Biking around the main quad is like a free-for-all psych out dance.  Undergrad flying toward you on the wrong side of the road?  Stare them down with equal determination OR veer off further right and give them their room?  These are decisions we have to make every day.

The craziest is definitely the cell phone bikers who are on their phones one second, and splat on the ground the next.  The other day two bikers who crashed into each other started a fistfight in the middle of the street.

As a primarily biking campus, this place is sure unique – notoriously unique.

In class a couple weeks ago, we watched the first chapter of a very though provoking documentary about health disparities that exist even within one city titled “Unnatural Causes” Ch: In Sickness and In Wealth.

Trailer:

It was shocking to see how there exists a nearly ten-year gap in life expectancy in Louisville, KY alone between the $20k per household and +$80k per household families.  Though I have watched snippets of shows like the Up Series, this was the first time these health disparities were actually presented in tangible, number form. Scary.

This upcoming week I am starting a project with a group in my Pop Health class on asthma education within the Health Plan of San Mateo. Should be an eye-opening experience!

Now armed with car, I am experiencing first hand driving adjustments I’ve had to quickly make.  I am much more alert everywhere I am, especially on the curving highways where people are either driving at <50 or 80+ mph.  Also, many more people here tend to have poor judgment on making lane changes, parking, and a lot of the people seem to especially relish in suddenly stopping in the middle of the street (next to a row of parallel parked cars)!  I’ve never gotten into an accident before, but I am convinced some sort of incidence will happen in the next couple of years I am here. Considering someone in these apartments already had their new car rear ended in the parking lot, my new baby Corolla is taking minimal trips and staying away from other cars.

Tortilla Pizza

Serves 1. Time: ~10 min + ~20 for toppings prep if necessary. Grocery bill: $2 (minus basic kitchen ingredients).

Required: Pan with lid

Ingredients:

10 inch flour tortilla (1 – 3 depending on how hungry you are)

shredded mozzarella/ cheeses of choice

pasta sauce/ pizza sauce if you really want to be fancy (I recommend Trader Joe’s)

toppings/ spices of choice (recommend: oregano, sage, italian seasoning, basil)

Important: make sure whatever topping you add is as dry as possible because soggy toppings make for a soggy pizza

My favorite combinations:

~ cooked spinach (drained), caramelized onion, cooked italian sausage, sage, feta

~ raw green pepper, sausage, pepperoni, caramelized onion

~ sliced roasted beets, gorgonzola, roasted red pepper, caramelized onion

~ sautéed portabello, roasted red pepper, caramelized onion, basil

1) Warm your pan on medium low with lid on.

2) Meanwhile, make pizza on plate.  Add: sauce, spices, cheese, toppings, more cheese?

3) Gently place pizza in pan, re-cover and cook for ~ 5 min (u can set timer) or until the bottom of the tortilla is light and crispy and the cheese is bubbly

4) Remove with spatula, let cool for ~2 min, cut and enjoy

In addition to required classes in embryology, genetics, biochem, anatomy, and practice of medicine (our dress up class & other classes like ethics, pop health that don’t fit in a specific category), I am taking several weekly seminars.   These include: PALS (shadowing chronically ill patient & learning about chronic illness), cancer bio journal club, med Spanish, med Mandarin, Internal Med seminar, and student rounds (case presentation by clinical students).  It sounds kind of a lot but there is so many neat things going on here I couldn’t narrow it down!  I am also hoping to do some shadowing and some investigative work into finding a lab.

My friend already made fun of me for turning into “one of those people who does everything” after I signed up to give tours and attend student/faculty meetings (hey, those are mandatory for me!).  However, I am really hoping this doesn’t become a repeat of Senior year where I was biting more than I could chew.  So far, I have been avoiding committing to specific student orgs and conference-like meetings and I try to make time for a couple of class social events a week.  Since school has a really early drop deadline (this past Friday), I am really hoping I’ve found the right balance this quarter!

Some highlights of the week…

An exclusive hard-hat tour of a new building for med students. We have a new building for the med school opening up and it looks pretty spiffy on the inside, though most of it is still under major construction. I can’t wait for us to actually move in next year and be able to use some of the fantastic simulation rooms.  The entire basement looks and feels like a hospital already but is actually multiple sound stages. Cool!

Jabbing each other with needles to learn such things as drawing blood and administering PPD.  Welcome to med school, I guess.  Though, I would much rather have my first go be on a fellow student than a patient.  Either way, thankfully I did not mess up any of the tasks involving needles thanks to the incredibly helpful and skilled TAs and PA students circulating the room. I’m proud to say my faux-PPD didn’t even draw up blood! Now if only my luck can continue this way….

A lecture and lab on the brachial plexus, one of the most hard to learn clusters of nerves on the human body. We’ve moved from the thorax to the upper limb!

Some funding meetings culminating to a retreat tomorrow at a beach resort! Wow, I did not realize such perks existed as a student rep.

Though med school is like a full time job (and more), it sure doesn’t get boring around here.

Edit: Video (lower right after clicking on link) of how genome sequencing is done.

If you are curious about what they know about various SNPs right now.

We had a very interesting lecture recently about getting your genome sequenced.  It was amusingly titled something like “what to do when your patient walks into your office with their genome in hand.”  (Oh, only in Silicon Valley…)  This subject has intrigued me ever since I heard about the rise of mail order genomics a couple of years back where companies would charge ridiculous fees to look up your ancestry with the swipe of a cotton swab.  I always thought this was appealing yet I wondered how far the research has progressed for it to actually be useful.

