Happy Halloween!

It's absolutely my favorite holiday of the year, so even though I am studying, I could not help but post a short post in celebration. We put out a jack o'lantern that I painted (okay, with a permanent pen) instead of carved because we plan to (insert evil laugh) eat him.

We had about a dozen trick-or-treaters, with the most popular female costumes being cats and Minnie Mouse, and the most popular male costumes being monsters (all black with a scary mask). Best female costume: Harry Potter! Best male costume: A soldier with a purple heart.

Best group costume: Three Muni trains! If you've ever ridden the Muni in San Francisco, you will understand why it is appropriately scary. They were beautifully detailed, with working headlights, perfect logos, and the correct route stuck on their fronts. They even had advertisements on the sides! Here they are getting derailed...

... and eating their lunches. Trains need fuel. Ironically, these MUNIs chose Subway for lunch.

It was a beautiful Halloween night as the sun set over the sea...

 And here is the Haunted Wood on my way home from work:

Hope you had a Happy Halloween!

To NIH and Back Again

The NIH Clinical Hospital: Every patient is on a research protocol

I recently made a brief journey to the National Institutes of Health for what I believe qualifies as my first-ever business trip! That is, if you consider a 'business trip' to be one that is both mandated and paid for by your employer. It was an incredible trip. I met nearly 100 other medical students also taking a year "off" from school to do research. They represented an incredible range of schools and interests. I took a chance by going to a neurology networking lunch one afternoon, and was invited to do an elective at NIH next year by one of the physicians there! Wow. We also attended presentations about residency selection, balancing a clinical practice with a research career, finding funding, and dealing with student loans.

The keynote speakers were very famous people -- Francis Collins (NIH director, working on aging), Anthony Fauci (he and his PI essentially discovered the treatment for Wegner's granulomatosis and his lab went on to develop AZT, the first antiretroviral, discovered much of the natural history of HIV/AIDS, and convinced three presidents to fund AIDS interventions in Africa), and Marston Linehan, whose lab is responsible for discovering the basic pathways of kidney cancer AND creating new techniques to vastly extend life in patients with kidney cancer. I was in awe that such brilliant people were also such good speakers and seemed very personable. They encouraged us to take over from them in the next generation. What shoes to fill!

Building 50: My Old Lab!

We were housed at the Hyatt in Bethesda -- my roommate was a wonderful person who studies colon cancer risk decisions and wants to be a rural family medicine doctor. I was very glad to have met her. I also reunited with medical students I had met on the interview trail years ago, but had gone somewhere else. There was not too much time to socialize except for the meals --  which were delicious and plentiful. I was very grateful that NIH had organized the weekend for those of us funded through NIH student grants (of which there are many). Bethesda was beautiful in October -- crisp air, deep blue skies, fluffy clouds, and trees just beginning to change. I very much enjoyed being back there after four years away. It was over so soon.

Trees Changing Color at NIH

I flew home and found, to my surprise, that I was sitting next to two medical students from Yale, a year my junior, going to a surgical conference in the Bay Area! We spoke at great length about the Bay Area and medicine versus surgery. We called our little area of the plane 'Medical Student Row,' and were continually being visited by other students on board who were also attending the same conference.

Cat in a Bag

NIH or no NIH, however, there is no place like home. My sweet cat had been moping around, according to B, but she was perky when I arrived, and we found her contently chewing on a receipt in a brown paper bag that evening.

Cactus and Aloe in Window Silhouette

Exam Rose!

Our plants were looking wonderful, the rose B had given me to cheer me up was still in bloom -- and this reminds me that now, and for the next month or so, you will please forgive me if you hear very little from me. I must somehow gear up for all the examinating that lies ahead. There are now only 18 days between myself and Step 2 CK.

