Now that we're back I wanted to give one final update on the trip and disaster response itself. While I think everybody would agree that we made a difference, there are areas for improvement.

It was interesting seeing the FEMA contractors working alongside nonprofits and church-based organizations. While their street closures made it tough to get to certain areas, in general I thought the contractors were relatively accomadating of the volunteer groups. Their impressive crane trucks were constantly driving by to collect the piles of debris we made.

The organizations I saw the most of were Red Cross and Samaritan's Purse. Red Cross was doing great work providing homeowners and volunteers alike with meals, snacks, and drinks during the day (although I believe that service ended this week). Samaritan's Purse was very well organized, and while they follow a very strict code of rules (including ending around 5 PM and not working on Sundays) they are great at getting people together from all over and putting them to work. They also are well-supplied with equipment and tools. Additionally a number of church groups were providing meals and showers for anybody who needed them (including some excellent burgers).

Andrew mentioned this a bit while on the trip, and I agree: FEMA should be responsible for managing a master list of homes needing help. Because even well-intentioned volunteers walking onto private property to clean up debris isn't very wise, we had to either go through Samaritan's Purse, who had lists of places they had already cleared to work, or ask the FEMA workers or homeowners directly as we drove through a neighborhood.

I think it would be helpful if a centralized database was maintained that homeowners could add their houses to, perhaps with a code for what kind of work they wanted done. That way anybody who wanted to help could directly find out where they were needed, as could organizations. In the meantime, homeowners could approximate this by putting up a "volunteers welcome" sign in their yard.

As for our part of the trip, driving there took two days each way. I think it might have been better to have everybody in the group cleared to drive the church vehicles. By trading out drivers we could have gone straight from California to Joplin in one stretch, saving money on the hotel and having more time to work once we were there.

The spirit of cooperation within our own group was strong as well. We came from different backgrounds and now that we're back we returned to them, but while we were there we were all Re:Live. To me that is how a church should be.

Starting things in the lab has been time-consuming as we realize all things we’re missing and still need to order. Some of the techniques I’m familiar with from my previous work at UMB, but I’m completely starting from scratch with cell culture. In the spaces between I have been doing a load of reading about the research questions I’m going to be attempting to answer.

Without any data to show yet, presenting this in some form is the most I can offer at the joint meetings we have with our neighboring lab. They’ve got a completely different research focus, so the challenge in a presentation like this is taking people from knowing next to nothing about what you’re talking about to a point where the more detailed experiments you’re attempting make sense.

I’ve found this especially challenging, as a lot of things that seem obvious to me after months of reading and studying these things make absolutely no sense to people listening. This was especially clear when I tried to explain everything to Rachel in preparation. Let’s just say she showed some incredible patience.

Ultimately, the logic is going to have be tight, with every fact I state backed up by evidence. As frustrating and demoralizing as it can be, identifying the myriad holes and gaps early is going to help me later on when I start writing my thesis.

I had some other childhood allergies to things like milk that I soon grew out of, but peanuts (and the others to a lesser degree) have remained unrelenting in their ability to bring me to my (itching) knees. Growing up before peanut and other food allergies were common enough for manufacturers to start highlighting potentially offending ingredients, reading the word “peanut” is somewhat discomfiting after so many years spent meticulously searching every ingredient on a package for the lexemes synonymous with affliction. Thanks to the allergy I missed out on some of the staples of childhood – no PB and J or peanut butter and celery unless we got almond or cashew butter to stand in. Reese’s Peanut Butter Cups? Getting peanut butter in my chocolate was a capital offense, a policy that worked well until I met Rachel and grudgingly admitted that her favorite candy might be tasty to everyone else.

People regularly get confused when I explain my “naughty list” to them, immediately trying to divine a relationship between them. A lot of them inevitably hear “peanuts” and settle on “nuts,” fretting over the contents of food containing walnuts, hazelnuts, pecans, and the like, all of which are perfectly acceptable. Unlike pea”nuts,” those are all real nuts, not imposter pods pretending to be nuts. Legumes is another popular inference, and while the category does seem to contain all of the things I am allergic to, I grew up eating and drinking all and sundry soy products and eating carob in place of chocolate. Interestingly, I’m also not allergic to peanut oil, at least the kind used to make French Fries at places like Five Guys, nor does the smell of peanuts affect me (aside from setting off raucous mental alarms). Deftly avoiding these pitfalls, my roommate Alex once concluded that I must be allergic to things containing “pea,” helpfully alerting me to the potential reaction danger contained within peasants and speakers.

