Slow news day?

I find that on the slower news days, many of the things I’m actually interested in get covered. When there are no massive natural disasters, war is not declared (officially or unofficially), and celebrities are not making public their battles with substance use (officially or unofficially), questions about equity in terms of gender and sexuality are suddenly interesting fodder for discussion. It helps a bit that the Supreme Court has agreed to hear a case in which Wal-Mart claims that the women suing it for employment discrimination do not have enough in common to warrant a class-action suit. Although Wal-Mart would have you believe that the case has nothing to do with the sex discrimination the formed the basis of the case at the beginning, and that it is only about standing in the court, but I think it will be interesting (and maybe scary) to hear the discussion about whether or not having one’s sex and (former-)employer in common is enough to join up into a class-action suit. Below are a few other links I found interesting and though I’d share. Some of them are restricted (through the Chronicle of Higher Education), but even the little tidbits are interesting.

For Women Seeking to Advance in Academe, Advice From 4 Who Made It to the Top

Taking the Gender Fight Worldwide

Leadership Spots Opening Up for Gay and Lesbian Academics

Gay Academics Find New Paths to the Top

Episode 13: An ‘All-American’ Student Leader’s Search for Identity

Your Electronic Thesis and Dissertation (ETD) submission was successful.

From Dose of Reality:

This is what my e-mail said this morning after my post-defense meeting at the graduate school to review the formatting of my dissertation, turn in the final approval document, and submit my dissertation online to the library. When I asked about the publication fee I knew was owed to the University, however, I was informed that because I was an MSTP student this fee would not be assessed until I finished my MD, and that if I am lucky, it will have disappeared by the time I graduate. Hopeful as I am to avoid the $70 fee, I do wish, at least a little bit, that my dissertation could be available online (and in a bound version in my department) before 2013. Apparently they don’t process anything really until the degree is conferred, which in my case is not for another couple of years.

Lesson #1: No matter how much you love the MSTP, it is impossible to also love all of the exercises in delayed gratification.

Lesson #2: Publish your work so that you are allowed to show it to your family and friends before you graduate.

Relaxing

As has been discussed in this forum previously, I’m not good at relaxing. Really not good at relaxing. As a result, my schedule last week did not include work related to my dissertation (except for finishing up my revisions on Friday), but did include approximately 1,000,000 other things that needed to get done. I also started a running list of other stuff that needed to be completed before returning to the medical school. This sort of thing usually calms me because I feel more organized, but by yesterday afternoon I had worked myself into such a state that I was completely overwhelmed. I quickly realized that this was not good, and vowed (again) to relax a bit.

Success! This morning, Walt and I stayed in bed and read until after 9am and it was really wonderful. Walt did less reading, but still enjoyed the relaxing morning. I finished Little Bee, a book my Aunt Elizabeth sent for my birthday, and thoroughly enjoyed it. It was a surprisingly easy read for the subject matter (asylum-seeking, oil wars, and serious mental health issues, among others) and very well written. I enjoyed the style so much I purchased the audiobook version of the author’s other book, Incendiary. This is the kind of morning we had:

I also worked through my list of stuff to do and partitioned it out over the days of this week. I’m feeling good about getting everything done, and have reminded myself 2-3 times already that I have a few more weeks left as well.

In closing, here is a photo of Walter attempting to sleep on every item on the futon all at once:

There are actually two pillows underneath him...

Winter of Detroit Warms Up

Last week Alicia and I headed down to the D to transition our Winter of Detroit into Spring of Detroit. (As an aside, clearly the Michigan weather is confused about that transition, but my hopes are high that it will really be spring soon…) I know I’d heard about Small Plates before, but had never tried it out. Alicia snagged a great Groupon, and we were on our way to distract me from my impending defense. It was really quite delicious. For those of you unfamiliar with it, they feature a variety of appetizers and easily divisible entrees, and your table comes set with a stack of, yes, small plates. Everyone shares in the slightly-fancier-than-family-style family style. What we ordered:

• Caesar Salad (small)
• Veggie Spring Rolls
• Garlic Shrimp
• Chicken-Something Lettuce Wraps (I didn’t eat these…)
• French Fries

The salad was great, as were the spring rolls and the shrimp. I’d have to say that I could take or leave the fries, which was a bit disappointing. Overall, it was an enjoyable dinner!

I did not remember to bring my camera, but will leave you with a disturbing phone photo of the graffiti I saw on the way in. (Please accept my apology for posting a picture of graffiti in a post about Detroit - it's overdone and annoying, but this one relates to my academic work!)

Nothing has ever inspired me to think and talk about masculinity and the criminal justice system quite like this.

The Fit!

