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.

David discusses med school by correspondence

Normally, my rant:rave ratio here is pretty high, and hopefully that’s something the six dedicated readers have come love. For once, however, I’m going to discuss something neither rant nor rave, but rather simply a part of med school I never expected.

I’m not exactly sure what I thought med school class would be like, but I imagined it would more or less follow the structure of my undergrad pre-med courses: go to class, take some notes, maybe read a textbook, study for exams, bubble in the scantron to make a funny picture and hope to live to do it all again in a few weeks. I figured there would be great, inspire-you-to-learn teachers, other, less effective profs that droned on and on, and a wide variety in between. One thing I did not expect was how much of the first year could be just as easily taught by correspondence as in class.

It may be no great revelation that the MS-1 curriculum is mostly about learning the vocabulary of the body and disease and important background information about biochemical, immunological, blahblogical processes, etc. Beyond the obvious exceptions – anatomy lab, clinical stuff – most of this information can be effectively taught through textbooks or a solid syllabus. Of our many classes, a few have concise, well-written syllabi that comprehensively present the important information, some interesting extra details, and do a generally excellent job of teaching the material. It’s no coincidence that the professors for these classes, as a result of good preparation/organization/whatever, also tend to deliver good lectures. Yet since the provided written materials are so strong, and because it takes even the most gifted lecturer much more time to deliver a talk than it takes a student to read that content in condensed form, many people appropriately choose to skip those lectures. And it’s not because they’re lazy students. I imagine they make the calculated decision that they can save time going over the material at home or would rather dictate their daily schedule and decide exactly when they want to review that information.

On the flip side, in classes without dependable syllabi, where the organization is relatively poor and the expectations for students consistently vague, attendance skyrockets. Not surprisingly, these lectures are often disjointed, even incomprehensible, and sometimes I come away far worse for the wear with almost no new knowledge to show for it. (Loyal reader, you might be thinking, “David, that’s probably because you’re an idiot.” True though that may be, I assure you that I am not the only one that feels this way.) This theme doesn’t necessarily depend on the content of the class or even the attitude of the professors towards student learning, it’s just a product of how well the course and study materials are organized.

Maybe this isn’t surprising, but it seems odd to me that the most engaging professors who have the most well-developed lectures are the ones that face an empty auditorium, while those running the classes that most frequently frustrate the students get a full house. What’s more, if the latter profs emulated the former, there would be virtually no reason for many people to attend class at all. Students would have high-quality study material, complete all of the educational objectives set forth by the faculty, do well on exams, and basically be med students by mail. This dynamic would collapse later on during the transition to the wards, as well as in those aforementioned pre-clinical classes that provide exceptions. Still, on the whole, a University of Phoenix-style curriculum would be about as pedagogically sound as the one we have now (that’s right, I used ‘pedagogically’, what of it?).

Not to complain, because I do think we are getting a good education, but isn’t that still a bit strange?

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.