So you're probably sitting there asking yourself...

...where did Aequanimitas go?
The truth, my friends, is that I've been wandering through the valley of the shadow of basic science research. Unfortunately, I discovered that, indeed, my research to date was all just a shadow... an illusion. I got the answer to the basic question that I had been pursuing for two years. The null prevailed.

Fortunately, I work for a prominent scientist who has good collaborations and multiple irons in the fire. Sadly, due to the nature of science, a great deal of time is required to finish a project, meaning that because I am starting a new project, my graduate training will be rather prolonged... five years is starting to look like a very optimistic completion date, stretching my total time in the MD/PhD program to nine years. If things take longer than expected, as is almost always the case in the scientific realm, it might be possible for me to spend a decade in formal graduate level training. Damn.

Thankfully, life goes on. Outside of lab, your unmotivated and unfaithful blogger has continued to enjoy the fruits of his significant other's labor, which are enough to keep the bills paid and good beer in the kegerator...

...But enough of this wildly optimistic delusional crap where I try to frame my life in order to feel better about it--lets talk about the problems here--let's embrace the reality in which I find myself. We know that whenever something fails there are lessons to be learned and reasons that need to be identified so that the same mistakes are not repeated in the future.

1) As a graduate student, you should not go developing new systems within your lab. It takes a long time to bring a complicated new technique to a laboratory. I did this successfully--I brought a complicated stem cell differentiation to our lab, which I used in my experiments, however, when I used them as a model, it turns out, our hypothesis was wrong. Thus, I spent a long time working on developing a model, to answer a question, which turned out to be unimportant. Two years gone. Boom! Consider for instance, if I had worked with a different person in the lab who was heading into a very productive period of their work--I would already have two middle author publications and most likely have key data for my own first author work. However, I was assigned/unlucky/unwise and worked with someone who was not productive, and so I worked hard for two years, but have nothing, except the experience of bringing a complex technique from another lab to ours--unfortunately, techniques do not a good scientist make.

2) So why did I end up in that position? This, I believe, is the critical question. This is also something thing that is absolutely essential for new PhD students to understand, which unfortunately, I was never told. My training fell at a period of time where there was no mentorship whatsoever though the early research years including choosing a lab, etc. All that I had to lean on was the information from other graduate students, which I took, in my arrogance and enthusiasm, with too many grains of salt. Here is the gem of the blog, the mistake I made, that was preventable. Young students, please, take some time, go to a mountaintop, do some soul searching, go into a lab and do some experiments, whatever you need, but please...

Define your research interests.

I did not do this and it cost me dearly. I ended up going along with the flow, hoping (as I usually do) to get lucky, or that good things would just come my way. They did not.

More broadly though, I think this principle is crucial to all people, not just PhD students. You could change 'define your research interests' to read 'know what you want' for wider applicability.

I firmly believe that all people are selfish to the core. Selfless, altruistic people gain pleasure and are satisfied by helping others. The selfish people gain pleasure by getting what they want. Based on my observation and experience, we are all hedonistic. We do what makes us feel good, something determined by our neurobiology, which is the result of evolutionary selective pressures. Argue with me if you like, but I have yet to hear something to convince me otherwise. This is important.

It is important because this helps us understand why defining your interests/knowing what you want is so crucial. In the classic slit lamp quantum experiment, a photon is passed through a small slit--it has equal probability of landing anywhere on the screen, yet we only know where it will be once we observe it. This, in my opinion, is a great analogy to life. Had I known where I wanted to be and what my research and career interests were, I would have been much clearer in choosing a project, much more savvy in determining who to work with, and been able to observe the photon where I wanted to be. Unfortunately, I did not know this.

Now it could be argued that without these experiences, I would not ever be able to know this. It is an undeniable possibility. But if you can define your interests, set up a goal, and shoot for it, I think you will find your way much better than I did. Oh yeah, find a great mentor too--someone who cares about you. Good luck.

So to focus back on the original question you were asking me, "Where did you go?", I basically have been finishing up a few projects, trying to plan my new project, and taking strong steps to ensure that my next project is successful and to define my research interests further.

