Saturday, October 28, 2006
Talking Japanese
So far this trip has been great! Brandon got me to the airport in a breeze right through rush hour traffic. We even had time for a classy breakfast at Filliburto's. Nothing like starting the day ordering breakfast from someone who doesn't speak the same language as you; definitely a great way to prepare you for international travel.
Things were really smooth at the airport. Security was straightforward; although, I did learn that my new pants have metal in the clasp that bought me a hand wanding in PHX, but not SFO. United was great to San Francisco and then onward to Narita (NRT) which is about an hour train ride outside of Tokyo.
On the flight to SFO, I moved into the exit row for the extra leg room and ended up sitting next to an oncologist from Mayo Scottsdale who was traveling to Northern California to give a talk about breast cancer -- his specialty area. We decided that we should set up our own comprehensive breast care center due to his frustration with Mayo, my thinking it's a cool idea, and our mutual love of women's breasts. He gave me his business card and I spent the next hour planning our future attack on breast disease.
For the 10-hour marathon flight to NRT, I had another window seat and had Taku, a Japanese college student, sit next to me who studies in Northern California at a small college near Berkley. This was great because not only did Taku share my love for Jack Daniels (I had one, he had two) and beer ( we both had three -- hey they were free, we didn't have anything else to do, and I definitely wasn't driving anytime soon!), he also speaks Japanese as his native language. He helped me with my pronunciation of the three or four phrases I decided I needed to know how to say. I took his email address and invited him to come and visit the Arizona night life scene. He gave me some great tips on where to visit and reminded me how close I would be to Hiroshima and that I would be amiss to not visit.
NRT airport in retrospect was easier to figure out than many American airports mainly due to its layout, but it didn't hurt that all signs were in both English and Japanese (I think maybe Chinese, too but sumimasen for my not reading kanji). And boy was that a CLEAN airport. Everything was shiny, clean, and neat. Even the bathroom was spotless (more about the cartoon depicting which stall had a bidet later).
Immigration was a breeze -- they just took my visit card, verified my length of stay, and stamped my passport. Piece of cake (I should learn how to say that in Japanese). By the time I visited the restroom my bags were riding around the carousel. Customs was a cinch as I had nothing to declare and they were nice enough not to search my bags to make me prove it.
It took about fifteen minutes in line for me to get my Japan Rail Pass voucher exchanged into the real thing, but when I got to the head of the line the process was painless. They even reserved me seats in the Green car (like business class on Amtrack -- I paid about 15% extra for this.)
The train ride was relatively uneventful, but unfortunately there was some fearful excitement between my train to Tokyo and the train to Kyoto. I couldn't figure out where the hell my train was departing from. Tokyo's railway station is huge (like Grand Central Station) and the only English on the signs is typically one word which is the name of the rail line. Disappointingly, my train's rail line wasn't' listed because it's a subtype of the shinkansen (bullet trains) and I guess everybody just knows that in Japan. Finally, I found someone wearing a uniform and they pointed me in the right direction which was great until I got to the next intersection and had to repeat this. I got into my train with about 90 seconds to spare.
It was amazing riding the train through the city and countryside. The Japanese architecture, the neon lights, and all the action through Tokyo was very exciting. The train ride from Tokyo to Kyoto took about 3 hours and I think I slept about half of it. Once I got to Kyoto Station I was exhausted and about 30 minutes later I was unpacking in my hotel room. The traveling day is at a close.
Wednesday, June 07, 2006
Stop 'medicalizing' bad behavior
read more | digg story
The major fallacy in the article and many of the comments is the assumption that "medicalizing" an issue equates to relaxation of personal responsibilities in the diagnosed individual. Diabetes, HIV, benign essential hypertension, glaucoma, migraine headaches, epilepsy, claudication are all real diseases. Everyone reading this should know at least one person with each of these disorders. The key to treatment and alleviation of symptomatology in each of these diseases is personal responsibility which typically includes appropriate medical treatment. Proper treatment and education of all disease necessitates an INCREASE in personal responsibility.
