The Best Gift of Christmas

We draw names from a hat (or bowl) every year to see which family member we will give a gift to on Christmas Eve. This year was special because our grandma spent the holiday with us. We included Grandma in the name drawing and wouldn't ya know it, she drew my name.

I sent a wish list out to the family to help them in their gift giving pursuits. This chance comes only once a year so you would think the list would be pretty long; unfortunately, after typing it out, my list looked pretty weak.

My Plan:

I added some pretend items to the wish list in an attempt to give a false appearance of variety for family members: they would see a healthy list of gifts and would think to themselves, "so many options, I can definitely find something on that list that I would like to give." As they scanned the list, they would weed out the fake wishes and pick a real one as their targeted gift.

Christmas Eve came, we ate our traditional dinner, we read Luke 2, sang carols around the piano, and then the gift giving began. This was the first test for my wish-list-plan. My turn to open my gift came and this is what I found.
I didn't know what to think when I unwrapped the jack-o-lantern and pulled out these devilish boxers. I was in a slight state of shock. Then I remembered that I asked for breakdancing underwear. Grandma had looked over my list and she shared with my mom her concern that she just couldn't figure out what breakdancing underwear was. The joke was on me when Grandma called me on this and actually gave me her interpretation (a brilliant one, at that) of breakdancing underwear.

Me, breakdancing. My apologies that the photo doesn't tell the whole story

HSF Highlights

The Top Ten Moments of HSF[i]

1. Dr. Dirksen’s WWF Dance[ii]

2. TA Debbie Dao hemostating Dr. O on the last day of anatomy[iii]

3. Hemostating[iv]

4. Belinda Carlisle[v]

5. Dr. Pickett, “So much for…”[vi]

6. Impromptu yoga session in anatomy lab[vii]

7. “That’s what she said”[viii]

8. Dr. Davis’s Histo review[ix]

9. The arrhythmia video[x]

10. Cher[xi]

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[i] Our school curriculum 'subjects' us to one course at a time. Human Structure and Function is the four month course we completed on the 19^th of December, 2008. The following was taken from the course intro: The HSF course encompasses the subject matter traditionally taught in separate courses in

physiology, anatomy, histology and embryology. However, the course extends beyond these

traditional boundaries by providing the opportunity to integrate the facts and concepts across

disciplines, and to apply this knowledge to clinical problem-solving in your PBL cases. Finally,

the HSF course is integrated with the Introduction to Clinical Medicine (ICM) course.

The subject matter taught in the HSF course is coordinated with and complements your

introduction to the basic skills required to perform a physical examination on a patient, and your

HSF/ICM Integration Conferences are designed to emphasize the clinical application of the basic

science concepts taught in HSF.

[ii] This gets the number one spot because Dr. Dirksen blew us all away when the music came on in the middle of his lecture and he did a very convincing Wrestlemania victory dance for a solid minute. This teaching moment taught us that 1) our professors could be crazy and funny, and 2) that med school was going to be more fun than we had anticipated.

[iii] See below for “hemostating.” On our very last day of anatomy lab, Debbie Dao did the unthinkable. With all of the room sneaking a peak from their own dissection table, she clipped a hemostat right onto Dr. O’s scrubs as he taught table #24 about lower limb joints . The hemostat clanked twice against the dissection table and then no one could hold it back. The room erupted with laughter. Thanks to Debbie for sacrificing a letter of reccomendation for that moment.

[iv] This is a game we started to play to keep the mood light in the anatomy lab—as if our room needed anything more. We already had windows spanning one side of our newly refurbished 5^th floor anatomy loft. The sun was shining (or the snow was falling) and we were never short on laughter. So the purpose of hemostating is to clip a hemostat onto the clothing of a neighboring student without them noticing. I believe Drew won the medal of honor for getting five hemostats clipped to his back before he realized what was going on. I also should get an award for almost reaching the elevators before Zach let me know about the hemostat on my pants pocket.

[v]Our anatomy table broke out in Belinda Carlisle’s, “Heaven on Earth” one day. What can you do when something like that happens beside dance like you’re in the music video? Never mind that table 22 was the only all-male table.

[vi]One of the HSF all-stars, Dr. Pickett subconsciously (we believe) closed out each portion of the lecture with her signature line, “so much for, insert the organ or tissue of focus e.g. brain, heart. It never failed to get a shout out in intra-class conversation later that day.

[vii] We just started doing yoga one afternoon in anatomy lab. What more can I say. It was awesome, and yes, I may have had something to do with initiating/leading the session.

