Better than I could have imagined in my wildest dreams...

Back home in Washington, there is some exciting news. The University of Washington has some medical students, as part of the WAMMI program, that do part of their training in Pullman. I guess it was just announced that they are expanding the total class size at UW's medical school and moving the Pullman campus to Spokane. It also sounds like students at the Spokane campus maybe able to do all four years of their training in Spokane. Also, the long awaited Doctor of Osteopathic Medicine school opened in Yakima, WA and welcomed their second class this August. There are definitely are more medical school seats in Washington than when I left for Dominica. This got me thinking about how my life would have been different if I would have gone to medical school closer to home. Obviously, it would be awesome to be closer to home, friends and family. I wasn't able to come home to say goodbye to grandma or attend her funeral and at least two weddings--and I'm only in my third year of medical school. However, there are a lot of great things I've been able to experience because of attending a Caribbean medical school. I have a lot of amazing stories to tell my children and grandchildren. Sometimes things in life don't work out as we imagine, but they turn out better than we could ever imagine. Here are some of the interesting, exciting and humerous things that have happened to me.

• Meeting Farley. I don't know how I would have met him without going to a Caribbean Medical school and I can't imagine going to medical school without him. Besides being my partner, he is my travel buddy. Here is a picture from the day we first landed in at the Dominican Airport. Note how close the plane is to the Atlantic Ocean. Not much room for error. They have since remodeled the airport; however, they still have limited flights (like no flying at night and they can only have small plans land).

• Speaking of traveling, I've done a ton of it in the last three years. Obviously, I've been to Texas twice to visit Farley's family and we hopped over the border to Mexico once. Of the Caribbean countries, I've been to Puerto Rico, Dominica, St. Lucia and Barbados. I have had lay overs in Martinique, Antigua, and technically Barbados on an overnight layover. We had to stay somewhere, so we stayed at the closest and most reasonably priced hotel we could find--it wasn't our fault it was a wind surfer's paradise and we were right on the Atlantic Ocean! Seriously, who gets to have overnight layovers in Barbados and stay at a beach resort? I may in fact be the most brilliant person ever--I'm still going to be a physician when I'm finished and I've spent my first two years of medical school living 50 feet from the Caribbean sea and having layovers in the tropics. Not too shabby, except for the insects, brown water and other hazards of living in a third world country, but third world living just builds character! After our first year of medical school, it was so expensive to come home that it was actually cheaper to go to Argentina for a week than to go home. Looking back, I can't believe that Farley and I did this, but opportunities to travel don't always arise and one has to take every opportunity she gets. When we traveled to Argentina, we had a lay over in Panama. I couldn't believe the Panamanian airport--there were NO Panama hats to be found. In fact, there was one restaurant and two hot dog stands in very large Panamanian airport terminal. On a bright note, this terminal was basically a mall of European designer stores and chocolate stores! I ate a lot of chocolate with my hot dog in the airport. But unlike in the USA, the airline gave us two meals, two snacks, and free wine (but since I don't speak Spanish and Farley was asleep, I didn't know the wine was free) on the six hour flight from Panama to Argentina. Guess, I didn't need a hot dog and chocolate after all. Below is a picture from April 2008 of Farley and me waiting for the ferry to go to St. Lucia. The ferry ride could have been lovely if I hadn't have been so seasick!

• Strange Critters on the island. Before classes started we went to the Cabrits (the national park that we could see from our apartments) to hike. It was a lovely day, but everywhere we went, there was a ruffling of the leaves and ground covering. I thought it was just the geckos at first: I was wrong. We were surrounded by galliwasps. Click on the link to see a picture of them on Farley's blog. They look like geckos, but they have really small legs and they move more like a snake. Another exciting creature was this insect found near the study space right before the first exam of medical school. Just trying to go to the bathroom was an adventure, you never knew what you'd see on the way:

• Getting caught between a crab and a four cows. Yeah, that really happened. We were having a date night first semester after an exam (it may have been our first exam that semester) and then we were trapped between a feisty crab and four cows. See here is the blurry picture of the scary crab to prove it! I didn't dare take a picture of the cows since they were lining up in an aggressive, military-like formation.