Don't take your anti-hypertensive medication = die of stroke
Irritable bowel disease, eat chili = flatulence and diarrhea
Don't take your herpes meds = give girlfriend VD
Don't follow your diabetic diet = dialysis, blindness, amputation of lower limbs, death
Xeroderma Pigmentosa patients, don't stay out of sun = death
Got PKU and don't follow diet = mental retardation
ADHD; don't receive proper behavioral treatment and/or medication = 3x increase in emergency medical services, lower than expected grade level in math and English, lower likelihood of enrolling in college, lower expected lifetime earnings
The number one problem with treatment of common disease is that patients don't take their medication and/or follow their treatment regiments. THAT'S RIGHT!!! THE TRUTH IS PEOPLE DON'T TAKE PERSONAL RESPONSIBILITY OR TAKE THE PILLS. Study after study have shown that people are typically non-compliant with medications unless there is an uncomfortable adverse side effect to non-treatment (e.g. broken leg & pain pills). Do you think Americans are fat because doctors forgot to recommend diet and exercise? Do you think people with hypertension are given bad drugs?
IED is a slightly different issue. Nearly all people who drive have been a victim of road rage and IED raises a fear that the asshole who cut you off and forced you into an accident is going to get away with it with a letter from a shrink. That's probably the only good thing an IED diagnoses could be hypothesized to do; such a diagnosis would likely increase health insurance rates, make people hate you, increase auto insurance rates, cause workplace discrimination (it might not be legal, but do you think they'd hire someone with IED if they could avoid it), and is comorbid with most DSM-IV mood, anxiety, and substance disorders. Sounds crappy to me.
Ok, since all of you holier-than-thou Digg-nation fans are lucky to be perfectly healthy and unmedicalized, remember this (USA anyway) is a capitalist, keep what you kill society. Do you really want to encourage all these people to get out of traffic court, go to college, stay off the shrinks couch, diet, exercise, and get black belts? I didn't think so! On average the fat sloths with poor interpersonal skills, who won't stop sharing needles or wear a condom and with reckless driving habits won't be rising the corporate ladder and taking your job (and place in line for a Prius) anytime soon. So relax.
Unless you have IED and in that case don't get mad at me, it's not my fault either!
Monday, May 15, 2006
Well Friday was the first day I wore a gown in a long time. Calm down with the conspiracy theories! It was my graduation! Yep, the big MD. Not a whole lot has changed in the three days since I've been a doctor. Well, I guess I have been asked my opinion about the reality of Gray's Anatomy a lot more. (It's only a tad bit more realistic that General Hospital)
And graduation sure came at a good time! Other than being a requirement so I could start internship, graduation made me a little money and a lot of Hallmark cards! How much money you ask? Well, I wouldn't have had enough money to pay my rent had it not been for some of my gifts which I quickly cashed on Friday! Plus, another little gift I received today helped me buy some toiletries and Diet Pepsi! Yes, you can tell that I am not only a doctor, but a rich one. Okay, half of that is not true.
I had more money when I was an undergraduate! People don't seem to understand that you don't get a Porsche and a paid AMEX card during medical school orientation. You sure as hell don't get them during medical school either. You don't even get them when you graduate. (rich daddy stories will be ignored for illustrative purposes) It's a long road to having some cash in your pocket.
For the primary care (family practice, internal medicine, pediatrics) specialties and their income equivalents the decision to go to medical school likely will never pay off financially. If you compared an average income for a person with a college degree compared to the Average Primary Care doctor (APC), you'd see that they never break even. Let's set the average college degree income at $40k, the length of medical school training plus residency (for primary care without further specialty training) at seven years, and the average indebtedness of United States Allopathic Medical School (MD) graduates at $125k.
Starting to see the picture? At the point the medical student graduates he's $265k behind his friend who jumped the academic ship after college ($40k X 4 = 160k; 160k + 125k). After three more years of residency, the APC doctor is still roughly the same amount behind because at the roughly $40k/year residents are compensated most cannot afford to start repaying their students loans.