[viii]This never grew old for Bryan, and hence, only occasionally grew old for anatomy table #22—we’re a team no matter what.

[ix] Not only did these reviews help 90% of the class to pass the histology, this also made the list because of moments like Judge Jerry, the Dr. P impersonation, and every other attention grabber attributed to the HSF all-star, Dr. Davis.

[x] There is really no way to describe this. You’ve just gotta watch it!

[xi] No one can explain how, perhaps there was a subliminal link between a Dr. Davis lecture, but one day table #22 (mostly myself) spontaneously started singing Cher, “If I Could Turn Back Time.” Maybe we were just lucky that day!

Haunting or Hilarious

I almost laughed out loud walking home from the hospital this afternoon.

The application process for medical school is not like any other graduate school application process. First, it takes more than a tanking economy for someone to decide to apply. Second, it involves more than a purchase of a Kaplan review book, some letters of recommendation, and a $200 exam. It is more like an application for the FBI or CIA; I confess that I have never applied for a job with the CIA or with the FBI and therefore have no idea what the application process looks like; but if I could imagine, dream, postulate on the details, I would say there is a lot of screening, a lot of interviewing, a lot of intimidating going on. If this is true, than my experience of applying to become a doctor was indeed very much like applying to work as an FBI agent.

I was interviewed fifteen times, including the two at BYU used to judge if I was suitable to even apply to medical school, at seven different schools throughout the application process. As far as the screening goes, I wrote essays on every ethical issue under the sun, wrote a 3,000 word personal biography, and did an interpretive tap dance of photosynthesis for one particularly demanding dean of admissions. That is just the direct screening. There was plenty of non-direct screening and intimidating to pass around. Every time I told anyone I was interested in medicine, and by anyone, I mean anyone not enrolled in an undergraduate institution, their face would contort into this marquee flashing messages like "You are crazy!","You are evil","You have no idea..." and so forth. Truthfully though, none of that amounted to much in my head.

One of the things that actually did concern me about the decision to be a doctor was whether I could handle the anatomy lab. I heard that students dissected their way entirely through a human cadaver. I confirmed this at one of my interviews when the student giving me a tour unexpectedly pulled back the sheet over his cadaver, mid-sentence! It was every bit repulsive as I imagined.

So I almost laughed out loud as I walked home from the hospital this afternoon smiling at everyone and everything I passed, thinking about how awesome the dissection of the pelvis (yes, that required us to split the pelvis with a handsaw and dissect the leg with a scalpel) was that I just did, and how much I LOVE the anatomy lab, and comparing that with my pre-med concern. The contrast nearly put me in stitches.

Dining in the New World

My medical school class is 104 students small. I know approximately 99 of these students by name and consider all of them friends. We usually cross paths, me and one or two or three other students as we walk to campus each morning. If I don't join up with any friends on the neighborhood sidewalks, I usually greet a classmate at the bike racks outside of school. If I still haven't bumped into classmates (meaning that I am still reading my morning magazine, The Economist or National Geographic) as I enter the hospital, then I'm sure to join up with a handful of classmates getting their coffee or hot chocolate outside the student lounge. We converge every weekday morning at approximately 7:57 on the lecture hall indicated in our syllabus.

I spend most of my day with fellow students of medicine be it in lecture, lab, lunch, or small group. I study with med students outside of school, I eat dinner with friends from class, I go to movies or shows with med students. I play sports with other medical students. I'm not writing this thinking the reader is interested in knowing how I spend my am/pm hours. I am writing this to justify what I said at the dinner table Wednesday night.

Classes ended Wednesday at 12pm. I was on a plane two hours later bound for DC. Lil Sis picked me up and we cruised out to Poolesville for our first of many family dinners over this Thanksgiving break. The house as usual smelled incredible. Mom was near completion on some Indian soup masterpiece. It wasn't long before J & J arrived with the flat bread and away we ate. I don't know where the conversation was going (perhaps someone can chime in) but I enthusiastically announced, "Well, I was digging poop out of a cadaver this morning!" I realized, with the chorus of spoons clanking against the bowl that I just said something very, very disgusting. A split second later, the sound of the spoons dropping was replaced with moans of, "Ah, that is DISGUSTING...SICK...You just ruined everything, I can't believe you said that, that is DISGUSTING, I can't believe...!" All of the above accompanied of course with terrible looks of pain, anguish, and a pinch of anger.

I tried my best to recover, "Oh my, I'm sorry, I mean, I just made some precise incisions at various points along the small and large intestine to appreciate the differentiation of tissue & musculature...It's really not that gross, I mean, it wasn't like that...PROMISE, I'm sorry. Just looking at muscle..."

