And We're Off!

Trinidiom #93

2011-03-20T16:52:00.001-07:00

"That's got to be a hard bullet to swallow."

Trinidiom #92

2011-01-14T18:24:00.001-08:00

Trina: "You think you are all that and, what is it? a bottle of chicken?"

Trinidiom #91

2010-11-26T10:56:00.000-08:00

"Today is the best day to shop [this makes me gasp, I can hardly get her to come with me to the grocery store most of the time], It's the all that bustle and hustle."

Trinidiom #90

2010-11-26T10:55:00.000-08:00

Trina: "We could nail all those birds."

Ron: "Huh?"

Trina: "You know, with a stone. Like 'nailing two birds with a stone.'"

Trinidiom #89

2010-11-11T20:03:00.000-08:00

"Ron, I believe that deep in my fiber!"

Trinidiom #88

2010-11-10T16:00:00.001-08:00

"I'm here for your back."

Trinidiom #87

2010-09-05T16:51:00.001-07:00

"That's such a load of crack."

Trinidiom #86

2010-09-05T16:50:00.001-07:00

"That's such a load of crock."

Trinidiom #85

2010-08-20T14:34:00.001-07:00

She says these all the time, but I haven't been writing them down so much lately. Today's was discovered by my father-in-law, Ron.

"They're going to laugh you out of the water."

I know it has been forever

2010-07-16T11:02:00.001-07:00

...but life is like that.

So, hey, a little interesting piece of information. You may have seen the very buff lady trainer that teaches my Insanity class here (or scroll down to "Our new Life in Philadelphia").

As it turns out, she was Ms. America. Uh huh. Now I don't feel so badly that she can do more pushups than I.

The first time in my whole life

2010-07-01T14:23:00.000-07:00

For the first time in my whole life I snoozed my alarm so many times that it shut off.

I am on summer vacation!

One of my favorite parts is not keeping my cell phone on vibrate. There are no lectures to interrupt or labs to disturb. My phone can happily sing, beep and chirp.

I haven't dried my hair in weeks. I can wear the same thing three days in a row and no one cares!

It is good to relax.

My only appointments are at the gym where I'm learning to loose my inhibitions dancing salsa, mambo and cha cha. I am kind of a troll of a dancer, especially compared to the tall, lanky, graceful Tahitian-dancer instructor. But, I just close my eyes, pretend I'm thirteen making a music video with my cousins and go for it! My instructors generally smile at me, with that kind of pity/entertained look that says, "you're hopeless, but good effort." The goal is simply to sweat and enjoy myself, both of which are happening in large measure.

Last Philadelphia Apartment

2010-06-29T08:41:00.000-07:00

Four weeks into our stay we transplanted from the Washington Square side of town to the Rittenhouse Square side of town. Our new place is urban, chic and tall.

Welcome to our place...

Look at how tall this place is...

Here's where we eat...

This chair makes my neck bend forward...

This couch is more comfortable. The lamp to the right of Ron has a red bulb in it. It looks creepy at night...

Doorway between the kitchen/eating/living area and bedroom/bathroom area. Look at how tall the doorway is!

Very comfortable bed. And, our air conditioner that we brought from home. It's one of the hottest Junes on record here.

Closet...

Last, but not least...the bathroom.

That's the tour.

First Philadelphia Apartment

2010-06-29T08:33:00.000-07:00

We're only here in the city for eight weeks, but we are living in two different places. For the first four weeks we were living on a quaint street, in a cutesy part of town, in a bed and breakfast full of antique furniture. We moved in late at night, so it was dark outside.

Here's the front door to the building.

Then, the hallway of mirrors...

Shared sitting room #1...

Shared sitting room #2....

Hallway to our room...

The bedroom/sitting room...

The kitchen...

This last picture is a little blurry, but you can see the main room and the kitchen in the back. There was a bathroom too, but who wants to see a bathroom?

All in all it was a charming little place.

Our New Life in Philadelphia

2010-06-15T13:32:00.000-07:00

Hi. Welcome to Philadelphia.

Right now, we are living in a bed and breakfast in a cute neighborhood right in the center of things (we're on Clinton St, near 11th and Spruce). This is Clinton St, but it is not my picture. It's a pretty good one though.

We are here because Ron's got an internship at a legal firm called Berger Montague. He is working on antitrust litigation. If you'd like to know what that is, please ask Ron. I do not really know. He seems to like it because it involves lots of arguing and having opinions and depositions.

I am a stay at home Trina. Basically I have 11 weeks off this summer before I am a full time med student/resident for the following six years straight. So, while many of my classmates are off doing research, etc. it seemed like a good idea to me to not. I'm working on editing our book that we wrote while traveling around the world, trying out new classes at the gym, baking these new blueberry bars my mom invented and stuff like that. These intense med students need to learn to relax! I am enjoying remembering that I am a person and not just a memorization machine.

Speaking of the gym,

it is called 12th St and it is pretty cool. It was a great deal and they have tons of amazing equipment and really strong trainers, etc. I picked it for the deal. An anonymous source recently confided to us that this gym is the center of the gay pickup scene in Philadelphia, which explains all the guys with hairdryers and the men's only spa. But, as far as I'm concerned that just makes it an easier place to learn salsa dancing. We are both having a blast with our classes. Ron's first was one called Insanity taught by Midge.

Here's Midge:

She's a really nice lady who provides an excellent workout. Yesterday I went to a Tae Bo class taught by this lady whose sweats said "Tae Bo Extreme" and shirt said "Boot Camp." I accidentally went to the advanced one. Oops. I didn't know I could get sweat to pour off my pony tail like that.

Today I tried out Zumba for the first time. There were elderly people in there, so I felt like I was in less danger of passing out or throwing up than last night. It's like a "learn to be a latin lover dancer" class. We wiggle our hips and shake our top and make seductive faces. The old guys are my favorite. No one really keeps up with the steps, but I theoretically salsaed, mamboed, sambaed and generally felt like I was on Dancing with the Stars. Tonight, Ron's trying one called Muscle Attack, but since that is more of a description of my body right now, I'm going for the Easy-Does-It-Gentle-Vinyasa-Yoga. I'll let you know how it goes.

This is generally a way cooler city than I thought. I had in my head that Philadelphia was kind of a rough, industrial place. Ok, I admit, a large portion of my knowledge about what Philadelphia was was from the beginning of Fresh Prince of Bel Air ("in west Philadelphia born and raised, on the playground is where I spent most of my days") - don't pretend like you don't know what I'm talking about!

In actuality, it is a clean, friendly, major metropolis. It's the fifth largest metro area in the country! Who knew? (The first four are NYC, LA, Chicago, and Dallas...at least according to Wikipedia.)

Philadelphia is exceptionally walkable, with friendly little maps posted every couple blocks. FYI, we live in the purple section, approximately three squares down from the little star.

I get a little confused because they rotate the maps so that the top is whatever direction you are facing. I'm still working on keeping left and right straight, (part of my decision to avoid surgery as a career), so you can imagine that putting East at the bottom of the map doesn't really work for me. I usually end up cocking my head to the side trying to put North on top, like this.

Ron came up with this helpful little mnemonic so I can stop making a fool of myself. Merry Christmas Santa, We Love SPiLLS (Market, Chestnut, Sansom, Walnut, Locust, Spruce, Pine, Lombard, South). So now I'm wandering the streets muttering to myself "Merry Christmas Walnut, what was that about knocking things over?" I'm not sure if its a lot better than the head tilting.

That's about it for me.

Since I'm working on the book, if you have any particularly favorite stories from our trip, please let me know. I want to be sure I don't leave out the best part!

Rage Against the Law Review

2010-04-23T10:15:00.001-07:00

The Harvard Law Review is a truly venerable institution. But beside its impressive exclusivity (if such a thing can truly be impressive) and the fact that it has produced major leaders of several fields (including, "The Free World"), I'm a bit skeptical about its application to my own life.

After I arrived here, it didn't take long to find out that the really amazing students tend to go for law review. I've heard "everyone tries out for it; at least everyone who thinks they have a shot" and "it's the ticket."

There's that darn ticket again. Who knew I'd meet so many tickets that led to more tickets? I used to think the ticket was a good SAT score and getting through calculus my junior year (oh, and student leadership and sports). Those were 13 years ago! Since then, the ticket has included (but has not been limited to) college, excellence in college, good graduate standardized test scores, good professional credentials, good networking, law school, an amazing law school, Harvard Law School, top grades at Harvard Law School, and now law review. Or legal aid bureau if you aren't quite Law Review material or you are woefully bent toward the practicalities of actually doing something for resource-less people.

Now, I'm sure law review has its place. It is, after all, a proxy for "hey you, I'm smarter than smart." (better translated as, "I'm smarter than you"). And, frankly, that opens doors. So does wiling countless hours away with brilliant peers who will go on to do great things and be the connections you need in a connection-driven world.

And, if you are a future academic, it will look odd if you didn't do law review.

But that's my point. This whole prepackaged path you should take thing is starting to really grate on me. Really? Another one? THIS one, finally, will be the one that makes it so I don't have to find any more of these super-panaceas for my professional launching? I'm skeptical.

The law review competition lasts about a week, and, I'm told, includes scouring a couple thousand (!) pages of legal documents so that you might write some sort of document that impresses the readers. And correcting another document.

Of course, if you are smart enough to get in, you get to spend 20 hours a week for the next two years working for them. The first year, though, involves mostly technical work (what we call sub-citing here). That means that you spend your time looking at the citations in scholarly articles to make sure they are correct. Formatted correctly (there's the 300 page bluebook for that--just for formatting citations!) AND cited correctly (is that really what that document said or implied on that page or in that chapter or as a whole?).

