Senior Mentor Reflective Essay

We had an assignment where we had to reflect on our feeling towards providing healthcare to the elderly.  Here's my essay:

Reading the three vague questions demanded of us in the senior mentor reflective essay, I can’t help but assume the administration just wants us to ramble on about our thoughts on providing healthcare for the elderly - so I plan on doing just that.  I apologize in advance if I don’t answer all three questions.

BMS

In 1978, Samuel Shem famously wrote a pseudo fictional memoir called House of God, in which he told one of the first tell-all books of the insanity of internship.  Shem covers a wide range of the insanity - the depressing isolation, the extreme coping methods, the reality of how little medicine can actually do - but one of his favorite targets is GOMERS, which stands for Get Out of My Emergency Room.  GOMERS are elderly patients that are suffering and actively dying, but medical technology is somehow keeping them alive.  The doctors and nurse taking care of GOMERS are frustrated that they take up so much of their valuable time and attention.  The question they ask is, “Shouldn’t they be allowed to die with dignity?”

My view on healthcare towards the elderly is, unfortunately, similar to Shem’s.  It is frustrating to me whenever I see off-hand statistics that mention the surprising concentration of healthcare dollars that are spent on the last six months of life.  If there is not enough money to go around to provide healthcare for everyone, don’t we need to ration our resources, and invest the money where it’s actually going to help our society?  On a simpler level - should we even be taking care of people that can no longer control their bowels, or worse - their breathing?  I imagine I am not the only young person that sees the world through this cynical lens.

Who deserves healthcare? ...a loaded question

These frustrations over serving an aging population that is no longer able to serve society like it used to, is one of the main reasons driving me towards something bordering on a fear of the elderly and an in interest in pediatrics.  I can't help but relate to the doctors portrayed in Shem's House of God and predicting that I too will fall into the same pessimistic bunch of docs.

I understand the situation in real life is much more difficult than crunching numbers - seeing one of your loved ones passing away, it must be difficult to let go.  There must be a point when it becomes more than just being about efficiency.  To that extent, I have never had close relationships with anyone over the age of say, 60, and being so unfamiliar, it is definitely difficult for me to relate to this age group.  

On a sidenote, I want to believe in the value of every life - young, old, black, white, rich, poor - whatever.  I definitely cannot say I live a life that embodies that ideal, but it is an ideal I wish to attain.  I sincerely hope the Senior Mentor activity will change my views on serving the elderly.  They have certainly done their part to serve out society, and they deserve to be taken care of in their dying days.  I also hope the senior mentor activity will help me understand the issue of dying.  Is it possible that it's not wrong to let GOMERS die?  Don't the elderly deserve the respect of dying with grace?  

It's hard to reach any substantial conclusions in a rambling reflective essay, but here's what I've come up with: I see a lot of personal conflict in serving elderly patients, and I hope that will change in the coming years.  

See you on the other side,

from ken

Insane in the Sarcolemma: test week #2

So we just started test week #2 - musculoskeletal aka f-load of anatomy.  For non-MUSC readers, before every test we get a week off from classes and small group discussions to focus on studying.   I thought the last study week was crazy.  [link to test week #1]  Turns out that was only the beginning.  

don't waste your time

The last test went well - the class average was an 88.  That block was mostly a review of undergrad, but this musculoskeletal block has been completely different.  The material is almost all new, and there's a TON of it - one of my friends estimated 650+ powerpoint slides of anatomy - slide after slide of muscle, nerve, bone, ligament, artery, repeat.  It's hard to describe how hard it is, but I consider myself a fairly intelligent guy, and I've had to wake up at 5 AM just to cram in enough time to study.  And I just scored a 40% on the metabolism self-assessment.  

In a sense, this was the block med school got real and lived up to the hype.  It definitely got hard.  

exactly how I feel

But.. how real is it?  Anatomy seems pretty useless, although you could maybe sell me on it - I guess we should understand the structure of the body.  On the other hand, I'm about 200% sure glycolysis has nothing to do with being a doctor.  Personally, I want to be a cancer scientist - and glycolysis/TCA cycle/oxidative phosphorylation is even meaningless to me.  Sidenote - I'm pretty sure the Warburg effect is controversial, which isn't surprising considering Otto Warburg came up with it 50 YEARS AGO.  I would not be happy to see it on an exam of modern science.  Anyways, It might help to have a general understanding of metabolic principles - but to know the exact name of each enzyme?  Absolutely useless - just wiki that shit.

