VAMPIRES DO EXIST - Science can explain ANYTHING!

We learned about vampires and how bruises work and human molecule rainbows in biochemistry today. I love this class.

1. VAMPIRES:

Lets start at the beginning. Humans have blood that provides oxygen to their cells so they can function. The blood has a special part that carries the oxygen, called a heme group. The heme group is composed of a porphyrin ring and an iron molecule (Fe). A picture of the home group is shown to the left!

Now for the vampires!!! When making a heme gets messed up in the body, it results in a porphyria. There is a specific type of porphyria called "Porphyria Cutanea Tarda" that is caused by the deficiency of an enzyme that builds heme (its called uroporphyrinogen III decarboxylase FYI). This disease is thought to have lead to the myth of vampires.

Porphyria Cutanea Tarda (PCT) causes a number of symptoms. Lets go through them, shall we?
(1) Fluorescent White Teeth: Uroporphyrin, which builds up because of the enzyme deficiency, is actually fluorescent, and causes bright white teeth. The teeth (and fingernails) may also turn red from a different molecule that builds up because of this enzyme deficiency.
(2)Fear of light: The build up of the partially formed heme groups causes "skin photosensitivity" or blistering and skin damage when exposed to sunlight.
(3) Drinking blood: Thats right, one of the cures for PCT is blood. Nowadays, the blood is infused, but back in the day, these people may have drank blood, because it would tell the cells to stop making the intermediates that damage their bodies.
(4) Garlic: it is believed that garlic may contain a compound that makes porphyria worse.
(5) Pale skin: porphyria causes anemia, or low blood count. This makes people pale!

Now I did some research after class and apparently the guy who came up with this theory (David Dolphin) was wrong. Drinking blood wouldn't help the disorder, garlic does not make porphyria worse, and people with porphyria don't crave blood and wouldn't know to drink it because they probably didn't know they had the disease. But its cool to think about, and was fun to learn about in class!!!

2. Bruises and colorful breakdowns
When you get a bruise, they turn all sorts of funky colors. Here is why:
First they turn red from the damaged heme from a broken blood vessel under the skin.
Then bruises turn green from the billiverdin as the heme breaks down.
Next it turns yellow from billirubin, and stays yellow for a while until the billirubin can be sent to the liver to be broken down completely.

Heme breakdown also produces purple (porphobillinogen), brown (sterocobillin, which causes the color of feces), more yellows (urobillin in urine). Its a colorful process aparently!

(also, people like to guess what disease famous people / mythological creatures have - we have so far learned that Abe Lincoln may have had Marfan's Syndrome, and that porphyria could potentially explain werewolves too. And crazy ole King George probably had a Acute Intermittent Porphyria because his urine was purple and he was crazy - both symptoms of that type of porphyria)

LIFE!

Finally an update on my life rather than something random. This is going to be a long post...

So this is a good snapshot of the last two weeks: 48 lectures, learning what a double line means in a pedigree, figuring out what my dad does for a living, getting a very white coat, and interviewing patients...about sex...


So the past two weeks we have been studying glycolytic pathways in Biochemistry, fertility and infertility in Cell Biology (my dad's kind of medicine!), inbreeding, ethics, genomic medicine, and risk for genetic diseases in Genetics (a double line on a pedigree means consanguinity - relatives having children together), and bone, connective tissue, and epithelia in Tissue Biology. Lots to learn in just two weeks. But its over, and I just recieved my third syllabus for the next test. This one's pretty hefty, but we have 3 weeks to get through it so I am feeling confident. We started two new courses - Molecular Biology and Immunology. Fun fun!

Last weekend my parents came to town for the White Coat Ceremony! Saturday night they took me and my neighbor Brian (who we adopted) out for a super shnazzy dinner at Taranta - a Peruvian Italian restaursant - YUM! The next morning we rolled into a really fancy theater for the ceremony, which was a lot like graduation, but instead of a diploma, we got short white coats. Luckily for me, Dr. Monaco, president of Tufts University (and coincidentally an M.D.), cloaked me! He's a Tufts-lebrity! Cloaking is done by faculty of the school to represent their belief that we will successfully carry on the traditions of medicine. Very exciting. We also heard an AMAZING speech from Dr. Amy Ship about the importance of humanism in medicine. To sum her up, we should fill our white coat pockets with useful tools - attention, curiosity, and compassion. She absolutely inspiring and made me feel like medicine was the right choice.