Now you're probably thinking, "Wait! But the MD is going to make a lot of money and he/she will win in the end!." Well, er, maybe. The APC doctor makes around $140k/year. Their first years out of residency though they are likely to start around $80k. It appears to take 3-5 years for most doctors to A) grow their practices enough and/or B) reach partner in a group practice and/or C) learn how to actually make money as a doctor -- to reach this "average" level.
Even if we leave the average bachelor's degree at $40k/year he/she stays financially ahead until the doctor attains his average level of income when we finally see an apparent break even point. I said apparent because we forgot about the power of compounded interest! By the time the income balance appears to even out, the "lowly" college graduate has had the ability to contribute to a 401(k) or other savings vehicle for around 11 years! (We also assumed the physician repaid their student loans ASAP)
See illustration of this at:
http://www.fool.com/money/401k/401k01.htm
The APC doctor will have a chance to chase this investment by making the much larger contributions he/she will be able to make into savings, assuming they have the willpower! The expected lifestyle of a physician is much different than that of the typical average college graduate and making those larger savings contributions can hurt.
...oh well, I just wanted to illustrate, similar to the way it was explained to me, that medicine is not the way to get rich! I didn't go into medicine for the money and I'm not suggesting many of my colleagues did either. Yeah, we're going to have a nice lifestyle, but even at the epilogue of medical school training we're still a ways off!
(And if you're still perturbed by this idea remember that we assumed the average college graduate received no raises and also did not account for the greater number of hours worked by medical students and physicians to achieve the stated incomes. The average medical student works (at education related activities including studying) about 80hr/wk. The average resident works 80hr/wk. The APC works 50-60 hr/wk.)
Tuesday, May 02, 2006
What exactly is in your beer?
Each is an additive commonly used in the production of mass market beer: betaglucanase can be used to speed up the brewing process, while propylene glycol alginate can be added to help stabilise a beer's head of foam.
read more | digg story
Walk a Quarter-Mile or Die
"The ability to complete this walk was a powerful predictor of health outcomes," said study leader Anne Newman of the University of Pittsburgh School of Medicine. "In fact, we found that the people who could not complete the walk were at an extremely high risk of later disability and death."
read more | digg story
Sunday, April 30, 2006
Young Men Also Experience Sexual Dysfunction
read more | digg story
Saturday, April 29, 2006
IRS Claims Symantec Owes $900 Million In Back Taxes
read more | digg story
You Tube burning through cash while entertaining millions
The site's bandwidth costs increase every time a visitor clicks on a video and are estimated to be approaching $1 million a month, much of which goes to provider Limelight Networks.
read more | digg story
Top 5 Creative Uses for Your iPod
1) Subway Maps - http://www.ipodsubwaymaps.com/
2) Dictionary - http://www.ipreppress.com/Pages/Reference/MWPocket.htm
3) Find Dates - http://www.poddater.com/
4) Personal Trainer - http://homepage.mac.com/berbie/TrailRunner/english.html
5) Play Doom - http://ipodlinux.org/Main_Page
Linux on your iPod also allows you to install things like:
Wikipedia - http://encyclopodia.sourceforge.net/en/index.html
Periodic Table - http://ipodlinux.org/Special:Module/periodic
read more | digg story
Why Do 'American Idol' Voters Have A Southern Bias?
For five years, the most popular talent contest on American television has been dominated by kids from Southern Hicksville, USA. Seven of the eight top-two finishers in the first four years were from states that once formed the Confederacy, and five of the seven remaining finalists this season are, too. Is it the Gospel music? Check out the article link below.
read more | digg story
Thursday, April 27, 2006
Amateur Hacks Into US Military Computers Looking for UFO and Aliens Truth
An amateur exposed security flaws in US governmental computers to unlock the truth about UFO's and aliens. He has also revealed evidence that makes it sound like they exist. He's likely going to jail or worse. He's being charged with crimes that will likely cause him to be extradited to the US for trial. The punishment could be at much at 70 years in jail (possibly Guantanimo Bay) and over a $1,000,000 in fines.
Okay, this is seriously scary. Despite this guy sounding like the friendly-hacker-next-door, I think he did something completely irresponsible. What exactly is his sympathy plea based on? "Yes, my hand was in the cookie jar, but I was only looking for knowledge." Puhhlease. Could someone please keep people out of our government secrets and computers that aren't supposed to be there?
