Newton/Noguchi tackle theology: Why do bad things happen? pt 1

Heath Newton loves Texas, basketball, and winning.  He also loves people and relationships.  We met at the Agape Church of Christ in Portland, OR, watched basketball, and analyzed life’s big questions along the way. 

Wouldn't have survived Portland without him

So here’s one big question I posed to Heath:

Ken: Why do bad things happen?

Heath: So here's my short on why bad things happen. Because they must. If we understand ourselves as free agents or people with free will, there must exist the possibility of bad things happening to good people or we do not have free will. 

However, I'm not completely sure if I believe we have freewill. And that's another conversation, but its a huge part of the equation. 

I also think we learn the most and connect closely with others through pain and suffering. I feel like most people would not reject the hard time because those times have made them who they are.

My final point for now would be ... well I forgot because I got sidetracked ... but this might have been it. I grew up in a sheltered and loving home so I typically wear rose tinted glasses, at least more than the average person it would seem. So that is an important piece of my context and lens. What do you think Ken?

on top of a rock,
probably thinking about life

K: Bad things must happen.  I love that, it's simple but it gets to the point.  

You once asked me the biggest problem the world faced, and I think there are lots.  But one is that we have a misconception of what life is supposed to be.  Maybe things aren't bad, they're just things.  

These bad things provide an opportunity for bonding.  I feel like this week - test week at school - has been super stressful but at the same time a real point of bonding for me where I've been able to start developing relationships.  

H: I certainly agree with your idea that bad things usually provide unique and special opportunity for growth. There are a lot of examples in nature where this is the case ... forests must burn down as a natural part of the cycle of things comes to mind.

Also my Africa experience left me with a couple top lasting messages as far as me evaluating what I provided and what were the most important things I did. They were:

1.     Be there - Woody Allen said that some high percentage of life is all about showing up

2.     Speak their language - beyond anything we said, the fact that we were saying it in their native tongue was probably more important

3.     Suffer together - to your point

K: Before we transition into Africa I’ll cut it off and send it to a part 2 next week.

See you on the other side,

from heath and ken

Thoughts on why bad things happen?  Please comment.

Insane in the Membrane

This week is block 1 test week.  To translate - before every test at MUSC we have a week off from our usual routine to study.  On the surface it seems great. 

ah the old lecture hall

We get a break from the usual bullshit of med school like cultural sensitivity training and following nurses around like lap dogs for 4 hours.  Wait, we're really going into hundreds of thousands of dollars in debt to do this? When normal people go into hundreds of thousands of dollars in debt they're buying fast cars, fake boobs, and big houses. 

Sidenote - the world needs to know that the education process of doctors is 70% bogus.  People, we could have more doctors by just shortening the MD training.  

if you're the president of AAMC
you can thank us later

Half-baked idea: cut out summers, condense the first 2 yrs (18 months total) into twelve months. Think about it - only about 70% of the syllabus is useful.  If I ever get pimped for not knowing the molecular mechanism of microfilament assembly I will shoot myself on the spot.  3rd year is actual time practicing being a doctor so say we leave that alone, but 4th year is mostly interviewing and sitting around, so that can be condensed into 0.5 yrs.  We add that up and you get an MD in 2.5 yrs.  

But as you dig deeper, test week is pretty f-ing crazy.  For several reasons:

1) It's incredibly unstructured, which doesn't work for 90% of students.  That's why we had to be students - for the structure.  If you left us alone we'd just go home and write blog posts complaining about the system or watch endless episodes of Grey's Anatomy.  For the 10% of students that are disciplined, it's equally terrible because you spend way too much time obsessing over every little fact you don't know yet.  That can't possibly be good for a subset of the population that is already ADD and/or on fluoxetine. 

2) It's the ultimate peer pressure experiment.  The library is literally a scary place to be.  There's about 80 stressed out young people wired on coffee thinking about nothing but vitamin B3 deficiency, receptor tyrosine kinase signaling, and neural tube formation.  I can't deny that everyone has been friendly on day one of test week, but at the same time… it's feels a little bit crazy, I'd rather hole up in a room by myself and listen to my neon green beats. Sidenote - if you were wondering, yes, they do sound better than the other colors.

the library during test week

You either have a whole week to obsess about the test inside your head and wonder if you’re insane, or you have the whole week to complain and bitch about it with your friends, confirming the insanity.  