• Lizards. Giant Lizards that fall from the sky...or my third story apartment. Or that just decide to hang out in my apartment looking out the window. How about the one that decided to drop his tail as Farley was escorting him out and a gust of wind made the tail fly through the air toward me before it started flopping on the floor. If that wasn't enough, how about the lizard that died hanging upside down from my balcony ceiling. To top it off, that was just in Dominica. One of them, which I named Leo the Lizard, moved into my apartment the last time I lived in Miami. Lizards can't get enough of me.

• Animal herds: In Dominica they let the animals run free. I talked a lot about the cows, since they were everywhere. Heck, one even chased me as I was trying to go study. Now, that doesn't happen every day! But it wasn't just the cows running free in Dominica. There was a pack of dogs that went all over. I a little afraid of dogs since I was chased by two baby pit bulls when I was a toddler and I was bit by a dog in my pre-school years; however, these Dominica dogs were so harmless they didn't even scare me. They were, nonetheless, annoying. They'd brush up next to you as you carried your lunch and they'd try to get you to pet them (there are a lot of insects, bacteria and parasites on that island and I'm sure there were some creepy crawlers on those dogs--I sure as heck didn't pet them!). There was a cat that lived near my apartment and would try get people to feed her (I usually set something outside my door). I was most surprised by the goats running free in Dominica. Who would have thought that there would be goats in the Caribbean.
  

• Natural Disaster. Now so far, we have been extremely lucky and there have not been any horrible disasters anywhere I've been. However, there was one tropical depression in Dominica while we were studying there. The sea come up high and flooded the lawn near our apartment. The only good thing was that I got to take a nap (it happened near a test and I was extremely tired, so it gave me a few hours to rest). I can joke about the tropical depression because no one was hurt and the only damage reported was the dock near our apartment. Overall, if the only thing damaged was a dock, we were all lucky.

• Who could forget the time that I fell down the hill in Dominica and was covered in mud. I think I should have learned that going to my apartment if I forgot something while studying on campus, was almost always a bad idea. I would end up being chased by cows, attacked by insects or slipping on mud. That is how I earned the nickname "mudslide".


• Living in a Third World Country. It is amazing how much we take for granted in America. Living in Dominica reminded me that in many places of the world, water isn't safe to drink out of the tap, there are insects, parasites and bacteria with your meals, and the power will come and go. All of these things were very difficult for me to adjust to; however, I think not being able to get a hot shower with clear water had to be the most difficult. If it rained a lot in Dominica, the water would turn a brownish color (like really watered down coffee). The filtration system couldn't keep up with the demand when there was a lot a rain, which happened frequently as Dominica is a rain forest. First semester, the water heater worked but something changed along the way. I soon learned that if I wanted a hot shower, I needed to hop in between 4-7 pm because otherwise, it was extremely cold. I'm not even sure how the water got so cold as Dominica is almost always between 84-92 degrees. Don't even get me started on the insects in Dominica, I still have scars from the mosquito bites! However, Dominica has it's redeeming qualities too--some of the best sunsets in the world.

• Bats. I don't know if I've every blogged about the bats in Dominica. Usually, Farley and I saw them when we were walking on the trail at night either coming or going to campus. It was the most strange thing in the world because out of nowhere there would be this slight gust of wind and a black thing in front of you. Then it was gone. They really make little or no noise at all. Obviously, I was frightened as they'd fly by because I'd be so shocked and I hate all creepy and icky things. But they have sonar so they never hit us. One night in early 2007, however, I did come face to face with one of these flying, ugly creature. I had my wooden panels covering my windows open. I stepped out onto my balcony to enjoy the cool night air. The light from my room bled though the wooden panels and I heard an odd noise. I looked up and there was a bat lost and unable to navigate out of my balcony. Besides the wall of windows, two walls the ceiling and the floor were cement. The other side was open except for the railing and about a one foot hangover of cement. I think all of the cement towards the ceiling, where he flying around, had his sonar all messed up. In case you have not had the honor of meeting up with a bat face to face, let me tell you bats are really ugly. Clearly, I made a mad dash for my door, shut the wooden panels on my windows and hid--as if the bat was going to penetrate though the walls and attack me. I believe that there are only fruit bats in Dominica, but you know even fruit bats can have histoplasmosis or rabies!