The ceremony was followed by a fancy lunch provided by the Tufts Medical Alumni Association. I got to spend time with my parents and uncle, and got to meet my classmate's parents which was really fun and interesting. You can learn a lot from someone's family! My parents also got to see some old friends from their time in medical school, which was surreal. One of my associate Deans still had a recipe that my mom gave her in the 80s! After the ceremony, Mom and Dad took me shopping with help from uncle David and restocked my kitchen!! It was a fantastic weekend and I was sad to see my parents go.

I feel the need to note my annoyance that I am going to have to wear white coats for the rest of my life. As some of my friends from Hillel@UCF know, I really despise wearing white. I guess I need to get used to it...sigh.

Below is a picture of me in my white coat with my parents!

There is no way its going to stay this white...

I am done interviewing at the residence for the elderly and am switching over to interviewing at a hospital next week. In my review, my interviewing group leader told me that I am the best at empathizing with my interviewees and creating quick bonds with them, but that I need to work on my confidence and asking questions in a more organized fashion.

I went back to Sharewood last Tuesday and learned about Case Management and enrolling people in MassHealth (insurance). I also got shot-trained, so now I can give intramuscular flu shots and vaccines. I practiced in an orange and then was certified by giving a shot to a very brave friend. I am now a useful member of the medical community. Who knows if I'll use my new skill, but I figured it would be useful!!

This past weekend I mostly just studied. The good news is that I love everyone in my class so studying can sometimes be really fun. My friend Kate and I put on a puppet show with my socks, my friend Wendy made squirell and unicorn origami, and Kostas brought us all PB&Js. Not bad for a study weekend. Also, my Annapolis buddy Emily came to town for a conference and we meandered through North Boston for the afternoon. We had beers at Beantown pub (cold Sam Adams in front of a cold Sam Adams), tried the original Boston Cream Pie at the Omni Parker House (SO. GOOD.), ran into Jeff Bridges and Ryan Renolds on the set of RIPD, ate in Little Italy (I've been doing that a lot!) and caught up on each-others lives.  I miss all of my friends all over the country and need to be better about staying in touch!

After the exam, my roommate prepared an amazing meal for twenty of our friends. Chicken marsala, pastitsio (pasta with meat sauce and a cheesy mousse-like sauce on top), and spicy raspberry chocolate tarte! Soooo delicious, especially after such a draining weekend and exam! Then we went out to a bar called Coogans to dance and celebrate the completion of test two!

I have been having a great time in medical school, but I am definitely tired a lot and there is always so much going on all the time. I am taking it easy tonight and getting back to the books tomorrow night. I needed the break. My hand was cramping from all of the typing and writing down notes and drawing pathways. I haven't even been doodling! Gasp!

Not-So-Standard Patients!

I apparently never posted this? I wrote it a long time ago and just realized I never posted it. Sorry! Backtrack a few weeks....

Life update: lots of studying. Also, ECS (eat, class, study) is more like eat, class, lunch meeting, class/interviewing/MPH class/study/HW, study, eat, study, nap, repeat. Too complicated...so from now on, ECS means all of those things. I also cook once a week, go to C-Mart (I'll devote a post to C-Mart later, be excited), run errands, and started a yoga class on Thursdays (also deserves it's own post).

My lunch meetings are a result of joining all of the school clubs and interest groups. This week I had a Family Medicine Interest Group lunch and a MERC (Medical Education Representative Committee) meeting. Within MERC, I am the class representative for Physical Diagnosis, which hasn't started yet. But I still go to the meetings and discuss how to improve classes.

As always, lots going on. I am attempting to be brief but I always have so much to tell you!!! I have 3 things to discuss:

1.) FIRST TEST ON MONDAY!!! Freak out!!! No, don't freak out, because it's Pass/Fail, so I can get a 65% and still become an MD. This is slightly concerning to the patient in me, but to me its a huge relief as a med student. Its super helpful right now because my life is super crazy and I am in Gainesville and enjoying spending time with the family too much to study...oops. Good thing I studied so much after class every day. Hopefully the hard work throughout the block will help me make it through this exam despite a semi-slacker weekend.