Interestingly, this has taken me back to my original question, which I formulated in high school. Why do people behave the way they do? To know that, I wanted to pursue a career where I reached out and helped and understood people at their most vulnerable points--to me, I can't imagine a more vulnerable time than asking someone to open up your head, stick a scalpel in, and make your life improve! In addition to meeting people at that clinical point and psychological point, I also wanted to understand the 'why' part of the question, which led me to neuroscience. My new project will allow me to explore the biology of how the brain changes in response to activity, which to me, is the crux of why we do what we do. Realistically, I hope to learn a bit about why a mouse does what a mouse does, but I think that is where science and technology are. I hope this new project on which I am embarking will allow me to begin to answer this fundamental question I had as a youngster, while at the same time honing my scientific mind.

I have spent the last several weeks coming to this place, refocusing my efforts, and strengthening my life on the homefront. I hope that by returning to my interests, my motivation will reignite, and I will be able to complete this difficult phase of training. The most salient insight is that in order to attain satisfaction, you must know what you want [both in life and in your research].

As I wrap this up, I'm reminded of an editorial I wrote in Phi Psi entitled, 'What is a physician-scientist?' At that point, early in my educational career, I scoffed at my colleague's statement that you need to know what you want, and then go get it. His words were clearly true and wise. Unfortunately, I took them with too many grains of salt, scoffed at them as unattainable, and wrote the article. I wish I had taken them to heart and spent some time actually contemplating that and working to define what I want. We live and learn.

Reality, boo-yah!

So one of the more avid readers of the blog made some comments critiquing my blog. He audaciously suggested that my posts all sound like personal pep-talks in an attempt to reframe the graduate school experience. To make things abundantly clear, since I'm not one who likes to mislead others; yes, I am absolutely trying to brain-wash myself into enjoying the phenomenally humbling and depressing process that is graduate school. That is the whole point of this blog! My readership is intelligent! Wonderful!! I guess aside from the personal brainwashing, some other unfortunate souls may find themselves in my position and find my musings and coping strategies useful or encouraging, or at the very least, let them know that their struggles are not unique. Why that helps us humans, I don't know, but we always feel better if we know others have gone through a difficulty through which we are struggling. Its interesting to think how this contrasts with so many individuals desire to be 'unique', but that's another topic for another time.

Back on track... while a difficult and depressing journey is not the case for everyone's graduate school experience, I've ran myself into quite a deep gulch, forging into the scientific world in an area that is not really studied by my lab, or in fact, anyone at my university. This is what my mother calls a "character-building experience" or "learning from your mistakes." It is not for the faint of heart or the sober of mind. My graduate experience has been a case study in how to make poor major decisions. While my mentor is excellent, and does great science, I stuck with a difficult project that led way outside of the lab's experience, let alone, its expertise. For someone who hopes to sail through graduate school, make a contribution to science, and roll out--this would be a very poor choice indeed.

Interestingly though (beware, here comes the personal pep-talk), this is one of those experiences that actually does make you grow. Like in a fraternity initiation (yes, I just compared grad school to Greek life), you must be broken down before you can rise and become one of the group. It is only through that breaking down and rising back up that one is able to truly understand and appreciate the bond of the brotherhood--or in the case of science, any chance at understanding how the best and brightest, the leaders in the field, think; or how you might actually succeed in a scientific career. In the fraternity, if you let the beating get to you, you're a puss and you're out. In science, if you let the depression, the repeated failure, or the complete lack of progress affect your love for science or your intrigue into seemingly asinine pieces of biology, you'll fail. However, if you can handle the internal destruction of your person and morale, letting it roll off you like water off a duck's back, then you can come out on the other side, publish a paper or two, get the letters of recommendation, and move on to the next step where you can do it all over again at the next level, and then maybe, someday, the complete body of your life's work, just might, possibly in a very small way, illuminate some important aspect of biology. In an even more rare situation, this might impact normal people's health care, and subsequently their lives. Finally, like in a fraternity, such rigor and challenges are always much more enjoyable and make complete sense if you have a few brewski's on board. I highly recommend it.

Response to "A Quibble"

My father-in-law to be sent me this article, which I thought was fascinating. I wrote a response e-mail to him that I thought might be appreciated by the wide-readership (now over 50 hits/month, probably not more than 25 of those by me) that this blog draws.

