David questions Kevin's sanity

Just like grandma’s first resting tremor, Kevin’s recent post is an unfortunate sentinel sign of a burgeoning neurodegenerative disorder. Yet worse than Parkinson’s, Kevin’s affliction is a severe case of Nicolas Cageophilia. No other reasonable conclusion can justify his inexplicable love for the actor that brought us such cinematic asshattery as Snake Eyes, Ghost Rider, and The Wicker Man. Just look, if you dare, at the list of his four latest “films”:

1. Knowing - "Knowing is Everything."
2. Bangkok Dangerous - Something's happening in Bangkok, and it's probably not safe...
3. National Treasure: Book of Secrets - Fresh off a thrilling adventure in the first installment that involved a hidden treasure map on the back of the Declaration of Independence, the gang is back to uncover ancient Native American gold hidden within Mount Rushmore!
4. Next - Nuclear terrorism is afoot, and Nic Cage, Vegas magician, is the world's only hope.

This is a guy about whom YouTube videos are made en masse (thanks, NicCageFanClub1) solely to evidence the sheer ridiculousness of his frequent affronts to cinema. The actor whose movies even Kevin (and his early-onset Alzheimer’s) agrees he’d be most likely to avoid among Hollywood’s current leading men. The man who, after making the epic failure that was Ghost Rider, actually decided to re-up for a sequel to further his quest to make more people voluntarily claw out their own eyes. An actor whose recent run of movie-making futility has been so painful, I’m actually scared to turn on the TV during the summer for fear of watching 30 seconds of his next “I’ll-grow-out-my-hair-and-then-look-thinky-for-2-hours” debacle.


Knowing: Ooh, I’m thinky…


Next: Oh yeah, now my hair’s even longer, and I’m still thinky…


This isn’t even a movie, that’s how thinky I am!

Sure, Cage made a couple of decent movies in his distant past, but few of them depended on his acting prowess – The Rock was great, but does Nic Cage deserve a ton of credit for playing Overwhelmed Guy? – and none of his recent offerings have done anything but steal money from audiences and make babies cry. And yeah, he won an Oscar, which is basically a Hollywood political popularity vote, allowing him to join the illustrious ranks of Jennifer Connelly and Kate “The Female McConaughey” Hudson in the acting pantheon.

What’s worse, if Cage does possess any true talent, he’s even more unlikeable for electing to unleash such a garbage parade on humanity over the past half-decade. You can’t really criticize Keanu Reeves for poor acting; it’s all he can do. But if Cage can do better – and at this point, who would actually believe he can? – it’s an even bigger slap in the movie-going public’s face that he continues a nearly unprecedented run of sad clown cinema just to cash a check. In the medicine metaphor, Cage isn’t the plastic surgeon who sells out with breast augmentations instead of cleft palate repairs in the third world, he’s the doc that runs a healthy patient through the excessive work-up ringer to squeeze out as much insurance compensation as possible, delivering substandard care (and perhaps a bit of iatrogenic psychological trauma for good measure) to line his own and the hospital/movie studio’s pockets.

Honestly, Nic, how do you sleep at night? At least Kevin’s cortical tau body extravaganza gives him a legitimate excuse for supporting you…

Kevin is incensed at David's blatant consumption of Nicholas Cage Haterade

So David and I were chatting about movies yesterday when the subject of Nicholas Cage came up. Throughout the course of the conversation it became clear that while David has yet to obtain his MD, he has long since obtained his PhD. I know Nicholas Cage is not the easiest actor to defend but I felt the need to step in to prevent David from OD'ing on Haterade. Allow me to make a few points in support of our friend Nicky-G.

1) He's a good actor
Yes, he's put out a lot of stinkers (more about that later) but he has also put out a lot of quality films. Let me just list off some awesome movies he's been in:

1. Leaving Las Vegas
2. The Family Man
3. Adaptation
4. Matchstick Men
5. Lord of War
   
6. The Weather Man

These are all quality films that span quite a few genres. His acting was bananas in Adaptation. Lets not forget that he actually won a god damn Oscar for Leaving Las Vegas. DIf you haven't seen any of these movies, I suggest you stop being like Jesse and go rent them now.

2) He makes a shit load of money for himself
Despite having been in several really solid movies, I admit he's had his share of clunkers. But I would argue that he knew these were crappy movies going in and is only in it for the money. And how can you fault a brother for just wanting some cheddar. He loves classic cars and castles, and last time I checked, neither were on the Wendy's 99c menu. A lot of people do things "just for the money," especially David and this whole "medicine" thing. All I'm sayin' is, if plastic surgeons are allowed to fill their pockets w/ boob job money, Nicholas Cage shouldn't be hassled for cashing in his $20 mil. for National Treasure. Plus, even his crappy movies are reasonably entertaining if you just want some mindless action. The Rock and Face/Off are action movies staples that every man should have seen twice if not three times. Simply put, he's stared in some kick ass movies.