• Living in Miami. There are few places in the world as unique as Miami. In fact, I think it is more essential to speak Spanish in Miami than it was in Argentina! This city is a mix of money, cars, beaches, model-like people on the beach, heat, humidity, Spanish culture, retirees, colleges and universities, insects, lizards, crazy drivers, and to my shock farmlands less than an hour away. But obviously, the thing I love to complain about the most is the drivers. I think I've mentioned before that Miami lost it's title of the country's rudest drivers, which it has held for the last four years. Yes, the rudeness of Miami drivers even impresses those from L.A.

• Rainbows: Living in Dominica really makes one have to be an optimist to survive. Medical school is so tough, let alone living in another country--a third world country--and being so far away from not only family and friends but also convenience, such as grocery stores. To survive, you really have to keep a positive outlook even when things don't go your way, both with the living situation and with school. I've never lived somewhere before that there was always a rainbow at the end of a storm other than Dominica. You could practically see a rainbow every day and usually there were two or three together in the sky. I think this is a cheesy metaphor for medicine. When times get tough, and they will, you've got to look for the light at the end of the tunnel, for the rainbow at the end of the storm.
  

I guess the bottom line is that things sometimes don't end up as I predict or think I want. But I'd never dreamt that all of these amazing things would happen to me. Being willing to take a risk and run off to the Caribbean to fulfill my dream of becoming a physician, is the best risk I've taken so far. Who knows what risks and opportunities will present themselves in the future!

Women, Medicine and Health Care

I think it has been an interesting time in the news for woman lately. Starting on a positive note, yesterday it was announced that the Nobel Prize in Medicine was awarded to Elizabeth H. Blackburn, Carol W. Greider and Jack W. Szostak. Their research was on telomeres and telomerases , which are sort of like protective caps of "junk DNA" at the end of chromosomes. When the "junk DNA" is gone, most cells cannot make more and will die off. Stem cells and cancer cells are amongst the cells which can make more telomeres--thus they don't die off like other cells. That is a good thing with it comes to our stem cells and obviously a really bad thing when it comes to cancer cells. It has also provided information about aging. This research on telomeres and telomerases has taught the scientific community much more about the cell cycle and death than was probably anticipated when the Nobel Laureates started their research in the 1970. Yes, I said 1970s. This research was completed int he 1970s and 1980s and results of their research are so essential to understanding the cell cycle, that it is taught at the undergraduate level.

Getting back to my point, there have never been two women that have won the Nobel Prize in Medicine in the same year. In fact, between the years of 1901 and 2008, only 36 times have Nobel Prizes been awarded to women (to 35 different women--Marie Curie, has been honoured twice, with the 1903 Nobel Prize in Physics and the 1911 Nobel Prize in Chemistry won Nobel Prizes). There have been two winners in Physics, three winners in Chemistry, eight winners in Physiology or Medicine, eleven winners in Literature, and twelve winners in Peace. Less than half of the Nobel Prizes won by women have been in the sciences. It is so exciting to have two women win the prize for medicine this year! I've been reading some articles about the lack of women winners. Some have noted that the Nobel Prizes, especially in the sciences, are usually granted years after the research occurred and since historically women were not scientific researchers, women are for today's standards underrepresented due to a delay in time of research completion to recognition. Others have suggested that women have been overlooked. I'm not sure of the answer, but I'm extremely excited that two women have won the award in medicine this year and to top it all off, all three of the winners are Americans!