It's like throwing a 17 year old Kobe Bean Bryant into the LA spotlight and the NBA.  Yeah it worked for him.. but it’s not like it was the ideal path.  Similarly, yeah med schools churn out doctors, but most doctors I talked to before med school have told me to reconsider my career choice, so it’s not perfect.  Anyways, I should get back to anatomy flash cards. 

See you on the other side,

from ken

Relationships in med school pt 3: Marriage Review yr 1

first dance - katie's favorite part of marriage

Since I've written book reviews, I figured it was only natural that I review other things, like marriage.  About a year ago (according to my wife) we got married.  

chronicled here: link to pre-wedding running diary

Sidenote - the actual wedding isn't chronicled because I was too stressed out to remember anything.  It's like I blacked out on cortisol.  Note to introverts: don't schedule too many social events before a wedding.  Or a wedding, maybe.  Wait, I could get in trouble for saying that.  

Anyways, here's my thought process on how I got married.

what are gods, anyway?

After attaining all of my collegiate goals, and feeling pretty empty about it, I decided the meaning of life was not goals.  Sidenote - I still love goals and I'm extremely goal-oriented, I'm just trying hard not to let it dominate my life.  So my second hypothesis was - life is about what you do day to day.  One of my wise friends had a quote in their facebook profile that said - "no one suspects the days to be gods."  The things you do everyday are the gods you worship.  

And one god I want to worship is other people - I figured the best way to do that would be to find someone cool from Wyoming and make them hang out with me all the time.  Sidenote - I feel like that's marriage at it's core.  Making someone hang out with you all the time.  

Overall, it's been the best year of my life.  Here's why:

Being married is like being on a team.  

At the beginning of every week Katie and I have a team meeting to recap the last week, plan what we can do for each other, and figure out how we can support each other spiritually.  

a team

But the best example of marriage team is how Katie was there for me throughout that long long interview year. 

She planned a wedding while I struggled through countless revisions of my AMCAS and a giant pile of secondaries.  Less than 20 days after marriage I flew out to Minneapolis to do my first med school interview.  Katie graciously drove me to the airport before the 6 AM departure, and picked me up after the 12 AM arrival.  She survived in a big bed all by herself as I went on six cross country trips.  She patiently waited as her life for the next seven years was hanging in the balance - would we stay in Portland?  Move to St. Louis?  Move to Charleston? Will we be taking on hundreds of thousands of dollars in debt?

And if there's anything I learned from seven years of running competitive cross country and track, it's that life feels more meaningful as a team.  Everything we do has a purpose bigger than ourselves, which is great if you're into stuff like that.  

So anyways, that's what year one of marriage is like.  Stay tuned for updates on M2.

ps - happy first anniversary katie!

See you on the other side,

from ken

What do you want to do with your life?

What do you want to do with your life?  

An always relevant question in our Gen Y culture of staying in college too long, bouncing around random jobs, and living at home.  I've read a lot of commentary suggesting our generation needs longer to incubate, so hopefully we’ll be inventing the next iPad and Pintrest in our 30’s and 40’s.  I also feel like I've fielded that question a million times since coming to med school. 

"Oh you're in med school? What sort of doctor do you want to be?"

I got here a month ago..
can I just be a med student for five minutes please?

We're already shuffling through "interest groups" where we meet and network with young doctors in different specialties.  We've been in med school about a month and we just learned how to measure heart rate. Sidenote - we pay $50,000/yr in tuition for this? Do we really need to know what our lives will be like five years from now? 

And frankly, I don't exactly want to be a doctor...  I want to go to med school to become a pediatric oncologist, but I mainly want to be a scientist, run a basic science research lab, and cure cancer.  But I think it's overrated to define "what you want to do with your life" with a job. 

Four years ago, I spent a summer waiting tables at a ranch near Yellowstone.  That was an amazing summer on so many levels.  I had just become a Christian and started to know God for the first time.  I ran 1000 miles. I had a girlfriend for the first time.  I started studying for the MCATs, which lasted about three days.  I was living on my own for the first time.  Lots of firsts. 