As many of you know, I bought a car yesterday. I found it late last week, and reserved it then, but I actually purchased it yesterday. As ambivalent as I was about owning my own vehicle (as I much prefer the bus, my bike, and walking), I realized over the past month that being carless in Ann Arbor was much more difficult than I’d thought. I suspect that I could probably survive without a car, but having transportation after 7pm and on Sundays without having to rely on someone else is really useful!

My first view from the car on Wednesday:

(I was still safely in the parking lot, so no need to worry…)

Now that it’s sunny today, I present to you, the Fit. I don’t believe in naming cars, so that’s all it is…

Someday gets closer

Today was a relaxing day. I was happy with how my defense went yesterday, and even happier that it was over and finished. Here I am with the poster announcing my defense:
I don't officially get my degree until I finish the MD in 2013, but I like to think I have an unofficial doctorate. In any case, I had a fantastic time celebrating afterward with friends and family yesterday, and am particularly pleased to note that there are more celebrations already in the works. Carrying the celebrations into today, Ruti sent me beautiful flowers:

The box also contained chocolates, so she wins double (maybe even triple or quaduple) points.

Alicia and I also went to the opening gala of the Ann Arbor Film Festival, which was notable both for the films (which were great), and the people watching (which was amazing). I really enjoy events where the old hippies and the young hipsters mix and mingle.

There was also tasty food, including cupcakes, which made my day complete.

Tomorrow, I go and officially buy my car! (It is reserved for me and all the paperwork is done, but I have to actually buy it tomorrow…) Watch for the classic car ad photos of me in some kind of skimpy dress modeling on my car in the ice pellets we’re supposed to get tomorrow. Or not…

Delicious

Having finished most of the big things required for my PhD, I’ve made a little resolution to make sure I’m cooking more. It’s not that I was eating particularly unhealthfully in the traditional sense, but I would consider eating cereal for more than one meal per day more than 3-4 days per week to be unhealthy, even if there are lots of fruits and vegetables on the side. It is monotonous, and makes me feel a little desperate and somehow… mentally unhealthy. The best course of action when I’m feeling this way is to peruse some cookbooks. My go-to options are Mark Bittman’s How to Cook Everything and How to Cook Everything Vegetarian. Between those two, there is a recipe for just about everything a person could wish to eat, all of them are fairly easy, and many are flexible based on what is in my refrigerator/freezer. Every time I think I’ve found all of my favorite recipes, I find another. Today, I present to you a delicious way to use chick peas and all kinds of random vegetables. This is a serious refrigerator cleaner!

Stewed Chickpeas and Crazy Delicious Trimmings

adapted from How to Cook Everything by Mark Bittman

4 cups drained cooked or canned chickpeas
2 cups bean cooking liquid or stock (or some combination)
salt and pepper to taste
1 tablespoon grapeseed oil
1 zucchini, chopped (this is optional, or you could use eggplant or some other hearty vegetable you aren't sure what else to do with - I foresee this being very popular when the zucchini plants being producing more than your typical human can cope with)
1 package of chorizo flavored seitan, or some other delicious meat or non-meat protein (the original recipe uses chicken)
1 large onion, chopped
3 celery sticks, chopped
2 carrots, chopped
1 tablespoon minced garlic
1 teaspoon peeled and minced fresh ginger
1/2 teaspoon ground coriander
1 teaspoon ground cumin
1 28 oz. can tomatoes (drain more or less depending on how soupy your like your stew)
minced cilantro for garnish

Warm the beans in a large pot with the liquid; add salt and pepper. Adjust the heat so that the mixture bubbles very slowly.

Place the oil in a large skillet and turn the heat to medium-high. Brown the zucchini and fake chorizo, about 15 minutes. Transfer to a serving bowl, leaving any remaining oil in the pan.

Turn the heat to medium and add the onion, celery, and carrot, as well as a bit more oil if necessary. Cook, stirring occasionally, until the vegetables are the consistency you like your stew – mine were slightly crunchy. Add the garlic, ginger, coriander, cumin, and tomatoes and cook for 5 minutes more. Stir occasionally and scrape the bottom of the pan to loosen any brown bits. Add the mixture to the simmering beans and let simmer for a bit (5 minutes?), or longer if you like a less soupy stew.

To serve, ladle the stewed chick peas into a bowl, spoon over the zucchini and fake chorizo, and then garnish with chopped cilantro. So delicious!

Brain recovery…

Apparently my last post sounded despondent enough to concern my mother, so here I present to you the post of reassurance. In addition to freaking out a bit about returning to the hospital, I have been doing the following to recover from the stress of defense preparation:

1. Taking gratuitous pictures of the dog. Enough said…

2. Reading books that could in no way be construed as upsetting or stressful. I just finished reading Knit The Season by Kate Jacobs, the third book in the Friday Night Knitting Club series. It was great. The writing was perfectly acceptable, the plot was entertaining, and enjoying it took approximately no effort on my part.