Please enjoy:

I think it really hit the nail on the head, when the author points out how detrimental (and amazingly prevalent) anti-intellectualism really is. It is incredibly sad, and does not bode well for the future of our country. In a similar vein, its sad to see people label Obama with titles like "elitist"--these degrading terms further that devaluation of thoughtful consideration, intellectual rigor, and the value of science. Reflecting on the article really makes me appreciate the education my parents provided for me--as much as I disagree with some of their religious views--they instilled a high value on knowledge within me, that still motivates me today. Having now spent significant time working to become an expert in some very small corner of science, I'm beginning to appreciate just how hard it is to find the truth on anything. It takes an incredible time of thought and discipline to get to the bottom--or as close as you can--of the issues that present themselves. I think this is a major factor that discourages people who love the immediate gratification of knowing something right away.

My first critique of the article is the lack of acknowledgment that nearly as many people drink the 'left-wing Kool-Aid' without at all engaging or seeking to understand the issues--much like those on the far-right. Secondly, the author didn't mention how necessary it is to learn to deal with uncertainty, and the impact that that plays on the anti-intellectual culture. Seeking to get to the bottom of issues, whether drawing the line on acceptable interrogation techniques, or drawing up a new healthcare model, almost invariably lead you to a conclusion that contains some degree of uncertainty. Learning to accept that uncertainty, and deal with it, is crucial to being comfortable with a decision while maintaining flexibility to respond to changes in the situation at hand. Dealing with and accepting uncertainty is not very enjoyable or satisfying. Contrast this with believing that you know the 'absolute truth' or that your opinion trumps all others, and you can see why a simple-minded anti-intellectual approach would be embraced by a wide sector of people who are seeking rapid gratification in all areas of life.

Focus

I heard a fascinating interview on NPR last night where the host was talking to 'experts' about recent findings in the UK that 1 in 7 people reported anxiety issues. The experts were talking about potential explanations for this high rate of anxiety, which is increased relative to years past.

I was intrigued by the proposed explanation--a loss of personal contact and increased exposure to negative news caused by hard situations in the world, but primarily due to the constant media exposure that people receive these days. The experts hypothesized that since people spend so much more time exposed to news via 24 hr cable, internet news feeds, internet on our mobile devices, etc. that we are subconsciously influenced by the heavy negative outlook on the world that the news media takes. Obviously, negativity sells, so it makes sense that the news outlets share it. The experts forward the idea that by hearing about all the negativity in the world, which there is plenty to worry about these days, people focus on that, and ignore many of the positive things in their lives. Couple that to the personal isolation that occurs when you read/watch TV/surf the interent, etc along with the general stress most people feel these days with layoff concerns, decreased income, etc, you get a generalized increase in stress/anxiety levels.

What most intrigued me though, was the impact that this could have on my graduate school experience. Would spending time reading about the stock market crashing or joblessness or declines in real estate values increase my stress and anxiety? As a graduate student, I have complete job security--unless I spend too much time doing other things, but even that can be forgiven occasionally. So could reading about other's anxiety actually increase my own?

In addition to reading negative news, graduate school has its own constant rate of failure that is inherent to science, especially when you're young and still learning. Grad school also definitely provides plenty of alone time, especially when you've made the choices I made that left me as the only person in my particular field at my university. Together it seems like a recipe for excess anxiety.

The lesson, it seems, is that as a graduate student, we are at significant risk for anxiety related disorders--as most grad students will attest, it is a rather stressful endeavour. So, how do we deal with it? I think the key is staying tuned into the big picture, and then focusing on our work so that we're not distracted or exposed to excess negativity, which can be provided bountifully by all the favorite news sites. For me, the greatest struggle is staying focused on work and not spending time reading news, blogging, etc... hmmm. Back to work, so I can get home and increase my personal contact. : P

Why the economy is the way it is...

I think this article is a fascinating and enlightening analysis of our current financial situation, and why we got here. It's written by two professors from Chapman University, one a Nobelaurette.

Their fundamental hypothesis is that the current crash was/is the second consumer consumption crash:

"We propose is that a financial crisis that originates in consumer debt, especially consumer debt concentrated at the low end of the wealth and income distribution, can be transmitted quickly and forcefully into the financial system. It appears that we're witnessing the second great consumer debt crash, the end of a massive consumption binge."