But the damage was done. There's no recovery from something like that. It rolled right off my tongue like it was common place, totally normal. Family holiday dinner conversation can get a little out of line but my family members were no where near prepared to handle something like that. I was honestly just as shocked as the rest of the family that I gave utterance to such a foul phrase. It took me a while to realize why I thought that was OK to say in the first place.

And now I realize: I'm always around med students. Our world of cadavers, histology, and physical exams is just that: our world. For better or worse, I am always around people who spend a couple hours a day dissecting, examining, and removing body parts from cadavers. What was at first overwhelming and taboo to us is now part of the daily grind. And it is only natural that my language reflect this new environment of medicine.

Declaring the above does not excuse me from respecting what is predictably and understandably disgusting to the rest of the world. I recognize this new language tendency has a time and a place. Please know that I will do my best to remember that; but if I do slip and say something that makes you feel a bit queasy, well, just take it as an invitation to join me in this new found world of mine.

Shorts, Tis Never the Season?

I pasted below an article I wrote last week for the school paper--the b-school paper, because there is no med school paper. Med students don't have time to write! It's a little more facetious than usual. Enjoy!

Economists and financial experts around the globe have tried to pinpoint the cause of the financial market collapse. Some policy wonks claim that our financiers got too smart, that our derivatives became too creative. I don’t know about you but I’ve never been taught that creative talent was a bad thing. Others try to say that we got too greedy, that we wanted things we couldn’t really afford. Again, I firmly believe that progress can only come about by pursuing those things that are at present out of our reach. The true reason why this country is in recession is because we as a nation have come up short with our dress codes. Standards are so lax that we are wearing shorts when pants are needed. We are wearing shorts to school; we are even wearing shorts to work!

In the Max Farash lecture on the 13^th of November, Daniel Forrester presented a very inspiring and powerful formula for better decision-making. He argued that Simon students must rely on data; they must possess the ability to tell the story; they must be visual and conceptual thinkers; and they must reflect and iterate on their work. The contributors of the Simonist fully agree with the above formula, but we recognize it omits one critical element to informed decision-making: pants.

We’ve made a lot of poor decisions in recent years. All of those telecom mergers, health savings accounts, subprime mortgaging, leadership over the wars in Iraq and Afghanistan. These are a few examples of some of the poor decisions we’ve made, decisions that for the most part were made by people dressed in shorts, or camouflage—equally bad.

How did this happen? Many human resource departments cite global warming for their shorts friendly dress codes. The most famous example is the UN. The UN announced this past July that it was going to reduce its carbon footprint by raising the temperature of its historic world headquarters building in New York. The announcement was hailed by the media as a green move. Not so fast, Simon readers! The true motivation behind the policy change was to allow employees to wear shorts! UN workers were encouraged to discard the professional suit and tie to “comfortably” work in a warmer climate. UN Secretary General Ban Ki-moon crowned himself the “environmental secretary-general,” but the truth is that the Secretary had a fall out with his tailor and could not keep wearing his 2002 trousers around his 2008 waist. And what can be said about the productivity of the UN under its new A/C policy? Their absence on the Georgia invasion and they’re failure with everything they recently tried to put their hands on in Africa: Congo, Zimbabwe, South Africa, etc, highlights the effect of shorts in the work place.

This professional slide in America to casual wear is a direct effect of school children who were educated in pro-shorts institutions. Many American public and private schools at one time required children to wear trousers to class until the seminal ruling in 1979 when Moody v Cronin 484 F. Supp. 270 (C.D. Ill. 1979) ruled in behalf of the students—a decision made by individuals dressed in robes, not pants. This ruling led to many other dress codes being overturned. School children united and fought any school policies framing the issue as an anti-shorts policy. This cleaver campaign attracted huge donations from powerful organizations such as the ACLU and Sesame Street. The school administrators managed to get AARP behind them but that was not enough to counter the strength of the anti-shorts campaign.

I remember the monumental day when the no shorts law was revoked by my local school district. Many readers can recall such a day in their own past. It seemed so much like the right thing for us to do then. We saw a nation no longer divided by a pant line; we believed freedom of expression, we believed self-actualization would come from this change. Little did we know the consequences would be so grave. Now we know, and knowing is half the battle. Let’s take care of the other half and put America back on track. Let’s wear our dress pants to campus lectures and activities, and when we reenter the work force, let’s be dressed in our best slacks. We won’t get out of this recession until we get back into our pants.