So why do we learn this?

Maybe we're trying to develop a crop of doctors that's planning to dominate bar trivia - I swear my classmates would be the top 160 trivia masters in Charleston.  We are REALLY good at memorizing facts.  But if any of you have complaints about your doctors not spending enough time with you, or not having a human side - don't hate the player, hate the game.  I'm surprised any doctors come out of this training system with a lick of humanity left in them.  

But anyways, here's my simple answer to why we're trained in this outdated style - because the class of 2015 learned it, and the class of 2014 learned it, and the cl...  It's the status quo.  But is producing trivia robts really what med school should try to accomplish?  Do patients want robot doctors?  Should students be investing $200,000+ in loan money for this?  Don't we deserve to get training that will actually help us be better doctors?  

See you on the other side,

from ken

What is sidenote?

This post is for all of you who have wondered - what is Sidenote?

Here's how I define the writing tool "sidenote": A few years ago my friend Amulya and I had an epic email chain where we rambled about our relationships and life philosophies.  In the middle of our email, if we had a more interesting idea we'd simply write "sidenote" and take our rambling on a 180.  Sometime these sidenotes would be completely off the wall and only interesting to one of us, but other times it'd turn into the best part of the email.

for some reason beautiful places
produce lots of ideas

And similarly, here's how I define the blog "Sidenote": it's about a lifestyle where it's ok to stop whatever you feel like you should be doing and instead follow random sidenotes, because that sidenote might be more interesting, and interesting is better than important.  

Here's how I reached that conclusion:

During college I read one of my top 3 favorite books ever - Tracy Kidder's Mountains Beyond Mountains.  The short synopsis - biography of Dr. Paul Farmer - who provides American quality healthcare to the destitute poor in rural Haiti.

After reading it I was immediately convinced that this was what I HAD to do with my life.  I started organizing a service trip to Haiti, wrote about Haiti for the school newspaper, blah blah blah - by the end I had became a major social justice advocate at Kenyon, but I was also left burnt out.  

Near the end - I hosted a group conversation called "What is Social Justice?"  It brought together campus leaders to discuss how we ought to live out a life of social justice.  

Here's what I came up with:

"Ask not what the world needs.  Ask what makes you come alive... then go do it.  Because what the world needs is people who have come alive."   - Howard Thurman, civil rights activist

The point was that Kenyon didn't need more people giving money to Haiti, but it did need more people who were really engaged in their lives. 

Since then I've been trying to shape my life to be consistent with that belief - interesting is better than important.  My life is looking less and less like a traditional activist - I have minimal interest in working at homeless clinics, I don't vote in elections, and I'd rather read Bill Simmons or Cell than the New York Times - but I still consider myself an activist.  

i might have analyzed this too much

Thinking that the world can be fixed by simply giving more money to the poor or showing up to church on Sunday is simplistic at best, and counterproductive at worst.  I think there's a truth out there somewhere that could turn the world around, but it's complex and I have no idea how to get there.  I feel like if anyone's ever going to get there it's going to be people who are on fire.  And I think sidenotes are life's way of showing us what we care about.

Uh but anyways, that's what sidenote is.  I might have analyzed this too much.

from ken

Why Kenyon College kicks ass

from Liberal Arts

Top 3 question I've been asked since moving from Portland, OR to Charleston, SC for med school - Where'd you go to college?  

I've learned that this question has three right answers - Clemson, USC (hint: not LA), or token small Christian college in South Carolina.  I feel like the odd one out.. my answer: uh, I went to a small liberal arts school in Ohio called Kenyon College - it was mostly rich hippies' kids.  

For all of you that don't know Kenyon - I thought I'd explain why Kenyon College kicks so much ass.  Here's the top 4 coolest things produced by Kenyon College:

4) Liberal Arts

The latest film from the star of How I Met Your Mother Josh Radnor (Kenyon alum).  Liberal Arts is about an alum of a small liberal arts college that at age 35 still can't figure out what to do with his life.  If it sounds like your life - you just might love this movie.  Plus, it was huge at Sundance.

3) Artists

HUGE shoutout to my friends who are seriously pursuing art.  Kenyon has a knack for incubating young people who say - I don't care about having a normal 9-to-5 job/2.5 kids/white picket fence, I just want to do something COOL with my life.  

