Monthly Archives: March 2014

4 Kinds of People Who Must Love/Hate the Internet

We all live in a new age. Since the Internet has connected all of us in ways previously thought impossible, our very culture has changed in so many ways. Some companies have profited greatly from the rise new technology (Google), while others have been ruined (Blockbuster). Some people, however, have a mixed bag. These people include

1. Photographers

Despite my own complete artistic ignorance, I am aware of the fact that there is a group of highly skilled artists who take pictures. They understand concepts like lighting, focus, mood, color, and other artsy words to create pictures that are dramatic and inspiring. I think about guys like Robert Capa, who covered five wars. He was quoted as saying “If your pictures aren’t good enough, you aren’t close enough”. To put that in perspective, this is the same man who covered relatively dangerous situations like…oh, D-Day.

Doesn’t get much closer than this.

These kinds of people still exist today, I am sure of it. The problem is that they are completely overwhelmed by millions of teenagers with Instagram. Having an iPhone and access to the internet virtually guarantees pictures with sepia filters will be posted #nofilter to Facebook at some point in time.

The upside to being a photographer nowadays is also the internet. Building a portfolio, maintaining a website, and social networking give easy access to potential employers and give an aspiring photographer more exposure than was possible years ago. It’s also possible to edit all of your pictures with photo shop, but that’s an entirely different story. In college I had a roommate who was a photographer. He would shoot weddings and senior pictures, and actually rented out a studio in his hometown (which was ~2 hours away). He was very talented, and would upload his pictures directly to an iPad so his clients could see them immediately after he took them. Keep in mind he was about 20 at this point. He made thousands of dollars in cash every weekend (which he unwisely decided to keep in his desk drawer for a long time), and he now works for ESPN, shooting college sports and parts of their annual swimsuit edition. He relied absolutely on the internet and 4 different computers to keep all of his projects straight, but he was very successful.

2. Cable Companies

Cable companies want you to buy their big cable packages. That’s where they make their money, and it’s also why I get ads in the mail every week to upgrade to cable and phone. It is becoming increasingly common for people (like me) to skip out on the cable part and just pay for monthly internet. Cable costs about triple the price, and I know we won’t watch it, so we don’t pay for it. From their perspective, they just lost a significant part of their “income” from me, their customer, while still having to maintain the infrastructure necessary for me to have that service. Netflix, YouTube, and medical school suck up huge amounts of data, and the race is on to keep up with society’s insatiable need for bandwidth (upgrading to fiber optic cables, for example). This is expensive for them, but it might also save them in the future as more people ditch the traditional cable packages but remain customers for the internet access.

3. Actors

Admittedly, celebrities have always had many people paying close attention to them. In fact, there are other people paid to follow them around and report on what they are doing, which is ridiculous, but whatever. This applies mostly to people who are already rich and famous, so it isn’t the worst thing that could happen, but it must certainly be annoying. They used to run the constant risk of having unattractive pictures taken and then finding those pictures on magazine and newspaper covers everywhere.

Now things are much worse. Paparazzi still follow celebrities around, like those little fish that attach themselves to sharks, but now they can post things to the internet. Once things hit the web, they will never ever go away, just like when you eat a single piece of pizza for lunch and you can still taste it two days later. Instead of having yourself on a magazine cover at the grocery store checkout for a week or two, you now have thousands of copies of that picture or news story circulating on the internet. Forever. Awesome. Paparazzi are also assisted by people who attempt to hack cell phones, Facebook accounts, and laptops to produce scandals and generate publicity for themselves, and they do it for free.

Most celebrities are also benefiting from their ability to use the internet to generate positive publicity. They can maintain an online presence and still generate attention, even if they aren’t in any upcoming movies or TV shows. I follow a few celebrities on Twitter just because they are funny (I have absolutely no idea if they are in any recent movies).

4. Musicians

Becoming a professional musician that makes a gazillion dollars is a lot like becoming a professional athlete. At one point, most boys in this country played baseball. Only a fraction of a percent of them ever sign an MLB contract. Tons of kids learn to play the piano, guitar, or drums. Very few of them ever play for Maroon 5 and make tons of money. Becoming a successful musician isn’t always about talent. Certain Disney stars have turned into “musicians” and continue to make money and sell songs despite their (sometimes) questionable musical ability.

I would hate to be a professional musician. It’s one of those fields where, no matter how good you are, there is always someone better than you. Nowadays, thanks to the internet, those people can be anywhere on Earth. Even when popular mainstream bands create good songs, it won’t be long before some talented teenagers with good equipment make a cover that is better than the original song.

