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So much stress. I have other things to work on, an apparently boundless capacity for packing my schedule, and wildly swinging sensations that I have a vibrant social life or am terribly anti-social and just want to sit in my apartment, playing Jessica's Theme and the Well-Tempered Clavier Prelude XXI. Some people have video games, I have piano music I've been working on for eight years and still haven't memorized.

At least I found a really, really good diversion this morning, which was a doctor's appointment over some whats-its whereat. Turns out that the mumble-mumble could be fixed quite easily with surgery, and it wouldn't be billed as an elective surgery because it's a matter of health and chronic pain. Two weeks of pain and forced inactivity and an additional month of delicate management, small price to pay for the ability to use tampons, not to mention I've put up with it for ten years or so already. And to phrase it as ambiguously as possible, it's not like I have any immediate plans that would be upset by lengthy convalescence. No one ever mentions these things, of course, except the occasional reference to vulvodynia, which as often as not simply implies some psychosomatic problem that could be resolved wirh proper conditioning and maybe a few romantic candles.

After the efforts I went to to avoid surgery, it seems a little ironic I'm now going to be planning my winter break around one. Still, best to pick a time I don't have to go to class or work, and middle of winter means I'm not going to miss out on the great outdoors. Still, how many other people plan their illnesses like this? I've spent quality time at the clinic every year now for the last three years, and it is ALWAYS during winter break.
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One more week of waiting to hear back about EIS (we think...there are no solid facts on this). I'm finding distractions this weekend. Shopping is not a good distraction, but going running, clearing a garden, and painting a treehouse have all worked admirably. Actually, the treehouse painting was rewarding but I'm gonna have to say, provided an awful lot of time for thoughtful contemplation. You would think I had plenty to work on mentally for school, but it's all so bound up in this application, it's not as helpful as you'd think. So I started looking at internships I could do next year, provided that I can find one somewhere I want to go. It seems that surgery and emergency medicine is not a bad combination, at any rate. Which is yay, I think. I remember wondering if I could survive a surgery residency, and an internship isn't going to be any easier. Sometimes it really is obnoxious to have a chronic disease which forces you to question your physical limitations. As I get further out from the End of Prednisone, I think I have a better idea of how hard I can push myself, and I really think I could pull it off.

I have to keep myself in pretty good shape, since my guts seem to respond nicely to that. The weird thing with Crohn's is how the side effects are worse than the disease. So if I'm exercising and eating well, I am a normal person. If the balance is off, however, I am suddenly unable to sit on a bike, I have to run to the bathroom every hour, and am in general an unhappy woman. At which point my busy life generally effects a rescue by providing me an excuse to not eat for a day. The balance seems to be most affected by too much cake and staying up past midnight. And yet! When I attended surgeries in the middle of the night for the emergency rotation, I was easily able to stay bright and alert. No gut pain that went over the threshold of noticing. So I think there's and element of adjusted sleep schedule and a huge element of whether I had drained my one-day emergency reserve.

So really, the biggest concern I have right now is my time management. I am occasionally on time. I am occasionally early. Mostly I am late. I am trying to make it more serious for myself when I am late for lectures by not attending the lecture (since the thing I hate most about being late is disrupting other people's learning and being rude to the professor). But when I am meeting groups for projects or watching movies, I am consistently 20-30 minutes late. It's like punctuality, as a concept, surpasses my understanding. I would like to be that person who is never late, who always arrives with a few minutes spare, but I am continuously baffled by this lag-time wherein I do not seem to snap into "getting there" mode until the actual time I was supposed to have arrived. And it has started to bleed into my homework as well. I swore I'd never let myself get into an essay marathon again, and then I had to spend all Friday night doing my biostats homework. Sorry to write this long rant about it, but I really am determined to figure out how to change this. It's a habit, hopefully not a character trait. I love hanging out with people who have good time management skills, since it's such a revelation to arrive on time, consistently.