Sound fun? Nope. But each year, hundreds of geniuses line up like lemmings to try to do it.

I've done some subciting for a journal (two days of it was enough to make me want to swallow turpentine). I'll maybe do a little more, just to make sure I have the skills I need. But I'd rather, I don't know, enjoy and engage my classes than do it 20 hours a week. Take the extra time and have a life, or even if not, choose academic pursuits that aren't hellish.

True, maybe I could get on law review and publish an anonymous note that I might later get credit for. That's publishing (sort of). Or maybe I could try doing novel research and actually get myself published in a law review, rather than being the publisher's slave! Perhaps I'll get better grades if I don't spend all that time running over my soul. Might I make friends without getting on law review? Maybe? Might I start chasing down people who are already successful professionals, rather than just betting that some of these smarty-pants will end up in a position to help me? Perhaps.

There are people who genuinely belong on law review, and I'm thrilled that they are going to compete. They should and I'm proud of them for working hard and making it. But I'm stunned by how many people have fallen into the herd and have abdicated their greatest talent--independent thinking.

Not me, not this time anyway. I didn't give up a lucrative professional career, leave my extended family and quit traveling around the world so that I could go to law school and ruin it as quickly as possible by over-committing to something with mostly replaceable benefits and purgatorial demands. I'm not going to do it just because it is someone's twisted idea of more and better, especially when it is, in so many ways, less and worse (if you are me, anyway).

Nope. I plan to sing along with Sinatra when I finish law school: "I did it my way."

Justice

2010-04-21T16:40:00.001-07:00

Great news! Yesterday, I was offered a job teaching for Harvard College. The position is for a hugely popular, internet-published class called "Justice" that examines contemporary moral and political conundrums in light of the western (political) philosophical tradition. Perfect!

I'll have a group of 18 (or two groups of 18) students, who I'm responsible to further the weekly lessons with. Apparently I'll be posing novel problems (not the ones he addresses in lecture) and working the discussion to teach whatever it is I'm supposed to be teaching.

I'll also coaching the students on paper writing, and grading their two papers to boot, as well as preparing them for their final. It should be pretty exciting.

Check out the link to the online course; it's got a promo video that explains the course.

http://www.justiceharvard.org/

A little hard to study

2010-04-20T15:30:00.000-07:00

When I think about where we were headed a year ago. Why again did we decide that law/med school were a step up from living in Cabo for six weeks?

Mother Teresa Interview

2010-04-19T16:45:00.000-07:00

http://sarahthomasbaldwin.blogspot.com/2008/06/unstoppable.html

What a woman.

No More Launching

2010-04-17T08:28:00.001-07:00

Once again, it has been a long time since I have blogged. The last few months have been very full: We've had a parade of friends and family visiting, we had a dear family friend in his early twenties die, and we've been continuing this whole medical and legal thing.

All this has had me thinking. Yes, I've been thinking about whether a contract was unconscionable, when the police power goes too far in land regulation and should be called "a taking", the role of international law in shaping behavior and of course of litigation strategies.

But I've had lots of bigger questions on my mind. The really big ones, life, death, faith, security, will be left for another time.

But behind those has been a nascent realization that I'm going to try to put in words.

I've spent my whole life launching. From the beginning, it's been "reach for the stars" and "you can do anything". And, sitting at this place and time, it feels quite true. Just graduating from HLS, I can access and be a part of the highest echelons of US money/power culture: politics, corporations, government, investment banks, consulting and law firms. I can do more, get bigger, better, keep on expanding until...what exactly?

I guess I'm starting to fixate on this "what, exactly?" I kind of asked this question when I chose against my burgeoning corporate career and came here, because I had to stop a lot of momentum, economic and otherwise, to choose to travel and go back to school. But it still all bore the mark of more, better, launching into a new stratosphere of challenge and adventure.

Maybe this is just my impending thirtieth birthday talking, but I'm sort of done with this whole launching-expansive thing. It's not that my eyes aren't set high. Sure, it would be fun to run a Fortune 200 company, or sue one, or work for justice department, or be the guy who appoints the head of the justice department (that means be president). Yes, I'd like to remake the academic/legal/political/technological world. I want to chase interesting adventures and find ways to use those adventures to make a real difference in people's lives.

But I wonder if Solomon is a few steps ahead of me. It seems that this is all a bit of a meaningless chasing after the wind. More isn't necessarily better. In fact, it seems they often have an inverse relationship (gasp, there went my chances at the Presidency).

I guess I'm struggling to ask, how much is enough? Or, better yet, what is a better measure than quantity/prestige/power/exclusivity/impact? I'm sure that the answer lies in the words of the One who said, "blessed are the poor in spirit", but I just haven't quite figured out how to integrate all that.

I've noticed something. That almost always, those who are chasing these windmills are working themselves literally to death. Maybe that's worth it, if you have something or some end you are working for that is worth giving your life (and relationships too). I can't imagine any worldly cause worth sacrificing my relationships for (although that may just be a measure of my selfishness too, hard to say). Certainly it wouldn't be worth it for a "cause" that merely represents my own desire to have engaging or satisfying work. In the end, those sacrifices would be the opposite of satisfaction.

The truth is, I don't find these people all that impressive. They are a bit smarter and savvier than average, but not disproportionately so. They work hard yes, and were in the right place at the right time, usually by accident. But they aren't larger than life. In fact, a lot of them seem kind of small.

Anyway, I don't have any answers. I don't know what my life will ultimately look like. I don't know what dragons I will slay, or whether I will be a stay-at-home dad dragon slayer. What I do know is that I'm done graduating and getting sent off...I'm almost thirty years old now. Yes, I want adventure. I want intellectual challenge, to continue to see the world, to be pushed. But I also want to be rooted, to make choices that are judged on a value scale more worthy of the Kingdom I'm inheriting.

Maybe I'm just growing up?

Update

2010-03-15T19:26:00.000-07:00

I just finished a week of exams, a week of Spring Break and now Ron's on Spring Break. The good news - we've generated a lot of stories and pictures for the blog. The bad news - we won't have time to post it for another week or so.

Talk to you soon.

Trinidiom #84

2010-03-07T14:03:00.000-08:00

It feels like it pushes my bristles the wrong way

Trinidiom #83

2010-03-03T14:02:00.000-08:00

I'll stand vigil for you.

Trinidiom #82

2010-03-01T10:46:00.000-08:00

"It shoots them"

(They're shot)

Trinidiom #81

2010-02-28T10:45:00.000-08:00

"You are bouncing all over the bottom floor like a ping pong ball!"

Trinidiom #80

2010-02-26T10:45:00.000-08:00

"You're between a hard place and a wall."

Trinidiom #79

2010-02-24T10:45:00.000-08:00

"I'm on my last legs!"

Trinidiom #78

2010-02-22T10:43:00.000-08:00

"Sorry for being such a pain on the side."

Trinidiom #77

2010-02-20T10:43:00.000-08:00

"I'm covered from tip to toe!"

Also present on New Years Eve...

2010-02-18T14:50:00.000-08:00

Romy was the most fun to take pictures of...but there were a few other people there =).

My gorgeous cousin Jossie.
My aunt Linda, Mom, Dad, Ron and directing the scene...Romy.

Last but certainly not least...I got to spend a wonderful afternoon with my grandparents on New Years Eve. It was great to see each other again!

It's Dec 31st!

2010-02-18T14:46:00.000-08:00

Speaking of adorable little girls...here's Romy! I can't believe how much she's grown and changed since last time we saw each other.

Trinidiom #76

2010-02-18T10:42:00.000-08:00

"Suck it for all it's worth!"

Chocolate is important

2010-02-16T14:55:00.000-08:00

I love Trader Joes 72% dark chocolate. Love it. Plus, it's good for you. And, that's a great justification.

Lucky me, they sell it in "pound plus" sizes, so one bar lasts quite a while. Unlucky me, we ran out the other day. This upset me.

We do not live with easy access to Trader Joes, but desperate times call for desperate measures. I figured out if I took two buses and walked about ten minutes I could get there.

Relieved to see a full supply of them, I loaded ten bars in my basket and got in line. The woman behind me in line said, "Wow! That's a lot of chocolate! What are you going to do with all that?"

"Eat it." I said, totally straight-faced.

"Oh!" she said, nervously laughing. "Well, enjoy!"

"I will." What's wrong with these people. This is awesome chocolate. Why would I need to "do" something with it?

I get to the checkout. The clerk says, "Oh my! 10 lbs of chocolate! Are you having a big party or something? Fondue?"

"No. I just like it. We ran out."

"I'd say so!" Same nervous laughter. Weird, what's wrong with everyone here.

I walk in the door with ten lbs of chocolate in my arms. Ron looks at me, a little surprised, but with a huge smile on his face and says, "maybe we shouldn't have sent you there this time of the month."

Trinidiom #75

2010-02-16T10:42:00.000-08:00

"I'm falling off my job."

White Coat

2010-02-15T13:58:00.000-08:00

It's the strangest thing. The white coat has power. It gives entrance to the most private parts of peoples' lives. Someone you've never met lets you look inside their ears, listen to their heartbeat, take off their clothes and touch them. It's a weird amount of power. I think I notice it so much because I feel so wholly unworthy of it.