Despite having lived with this all my life, I’m always convincing myself that I’ll be okay, that if I do happen to ingest food derived from or contaminated by the vile pellets, I can just take some Benadryl and the problem will immediately vanish. I conveniently forget the stomachache and general malaise that I’ll get, at best, provided I only got a little bit and take a strong hit of antihistamine within minutes. This may be one reason I seem to have had more allergy episodes than usual since moving here.

Another possibility is that I now have a Thai friend and classmate, J, who has introduced me to the piquant wonders of Thai food. However, some dishes are made with peanuts or peanut derivatives, meaning I have to ask for things without. Part of me always feels awful about having to ask people to cook things differently on my account – it brings back childhood memories of inquiring as to the peanut content of every cookie or piece of candy I was offered. On several occasions after eating homemade Thai food supposedly sans allergie I’ve been ambushed by some mystery contaminent or allergen, my rapidly swelling tongue a harbinger of the lousy night to come. It’s perfectly humiliating to have to say “Yeah, the food your mother made specifically without things I’m allergic to is trying to kill me anyway, can you leave the house while I attempt to control my hysterical immune system?”

This past week they were handing out homemade cookies after chapel , and whether it was because I was hungry for lunch or led astray by the chocolate chips, I didn’t thoroughly inspect the would-be treat. My friend Heather bravely attempted to save me, looking over and asking, “Are you sure there aren’t peanuts in that?” “Yeah, definitely,” I replied as I took a bite, apparently oblivious to the massive whole peanut embedded in the opposite side – a gloating matriarch of a cookie-spanning brood of others.

As I swallowed my first mouthful of cookie, I began noticing the telltale signs of impending disaster. Thankfully, Rachel was home that morning. The phone call went something like, “Hi, can you come pick me up and bring Benadryl?” For some foolish reason I didn’t have any in my backpack. Although I do carry an EpiPen in there in case something especially serious happens, deploying it feels like overkill when over the counter Benadryl will suffice – and as a result, I have yet to use one. Rachel swooped in with the car bearing saving pink pills, I still clutching the cookie-containing baggie. She, of course, noticed the peanuts right away. “You are an idiot,” she said lovingly, pointing an accusing finger at the goober-infested little biscuits. I kept silent, knowing she was correct.

In addition to bringing in snow, they had brought horse-drawn carriages to give us rides around the campus. Rachel and I and our friends made a beeline for them as soon as they pulled up, beating the line to be the first people to ride. The carriages were also covered in lights and the horses had bows braided into their manes – all very festive. There was a turkey dinner that was tasty (despite being vegetarian), and for dessert they had caramel apples. Everybody got little stockings with candy and a five-bladed razor (we stocked up on those). The grad students even got a group picture with Santa.

I think that the older you get, the faster Christmas sneaks up on you. I remember getting an Advent calendar every year and feeling like there was an eternity before I would be able to open the next day’s window. Now, Thanksgiving and Christmas feel more like a one-two punch that leave me in a daze. Upon awakening I realize that it’s a new year and I’ve just written the date incorrectly again.

It was great to have the chance to get excited about Christmas, to do some of the fun little things that always made it so special when I was younger, despite being far from home. It’s too easy as an adult to just think about the meaning of Christmas and worry about buying people presents. Snow and horse carriages went a long way toward giving us back a little bit of the magic.

The MD and PhD degrees differ in more than just the requirements – they represent two perspectives on problem-solving. The way I see it right now, medicine ultimately teaches students how to correctly apply what we have learned to new situations, and how to recognize something you have seen before when it is placed in a new context. Graduate school, however, teaches students how to find the gaps in what we know, and design questions that will yield new information.

I think the two schools of thought are complementary, and that having experience with both will improve my skills as a clinician and as a researcher. Additionally, in the field I’m currently looking at, neurology/neuroscience, I will be able to help bridge the gap between what we’re continually learning in the lab (neuroscience) and the application of that knowledge to patient care (neurology). Not only through translational research (a popular buzzword) I do myself, but also by being cognizant of and having experience with developments on both angles.