I suspect part of it is always feeling I can slip one more action into the pre-leaving time. Whether it's reading two pages of a book, brushing my teeth, or the sudden urgency to clear the floor, it puts me over some indefinite time-of-departure. At this point I would be only a little late, or maybe even still on time. But there there is ANOTHER last action to perform, and then I'm late. However, oftentimes the very last action really is necessary. Grabbing my lunch. Brushing teeth. Going back in to retrieve my bike helmet, or the homework for class. So going back earlier, to the unnecessary action that in itself has not made me late. Breakfast. Book. Changing an outfit twice. Staring indecisively at the computer, trying to remember what I wanted to look up last night as I was falling asleep. The sudden compulsion to clean the sink (I have a lot of these sudden compulsions...I think that setting aside Sunday evening for complete apartment clean-down helps, since at least they are not a necessary action in the mornings then).

Or, very occasionally, writing a blog post when I intended to do my readings...
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 A few things the last few days.

I saw a guy riding by on a moped. The guy was wearing a red cape and a thong. I think it says something about the campus that there were no signs of people noticing this as unusual. You know, no pointing fingers. No exclamatory question marks hanging in the air. No one suddenly chuckling for no apparent reason (except me). 

I went to a Sheep and Wool festival today. There was much yarn! There was so much yarn that for the first half hour I was in yarn heaven, running from shop to shop in an ecstatic fervor brought on by color and texture, and the next three hours had to deal with the grinding depression brought on by three facts: 1. I do not have money to buy lots of fancy yarn. 2. I do not have time to make things with the fancy yarn. 3. I don't really like most of the things you can make with fancy yarn,


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"Snow" is a short 20-minute movie directed by Isaac Ergas, about the efforts of Dr. Snow to pin the cholera outbreak in the Soho district of London on the Broad Street Pump. I do like that they bring up Snow's experience with ether and anesthesia to explain part of his suspicion of the miasma theory of disease (It's bad air!). But. um, Hollywood treatment, wow. The guy playing Snow runs around constantly full of angst and whimpering about the pump, all on his own, getting beat up by workmen and storming into upper echelons of society uninvited. 

My preferred recounting of the cholera epidemic is the book "The Ghost Map", by Steven Johnson. He does a fantastic job of pulling together all the threads that led to the removal of the pump handle. One of those threads was the involvement of the Reverend Henry Whitehead, who knew the area intimately and was crucial to Snow's fact-gathering that led to the famous map. Another thread was the source of cholera in the well in the first place. It was true the epidemic was dying down when the pump handle was removed, as the amount of cholera in the well dropped, but evidence suggests that the well had just been recontaminated that morning. As with so many other instances of public health, no one will ever know how many lives were saved by the closing of the pump. 
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Journalism takes too much time.

Obviously I do have blog, here it is, but it's nothing like the news blog I happily worked on during my sophomore year. Ah, heady times, every day hunting down the science and ecology articles in the Wall Street Journal and anywhere else I respected, which I think restricted me to the BBC and occasional forays into the New York Times. That was a whole 6 years ago, there wasn't quite the same proliferation of high quality blogs. Plus I was a sheltered undergrad with a slow internet connection, also a major crimper of cyber-awareness. Now I am a sheltered grad, finally aware that simply summarizing issues (I had fantastic summaries though!) does not count as good journalism, unless you put a lot of time into reading point-source papers and thinking original thoughts about them. Also, you have to think of a good hook to start out with, construct a nice flow-of-ideas and finish off with a stunningly insightful and memorable ending. None of which I'm going to do here.

This is why I don't have a blog.

The Sign

Aug. 21st, 2012 12:46 pm
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Forgot the best break-up song of all!

Oddly, I never really listened to this song before, just remember someone saying "it's weirdly upbeat for a song about breaking up", and now it is...exactly where I'm at. 

I, I gotta a new life
You would hardly recognize me I'm so glad
How could a person like me care for you?
(Why?) Why do I bother
When you're not the one for me
Ooo, is enough, enough?

I saw the sign and it opened up my eyes
I saw the sign
Life is demanding without understanding
I saw the sign and it opened up my eyes
I saw the sign
No one's gonna drag you up to get into the light where you belong
But where do you belong?