On the other end of the spectrum, I've read a few articles lately regarding health insurance and women. Did you know that in eight states being a victim of domestic abuse can be considered a pre-existing condition and you can legally and the District of Colombia be denied insurance? I guess from an insurer's prospective this makes complete sense. A women who is abused would be more likely to get back into another abusive relationship or even return to her abuser. It makes sense that an insurer wouldn't want to pay for the broken bones, bruises, ruptured organs that could ensue if they insured someone with this history. Insuring this person would probably not be a big money maker so I guess that the insurance companies don't want to pay. I, personally, cannot believe that it is legal in some places in the United States to deny insurance because they have been a victim of abuse. If the woman decides to leave, she won't be able to get insurance. I'm not sure of the laws, but I believe that the insurance companies would have access to any mental health medical records, so they would be able to see if a women went to a therapist for help.

I'm probably not the most objective voice regarding pre-existing condition and health care coverage. I've chosen to go into medicine, not because it is a business and a way to profit, but because it is a way to care for others and study science. I don't have a business mind. I guess I think about the patients as people not profits. I know that it isn't fair to blindly judge everyone working in the insurance industry, because they may also disagree with practices of the industry; however, insurance is a business. Maybe the problem is just that: insurance is a business. Health insurance isn't like car insurance. If someone is denied car insurance because he or she habitually gets into accidents, I can understand. In fact, not insuring the person may protect others on the road (presuming that the non-insured person doesn't continue driving illegally). However, if someone is denied health insurance what does that say? The person is too big of a liability. Does it mean that we as a society believe the person is not worth caring for? Now, I'm not an economist, businesswoman or a politician and I have not researched this enough (I do have a set of boards to pass), but what if we had insurance companies that were not-for-profit. What if the profits that insurance companies make, were put right back into the pot and used to care for those using the insurance that were sick. What if there were no pre-existing conditions that would deny someone coverage. I would feel better paying for insurance knowing that if I did get sick, I wouldn't have claims denied because I've maxed out the policy; since rather than making profits for a company, that income would be used to actually insure people are cared for through the entire duration of their illness.

I, like 63% of physicians, support a public plan in the health care reform. I don't know what would be best and I don't know how the best way to put a policy in place, but I know that we, as Americans, need to offer health insurance to all and make it affordable to everyone. I read an article on Newsweek about Italian health care. It didn't sound perfect, but everyone was covered by the state and then you could buy insurance to have things done faster. I don't know if a plan similar to the Italians' is the answer to health care reform, but we have to be able to care for our people here in American like they do abroad. We have to provide some security--I've never head of people anywhere but the United States going bankrupt because of a health problem. Americans are busy doing outstanding research in Medicine, so outstanding that that win Nobel Prizes, now can't we also take care of our people as well?

They give me fever....

Being away in the Caribbean means that I don't get to enjoy Gonzaga Basketball as much as I would like to. I'm teased by the alumni emails stating that "alumni seats are still available" when I obviously can't attend any games. Also, being so far away I only get to see games that are on ESPN and they often come on t.v. very late here. Finally, being out of the U.S.A. you generally cannot watch t.v. over the Internet, so I can't even watch games over the Internet.

But it's March and my Zags are still dancing, which is something to celebrate. The feed of the NCAA tournament in the Caribbean is via the east coast; therefore, we didn't see much of the Zags in the first two rounds. They would just pop on over during half-time of some east coast game to the Zags game and obviously we got to see the end of the Gonzaga/Western Kentucky game. My heart was pounding, I was screaming, and jumping with excitement, my sympathetics went into overdrive---it was like reliving the best moments of undergrad!!

I'm not sure if they will be showing the UNC/Gonzaga game in Dominica on Friday night, but I'm scheduled to be studying clinical medicine skills in lab at 10pm on Friday night--the same time as tip-off is scheduled. I'm not 100% sure my Zags will beat UNC, but I'm hoping and praying because then I can brag to all of the UNC graduates at school. Besides, we haven't been to the elite eight since 1999. Go Zags!

This one is for you, Farley!