I also propose that this guy has been alone with his dial-up modem and computer for far too long. He's said to be an out of work computer programmer who: 1) doesn't understand why it's wrong to break into government computers; 2) is dumb enough to joke about revealing the secrets. Don't we have government agencies that make people disappear for stuff like this? Maybe this action of actually trying the guy for the crimes is a sign that they're more worried about making an example of him than they are about what he's found out. If he had dangerous government secrets, I doubt he's be giving interviews.
Check out the story!
read more | digg story
Wednesday, April 26, 2006
PSM "reveals" PS3 release date, price
read more | digg story
I was surprised that I made the 437 miles in just over 8 hours. I am also, continually, amazed at how well drivers in other parts of the US (I live in AZ), drive. For most of the day I drove at close to 80 MPH while going for long stretches without passing or being passed. Yes, there were plenty of drivers surrounding me. There is some unspoken rule in the Eastern turnpikes about everyone going fast is good, but driving like a jerk is bad. 437 miles and I think I was only cut off twice. No, it wasn't a MASShole. Just a Mercedes in a hurry. In Arizona, I think there's a 26% chance I'd die after driving 437 miles in one day.
Love Muffin's brother-in-law is hosting me for the next two nights in Philly. Burgers and wings coming up. I better not drink too many Coronas. God forbid I have to take (or pay) for this test again.
Peace out homies.
Tuesday, April 25, 2006
Microsoft faces strong competition, says it's own lawyer
Words from the mouth of the giant, but is it a Trojan horse?
read more | digg story
Monday, April 24, 2006
22 Reasons for Human Clones
Twenty-two key reasons to support human cloning, including the practical (for future financial security), the vain (to cure baldness) and the truly awe-inspiring (to cure infertility, fix deformity and prolong life).
First I want to say that growing basic organs such as skin, cartilage, bladders, and blood vessels in a "test tube" is already a reality. Nice blog of bladder development.
While I'm typically a progressive about medical advances, I think human cloning is a bit creepy. Give me LASIX, slap on a robotic arm (if I need one), anti-obesity drugs, sugar substitutes, etc... I just can't wrap my head around people cloning themselves.
I'll use some of the "reasons" to clone human beings given in the digg.com article as a framework for why I think we are not ready for this.
Medical Tragedies: Some of the examples given were girl who needs a kidney, burn victim, cosmetic deformity. Okay, growing organs is cool. Making a kidney in a Petri dish is very cool. Cloning a complete human just so you can farm some of their organs is not cool.
Ethics boards have already dealt with this one and typically discourage a planned pregnancy solely for the purposes of a willed organ donation to a sibling. One of the main reasons is that the child cannot make an autonomous and unbiased decision on whether to give the organ. Can you expect a clone to make an unbiased decision on whether to give up his skin for a burn victim? "Sure Bob, I really like your DNA. You can have my skin."
To Cure Infertility: Many employers and many medical plans cover infertility treatments. ALL insurance carriers do not cover heart transplants and bone marrow transplants. Non-universal access to reproductive specialists and treatments are a poor argument to clone a human. Additionally, if a person is infertile and cannot afford access to infertility treatments, how are they going to afford to have a person cloned? In what day and age will cloning be on the HMO basic plan? If we're going to talk about "changing the world," then let's promote adoption.
Bad Parents: WTF? Is this seriously a social, medical, legal argument for cloning based on having a bad childhood? Did I miss the "just kidding" disclaimer? I think it's sad and horrible the childhoods that some people have endured. I can't, even with this in mind, stand behind a policy that says it's okay to cloning yourself so "you" can have a better chance at a normal childhood. Pay your intentions "forward" in other ways. There are many children who can be helped to have better lives without cloning yourself. SELFISH!
A child's right to be better than its (sic) parents - I'm not sure about a cloning advocate that labels a child an "it." Anyway, I digress... Nobody told me that I had a right to be better than my parents. I'm going to call my Mom and tell her about it.
