Crash

I finally finished finals last week! My last one was on Thursday, and it feels GREAT to be over. However, that night, my body finally succumbed to the inevitable and I got a fever and chills. This always seems to happen once I do something stressful. Luckily, it happens AFTER finals and not during it, but I can almost count on it. So the next day I slept in until about 11 am (which was amazing since I got about 3 to 4 hours of sleep each night the week before), and I felt pretty good. I should have just rested the rest of the day, but I was bored and wanted to do something fun, so we did. And now I'm still sick. Hopefully I'll be completely healed before we drive out to Virginia.

Also, I would just like to say how awesome Katie was during finals week. I basically only saw her for only 2 hours everyday and she didn't mind that I studied so much. And she made me awesome lunches everyday. They were actually like little Japanese bento boxes, except with normal lunch food instead of sushi. And then when I was done with finals she had this little celebration thing planned and we ate chocolate cookies and watched the Avengers. I really liked that movie. 

I'm going to sleep some more now, so good luck Nathan, Alison, David, Lisa, and Mark with finals! 

Last day

I've just spent the last few hours studying and my brain hurts. This is not a fun way to spend a Friday night. I just keep telling myself that life will get a little better once Thursday afternoon rolls around and finals will be over.

And I wrote on my blog everyday this month! I did it!

Drawing disorders

I'm studying for finals tonight, and I finished going through my notes for my Visual Neurophysiology class for the entire semester. These last few weeks w have been discussing brain disorders and how they affect vision. It's actually super interesting. If you've ever read anything by Oliver Sacks, you are pretty familiar with what can happen.

Anyway, I made a list of 5 disorders that can be manifested by asking a patient to sketch a picture. And to help me study, I thought I would sketch some examples here on my blog for you all. Now you can say that you studied Visual Neurophysiology with me!

1. Apperceptive agnosia. If you have this, you can't understand what you are looking at, but you can still draw objects from memory. If asked to draw the sketch on the left, you would draw something like this on the right:

2. Associative agnosia. If you had this, you can draw objects extremely well, but you have no idea what they are until you touch or smell them. So if you were asked to draw the apple, it would be very accurate, but you would have no idea what it was that you drew.

3. Simultagnosia. If you had this, you can understand bits of pieces of what you see, but you can't pull it all together to understand the "Gestalt" of that thing. So you would say that you see a leaf, stem, and a round thing, and a small white reflection, but you wouldn't say you see an apple.

4. Constructional apraxia. If you had this, you know you're looking at an apple, but you can't draw it well. And I don't mean that you just draw things badly. I mean it looks really bad. This is common in people with Alzheimers.

5. Unilateral neglect. This one is really interesting. If you have this, you neglect half of whatever symmetrical object you're looking at. Men with this often shave only half of their face, or only put on one shoe. You might think that your left arm isn't even yours. 

I am proficient (I think)

I took my final proficiency exam today. It was a full exam that I performed on another student while a professor proctored me. I was really nervous, but I think I did alright. Actually, I was mostly nervous about being nervous, because I didn't want my hands to get all shaky or sweaty, and I didn't want to stutter or have my face turn red. But none of those things happened!

I messed up on a few things, but nothing too serious. So if it turns out that I have passed, I'll start seeing patients in January! Woot woot!

If anyone wants a free eye exam, come see me between January and April! The 2nd years all offer free comprehensive eye exams to friends and family, and we have to find our own patients to work on. Once May hits, I'll be a 3rd year student and my exams aren't free anymore--I guess I will be just too awesome at that point.

Make your eyes look like a dead fish

You can do this thanks to a reflex called "Bell's phenomenon." Basically, it means your eyes move up and out when you try to close your eyelids. You can see this if you hold open your eyelids then forcefully try to close them. You can't see it yourself, but if you do it on someone else, you should see their eyes move out.

Why is this useful? Basically, it's a defense mechanism. If something is coming at your eyes and you clench your eyelids shut, you move the center of your eyes out of the way so that they won't get damaged.

This was first noticed in patients who had Bell's palsy, where half of their face was paralyzed. When they try to close their eyes, the eye on the paralyzed side of their face moves up and out, like int he video below. I've seen a few patients with Bell's palsy at the clinic where I work. They often complain of their eyes drying out because one of their eyes cannot blink. Fortunately, Bell's palsy is usually not permanent.


I remember doing this to David while he was sleeping. We got the Gameboy Camera and held his eyes open and took a picture, and I guess he was trying to close his eyes while sleeping, and his eyes rolled out like that. It was really funny/creepy.