This reminds me of my earlier post where I argued that American's spending habits, which are/were clearly out of control, would be unsustainable. I hate to echo the words of my father, but he is correct when, as a child, he lectured me that personal integrity and responsibility (which he argues arise from personal morality) are the foundation of a thriving and viable society. I think he's right. We need to start educating all American's on financial responsibility--something that should probably be included as a foundational component of secondary school.

Being a graduate student at a University that severely limits your loan opportunities has taught me this as well; in addition, dealing with debt in the past, I know what a burden extra debt can be, and what a limit it can place on one's life, both physically (can't afford to do things) and mentally (stress, pressure, etc). Hopefully, the lessons learned from this downturn will be strongly ingrained in the those of us who have been through it, and we'll pass them on to our children, like what happened in the great depression, and drove the successful building of wealth for two generations. Since history tends to repeat itself (humans are all still humans), I assume after a generation or two, this will happen again...

I guess the key lesson is the importance of personal financial responsibility--budgeting, tracking expenses, saving, living within your means. All the boring stuff that makes grown-ups lame, but also able to retire and have a roof over their heads.

Battling defeat...

Grad school, as I've mentioned in the past, has been brutal to me (although my non-scientific social polling has led me to believe that this may be an inherent part of the graduate school process). I'm batting 0.000 when it comes to finding important results or having biologically important data. To make it worse, I've had technical difficulties long the way, although, I've gotten to the point where I'm quite confident in my experimental ability. The experiments I'm doing work well technically, but the null hypothesis is prevailing.

At this point, my learning is focused on designing better experiments, so that regardless of the result, I'll produce interesting data that will move my science forward.

Meanwhile, my spirits have been uplifted as I've spent some time thinking about the concepts in the following quote.

"It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat."
-Theodore Roosevelt

This idea of trying hard, and taking pride in your effort, has definitely helped my focus. So often I've hung my hat on my accomplishments, which of course, is quite natural. However, there is a time to take pride in the effort that you made, and in 'valiant striving'. I'm beginning to also realize that there is a great deal to learn in our mistakes and defeats.

Furthermore, reframing my thought processes on grad school has also begun to help me fight off the burnout that has been coming on with a vengeance in the last 6 months. By staying more focused on the big picture and adding balance to life, I've been able to accept my struggles and thrive despite the continued uncertainty, primarily about how long it is going to take me to finish my research.

Lastly, having a very supportive partner, who makes life outside the lab wonderful, has also helped immensely. Its helped me realize the value of balance, and appreciate many of the benefits of graduate school, such as controlling my own schedule, not having pressure to be up early and having control over my work and creativity.

Budget Deficits...

In another note--while I've been very supportive of Obama, and definitely am enjoying his reinstatement of scientific input into policy, I'm quite concerned about his ability to budget. As a regular humble resident of main street, the wife and I have had to work hard to get within a budget, however, it seems that the federal government isn't quite as constrained. While it seems reasonable that some deficit spending might be needed, I get a bit worried about $2.3 trillion errors in estimates. As a future economic driver (I hope), it worries me to think about the tax rates that will be placed on my income to service these types of deficits, let alone pay them down a bit. It doesn't seem so unreasonable to me that the federal governement might face some of the same problems as the state of Califorina did if they continue to spend like this. Anyway, back to work--I mean Tournament--I mean work.

Good days in the lab...

While lab work can be frustrating and tedious...
...it sure is nice that you have incredible flexibility in your hours and work schedule. It is especially nice during the weekend of the first couple rounds of the NCAA Tournament! Definitely enjoying watching... er, following... some of the games. Oh wait, I mean, I've been rocking out on a lot of important computer work--getting my constructs in order and what not. : P You have to enjoy the perks, especially if you're going to put up with all the crap that being a molecular and cellular biology grad student incur. Also, finding interesting things that help your research while reading papers on add breaks that you wouldn't normally take time to read is totally awesome!

Grad School: The Internal Struggle

I've been fascinated recently...
...while reflecting on life events, what a contrast graduate school is compared to any challenge I've faced prior. In the past, I've always had an insane work ethic, taking on any job with my typical vigor. This has allowed me to succeed beyond even what I thought possible.