2.) Standardized Patient Interviews! So for interviewing class this week, we went to the Sim Lab (Simulation Lab) where we had our first SP experience. Actors come in and pretend they are patients with problems. We will be using SPs for Interviewing and Physical Diagnosis practice before attempting on real patients. SP experiences are half fake and half real, because you are (usually, not this time though) being graded for your professionalism and competency, but the actors aren't really sick. It's almost a game because the point is to ask the right questions and do the right tests to figure out the problem and find a solution for the patient. Weird. But again, this experience was just for practice. So we were told to get the CC and the HPI for the patient. CC = Cheif Complaint. HPI = History of Present Illness. Gotta keep up with the lingo!

The HPI involves asking a series of questions about the CC. The mnemonic to remember when asking questions about a new complaint is FAR COLDER, which I could explain, but 1) I can't remember all of them, and 2) its basically just questions like what, where, when, how, why, for how long, etc. But in (standardized) reality, when you just ask "Why did you come in today?" let the patient talk, then say "Tell me more about that..." the (standardized) patient will tell you most of the acronym up front. Then I can just get more info as needed without pestering them with tons of questions!!

I LOVED working with the SPs and here is a sample of the fake patients we got:

• An anxious law student with a mother with Alzheimers who isn't sleeping well
• An elderly woman with follow up for hip fracture who's husband just died. 
• A woman who is having blurry vision and has to urinate frequently.
• An 80 yr old man with a new sexual partner who wants more information on safe sex

Our interviewing group messed up a lot.  But we basically got a sample of the different types of patients we may see, and will have lessons on how to handle each type (mental health, dying, crying, sexual health, bad habits, etc.).

• Blurry vision and frequent urination (do I talk about pee too much?) is probably indicative of diabetes...
• Don't forget to ask a patient's name, and always wash your hands when you walk in the room.
• Don't try to get stubborn people to change unless they are somewhat willing to!
• With mental health issues, there are a lot more mnemonics (SIGECAPS for general mental health issues, DIGFAST for mania)

Poha Chivda and the Citric Acid Cycle!!!

Poha Chivda is a delicious Indian snack made of rice flakes, peanuts, salt, sugar, chiles, and CITRIC ACID (see recipe: http://kimberliskitchen.blogspot.com/2011/03/beer-and-poha-chiwda.html)

Picture cred to the blog I linked to above!

I am currently studying at Nami's adorable studio in the Back Bay, and I'm eating Poha Chivda (Nami calls it Ponwa Chevdra, but google says its Poha Chivda...?), and thus Citric Acid, while studying the Citric Acid cycle (part of the process that breaks down glucose into energy).

Poha Chivda is delicious - spicy (chiles), sweet (sugar), sour (Citric Acid), salty, nutty (peanuts) - what more could you ask for?

Just wanted to share!

Pathways, Pictures, Dinosaur Bones, and Mutant Sperm!

I don't have time anymore, so the blogging is declining. Med school is real now, and we have class or activities to do eight to six then I study or do more activities until midnight every night...ack. They went easy on us for the first exam I guess.

So instead of a huge blog rant, here are cool lecture pictures!!

1.) Pathways: For reference, this is what I learned in two weeks in Biochemistry, which accounts for only 1/4 of my classes. We have a test Monday on everything in this picture and much more. Plus the other 3 classes. Yay. We call these Pathways. But to me they are Pain-in-the-buttWays. This shows glycolysis (breakdown of glucose for energy), different ways other molecules can enter glycolysis, glycogenesis (synthesis of storage form of glucose), glycogenolysis (breakdown of storage glucose for energy), gluconeogenesis (creation of new glucose molecules for energy), and other related pathways. We also need to know inhibition / activation of all of these things. My favorite inhibition is the phosphorylation of phosphorylase phosphatase in order to inhibit phosphorylase. If you get that on the first read, major props.

2.) Dinosaur Haversian Systems  - Cool picture from Histology, which we call Tissue and Organ Biology (TOB) - the study of tissue / organ structures. In compact bones (think skeletons), there are structures called "Haversian Systems" that keep the bone strong and allow blood vessels to run through the thick dense bone tissues. Below is a picture of dinosaur Haversian systems. The color changes are based on which systems are  newer (darker) and which are lighter (older). The white spaces indicate where blood vessels run through. This looks the same in humans as it does in dinosaurs, and I thought it was a really cool picture (that I may paint sometime soon hopefully - maybe Monday**). Reminds me of abstract art. Somebody find the artist I am thinking of and comment, I don't have time.