The best part - I had an epic email chain with my friend Amulya Iyer.  It started out innocently enough, but soon one of us raised the challenge that every successive email had to be longer than the last one.  We ended up exchanging 19 email, with the last email over 6000 words.  We talked about everything in the email chain.  Girlfriends, Donald Miller, olympics, endless premed hoops, the meaning of life.

One night that summer I was sitting under the one-of-a-kind Wyoming night sky, drinking beer, thinking about the meaning of life, and writing one of these emails.  That was the exact moment I decided what I wanted to be when I grew up.

big old Wyoming sky

I wanted to spend the rest of my life thinking about the meaning of life.

After that, I had to go to med school to become a pediatric oncologist.  I wanted to work with people that were dealing with the most serious side of life - death of a kid has to be up there, right?  Mainly, I needed to live in a world where I could justify philosophizing about the bs/meaning of life on a regular basis. 

"You cannot lie in this work.  There are so many people in this world who have no idea who the fuck they are."

That's what a pediatric heart surgeon said about his job.  I wanted to be at that apex, where my life would stretch me to my limits, and through that experience I would honestly know myself. 

Helping people and getting paid is a good part of the deal too.

See you on the other side,

from ken

Iyer/Noguchi on med school admissions: Virtual Coffee Date pt 2

ken and amulya

Here with Amulya Iyer, current med school applicant.  A continuation of last week's post, analyzing and critiquing med school admissions. 

Ken: Another half-baked idea to build on the intangibles: in the NBA, teams send scouts out to check out top college players.  Why don’t med school do the same?  Send some faculty out to the local colleges, observe students in class, chat with other students, read the school newspaper, get the pulse of the school. 

At this school, which students matter? 

If you’re a school like Stanford – intentionally trying to recruit the future leaders of medicine – wouldn’t you want the students that matter?  Can you tell that from a resume, where everyone looks the same?  Nah.  Can you tell that by going to a school and talking to the dean, the department chairs, a handful of students?  For sure. 

--

Amulya: Love this. It sounds difficult logistically, but I doubt that it really is. Let’s get some stats in here courtesy of University of Michigan. Thus far in the application process they have made 117 interview offers: 54% of these interviews were made to students from just 9 undergraduate institutions.

A school like Michigan could benefit enormously from sending an ‘MD scout’ to each of those 9 schools for a week or two and seeing the students in action in the classroom or with their friends. If it works for the NBA, why not use it in medicine? When a player retires from the NBA, they become a scout. When a doctor retires from practicing medicine, he should become a scout.

--

md scout home base

Ken: True.  Wouldn’t retired doctors love this?  This blows golfing out of the water. 

If you’re an MD scout, what are you looking for?

--

Amulya: Hmmm, tough question. Just off the top of my head, if I was a scout chilling in the back of a classroom discussion I'd look for:

1.) Works well with others and functions well in a group setting.

2.) Shows intellectual curiosity.

3.) Respected by peers and teachers.

Just like I don't think it's fair to judge an MD applicant based on their paper application alone, they shouldn't be judged just on the MD scout. Instead, the scout should serve to single out candidates that wouldn't necessarily be noticed otherwise. I imagine the scout sitting in the classroom, meeting with Dean's and professors, going to sports practices, etc. with a list of pre-med students and then flagging some of those students as 'studs'. And it could also serve the opposite purpose - if someone is clearly selfish, then those tags can work against them.

--

If I was MD scouting at Kenyon in 2012 here is what I would look for.  

#1 - I would survey every science major to name the best student.  I'm a huge huge fan of respect by peers.  If someone's a beast, who better to know than the people always around them?

#2 - I would go to watch honors thesis presentations and pick out the students with the best presence. People with good stage presence are good with people - thus they'd be good doctors.  

people who go big, will keep going big.
true or false?

#3 - I would figure out who won these three awards: Anderson Cup, MLK Award, and the Humanitarian Award.  Basically, this tells you who mattered at Kenyon that year.  If they mattered at Kenyon, they'll probably keep mattering in med school.  