3) He makes a shit load of money for the studios
From my research, he's starred in 48 movies, 7 of which have gone on to make over $100 million dollars. Furthermore, the average gross of his last 10 movies was $74 mil, which actually beats out the likes of John Travolta, Pierce Brosnan, Bruce Willis, Denzel Washington, all of whom had similar per movie salaries.

Overall, I'm not saying Nicholas Cage is at the acting caliber of Russell Crowe or Edward Norton nor is he as bankable as Brad Pitt or Tom Cruise but he's not as awful as people make him out to be. He takes good 'actor-y' roles when he wants and then makes $100 mil. in between those to fund his little hobbies. Just let the man enjoy his money.

David and Kevin escape MS-2

As of approximately 4:30 PM tomorrow, Kevin and I, along with the rest of our intrepid graduating class of 2011 (and Jess, knock on wood), will move from the dark, windowless classrooms of MS-1/2 and on towards the glorious hit parade of life-saving, personal fulfillment, and sleepiness that is sure to be 3rd year.

All that remain in between are a few weeks of faux-summer and a wee board exam. Bring on the sweet downslope of this curve.

Comic: OB exams are tricky

David, Robby, Dan, Beth and the Johns save lives while on vacation

Recently, our MS-2 class finished winter quarter and moved one precarious step closer to the wonders of clinical Candyland and all its third-year clerkship glory. To celebrate this historic accomplishment, several of our noble band – including Dan, Old John, Stalker-y John, Robby, and Beth (Mrs. Robby) – traveled to Montana for a manly wilderness adventure. (Kevin wasn’t allowed because the state of Montana has an Asian quota that was met when I joined the trip).

This sort of trip means several things: (1) an ungodly amount of pork consumption (Beth managed to create this); (2) an uncomfortable amount of “That’s what she said" jokes; (3) a nonstop country music bonanza; and (4) 5 med students and an RN (who knows approximately 4.3x more than the rest of us combined) having nerdy faux-medical debates for 4 days.

After a productive morning of snowy adventuring (them) and sleeping (me), we cranked up the country and were treated with a stirring performance of Rascal Flatt’s “Skin,” which tells the story of Sara Beth and her fight against an unknown hematologic malignancy.



We did what any reasonable Spring Breakers would and beat the song to death with the following lively discussion:

After listening to the song, one thing’s for sure: someone’s a poor historian. Seriously Sara Beth, how can we help you without more details? Associated symptoms? Fatigue or fever? Throw us a bone. And Rascal Flatts, did you even go to med school? This OCP is just awful. Even the referring physician’s dropping the ball (“Between the red and the white cells, something’s not right?” At least give us a blood smear.). Clearly we have to do all the work…

First, Sara Beth’s only a teenager, so we’re immediately thinking ALL.

Easy bruising? Sounds like thrombocytopenia.

Mixed “red and…white cell” involvement? Could be an expected pancytopenia.

An aggressive chemotherapeutic regimen with a ~70% cure rate (lowered to "six chances in ten" for Sara Beth due to her older age and its negative prognostic contribution)? Perhaps a little CVAD induction therapy.

If needed, we’ll be ready for marrow transplant on second remission after relapse.

Go enjoy your prom, Sara Beth. We’ve got it from here. Now, if you’ll excuse us, the kid from "John Q" needs a cardio consult for his hypertrophic cardiomyopathy and then we’ve got a 3 o’clock to get a CD4 count from Andrew Beckett in "Philadelphia."


Your son's next, Denzel...

David tells you what to do (in an admissions interview)

Previously, I’ve given advice of variable seriosity to pre-medical students, both here and in person, usually with respect to the MCAT, personal statement, and general application process. This year, due to a clear administrative error in the selection process, I was allowed to join our school’s admissions committee to serve as a student interviewer. In addition to granting me a golden opportunity to implement my subversive personal agenda, this position has further demonstrated how important the interview is in the admissions process and where applicants commonly stumble or succeed in separating themselves from the pack.

When Kevin and I are asked to speak to pre-meds about admissions, people often think of the interview as a high-stress, nebulous obstacle shrouded in enigmatic mysteriousness with a black-boxy finish. To assuage these concerns, and so that future generations of medical students will learn from those who came before, I present a few suggestions for anyone with an upcoming med school interview:

1) Prepare, prepare, prepare:

This one’s obvious, right? In med school interviews, as in “8 Mile,” you only get one shot. You spent weeks/months preparing for the MCAT and years kicking ass in your science courses, during extracurricular activities, and while saving babies in the free health clinic you established in between curing cancer and playing varsity lacrosse for a school that isn’t Duke. That work ethic is what got you to the interview in the first place, so don’t abandon it now. You’d be surprised how often people seem un- or underprepared to discuss the most basic topics they MUST know will be coming down the question pipeline. There is a 105% chance you’re going to be asked why you want to go into medicine, why it excites you, and what experiences led you to the decision that the next 7+ years of training and three subsequent decades of practice are what you want to do with your life. Think about how you’d answer these questions and practice discussing them in some sort of mock interview format. You don’t need a canned script, but if you don’t have a compelling reason why you want the MD, why would the admissions committee make one up for you?