Commissioner Cleverbot

I wanted to draw something in MS Paint, so I asked Cleverbot what I should draw.

An apple? OK.

That was a little boring, so I asked another question.

That wasn't so helpful.

Fine. I'll draw a movie on the apple.

I hope you're happy, Cleverbot.

Fire

When I was little I thought fire was the secret ingredient to make things go fast. How did rockets reach outer space? They had fire coming out the back of them. How did race cars get a super-speed boost? Flames came shooting out the back. Even jet packs had flames shooting out of them.

So it wasn't totally unreasonable that I thought the same thing applied to paper airplanes. When I was little I made a paper airplane, went outside with a match, lit it on fire, and was totally expecting it to fly off for a few hundred feet. Instead it nosedived after about 0.01 feet and slightly smoldered on the ground.

10,000 hours

Katie and I arrived home from Virginia today after enjoying a lovely Thanksgiving break. On the drive out there and on the way home we listened to Outliers by Malcolm Gladwell. I read it a couple years ago, and we also listened to it last year on our drive out to VA, but we both thought it was pretty interesting and entertaining, so it made the 7 hour trip a little nicer.

One thing he talks about in the book is that in order to become an expert at something, you need to practice a lot. Studies have shown that it takes roughly 10,000 hours of practice to truly master any activity. That is a lot of practice. And it got me thinking: is there something in this world that I want to become a master of? The interesting thing about this study is that it seems that innate talent plays no role in how good you actually become. The more you practice and the harder you try, the better you are at whatever you are trying to do.

How much practice is 10,000 hours? Let's say you do your hobby an hour in the evening every weekday, and three hours on Saturday. That would be 8 hours a week. It would take 1250 weeks, or 24 years to become a master of that hobby.

Or you can practice 40 hours a week, lowering the time required to reach expert level to 250 weeks, or about 5 years.

Maybe I should practice drawing everyday. That way I will a master artist by the time I'm 50. Well, probably sooner than that because I have been drawing for a few years already.

Or I can start something completely new and be an expert at it by the time I'm 50. I just can't think of anything new right now that I want to learn...

What about you? What would you want to be an expert in if given the chance?

Vacation is nice

It's nice to get away from home every one in a while. I really like being able to relax and not worry about the million other things associated with being at home. I've only touched my books once today, which has been a very nice change. But finals are approaching, so I'll have to start studying again once I get home.

It's been a nice break, and I'll be able to breath again in a couple of weeks.

Donate to Wikipedia

Wikipedia is a source that I use all the time. It has helped me out in school in so many ways. I used in in all of my biology and chemistry classes at BYU, as well and my history classes. I never quoted Wikipedia as a source, but I often used Wikipedia as a starting ground to find good sources, or get a quick overview of topics.

How often do you use Wikipedia? Since I've used it at least daily for the past many many years, I thought I would donate in their latest fundraising campaign. I just donated $5 because I still had money sitting in my PayPal account from when I was selling portraits last summer.

I got an email from the directors of Wikipedia as a thank-you. It was really nice. This is what it said:

Dear Bryan,

Thank you for donating to the Wikimedia Foundation. You are wonderful!

It's easy to ignore our fundraising banners, and I'm really glad you didn't. This is how Wikipedia pays its bills --- people like you giving us money, so we can keep the site freely available for everyone around the world.

People tell me they donate to Wikipedia because they find it useful, and they trust it because even though it's not perfect, they know it's written for them. Wikipedia isn’t meant to advance somebody's PR agenda or push a particular ideology, or to persuade you to believe something that's not true. We aim to tell the truth, and we can do that because of you. The fact that you fund the site keeps us independent and able to deliver what you need and want from Wikipedia. Exactly as it should be.

You should know: your donation isn’t just covering your own costs. The average donor is paying for his or her own use of Wikipedia, plus the costs of hundreds of other people. Your donation keeps Wikipedia available for an ambitious kid in Bangalore who’s teaching herself computer programming. A middle-aged homemaker in Vienna who’s just been diagnosed with Parkinson’s disease. A novelist researching 1850s Britain. A 10-year-old in San Salvador who’s just discovered Carl Sagan.

On behalf of those people, and the half-billion other readers of Wikipedia and its sister sites and projects, I thank you for joining us in our effort to make the sum of all human knowledge available for everyone. Your donation makes the world a better place. Thank you.

Most people don't know Wikipedia's run by a non-profit. Please consider sharing this e-mail with a few of your friends to encourage them to donate too. And if you're interested, you should try adding some new information to Wikipedia. If you see a typo or other small mistake, please fix it, and if you find something missing, please add it. There are resources here that can help you get started. Don't worry about making a mistake: that's normal when people first start editing and if it happens, other Wikipedians will be happy to fix it for you.