#4 - I would ask the athletic director to pick the top 10 athletes.  There should be more points for athletics in the admissions process.  If you have an average premed student that spends a ton of time training to be D3 Nationals caliber swimmer, what does he do when he's done with competitive swimming?  Probably training to be an excellent doctor.

If there's any top athletes with any of #1, 2, or 3 I would offer them admission on the spot. 

Anyways, we’re getting long we’ll cut it off here.  Let me know if you have any ideas to make the med school admissions process any better.

See you on the other side,

from amulya and ken

Iyer/Noguchi on med school admissions: Imaginary Coffee Date pt 2

Amulya and Ken

Amulya Iyer is currently applying to medical schools.  Ken and Amulya have a virtual coffee date about the admissions process. 

--

Ken: How did you like your undergrad premed education?

Amulya: I loved my pre-med education at Williams. Apart from a small percentage of science geniuses, most of us will have a similar understanding of science regardless of how much we memorize for the MCAT. We don’t need expert scientists to be good physicians (excluding MD-researchers) we need expert human beings.

What I think will set me apart from other doctors isn’t my science ability, but my people skills. These were developed through English classes, small discussions, and broadening my cultural understanding with classes in Art History and Religion. (half-baked idea: Can we require American pre-meds to go to a third-world country and live there for a month??)

Ken: Totally legit half-baked idea, it gets to the core - pre-med students are living an unreal college life, so that makes us largely unreal humans.  The last med student I want to meet is a 21 year old whose life summary consists of college: classes, token volunteering in a clinic, and partying.

It seems realistic to give students extra points for studying abroad.  Other ideas?

What do these molecules have to do with doctoring?

Amulya: I would get rid of the physics requirement, and instead have all students perform two semesters of original research. Completing an undergrad thesis, and working in a research lab now, helped my understanding of biology and my critical-thinking skills more than any class.

Here’s the question we need to address:

Pre-med students need to feel the freedom to experience college and grow into caring/thoughtful humans and excellent physicians. Med schools need to objectively compare students so they can determine who to accept. How can these seemingly conflicting ideas coexist??

Ken: The pressure HAS to be on med schools to develop creative ways to assess students.  We need some half-baked ideas on creative med school admissions. 

Amulya: OK, right now med schools screen on GPA+MCAT and then go further into essays and letters of rec after they’ve eliminated students with low GPA+MCAT. This is probably done because it’s easier to screen on objective numbers and reject or ‘hold’ students that don’t meet a certain stats cut-off.

My half-baked idea is to turn this paradigm around – what if admissions committees initially were blind to GPA and MCAT and only screened based on essays and letters of recommendation. Then, after the initial screen they could see GPA + MCAT and interview performance to make the final decisions.

Ken: Genius, I love adcoms seeing essays/letters of rec first - it puts everyone's personal side up front.  I feel like some schools are thinking about this, but we need creative ways to get at the heart of each applicant.

don't you want a real human being taking care of this girl?

Amulya: The model for this is University of Southern California. Here are some questions they asked on their secondary application:

1. What are three words that your friend would use to describe you?

2. What is the most fun you’ve had in the last year?

3. Imagine your obligations were cancelled for the afternoon and you had three hours of free time. What would you do?

Skeptics will say these questions have nothing to do with medicine and are inappropriate for a medical school application, but that’s exactly why they are appropriate. These questions get at the humanness of an applicant, which is arguably the most important requirement for being a doctor.

As an admissions committee I don’t care about an applicant’s handling of a moral dilemma or past medical experiences – they’re going to med school to learn that. Instead, I care that my school is full of thoughtful, caring, real individuals.

--

Ok this is getting long, so let’s take it to a part 2. Please share your thoughts on fixing med school admissions.

See you on the other side,

from amulya and ken

MUSC Orientation Running Diary

Ever wondered what med school orientation is like?  Here's your chance to find out.  

Enter Bill Simmons style med school orientation running diary.  This is the second installation of sidenote running diaries. 