Boundaries and Bosses

I have two bosses. They are both incredibly bright, lovely women who happen to have advanced degrees and a lot of clout. Big Boss is the head of our lab. She is one of those people who looks between 10 and 15 years younger than they are. She is very driven, down-to-earth, straightforward, and to the point. She is always juggling several things at once but somehow manages to get all the important things done. She keeps her promises. She doesn't have a lot of patience with personnel drama. However, her husband works in her lab, so I have a window into her world through their interactions.

The second boss I call my Little Boss. She is a young attending physician-scientist who works in the lab, and I'm helping her with her first big research study. She has a three-year grant and has nearly completed the work mid-way through her second year. She has been that kind of worker throughout medical school and her PhD program. However, she and her husband have just adopted a two-year-old boy and she is feeling a powerful maternal urge, I think. She is now planning to leave academia this year for half-time private practice so she will have more time with her son. I do not know that this goal will materialize for her, given the climate of private practice these days. I hope it will, since she feels compelled to leave so soon to pursue it. I have my doubts.

My Little Boss

I have come to realize that in my lab, the blurring of boundaries between work and home is so great that most of the folks who work here could write each others' biographies. Each day, we all sit down to lunch for an hour from noon to twelve, the unwritten rule being: No Work Talk. Every time I have mentioned work at lunch, I have been gently hushed until I, greenhorn that I am, got the message. It is the socializing, networking, debating, and gossiping hour, but never work. It seems so civilized and old-fashioned. It is a far cry from the inpatient hospital world, where sitting down is a crime and chewing (meaning eating) a sin. In addition, Little Boss and Big Boss tell me so much about their lives. I know about their kids', pets, spouses, their home lives, etc. Perhaps the culture is that way because everyone is a parent -- Big Boss has two teens, four others have grown-up kids, and Little Boss as well as two other scientists all have kids under two.

Little Boss says that part of the reason she wants to leave is that she thinks that private practice will have more well-defined hours. For instance, in our lab, she can go home in the middle of the day if she wants to have lunch with her son. But she hates feeling that research is this amorphous entity that could take up 20 hours a day if she allowed it to. She'd rather have the stricter hours of a clinic, knowing that when she packed up for the day, she was not bringing her work home with her. I think the people she works with are far more important than the job description on paper -- if they value family time, that will affect the culture of the workplace. I personally think our lab environment is much more family friendly than the clinics I've seen -- of course, I've only really seen clinics that are affiliated with big hospitals. Perhaps community clinics are more flexible.

I am very grateful for this year. It is giving me a chance to study, think, earn a little money, work hard but sleep enough, and reflect about my future. I really, really needed it after an emotionally overwhelming and academically underwhelming third year. The other day, Little Boss introduced me as her "senior medical student," and I could not help but think that I am really too far behind in my studies to be referred to as such. Then again, that is what my precious year is for.

Today, both bosses were helping me prepare for my lab meeting on Friday afternoon. Big Boss wanted me to include more basic science, more details about the mechanisms, signaling molecules, hypotheses and how we were going to test them. Little Boss was of the opinion that this would put my audience to sleep, and that I needed to clarify the basic principles, questions, and background. The lab meeting is a practice session for the Works in Progress talk I am giving to the other year-long research fellows on Wednesday. That one is a bit more nerve-wracking because there will be another student speaking as well, before me, and one whom I know to be very hard-working. Anyhow, my task now will be to take the advice of Little Boss while somehow also pleasing Big Boss. I am so thankful for all this feedback and attention -- it's far more than I got last year. It is challenging, though, to navigate two opposing opinions -- clearly, Big Boss trumps Little Boss, but I work much, much more closely with Little Boss and want to keep her happy.

My only fear is that I will be pressured to divulge all the personal details of my life while at work. I guess I just have to guard against it. I have already been put in an awkward position a few times because my higher-ups ask me to keep secrets from one another; I don't want them to know enough about me to get under my skin. Ironically, it's safer perhaps to discuss things here, on this online blog, than at work. It's getting late now, so I think I will turn in for the evening. Good-night!