I'm a fan of getting my taxes done early. Way early. It helps that OSU's due date for FAFSA (Free Application for Federal Student Aid) submission is March 1 and that the FAFSA requires one's tax information from the previous year, but it's also much less a headache and source of stress than waiting around until April 15.
Apparently, most of my fellow countrymen do not share the same sentiment. The IRS is now reporting that an estimated $300 billion in due taxes goes unpaid every single year -- an average of $2680 per household. In other words, this amount is more than enough to cover the national deficit, pay for Pres. Bush's overseas mistakes, and help rebuild New Orleans. About 70% of that amount comes from underreporting on the part of individual Americans while the remainder can be tagged to businesses, both big and small.
I fail to understand the sense in this. Perhaps it's the fact that I've never made enough money in a year to require a hefty pay-in during the spring, or the fact that my parents raised me better than that (when all else fails, blame it on a good upbringing!), but it seems one of the most moronic things you can do is expose yourself to an audit that potentially could destroy your finances for the rest of your life. Don't get me wrong: I loathe the fact that we as a people allow our government to fleece us for nearly 40% of our collective income by requiring as much in payment for its below-average services, but hasn't the old adage, "Give to Caesar what is Caesar's," been proven most wise already?
Sunday, March 4, 2007
Saturday, March 3, 2007
Ohio State Beats Michigan ... Again
Since I've been at Ohio State, the three major varsity sports -- football and men's & women's basketball -- have beaten the University of Michigan like there's no tomorrow. This afternoon was no different. The #1 Ohio State men's basketball team came from behind to win its 14th consecutive game, this time over Michigan 65-61 in front of a loud and supportive crowd in Ann Arbor to finish 15-1 in conference play (the lone loss coming Jan. 9 at Wisconsin) and with a final regular season record of 27-3. The other two losses were at North Carolina (without then-injured superstar center Greg Oden) and at Florida (in one of Oden's first games back).
The question of Ohio State's recent sporting dominance over UM is starting to pop up in local indie newspapers -- "Has this gotten old yet? CAN this ever get old?" Both can be summed up quite succinctly: No. During the '90s Michigan owned OSU in football, and until the latter part of the decade the same could be said for men's basketball as well. Now the pendulum is in full swing back toward Columbus, and most sports fans in town couldn't be happier.
It would be ludicrous to expect such good fortune to last forever (next year's football game, in addition to be played in Ann Arbor, will be OSU's first without Wolverine-killer QB Troy Smith since 2003 [perhaps not so ironically, the year of Ohio State's last loss to Michigan]), but rest assured the entire state is enjoying what has been a long time in the making.
The question of Ohio State's recent sporting dominance over UM is starting to pop up in local indie newspapers -- "Has this gotten old yet? CAN this ever get old?" Both can be summed up quite succinctly: No. During the '90s Michigan owned OSU in football, and until the latter part of the decade the same could be said for men's basketball as well. Now the pendulum is in full swing back toward Columbus, and most sports fans in town couldn't be happier.
It would be ludicrous to expect such good fortune to last forever (next year's football game, in addition to be played in Ann Arbor, will be OSU's first without Wolverine-killer QB Troy Smith since 2003 [perhaps not so ironically, the year of Ohio State's last loss to Michigan]), but rest assured the entire state is enjoying what has been a long time in the making.
CAPSTONE
The "final course" of the first two years of medical school at Ohio State is called CAPSTONE, a class designed to put the finishing touches on pre-clinical medical learning and prepare the student for life in the trenches next year. Last Friday (2/23) was my class' first CAPSTONE meeting, and I left feeling absolutely stupid. The entirety of the first two years of medical school is spent learning physiology and disease states in a 'unidirectional' manner -- i.e., name of disease, etiology (aka "causative agent"), epidemiology ("who gets it?"), pathophysiology ("how does it work to cause disease?"), signs and symptoms, and treatment. I've trained my mind to work fairly well in this manner, as reading through a course packet or a fairly dense pathophysiology textbook is no longer the chore it once was.
