First day of my ICU month!

My kidney text book has just arrived and it weighs 19.5 lbs!!!! I guess I'm such a nerd for weighing my textbook. Anyway, the goal is for me to have that read.

Will need to start waking up earlier, however I've been working on my paper forever!


John

I have a new goal in mind. This will actually be my new habit for the upcoming month. This is partly inspired from reading blogs like "Success for Today". My long term goal for the moment is to finish reading The Kidney by Brenner and Rector. However, there is no free time in my schedule. In order to free up time in my schedule I will need to wake up earlier. Here is my plan

First month (I will be on ICU)
Goal for the month: Wake up at 5:30 in the morning except when I'm post call
Ways to accomplish this goal
1. Wake up immediately when the alarm goes off
a. Create a subconscious loop in my head that I will automatically get up. (Creating a habit)
b. Start jogging for 10 minutes immediately after I wake up
2. Get to work by 6:15 in the morning
3. After 30 days, gradually shorten the wake up time by 15 minutes to 5:15, and get to work by 6:00 in the morning
4. After 30 days wake up by 5:00 in the morning. Increase exercise time to 20 minutes

Now I'm in July on a consult month (Renal Transplant)
Read 30 minutes of Brenner and Rector on renal transplant. Get to work by 6:30 am.
Read 30 minutes of Brenner and Rector at night.

I'm on my way to reading 3000 pages (300 hours work of reading) for the year. Thus it all starts with waking up early.

J
P.S. I still need to do MKSAP questions and Medstudy reading as well. AAARgh!!!

I had an awesome trip back to California. My goals for my short time there was to learn 5 new dishes and get lots of sleep.

I have to thank my friend Dave for teaching me two new dishes. The first dish was a combination of straw noodles and eggs. The second dish was a tofu dish with Yu Chai. At first I said that it was Yu Choi, but my wife got totally confused. I was mispronouncing the name of the vegetable ;)

The rest of the dishes that I learned was wonton soup, fried noodles, and another tofu dish. It is a good thing that I got the recipes in writing, otherwise I would forget how to cook it.

I also spent the majority of my time sleeping and also viewing trips about Europe. I will blog about my tentative trip a short time later.

John

SWANSON'S UNWRITTEN RULES 1: Learn to say, "I don't know." If used when appropriate, it will be used often. 2: It is easier to get into something than to get out of it. 3: If you are not criticized, you may not be doing much 4: Look for what is missing. Many know how to improve what's there; few can see what isn't there. 5: Presentation rule: When something appears on a slide presentation, assume the world knows about it and deal with it accordingly. 6. Work for a boss to whom you can tell it like it is. Remember, you can't pick your family, but you can pick your boss. 7: Constantly review developments to make sure that the actual benefits are what they were supposed to be. Avoid Newton's Law. 8: However menial and trivial your early assignments may appear, give them your best effort. 9: Persistence or tenacity is the disposition to persevere in spite of difficulties, discouragement or indifference. Don't be known as a good starter but a poor finisher! 10: In doing your project, don't wait for others; go after them and make sure it gets done. 11: Confirm the instructions you give others, and their commitments, in writing. Don't assume it will get done. 12: Don't be timid: Speak up, express yourself and promote your ideas. 13: Practice shows that those who speak the most knowingly and confidently often end up with the assignment to get the job done. 14: Strive for brevity and clarity in oral and written reports. 15: Be extremely careful in the accuracy of your statements. 16: Don't overlook the fact that you are working for a boss. Keep him or her informed. Whatever the boss wants, within the bounds of integrity, takes top priority. 17: Promises, schedules and estimates are important instruments in a well-run business. You must make promises — don't lean on the often-used phrase: "I can't estimate it because it depends on many uncertain factors." 18: Never direct a complaint to the top; a serious offense is to "cc" a person's boss on a copy of a complaint before the person has a chance to respond to the complaint. 19: When interacting with people outside the company, remember that you are always representing the company. Be especially careful of your commitments. 20: Cultivate the habit of boiling matters down to the simplest terms: the proverbial "elevator speech" is the best way. 21: Don't get excited in engineering emergencies: Keep your feet on the ground. 22: Cultivate the habit of making quick, clean-cut decisions. 23: When making decisions, the "pros" are much easier to deal with than the "cons." Your boss wants to see both. 24: Don't ever lose your sense of humor. 25: Have fun at what you do. It will be reflected in you work. No one likes a grump except another grump! 26: Treat the name of you company as if it were your own. 27: Beg for the bad news. 28: You remember 1/3 of what you read, 1/2 of what people tell you, but 100% of what you feel. 29: You can't polish a sneaker. 30: When facing issues or problems that are becoming drawn-out, "short them to the ground." 31: When faced with decisions, try to look at them as if you were one level up in the organization. Your perspective will change quickly. 32: A person who is nice to you but rude to the waiter, or to others, is not a nice person. (This rule never fails). 33: Never be afraid to try something new. Remember, an amateur built an ark that survived a flood while a large group of professionals built the Titanic! Postscript: The qualities of leadership boil down to confidence, dedication, integrity and love.