I think that’s what gets to me the most: The necessity of pushing past the ever-present fear that spittle will somehow enter my bloodstream while dispatching zombies face-to-face, and having to coldly kill somebody who might have been warm in your arms mere hours before. Not surprisingly, my overactive imagination causes this concern to manifest in some interesting ways.

One of our animal rooms has a locked antechamber, and I often imagine that when I open the second door I will be greeted by an inhuman moan as one of the animal care staff, turned, clumsily rises from the floor. This is especially salient when the room is on a reverse (dark during the day) light cycle; I half-expect to turn on the red lamp just in time to see a hungry face approaching. Hey, these things have been known to start in animal facilities.

There’s also the shower, where I worry that the attack will come immediately after I close my eyes to wash my face. I will hear the sound and be confronted with my vulnerability; naked, weaponless, and with a zombie guarding the only exit. Around the house, Rachel has been known to taunt me by sneaking up and lunging for my neck, growling; I do not find this amusing.

These kinds of psychological aspects are explored by Max Brooks (a bona fide Anne Rice of zombie lore)  in World War Z. It’s a book that sounds like it’s going to be action theater a la Resident Evil, but in actuality invites you to share the in the physical and mental horrors individual people experience in such a scenario. While it has a bit more of the YA romance threaded in, The Forest of Hands and Teeth has a similar bent. With the addition of fast zombies that arise when the neighborhood is low on undead, Carrie Ryan details a world far more fragmented. It’s an excellent example of what could happen without the rapid implementation of ruthless-but-necessary defense strategies.

Setting aside some of the more exotic über-mutants to focus on average specimens, I think Half-Life’s headcrab zombies are the worst of the bunch. Although the host retains some level of consciousness while headcrab’d, once the binding is secure it becomes unable to survive without the parasite. Unlike regular viral zombies, where the infected are already brain-dead, you are faced with a human remnant trapped in a grotesque shell. Though it cries in agony for help, death is its only escape.

This week I’ve been reading The Dead-Tossed Waves, the sequel to Forest. Due to heightened sense of alert such stories engender, I am showering with one eye open, the soapy sting in my eyes a small price to pay for an extra moment to react. It’s okay, people laughed at Louis, too. There is a guide to being prepared, the tenants of which should be committed to memory. You can find it at your local library where I did: the non-fiction section.

It’s time to stop vacillating and make a decision. Despite the plethora of concerned and well-meaning folks that have been asking me about it since I started applying almost a year ago, I’ve been rather taciturn about my thought process to all but a few. Applying to medical school is a frustrating, demoralizing process but I think I’ve finally calmed the maelstrom enough that I can elucidate my decision here with minimal LiveJournal-arity. I won’t be offended if you skip to the end.

Complicating the matter further is my crazy idea of trying to do an MD/PhD instead of “merely” an MD. Because I didn’t simply apply MD/PhD in the first place (a topic for another day), I’ll have to apply once I start med school in the hopes that I’ll be accepted before it’s too late.

University of Maryland School of Medicine

As much as I wanted to go to Maryland, the waitlist is far too uncertain to justify waiting around, hoping they deign to notice me. I’m in the “upper half” of the 192 waitlisted candidates, but with their class already overenrolled, there’s a great distinction between number two (possibly will get in) and number 96 (no chance at all). I’m moving forward as though they rejected me (sorry Maryland friends), and if they decide to offer an acceptance in the next month or so I’ll deal with them at that time.

New York Medical College

NYMC offered me a partial scholarship renewable for each of the four years of med school, and their children’s hospital is impressive. Their MD/PhD program has weaker benefits compared to the other schools and the cost of living in Valhalla is outrageous.

Penn State Hershey College of Medicine

Penn State boasted my favorite campus environment with incredibly friendly faculty, staff, and students. This made the rude and unhelpful financial aid lady more conspicuous than a putrid diaper. The curriculum included a focus on the humanities and surrounding community that I appreciated, and one of their lecture halls even had a piano. Their MD/PhD program seemed excellent, and they would have been on top if it weren’t for…

Loma Linda University

LLU offered me a partial scholarship for the first year, but their tuition is one of the highest. Like Penn State, they have an excellent campus environment and teaching philosophy. The immediate surrounding area is nice but is suffering from the housing slump; unlike any of the other areas Rachel and I might actually be able to afford a house next year. Their MD/PhD program is different than most in that it begins with graduate school, not med school. Incredibly, the application deadline had not yet passed.

