https://sites.google.com/site/microbeinvader/

This is a step in the right direction: making learning fun and with more short-term benefits.
I can't vouch for correctness, but the game seems well-designed.

Now, I don't know if studying for the Step using a videogame is a particularly good idea. But its definitely a novel one.

Foodie

I've been lying in bed for 2 hours now, waking up with what feels like a grade D hangover. Tired, feeling like my house suddenly came to life, and its rectum is situated directly over my bed (On a completely unrelated note, a bird shat on my yesterday morning. Not a great way to start the day). The thought of reviewing another organ system was about as appealing as peeling an eel.

My current mood probably has to do with the fact that I didn't have enough to eat last night.

Thinking back, my food situation in my new apartment has been rather inefficient. Unlike my last apartment, the additional roommate meant even less space in the fridge for food. More of my food gets lost in the vortex of hidden fridge space until it goes bad, or it has to sit out on the counter. Additionally, the pots and pans here are much smaller as well, which means I can't prepare enough food for a week in one sitting. I've essentially had to prepare between 1-2 meals at a time, which takes up a lot of time. And finally, my preferred grocery store is now a few minutes away. This wouldn't be a problem, save for the fact that I don't have a car. I simply pack as much food into my backpack as humanly possible, and then carry it all home. Occasionally, I have to make 2 trips, and my last attempt at grocery shopping was so frustrating that I never bothered to come back for the second round of shopping.

Ergo, I am currently alternating between breakfast and lunch continually.

Anyways

In other news, the laundry situation has been an improvement. I replaced my last detergent with something that doesn't seem to cause my skin to explode. I don't know how much of my clothes I'll be able to bring back to Canada, as my books already exceed my luggage weight limit. When I return to the states, I plan to supplement my 8 pairs of mix-and-match socks with just a few pairs of new sock/underoos. The following are pricier than what I usually go for, but have great reviews in terms of comfort and durability.

Socks

Undergarments

Finally, tomorrow is Valentine's Day. You know what that means? Next week, I'll have access to a ridiculous amount of discount chocolate. For those of you that have a significant other, I would recommend a holiday card from the heart.

Uberty

I'm at a wierd place in life. My body is changing. It yearns for lofts, and steamer trunks, tables made from salvaged wood, and color schemes. It demands better coffee and clothes that exist outside of the category of "hoodie". I fear I might be going through Urbanuberty, puberty's lesser-known cousin.

Looking at some pictures today:

 I came across this textured wallpaper

as well as these invisible bookshelves

and this...whatever its called. Vanity tray? Club bathroom imitation?

All three seem easily doable. The bookshelves are from a Norwegian (autocorrect is having a fucking field day with that word) company, but it doesn't look like it would be hard to weld something similar. The textured wallpaper is the only thing that can't be scrounged together from spare parts of goodwill.

Anyways. (and yes, I use anyways as often as Kurt Vonnegut "so it goes".

a) I am out of food. I need to go grocery shopping.

b) I noticed that I can have a very tough time getting started some mornings if I don't talk to someone. Its very odd. All it takes is a 3 minute conversation and I'm good to go.

c) I've had trouble with waking up early in the morning for the last week. Yes, pretty much the entire week. Probably because of stress. A friend suggested that instead of sticking to strict schedules, I should just start working when I feel like it. Its been somewhat helpful, if not in sleep, at least in motivating me. I started getting work done for the first time in 3 days. Then again, it might have something to do with the fact that I took 2 days off.

This actually reminded me of a conversation I had with another student. It seems to me that among Caribbean med school students, I've come across a few groups of students that applied. The following two were the more interesting. 

One group was impatient. I don't mean to say that they suffered from a personality trait; rather, due to various life circumstances, going through the traditional route to a North American med school was not feasible. Truth be told, many people can go through 6 years of studying and waiting just for their application to hold any potential.