But here's the thing about CAPSTONE -- now I have to "unlearn" everything I've learned about medicine and start applying it in reverse. Last Friday we were given six packets of patient cases; in each of these packets are summaries of four fictional patients with a wide variety of current medication lists, presenting symptoms, physical examination findings, and relevant histories. Our job now is to apply what we've learned since August 2005 and find out exactly what is causing the problem. Easy, you say? Think again.
The only analogy I can think of is this: imagine learning to play the piano without your hearing. Your ears have been plugged, and the only things you can rely on to play this instrument are (1) your manual dexterity, and (2) your sense of sight. You certainly would be able to read the music and process your visual sensations into specific finger movements after a good deal of training. That part is like being a Med-1/2 student.
Now imagine your ears have been unplugged for the first time since your piano training began -- except now your vision is taken away in return. Part of the skill set you used to learn the material in the first place is gone, and now you need to teach your ears what your eyes already knew using only the memory of movement and placement ingrained in your fingers. The only problem is that you need to do this quickly. And flawlessly. Why? Because your grade and subsequently your chance at a prestigious placement in postgraduate training depend on it. This is akin to being a beginning third-year medical student.
Ready for a breather yet?
Despite the overwhelming nature of the course, I think CAPSTONE will be of great benefit to those of us willing to take it seriously. The learning curve is steep, but in the wake of "solving" the first case (see below), I believe our group of six students has taken the first step in the process of transforming our thinking. And that is a very good thing.
Case 2a -- 3/2/2007
Middle-aged white paraplegic female with a history of breast cancer with spinal metastases presents with a 2-day history of progressive dyspnea (shortness of breath) and tachypnea (increased number of breaths per minute). Patient has difficulty completing a sentence without stopping to catch her breath and has difficulty eating and drinking. Patient denies chest pain but does have a dry cough.
Medications:
Naproxen 375 mg po BID
Percocet 5/325 mg po q6h
Duragesic patch 75 mcg q72h
Xeloda (dose unknown), per protocol
Physical Exam:
Temp. -- 100.4F (normal 98.6F)
Respirations -- 40 per minute (normal 12-20)
Heart Rate -- 149 per minute (normal 60-100)
BP -- 90/40 (normal 120/80)
Pulse oximetry on room air -- 89% (normal 99%)
Pulse oximetry on 100% oxygen -- 93%
Due to her immobility, history of malignant cancer, heart rate > 100 bpm, and increased respiratory rate, our group diagnosed this patient with a pulmonary embolism resulting from deep vein thrombosis (i.e., a clot resulting from stagnant blood in the deep veins of the patient's legs broke off from its site of formation and traveled through the venous system into the right side of her heart; since blood from the right side of the heart is pumped into the lungs for re-oxygenation, this clot became lodged in pulmonary vessels leading to the lungs and is causing her shortness of breath, increased rate of breathing, and decreased arterial oxygen content).
It seems easy in hindsight, but when first confronted with this illness script after learning about pulmonary emboli in the way described above, it was a bit daunting, to say the least. Several different diagnoses have to be considered and discarded before finally settling on the most correct one (the process of developing such a list of possible problems is called "formulating a differential diagnosis"), and eventually it will have to be done within a matter of seconds. All the possible disease states this patient could have -- pneumonia, pleural effusion, acute pulmonary edema, sudden inflammatory response syndrome, congestive heart failure, etc. -- have to be thought of, considered, and ruled out before the doctor can begin discussing treatment options with his/her patient.
I was lucky to be able to come to a conclusion after an hour of re-reading through textbooks and study guides. Your doctor is able to do this in less than 15 seconds.
I've got a long way to go ...
But here's the thing about CAPSTONE -- now I have to "unlearn" everything I've learned about medicine and start applying it in reverse. Last Friday we were given six packets of patient cases; in each of these packets are summaries of four fictional patients with a wide variety of current medication lists, presenting symptoms, physical examination findings, and relevant histories. Our job now is to apply what we've learned since August 2005 and find out exactly what is causing the problem. Easy, you say? Think again.
The only analogy I can think of is this: imagine learning to play the piano without your hearing. Your ears have been plugged, and the only things you can rely on to play this instrument are (1) your manual dexterity, and (2) your sense of sight. You certainly would be able to read the music and process your visual sensations into specific finger movements after a good deal of training. That part is like being a Med-1/2 student.
