outside of their magical kingdom.

Wizards, it appears, can do whatever the hell they want. They can fly on brooms, conjure random shit out of midair, make food with magic, heal people, and do a million other things that could be ridiculously useful. Yet they never seem to apply their prodigious talents to saving non-wizards. What ‘s up with that , Harry et al? Basically, the next 10-plus years of my medical education will be spent learning to do things some magical person could do with unintelligible gibberish and the flick of the wrist. There would be no starvation, no disease, and no embarrassing ascites. The Gates Foundation’s philanthropic efforts would border on puppy-kicking in comparison to what a few wizards could do. Need a house/school/new pony? No problem, I’ll whip one right up! Oil conflict? Let me conjure a Hummer H4 that runs on baby laughter. If a normal person walks down the street, sees an accident, and fails to help in a situation where he might be reasonably expected to lend a hand, it's negligence. Jerry, Elaine , George and Kramer went to jail for that shit. Yet wizards let genocide happen without batting an eye. It's like one community-sized Milgram experiment gone wrong. On a more personal level, just today, on the way back from lunch, my friend got pooped on by a bird. Even now, I can see the solitary tear welling up in his eye. Magic could have stopped that from happening.

What are you teaching our children, J.K.? That it’s OK to turn a blind eye to the suffering of people who aren’t magical? That fighting some random bald dude who looks like a snake excuses one from addressing the greater problems of the world? I for one am saddened. For shame, J.K., for shame.

(On a mostly unrelated side note, how exactly do wizards decide what creatures are special or magical? Is it completely arbitrary? Everyone knows that dragons and centaurs are magical, that’s just common sense. What about alligators? They’re basically modern dinosaurs, but wizards don’t seem to give them much respect. Duck-billed platypi? Those mammals can lay eggs, for Xenu’s sake! Sounds like advanced witchcraft to me. And if talking is a general prerequisite – which it seems like it shouldn’t be – who’s to say the platypus can’t talk? I sure as hell haven’t ever seen one. I know I wouldn’t underestimate anything that looks like this:

                                       
                                                    How is this guy not magic?

I bet the platypus wouldn’t have let the bird poop on my friend…)

David: Hello World

Since this is my inaugural entry, I’d like to start out with a brief mission statement for my contributions to Yellow Magic. Since my true Asian-ness has been diluted by generations of the American Dream and the sweet air of democracy, I did not jump on the Xanga bandwagon in high school or college like so many others. I had no outlet for my late-adolescent/early-adult self-discovery and, tragically, was forced to wallow in sadness without a forum for my archives of digital pictures in which I flash the V sign with both hands or point to the creases of my wide, wide smile, again with both hands.

Well, those days are finally over, so here’s what any of the paltry number of people that accidentally clicked to this page can expect from me. I can’t draw, and I’m not smart enough to come up with something funny anyway, so I will leave that stuff to Kevin. Instead, 60% of the time, I will be finding myself 100% of the time. I will make sappy metaphors about life, dramatic emo statements, follow everything with ellipses, and apologize for nothing. Poems that don’t rhyme? Don’t mind if I do…

Enjoy.

Kevin hates saying "Hi" to people

I always hate it when I walk through campus or T-wing and I encounter someone I know and must say "Hi". The act of saying "Hi" is not bad part, the motions I have to do leading up to it is the bad part. I must note that this only pertains to people I know and thus feel obligated (and want) to say Hi , but not well enough to actually stop and have a conversation. And i alos MUST stress that it's not the person I hate but the awkward series of motions I need to do just to say Hi.
Anyways, the awkward moment is if I see them walking towards me from really far away. At this point I am completely unsure as to what to do, they are too far to talk to, you can't tell if they are actually looking at you, and any kind of hand motion could be meant for someone else. To make matters worse, even if you COULD communicate with them, by the time you've said Hi and held the canned mini conversation (I'll talk about that later), they're STILL in front you of and you have a super awkward moment where you are actually walking past each other and theres nothing else to say.
In order to remedy this, although not necessarily efficiently, I employ what I call the "anywhere but at you" maneuver. By this I mean I will first notice the person from far away, I will gauge their walking speed and my own and their distance from me. I will then either look down, left , right, basically anywhere but in front. I will continue to do so until they're at an acceptable distance for me to look up, "notice" them, feign surprise, wave high and hold the usual conversation of
"Hi'
"Hi, how are you"
"good, you?"
"good good".
If the timing is perfect, the final "good good" will occur just as the person passes. Wow that's quite a lot of analysis for something so small. Oh well, atleast it beats staring at the person for a full 30 seconds before speaking to them.