Notable examples:

• One student was a fully licensed doctor that wanted to specialize in a new field after practicing for +20 years. His university credits were no longer valid, and thus he would need to go through an additional 4 years of undergraduate college/university just to apply to a US med school. 
• One student had applied for 2 years in a row, and while getting an interview to a US med school, her MCAT scores were about to expire and she wanted to move on with her life instead of being stuck in limbo.
• Several students had families, and were unwilling to have them spend years waiting while the application inched forward

A second group just had problems. Bright students, but with factors beyond their control. For some, that meant financial issues or difficulty accessing a loan for a US medical school. For others, it meant psychiatric or social issues that prevented them from excelling all the time. A history of anxiety/ depression/ ADHD/ bipolar disorder/etc...  likely affected their performance in undergrad and kept them from having a competitive application for a US med school. Regardless of whether the issue was under control or not, the rest of their life was derailed by something beyond their control. Ross has a hit-or-miss in terms of addressing some of these issues. They do have staff dedicated to helping students with certain issues, as well as counselling services, but they are limited in high quality staff.

So maybe I don't function well with only 1 day off per week. I'm just inefficient like that. Oh well. 

I'm sure there are other groups, such as those that were pushed into the field by their parents, but I haven't directly observed this phenomena at Ross.

So it goes. Uh. I mean, 

Anyways...

Interesting read, in case you want to keep procrastinating.

Rxercise!

The cycle seems to be repeating again. Woke up at around 6:30AM today, despite alarm being set for 7:30 AM. Blarg.

Looking at possible causes:

-I exercised later at night than preferable
-
-
-yeah that's all I got

Asking a doctor about my observation

I blame my decision solely on my preference to go gymming at 8PM. Why, you may ask?

To ask "Why?", press 1 now.

To just sit there and keep reading, stay on the line, and a representative will be with you shortly.

We are expecting longer than normal call volumes. Just stay on the line and we will be with you shortly.

How I Met Your Mother airs on Mondays at 8. That's the reason. Yes, I watch the show. Yes, its suffered somewhat in quality. Yes, it makes cardio workouts a lot less boring.

Anyways, after the cardio I tried doing a few squats. I've been on an endless quest to try and squat with proper form. My first attempts in university used videos and advice given by people who sadly didn't know what they were talking about. The advice "don't go below parallel" contributed to an annoying amount of knee pain I've felt over the years. Poppycock, I say! My attempts on the island's gym were thwarted when I began focusing on continual increments in weight plates, as opposed to how my body felt. After some back and knee pain, I finally stopped following sharp right-sided abdominal muscle strain, which I feared was a hernia at the time. In Miami, I came across a fellow that gave one or two suggestions, and also purchased a better book.

Each time, I try to incorporate the previous lessons I have learned. It actually reminds me a lot about medical education. Some facts/advice comes easily and a student understands and integrates into the thought process, and others are read but not consciously incorporated. Facts/advice that is easily understood usually forms the backbone of our understanding of topics, but at a cost that students may rely on this information at inappropriate times. Sort of like using a hammer that I understand well (hit the small pointy thing into the not-pointy thing) when what I read is a screwdriver.

A Uworld question comes to mind that asked about maximum pulmonary vessel dilation in relation to the respiratory cycle. I thought back to the cardiovascular cycle, where during inspiration, pulmonary vessel dilation reduces the blood going into the left atria, causing a decrease in heart rate. Thus, I assumed that pulmonary vessels would be maximally dilated during inspiration. The majority of other students chose the same response as I did, and similarly got that question wrong. The correct response involves understanding the pressure/volume curves of the lung/chest wall. This is why doing questions are an important part of many sciences. Its not that one fact is wrong, but rather, not all facts are equal, and thus the right fact is necessary for the right process, to answer the right question. I believe this is all part of the meta-test; you aren't simply learning pathways, processes, facts and associations; rather, a lot of the implied training is having your thought processes line up with those of the test-writers. 

Anyways. I wonder where others are at incorporating sensors to help visualize and keep track a body while lifting. Seems like a fun project for when I get back home.

Oh, nearly forgot. I was musing on Kessler Syndrome yesterday (a potential phenomena involving debris flying around earth). Creating a hypothetical solution to this also sounds like a fun problem.

So many decisions...

No, not the movie Ted

Came across this Ted Talk by chance. He mention some of the stuff I've discovered on my own, or have read about from earlier readings, but also incorporates the tiniest bit of new physiology I hadn't come across before. Of course, physiology is a giant box of blarg that he barely touches on (with the exception of cardiovascular physiology) and I wish there was more on this.