When I'm in the exam room I am not a person, a woman, a wife, a daughter...I am a doctor. When I greeted a teenage boy patient...I have never been looked at so utilitarianly in my life. It was as though I was the most uninteresting thing in the world. I wasn't a girl, I was a doctor.

I think it says something about how we rationalize the gross invasion of privacy. I go to the doctor, he is a man, I am a woman...about the same age. In any other circumstances him instructing me to remove my clothes, then touch, look, ask probing questions...this would be totally inappropriate. But, when it's a doctor, it's ok. Even when you're little and they teach you about stranger danger and everything...they say no one should touch your bathing suit areas, except your doctor. It's really intimate. So it's like everyone involved compensates by detaching. I, the doctor, see you as this machine that needs fixing. You, the patient, see me as the mechanic who can help you figure out this problem. So, I think it's a little weird.

Trinidiom #74

2010-02-14T10:41:00.000-08:00

"I'm gonna throw trash at you!"

Cadaver Thoughts (last week or two of Anatomy)

2010-02-13T14:26:00.000-08:00

We removed his brain today. The only thing I can imagine is like it is watching a baby be born. Emotional, amazing, scary, wonderful, supra-human.

I want to hold it! I want to love it. I want him to know it's going to be ok. God is so incredible.

This nerve between my fingers is how he could smell. This right here is how he saw the world for 83 years. This one gave him the ability to wiggle his tongue.

This was him. All of him. In my hands. I want to love it and hold it.

What an incredible honor. An intimacy beyond all intimacy.

First day in clinic!

2010-02-12T10:59:00.000-08:00

I get to spend one afternoon every week following around a family medicine doctor, wearing my white coat, my stethoscope and pretending I'm totally official!

I feel like such a fraud. I walk in the room, introduce myself to a patient saying, "I'm a first year med student" meaning - I know nothing! Don't trust me! Don't believe anything I say! The patients hear me say, "I'm basically a doctor." I find this unnerving.

My teacher-doctor will put his stethoscope on the patient's chest and I'll mimic him and nod knowingly. The first time I couldn't hear anything. Turns out I had my stethoscope on backwards.

One of my fellow students said it perfectly the other day. "I go to do the heart and lungs exam and basically when I hear the beat, I think to myself - he has a heart, check!"

Everyone has to start somewhere right?!

I have to say though, I am learning so much. It is fascinating to watch it all come together. We have spent the past many months absorbing incredible amounts of information. To see why it matters and how it fits is wonderful.

Trinidiom #73

2010-02-12T10:41:00.000-08:00

"Don't bust with me right now!"

Cadaver Thoughts (November-ish)

2010-02-10T16:39:00.000-08:00

Our poor guy. He's had a lot of surgeries. Given all the creative re-plumbing, his intestines are very confusing. But, they're his. We're studying for the practical and even when the tables get moved around, I always know when we're with our guy because of his look.

I find myself holding hands with or gently touching the head of whoever we are studying on. These bodies don't scare me anymore. They are wonderful, interesting and sometimes I think a little lonely. Probably not really. But, just in case, it doesn't hurt to quietly hold a hand while we identify the splenic artery.

In order to do the pelvis dissection we have to bend his knees into the stirrups. This requires severing the patellar tendon. I'm cutting it. It gives way and what in the world is that?! It's metal! He had a knee replacement. No way! He was holding out on us. I didn't know that. It feels like I just found out that my cousin Jossie got to go to the mall alone before me and didn't tell me.

It's Dec 23rd!

2010-02-09T14:29:00.000-08:00

We got to spend December 23rd with two of our all-time favorite people...Melia and Joe.

Found a couple more priceless ones...

2010-02-09T14:20:00.000-08:00

There were other people there too...

2010-02-09T14:15:00.000-08:00

It was so wonderful to be home and spend time with our friends. We miss you so much here on the other coast.

Aaron and Holly

Melinda and me.They're still the stars of the show =).
It was

Trinidiom #72

2010-02-09T10:40:00.000-08:00

"The bug in my boo."

Cadaver Thoughts (October-ish)

2010-02-08T16:27:00.000-08:00

We're done with Back and Limbs - the first of three sections of Gross Anatomy.

Today we need to remove his chest wall to visualize the heart and lungs. His ribs need to be disconnected to get the chest wall off. No one wants to do it. It doesn't bother me. I feel increasingly close to him. We have all spent a lot of time together. He's ok with this. He knew exactly what was going to happen to him when he decided to give us this ultimate gift. I can almost see him winking at me as if to say, "you ain't seen nothing yet."

We lift off the chest wall. OH MY GOSH. I can hardly catch my breath. It's the most amazing thing I have ever seen. Oh my gosh. I have tears in the corner of my eyes. I look over and one of my lab partners has them streaking down her cheeks. It's his heart! It's his lungs! I finger his lung lobe; it's soft and spongy. His heart is like a centerpiece. The aorta feels like a rubber hose. It is so strong. It's tough. This is his heart!

Heart removed and we can hold it. I had no idea it would feel like this to hold a human heart. And it's not just "a" human heart, it's his heart. It's strange how we all feel increasingly close to him. It's like he keeps inviting us in farther and farther.

Next lab, we open the abdomen and there's no omentum! I'm still a little rusty on exactly what the greater omentum does, but I'm pretty sure there's something missing. And, where's his stomach? They told us in lecture it is often a lot smaller than you imagine. I ask my lab partner. We can't find it. I feel dumb asking a prosector to show me his stomach. They just posted the cause of death on the board. Do we want to look?

He's 83. He died of stomach cancer. He's 83. I'm so glad to know. He has no stomach. They took it out in a surgery. Someone has seen this before. Weird. Some surgeon had his hands inside our guy. How violating. I'm sure that surgeon didn't love him like we do. Did I just say "love"?

Trinidiom #71

2010-02-06T10:39:00.000-08:00

"You're like a drunk in a crystal shop."

Cadaver Thoughts (September-ish)

2010-02-03T16:14:00.000-08:00

I didn’t expect to feel much the day we met our cadaver. I took Anatomy in college, studied on a cadaver. I remembered that each day my heart would catch in my throat when I first glimpsed a skinless body from the door. But, one deep breath later, I saw Flexor Digiti Minimi, not someone’s finger.

I walk in the room. We unzip the bag. It’s a man. His legs, stomach and arms don't trouble me. Fingernails. Earlobes. Forehead wrinkles. It isn't passing. He still looked like he, not that. We gently wrap his hands, feet and head to preserve the delicate structures. I can’t help but wonder if we aren’t covering up the most “human-looking” parts of him to make it easier for us to begin cutting into him.

This man lays before me, a wonderland of learning. The pinnacle of biology, chemistry, physics, all wrapped up into what was…a life. I’m going to get to do something no lay person gets to. I get to look inside. I get to see how it works. Touch it, feel it, look at the actual inside of a human body. It’s amazing.

The first cut is the hardest. Piercing the skin seems violating. His outer shell now has this penetrable opening. Task at hand is removing the skin of the back. We’re trying to “find a plane” and not cut anything too important. Not a lot of time to feel how weird and gross it is that we are taking the skin off a person. Not until I close my eyes to go to sleep. The dreams aren’t upsetting, and that’s upsetting. It’s so matter-of-fact to visualize skin systematically removed.

By the second lab, removing skin isn’t a big deal. It’s a hassle, and we are flying through it.

Third lab, we are dissecting his Axilla and Cubital Fossa. I don't have any idea where that is. The armpit. Why can't they just say armpit? To get to his armpit and visualize his Brachial Plexus, we have to put a rope around his wrist and tie it to the post at the head of the table. I'm holding his hand as I'm awkwardly trying to tie up his wrist. It feels good and strange all at once. I drop my tweezers and as I bend over to pick them up, his hand slips into my scrub pocket. I jump, and laugh and the whole thing is just so weird. How am I supposed to feel about a dead man's hand in your pocket?

The experience of lab feels increasingly normal. Ron has to remind me to take off my scrubs before I come in the kitchen because I don't notice the smell anymore. I don't know his name. We've taken to calling him "our guy." Officially he's Pod 1, Table 1, but by the time we've reflected his biceps brachii, it seems like he's ours.

Thoughts (Later October-ish)

2010-02-02T16:12:00.000-08:00

I think the human body is amazing. It is utterly complicated, yet filled with elegant patterns. It’s inspiring. I think it’s because it’s so immediate. The concepts are so instantly relevant. Where does my Sartorius attach? Where does the cleaned blood from my liver meet up with the inferior vena cava? What happens to the triglycerides I ate at lunch? Unlike a lot of my classmates who are so eager for the “clinical correlations” (aka what can go wrong with this part of the body), I’m eager to understand how it goes right. It really does seem like a miracle that eating top ramen doesn’t completely throw off my sodium/potassium balance, that drinking toxins (alcohol) doesn’t poison me and don’t even get me started on how in the world a baby comes to be and be born. Points for creativity there, but whoa. Not exactly run of the mill.

It’s intoxicating. The wonder of it all. I like to glory in the wonder. I imagine next year, which is devoted to pathophysiology (what goes wrong) might leave me a depressed, hypochondriac mess, but for now, I’m soaring.

The only interruptions to my ecstatic happiness are the occasional exam and the beginnings of clinical instruction. As they say over and over, “During your career, most of what you learn in medical school will become obsolete, but anatomy never changes.” So, the material stands alone. It is the obturator internus. Lining the inside of the obturator foramen, pierced by the obturator nerve. That’s just what it is.