3. Making new brains!

We have a long tradition of making chocolates for big events (graduations, weddings, green card approvals, etc) in our family, and even though I’m not actually getting the PhD for another few years, mom suggested that we make chocolates for my defense (with the promise of more chocolates when I actually graduate). After perusing Amazon’s dazzling array of chocolate molds, I found the brains. They proved to be somewhat larger than expected (the story of my family, I suppose…), but look pretty awesome.

Starting to seem real

My defense is happening in a week in a half (in case you’ve been wondering why my posts have been, how shall we say, irregular recently), and it’s finally starting to seem like I’m going back to medical school.

I went and saw the Smoker last weekend, which is the University of Michigan Medical School’s student-conceived, –written, –directed, –acted, –danced, and –sung musical about the medical school and the hospital. It is always based on a movie or musical, and this year was a medical version of Mean Girls: Spleen Girls. Seeing it made me miss participating - I danced and had small non-speaking walk on roles in Orifice Space (Office Space), The Breakfast Clubbing, Cyanosis, and Edema (The Breakfast Club), Billy Medicine (Billy Madison), and Old Stool (Old School) – and also reminded me of how much UMMS trivia I have yet to learn as an M3!

I’ve also been thinking about some of the practical parts of going back to the medical school. I’m ordering a few extra white coats (so that I have some laundry leeway), thinking about my car situation (after my trusty ‘93 Escort died in December), and looking into dog sitters/walkers for Walt. It’s all a little overwhelming, so I’ve been reading, knitting, and sleeping to avoid addressing everything for a little bit… As it gets more real, however, it’s becoming unavoidable.

Meet Dr. Watson

From Dose of Reality:

Shortly after I heard about Watson the super computer’s debut on Jeopardy, I was talking on the bus with Abe and he asked what I thought about Watson’s next big challenge: medical diagnosis. I appreciated Abe’s assessment that I wouldn’t be upset at a question that cut directly to the issue of whether a human being is necessary in a typical medical visit, and had to admit that it was a disconcerting prospect. Adequate as I like to imagine my information processing capabilities are, I am not, at the risk of stating the obvious, a super computer. My constant connection to my BlackBerry doesn’t allow me the same level of internet search that Watson commands, and familiarity with statistical software and electronic medical records do not an instant meta-analyzer make. In spite of the nagging fears at the back of my mind that Watson would make a much more useful companion on rounds than I would, I couldn’t shake the sense that it had to be useful to have a human physician (or for that matter, a human nurse, physicians assistant, etc) for something. At that point I remembered a recent New York Times article by Abraham Verghese. Recently profiled in the NYTimes for his dedication to history taking skills and the physical exam, I knew that if anyone could justify a human presence in the consult room, he could. And he did. He pointed out that much of the value of a doctor’s visit is in the human interaction, noting:

I find that patients from almost any culture have deep expectations of a ritual when a doctor sees them, and they are quick to perceive when he or she gives those procedures short shrift by, say, placing the stethoscope on top of the gown instead of the skin, doing a cursory prod of the belly and wrapping up in 30 seconds.

He chastised the medical establishment for being “glued to [computer] like piglets at a sow’s teats.” He describes the creation of an “iPatient,” the collection of clinical records and test results that stand in for the patient, and emphasizes that “complaints…from patients, family and friends are never about the dearth of technology but about its excesses.”

We have yet to create appendages for Watson that function as well as the physician’s hands, ears, and eyes for assessing the physical state of the body, and it seems unlikely that he will develop the ability to empathize and connect with a human being anytime soon. Ultimately, it seems that although Watson may, in fact, make an excellent companion on the wards, he is unlikely to truly replace a skillful (human) history and physical exam.

It really does start to come back

From AMSA On Call:

Post #6 of the "Back to the Wards" series focusing on the transition from research years back to the medical school and clinical rotations.

It’s hard to believe I’m already at post #6 in this series. I’ve been averaging about one each month, which means that almost half a year has gone by. In that time I’ve done a lot of things to prepare me for my return to the medical school! I’ve scheduled a dissertation defense, written a dissertation (only edits and formatting left…), and worked with two different internal medicine attendings to try to remember how to be a medical student. Believe it or not, I think that the last item on that list has been the most anxiety provoking. Something I can tell you for sure, however, is that it really does come back. Something else I can tell you is that apparently anything can feel normal after you try it a few times. If you had told me just a few weeks ago that I would casually walk up to one of the nursing stations in University Hospital, have someone help me identify a patient, and then take a reasonably competent history and perform a slow and imperfect, but adequate physical exam, I would have laughed at you. If you had said that I would attempt to present this information to an attending I would have cried. So take heart, whether you are simply making the transition from the pre-clinical years to working on the wards, or you are working to regain the skills you had before a break, because it all really does come back.