However, with graduate school, my motivation has been challenged, probably in part because of the abstract nature and creativity required to perform many of the tasks at hand. The life of a scientist is daunting, featuring such pleasantries as repeated failure, uncertain future, low reward, unclear direction and often difficult and lonely work environments. Together, these factors can combine to destroy morale and drive, potentially some of the most important ingredients for success in grad school.

To face these issues, one must first acknowledge and recognize their own weaknesses... much easier said than done. Reminds me of the scared passage, which so clearly exemplifies our natural human tendency:

"How can you say to your brother, 'Here, let me remove the speck in your eye,' when you are standing their with a plank in your own eye?"

We are so often blinded to our own issues that we never even see them. However, with enough time alone thinking and reflecting--as takes place in graduate school--these issues begin to emerge.

For me, one of the great struggles has been staying motivated, focused, and on task; refusing to be distracted by the numerous distractions that surround us. This has been especially difficult because of the lonely nature of my work... studying something only myself, and to some small degree, my PI, are interested in. Without camaraderie or a rich and engaged research environment, its hard to stay motivated and focused. After all, we are humans, an extraordinarily social species.

Yet this is the very time when character is sharpened and strengthened. Staying focused and fighting the internal distractions and the mental clutter are the very qualities that will enable one to be successful in an incredibly demanding and diverse career, such as that of a physician-scientist. Its striking to see myself facing such challenges, and seriously struggle with them. But in all honesty, what better time to build those character traits than in graduate school when you have the time and freedom to fail and to struggle.

It is a difficult time, not at all like previous challenges, which were clear-cut and physically-demanding, but rather a time where the battle is primarily internal, struggling to refine and build the character necessary to succeed in the challenges that I will face in the future.

I guess its time to embrace the journey, cause life certainly isn't about waiting for the end point.

2009... the year of change!

"There is nothing new under the sun."

Well, the recession continues! John Thain resigned today from Bank of America. Thain's quite an interesting man, aside from looking rather orange in recent photos. He led the NYSE during the boom era, and then in Nov. 2007, rolled over to Merrill-Lynch to take over as CEO, where he received a $15M signing bonus. During the 2007 year, he was nicely compensated with a reasonable $83.8M. Under his stellar leadership, the company entered the recession. Unfortunately, even with Thain's brilliance, the company could not stay afloat, and had to be bought by Bank of America. Despite that, Thain requested a $10M bonus for his 2008 performance. Outcry from the NY Attorney General and the public, led to Thain withdrawing his request. Apparently, the reason he's being fired is that he really didn't know what's going on with the company, hence the additional write-downs of $15.3B this last quarter! This complete lack of awareness led to the tension between Bank of America CEO Ken Lewis and Thain, ultimately resulting in Thain's exit. Either that, or without getting the $10M bonus, it really wasn't worth Thain's time... he'd probably rather go enjoy a massage or whatever $83.8M can buy you.

My key thought on all this...
...is the importance of doing your homework and sticking to the fundamentals. I was reading the prospectus of my mutual fund, which thankfully I don't have to retire on for at least another 40 years, and the fund executive summed it up very nicely. He basically said that financial people had forgotten the fundamental principle of accurate risk management. It's not difficult to imagine how you could turn a blind eye to risk, or not do your homework to identify risks, when you have the opportunity to make mad cash. I don't blame Thain for going big--hey, if I could make $83.8M, I'd definitely go for it--but the problem was that people got so excited about winning, that they forgot the fundamentals of the game. They 'were lookin' down field before they got the ball tucked away' (I still can't believe those Colts, amazing!). Unfortunately, we all now get to pay the price by enduring this recession. In the future, I don't think we'll see the same sorts of gains that we saw in the past because people will manage risk better from now on. I'm expecting mostly single digit returns for a long time, until people forget the fundamentals again, make tons of money, and then crash. Life has a way cycling. I guess the wise man was right when he said,

"There is nothing new under the sun."

Cynicism is so natural!

Its amazing to me...

...how naturally cynicism can come to anyone, even an optimist like I classically was, when confronted with the realities of graduate school. Imagine working away for three years, on several different projects (most failed, despite hard work), and finally finding your holy grail, the novel important finding--the illusive 'Na-cha-uh Pap-uh'. Then you can't repeat your finding. This is the amazingly difficult and absolutely humbling process that wet-lab scientists get to go through. From what I gather this is not uncommon. Furthermore, you have very little feedback throughout this process, and no definite end in sight. Its absolutely amazing how taxing this can be on one's optimism.