My grand project for my third year will be to finish Brenner and Rector's, _The Kidney_.

This might be the most monumental project that I've ever done. Basically encapsulated within those 3072 pages is the state of human knowledge on the kidney. I figure 1 year is a doable goal if I read at least 10 pages/day.

Things to do to accomplish this goal:

1. Publicize it on my blog. Done!

2. Find the book
Ok, here's the hard part. The book costs $420 and there is no copy in the library. My goal is to find a renal fellow who would let me borrow the book for the year. Another thought is to try to convince the drug reps to buy the book for me.

3. Wake up early in the am to read.

4. Start by doing another doable goal. For example, for this past month I've been very diligent in reading the bible. I have a reminder system by email to remind me to read the bible every day. Prior to finishing this book, I plan on finishing immunobiology within a month. I've already read a third of the book.

5. Since the book is in electronic format, I will try to read random chapters when I'm bored.

J

Due to overwhelming popular demand, I'm going to post on a more regular basis :)

After my licensing exam, I will be going back to California for a little R and R. Unfortunately, my wife is busy working at Goldman Sachs doing American taxes on European investments.

To do list for Step 3

1. Finish 5 practice exams (done with 4.5)
2. Review Ob Gyn again.
3. Reread pediatrics
4. Look at urology and orthopedic surgery
5. Do all the computer exams

To do list in California
1. Do nothing!
2. Look at Rick Steeve's videos on France, Italy and Greece
3. Learn how to cook 5 new dishes

J

Time for another random musing.

I've been on the internet for way too long. It's good that I'm no longer using it at home (I'm quitting cold turkey). However here is a list of recent random stuff I was searching:

1. The first description nephrology. (Aretaeus of Cappadocia - he also came up with the term diabetes).
2. Housing styles in the United States from Octagonal, Italianate, etc.
3. NCAA tournament
4. Increasing productivity
5. Origami project
6. Oregon Nike project
7. Infinite pools
8. Travelling to Turkey
9. Meteora and other cool monasteries
10. Corfu and Santorini
11. Scrabble tournament
12. Design of the colliseum

Oh well, just looking at the list I will need to figure out to concentrate on the essentials.

Later,

J

Dinner

A and I invited Pascal and Kerri over for dinner tonight. Both Kerri and Pascal has quite a bit of experience in evaluating steaks. Kerri is from Iowa where her uncles owned a meat-locker facility, while Pascal used to be a manager for a restaurant. It was the first time for all of us trying the Omaha steaks. I thought it was pretty good, but I'm no steak connisseur. It was definitely a higher grade of steak than the supermarket and it is on par with some of the steaks I've had for weddings. But the best part for me was the cheesecake with raspberry (we bought it) with the special sauce.


J

Reply from cartalk

Thanks for submitting a puzzler suggestion.

If your puzzler is the one about the helium balloon and the car, or any of the
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As you know, Ray is in dire need of puzzlers that are somewhat less lousy than
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Click and Clack the Tappet Brothers

Hey Car Talk guys,

I have a puzzler for you guys based on a real life experience at the gas station. I bought 12.901 gallons of gas for 2.249 for a grand total of $29.01.

Here's the puzzle:
How many gallons of gasoline (DA.BCD) do you have to buy at $2.249 to come up with a total of (AB.CD).