Under the clean moon
For so many years I've wondered who you are
How could a person like you bring me joy?
Under the pale moon
Where I see a lot of stars
Oooo, is enough, enough

I saw the sign and it opened up my mind!
And I am happy now living without you
I've left you, o-o-Oh!
I saw the sign and it opened up my eyes
I saw the sign
No one's gonna drag you up to get into the light where you belong.


So last year I did a tarot reading for myself, and it was a little more complicated than my usual situation-problem-solution layout, with more of a focus on the relationship. The relationship was taking an enforced break while other-person was off at language boot camp anyway. Enforced breaks have been the only way I get away from the smothering influence of the bizarre mix of adoration/ignorance to admit there is a problem. Realistically, I have known on some level there was a problem since the second week I was dating him, when all my stories fled. I assumed that they would come back, but they took their time and tended to hide at the vet school, until this spring when I started traveling.

So the tarot reading happened last summer. Tarot does the same thing as therapy, which is to say it asks, "Have you looked at it this way? Does that fit your situation?" I remember two cards distinctly, one that referred to the nature of the other person and one to the strongest quality of the relationship. So other-person's card came up as knight of pentacles, which with the deck I use looks like a guy riding a snail. It pretty much translated to someone set in his ways with tunnel vision. Oh.

Surely the strength of the relationship would be a good card though, right? Right? After all there were lots of good things in the relationship. Absence of abuse. Cuddling.

Hello, card of Death. Granted, again the deck is pretty good at allowing an ambivalent interpretation, and this one was a phoenix bursting into flame, but the rationalizing mechanisms still had to kick in pretty fast. "It's 'cause we're good at...dealing...with...change?"

It occurs to me now that this was all pretty much exactly a year ago. And while I am horribly distraught---or rather, hitting mental speed bumps etc. etc. how could I do this to someone I love etc. etc. although questions remaining on that score ahem *cough* going through the unpleasant justification phase of the break-up that reflects poorly on my character--- from this vantage point, I think the greatest strength of the relationship ultimately was that it ended.

The best tarot reading of all time was one I did this spring, which played a role in convincing me to break off my engagement and may have ended the relationship outright except no one should base major life decisions on random cards. That would be crazy!

1. The situation: Two of cups, a pair of lovers. That's where I was at yep yep. Engaged and everything.

2. The problem: Hanged man, a seeing things in a new light, a shift in perspective. Spot on, cards, well done! 

3. The solution: The Tower. Strike with lightning, releasing emotion, dispelling illusions. Raze to the ground. Well. Um. That is very definitive.

So really, the question is why did it take so long to get to that point? A friend pointed out to me that my lack of distress (although not lack of wanting to talk about it incessantly) following break-up day is because I've already gone through the phases of mourning the relationship. I was in denial for long enough, that's for sure.
Anger got transmuted into irritation, some of which is still coming out in obsessive blogging, some in satiric drawings, and quite a lot of it directed at myself, because you can't blame the golden retriever for doing puppy-eyes at you. It's just the way he is, he doesn't know any better.
Bargaining was actually a huge part of summer, with counseling and a lot of "well, we'll put off the wedding for now....um, and let's not be engaged...tell you what, when the time is right, we'll get back to that question." Which was part of my mind was refusing to give up plans for future and, of course, cuddling.
Grief...honestly, I think I may have gotten this one out of the way when I was on prednisone and horrendously emotional.

Acceptance occurred last week when I got on the plane to go somewhere else, and the last bits of adoration/ignorance dropped away. Of course, I still needed a firm push from a friend to set a time for official relationship-ending talk, but that was simply so other-person can start his own mourning of the relationship. I have to say, working on essays for a week solid--it had to be done--made it easier.

And though I think I would have felt more morally in the right if I had broken-up earlier in the summer, from a logistics standpoint that would have made it way more traumatic. We were living in the same apartment, other-person was getting bummed from initial rejections of his job applications, and all plans felt nebulous and the future uncertain. Waiting two months got us into separate living spaces, got him into an exercise routine, and put him back into a social circle.

And now I'm tired of talking about it.






Playlist

Aug. 17th, 2012 04:24 pm
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You know just from looking at it...