The contrast to medical training is sharp. Its much easier to be strong when there is an end in sight, an end that society appreciates, an end that has rewards such as a comfortable life (assuming you're comfortable working crazy hours, which you probably are if you've made it to this point). Its also something you share--you go through with many other classmates, generating a 'herd effect', which eases the pain.

With graduate school, you don't have an easy way out, there's no concrete end, until you get solid data, and you're on your own throughout the process. And if you don't get data? Well that's even worse--a PhD with no publications? What happened?... Grad school is similar to med school though, in that both require a lot of work, and emotional strength--yet they're differnet even within these similarities. The hard work for medical school is completely dictated by others--you have to be at rounds at 5AM, etc--you have no control over your schedule, whereas the hard work in grad school leaves you complete freedom over your schedule. However, if you want to finish your PhD in a decent amount of time, you'll definitely be working serious hours. With regards to emotional strength, in medical school you have to see difficult situations where people's lives are destroyed; you'll have to talk with people all day long and keep your composure in the face of significant fatigue, patients engaging in self-destructive behavior, and the like. With graduate school you have to stay strong in the face of significant failures and continual frustration. Additionally, you have to be emotionally strong in that you are the one motivating yourself--you have to be the one to push yourself. Its interesting...

...difficult as it may be, I'm certainly very glad to be here, where I have a guaranteed job through the end of my training, and beyond. Much better than struggling out in the real world during a recession.

Follow up to "Integrity" post...

So after considering for some time my rant on integrity, and the situation of external review, and talking with several professors, I think I've come to reconsider my thoughts. One professor put it best,

"You don't flaunt your internal problems to external reviewers. You deal with them internally."

This makes sense to me. Further contemplation helped me realize that this is actually much like a family, where you can fight it out like crazy between one another, but if there's ever an external attack, you stand up for your sibling, parent, etc. That doesn't mean you can't be objective, or you hide problems. On the contrary, you have to be objective, self-critical (as I am here regarding my previous post), and address problems that my be present. The key is to find the appropriate venue to address these issues. An external reviewer, who's only decision is whether or not to support you, doesn't need to hear about internal problems. In that situation, the key is to get the funding, so you have a venue left to deal with the problems. Lesson learned.

Driving us towards renewable energy

I read a CNN article proposing that we add new taxes onto gas and other fossil fuels in order to promote research and development of non-fossil/greenhouse gas emitting energy. The last few lines of the article are worth quoting:

To this last point, Rosenblum and other supporters say the carbon tax can be offset with tax breaks, like a reduction in the payroll tax.

That way, they say, the government could discourage something it doesn't want - pollution - and encourage something it does - employment - through the tax code.

Still, a carbon tax has attracted scant supporters in Congress.

When Rep. Peter Stark (D-Calif.) proposed one last year, it attracted a total of three co-sponsors among the 435 House members.

"I know it's widely popular and makes a lot of sense to economists and academics," said one Democrat Senate staffer. "But unless a member of Congress was considering early retirement, it's not an approach they would consider on the Hill. It's political suicide."

This is the problem with the way Congress works... or maybe its what the founders intended.

Money's Effect on Medicine

I read a fascinating article in yesterday's New England Journal of Medicine. Briefly, it was an essay by Pamela Hartzband and Jereome Groopman discussing the influence that they see money having on the ever evolving practice of medicine. They describe a fascinating sociological experiment designed to test the effect of money on people's behavior.

A truck was parked with a couch close beside it on a busy university walkway. The investigators asked passersby to help. When they asked them to help them as a favor, they got a good response; however, people's willingness to help dramatically decreased when they offered passersby 50 cents to help out. If they offered them a piece of candy to help out, they got an equal response to the control group that did it as a favor. They had to offer passersby $5.00 before they got an equal percentage of people to help as when they asked people to do it as a favor. (n=614)

The interpretation of the study, which is supported by several other studies, demonstrates the effect of money on people's responses. Simply put, even the presence of money in the room affects people's altruistic inclinations. The implications for the practice of medicine are quite staggering, particularly as medicine becomes more heavily influence by business.