The Decision

In addition to being an excellent school I won’t mind spending the next four to eight years of my life attending, there is a chance that at LLU, I will be able to get into the MD/PhD program this fall. Even though that chance is slim at best, it’s better than zero chance everywhere else.

With heavy heart and moist eyes I withdrew my applications from Penn State and NYMC last week. Of course, the relief at having made a decision is tempered somewhat by the fact that I’ll have to defend it for the next several months. Hopefully this post will help somewhat.

It’s still sinking in that I’m moving to California this summer. It’s the germination of an adventure and simultaneously downright terrifying. What with the prominence of the Baltimore skyline in my website design and all.

I suppose there is never a “good” time to leave behind everything you’ve known. There are a lot of people I am going to miss, not the least of which are my family members, but that’s what the internet is for.

I imagined that there would be some kind of a table set up, with the people I knew from the leasing office handing things out. Whether some kind of bright sign or banner, balloons, or friendly faces, it was clearly going to be recognizable.

That morning, I stumbled out of the house in my typical morning daze. Not seeing anything matching my concept of the event, I promptly forgot about it. As I prepared to turn onto my street, a dour fellow guarding a lime green laundry basket approached my car with a nondescript item in hand.

“What are blasted pamphleteers doing in my parking lot?” I fumed to myself, pointedly ignoring him. “You’d think they’d have better things to do this early in the morning.” Only when I was halfway down the street did the realization occur: that guy had been handing out the free breakfast and I completely missed it. Shortcomings in the event itself aside, I had such a clear pattern going in that I was unable to adapt my construct to match the real situation, and lost out as a consequence.

Speaking of questionable male figures, when I worked at the stables I knew people who looked just like this guy, only instead of shopping at farmer’s markets they slept with underage girls in the back of horse trailers… His look is probably the visual definition of hick, but the joke’s on you because he’s the one Summer Glau sleeps with at night.

Think on that, fanboy.

In response to somebody making a similar complaint to mine, this commenter replied:

“I’ve heard that complaint so many times, and naively, in a vacuum, it makes sense, but we live in a world with so many acronyms and so little clarity of communication, just think of trying to ALWAYS repeat the last letter’s word as a kind of checksum on the data compressed in the acronym, and/or so the sentence reads OK even if someone is unfamiliar with acronym…”

That’s brilliant, and entirely true. With so many acronyms floating around that “last word checksum” can be instrumental in allowing the reader or listener to parse the compressed data. For acronyms with multiple meanings, like NIC, that repetition can inform whether you are referring to a network interface controller or card.

Some other good reasons for RAS syndrome include acronyms of other-language words (please RSVP) and transforming the acronym into a noun, making it redundant in the same way “pine tree” is redundant. Regardless, thinking this way makes me feel a tiny bit better when the self-checkout at Giant asks me to enter my “PIN number.”

I’ve been trying to employ strategies like Getting Things Done with a decent measure of success, but every so often I have days like today where I realize it’s already twenty past eight, and I have barely gotten to the grand personal enrichment tasks I imagined this morning I’d get to today.

There’s the things that are outside of my control, like the extra behavioral tests I had to run in the lab this afternoon, and the horrendous traffic I encountered as a result of leaving later that tripled my commute. But I’m realizing that there’s a controllable part of the problem as well. I think that a lot of the personal projects I keep trying to push myself to tackle are a little bit too open-ended. I haven’t broken them down into small enough steps that I can look at and say, “Oh, I’ll get this part done today.”

Instead, there’s a gulf between “start” and “finish” that remorselessly consumes hours and excretes inertia, such that I can work on something a whole afternoon and not feel like I’ve gotten anywhere – or lose the motivation to start again, and waste the time mindlessly scrolling through Google Reader. Of course, this goes back to GTD and intelligently defining steps. I suppose I’ve just been failing at appropriately applying this to my side projects lately.

Oh, and before you say “Why didn’t you work on some of those things instead of blogging about it?” writing a post was one of my goals for today, so nyah.