One more thing. Remember when we bought actual CDs? From music stores? From the perspective of the band, that’s actually a good thing. How many times did you really like 4 (or less) of the songs on the CD, but you ended up buying the whole CD for those 4 songs? That created a good margin for groups, who got a whole CD of sales, even if they only had a single good song. Now nobody buys CDs. Instead, we buy music on iTunes, if we buy it at all. I haven’t bought music in years, I just listen to Pandora, YouTube, and the radio and I’m fine. Even if there was a song I absolutely had to buy, I’d get it on iTunes for $1.29. That doesn’t work out nearly as well for the band, since I am no longer paying $12 for the CD.

I could add to this list, and you probably could too. Authors lose money from illegally downloaded PDF copies of their hard work, but the Fifty Shades of Grey series started out as a PDF and that lady made a gazillion dollars. Many doctors who lecture at medical school complain about patients who are convinced they have cancer (thanks, WebMD), but huge advances in electronic health records have changed the way we do medicine. I’m convinced that an internet outage at my medical school would cause some students to have serious anxiety attacks. I am on the internet for hours and hours every single day, and many of my hobbies (like writing this blog) rely on the internet. I love it, but I hate it.

Thanks for reading! Thanks to a recent guest post featured on Student Doctor Network, I have had a huge influx of new readers from more than 15 countries, which is awesome. Thanks for the emails and comments, it’s been a lot of fun.

I Don’t Know Anything About Brains

The newest unit in my adventure called medical school is Neurosciences. After just three days, I have come to a couple of conclusions.

First, neuroscience is really hard. The content of the class itself is just very challenging. There are many anatomical structures to learn, pathways to memorize, and some fairly abstract concepts that need to be applied in order to really understand what’s going on. The class itself is going to be hard because we don’t take an exam until April, meaning we cover 5 weeks worth of material before taking any sort of evaluation. There is huge potential to fall behind before the test, and there will be too much material to catch back up.

Next, I have started to second guess my speaking skills. I have always thought that the neuron, the fundamental cell of the nervous system, was pronounced “nur-on”. In fact, I have never heard it pronounced any other way until Monday, when 4 separate neurologists called it a “nur-own”. Is this some sort of professional neuroscience thing to mark the pros from the outsiders? What’s going on? We need to ask the teaching staff to address this ASAP. Every time they confidently talk about nurrowns, i feel a little bit like a morrown.

Finally, I have realized that nobody really understands the brain. I don’t mean that we know nothing about it, just that we don’t understand it. Yes, we understand the areas of the brain that process certain information. We know tracts of the spinal cord and the types of sensations they relay. We even know the functions of the brainstem and midbrain. What no one really understands is how all of this happens. Even in “smaller” nuclei in the brain, there are something like a million neurons synapsing together. There is a huge body of scientific knowledge on what a neuron does and how it functions, but a complete lack of explanation as to how a billion neurons together create conscious thought. The brain is the most complex organ in the body, home to all of our higher orders of reasoning, memory, emotion, and thought. It’s amazing, but we still don’t actually understand it.

This is the first cool brain image Google brought me.

I was talking about this with my family last weekend. Have you ever seen a 30 second commercial for an antidepressant drug, followed by a full minute of side effects and warnings? It’s because we still don’t get the brain. Compare that drug to, say, an antibiotic. We know exactly how that antibiotic is metabolized, the effect it has on bacteria, side effects on the patient, and certain kinds of infections that can be more easily treated with that drug. An antidepressant is far more complicated. For an SSRI, for instance, we know what it is supposed to do, but this action causes a huge amount of side effects due to its action on the brain and neurotransmitter levels. Why would this drug cause suicidal tendencies in younger patients? Good question.

I really like studying neuroscience because I think humans have awesome brains. We have enormous brains, by the way. Why are babies born so young and relatively helpless? Because otherwise their enormous brains would be too big to squeeze through the birth canal. Our skeleton is designed to support a large skull full of brains, and our metabolism is geared to continually supply our brains with the energy it so desperately demands. The most spectacular part of our brains is the interconnections, or synapses. This is where the magic happens. This is why humans are so fundamentally different than any other animal. The interconnected nature of the brain is the reason we make music, paint pictures, write stories, love, hate, and want things. It’s the reason certain smells can evoke such vivid memories, and it’s the reason we can even undertake an effort to learn about our own amazing cognitive ability.