We need to preserve the art, the compassionate side of medicine, while also embracing the reality that we are running a business. This has been a significant conundrum for medicine over the centuries. While typically history would have many lessons, I'm not familiar with a time where medicine has been as complex and expensive as it currently is. Only a small percentage of individual patients with significant medical problems could cover the true cost of care on their own. Clearly, we need some kind of cost-sharing system, but the best model has yet to be determined. I'll be following Tom Daschle's proposals on how to improve our health care system with great interest, assuming he is confirmed as HHS Secretary, which is still under review by the senate committee.

Integrity

I was absolutely astonished today by a comment from someone while we were discussing external reviews. I've always been a proponent of honesty... definitely put your best foot forward, but part of embracing reality is acknowledging and identifying your weaknesses. The only way you can improve yourself or the world around you is by being honest in your assessment of yourself. Anyway, the comment went something like this [quoting from memory],

"You know the external reviewers use 'SS' style interrogation techniques during their site visits. Be careful what you say, especially when they ask questions like, 'How would you improve your program; we can be an advocate for you.' When they do that, don't really tell them what you think cause they could use that as negatives during the review."

I could not believe the subtle dishonesty and lack of integrity that this demonstrated. Why wouldn't you be honest? I know, I know, you're supposed to 'play the game' to get ahead. How can you sleep at night knowing you're lying to get ahead. By avoiding acknowledging and dealing with the serious issues that this particular program faced, you prevent yourself from moving forward. This is serious business. These are the precise reasons that this type of grant was not funded. You can't go around trying to pull the coat over people's eyes, especially in education, or charity... even if you're as slick (and devoid of integrity) as Madoff, karma or justice is going to come back and bite you in the ass.

This seems to be the course taken by people who get comfortable. I know when I get comfortable in the lab, I get lazy, and tend to try to make everything look rosier than it is... that's my downfall, my weakness. I have to fight hard to stay focused, continue to work hard, and strive to maintain my integrity. Cheating the boss, whether a granting agency, a PI, or program director, or anyone, tends to come to light eventually. Its amazing that these values aren't taken more seriously, especially in a profession, medicine/science, that is so based on finding the truth--following the evidence. I'm appalled... but I better get back to work before I fall into the same trap myself and begin cheating my boss of my time.

American Spending

I came across this article, which I found fascinating; this, in particularly, is astonishing:

"The cutbacks by the Muirs and others their age mark a particularly profound shift. In the American buying spree of recent years, the most profligate spenders were those under 35. As recently as 2006, for every $100 these Americans earned, they spent about $117. Those aged 35 to 55 had negative saving rates nearly as large. Only the large number of Americans 55 and older, who have always had high double-digit saving rates, kept the overall saving rate above zero, according to data from Moody's Economy.com and the Federal Reserve."

I know we want to get the economy back to good, but isn't spending $117 for every $100 earned, and then hoping that your house, or your mom, or the lottery, will bail you out, utterly unsustainable? How can people expect increased spending to get us out of this recession? I know this has worked in past recessions, but as with everything, it seems we've come to a day of reckoning with regards to our spending. If American's habits change, as they are, we'll have a prolonged recession. This however, is the painful process that is needed to get us back to a healthy economic place! We need to stop overspending and learn to live within our means. While this may astonish some people, you need wealth to create wealth. The way to gain wealth is to live within your means and then use your discretionary income to generate wealth by making wise investments. This downward adjustment in both personal spending habits and overvalued assets is needed in order for our country to regain a strong economic foundation.

On a more pragmatic level, I hope my wife doesn't get laid off, cause she wouldn't be happy sharing my meager income, and we'd lose the house, and life would really suck.

Welcome one and all... or just me. : P

Welcome to my blog. I've started this blog to help me process my thoughts through writing. It gives me a chance to comment on and respond to the world around me. In this blog I will discuss my experience training in an MD/PhD program. I will also discuss the political world, from local to international. In addition I may occasionally vent the bitterness and frustration that goes along with being an Indianapolis Colts fan. Speaking of bitterness, I've labeled this blog 'Fighting cynicism, embracing reality'. I chose this label because I think that within this training experience, as well as with growing older, cynicism tends to take hold. I've been falling prey recently, and think that a healthy way of processing things, such as blogging, might help me fight the apparent inevitability of becoming a bitter, dirty old man. I'd much rather become just a dirty old man.