Song                                                Artist

Poison Prince                                  Amy MacDonald
I won't by your Yoko Ono              Dar Williams
Maid on the Shore                          Jennifer Clarke Skromeda
Hot n Cold                                        Katy Perry
Ann and the Magic Gown             The Kennedys
I Don't Want You Now                    KT Tunstall
This Love                                          Maroon 5
The Operative                                  No One Lives Forever
Love Song                                        Sara Bareilles
King of Anything                              Sara Bareilles
Fairytale                                             Sara Bareilles
Free                                                    Sarah Brightman
Wicked Girls                                     Seanan McGuire
Tainted Love                                     Soft Cell
Break Your Heart                             Taio Cruz
Titanium                                             David Guetta
Lucky Ball and Chain                     They Might Be Giants
Eh, Eh (Nothing Else I Can Say)   Lady Gaga
Ready For the Storm                       Deanta
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Beginning draft:
 IN the discussion of the health care system, a term much bandied about is the private sector health delivery reform. This essentially refers to the business of medicine at the ground level, how individual clinics are run based on the choices of individual practitioners and patients seeking care. The nuts and bolts of medicine. The current system has divorced practice from financial considerations, leading to the current difficulties in establishing a cost-effective nationwide system. A team approach is needed. The fee for service in insurance program rewards inefficiency. Market forces being what they are, this leads to ballooning market prices and very little control inside or outside of the industry. Doctors who need to pay back medical school loans, people with insurance...there's a certain mentality here which does not allow for much consideration of the greater good.
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"The yuck factor informs a lot of health policy in this country." Learning today about needle exchange programs to reduce HIV transmission among injection drug users, which is considered "harm reduction". Supervised injecting facilities are a step beyond, present in countries which are not the United States. The idea is providing a safe, clean environment, an improvement over using discarded needles found in the street. From a preventive medicine standpoint, this is wonderful. From a War on Drugs perspective, this is a major backward step.
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"The yuck factor informs a lot of health policy in this country." Learning today about needle exchange programs to reduce HIV transmission among injection drug users, which is considered "harm reduction". Supervised injecting facilities are a step beyond, present in countries which are not the United States. The idea is providing a safe, clean environment, an improvement over using discarded needles found in the street. From a preventive medicine standpoint, this is wonderful. From a War on Drugs perspective, this is a major backward step.



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Running into the problem of essays and assignments piling up at the end of the session. Part of the problem was me not looking ahead in the provided material to see what might be worked on during lectures or just after, when information is fresh in my head. Part of it this time was getting overwhelmed by readings, and just when I felt caught up in one class (and potentially able to write an essay) another class started and took up my time.

So this is a note for future reference.
Work on assignments from the first day. If there's not a time-crunch that day, start and work on the final paper.
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I had so much fun describing the role of posters at conferences, I forgot my original thought, which is that there really ought to be a guide to putting together a student poster. The problem I'm running into today is that they want us to make a poster like we would if we were grown up scientists, but I'm not a grown-up scientist, I'm a transplant from vet school and journalism. As such, I have nothing to put on a poster. This will change rapidly in the next few months--I hope--but right now I'm doing, what, a meta-review poster? But because I tend to just hang onto classes by my fingernails, I didn't exactly see this on the horizon, and don't have a spare meta-review. On the other hand, I do have a dozen potential sources that I've been collecting, so I will be doing some research in addition to my frenzied essay writing.
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I have somehow accumulated four--no, five--essays that are due next week. Plus I'm flying to another city for four days, where I will presumably have a little bit of time to work on papers, but it's going to put a serious break in my workflow. Today is Thursday, which has been a decently productive day for me in the past, not quite as good as Friday. Since I'm wondering right now if I've bitten off too much, I am almost ready to start working. If I put things off for a few more days, I would be certain I had bitten off too much and would immerse myself in frenzied essay preparation. I'm hoping to access frenzied essay preparation today, for the pipe dream of finishing early.

But first I am learning how to build a poster. Posters are these excuses for scientists to get together in pleasantly distant cities like Las Vegas and San Francisco. Because all the information that really matters is on the poster, and all the posters are gathered into a big room for the duration of the conference, it's easy for the scientists to browse through, get the scoop on the newest research and (with the better posters) what the current state of the field is. And then they can go goof off for the next three days.