3.) Mutant Sperm: We are studying infertility / menstruation / ovulation in Cell Biology, and were shown this crazy picture of defective / mutant sperm (which usually causes infertility or seriously messed up embryos). I thought it was cool, so I decided to share.

 

I hope you enjoyed my quick blog post. I promise to update on my life when I have time.

**I tend to put everything off until after the test (such as laundry and leisure and exercise). Then after the test, I am too tired to do anything and end up being a vegetable in bed all day. This Monday (test two) I plan on watching Glee, painting, cooking, doing laundry, cleaning my room, and doing MPH hw. The likelihood that I will do anything other than watch Glee is very low...

Interpretations and Muffled Noises

After the chaos of post-test celebrations, things returned to normal - eat, class, study, sleep. I am trying to add in some fun and some exercise for mental health, but its proving difficult. I did work out yesterday, though!!

So anyways, on Wednesday, I had my first Problem Based Learning (PBL). We had an introduction lecture on PBL last week that was sooo awesome! The professor used every type of teaching method possible in one hour, and had a glowing fluorescent disco stick that he used to encourage us during the lesson. He was also wearing a bowtie and a cowboy hat when we walked in. He had my classmates dress in different hats and write things on the board and shout out answers and more. It was my favorite lecture so far, and was a great way to lead into PBL

So PBL is basically a small group (5 first year students and one 4th year facilitator) where we slowly make our way through a clinical case and stop every few lines to discuss:

1. What we know (from the case)
2. What we want to know (questions we want answered based on what we know)
3. Problem List (known medical problems in the case)
4. Hypothesis (guesses of what the medical problem is)
5. Learning Quesitons (questions to look up to make solving the case easier)

So from a case on a 6 year old male presenting with fatigue, bleeding gums, and a sore throat our hypotheses were scurvy, overbrushing, a viral or bacterial infection, a clotting / blood disease, and an autoimmune disease. We later found out that he had petechiae all over his body, and we aren't allowed to look up what it is until next week. It is hard not to skip ahead to find out whats wrong with our poor patient, but it is cool to come up with different ideas, questions, and thoughts based on very few details and then more and more as we go along.

Throughout PBL we will have 6 cases. We can go through them as slowly or quickly as we want, and every week we each have to chose one or two Learning Questions to present in the next session. The facilitator just keeps us on track and encourages more questioning and thoughts. And the process is not about finding the exact thing that is wrong with the patient, but to come up with creative differential diagnoses and questions that we should ask when presented with certain things. I love PBL, and can't wait to find out what petechiae are. I'll keep you posted!

On Thursday I had interviewing yet again, back at the home for the elderly. This week we worked with interpreters, and for the first time had to do AN ENTIRE MEDICAL INTERVIEW. Which includes:

Chief Complaint (CC)
History of Present Illness (HPI) - What, Where, When, How long, Why
Past Medical History (PMH) - hospitalizations, surgeries, chronic illnesses, OB/GYN info, prevention
Social History (SH) - home, work, sex, drugs, smoking, alcohol, seatbelts, guns, violence
Family History (FH) - family members with diseases

Its a lot to remember, especially when you are trying to listen to the patient's answers and store the information to put in the chart later! ACK!

But using an interpreter was cool! We were instructed to set up with the interpreter next to us and the patient in front of us both. We were told to look only at the patient, and speak directly to the patient despite having to use the interpreter. We were also told to never speak only to the interviewer, and to assume that the patient can completely understand us (no side convos!). It was hard to listen to one person while staring at another, but I think it really made the person I was interviewing more comfortable. She was an adorable 72 year old Chinese woman who gave us all grapes and had very few health problems.

I did not study enough this week and am 8 lectures behind. Thats 16 hours of work. EESH!!!

PS: I got my stethoscope!! Its purple!!! I can't hear anything I'm supposed to yet, just a bunch of muffled noises...but its pretty cool and I can at least look official now despite the fact that I still know nothing of significance. Other than some really weird rare diseases and a lot about Trisomy 21 (Down Syndrome).

Annnd an awesome package from my old coworkers at AACPS!! Thank you so so much to those of you that contributed, I absolutely LOVED it!!

The First Test

After a long weekend of family time and attempted studying in Gainesville, an anxiety-ridden delayed flight to NYC on 9/11 and a race to catch my connecting plane to Boston, I made it back at about 12:30am to take some practice tests. I got to bed around 2am, and woke up at 7 for some extra study time.