I admire that attitude of not giving a shit what the world wants you to do.  

Follow Your Heart

Matt Davis [link to his website], - to explain Matt - whenever I hear about one of his projects I say to myself - only Matt Davis could come up with something that weird.  

My favorite - a collage entitled Follow Your Heart, in which Matt ran from Gambier to Granville - a full marathon - while wearing an EKG device that recorded every beat of his heart.

Sarah Dougherty, living in NYC (sidenote - I'm super jealous, is there any better city for an aspiring writer?) and repping her English major on her blog - Salt That.  She is passionate about language's right to absurdism.  

Geoff + Kathy = heart

2) Geoff Anderson

Another Kenyon artist, but one that deserves a special shoutout for just getting engaged to Kathy Lin, which he means he made his fiance the luckiest woman in the world.  He also put up with living with me for two years.  He doubles as a teacher and published poet - "Amen" [link here].

1) Walk The Moon

Sidenote - it's easier to be an artist when you're in the safe environment of the Kenyon College bubble, but after picking up that diploma it gets a lot harder - college loans pile up, your parents email every other day with temp job websites, all while your friends are getting paid and living large.  Except Walk The Moon didn't conform. They said fuck the world and kept doing what they love.  And they blew up.  

Maybe you've heard their song Tightrope on the new HP commercial.  Their first hit "Anna Sun" is equally amazing - it's named after a sociology professor I had at Kenyon.  In the words of lead singer Nick Petricca: 

"It's about college, don't be afraid to play."  

Huge shoutout to Walk The Moon, Matt, Sarah, Geoff and all the other unmentioned dreamers from Kenyon College.  Please keep playing.

See you on the other side,

from ken

Newton/Noguchi tackle theology: Why do bad things happen? pt 2

Heath Newton loves Texas, basketball, and winning.  He also loves people and relationships, but those topics are not quite as interesting.  We met at the Agape Church of Christ in Portland, watched lots of basketball, and analyzed life’s big questions along the way.  

This is part 2 of a virtual coffee date with Heath.  [pt 1 here]

The topic: Why do bad things happen?

Ken: Interesting – what about Africa taught you the “suffer together” point?

there's something special about people you suffer with

Heath: One day (and sadly many days, this just happened to be the first of its kind) we went to a village and a family was in mourning because their child had just died. Their customary way is to have guests sit with them. Just sit with it. Just feel heartbreak together.

The level of connection in that moment was immense. To simply sit with someone as humans. As people who experience things in similar ways.

We did not ask for bad things to happen, but once they did we were bonded by a shared experience because we were with each other and we have the capacity to feel what others feel.

They also have a phrase of mourning that I always think of when I'm in a situation of immense suffering. I don't know how to spell it so I won't attempt it, but it was an actual word that translated to "oh no." Most of the time it was difficult to even muster up that word, but it was the only one that was ever appropriate beyond simple groaning of shared pain.

what's the point of having friends?

K: Powerful story - regardless of who we are, we are all human and we all fundamentally feel the same emotions.  I once read somewhere, maybe in an Anne Lamott book, that chicken little already proclaimed the sky was falling, so we needed to spend the rest of our time comforting each other about it.  

This is definitely a powerful plug for your job as a counselor - would you say this idea of being with other humans is a strong driver for you being a counselor?

H: I wouldn't necessarily call in comforting. I would call it validating. People sit across from me, knowing I have nothing at stake or reason to comfort them (I guess you could argue money), and when they are validated because I can grasp, understand, and perhaps share those "bad" feelings its a powerful thing. To know that you are heard and to feel that someone gets that. I think it shares the burden and allows you to not have to hold the weight of the badness, which itself may not be understandable or controllable. 

Maybe that's one reason why pain and suffering bonds us together so well. We are forced to say we are not in control. And when others bear that truth with us, we can cope better with a truth that is hard for us to swallow. By the way, I'm thinking out loud and I'm not sure if I will believe any of this in 5 minutes.

K: Money - I love the idea of validating way more than comforting.  I wish I had thought of that.  Empathy is so much more powerful than sympathy.  And maybe that's why relationships are so important, so we can share the truths and struggles of life?

We didn’t even break into the God stuff, but we’ll wrap up here.  Thanks Heath!

See you on the other side,

from ken and heath

Why do you think bad things happen?  Please share!

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