Now imagine your ears have been unplugged for the first time since your piano training began -- except now your vision is taken away in return. Part of the skill set you used to learn the material in the first place is gone, and now you need to teach your ears what your eyes already knew using only the memory of movement and placement ingrained in your fingers. The only problem is that you need to do this quickly. And flawlessly. Why? Because your grade and subsequently your chance at a prestigious placement in postgraduate training depend on it. This is akin to being a beginning third-year medical student.
Ready for a breather yet?
Despite the overwhelming nature of the course, I think CAPSTONE will be of great benefit to those of us willing to take it seriously. The learning curve is steep, but in the wake of "solving" the first case (see below), I believe our group of six students has taken the first step in the process of transforming our thinking. And that is a very good thing.
Case 2a -- 3/2/2007
Middle-aged white paraplegic female with a history of breast cancer with spinal metastases presents with a 2-day history of progressive dyspnea (shortness of breath) and tachypnea (increased number of breaths per minute). Patient has difficulty completing a sentence without stopping to catch her breath and has difficulty eating and drinking. Patient denies chest pain but does have a dry cough.
Medications:
Naproxen 375 mg po BID
Percocet 5/325 mg po q6h
Duragesic patch 75 mcg q72h
Xeloda (dose unknown), per protocol
Physical Exam:
Temp. -- 100.4F (normal 98.6F)
Respirations -- 40 per minute (normal 12-20)
Heart Rate -- 149 per minute (normal 60-100)
BP -- 90/40 (normal 120/80)
Pulse oximetry on room air -- 89% (normal 99%)
Pulse oximetry on 100% oxygen -- 93%
Due to her immobility, history of malignant cancer, heart rate > 100 bpm, and increased respiratory rate, our group diagnosed this patient with a pulmonary embolism resulting from deep vein thrombosis (i.e., a clot resulting from stagnant blood in the deep veins of the patient's legs broke off from its site of formation and traveled through the venous system into the right side of her heart; since blood from the right side of the heart is pumped into the lungs for re-oxygenation, this clot became lodged in pulmonary vessels leading to the lungs and is causing her shortness of breath, increased rate of breathing, and decreased arterial oxygen content).
It seems easy in hindsight, but when first confronted with this illness script after learning about pulmonary emboli in the way described above, it was a bit daunting, to say the least. Several different diagnoses have to be considered and discarded before finally settling on the most correct one (the process of developing such a list of possible problems is called "formulating a differential diagnosis"), and eventually it will have to be done within a matter of seconds. All the possible disease states this patient could have -- pneumonia, pleural effusion, acute pulmonary edema, sudden inflammatory response syndrome, congestive heart failure, etc. -- have to be thought of, considered, and ruled out before the doctor can begin discussing treatment options with his/her patient.
I was lucky to be able to come to a conclusion after an hour of re-reading through textbooks and study guides. Your doctor is able to do this in less than 15 seconds.
I've got a long way to go ...
Hey Coach Amaker ... Shutup!
Michigan coach Tommy Amaker was called for a 2nd-half technical foul in this afternoon's Ohio State v. Michigan basketball game; apparently Amaker was incensed that OSU center Greg Oden was not called for a foul on the other end.
First of all, if there was a foul committed, it would've been ticky-tacky at best. Second, Amaker's goons were all over Oden the entire game: he ended up with four fouls simply for playing in the same way Michigan's hackers were doing.
Next time, Tommy Amaker, do yourself a favor and keep your mouth shut. Until your verbal diarrhea, you benefited from some major home cooking and were on your way to an upset of #1 OSU. Now you find yourself not only the loser of a game you should have won, but you quite possibly cost your team a spot in the NCAA tournament. Way to go!
First of all, if there was a foul committed, it would've been ticky-tacky at best. Second, Amaker's goons were all over Oden the entire game: he ended up with four fouls simply for playing in the same way Michigan's hackers were doing.