[link to pt 1, pre-wedding running diary]

--

Aug 15th WED

dr dre uses these actual headphones,
immediately the coolest thing I own

7:30 AM -  Brand new headphones, pens, and notebooks in hand.  Ready.  The upside - orientation starts with a free breakfast, the downside - it's crappy coffee and stale bagels.  

7:35 AM - Walking through a hallway crammed with med students. Everyone brought their friend cliques from Clemson or token local Charleston high school.  I wish Keyser and Jon Weil were here.  

9:00 AM - Orientation starts with an inspirational video about MUSC.  Over/under on number of inspired students: 1.   

10:30 AM - The boss, Dean of Medicine Dr. Etta Pisano gives a speech.

10:38 AM - Dr. Pisano throws in a clip from Scrubs. This is great.  Scrubs is the #1 influence in my life guiding me to medicine.  

10:44 AM - Scrubs clip #2.  I was born to be a doctor.  

11:05 AM - Scrubs clip #3.  Second guessing my decision not to write my personal statement about Scrubs.  

like a duck

2:15 PM - Waiting in line to get fitted for some sort of mask...  I think it's to pretend to be a duck so we can entertain sick kids. Patch Adams?  

3:00 PM - Considering going back to the lab.

--

Aug 16th THU

8:00 AM - Scheduled departure for MUSC.

8:01 AM - Wait, why aren't we leaving?  We have a flat tire?  Oh, great...

8:40 AM - Sitting on bus.

9:30 AM - Sneak into giant lecture hall to listen to more bureaucracy.  Something about student affairs.  Maybe that flat wasn't that bad.

3:25 PM - Ken and Katie arrive at airport after Katie spends 6 hours sitting and waiting for car tires to be repaired.  Maybe the flat was that bad.  

3:30 PM - Mom arrival for vacation/white coat ceremony.

6:00 PM - Crappy orientation meals end, expensive dinners start. 

--

Aug 17th FRI

pretty sure this place isn't on groupon

9:50 AM - Pick up syllabus.  500 pgs of power point slides.  Test in 4 weeks.  Over/under on score a current doctor would get on this first exam: 50%.  

12:00 PM - Picnic lunch in gymnasium.  Walking around making awkward side glances at all the tables.  

Should I sit there?  

Are they too cool for me to sit with?  

Oh hey!  

Someone I know!  

Saved!

1:15 PM: Strongly considering going back to the lab.

--

Aug 19th SUN

12:00 PM - White coat ceremony

3 out of 4 of the 2012 MD/PhD family

Sidenote - Debated wearing the smily face tie, ultimately opted for my grandfather's tie.  It's funnier if people think I'm serious first, then learn my weird sense of humor.  

Anyways, I'm officially a doctor.  No, wait.. in 6 to 10 years, I will officially be a doctor.  Then I'll be a resident for 3 years.  And then I'll be a fellow for 2 to 5 years.

THEN I'll officially be a doctor.  So that's...  adding in head... 11 to 18 years...  

Glad we did this whole white coat thing.  

--

Aug 20th MON

8:00 AM -  Orientation finally ends.  Classes start.  Wake me in 11 to 18 years. 

See you on the other side,

from ken

Metzger/Keyserling wedding highlights

the happy couple

My friends Lauren Metzger and Kaleb Keyserling got married last Saturday! 

the wedding site

They met at Kenyon, and were both excellent runners there, so they decided to have the wedding at the Kenyon College Indoor Track. The track is one of the most beautiful buildings on campus, which says a lot – Kenyon is consistently ranked one of the most beautiful campuses in the country. Lauren and Kaleb are both amazing. 

Here’s a collection of people’s favorite moments from the Metzger/Keyserling wedding. 

Naomi Blaushild - My favorite moment was the entire weekend of reclaiming Caples for KXC. #4AMpartypatrolwakeupcall 

Rob Carpenter -laurens smile when she was standing next to kaleb in front of everyone 

Steven Couper - The seamless integration of all people young and old from all parts of kalebs and laurens life. Also the general air of happiness, love and generosity esposed by all involved with the wedding, particularly from kaleb, lauren and their families. 

Tom Geiger - Lots of good memories, many of which should not be documented. I think my favorite moment may have been watching a train unfold during a 50 cent song. 