The brilliant part is that it's relatively easy to get a poster accepted, so there's a huge number of scientists who come to these things to "present" the poster, meaning they stand by it and talk to browsers, and then they are done. There are speakers and seminars and sometimes workshops at these things too, but thanks to the poster session, scientists can be choosy about which ones they go to and how much time they spend in other, more diverting pursuits.

So you can see, it's very important to know how to put together a poster.
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...between core product and actual product:

Coca-Cola
Actual product: Carbonated high-fructose corn syrup
Core product: Refreshing rejuvenating liquid joy

Mammogram
Actual product: Your breast in a vice
Core product: Serenity

Kotex
Actual product: Wad of hopefully sterile cotton
Core product: Tennis!

Axe
Actual product: Stinky body spray
Core product: Flashmobs of hot women 
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 ...are now "Transboundary diseases."  Sigh.
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...is marketing it as public health.

People are motivated by self-interest, and they say it like it's a bad thing. If everything we knew to improve health was marketed like Coca-Cola, though, who knows what paragon of fitness and immunological perfection we would all be! Well, actually, it would be hard to market it exactly like Coca-Cola, which after all has the advertising funds to actually buy the world a Coke.

After this morning's class, I would have said it wasn't hard to work out a public health marketing campaign. I loved the metric we were given for it, because it lets you show what the "true" goal of the campaign is, but then focuses on the "product" being sold.

1. Actual product
2. Priority Population
3. Core product
4. Position (competition)
5. Augmented product
6. Price
7. Placement
8. Promotion

1. Actual product: In terms of public health, this can mean anything from getting vaccinations to getting exercise, breast feeding, or washing your hands before eating. Something simple is best. If this were commercial marketing of soda, this would be the can of pop.

2. Priority population: The target audience. Who is gonna buy? To me, this is actually the most nuanced part of the whole process. Public health as a field focuses on the "most needy". However, the neediest are already drowning in intervention programs, busy with scraping the bottom of the barrel, and in general half-deaf to any new demands on their lives.

So we aim for the low-hanging fruit, those people who are just about ready to buy the product anyway, or who only need a little push to follow our expert advice. But wait, there's more! The demographics don't really break people into tidy groups. Age ranges only do so much, gender only does so much. So segmentation into more specific groups helps. (Woman 20-35: College students. Young professionals. Stay at home moms. Career women. Career women with kids. You get the idea) 

3. Core product: This is where the traditional public health experts get snooty (at least according to my sources...I haven't experienced it first hand), since they feel people should be doing healthy stuff for the "right reasons". Phooey. 

The core product is what people are buying into. They don't get vaccinations to improve herd heatlh, they get them so they don't miss a day of work. Kids don't go rollerblading to decrease rising trends in obesity, they do it for the cool factor--and it's fun. Women won't breast feed their babies to save Medicaid money (though it does), they do it for a special mother-child bond. And did you know you burn more calories breast feeding than during the actual pregnancy? Oh, the fun facts we learn in social marketing. 

4. Position--this is how we deal with competition. Competition is all the things in life that take time or money away from the action desired by our campaign.

It can be the internet *wave* Hi y'all!*
It can be jobs.
It can be sleep, school, relaxing activities.
Even other health needs like cooking dinner.

Again, nuance. We will return to ways to deal with the competition.

5. Augmented product: All the toys that make selling the product (can of soda, rollerblading, breast feeding) so much easier! Free entry to skateparks, pink ribbons, baseball caps, etc. Reusable grocery bags help reduce plastic bag litter.

6. Price: The price is right. Vaccinations are often covered by insurance or federal and state programs (hurray, something to use our insurance dollars!). Breast feeding: Cheaper than formula! Rollerblading...well, free skate rentals sound good. I still question if free=better sales. In vet school we are told that people who enroll in puppy classes are less likely to get rid of the puppy, because they feel they have an investment. And hands up--who goes to the gym because they're paying for it?

7. Placement: Can be surprisingly closely tied to price. Convenience is huge. Recycling only caught on once curb-side pick-up was started and let people follow their exact same routine.