Next time, Tommy Amaker, do yourself a favor and keep your mouth shut. Until your verbal diarrhea, you benefited from some major home cooking and were on your way to an upset of #1 OSU. Now you find yourself not only the loser of a game you should have won, but you quite possibly cost your team a spot in the NCAA tournament. Way to go!
Yarn Store Outing
Today's adventure will be to the yarn store (with Sula -- I've only made one solo trip and am frightened of doing so again) and to Kroger. I find knitting adventures to be somewhat cathartic, but I'm always able to fill right back up again with a little junk food from the snack section at Kroger.
Only three hours left in the 4th season of 24 -- terrorists have just released the warhead-containing rocket into the sky, Jack Bauer's caught the ire of the Chinese government for his attack on their U.S.-based consulate, Audrey's ticked as can be at Jack, and the Tony/Michelle tension is starting to ease up a bit. How can Jack possibly take down the rocket, win back Audrey, and save his own skin all at the same time?
After several consecutive days of near-springlike weather, a small snowstorm again blanketed the area this morning. Ahhhh, winter in Ohio!
Only three hours left in the 4th season of 24 -- terrorists have just released the warhead-containing rocket into the sky, Jack Bauer's caught the ire of the Chinese government for his attack on their U.S.-based consulate, Audrey's ticked as can be at Jack, and the Tony/Michelle tension is starting to ease up a bit. How can Jack possibly take down the rocket, win back Audrey, and save his own skin all at the same time?
After several consecutive days of near-springlike weather, a small snowstorm again blanketed the area this morning. Ahhhh, winter in Ohio!
Friday, March 2, 2007
The Strangest Film
I love the Gilmore Girls. There, I said it. Laugh, point, smirk, and whisper your good-for-nothings behind my back -- I'll just be sitting here enjoying sass and wit and pure weirdness, the likes of which you can't begin to imagine. In one of the past seasons, Kirk, perhaps the most eccentric of all residents of Stars Hollow, CT, produced and displayed a film he created co-starring the equally odd Mary Lynn Rajskub (she of 24 fame as CTU agent Chloe O'Brian). This 2-minute masterpiece is so bizarre it makes me uncomfortable and slightly hiccupish. Especially noteworthy: the out-of-place "I love you" delivered to Kirk before entering the house.
Thursday, March 1, 2007
Last PCM Ever!
Today I attended my last PCM small group ever -- patience and perseverance are not two of my strongest qualities, but somehow I managed to pool two years' worth of both into accomplishing this single task.
PCM (Patient Centered Medicine) is a class Ohio State offers in addition to the core curriculum that focuses on the doctor-patient relationship and its importance to the student. The two components of the course, lecture and small group, offer different takes on a given topic within the current subject (i.e., Ethics, Substance Abuse, etc.). The lecture component generally introduces the topic to the class, then the small group session serves to further elaborate on it in a more "intimate" environment.
I don't know what it is about PCM that bothers me so much. The facilitators have all been excellent, the material is clinically relevant, and I enjoy hearing my classmates' opinions on different -- often controversial -- medical matters, so what could be the problem? Maybe it's my own impatience shining through, or the fact that the core curriculum seems so much more important right now, or that my ISP status effectively is negated by the small group attendance policy (only one "allowed" absence per year). Whatever it is, there's a kind of je ne sais quoi about the whole affair that leaves a bitter taste in my mouth.
PCM (Patient Centered Medicine) is a class Ohio State offers in addition to the core curriculum that focuses on the doctor-patient relationship and its importance to the student. The two components of the course, lecture and small group, offer different takes on a given topic within the current subject (i.e., Ethics, Substance Abuse, etc.). The lecture component generally introduces the topic to the class, then the small group session serves to further elaborate on it in a more "intimate" environment.
I don't know what it is about PCM that bothers me so much. The facilitators have all been excellent, the material is clinically relevant, and I enjoy hearing my classmates' opinions on different -- often controversial -- medical matters, so what could be the problem? Maybe it's my own impatience shining through, or the fact that the core curriculum seems so much more important right now, or that my ISP status effectively is negated by the small group attendance policy (only one "allowed" absence per year). Whatever it is, there's a kind of je ne sais quoi about the whole affair that leaves a bitter taste in my mouth.
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