I appreciate your trust in us, and I promise you we'll use your money well.

Thanks,
Sue

Sue Gardner
Executive Director,
Wikimedia Foundation
https://donate.wikimedia.org

Happy Thanksgiving Back

My favorite scene from this movie.

We're here at my parent's house and it smells amazing. We all ran a 5K this morning and Katie and I ran the entire way. My legs are pretty sore now.

Hope your Thanksgiving is a good one.

Instant Energy

Blackboards

I saw these photographs the other day and I keep thinking about them. They were taken by Alejandro Guijarro, and it's a series called Momentum.

He took pictures of physicists' blackboards from around the country, and they look really neat:







I really like it when professors use the chalkboard or white board to teach classes. I find myself much more engaged in class compared to when I am shown yet another PowerPoint slide. I feel that only time PowerPoint is appropriate to use is to show pictures or animations, not paragraphs of text. I hate it when professors read paragraphs of texts off of their PowerPoint slides.

You should look at the rest of the blackboard photographs--they're really cool. Also, they're bigger on his website, so they look better too.

Test night

I have a pharmacology exam tomorrow, so tonight's post will be short. I will like to tell you two things:

1) Rifampin will make your urine turn red.

2) Nitrofurantoin will make your urine turn brown.

3) I am so ready for this semester to be over.

That it all.

5 second rule

Blik

There was an ad on a Youtube video that I watched that looked kind of interesting. It was the first ad that I actually intentionally clicked. It was for an art/graphic store called Blik. It's actually really, really cool.

Good job, Youtube. One of your advertisements actually worked. Well, not really...because I didn't buy anything. But then again, I am talking about the store, so I'm just continuing to advertise for them...except I'm not getting paid.

Check this stuff out:

http://www.whatisblik.com/shop/explore/seasons

http://www.whatisblik.com/shop/explore/imaginary-forest

http://www.whatisblik.com/shop/explore/to-scan-a-forest

I'm terrible at drawing mazes

I really like to doodle in class, especially when I'm getting tired. It keeps me awake and it's kind of fun to look through my notes later on. Sometimes my doodles come in handy. For instance, I had a test a couple of weeks ago about episcleritis and scleritis, and one of the questions was asking about a "salmon patch" in the eye. I totally remembered what that was because I drew this awesome picture of a salmon next to the PowerPoint slide.

However, I have never been good at drawing mazes. There was this kid in my 2nd grade class who was really good at drawing mazes and I tried to do it, but failed miserably. The correct path was always so obvious when I made them. I tried again today, and it was pretty pathetic. I have not improved at all in the past 18 years.

This is a skill I wish to master someday. Someday I will draw an epic maze and it will take you at least 3 attempts to complete it!

Bedtime story

For the last couple of months I have been telling Olivia bedtime stories. I thought I would re-tell tonight's story. Ahem...

Once upon of time there was a baby map named Mappy Mappy. Mappy Mappy wanted to get bigger and bigger like Clifford, but she didn't know how. She asked her mommy what she should do to get bigger, and her mommy said she had to eat all her dinner.

So Mappy Mappy ate all her dinner that night. She ate Texas, Oregon, Virginia, Utah, and Ohio and her tummy got so, so, so big! And then she ate Mexico as a snack. Then Mappy Mappy was so sleepy that she just took a nap, and when she woke up, she was bigger!

The end.

 

 

My opinion on the Affordable Care Act, or Obamacare

I think there has been a lot of confusion about what Obamacare is actually about, so I thought I would give a summary here, with the help of Wikipedia and discussions I have had in classes, other students, and doctors. I think I'll just continue to call it Obamacare because the PPACA or the Patient Protection and Affordable Care Act is just a mouthful to say. And President Obama said that he also likes the name, so I don't think it's disrespectful.

Just in case you're curious, this is the entire 974 pages of the entire act.

Basically, Obamacare is the biggest overhaul to medical insurance since Medicare and Medicaid were passed in the 60s. They made a whole bunch of rule changes to make health insurance more affordable overall and decreasing the number of uninsured Americans.

(FYI: 20-27% of Americans were uninsured in 2009 in Texas, California, New Mexico, Georgia, Florida, and Nevada, with many other states falling close behind.[source].

So what did Obamacare actually change? There are a lot of changes made there were gradually put in place, starting in 2010 and will continue to go into effect in 2014.