The exam started at 8:45. My roommate's pre-test ritual is to play opera music, so we jammed out and got excited. She apparently loves test days. I think shes crazy! She got all dressed up, so we walked to class together, her in her adorable outfit... and me in a sweatshirt and yoga pants. Most people looked less frumpy than I did, but I was comfortable so whatever.

My assigned seat was luckily near where I normally sit sometimes, so I took my seat and we began. My roommate, I am proud to say, was the first to finish! I actually got out of there pretty fast, too. I didn't check my answers - I was too tired and second guessing usually just messes you up in the end. Then I went home and took a two hour nap, which I will be adding hours to as soon as I am done eating lunch.

I am pretty sure I passed, but I got a little annoyed at some of the genetics questions so I may not have passed the genetics section. Either way, the questions were fairly reasonable considering the material, and I am DEFINITELY changing my study plan because I was overdoing it before.

Most of my classmates are at "The Tam,"which is a bar thing near my school where people go after exams for some drinks. I am too tired to go, so I will have to ask them how that Tufts tradition is. Tonight we are celebrating the end of the exam at "Sissy K's" with karaoke and dancing. The second years planned the festivities for us (they are so sweet!) Sounds fun and hopefully I will be less tired by then and ready to party!

Patients Acting Standard

First off - TEST MONDAY!!!!!!!

So for interviewing class this week, we went to the Sim Lab (Simulation Lab) where we had our first Standardized Patient (SP) experience. Actors come in and pretend they are patients with problems. We will be using SPs for Interviewing and Physical Diagnosis practice before attempting on real patients. SP experiences are half fake and half real, because you are (usually, not this time though) being graded for your professionalism and competency, but the actors aren't really sick. It's almost a game because the point is to ask the right questions and do the right tests to figure out the problem and find a solution for the patient. Weird. But again, this experience was just for practice. So we were told to get the CC and the HPI for the patient. CC = Cheif Complaint. HPI = History of Present Illness. Gotta keep up with the lingo!


The HPI involves asking a series of questions about the CC. The mnemonic to remember when asking questions about a new complaint is FAR COLDER, which I could explain, but 1) I can't remember all of the questions, and 2) its basically just questions like what, where, when, how, why, for how long, etc.

But in (standardized) reality, when you just ask "Why did you come in today?" let the patient talk, then say "Tell me more about that..." the (standardized) patient will tell you most of the acronym up front. Then I can just get more info as needed without pestering them with tons of questions!!

I LOVED working with the SPs and here is a sample of the fake patients we got:

• An anxious law student with a mother with Alzheimers who isn't sleeping well
• An elderly woman with follow up for hip fracture who's husband just died. 
• A woman who is having blurry vision and has to urinate frequently.
• An 80 yr old man with a new sexual partner who wants more information on safe sex

Our interviewing group messed up a lot.  But we  got a sample of the different types of patients we may see, and will have lessons on how to handle each type (mental health, dying, crying, sexual health, bad habits, etc.). Also, all of the Boston schools share SPs, and they are super good actors. The anxious guy was so convincing. I love when they break character at the end and give feedback as themselves and you see how well they were acting like the patient! So here are a few things I learned:

• Blurry vision and frequent urination (do I talk about pee too much?) is probably indicative of diabetes...
• Don't forget to ask a patient's name, and always wash your hands when you walk in the room.
• Don't try to get stubborn people to change unless they are somewhat willing to!
  
• With mental health issues, there are a lot more mnemonics (SIGECAPS for general mental health issues, DIGFAST for mania)

I had the anxious patient and the diabetic for my two interviews (each 15 minutes long btw). I got great feedback - I apparently ask a lot of "multiple questions" Like "What is the pain like? Is it sharp or dull?" I should only ask one at a time, because multiple questions stress out the patients and they forget parts of the question(s).  I am great at creating rapport with the patients, and am a great active listener. I sometimes lose track of the point of the interview, but its ok because its usually to chat with the patient about their interests.

We didn't have any solutions for the problems because we haven't been trained on what to say / advise in these situations (yet), so the interviews were slightly awkward because we just asked a lot of questions and then didn't give advice. But I loved the experience and although in the future my experiences will be tested (aka way more stressful), I like working with the standardized patients!

I wanted this post to be way more entertaining, but I'm tired and don't have the energy to go back and make it clever, so it will have to do. Sorry!