But, what about teaching us to interact with patients? The same approach is taken and I find it a little offensive. There is a way. A professional, best practice, code of conduct way to interact with patients. But, patients aren’t body parts. They’re people. “Yes, of course. That’s why we’re teaching you Human Behavior in Medicine. We’ll cover the typical personality types, methods for handling them and ‘anomalies’ you might encounter.” Really? I’m already impressed and upset that you can teach me the entire anatomy of the human body in sixteen weeks. But, now you’re going to logically and coherently explain to me human behavior!?

I don’t buy it. I understand that there’s a level of professional distance that must be developed and maintained to function as a physician. But, my humanity must be tempered so I can do my profession?

Snow! (It's Dec 20th)

2010-02-01T15:13:00.000-08:00

Thank goodness my Neuroscience midterm forced us to delay our flight from "today" (airports shut solid) to "tomorrow" (airports all clear). We enjoyed our first big Nor'easter!

Thoughts (October-ish)

2010-01-31T16:09:00.000-08:00

Something happened the day I said, “I think I want to go to medical school.” Something shifted in the universe. All of a sudden I was a pre-doctor. I was going to become a doctor. People looked at me differently. They assumed a set of things about me – you must be smart, you want to make a lot of money, you don’t believe in natural birth, you might know why my glands are swollen.

If I’d said, “I think I want to be a veterinarian” or “an accountant” or “a firefighter” it would have been different. Everyone experiences being doctored. Everyone has an opinion about health care. Everyone knows someone who was saved by a heart surgery and everyone knows someone who knows someone who died at the hands of an incompetent physician.

With one small statement, I felt the weight of all that hope, grief, anger, fear and expectation come swirling at me. A literal tornado heading directly toward me with my feet cemented in ten feet down. I feel dizzied and blown around and important and compassionate and angry.

Stop it! Stop assuming you know anything about me or what I think about diabetes or ADHD or that you know I’m called to be a neurosurgeon.

All of a sudden I’m asked for my “position” on everything from childhood immunizations and autism to health care reform and the appropriate salary for primary care physicians.

Not that long ago I was a marketing manager for a software company. I loved the communication challenge, but over time, found the subject matter to be a little thin. Having always loved biology and nearly missed a pre-med major I began wondering wistfully if medicine could honor my communication side. I had an epiphany at a doctor’s appointment a few weeks later. This doctor spends his days remarkably similar to how I spend mine. He interacts with a wide variety of clients, building rapport and asking questions. He’s listening for what they’re saying and what they’re not saying and running it against the problems he’s equipped to solve. He quickly determines what the first line of action ought to be, but takes time strategizing about how to enact his desired behavioral change. He’s interested, enthusiastic and competent. And, he’s on a tight schedule.

I come to medicine looking to harmonize my deep interest in the science of the human body and my love of communication. I want to help people, but more specifically, I think my constitution is really well suited to the daily work of a doctor. I think I can not only do it, but enjoy it, help people and do it well without burning out because I’m not working against my natural grain.

I begin to learn something about the culture of medicine in my first application. “What do you think it takes to become a physician of the future?” “What historical figure do you most admire and why?” “What challenge have you overcome that best prepares you for a career in medicine?” Asinine. They are seriously going to decide who gets to become a doctor based on icebreakers?

On my mind

2010-01-31T16:03:00.000-08:00

During this harried fall, I didn't find time to post blog pictures, or posts...but I was still writing. Much of it was unfinished, but I managed to capture my thinking and feeling process during the first few months of med school.

I'm reading back over it and it seems to fall into basically two categories - experiences with our cadaver in Gross Anatomy, and bigger questions about medicine.

Read my thoughts knowing that they were (and are) half-formed and the musings of someone who had been breathing a lot of formaldehyde!

Winter Coat shopping

2010-01-29T15:05:00.000-08:00

First, I hate shopping.

Second, ever since I showed up, everyone says, "Oh, just you wait until the winter! You have no idea what you're in for." Given that I was the 3rd grader intimidated by the 4th graders who told me I'd have to "have a notebook" and "take notes," I'm easily spooked.

I've been stressing about this winter coat thing. I've surveyed most of my new friends here and the consensus seems to be: must be down, must be knee length or lower, must have a hood (preferably with fur for blocking wind), must be water-resistant or proof. Some quick looking informs me that this will cost a minimum of $200. I do not have $200. But, I am afraid of the winter.

One day I'm riding home on the bus, staring out the window and I notice an Eddie Bauer outlet in the middle of downtown that says "Down Sale." I pop my head in and find a coat that meets all the requirements, but is still $150.

The morning after Thanksgiving, Ron casually suggests that I call to find out if they're having a Black Friday sale. Sure enough, my coat is selling for $102 until noon!

Here's a sneak preview.

It's the Most Wonderful Time of the Year (aka Nov 22)

2010-01-27T14:52:00.000-08:00

We get a little Christmas crazy. By we, I mean Ron, and I'm suggestable. Living on a tight budget might make our celebration a little chintzier, but it did not dampen our decorating spirit.

Our fake Target tree, Dollar Tree ornaments and Santa hats and many thousand five hundred lights adorned our home for seven weeks! (Come on, we were gone for two of them =).

Happy Thanksgiving (It's Nov 27th)

2010-01-26T14:59:00.000-08:00

I love turkey. Seriously, you probably don't know anyone who is as devoted to the bird as I. By devoted, I mean like to eat.

When it came time to select our bird for our family celebration (my parents found a last minute deal and decided to fly to Boston for the week!), it was clear to me that only one size would do. 22.5 lbs. That was the max the cooker bag would hold, thus, that must be the size of our turkey.

We laughed hard and had a wonderful time together.

Boston in the Fall (It's Nov 7th)

2010-01-25T14:42:00.000-08:00

Every day I commute to school, I walk along the edge of the infamous Boston Common. As fall was progressing, it was increasingly hard to just walk by every day. I wanted to stop and stare.

Actually, I wanted to see myself all bundled up for fall, carrying a warm drink in my hand, enjoying the New England leaves.

So, Ron humored me, and we did!

We popped up out of the subway at Park St, just opposite the historic Park St. church...

And, Boston Common!

Then, to the adjacent Public Gardens...
With the Make Way For Ducklings statue (the story takes place right here in the public gardens!)

Ah, happy fall.

A Romantic Nov 6th Evening

2010-01-22T14:27:00.000-08:00

On a whim, I decided to surprise Ron by recreating our favorite Portland restaurant, Urban Fondue, at home. He was coming from a presentation at school and was all dressed up. I used their online menu, my creativity and a little rogue substituting to create a pretty great night!

Course 1: Cheese fondue with swiss, mozzarella, gruyere, parmesan, garlic and some white wine (but I didn't have any so I used champagne,) artisan bread, apples and red peppers to dip.
Course 2: Chicken cooked in chicken broth, dipped in one of seven sauces (inspired by Urban Fondue, adapted by Trina). Peanut butter, Maple syrup/soy sauce, Pesto, Raspberry fruit spread, Parmesan cheese, Dijon mustard and one other I can't remember. Sounds weird, but it was fun. Chicken is pretty flexible.

Course 3: The most important, chocolate! Strawberries, graham crackers and homemade macaroons dipped in Trader Joe's 72% dark chocolate.

We don't have a fondue pot,

It's Halloween!

2010-01-21T14:17:00.000-08:00

We went to two Harvard Halloween parties in our matching Ao Dai's from Vietnam. Ron wore his Superman wig from two years ago.

Now I can't go and say that without showing you the Superman origins...

(I was a banana)

The year before we were anxious for Christmas, spent a few hours at the Dollar Tree and ended up...Please notice the bows on my toes.

Five Years Ago Today

2010-01-16T18:21:00.000-08:00

It's October 24th!

2010-01-15T18:07:00.000-08:00

The Angells are here! My beloved college roommate, Sarah Angell and her family were in town for a cousin's soccer game and we had the privilege of hosting them for a meal.

It's September!

2010-01-15T17:35:00.000-08:00

So, after Family Day, my parents, Ron and I flew to Boston, it was killer hot, my dad and Ron started the move by hauling an enormous couch up three flights of curly-que stairs in a non-air conditioned house when it was in the nineties (both temp and humidity) after flying all day and not sleeping the night before.

We worked feverishly to get air conditioners installed. Despite seventeen 70 lb boxes being held at the post office waiting for us to "pick up" and bring home on foot, a delivered bed with half the mattress missing and the enormous picture frame glass that shattered into the box containing every pair of our underwear...we made it.

I got my white coat, my parents left, Rick came, Ron/Rick went to Kennebunkport, Rick left, Ron started school, I started hanging out with dead people and Ron started to say "I'll sue them!" in response to every small irritation.

We spent the month in awe of how fast the people here walk, how funny they talk and how in the world they stand the excessive heat.

It's August 2nd! Come on, pretend with me...

2010-01-14T17:22:00.000-08:00

My dad's side of the family has this great tradition of gathering together once a year at this lot in the Cascade foothills for "Family Day." It's a day of food, togetherness and GAMES. Every family makes up a game and everyone has to participate...no matter how silly.

This year we had Pirates of the Lot, Family Day at the Fair and a game that is most memorable for the torrential soaking of brother to brother, to grandma!

Romy is the cutest pirate.
Who else has a Grandma who will don a pirate hat and jump into all the fun!? We have the coolest family!

Two days later, we are moving to Boston.

Delinquents

2010-01-13T17:14:00.000-08:00

We are hard core blog delinquents. Yeah, yeah med school, law school, but seriously, when was the last time you posted a picture?!