Here are some of the changes that have already occurred:

• The FDA can approve more generic drugs
• A non-profit was organized to research more effective methods of treatment and management
• Chain restaurants have to display how many calories are in their foods
• 10% tax on tanning salons
• Children can stay on their parent's health insurance plan until they're 26
• Can't exclude children (under 19) from health insurance due to preexisting conditions
• Only 20% on profits earned by insurance companies can be used for administrative fees (reducing the amount they can charge on premiums)
• Certain preventative screenings are done without a deductible, like well-women visits, gestational diabetes tests, human papilloma virus test, HIV tests, and domestic violence screening.

Starting January 2013:

• A tax increase of 0.9% on those making $200,000 or more who are filing as a single individual, or $250,000 when filing as married-filing-jointly.

Starting January 2014

• No more preexisting conditions for anyone anymore. Everyone will be charged the same regardless of their gender or medical history (except for tobacco use).
• A penalty (or tax) is given to those who are not on health insurance. This penalty is either $95, or 1% of income over the filing minimum. The penalty will increase in 2016. (There are some exemptions given so you don't have to buy insurance, such as for religious reasons, or if the least expensive option is still over 8% of their income.)
• Medicaid is extended to all those who are within 133% of the poverty line. (This is $31,000 for a family of 4).
• Companies who employ over 50 workers are required to offer health insurance to their full-time employees, or they will face a fine.

Starting January 2015

• Doctors will be paid differently now. Larger payments will be given to physicians who provide high-quality care compared with cost.

Starting January 2017

• States can apply for a "waiver for state innovation," meaning they can use an alternate health care plan (without the penalties and forcing people to get insurance) as long as the replacement plan is as comprehensive and affordable as Obamacare.  

Starting January 2018

• All existing health insurance plans must provide preventative care and check-ups without a co-payment. 

An finally, in January 2019

• Medicaid will extend to former foster care youth who were in foster care for at least 6 months and are under 25 years old.

This plan will be pretty expensive to run initially, but it will actually save money in the long run. It will cost 1.7 trillion dollars to implement (between 2012 and 2020) but it will actually reduce the deficit by by $210 billion during that same time frame.

I think the biggest issue that people have with it is the individual mandate, meaning the government forcing you to buy health insurance. This is what the whole Supreme Court case was about. The Supreme Court upheld this law, saying that the government can "force" you to buy health insurance, because what they are actually doing is just implementing a tax on those who do not have health insurance.The reason why the government wants everyone to buy health insurance is because it will make it cheaper for everyone. If you didn't have to, only sick people will buy health insurance, and then it will be really expensive.

Also, you do not have to switch health insurance if you like the one you have. You can keep it. You don't have to use Obamacare if you don't want to.

All in all, I think this is pretty good. It's not perfect, but I think this is better than what was in existence before. One thing I would change if I could would be the requirement that companies offer health insurance. I think it is totally weird and archaic that our places of employment are also the sources of our medical insurance. These two things have nothing in common! They only started doing this during WWII when there was a government restriction issued on how much companies could pay their employees, so companies started offering other benefits beside salary (like health insurance and retirement benefits) to attract new employees.

Anyway, that is all that I know about Obamacare. I learned some new things while researching this, and hopefully you did to!

Gets me every time

Just so you know, I'm working on an epic post about the Affordable Care Act, or "Obamacare." I just didn't finish it tonight and I'm tired. Stay tuned!

An awkward situation

This happens to me WAY more often than it should. Do you ever accidentally make eye contact with someone who is sitting in a toilet stall? You know, through that little crack between the door and partition?

I think it happens because I just want to see if someone is using it, and it seems less awkward to do a superficial and quick glance to see a dark shadow or something than the bend down to look at their shoes.

Here is what I propose: if you're in a stall, never look out through the crack. This will avoid me having to decide whether to acknowledge the fact that I made eye contact with you while you're doing your business.  

Temple Infographic

This is a really neat temple info graphic designed by Brian Olsen. You can't really read it here because it's too big to fit, but here is the direct link to it: http://3dtemples.photogent.com/infographic/ 

Songs

I can't really think of anything clever to write about now, so I'll post some songs that I have had in my head for the past few weeks:

Here is Nevershoutnever singing Dare4distance:



Here is the Cold War Kids singing Hang Me Up To Dry:



And finally, here is Muse singing Madness:



Enjoy!

Progression

I love drawing

Drawing is one of those things that I never really thought I was good at but I wanted to become good at. I remember being super embarrassed in first grade by a drawing I did because I thought it looked so dumb. And then I remember when I was a teenager that Chris and I used to laugh at our attempts to make serious drawings, which usually ended up looking something like this.