Anyway, the verdict?  It’s too early for there to be much use.  Despite the fact that Google-tied entrepreneurs will want you to shell out hundreds to find your disease susceptibility on 23andme, there’s really not that much solid research out there linking SNPs, or single nucleotide variations between individuals, to specific diseases.  And the known ones? You’re better off asking your own relatives about their medical histories.  And all the known news seems to be rather grim and would only instill worry.  What’s the real point of knowing that you are 1.1x more likely than the average person to get type 2 diabetes?  There is also the problem that 1/20,000 nucleotides will get read incorrectly with current technology.  With over 3 billion nucleotides in the genome, that’s a pretty high number.  Also, there’s the fact that what you really want are cells close to the germline, or cells closest in DNA sequence to the single-celled organism you once were, and my suspicions are cheek cells just aren’t going to give you that sort of DNA.  In fact, there is probably some non-trivial amount of cell-to-cell differences.

Additionally, regarding ancestry, there is also no good research out that is going to pinpoint within a few hundred km where you are from (though a paper came out recently about this so we will see).  Most likely you are more closely related to someone in Africa than the average person in your native country anyway.

Finally, I feel like what is very concerning is how this information is going to be treated in the future.  Will people get sold out to insurance companies?  What are going to be ethics behind genetic testing? It seems like there needs to be a bit more solid legislation and laws before it is a good idea to walk around with your genome in hand.

The upswing is, there is a lot of research now being done to better understand these SNPs and draw more solid connections between disease susceptibility, ancestry, even traits and genes.  It will be interesting to see where this goes in the following years.

—

If you are interested, a paper on how a genome is sequenced nowadays. Fig 3 is pretty good.

Something fun and romantic we made awhile ago when my boyfriend visited… looks almost restaurant quality, eh?

Spanish Shrimp (adapted from Cook’s Illustrated, a fantastic cooking magazine for the science-minded) (Side note: an interesting recent article about CI.)

Serves 2. Time: ~45 min. Grocery bill: $8 (minus basic kitchen ingredients).

11 garlic cloves

2/3 lb shrimp, fresh (31-40 ct or larger)

6 Tbs olive oil

1/4+1/8 tsp salt

3 dried bay leaves

1/4 tsp paprika

2 tsp dry sherry

1 tsp white vinegar

1 Tbs fresh parsley, chopped

Mini-baguette (optional) cut into diagonal slices… great for dipping!

1) Peel and devein the shrimp, place into bowl.

2) In a small container, mix 2 cloves of minced garlic, 2 Tbs olive oil, and salt.  Pour over shrimp and mix throughly. Cover and marinate in fridge for 30 minutes.

3) Meanwhile, smash with the side of a large knife 4 garlic cloves and add to a skillet with 4 Tbs of olive oil that has been heating on medium low.

4) Heat while mixing for 4-7 minutes, until garlic is light golden. Take off heat and discard garlic cloves.

5) Slice remaining garlic cloves into thin slices.  When shrimp is almost done marinating, heat up cooled oil, sliced garlic, and bay leaves on medium low. Meanwhile, you can toast the baguette slices by broiling them in the oven with careful monitoring (~ 2 min/side).

6) Add shrimp in single layer and cook for 2 min.  Flip and cook for 2 more min.  You can extend the cooking times by 1 min if the shrimp are large. Do not overcook.

7) Turn heat to high and vigorously stir in paprika, sherry, vinegar, and parsley.

8) Remove from heat and enjoy.

Also, I am very excited I got elected as one of the class representatives.  I was planning on going to the inter-class meetings in the first place since I am quite unfamiliar about this campus, but embracing such a role is a nice bonus.  I hope I can advocate for the class well!  One of the biggest issues I am interested in is the new med school building they are constructing on campus set to finish early next year.  We’ll be the first class using the facilities and I signed up to be on one of the steering committees to make sure the building will be student-friendly.  Perhaps my penchance for design/ making things look pretty will be of use?

This weekend, I also got to take my first history – ever.  Though it has been stressed upon by professors, the transformation upon donning a white coat and stethoscope really hit home today when I experienced it personally – in a room with a patient.  You are really transformed in front of people’s eyes.   Today, I may have been just another fumbling med student trying to avoid awkward conversation and using – stupidly – a pencil to take notes.  However, in the future, I really hope I will one day be able to live up to the expectations and responsibility that come with such dress.

Speaking of sleep, I realized my hardest adjustment is actually being able to pay attention for 3 and then 4 hours in a row.  Unlike college were there was about 3 hours of class a day, med school returns to the standard high school schedule of school for 8 hours a day (along with the high school drama; but hey, what do you expect out of a class of 86?).  Man, I thought I was done with all that after high school.  And the food coma after lunch sure doesn’t help.  Granted, there is the option of listening to lectures at 2x speed at home, but at home there are SO MANY DISTRACTIONS! Like that Safeway card on my desk which just became about 100 times more interesting.

Therefore, I have attempted to solve my problems with my new friend the French press.  After reading about it on Cook’s Illustrated, I just had to try it out.

It actually works really well if you buy the coarsely ground beans at the supermarket.  Unfortunately for me, I bought the cheap-ass Breakfast Blend which doesn’t actually taste that great with extra plus flavor injected into it.  Oops. Better luck next time.

Anyway, Wednesday.  Today I plan to finally get my place in order and unpack everything I bought this past weekend.  Thank goodness for these recess days in the middle of the week!