 Parts of his talk do seem gimmicky and oversimplified. Then again, packaging and simplifying is all anyone sells these days. Nonetheless, he message across to a lay audience. The biggest downside to this talk is that the presentation ends just when it starts to get interesting. Mentioning other methods of improving physiology would have also been nice, as far as improving upon my last post.




In other thoughts, I really feel as though my GI physio (secretin? CCK? VIP?) and reproductive physiology  (specifically hPL) isn't up to par. Similarly, there is a huge bucket of liver that I haven't touched with a 10-foot pole, including: cholesterol and bile synthesis/excretion/reabsorption, genetic pathologies (Dubin-Johnson, Rotor, etc) and lipid-lowering agents (High Yield). Oddly, I feel as though I understand respiratory physiology, but my performance on Uworld indicates otherwise. I'm hoping to take a good chunk of tomorrow just revisiting the material I've studied this week and trying to re-commit it to memory and do more practice questions.

Update: reviewing bile synthesis and excretion proved relatively painless. The only thing that I seem confused about is whether there is a biological reason for the reabsorption of urobilinogen into the portal vein via the enterohepatic circulation, or whether this is coincidental. I suspect this fact is taught for diagnostic purposes, to distinguish between causes of jaundice based on laboratory values of serum/urine Unconjugated bilirubin/Conjugated BR/urobilinogen and symptoms (pale stools/dark urine/etc).

Double Update (Dubdate!): I really need to review the whole ALT(Alanine Transaminase), AST (Aspartate Transaminase), ALP (Alkaline Phosphotase), and GGT (y-glutamyl transpeptidase)

Cycling

Yesterday, I started packing my bags. Besides the few clothes and toiletries I have, my few remaining items include books, more books, some binders + pens, an Aeropress and Contigo mug, a B&D clothes iron...and thats it. Oh, I almost forgot: I have even more books. Too many to fit in one piece of luggage (and yes, its overweight). I'll probably need to buy a carry-on

This morning, I set my Comp retake date for April, and bought my plane tickets home. Currently on my third bowl of oatmeal. I really hate oatmeal sometimes.

I'm sitting back and looking at the last few days of work. It started out, predictably, with a lot of disorganization. By the next day, I had straightened up and was able to manage the urge to distract myself. I could write a thousand words about how it feels at times, but why bother?

One biochem pathway later...

Suffice it to say, the act of studying causes me stress and discomfort. I don't know why. Some people are distressed by spiders or dogs or falling out of an airplane (or possibly some combination of falling out of an airplane full of spiders and landing on an island inhabited by wild dogs). And so my first thought is to do something besides work. Maybe check my email, or look up a webcomic, or (the nuclear winter scenario) log onto Reddit. 

The stress continues as long as I study, and the urge to relieve that stress is endless. On days that I have slept well, I have more self-control and can march forward with less stress-relief interruptions. 

This describes the first 2-3 days of a new study session. 

Then, the unhappyness starts piling on. Going to the gym for an hour daily or every other day doesn't relieve the physical pain associated with desk-work. My sleep worsens, as I both tend to sleep later in the night (usually in search of things that will cheer me up) and wake earlier in the morning (because fuck you, circadian rhythm). My hobbies are reduced to snacking, or going to the empty fridge to remind myself that I don't have any food left. This might continue for 2-3 days of declining accomplishments.

Finally, I reach Minimum Effective Concentration. A day flies by and I'm a whole chapter behind schedule. 

Then I take half a day off to watch some TV, sleep in, or make food. 

Of course, there are times when its not as much about stress as it is about boredom. Hearing about a topic for the 5th time can be only so interesting. In this case, I can sometimes increase my level of interest by increasing the speed of the lecture (if its audio/video). 

Other things I've done in the past that have marginal benefits: 

-have my bags packed before I sleep, with a plan for the next day

-turn off distracting skype/cell phone/other ways for people to break one of my few minutes of concentration

-change study areas

-change my study sources (rotate between questions, books, lectures)

(Pomodoro and flashcards did not show signs of effectiveness, but perhaps I didn't do them properly the first time. )

In the past, I've focused on trying to reduce the urge to slack off. However, this all seems to stem from the fact that studying causes stress. Is there a way that I can dissociate the two? Maybe cognitive behavioral therapy?

More to follow once I've had a real lunch. I really hate oatmeal right now