I remember in 9th or 10th grade I had a really good art teacher who taught me a lot of things and I remember wanting to be good at drawing like him. He told me that I had real talent and could go far if I really studied and practiced. So I practiced a lot in my room after school. I would practice drawing eyes over and over again. I also liked to draw lots of maps. I would create islands and study maps and try to create a geography of the island that would make sense, given the ecosystem I imagined for that island.

I really wanted to get a minor in art at BYU, but they discontinued the minor the year I arrived. I was pretty disappointed. But I took a beginning art class from the coolest professor at BYU. His name was Andy. Katie knows who he is because she also took an art class from him. He also taught me some really cool things. David, if you get a chance, you should take a class from him. His really weird. He liked to wear a shirt that says "I fart in your general direction."

Sometimes I like to watch videos of people drawing. I used to watch Bob Ross on TV and thought he was amazing. Then I saw the following video on Youtube and it made me want to stop memorizing facts for the night and draw. But I have a test tomorrow and I need to get back to studying.

 

Green wave

I was a missionary in Switzerland and while driving around Zurich, I came across a sign saying that the rode I was driving on that implemented a "Grüne Welle" or a "green wave". I wasn't sure what that was, but the sign said I should drive a constant 45 kph.

It was amazing. The lights on this long stretch of rode were synced so that if you drove at the right speed, you would hit all green lights all the way.

According to this Wikipedia article, here are the benefits of implementing a green wave:

• Reduce CO2, NOx and PM10 emissions from traffic.
• Reduce fuel consumption of vehicles.
• Be used on roads that intersect with other green waves.
• Reduce the time cars wait at side roads.
• Give pedestrians more time to cross at crossings and help them to cross streets as vehicles travel in platoons 
• Control the speed of traffic in urban areas.
• Reduce componant wear of vehicles and indirect energy consumption through their manufacture 

Pretty sweet. And here is a video of a green wave in real life in Copenhagen from the point of view of a bicycle:

My thoughts on LASIK

Chris wanted to know what I thought about LASIK, so I'll tell you what I know. I haven't had it myself, but I've learned about the procedures and seen people who have had it done and have seen videos of the surgeries a couple of times and have had quite a few classes about it. So i'm pretty much a profi. But not really.

So here is what I think: LASIK is pretty cool. I think some optometrists are "against" it because they think that they're losing patients, but I don't think of that at all. You'll still see patients for pre and post-operative care, and for their other ophthalmic needs.

Here are the pros about LASIK (that I know about):

1) You no longer have to wear glasses (at least until you hit the age of 40 to 45, then you'll need reading glasses. That's something I didn't realize until I came to optometry school: EVERYONE will need reading glasses to see things up close once they hit the mid-forties).

2) The correction can be incredibly precise. They can correct the normal first and second order aberrations (like your typical myopia/hyperopia and astigmatism), but can go even further and correct the higher order aberrations that glasses cannot improve. Can most people tell a difference? No. But it's still pretty cool.

Here are the cons that I've heard of:

1) You'll need to wear glasses eventually. So paying $4000 out of pocket for 15 to 20 years of glasses-free vision will be worth it for some people, but not everyone.

2) It's not reversible. Once you cut the cornea to reshape it, you can't go back. So if there is a new type of technology or vision therapy developed in 20 years that can correct refractive error, you might miss out.

3) The surgery can be painful. At least that's what I've heard.

I go back and forth as to whether I want LASIK or not. I've known a few optometrists who have gotten it, and others who refuse to get it. Some really like the fashion sense of glasses and that's why they decided to stick with glasses.

I think I'll just plan on wearing contact lenses for as long as I can and just get readers when I need them.

So that's it.

My eye abnormalities - part 2

Here's another thing about my eyes that are weird: I see different colors out of each eye. It's actually very subtle and I noticed it when I was about 12 or 13. My right eye adds a red-ish tint to everything, while everything out of my left eye looks more blue-ish. I only really notice it in bright light. It's especially prominent while looking at a white wall or something.

Last year we were learning about color vision defects and I asked my teacher after class about it. He said that he had never heard of that happening before. I took some intense color vision tests, one eye at a time, to see if there was a measurable difference between the two, and there was.

After seeing these results, my professor thought it could be the following:
1) Multiple sclerosis (not so likely because there haven't been episodes of it coming and going)
2) A brain lesion (also not likely because there haven't been any changes)
3) A difference in pigment in the back of my eye (most likely, but also most boring)

So my professor recommended having a complete, intense eye exam with the director of the clinic here at the college to rule anything major out.