The best analogy for the enormous complexity of our brain is outer space. Even the word we use to describe it fails miserably to convey the entirety of what it actually is. Calling the universe space is like calling the ocean wet. Astronomers are still discovering more planets and stars in our very own galaxy, which is sort of like finding more furniture in your living room when set to the scale of the universe. Small wonder we don’t fully understand our own brains. I wonder if we even can. Even with the elaborate supercomputer sitting in my head (ok, more like an iPhone. Or a fax machine), I will never be able to actually understand how big the Earth is, and I will definitely fall far short of grasping the size of the solar system or galaxy. I don’t think it can be done, but that doesn’t mean we shouldn’t try. Who knows, it could be my generation of neurologists that discovers ways of treating and curing Alzheimer’s disease. What’s the saying about effort? Shoot for the moon, and even if you miss, you’ll land among the stars.

Time for me to wrap this up for the night. Thanks for reading! If you have read this far, you may be interested to know I will have a guest post featured on the Student Doctor Network next week. I am very appreciative of this opportunity to reach a wider audience. Also, their forums are incredibly helpful for any pre-meds who haven’t found their way over there yet. Just saying.

Standardize Me

I didn’t post at all last weekend, even though I really wanted to do so. There are a few good reasons why. Besides unsuccessfully fighting off a cold and studying for three exams this week, I am also incredibly lazy and didn’t have the time or motivation to sit down and write the post that has been on my mind for several weeks. It’s only fitting that I find this motivation shortly before my pathology final, most likely using a blog post as another reason to avoid studying  for this test. As one classmate posted on Facebook so accurately: “I find that I Netflix better with study going on in the background”.

I don’t even have to study all that hard for this exam. Because of our grading system (pass/fail) and the assignments and tests I have already completed give me all but six points I need to pass the class. To put in another way, I need to get just 6/100 questions correct to pass this class. I could do that in my sleep. Don’t worry, I will study hard and do fine. (Edit: I actually did pretty well on it).

Our Pathology overlords are doing us a bit of a favor, they tell us. All of their exam questions are “board style”, similar to the format we can expect when we take Step 1 next year. This means that we take the exams on our computers through secure browsers, and that some of the multiple choice questions have options a-h instead of a-e.

Our questions are slightly harder than this, by the way.

Another way we are being prepared for Step 1 is that we are doing everything way faster than previous classes have ever done anything. As I write this in the first week of March, we have already completed all of the Year 1 curriculum. Next week we will begin Year 2 curriculum. The benefits to us include more time to study for Step 1, and more time in rotations before having to make important residency decisions. This all seems like a good idea to me, but we are the guinea pigs in this little experiment, so only time (and our board scores) will tell how it worked out.

This got me thinking about all of the standardization we are receiving. The main goal of the first two years of medical education is to perform well on Step 1. My understanding is that this test makes sure new medical students have an appropriate amount of basic medical knowledge before entering the wards and practicing on real patients. This actually works out very well for me, as I have a long history of crushing standardized tests (including NBME pathology most recently).

Recently my brother-in-law graduated from the police academy. Police officers have a very important and challenging job not unlike a doctor. They have a huge body of knowledge to learn, including the geography of their city, procedures of their department, legality issues, physical ability to drive, arrest, restrain, and I know many cops that have a highly developed “sixth sense” that gets them out of dangerous situations. Even my limited EMS experience has shown me the value of this sixth sense, but I doubt it could be taught.

Now if the police academy worked like medical school, they would spend 2 years in a classroom watching powerpoint presentations on street layouts, with the dangerous areas highlighted. They would take multiple choice exams on how to handle interactions with dangerous suspects, maybe watch videos on driving skills. Thankfully, my brother’s academy didn’t work like this at all. He rode with cops, listened to their advice, and saw firsthand dangerous areas of town. He went to an abandoned runway and spent an afternoon learning defensive driving techniques.

Medical school isn’t taught like that, and I’m not even sure it should be. All I know is that medical school has been taught the same way for a very long time, which is why it is so standardized. There is a well defined process to becoming a doctor, steeped in tradition and learning. If improving the quality of medical education came at the cost of leaving behind those traditions, would anyone attempt it? Will there be a series of huge sweeping changes in the coming years, or will innovation come in small steps, creeping along over the years?

I’ll have to think more about this, but it’s something that will be on my mind as I work my way through medical school.

This post is now very late, but thank you for reading!