Because you believe in freedom - Assuming that cloning does become a medical and legal possibility in the near future, who will have access to it? That's right! Rich people! We don't have universal access to basic healthcare in America and most people in the world don't have access at all. When do we suddenly leapfrog these problems so we can have the 2020 Assembly of People Worried about Universal Access to Cloning? Can't we worry about AIDS in India and Africa before we worry about rich people cloning themselves?
Too bad the essays link is broken (see referred page). All of my arguments have probably already been shattered.
Religious Freedom - I've never heard of the Raelian Religion and the Summum Religion, but even if they condone cloning and their members are cloned what if the clones don't want to belong to these religions? Maybe they'll become Catholics and then feel guilty about being a clone? I wonder what Mohammed would say about cloning?
Gay Couples - How does this couple decide which partner to clone? I fight with my girlfriend over where to get a burger. This argument would probably put me on the couch, again.
Okay, I've got to get back to studying. Please leave me some comments. Schwarzenegger movie theamed (The 6th Day) comments are encouraged.
Oh and here's a site where you can clone your pet: Genetic Saving and Clone
read more | digg story
Scientists find brain cells linked to choice
It appears that using monkeys they have evaluated orbitofrontal complex (OFC) reactions to different economical choices. Examples given were choosing between 3 drops of grape juice and 10 drops of apple juice.
Functional studies (such at PET and fMRI) have also shown that the OFC is also implicated in a variety of disorders including eating disorders, gambling, and other unusual social behaviors.
Here are some links to abstracts associated with the OFC:
Orbitofrontal cortex activity related to emotional processing changes across the menstrual cycle.
Functional neuroanatomy of aversion and its anticipation.
Orbitofrontal ensemble activity monitors licking and distinguishes among natural reward
read more | digg story
Brain responses to cocaine administration in the human brain by fMRI
read more | digg story
University Of Utah To Help Build Bionic Arm
We're getting closer and closer to making the movie The Terminator a reality. This is all part of the evolutionizing Prosthetics 2009 project. The key link in this research will be a peripheral nerve interface for the prosthesis.
Here's a direct link to another version of the study:
http://www.freerepublic.com/focus/f-news/1619143/posts
read more | digg story
Sunday, April 23, 2006
Amazing Truth Behind the Fast Food Industry
read more | digg story
Xbox 360 CPU to switch to Cooler Running Xenon Processor
read more | digg story
More evidence that sex is good for you
Definetely a "feel" good story. It's not new news that more frequent RELATIONS is related to better health. However, these stories (while a great reason to talk your significant other into the sack) do overlook the correlative nature of much of this research.
Most of these studies have no control over the possibility that maybe healthy people have more sex rather than the sex leading to better health. Even our most genitally obsessed friends would unlikely be thinking about shagging when in chronic pain from, say, metastatic cancer.
It also stands to reason that healthy people are more attractive and more capable of frequent sexual acts. On top of all this these studies are also confounded by the positive benefits of just being in a relationship and all of the positive physical contact that isn't "sex." I'm waiting for a study to examine the effects of a "sex-buddy" on health. Could we propose that the effects would be positive but not as good as being in a full-fledged relationship?
One of my favorite educational sites by a very educated woman who I was fortunate enough to meet and hear speak a couple of years ago.
Dr. Laura Berman
read more | digg story
Picture of the inside of two Women, 250lbs & 120 lbs
This is a very cool imaging comparison of two females with widely different amounts of body fat. Likely these images were made using a whole-body multi-detector computerized tomography (MDCT). Data is typically acquired in the axial plane in slice thicknesses of about 0.5mm. Using a computer the data is then reformatted into images in the coronal (in this case) and saggital images. Another computer program can then color the images using data from the density (Hounsfield Units, a measurment of X-Ray beam attenuation). This is what makes bone look white and muslce look red. Each has a typical CT density. This can explain why there appears to be fat in the obese woman's brain. These different planes have varying uses depending on the pathology a clinician and/or radiologist is looking for.
More about anatomical planes at:
Anatomical Planes
Other things about the comparison which are interesting are that the bone and muscle mass of the two are roughtly equivalent. Internal organs are roughly the same size. The obese woman appears to have larger organs because they are surrounded by significant amounts of adipose tissue (fat).