In unrelated news, do you call it soda or pop?

http://popvssoda.com:2998/

My eye abnormalities - part 1

Being an optometry student makes you think about your own eyes a lot. I've received so many practice eye exams this semester that I can't even begin to count them. Because of this, I have learned that I have a few minor but interesting abnormalities about my eyes. Many of these things are genetic, so I'll be examining all of your eyes when I get the chance, just to see if you all have them too.

The first thing that was pointed out to me is that I have something called posterior embryotoxon. This means that some structures surrounding my iris have been pushed forward, resulting in a whitish line around my iris. It looks like this:

http://childrennetwork.org/physicians/ags.html

I only have a few locations of this white line around my eye--it doesn't make a complete circle. And since my eyes are blue it is difficult to see. When you see this white line, you need to do gonioscopy to see if there is something wrong with the inside of your eye. This is gonioscopy:

http://blog.optonotes.com/2008/04/19/atlas-of-gonioscopy/

That thing is a mirror that allows you to see in the periphery. Don't worry--the eye is numb. Anyway, when this was done on me, they saw some peripheral anterior synechiae:

http://dro.hs.columbia.edu/pas.htm

You see that little bump that's pulling the iris over to one side? I have a little one of those. Nothing serious. Once you get the peripheral anterior synechiae, it's called Rieger's Anomaly. It just puts me at a higher risk for developing glaucoma, but the pressure inside my eye is really low, so I'm good.

Now here's the interesting part. I know what you're thinking: how could this get even more interesting? Well, it does. 

This is genetic. It is autosomal dominant, meaning that either Mom or Dad has this, and each kid has a 50% chance of getting it. 

I already know that Alison has this. I know this because corectopia is another sign of Rieger's Anomaly. This is corectopia:

http://en.wikipedia.org/wiki/Corectopia

You see how the pupil is off center? Cool, huh?

Now this is everyone's homework assignment: look in the mirror and see if you see any of these signs, and let me know. It will probably be really hard to tell because it's so subtle. It's so subtle it puts the "B" in subtle.

[Warning: if you do a google image search for any of these things, you'll see some crazy things. For example.] 

Which states actually influence elections

This video was made by NPR to show which states the votes actually matter in the presidential election. It's pretty interesting.


Living in Ohio, I've noticed that people take voting very seriously. There are lawn signs EVERYWHERE, and they are pretty much 50% Republican and 50% Democratic. The downside to this is that we get a lot of political advertisements, from both parties. On my Pandora station, I often get a mean-looking photo of Obama on the top advertisement, and then a nice-looking photo of Obama on the bottom advertisement. We got 3 phone calls on one day trying to convince us to vote one way or another. Luckily I can tell them that we already voted 2 weeks ago. I will be relieved when this election cycle is finished so that there will be less advertisements.

Baader-Meinhof and the Tragically Hip

The Baader-Meinhof phenomenon is when you see something new or learn a new thing, and then you see that thing all over the place. Like when you buy a new car and you see your car everywhere you go after that. I've had this happen to me. One of my professors gave a lecture about the gain-control function of cells and he used the Canadian band The Tragically Hip as an example and he played a clip in class. Then the next day I was reading Scott Pilgrim and they mentioned the Tragically Hip. And then the next day they popped up on my Pandora station. This experience has made me wish that I was a Canadian. Sometimes Canadians are cool.

Sometimes I think that I live in a Truman Show-eque type of world and I am being influenced to like certain things.

And just so you know, Nathan, the Truman Show is not real.

Here is one of their songs (I can't embed it): http://youtu.be/o6QDjDPRF5c

Mnemonics

I had my fourth midterm in pharmacology today. This is the hardest class I have ever taken in my life. Ever. I think I hate it so much because there is just so much brute-force memorization that has to take place. We have a test about every two to three weeks, and each test is cumulative. We learn about 150 to 200 drugs for each test, so this test today covered about 800 drugs, and I had to know each drug's class, mechanism of action, side effects, and how they interact with other drugs.

The only way I can pull it off is having mnemonic devices. Hundreds and hundreds of stupid mnemonic devices. I just pulled out my notes so I can give you an example. Let's see here:

1) There's a drug called imitinib. When I read that word I think about mittens, so I imagine rabbit-fur mittens, and the German word for rabbit is Hase, and "hase" are the first letters of that drug's side effects (hepatoxicity, anemia, skin toxicity, edema).

2) To remember the drugs in the "selective seratonin reuptake inhibitors" class, I remember this phrase: Villa flew over the citadel, certain to be excited to see a pair of oxen that are flying oxen. This refers to the following drugs: vilazodone, fluvoxamine, citalopram, sertraline, escitalopram, paroxetine, and fluvoxamine.