A long time ago. According to my latest Neuroscience lecture our perception of time can be radically altered by how long it takes to store things in our memory. I am going to exploit this fact and pretend in blog land that we're back in October. Get excited about leafy pictures, pumpkin pie and Christmas lights.

Before we turn back the clock, a year ago today, we were spending the night at a hotel called "Paradise" on a Thai beach. We were living in a hut, with temperatures so high the bathroom was open air. Right now in Boston it "feels like" 17. *Sigh*

Lessons from LegReg

2010-01-11T11:56:00.000-08:00

I thought I’d tell you all a little about what I have been learning these last few months.

Probably my favorite class was Legislation and Regulation. This class is new to the curriculum at Harvard. Many people take administrative law, which is about the legal issues surrounding federal agencies (the Environmental Protection Agency, the Federal Reserve, the Food and Drug Administration, OSHA, etc.). The latter third to half of my class was a somewhat cursory introduction to these matters.

There are a lot of constitutional and legal issues surrounding agencies. When does the president appoint someone who works at the agency? Does the Senate have to approve every appointment? Can the senate remove agency heads? Can the legislature have a veto over agency actions? How independent is an independent agency? What reasons can an agency head be removed for? Does the president have unfettered removal power over every agency official? If not, which ones and why?

These are only the beginning….

Then there was statutory interpretation, which is why I loved the course. Many people fancy that they have an opinion about the constitution and statutes should be interpreted. I had opinions about this too. And frankly, I was way out over my skis in having those opinions.

It’s very easy to pontification about these matters, but when you get in to the middle of them, it’s thousands of times more complex than you would think. And it’s not just because lawyers are involved (although that compounds the problem). Even the simplest statute runs into absurd applications. For example, there is this old case where it was a crime to stop the mail carrier from completing his duties; a mail carrier who had murdered someone was arrested and then initiated a proceeding against the government because of this law. What do you do about such an absurd application? Should a judge consider what the legislature would obviously have wanted or what they said?

Or, there was another case, where there is an excise tax on vegetables. And of course, a problem arose: is a tomato a vegetable? How does one answer this? Dictionary? Dictionary at the time the law was written? Do we look to the way the word is used by the food industry that is being taxed? The way that it is used by the lawyers who likely drafted the language? By the way the word is used by ordinary people? By the way tomatoes are actually used by ordinary people (not as a sweet, or a dessert, but as a part of the meal), or by what a botanist would say? These were all considered. And this was one of the easiest cases I saw all semester.
The problems get more complex. What if an agency is involved? What if they issue an opinion (and what process does that opinion’s issuance have to go through in order to be considered legitimate?). What authority does it have (it has a lot of authority, but there are a lot of exceptions). What about absurd applications. What about unclear meaning? What qualifies as unclear meaning? What about state’s rights, international law, the benefit of the doubt for criminals who couldn’t have predicted that the law would be interpreted in such a way? There are a whole host of what are called canons of construction that are applied to help sort through these matters. Some are “linguistic”. They all have fancy latin names that mean things like, “a think is known by its associates.” This means that if there is a list of items and one is more general (cars, trucks, buses and other vehicles), you limit the general term (vehicles) by its associates (cars, trucks, buses). So you might assume that vehicles doesn’t include boats or airplanes here. But what exactly it includes is unclear. Is it that all of the vehicles on the list belong on the road? Is it that they are licensed by the DMV? Is it that they have four or more wheels?

And for each fancy canon, there is a counter canon. There is a canon that says statutes should be read so that words are not construed superfluously. So, “vehicles,” if it only means the same thing as the words in the list already, might be a superfluous word. Since we want to interpret the statute so as to avoid this (assuming that the legislature wants to give meaning to all the words it passes, a hefty assumption), we might read vehicles more broadly, to include boats for instance.

One fun one is expressio unius, which basically means that a statutory statement excludes similar statements that are unwritten. So, “you may have tomato juice with breakfast,” does not mean “you may have Dr. Pepper with breakfast.” But does it mean you cannot have orange juice? It is hard to say… There is an opposite canon to make matters even more confusing.

Anyway, there are scores of these tricks that judges use to decipher the inordinately complex meaning of these statutes. Their complexity is only vastly expanded when the particulars of uncontemplated situations (like mail carriers getting arrested) get thrown into the mix.

By the end of the class, you start to wonder if statutory interpretation is just sophistry, an intellectual trick in order to bring about whatever result you desire. Certainly desire and intuition play a role in the judicial process, but these are greatly constrained by the plausible meanings of the text and by appellate review.

But, still, as the class wound to a close, most of us felt rather lost. I knew the canons and could apply them, but it was unclear in which order. Do you look at what the enacting legislature seemed to want? Do you look at legislative history (committee minutes, floor statements, presidential signing statements, statements by the sponsor of the bill, the supporters of the bill, the opponents of the bill, or the moderates who sign on at the last second…)? Do you look only a text? Do you try to look at purpose at all? What does any of that even mean?

It’s rather maddening (if you know me well, you now know why I loved this class). Sometimes I felt like professor Elhauge wasn’t just using the Socratic teaching method (which he did quite well, actually); rather I felt like he was Socrates. I’ve never seen someone move from one stance to another (in order to challenge students thinking) so effortlessly. At the end of the course, I felt like I had no idea what I thought, but that the picking apart what I do think had been quite a fun exercise.

Fortunately, my professor wrote the book on statutory interpretation. He is one of the most brilliant people I’ve met, and his specialty actually lies elsewhere (anti-trust law). But he still managed to step into statutory interpretation and come up with the most elegant, brilliant, predictive theory we came across. And he barely mentioned it (the theory) in class. He just said we needed to read his book as a way to review for finals.

His theory not only gave meaning to the canons and a made an excellent case for how to prioritize them, it also predicted the often seemingly contractory rulings that have come out of the US Supreme Court. And, while some might call Professor Elhauge a romantic (rather than a cynic, as most of us are, about the politics of the Supreme Court), his theory has real merit. And not just because he worked there as a clerk (of course he did). What I found so enjoyable about it is that is took a thousand years of judicial history and what has come of it (common law statutory interpretation) and the sort of interpretive bacchanal that it appears to be, and smoothed it out into one basic, elegant theory.

I’d explain it here, but it would be virtually meaningless (if the above hasn’t been already) if you haven’t studied the problems of statutory interpretation. This sounds very lawyerly, doesn’t it? Professor Elhauge is brilliant because he solves this intractable problem that hundreds of professors have failed for years to solve to elegantly, even though you didn’t know it was actually a problem.

Anniversary

2010-01-10T11:55:00.000-08:00

My parents recently had their 30th anniversary. Since I am dirt poor, I decided an appropriate gift this year would be something creative. I decided they’d like that more anyway, like when you make an ashtray for them in kindergarten (so what if they don’t smoke?)

Anyway, they did love it. We sent out a letter to their friends and family and asked for people to submit sentimental expressions directed at them and their marriage. We got something like thirty letters from nearly as many families. It was quite the outpouring of love and compliments! Both Amanda and I were really touched as we gathered the letters and as (she) put them into a nice scrapbook.
And mom and dad loved it. My mom was all tears, a sure sign of success.

Amanda

2010-01-09T11:55:00.000-08:00

One person I’ve really missed is my sister. We see our parents a bit more than we see our siblings (and siblings in law) and consequently have missed them quite a bit. They aren’t quite as able to just jump a plane to see us as our parents.

Anyway, my sister Amanda gave me this great present for Christmas. She knit me a scarf. The thing is, she learned to knit so that she could make it for me. She does crochet rather impressively, but this was a new skill. When I first pulled it out of the bag, it was sort of like this gray, tightly knit afghan-y looking thing. She said it needed an explanation. As I pulled it out I could see something was attached.

Two knitting needles. Amanda never disappoints. My sister is a bright, warm, fun, chronically disorganized person. She still needed to work on it! I loved it. It was the perfect gift from Amanda. She had been staying up late working on it, but hadn’t quite finished. Fortunately, she was going to spend a couple days at my parents’ house with us, and so she could work on it then (and she did finish it).

And it was much more than an afghan scarf. This thing, first, is really, really long. I wondered what I would do with all that material. But somehow, the way it was made, the color and the way it stacks up when it is on my next makes me look like a super-man-model. Maybe not quite, but it makes me look like I’m dressed like one.

Anyway, it is really, really nice, and it is warm and I will use it until it is threadbare. And I will smile each and every time, thinking of opening it with the knitting needles still in place.

Snowy Cambridge

2010-01-08T11:54:00.000-08:00

We had our first snowstorm in Boston, as I mentioned above. We got about a foot in about half a day. It was windy, creating big snow clouds, just as you’d imagine in a blizzard. Technically, we were only in a winter storm, but just a few miles away on the Cape they got a blizzard.

But we were prepared. We put on our sweaters, our down coats, our minus thirty degree snowboots and trudges to that mecca of heartwarming beverages, Starbucks. We noticed along the way that we passed nearly ten snow plows. In fact, as we crossed Broadway to enter Starbucks it was being plowed (the snow was still falling) and as we crossed it again when we were leaving an hour later, it was being plowed again, in the same spot. They were already working back through it (and don’t be fooled by the name, Broadway is not a heavily used street, especially on Sundays). Even the path we walk on was plowed.