Along these lines, make sure you’re familiar with the specific program for which you are interviewing. Why does the curriculum appeal to you? What’s unique to that school that will help you reach your professional goals and why are your strengths well suited to that school? This stuff is coming, so you might as well prepare for it. Be Eminem vs. Papa Doc, not Proof. (RIP, Proof.)


Your interview should be like this, but less profane and with fewer tanktops.

2) Research the health care system:

This is an extension of (1); you’re entering a system almost universally recognized as broken, with a myriad of significant issues and just as many proposed solutions. As Atul Gawande once said, “The infrastructure and delivery of American health care are wack, yo*.” This issue is all over the news and, more importantly, is going to affect you every day of your professional life. So spending 10 hours reading about our system and its major pros/cons, about the employees who studied in online medical coding courses, nationalized health programs implemented abroad, recent legislation, etc., would be extremely high-yield. And really, it’s not like anyone expects the applicant to solve the health crisis in one hour. Still, it’s reasonable to expect a candidate to be familiar with the major issues of the profession she wishes to enter; it shows the applicant cares and, just as significantly, that she took the effort to prepare for the interview.

3) Be honest:

Adcoms interview a lot of people. They hear a lot of stories and develop a sensitive radar for half-truths and general BS. If you don’t know in what or if you want to specialize, I think that’s fine, but a vague story about how reconstructive surgery is your calling will ring hollow if you have no experiences to back it up. If you get asked a factual question you can’t answer or are asked to discuss something that requires background information you don’t know, it’s better to admit it and ask for what you need or discuss ways you’d obtain the information required than to make stuff up on the fly. No one expects you to have all the answers. If you did, there’d be no need for med school. You’d just stop by the front desk for a white coat and board certification and be on your life-saving way.

4) Be engaging:

An interview is as much about figuring out who you are and how you interact with others as it is a discussion of your credentials / experiences. An interview is inherently subjective. Think about what types of interviewer-interviewee discussions would positively resonate with an interviewer when he or she evaluates a candidate. An applicant who is warm and personable makes a more favorable impression than one who is excessively reserved. Sure, the interview is serious, and it might not be the time for a risqué joke, but it’s still important to connect with your audience. Your demeanor during the interview can provide a window into how compassionate you might be with patients and how well you’d interact as part of a small team. Don’t affect insincere enthusiasm, but try your best to enjoy the interview and show your true personality. Smiling doesn’t hurt.

All of the above may seem intuitive, but you'd be surprised how often otherwise well-qualified candidates struggle in these areas. Mostly it appears to be an issue of preparation, so spend as much time thinking/talking through these issues as you can. It will definitely pay off in the end.




*He didn’t really say this. I think it was actually part of the Flexner Report…

Kevin is unimpressed with some of his future colleagues

Recently David and I went with many of our classmates to a medical student research conference to present the groundbreaking research we all did this summer. There aren't a lot of requirements for submitting an abstract but nevertheless it’s a great opportunity to waste 4 days in a cool location meeting students from other medical schools and boozing it up at night. At the end of the weekend you get your “research” abstract published in a journal that will likely benefit no one. But we're really hoping JAMA accepts Beef Stew.

Anyone presenting at this conference is assigned a specific time slot which falls into one of many half-day time blocks at various rooms/locations around the conference site. The format is rather simple, you give a 10 minute talk followed by 3 minutes for questions from the audience. Our school was very insistent about students maintaining a certain level of professionalism at this event. Most of it is pretty straight forward: wear a suit, be respectful, don’t be drunk during the day. Easy. They were also especially adamant about students attending the entire half-day session they were assigned to rather than just showing up for your specific time slot then peacing out after the 15 minutes was up.

All this seems straight forward and self-apparent but not so for some of our colleagues from other medical schools... especially this one from the north. Instead of waking up early and showing up at the start of the half day session, these kids would swoop in about 5 minutes before their slotted time. Inevitably 10 of their classmates would also march in to root them on. When it was his turn the main kid would give his schpiel aboot his research into something related moose-related hunting injuries. Then as soon as his/her presentation was done, the entire posse would stand up and dash out before the moderator could make a passive-aggressive plea for students to stay.

So essentially a large gaggle of students would loudly file in during the middle of another student’s presentation, stay for 15 minutes for their friend's topic, then make a run for it when the next student is setting up his slides. Way to go guys.

*I just wanted to add that while I witnessed a few of these incidents, personally I was not a victim since there were no students from that school scheduled after me.