3) To remember what all the drugs do that end with "lam" or "pam", I remember this: Aunt Pam and Lamb Chops are chilling on the couch watching Yo Gabba Gabba. This reminds me that this drugs are relaxing, anti-anxiety drugs and activate GABAergic neurons.

These mnemonic devices really help, and it's the only way I can remember these drugs. And this is what my brain looks like after a test like this:

Muchacho

This is the picture of the Muchacho Cup that I was talking about yesterday:

Doesn't it make you so happy? Now you can compare the muchacho with Olivia:

Not bad, eh? 

All the different Olivias

A few days ago Olivia, Katie, and I were eating lunch together and Katie and I were playing Farkle, I think. Since Katie won, I drew her wearing a crown. Once Olivia saw it, she wanted a picture drawn of herself. I drew a "Patriotic Olivia" because she could recite the pledge of allegiance so well. Then she decided that she wanted all sorts of different Olivia's. The next one I drew was a "Kitty Olivia" and it kind of just went on from there:

The "muchacho" is from Olivia's favorite cup, which she calls the Muchacho Cup. I can't find a picture of it right now, but it really is a great cup.

Some stories from work

Story 1:
I saw this really funny old black lady the other day. She was laughing and cracking jokes the whole time with me, which was pretty nice and refreshing since most of the people we see are seriously ill or have some rare disease and are understandably not in the best mood. But this lady was hilarious. When I brought her back from the waiting room to the exam room she was saying "Ah, thank you sir" and "Yes, sir" and "Mmm hmm, yes sir!" between each funny comment she was making.
Then about halfway through the exam she stopped mid-sentence and said, "Hey, hey, now, hold up. How old did you say you are now?" To which I replied, "Um, well, I just turned 26."
Then the lady laughed and said, "Oh my! I ain't callin' you sir no more! You's a baby is all!"
She then proceeded to refer to me as "baby." It was pretty great. I'm not sure how old I have to be to transition from "baby" to "sir," but I have apparently not yet reached that point.

Story 2:
One of my coworkers was reviewing a patient's record before taking them back and they saw a note at the bottom of the last exam's note saying "left eye damage is consistent with forking." He had no idea what "forking" meant and the doctors couldn't really remember either. The only thing they remembered was that he was a back-woodsy kind of guy from West Virginia. My coworker went and got him and then worked him up for the doctor. When he came out of the exam room he told us all about forking.
It turns out that when this guy was about 5 or 6 years old, he walked into his kitchen while his mom was putting away the utensils. However, the mom was standing a few feet away from the utensil drawer and was tossing the utensils into the drawer and this guy walked in between his mom and the drawer. The fork was mid-air at the time and it entered into is left eye, leaving him blind.
So there you go, now you know what "forking" means, in case you come across another similar situation.

Story 3:
Sometimes we see people who are blind in one eye (see Story 2). When I work a patient up for the doctor, I test a couple things: visual acuity (meaning asking them while line on the chart they can read), pupil response, eye muscles, and eye pressure, and sometimes we run a visual field to check their peripheral vision. Anyway, as I was saying, sometimes we see people that are blind in one eye. However, almost every time I see one of these patients, I forget they can't see out of one of their eyes. It makes for some very awkward situations. For example, I would tell them to cover one eye with an occluder, and they would just sadly reply that they don't need one. Or I would have their good eye patched and ask them to "look over here" and then just sigh and lift up their eye patch to see where I'm pointing. I always feel terrible when that happens.

Mars

Here are some pictures I found of Mars taken by the Curiosity rover on NASA's website.

Isn't it crazy how Earth-like it all seems? I mean, I've seen places that look like this in Utah. Pretty amazing.

Eye popping out

I had a very interesting experience today. I've been working with the neuro-ophthalmologist for about 4 weeks now, and I've seen some pretty shocking things, but today takes the cake.

Note: I have only linked to photographs instead of posting them directly here so that people can choose for themselves to look at them or not. You're welcome.

A patient came in today with Grave's disease. Grave's disease is a thyroid disorder that has many side effects, one of them being that your eyes may bulge out a little bit (just like this). This patient I saw was a middle-aged African-American lady who developed Grave's last year. She had some surgery on her thyroid a few months ago, but her eyes still bulge out. We see Grave's patients every day in our clinic, so it's no big deal to see someone with bulging eyes. They usually wear sunglasses because their self-conscious about the way they look.