Likely due to the excessive weight burden the obese woman has a more "knock-kneed" look or a varus deformity.
Varus Deformity
However you can see this deformity without the weight burden, it is more typical in obese people, paticularly women. This leads to orteoarthritis and is treated conservatively with NSAIDs. The "cure" is weight-loss and/or a knee replacement surgery.
Knee Replacement
One organ that is likely really larger in the obese woman is the heart which has undergone hypertrophy. The heart cannot generate an increase number of muscle cells, but instead the individual muscle fibers all get large to deal with the increased burden. This is not surprising. All that extra fat has blood supply and the heart does have to work harder to pump blood through all that extra tissue. I was once told there is a mile of capillaries in a pound of fat. I never took the time to measure it myself, though...
Cardiac Hypertrophy
You can see a variety of very cool medical imaging reformats at:
Fenestra Image Galleries
read more | digg story
Sexy gaming girls as next-gen gamer conference models: Allowed at E3!
Whether or not people like to admit it, sex sells. And it definetely sells videogames. Look at the success of games like Tomb Raider and the GTA series. You can see a nice review of video game babes here:
http://archive.gamespy.com/top10/may03/gamebabes/
read more | digg story
Saturday, April 22, 2006
True cost of a college education
This is espeically true when you figure in the value of 401(k) and IRA investments. Four to six years of even meager contributions to a 401(k) account that generates a ROI of even close to the market average can account to over a hundred thousand dollars by retirement. There's a good graph of this effect at Fool.com:
The Birds 'n' Bees of Your 401(k)
What this article does not take into effect is the ability to compete for jobs in a down-turned economy which we have not seen in recnet years It also does not account that some degress have much higher averages than other. While liberal arts degrees are only averaging about $30K a year, chemical engineers are starting at about $56K.
Most lucrative college degrees
At this difference, I think despite missing out on the 4-5 years of compound interest on retirement savings the higher earning degrees can overpower this loss by larger savings contributions.
read more | digg story
The Artificial Prison of the Human Mind
read more | digg story
One of the most lasting lesson from this experiment is the extremes to which "normal" humans will behave in given circumstances. Check-out the Milgram experiements which also illustrate this point.
Milgram experiment
Along these same lines an arguement can be made that these same types of indoctrination and obediance that lead to the creation of the war criminals in Nazi Germany around the time of WWII. These types of psychological phenomena help to explain how "typical" young-men could be turned into murderers.
Another interesting point about these studies is that they would NEVER be allowed by IRB's today:
IRB FAQ
Photo radar helps remove reckless AZ driver from road: clocked at 107 MPH
I'm a big fan of this result of the photo radar in the East Valley. This story highlights the apprehension of a 19-year-old female driver who was clocked at various times travelling in Scottsdale from 76-107 MPH!
I typically drive about five miles over the speed limit and this places me about an average speed. I don't mind being passed and I don't mind moving over for drivers moving along quicker than I am. However, I definetely do mind when someone zips by me at a ridiculous speed. It's not uncommon to be passed by people driving more than 20 MPH faster than me on the loop 101 where the speed limit is 65!
I agree with the sentiment that photo radar is not a substitute for police officers on the roads. However, if the radar can help the officers catch a few highly dangerous drivers then I'll for it until a better solution is proposed.
Maybe you're an excellent driver with tires speed rated for 100+ MPH and a car capable of safely handing at that speed, well in that case... drive it like it's stolen and try not to kill anyone! As I said before, I'd rather see more officers on the road. I don't know that photo radar is the answer, but I think the highways are more dangerous than they need to be:
"The total economic cost of motor vehicle crashes in 2000 was $230.6 billion. This represents the present value of lifetime costs for 41, 821 fatalities, 5.3 million non-fatal injuries, and 28 million damaged vehicles, in both police-reported and unreported crashes. Lost market productivity accounted for $61 billion of this total, while property damage accounted for nearly as much - $59 billion. Medical expenses totaled $32.6 billion and travel delay accounted for $25.6 billion."
2000 Economic Impact of MVA