Hope you talk about this puzzle on the air, especially since it has to do with cars rather than apples:)

JH

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China Trip Christmas 2000. (I found this thru my email to Rob)

I had a great time in China, here is a summary of what I did there.
The flight from LA to Beijing took approximately 12 or 13 hours. On the plane, I
saw the worst movie I've ever seen in my life. The movie, starring James Caan
and Randy Quaid?, were about two quarelling neighbors. The next movie was a
rather strange French movie, but it wasn't nearly as bad as the first one. I
fell asleep for the third movie.
The airport in Beijing was really nice. I was actually expecting an old airport,
but this one was fairly new and modern. The tour guide took care of our luggage
and check-in, so he took us directly to the restaurant. For this tour, all the
meals were paid for and there were 8 to 10 dishes/meal. Since I havn't had a
decent Chinese meal in over 5 months, I was really glad to be part of this
trip.
The first stop in our tour was the forbidden city. The forbidden city used to be
the living quarters for the emperors in the Ming and Qing dynasty. The last
person to live there was the last emperor, Pu Yi, who was there until the
1920's. After the communists took over he was assigned to be a gardener at the
forbidden city. What irony! The archictecture was really impressive, my only
regret was that we didn't get to see the palace treasures. The next stop in our
tour was the summer palace. There was a huge man-made lake which helped to cool
the temperature down in the summer. It was almost completely frozen in the
winter with a few cracks here and there. There were some really foolish people
who ventured out towards the lake. It was a pretty comical sight when we saw a
bunch of guards going in the middle of the lake to catch them. The next day, we
went to the most famous cultural landmark, the Great Wall. It is truly an
awesome sight to see first hand. I have no idea why they needed to build a great
wall, since there were mountains in the background. A few of us in the tour
decided to climb up one stretch (about a mile) of the great wall. It was kinda
scary to look down, but I tried to concentrate on the steps. When I went down, I
decided to count the steps so that I didn't have to look down. In all, there
were 1732 steps on the way down.
The next city that we visited was the ancient capital of China, Xian. Xian is
the place for the famous terra cotta figures. Xian also has the world's largest
and oldest remaining city wall. They are not done excavating the site --
according to the guide it will take another 100 years to finish the dig. Part of
the problem is that the technology is not quite advanced yet. In total, 40 years
and 750,000 workers took part in the construction of the mausoleum for the
emperor.
Gosh, this email is getting rather lengthy. After Xian, we went to Shanghai. In
a really short amount of time, Shanghai has transformed itself into a really
modern city. I think that Shanghai may have the edge in the number of
skyscrapers in comparison to Manhattan. The freeways had a lot more loops and
levels than the ones in LA.
We also went to a number of smaller cities (relative to Shanghai and Beijing).
It was really amazing for me to see all the development even in the smaller
cities. Still, there is still a large part of China that I havn't seen. Maybe in
a few years I could go back.
That's about all. Have a happy new year!

You are a Social Conservative (31% permissive) and an... Economic Conservative (76% permissive) You are best described as a: Republican Link: The Politics Test on OkCupid Free Online Dating

This is advice from someone who does research.

1. What is the question for today?
2. What could be the answers for the questions?
3. What experiment can discriminate among them?
4. What techniques are used in this experiment?
5. What materials: chemicals, solutions are needed?
6. What are the protocols?
7. What results do I expect?
8. Analyze and discuss the results.
9. Is the question answered? What is the next step

Renal Fellowships

After much thought, I've decided to apply for renal fellowships this year. The main reason is that I've decided to go into academic medicine and it would be nice to get plugged into a research project as soon as possible. Here are the places I'm thinking about applying

University of Washington

Seattle is a beautiful place and I've got good friends in Walla Walla. However their renal program is in disarray after their program director got fined by Medicare for billing compliance

UCSF

Fantastic place if I would like to do clinical research. The main PI that I'm looking into is Glenn Chertow. My sis is also next door at Berkeley

UCLA

Location, location, location. Unfortunately, housing prices are up the wazoo here in Los Angeles. I've also got a bunch of family and friends there.

UCSD

Fantastic weather and another place that has a strong clinical research program in acute renal failure. Ravi Mehta does a lot of work with the PICARD (Program to improve care in acute renal disease) group.

UT Southwestern

Of course the sentimental choice since I'm there right now. If it weren't for the compassionate hemodialysis (ie dialyze me before I die) and the VA it would be a very compelling choice. I'm very excited with what Chris Lu is doing with TLR-4 receptors. My wife also has a lot of roots in Dallas.