Anyway, I was working the patient up to get her ready to see the doctor. I took her medical history, got her visual acuity, checked her pupils and eye movements, and then started to check her eye pressure. Some people in other clinics check eye pressure by doing that puff-of-air-in-the-eye test, but since that test can be pretty inaccurate we do contact tonometry. This means that I put a numbing drop in the patients eye then press on the eyeball with a blue light to find the pressure inside the eyeball (it looks like this). It was pretty scary to push on someone's eyeball the first time, but now I'm used to it. Sometimes people blink a lot so I have to hold their eye open with one hand while pushing the slit lamp into their face with the other.

This patient with Grave's that I saw today was a blinker, so I had to hold her eyelids up while I measured her pressures. I always start with the right eye, and that one went OK. It took a couple of tries because she kept saying that her "eyelid was about to roll up" and she would pull away from me real quick. I wasn't sure what it meant to have an eyelid "roll up", so I didn't think much of it.

When I measured her left eye, I found out what it meant to have her eyelid "roll up." It means that her eyeball POPS OUT OF HER FACE and her eyelid is behind it. I still cringe when I think about it. I was measuring her left eye when she suddenly said, "Oh! Oh!" and then I felt a little pop against the tonometer. I looked up and saw this lady's left eyeball protruding out of her socket with the most horrified look on her face (just like this). I'm sure my face was more horrified than hers.

I had no idea what to do. It was kind of funny because we were all joking about this happening last week and someone mentioned that there is this spoon-shaped instrument used to push eyes back in, but I had no idea where to find one or how to use it. I ended up biting my tongue to keep myself from yelling, then asked the woman if her eye hurt. She said, "Oh, yes!" I then realized it was kind of a dumb question.

I was about to get the doctor when the patient ended up fixing it herself. She pulled her eyelid out from behind the eye and pulled it down in front of bulging eye, then used both hands to push her eye back into her socket. I asked her if this sort of thing has happened before and she said that it has happened a couple of times.

After finishing up the exam, I talked to the other technicians and they all the held their hands over their mouths and gasped while I told the story. I guess they've never seen that happen before. The doctor, on the other hand, seemed totally unfazed by it. He was like," Oh, which eye did the subluxation occur in?" and I had to relive the experience over again before I could confidently say "Left eye."

And now I will live in fear of testing the eye pressure of Grave's patients. Maybe I should just keep the little eye-spoon-tool with me at all times just in case I come across a patient who can't put her eye back in.

Katie is fast

When Katie and I were dating, we used to play a card game called Egyptian Ratscrew. I can't really describe it here, but let's just saw that Katie was awesome at it and I was terrible. We played it at least 40 or 50 times, and I think I won only once or twice. That is not an exaggeration.

I was looking on Amazon just a minute for a new game to buy or something, and I came across this game:

It's called "Blink: The World's Fastest Card Game"

It seems just like the kind of game that Katie would be really good at and I would be really terrible at. This is what it would look like if we actually play:

Happy Pi Approximation Day

You probably know that March 14th is Pi Day, but did you know that July 22nd is Pi Approximation day? Because 22/7 is 3.14285, which is pretty close to pi's digits of 3.14159.

On an interesting side note, I used to get my old zip code in Berlin mixed up with the digits of pi. The zip code was 14195, and I always wanted to write it as 14159 because that seemed to flow better. Okay, okay I admit saying that this side note was interesting was a bit of a stretch, but there you go.

According to Wikipedia, some other approximations include 333/106, or 355/133, or my favorite is 103993/33102. 

Hello

So, I guess I'm not so good at writing every day anymore.

Work has been crazy. Sometimes it has been literally crazy. Like, I've seen some crazy people at work. Last week there was a guy who was getting a hole cut into his iris to relieve some pressure that has built up in his one remaining eye. He was a crazy guy and didn't really understand what was going on. Every time the laser went off that was supposed to blast a hole in his eye, he would scream and jump away. This is bad, because you and easily go blind by looking at that laser directly. The doctor brought me in and my job was to hold him down and push his head up against the laser machine so that he would stop jumping. He was pretty strong, and he was pretty stinky. I had to hold him down for 25 minutes straight. My arms were shaking near the end of the operation and I was repeating over and over again, "Now, sir, you have to stop moving or you'll go blind, OK? Stop moving!" The operation was a success and I was the hero for an hour.

I saw the most disgusting sight I've ever seen today. I can't describe it in detail because it really makes me want to throw up when I think about it, but let's say that it involves an empty eye socket, a lot of pus, and a pencil...

In other news, I found some really neat pictures taken by Zander Olsen. These pictures are from a series called Tree, Line.