What we noticed is that a lot of people have plows they attach to the front of their regular pickup trucks (and there are big bulldozer looking plows too). Some people have then attached to lawmower looking motors. Dads and their kids were out plowing like crazy. It seems like there must be some sort of contractor system set up for this, unless these people are all just altruists.
Anyway, it was amazing. A few hours after the snow fell, our street was completely cleared (big snowbanks on the side, though). Granted, the police station is just down the street, so I’m sure we were targeted early, but I get the sense that most every road in Cambridge was clear by the next morning. There were no delays for Trina getting to school, or at the airport anyway. We were on our way rejoicing.

Being Home

2010-01-07T11:53:00.000-08:00

Being home this time was a little weird. It was wonderful to be with family, for sure. But it wasn’t quite like any other experience I’ve had before. It was a lot like being in college and coming home on Christmas break, a throwback of the distant past. But I am married and my wife was with me. It was kind of like visiting our parents’ house during the trip when we stopped in Portland, but still, it felt different than that too. I can’t quite put my finger on exactly how it felt.

Living in your parents’ home can be uncomfortable. It’s just not ideal to be an adult who happily manages your own household and then live under someone else’s roof, particularly your parents. Fortunately, our parents are wonderful and they just treat us as honored guests. We really enjoyed the unending time with them. Any feelings about living as a guest and the discomforts therein are very much dissipated by our wonderful families.

In fact, one of the hardest things about coming home is that it gave us all the time and space an access we needed to think about just how much we do miss our families.

Still, it was an odd experience at times. I think maybe it is safe to say it feels a little strange to be a student. I love it and like it for so many reasons, but there is some way that it feels a little anachronistic.

A break

2010-01-06T11:43:00.000-08:00

Well, we’ve spent 13 days with our families and have really enjoyed the break from the busy schedules. I finished on a Thursday and had a few days to unwind (read, clean up a disaster of a house, pack, cook, etc.). before we left on Monday for the big trip home. We also had the privilege of having my grandma Marta over and her son Greg. They came over on Friday and spent the night with us, bringing sharing in some eastern seaboard Davis family Christmas cheer.

Trina still had a neuroscience test to take on Monday. So she had to study during the weekend, and make sure her sleep schedule matched the planned Monday schedule. Fortunately, she was still able to participate in the festivities with Marta, Greg and I.

Another lucky thing: quite a few months ago we had booked tickets home for Sunday. We were forced to switch them when we realized that Trina had this neuroscience test on Monday (what we had thought was during Christmas break). We weren’t able to talk the airline out of the change fees, which frustrated me enormously (because I am born to talk people out of fees). I guess I’m losing my touch.

Anyway, as it turns out, Sunday we had a snowstorm (it was officially a blizzard out on the cape). We got just about a foot of snow in less than twelve hours. The snow was beautiful, dry (about 22 degrees outside) and blown around in big clouds by the noreaster.

This meant hundreds of canceled flights on Sunday. Some of those people had to wait days to get on a flight with openings since the following flights were so full (including ours). So we ended up very lucky that our flight was on Monday after all.

The trip home was great. We don’t mind long flights, and I enjoyed my first fiction book in a while (A Civil Action, really branching out topically). I didn’t know this when I started it, but one of the characters (it is a true story) is an existing Harvard Law professor, one I might take a class in Evidence from. Pretty cool.

Our families were thrilled to see us and us them. We spent the week catching up primarily with our parents and siblings to a lesser extent. We saw Aaron and his girlfriend Holly, Melinda and her kids, who we buried in dollar tree toys. Matt Goodwin came over for an evening too. We saw my extended family, Andrea and Trina’s extended family. We actually (other than Aaron/Holly, Melinda, Matt and Andrea) saw very few of our friends, since we were just so tired. Trina eventually got sick anyway, and so she’s been nursing a persistent cold, grateful that it didn’t impinge on her study experience.

And now we are back on the road, the place we are often the most comfortable. We are all filled up with family and friends. And fatter. At least me. Substantially. Even having given up dessert six months ago didn’t stave off the salty allure of foods filled with saturated fat and familial love.

Oh well, I eat very well 50 weeks a year. (I should say, the bad food was totally my fault. Our families both made huge accommodations to make sure we got all the good produce we needed; I just ate too much of the other stuff around too. I have the impulse control of a hungry puppy or a 3 year old.)

Being Stretched

2009-12-22T12:45:00.000-08:00

I wrote before that law school was about four times as much work as undergrad...

Granted, that doesn't mean it was so bad. After all, I actually enjoyed myself for the majority of the semester. After a couple weeks of adjusting, I really felt like I hit my stride. There was one particularly frustrating professor who seemed to take pride in making his easy class hard only in ways that didn't stretch anyone's mind or facilitate learning; that was occasionally discouraging.

But the rest of the experience was phenomenal. Absolutely amazing. I got what I wanted.

It wasn't harder than a new, hard job, in terms of hours and the endless pile. In fact, in sales, you are absolutely never done, so in some ways it was even easier.

But in other ways, it was more difficult. It was a marathon of the mind. It wasn't all marathon or all mind, but it was a pretty challenging mix of both. Philosophy bends the mind more than law, at least on a per capita (uh? per page) basis. But the problem is that if good philosophy is 90% mind-bending, law is still 60% mind bending, and then you have to do forty times as much of it. In law school, your logical skills may expand, but your ability to handle volumes of logical problems most certainly expands.

Law is mind bending not because the rigors of logic are particularly difficult (in fact, the standards are a bit looser than in philosophy). Instead, it is mind bending because the standards are looser and the opportunities are endless; law requires creativity. Since it is so experiential, narrative (fact pattern based), the application of general law to specific situations is immensely complex. And, the truth is, there are often two sides to the story. Or six. Or forty. Anyway, that makes for lots to write in finals.

I came to Harvard Law School to be stretched. It happened. I got the peers who pushed me, the professors who wowed me and the curriculum that kept me on my toes at all times. For those who liked to speak as if it was something to be feared, they were dead wrong. If I lacked the maturity to discipline myself, or my standard of normal was the undergraduate experience, it would have been prohibitively difficult. But instead, it was just really challenging. It required a lot of me, a LOT, more than I cared to give at times.

It wasn't that hard. I slept eight hours a night, ate nutritiously, worked out, and (with the exception of the last three weeks) spent a decent amount of time my beautiful wife.

But it was hard enough. The itch is scratched. I'm hoping someone gets the memo and next semester is easier.

Tests

2009-12-21T12:30:00.000-08:00

Well, okay, I haven't exactly arrived.

But I'm done. Done with finals for my first semester of law school. They say it's the hardest part. I sure hope so!

I figure, as an undergraduate (way back when), I was typically assigned 1000 pages per quarter, and I read around 200. I took notes in some classes and studied those notes for a day or so before the midterm and final.

Here, I was assigned probably 4500 pages. I read 4500 pages (mostly textbook, not small pages), pouring over many, taking notes on most. Then I bought study guide books and worked my way through another thousand or so pages (it was actually closer to 2000, but I skimmed). Then there were the four days of studying. Talking through the mass outline with my buddies, boiling the seventy page outline (which was boiled down from hundreds of pages of notes) down to about 10-15 pages of checklist. Then drilling, practice tests, answers and explanations books (the study guide books). Then, after four days of studying per final, I took my tests.

My tests were each 100% of the grade for the course. Typically, you show up and answer one or a few questions for three hours. There was some variety. Criminal involved a take home test. I had to write the precis for a screenplay (just 300-600 words) about a story that highlighted difficult and emerging issues in the criminal justice system (then I had to explain why they were difficult and emerging). I wrote about felony murder, the merger doctrine rape (and the problem of consent), culpability, free choice, and conflicts among the purposes of punishment. That was take home and 50% of my grade. Then we showed up to class and got an issue spotter, the standard law school test. Basically, you are given a complex fact pattern (story) and then there is a question at the end (you are an Assistant DA and you have to tell your boss all the potential homicide, sex crime, conspiracy, attempt or complicity (each affecting the other) crimes that can be charged (and the potential defenses).

Civil Procedure involved an issue spotter (but that was only 90 minutes of the test), and a bunch of five minute questions (true or false and explain..."Mullane overruled Pennoyer." Not my strongest showing--I have a problem with names. So I had to look up the cases; I didn't bother memorizing them, since there usually is no need if you are uber familiar with them and you have your checklist. I did survive, however.

Legislation and Regulation was the most complex convoluted question of the season. It was a take home test, eight hours long. It was supposed to be a three hour test (I would have been a dead man), but we got eight hours to do it, to take the stress off. Typically, other leg reg classes write questions that are 12-25 pages long! Einer Elhuage (aka, the smartest man in history) wrote a two page question that had more in it than could be digested by the Supreme Court in a week! It was absolutely brilliant, self referential, and clever. I used every minute and enjoyed it to boot.

That leaves Torts, my weakest subject. I wrote the most in Torts (8300 words in 3 hours! Civ Pro was second at 6600), which is a pretty good indication that I was stretching. That was a series of four questions, forty five minutes each. Three small issue spotters and a "should we abolish punitive damages for non intentional torts" question.

All in all, a pretty exhausting experience.

Victory!

2009-11-19T07:29:00.001-08:00

I've passed all the classes of my first semester of med school, except Anatomy (which has the final in two weeks)!

Time to celebrate!

Finals Week

2009-11-16T08:43:00.000-08:00

Today I just took my final Biochemistry exam and am officially done with my first med school course!

Tomorrow I will finish out Integrated Problems and Thursday will end Human Behavior in Medicine. Another two weeks of Head and Neck Anatomy and then my first term is over!

I cannot believe all I have learned in the past few months. It has been an incredible adventure.

I've got some great photos and stories to put up...as soon as I get through finals =).