University of Colorado

This choice is more of a gamble. Big risks, yet huge rewards. They are creating a medical industrial research complex a few miles in the southern Denver suburbs. The downside is the head of the medicine program James Schrier got fired for opposing the move. I just need to know more about how good they are in promoting their fellows to junior faculty.

University of Michigan

I believe this program and Johns Hopkins has the best balance between basic and clinical research. On the other hand, I hate Detroit sports teams with a passion!

Harvard/Brigham and Women's

This is the primier place in the country for basic research. The Man for acute renal failure (Joe Bonventre) is there. I heard rumors though that you need to apply for grants even before entering the program.

Yale

Yale has been making strides up my rank list. The main downside is its location. However in terms of research, it is the only program to have faculty that I'm super interested in both clinical and basic science research. Lloyd Cantley who is does some nice work on acute renal failure. Recently, he has a well-cited publication about mesenchymal stem cells in ARF. On the clinical research side, there is a junior faculty Chirag Patel who does translational work in developing markers in acute renal failure (my topic in resident's talk)

Johns Hopkins

I'll be interested in working with Hamid Rabb in ARF. He's a peripatetic wanderer, so I'm not sure how long he'll be in the program.

I'm trying to fix my garden (ok bad puns, but I love them)

At first I was horrified that I might have lost all 200 of my previous posts. But luckily I'm able to see it from the edit view. It was fun reminiscing through my journal, and I realize that by not writing in my journal I'm forgetting all the cool stuff I've done or thought. The hard part is putting it back into public circulation.

I may need my sis' help in restoring blogger (If you are reading this in Beijing, let me know if you can fix it by the time you get back to berkeley).

Procrastination

Alas, procrastination has been chief of my 7 deadly sins. Ok, I've sinned a lot more than that but don't tell anyone. I've decided to blog more frequently now that I have the time during my consult months. However, I will need to go back to serious mode in September when I'll lead my Parkland ward team. I just need to brush up on my writing skills as I will apply to nephrology fellowships this year.

Here's a list of what I need to do. In no particular order

1. Clean the house
2. Pay the bills
3. Get my car license renewed
4. Finish book by Burton
5. Finish Nephrology MKSAP
6. Copy Pulmonary MKSAP
7. Buy flowers for wife
8. Plan Austin trip
9. Buy board review books
11. Apply for renal fellowship (Finish ERAS)

Penguin Sex

My, oh my. After such a long time away from blogging why on earth did "J to the Izzay" (my gizoogle nickname) decide to blog on this. Sometimes in life crazy coincidences occur that make you realize that God has a sense of humour.

About a week ago, I had some free time from my nephrology rotation so I decided to go to borders and just chill ... Anyway, on the bookshelf I decided to pick up a book. The inveterate reader that I am started to read the book Blue Like Jazz by Donald Miller. This book is primarily about nonspiritual thoughts on Christian spirituality. In the intro of the book, he wrote about how he first fell in love with jazz when he first heard a sidewalk musician play the saxophone. As he played, there seemed like there was no structure, resolution, but he had the pathos to be immersed in the music for what seemed to be an eternity. For him, that was akin to his Christian experience when he couldn't quite predict what riffs God would play in his life. I just chuckled when this strait-laced Christian dude from Texas tried to reach out the pagans at Reed college. Yet in a way they expanded his conception of God beyond petty Republican or Democratic politics.

What does this have to do with penguins? He probably is the first Christian writer to write a chapter to penguin sex. Oh well ... I'm probably the second. To be honest, I don't quite remember what he had to write about sex however the mating habits of penguins are a wonderful analogy of love. Every year emperor penguins walk days and nights to the breeding ground in the harshest winter environment on earth to find love. They march one stubbly webbed foot after another through miles and miles of barren ice to their primordial mating ground. There the females fight over the choicest male to mate. With tender strokes they caress each other, the quiet of the antarctic ice broken by orgastic bleats. After the female delivers the egg, she shuffles the precious egg to the male partner. Soon afterwards, she leaves the male to incubate the egg until she returns to the ocean to feed. After months of waiting by papa penguin, she returns as the eggs hatch to give back regurgitant fish and krill to her baby penguins. Then it is the dad's turn to go back to the ocean to scavenge for food. This cycle repeats until the penguins grow big enough to fend for themselves.

So after my wife finished the bar we decided to go see a random movie. The title was March of the Penguins, but of course it was more about penguin reproduction ;)

Jizzo

You are Romans.

Which book of the Bible are you?