Pee Drinkers

If that title doesn't catch your eye, nothing will... This week is going to look a lot like eat, class, study, eat, class, study, meeting, class, study, eat, sleep (instead of GTL, the med school routine seems to be ECS - eat, class, study although some of my cooler classmates do go to the gym every day!). So instead of writing about class, I will tell you the weirdest / most interesting thing I learned, and then I will update you on cool things as they happen. No more day by day reports, because its going to look like ECS and thats just super boring.

So last week we were discussing birth defects in Genetics and got to talking about sequences. A sequence is a disorder that is caused by an initial problem that then causes other mechanical problems during the course of a fetus's growth / development. Like a small chin will cause a tongue that is too far back and that will cause a cleft palate, etc, etc, etc (aka Pierre-Robin Sequence).

But more interestingly, Potter's Sequence (also - gotta love the name even though the outcome is pretty sad) is when a developing fetus's kidneys don't work properly. Because of the kidney problems, these babies don't urinate enough, (and here's the craziest part) so they don't produce enough amniotic fluid. That's right, amniotic fluid is mostly FETUS PEE! It gets crazier. Because there is too little fluid, the baby isn't protected and becomes smushed (flat face, flat ears, clubbed hand) and the baby doesn't swallow / breathe in enough fluid so their lungs don't develop properly. Thats right, not only do we float around in pee for 9 months, we also DRINK AND BREATHE IT IN to develop our lungs and help with our gastrointestinal tract! I had no idea! I don't know what I thought amniotic fluid was, but I wasn't about to guess that it was part pee! Maybe you won't be as surprised...but it sure is interesting!

I am sad to report that Potters babies don't usually survive. Very sad stuff... I wish my fascination was with something happier.


But anyways, now you know - everyone was at some point a Pee Drinker. And you should be thankful that you drank / inhaled your pee successfully!

So you just learned 2 of the ~80 diseases that were covered in the last two weeks of medical school (I made a list!).

Not to mention those diseases were just quickly touched on while discussing cell components, transcription (DNA --> RNA), translation (RNA --> protein), protein structure, protein-DNA interactions, genetic diseases (Mendelian, non-Mendelian), genetic testing, prenatal screening, birth defects, and more.

But guess what - I FINALLY CAUGHT UP WITH LECTURES! Woot!!

The Very Complicated Joke

Thursday was pretty standard. Class in the morning followed by interviewing in the afternoon. The tenants we interviewed were INCREDIBLE and had amazing stories. Can't really say more than that, but I loved hearing their stories and could have listened to them all day. A lot of people went out for Tapas, but I stayed in to rest my foot and got a ton of studying done. I also met more neighbors - the Dental Students have finally arrived! There is a D14 who lives on my floor and he plays piano and mixes beats. Hurray for more friends!

Friday I had morning classes, then studied in the afternoon. That night I went to Hillel for a rooftop happy hour. We ate sushi, drank wine and beer, and played Jewish geography (what Jews do you know - oh I know them too!). As dorky Jewish medical students, we managed to mix class topics into socializing. When discussing how Judaism passes on through the mother, a classmate said "Must be a mitochondrial gene!" (***see the end of the post for an explanation if you don't get it!). The view from the rooftop was incredible. Boston is such a beautiful city, and watching the sun set from a rooftop with a bunch of my friends was a great and relaxing way to end the week!

I decided to give myself a day off on Saturday so I bummed around my apartment in the morning and then went to lunch with a friend from HS who is in her second year at Harvard Law. I took a nap in the afternoon, had a great phone convo with my mom, and then went to Wendy, Audra, and Becky's (WAB's) house for a potluck and a party. I made Trader Joes cornbread (always a good idea - thanks Mom!) and pigged out on the delicious food that everyone brought - YUM! There are going to be weekly potlucks and I'm excited to be friends with people who like food as much as I do!

Finally a short post!

***Explanation of the mitochondrial gene comment: I tried to explain this as simply as possible, but it was actually really difficult to do. I made it as basic as possible, don't be offended I wanted to make sure anyone could understand. Skip to the last point if you understand how babies are made and know how cells work...