Farley and I have been debating the wonder that was Aretha Franklin's hat during the inauguration. I wasn't a huge fan, but Farley was. He has been offering to buy a hat just like it for me. With a little computer magic, I think I've proven my case that I'd look pretty stupid in a giant grey with rhinestones. Leave me a comment and let me know what you think of my picture in the ravishing hat.


Yesterday was such an amazing day. I know that people in my age group haven't historically been engaged in the political process; thus, it was so exciting to see my peers excited and participating in the process this year. (I haven't missed an election since turning 18, even while in Dominica!) When I was home, my favorite 5-year-old even asked who I voted for and what I thought of the election. Can you believe that a 5-year-old brought up politics?! She told me that she was so excited that Barack Obama was going to be the president and that she voted for him. I'm not sure if there was a mock election in her kindergarten class or grade school or if Mr. Obama is just who she would have voted for if she could vote. She even told me why she didn't like McCain, but that she knew others who voted for him and that is is okay to vote for different people. I suspect she was just telling me what she overheard her parents discussing or from the news, but she was pretty spot on.


I'm glad that yesterday happened to be a free study day for me. I put my TV on mute and when the exciting things were on TV, I took a study break to watch history. I even heard a European woman interviewed, who was in D.C., that said she wished she was an American because nothing like this could happen anywhere else in the world. I agree. It was a shining moment for our country and I was so proud to be an American yesterday.


I sure wouldn't want to take on being the Commander In Chief at this point in history, with the countless problems we face. However, I'm very glad that someone as intelligent, well-spoken, and level-headed is willing to take on these challenges that appear to have no end. Here is one of my favorite political cartoons from Slate Magazine:

Rest In Peace, H.M.

H.M. was a young man when he underwent an experimental surgery to try and fix a seizure disorder in 1953. They fixed the seizure disorder, but he had anterograde amnesia; oversimplifying it, he couldn't remember after the surgery. He agreed to participated in neurological research and did so for 55 years. Anyone who has taken a course in neuroscience (and probably neuropsychology) knows who H.M. is. In Neuroscience last semester, we talked about H.M. in several different lectures about differing yet related topics. He was involved in so much research that I'm sure that there are entire books written on H.M. If I didn't have exams coming up, I'd explain more about him and what we have learned. Let's put it this way, H.M. is so significant that his brain is being perserved--like Albert Einstein. There are two interesting articles about H.M: the New York Times talked about his life and Slate talked about amnesia in general.

As a medical student and former clinical researcher, I express how much I appreciate everyone who has so shown such altruism as to allow themselves to participate in research, like H.M. There are not enough words to thank the selflessness of those who donate their bodies so students can learn in the cadaver lab or so someone else life can be saved with a transplant surgery. So with much gratitude, thank you H.M. and may you rest in peace. Your contributions to neuroscience and medicine are so vast, so remarkable and unforgettable.

World AIDS Day: December 1st

Amongst all of the happy celebrations that occur this time of year like Thanksgiving, St. Nicholas Day's, Christmas, Chanukah, and New Years, there is a more somber day: World AIDS Day. It is observed on December 1st each year and is a day to bring attention to the world AIDS epidemic. 2008 is the 20th anniversary of World AIDS day. Today we had a lecture on HIV and I thought it would be appropriate to give you some interesting facts we learned during our lecture. The information I've provided is directly from my lecture notes.

AIDS: Number Comparisons

• 40 million people infected worldwide; Population of Canada: 30 million
• Over 21 million people have died from AIDS so far; Population of New-York city 21 million
• Over 13 million children, mostly in Africa, have been orphaned because of AIDS; 15 million students are in primary and secondary school in the United States
• About 1/160 people is infected with AIDS worldwide; about 1/520 people has cancer worldwide
• 16,000 people are infected with HIV daily; 11,000 children are born each day in the United States.

In the United States, it is easy to forget about how horrific HIV/AIDS is since we have such amazing medications that are extending the lives of HIV patients (and giving horrific side effects). Nonetheless, AIDS is still a huge problem worldwide, check out these numbers from UNAIDS and the World Health Organization:

Citation for the Red AIDS ribbon image on this blog post.