Trina 2, Anatomy 0

2009-11-04T13:36:00.000-08:00

I passed my second Anatomy test!

It covered the thorax, abdomen and pelvis and it was a lot of material. But, I loved it! Learning about all the organs is just so cool.

Today we got the syllabus for the final (and most intense) section, head and neck. It is all so interesting, but I'll admit today it was, as I said to Ron "baptism by drowning."

Ooooh, also, I got my stethoscope today! I'll take a picture when I get home and put it up for you. It's like I'm really going to be a doctor!

A year ago today

2009-10-31T15:48:00.000-07:00

I was interviewing (and falling in love with) Boston University School of Medicine.

First line of defense

2009-10-26T16:25:00.000-07:00

In class our professor said, you have a patient with high blood pressure. You need to bring it down ASAP. What do you do?

"Beta blockers? ACE inhibitors?" We say, feeling smart that we know the terms.

"Nope. How could we have corrupted you so early? He says. The first thing you do is get him exercising, modifying his eating habits and give his body a chance to do what it does best. If his risk is too high, he might need a pharmacological agent to help in the short term. But, that's what it is supposed to be...a crutch until his body can make the necessary modifications to help itself. Any time you put someone on blood pressure medicine, it is with a lifestyle change plan. And, it's with the expressed expectation that they are weaning off in the not so distant future.

Of course drugs have side effects. Our bodies are amazing, really complicated machines. If you stick a butter knife in your computer fan because the noise is bugging you, how's that going to go long term? Drugs are the backup. They're for when you've done all you can do by eating healthy food, exercising regularly, sleeping well, investing in friendships to keep stress low and you're still having a problem. They aren't permission to behave badly. When used that way, they will backfire. And, really, is it their fault?"

The good, the bad and the magic pill

2009-10-25T15:59:00.000-07:00

You eat. Let's say eggs. Eggs and bacon. And, some toast.

The fat and cholesterol get zapped by some pancreas juice and broken into smaller pieces. They float into your intestine, get packaged up with a phospholipid shirt and a protein hat. A clever little huckster convinces the package to give up it's fat in exchange for...nothing. The clever cheat shoves the fat in a nearby cell and floats away. The remaining shrively package gets sent to headquarters...the liver. HQ can take the cholesterol that's left in the package, puff it up, repackage it and send it back out there. With a fresh shirt and three hats, it ends up selling a couple hats for snacks and end up chock full of cholesterol. He looks like a fat guy in a little coat. His protein hat is tiny and his cholesterol belly is enormous, hanging out. That's LDL. Low density lipoprotein (lots of lightweight fat, not much heavy protein). He's the bad guy.

He can prowl around looking for a home indefinitely. If he's out on the streets all night long, he might find some kindhearted cell to take him in, but he might run into a gang and get oxidized. If he's oxidized, he loses his mind, starts foaming and ends up lodging in an atherosclerotic lesion. Enough LDL's on the street, getting oxidized, lodging in lesions...some artery gets blocked with the nasty foamyness. Then, that's real trouble.

Fortunately for you, there are good guys to counteract this evil. A fit, muscular superhero with a large protein cape and just enough fat to not look scrawny roams the streets collecting bloated LDLs from the kindly neighbors who might have taken them in, and returns them to the liver to be dealt with by a higher authority. That's HDL. High density lipoprotein. He's the good guy. He actually chases down the slacker bad guy, hauls him off and gets him help.

As you can imagine, it's important to have a good ratio of superheroes to bad guys, or the whole happily ever after thing gets kind of screwed up. As if this wasn't enough, your body actually makes it's own cholesterol - you need it for making hormones, membranes, etc. So, there's LDL, parading his cholesterol-filled self all over the place, and your own cells are churning out cholesterol. Our whole town is threatened to be overrun.

There's a magic little pill to keep us in fairy tale land. Magic pill puts a wrench in the pipe that makes bodily cholesterol. Now, your neighborhood is panicking...where are they going to get the supplies they need to make doors, messengers, etc.? They start taking in bloated LDLs they find on the street like nobody's business...and sacrificing them (ok, so my story breaks down a little here...creepy neighbors, but go with it). They pull out the cholesterol inside LDL, use it for making doors, messengers and if they have any extras, superhero HDL will be by tonight to take it away. That's a statin. And it has saved millions and millions of happily ever afters.

Of course, the best possible solution is to stop throwing away the neighborhood by inviting so many bad guys into your city. But, it's pretty impressive that even if you make a few mistakes, you might still have a happy ending.

The End.

Abundance

2009-10-24T15:47:00.000-07:00

Have you ever thought about why your body stores energy as fat? You've probably heard that fat has 9 calories/gram whereas protein and carbohydrates have just 4.

So, if you could choose between a 3lb battery for your boombox that played for 10 hours, or a 6lb one that played for 9 hours, which would you pick? The 3lb one, of course! And, that's why your body picks fat. Energy dense storage to minimize how much you have to carry around.

The bummer is that while our bodies were smart for millions of years, in the past hundred or so, they're sabotaging us.

In the entire history of humankind, did you know that it's only in the last few (50-100) years that we've had access to more food than we could eat?

Less than 100 years ago the development of fertilizer, pesticides and herbicides meant we could stop sharing our food with the weeds and bugs. Add to that vast improvements in preservation and distribution channels and...voila...a truly unique experience in all of human history.

Our clever bodies worked hard over the years to be sure that when we planted and worked our field for months and a swarm of pests came through a week before harvest and destroyed 70% of the crop, we'd be ok. Our bodies learned to efficiently store fuel to tide us over when we ran out.

Now that we have the problem of too much food, we are seriously fighting our instincts and natural body systems to maintain a healthy weight.

I get this! But, what if I don't?

2009-10-23T15:42:00.000-07:00

After passing my first round of tests, I've started to feel like, "ok, I think I'm getting this." My study system seems to be working, I'm still sleeping at least 8 hours a night, eating/cooking/watching Ron cook healthy meals, exercising almost every day and...well, I don't do anything else, but still, not a bad life!

I've been feeling like I'm really getting this whole med school thing. I'm going to be the best med student in history and have a balanced life and revolutionize health and wellness in our country.

Then, I went to class last week and had trouble understanding two lectures in a row and now I'm certain I probably don't get it. Maybe I never really did get any of it. I'm never going to be able to maintain this, and I might hate medicine and it might hate me.

That about sums it up.

View from our world...

2009-10-22T15:36:00.000-07:00

You will never look at possums the same way again

2009-10-22T11:35:00.000-07:00

We've gotten to the pelvis in our study of anatomy.

Yesterday in class, our professor explained that male possums have forked members. The gents who noticed this examined a female possum and looked for a compatible structure. After much debate, they concluded that the only possible corresponding part could be her nose. They developed a whole theory about how after member/nostril-course she sneezed and delivered tiny fetuses into her pouch. This was published in a reputable scientific journal.

Years later, someone did a bit more investigating and determined that the female possum has two uteri joined by a common opening.

The lesson is, the fork fits in the glove, not the nose.

Class of '99

2009-10-21T15:17:00.000-07:00

We flew home to Seattle for a whirlwind weekend attending my 10 year high school reunion. Friday night's event was at a fancy place downtown, and Saturday afternoon was a BBQ held on the lawn out in front of the high school.

To be honest, high school wasn't my favorite time of life. But, I had a wonderful time at the reunion. I think part of the fun was showing myself how much I've grown and changed. It's good to look with adult eyes at people/places that used to have the power to make you feel so insecure/afraid...and with the logic of a not-17-year-old, realize just how far you've come.

I really enjoyed seeing my old classmates and hearing what has been happening in their lives for the past ten years. I've already hosted an old classmate for dinner who was traveling to Boston!

It felt good to make peace with the past and to move forward knowing that I have grown up a lot.

(My graduating class was about 100 people. The bottom picture was taken towards the end of the BBQ and many people had already left. There are some professional pictures of the whole group from Fri night, but they're not posted yet; I'll post it when I see it!).

A year ago today

2009-10-20T17:19:00.000-07:00

I was nervously, excitedly attending my first medical school interview. Full of hope, anticipation, wonder about what it might be like.

It has been one heck of a year.

My dad is the best

2009-10-20T15:10:00.000-07:00

During the aforementioned friend/occupation crisis when I was feeling lonely and sad, my dad was my number one ally.

He's exceptionally empathetic and can just tune into exactly what's going on. Every once in a while, like when you're standing outside class with five minutes and you start crying uncontrollably because you didn't realize you were upset until someone said "what's that feel like?"...it's a mixed gift =).

Later that night, he sent me an email with this exceptionally special message...

It takes time

2009-10-20T15:00:00.000-07:00

From my journal, about three weeks ago...

I am trying to make friends, but, it takes time. I know everyone's name and have a million acquaintences, but it's only been six weeks. Also, I'm noticing that while this really "diverse" group of people are really interesting to talk to, not having much in common makes it a tiny bit harder to get past the initial, "wow, that's interesting, what's it like to be raised in India?"

And, they're all science people. Turns out I really am 50% marketer, 50% scientist...which should serve me really well when I'm practicing =), but now, makes me feel like kind of a freak.

Just the other day at lunch, people were talking about what their parents do. I said, "my parents own and run an advertising agency. " The whole table looked at me really confused and said, "Oh, so he does fashion?" Now, I'm trying hard not to laugh at them because I'm picturing my dad in a leopard print leotard, with a black beret on and an orange feather boa around his neck.