Chris Houser - I guess my favorite part, in typical Houser fashion, was the dinner at the reception. The food was very good and the entire setup was beautiful. However, I really did enjoy every aspect of the wedding, and I thought the ceremony itself had a kind of simple beauty that was very touching. 

Jonah Keyserling – Steven’s toast. 

Chris Maccoll - Showing up at the cove on Friday. It was pure joy to see that Kaleb and everyone; a great reminder of what we all shared, the good and the crazy. 

Pat Meyers – (a haiku) Modest kind and fun they reminded us we're friends tomasauras rex. But seriously, in my eyes the wedding felt as much like a long awaited arrival as a celebration...but that didn't trivialize anything; it made the whole wedding better. I think that's pretty cool. Plus it was nice to see people...and stuff. 

Katie Noguchi – pre-wedding party, I actually got to know Ken’s friends 

Ken Noguchi – Kaleb and Lauren’s first dance to Soulja Boy’s Crank Dat Soulja Boy. Love it. 

Kara Pellegrino - allusion to the first night they became romantically involved and Kaleb was dressed as Soulja Boy 

kaleb, doing his doctor thinking pose

Garrett Thompson - I enjoyed getting to see the much heralded Kenyon campus for the first time. I found the traditional ceremony on the indoor track particularly unique and memorable. I also enjoyed testing out my Carolina Korgis singlet during my winning performance in a 3/4 beer mile with my fellow groomsmen and the groom. And of course, my most memorable moment was watching Lauren and Kaleb walk down the aisle and make a lifelong commitment to one another. 

Jon Weil - the slide show was appropriately corny, and also very funny and endearing. 

Happy wedding! 

everyone

from ken

family blend

figure 1

Just left Japan, I'm about 6 miles above the Pacific Ocean right now. 

The last time I was in Japan, it was the summer before college.  This time, the summer before med school.  So the next time.. vacation before residency?

A lot has changed since that last time I was in Japan - I survived college and turned into a passable adult.  Some combination of running, making friends, and studying did the trick.  Sidenote - I think endlessly repeating this three step cycle is what turned me into a passable adult (figure 1).

Anyways, being in Japan for the first time as an adult, it's made me realize how much I'm like my family.

--

The most obvious place to start.

My dad, who hasn't been a huge part of my life since my parents got divorced about fifteen years ago, is an MD/PhD that loves science.  He's a physician that studies and teaches Molecular Biology (my major at Kenyon), and he loves thinking about how to do good science.

--

Jobs of family on my dad's side:

doctor, nurse, nurse, nurse, doctor, vet, vet, vet

Medicine is in my blood.

--

I read a little bit of my (mom's side) grandfather's memoir, which he wrote partly because he was bored in retirement, and partly to leave advice to his children and grandchildren.

My Japanese is degrading every day.. but his memoir reminded me of sidenote. He thought incredibly seriously about life, and believed it was about people and relationships. 

He loved the poem "youth" by Samuel Ullman

Tokyo, in the midst of the busiest intersection in the world

"youth is not a time of life

it is a state of mind

..

it is a matter of the will

a quality of the imagination

..

youth means adventure over ease

..

years may wrinkle the skin

but to give up enthusiasm wrinkles the soul.."

I would have loved to have been friends with my grandfather, had beers, and talked life with him.

speaking of which..

--

My cousin Satoshi and I were born six days apart.  Since we're so close in age, we were paired up whenever I came to Japan.  I hadn't seen him in about six years, but after sitting down for coffee..  I saw a the influence of grandfather Mouri in both of us. 

satoshi and ken

He's shy, but he thinks relationships are the most important thing in the world.  At the same time, he doesn't have Facebook because being so connected to the world is too exhausting.   

He majored in philosophy because he wanted to be friends with the kind of people who stroke their chin hairs and ask, "Why?"

He wants to have a 9 to 5 job so he can spend the rest of his time reading, thinking, and writing his memoir.

--

The moral.. you can't escape your family, even if you jump continents and go to Ohio/Portland/Charleston.

From my dad's side - medicine.  And my mom's side - philosophizing. 

I was born to be a physician-writer.

See you on the other side,

from ken