1. More religious Jews only consider a person Jewish if their mother was Jewish.
2. Sperm and eggs are cells that mix together into one cell (zygote), and then that cell divides a lot and eventually becomes an embryo, then a fetus, then a baby. (pretty simple stuff, but again trying to cover all bases)
3. Cells have nuclei which hold the genes that are like the architects that plan how you will turn out. They also have other cell components which are like the construction team that puts everything together.
4. Mitochondria are a type of cell component (construction team) that have a little bit of their own genes (architects). They make energy for the cell and their genes tell them how.
5. The egg is a lot bigger than the sperm, so the sperm are mostly made up of nuclei, and the egg has a nuclei and a lot of other cell components, so when they mix together, the egg gives the zygote all of it's mitochondria. So the genes in the mitochondria only come from the mother, but the genes in the nuclei are a mix of mom and dad.

Soooooo...the joke is saying that because Judaism passes only through the mother, it must be a mitochondrial gene because those are the ones that only pass through the mom. 

Here is some more info from Wikipedia - Click me!

And here is a simpler explanation, skip down to "What is a mitochondrial disease?" - Better Source than Wikipedia - Click me!

Painful Learning and RICE

So Sunday was great, and Monday was great, and then Monday ended...and things have been a little less great, but I am trying to complain less in my life, so I will just say that things have been more challenging, which isn't a bad thing, just different!

I woke up Tuesday with a headache and on the walk to class noticed my left ankle was hurting when I stepped down on that foot. It got worse throughout the day, and since then it has maintained a constant state of dull pain when I walk or move it. Not very fun. My Dr. Mom told me that its sprained and I don't need to go to the other, less biased doctors. Hopefully she's right, and luckily, my ankle pain is a learning opportunity. So my treatment is RICE. No not the delicious white part of sushi, but...

Rest - Ice - Compression -Elevation

...RICE! So I have been RICE-ing my foot and trying not to walk much. Small problem - I live in a city, and my feet are my main form of transportation. I have only been walking from home to school (<2 blocks) and from the first floor of school to the library and back between classes and events, but even that is too much and by the end of the day my ankle is in bad shape. Ouch!

I have also had a hard time studying lately (lots of distractions and things to think about), but managed to put in a good number of hours and am only 3 classes behind as of this evening, which is pretty good considering one days worth of materials is about 3 - 4 classes, and each class takes about 2 hours to go back over. Also, based on classmates questions during study sessions, I am actually absorbing information!!! Yay!

BACKTRACK: So Monday we had our first Medical Ethics class. Luckily I was sitting next to my Philosophy Minor / genius friend Tim who helped me follow along, but all I learned during the first half was that medicine is exclusive and I need to join the club. Oh and that "our competitors" AKA chiropractors and naturopaths are fun to laugh at and that I am supposed to hate lawyers. I am not sure if my professor was trying to make a point or if he was serious, so I will reserve judgemnt. The second half was much better and I learned about Tuskegee, Mengele and other unethical studies, and we discussed some hypothetical situations (ex: woman with HIV doesn't want to tell the father of her child why the child needs medications) and how to potentially go about them. I also skipped a class to get a cold Sam Adams in front of a cold Sam Adams with Tim (Beantown Pub is in front of Sam Adam's grave) and watched the lecture I missed online - pretty awesome! But I still think I'll go to class...most of the time anyways.

Monday night my weekend guest departed and my fabulous and talented roommate cooked dinner for me and 10 of our friends - peppadew's stuffed with goat cheese, a caprese salad with a twist (tomatoes, basil, mozerella, balsamic, watermelon, and cilantro) and chicken tikka masala. SO. GOOD. After the feast, we played some games and Nami and I danced to Kesha / Katy Perry!

Tuesday is my long day, so I went to morning classes, went home to rest my foot during lunch, and then went to my MPH evening class. We had to take the Myer's Briggs again - now I am an E-N/S-F-J, (extrovert, equally intuitive/sensing, feeling, and judging). If you don't know what it is, here is a link to take the test, and from there you can find info (take it first though, and tell me what you got!!).

Myers Briggs Test - Click Me!

We also discussed techniques for working in teams while brainstorming solutions to obesity and had a guest lecturer speak about the "One Health" concept - how veterinary doctors, medical doctors, and environmental scientists should work together to solve public health issues.

Today I had class, studied, and then went to a Nutrition and Motivational Interviewing Training put on by TONE (Tufts Outreach for Nutrition Education) so that I can go out and discuss nutrition in the community.

Again I feel like it should be Friday, but its only Wednesday. I think medical school is just going to go by as one exhausting long blur of studying and activity. But I am learning so so much and getting great experiences already. Lets just hope the rest of the week is a little less painful and that at some point I actually catch up with my studying...