How have these people not heard of advertising?! What kind of people are they? I'm insulted and wondering how to go about explaining it.

"Not exactly. Have you seen a commercial on TV, or a radio ad, or billboard? Advertising agencies make those."

"Really? I thought that McDonald's made their billboards."

"Well, maybe every once in a while. But, the process is pretty specialized and time consuming, so most companies spend their time and money making their product and hire professional 'advertisers' to at least produce it."

I'm not even going to begin explaining to them that we're just talking about mass media, not direct, or interactive, etc.

"Weird. Does it really take that much time? I always figured they just decide to put something on sale and then you know, make a commercial."

"Well, they might. But, someone has to decide who is going to be in the commercial, what they're going to say, what kind of burger to put in the picture, what time and on what stations it will air..."

"Whoa."

Now, I launch into a brief summary of what I did at my last job and they look at me like I just said ten sentences in Japanese. They're kind of impressed and kind of weirded out. So, I'm not exactly feeling "understood." You add in that I'm from Oregon, "the state with the suicide doctors" and well, I'm kind of a freak.

Move it!

2009-10-19T14:52:00.000-07:00

People in Boston walk fast. I mean REALLY fast.

I have always been a fast walker. My co-workers used to make fun of how quickly I'd get up and down the halls. When you've got somewhere to be, get there already. Don't dink around. So, I move. And, I have little legs, but I accommodate for that with extra determination.

Here in Boston, I'm maybe in the top half of fast walkers. Maybe. I'm regularly passed walking to the subway, along the Common, to school, everywhere. Not just by 6'7" boys either. Old ladies, homeless men, everyone. This is a place on the move.

And, I love it!

fugacious

2009-10-19T13:40:00.001-07:00

"lasting but a short time"

Great word!

It's snowing!

2009-10-18T15:41:00.001-07:00

It is October 18th and it is snowing!

Did you know?

2009-10-18T14:49:00.000-07:00

Your lungs start with your trachea, then they branch into two primary bronchi, then they keep branching and branching until they end up in these minute little air sacs of capillary thinness called alveoli. It is here that all the key exchanges take place (oxygen, carbon dioxide, etc.). The way they're stuffed into your lungs is incredible.

If you stretched out all the surface area of all your alveoli flat, it would cover the square footage of a tennis court.

Wow.

Where to start?

2009-10-18T13:48:00.000-07:00

There's so much to say. The problem is, the more full life gets of bloggable events, the less time to do the blogging.

On the top of my mind is my second Biochem test tomorrow, which means there are no more "first" tests. In Anatomy we're working on the Thorax, Abdomen and Pelvis section of the class. Honestly, I find it even more interesting than the Back & Limbs section. This Biochem test is all about metabolic pathways, which has yielded a lot of interesting tidbits, but/and required a LOT of memorization.

More to come...

Trinidiom #70

2009-10-18T08:12:00.000-07:00

"If we get stuck in a pickle"

Trinidioms #69

2009-10-18T08:11:00.000-07:00

"...gets tizzled into a fit."

Trinidiom #68

2009-10-12T16:23:00.000-07:00

"You've got to take up your mantra."

Trinidiom #67

2009-10-10T13:41:00.000-07:00

"Let me have my humor."

(if this confuses you, as it did me, it derives from Humor Me.)

Foofaraw

2009-10-07T08:31:00.000-07:00

I like this word.
1.
Excessive or flashy ornamentation or decoration.
2.
A fuss over a matter of little importance.

Felony Murder and the Merger Doctrine

2009-10-06T12:33:00.000-07:00

I like to share legal oddities, so here is one.

In Felony murder, there is no mens rea requirement in the traditional sense. If you accidentally kill (take that for granted, assume it is proven) a person while committing a felony (or in some jurisdictions, a certain set of felonies, rape, burglary...) it is treated as first degree murder.

First degree murder is otherwise only an intentional killing with premeditation of some sort--the highest form of culpability (and, consequently, it is a capital crime, meaning life in prison without parole or a death sentence).

Is someone who accidentally kills while robbing someone morally the same as a person who kills on purpose with premeditation? Is he more culpable than someone who intentionally kills without premeditation (second degree murder)? This rubs me the wrong way. Why not charge for just the accidental death and the robbery separately? That's what he's actually guilty of. It's as if we multiple the culpability for the offenses, not add them.

This is complicated. What if Joe rapes someone and a week later kills that same person accidentally? What if instead he rapes someone and she has a heart condition and she dies (accidentally) during the attack? Why should these be fundamentally different?

The issue becomes more hairy with the merger doctrine. Some kinds of felonies (assault with a deadly weapon) are really just a part of murder. Because they are essentially an element of murder, the question of guilt turns on the normal issues related to murder (was it intentional, was it premeditated, etc.). Okay, that makes sense (if you don't have the merger doctrine, then almost all murders are just felony murders, which makes all the rules about murder pretty much moot).

But given that, if you if assuault someone with a gun and kill them, that means you get the traditional analysis (was it intentional?, was it premeditated?). And if you accidentally kill them while robbing their house (you accidentally knock over a candle while escaping and it kills someone because of the ensuing fire) you don't get that analysis (you just are guilty of felony murder). Is the latter person more culpable than the former? Clearly no. But we treat them as such; it makes an enormous difference in his sentence.

There are historical reasons we have felony murder, but whatever the case, this is what we are left with in many jurisdictions.

I did it!

2009-09-30T04:13:00.000-07:00

The tests were long, tiring....and successful!

I passed both the lecture and the lab with flying colors!

It's time to celebrate.

A Weekend in the WIld, Wild, West

2009-09-29T12:36:00.000-07:00

Maybe not so much.

I worked on Legislation and Regulation the whole ride to Seattle (and my memo), worked all day on Friday on my memo, reunioned like it's 1999, got up, did more memo work, did more reunioning, and finally was done around six oclock. Just in time for some wine, dinner, bed, breakfast and a trip the airport.

Fortunately, I had a nice relaxing ride home, studying torts the whole way.

More importantly, we did make it to Trina's reunion. It was great; the people were nice and I got to be arm candy. She was definitely the coolest one there!

Wish me luck!

2009-09-28T16:59:00.000-07:00

Tomorrow is my first Anatomy exam. The lecture exam is 3 hours, followed by a one hour practical exam in the lab. It covers all of back and limbs. I have to know 110 muscles, their attachments, innervations, blood supply, etc. Plus, 99 bones and all their features. Plus, ligaments.

Plus, reading a bunch of radiology (CT scans, MRI, etc.). Plus, a bunch about how the nervous system works. Plus, the first eight weeks of development (embryology). Plus a bunch of common pathologies of all the above.

I'm doing remarkably well panic-attack-wise when I look at that list. I don't feel like I 100% know everything on the list, but I know most of it and I am hoping I can recognize the rest.

After the Anatomy exam I will get back to you about the other major happenings - like flying home to Seattle, my 10 year high school reunion, etc.

In the meantime, use your extensor pollicis longus to give me a thumbs up!

Trinidioms #66

2009-09-22T14:29:00.001-07:00

"Don't be a sour blanket"

I swear we've had this one before...

A Contradiction in Our Criminal System

2009-09-22T07:26:00.001-07:00

We tend to think that moral blameworthiness is indelibly linked to intent. Evil intentions are, in a way, the ground of moral evil.

And we think of the criminal system as having something to do with blameworthiness.

And yet, in criminal law, we rate blameworthiness by outcome, not intent (we usually want intent included, but the RESULT is the key). Does someone actually die when you intend to kill? The outcomes aren't tethered to the intention, and yet we punish based on outcomes.

A tries to kill B, but only with regret. He succeeds.
C tries to kill D, with glee and malice, and fails.

We punish A much more severely than C.

There are theories that may answer this paradox, but it is worth thinking about.

Interesting article; Subsidies for Corporations in the 1850s and 60s.

2009-09-22T06:17:00.000-07:00

I just read a fascinating historical article by Martin Horwitz, called "The Transformation of American Law: 1760-1860"

Basically, he traces the rise of negligence liability as opposed to strict liability, and how negligence eventually overcame strict liability in that period.

Negligence theory operates on the assumption that we should only have to pay someone if we harm them culpably, that is, if we should have been acting differently than we did. There was some early basis for this, but it was only grounded in legal duties (contracts, or the role of various statesmen) that we failed to perform. The modern definition (act like a reasonable person would in the cirucmstances) hadn't yet come.

More dominant early one was strict liability. We still have this today (although it all but disappeared in the period in question). With strict liability we say, okay, even if you weren't negligent, you still caused this injury. You chose to act, and you derive the benefit from your actions. You have to pay the costs (of hurting others), even if you acted responsibly. The idea is that you don't get to externalize (i.e. make others pay for) the costs of your own activities. Fair enough.

As this period came to a close, negligence began to dominate all areas of liability. This brough with it a huge social change and an enormous hidden subsidy. Corporations could do whatever they wanted (as long as it wasn't negligent) and injury the people and property around them, and they didn't have to pay. They were able to externalize the risks of their activity to the weakest. It became a matter of the the "inactive" those who weren't engaged in activities that injured others) having to pay for the "active" (the corporations), more than a proportionate share (they weren't just buying their goods; they were taking it on the chin most every time they were injured by the production or product from a corporation).

What does all this amount to? A huge legal subsidy for corporations in the antebellum period; a massive regressive redistribution of wealth. It doesn't just have to come through taxes!

I'm a nerd and thought that was interesting. Maybe I'll write about retributive and utilitarian theories of punishment next...