Come Tuesday, it's time for exams, elections and events!

We have our second exam on Tuesday. Yupee. I just wish we could stop having classes so that I could go study. I think that this is one of the worst test information sets we have had for several reasons. (1) Disorganized: we were taught how to treat malaria before we were taught what exactly malaria is.---pharmacology professor thought we had already had the microbiology lecture on malaria and was NOT happy that no one answered her questions about the disease during class. (2) Poor Weather and Illnesses: We have had classes several classes moved to do weather and professors being ill. and (3) Segmented: All of the lectures are well done, but even before the schedule changes, we were scheduled for a lecture on viruses, then one on bacteria, then one on fungi--just really hit and miss --topic to topic. It makes things much harder for the poor student to keep things straight. Nonetheless, it is my job to make sense of it and I will.

Obviously, the election is on Tuesday as well. Every time I turn on CNN it says something like"6 days, 5 hours, 12.6 minute until the close of the polls" and that sure weirds me out. It's like a giant banner reminding me of my upcoming exam. As if I need reminding: I had 30 anticancer drugs to learn (than goodness I worked on oncology) and that is just 2 hours worth of lectures! I don't need to be reminded that I need to study. On another note, if you haven't voted yet, you should. I found time to read my voter's pamphlet, vote and mail in my ballot last week so I know everyone else can find time. I often don't even have time to go to the grocery store or gym on a regular basis because I have to study and review so much (Don't worry Mom, I have a stockpile of Costco products....no one is going hungry).

Most exciting, the EVENTS. Dominica is having their 30th anniversary of Independence (from Britain). These Dominicans KNOW how to party. They basically shut down the island from Friday until next Wednesday. Yea, you read correctly: FRIDAY (10/31) UNTIL WEDNESDAY (11/4)! They do NOT mess around when it is time to party it up and "jump up". I'm a bit bummed out that we can't go to the World Creole Festival (Sean Paul is the headliner) in Roseau, which is about 20 miles from us (and an hour drive). I'm also bummed out that they are going to be partying when we need to sleep, eat and study all weekend. The bars/clubs in the next town over (1.5 miles away) have the music so loud on normal days (I think it also amplifies across the bay) that it keeps me from falling asleep with my windows closed, air conditioner on and ear plugs in! However, I'm excited that we get an extra day to study for the exam (our exams are always on Monday, but the actual independence day is Nov. 3rd so school is closed). After we finish our super, fun exam, we Americans will get our own little party. The US Embassy/Ross University School of Medicine is throwing an election party for the students. I know you are jealous. We get to sit at our local beach side bar and grill (literally one step to black sands and the Caribbean Sea) and watch the election results come in.

Exams, elections and events....a very busy week!

Signed, Sealed Delivered....I'm packing my bags for Argentina!!

Yea! We booked our trip to Buenos Aires! I can't express how excited I am to go. I did a tango (in my head because I can't dance) all the way down the muddy trail back to school to review neuroscience after clicking YES to Argentina. We will fly out the Wednesday after our last final (I intend on spending my days off in the gym and on the beach). We will land in Puerto Rico in the morning and hang out at the BEAUTIFUL airport until 7:00pm, but who the heck cares: there is a Starbucks!! Then we will take a nice hop over to Panama...you know the place with the big canal. I'm not sure when we leave there, but it is a straight red-eye to Argentina! We will arrive at 6:00am. Then it's time for some breakfast STEAK!! We get to spend six glorious days and five tango-filled nights in Buenos Aires. Then it's just a hop, skip and a jump back to Panama then to San Juan. We will stay two nights so that we can ship supplies back to Dominica. Then we have to go to every island in the Caribbean to get back to Dominica, but heck, we are students on a budget.

However, before we get to tango the nights away, eat lots of Argentina beef and wine taste our way across Buenos Aires, there are approximately 300 million exams left in the semester. That is correct, we are halfway done with the semester but we have only taken two exams and have 300 million exams left. Obviously, 290 million of them are all in one week. August is going to be awesome!!