8. Promotion: The smallest factor. Not that it hurts to have a marketing budget, corporations have found they can budge their bottom line a crucial percentage point or two, enough to pay for super bowl ads. But it only lets people know there's a program. All the other factors make them want to take part in it.

We hope.



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...is full of meta.

Watching the movie makes a lot more sense than reading the play.  
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I have several half-abandoned blogs scattered across the internet, and it looks like it's time to add another one! I have just gotten back from Australia and a really depressing but still very cool conference that, when not talking with great enthusiasm about causes of death in animals, talked with gravity about the serious threats to the ecosystem. Many of these threats are already firmly entrenched, such as invasive species, pollution by degraded plastic, and the oft-cited topic of climate change. The world as we know it is already farther down the path of destruction than most people realize.

This doesn't mean there is nothing to do so full speed ahead. There are many ways that we can change our behavior and the environment we live in. There will be no putting it back in the box we took it out of, but I for one believe it's worth seeing what we can accomplish together. If we can cover an entire island chain in houses in a single generation, we might not be able to turn it back into its pristine state (assuming it had one) but we had better darn well be able to coax it back into some sort of functioning ecosystem.

Personally, I like ecosystems because I think they're way more complicated than we give them credit for, and I think they are beautiful. But they are also life sustaining. And we can all agree that everyone benefits from healthy ecosystems, be it for fish and timber, clean water, or personal aesthetic.

My blog will hopefully be a first step in my own efforts to bridge the gap between what scientists discover about our world and what everybody else knows. There's a lot of challenges, though. As I see them:
1. Base level knowledge.
Most non-scientists don't know how to interpret science, because there's a base level understanding needed for critical thinking. Without understanding, there is no trust, and without trust, there's not a whole heck of a lot of learning.
2. REALLY base level knowledge.
This one varies by person. Does it really matter that everyone know how cellular respiration works? Or maybe for some people it's better just to understand food safety. No one can agree on what we "should" know, but without out some experience with basic life functions, i.e. how a plant grows from seed to plant to food, it's probably going to be hard to find common ground.
3. Incentive
I see this as a job for communication sciences. Finding the message that speaks to people is hard, and it's even harder when there's no pay-off for their hard work in listening. Anyone who has had eight hours of classes each day for a year KNOWS that listening is hard work. But there's lots of ways to get the message across. Humor is good (see xkcd.com). So is good formatting (not present in this particular blog post). My personal favorite is cake, but that one is hard to convey over the internet.)

4. New and improved information
Both ways. Effective ways to communicate...and useful information communicated. To that end, I will be practicing presentation of scientific information, the things I find. I will also give tips for scientists on how to present their information so that it is appreciated by the masses. First tip: Start a blog...

Disclaimer: I am only a veterinary medical student. I will do my best to fact check and write clearly, but I love hearing from others, so if you know the topic or think I made a mistake, let me know! 

And if you've made it all the way down here, congratulations! Help me think of a name for the sort of blog I'm envisioning, because I'm pretty sure "caprices" sends the wrong message. :)

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Hello, holidays.

I’m sorry, not tonight.
I have a headache, dear.
Yes, of course I love you. Don’t you remember the first twenty-four times? I begged you to come faster, and wanted you to last forever.
But tonight, I’m just tired.
And I have a headache, of course.
If you could just give me a few days—some breathing room, please! I know I’ll feel better, and then we can both enjoy ourselves.
Think of the tinsel on the tree! Isn’t it lovely? Let’s just enjoy it tonight, not force anything serious.
The fun is all in the anticipation anyway.
It’s just I have such a headache tonight.
It has to be tonight, doesn’t it? We don’t get much time to ourselves anymore.
I wish we had the time, though. I loved just basking in it, listening to all my favorite songs.
They used to get me in the mood for it, but recently they just sound, well, like noise. Does it have to be the same thing every time?
Yes, I know that story too. I don’t believe he got nearly as much enjoyment out of it the twenty-fifth time.
I’m so sorry to keep you waiting, but I really just don’t feel like it. I’ve got this headache, and I think there’s been too much rich food.
You know me, I like it once in a while, but this much all at once is just grueling.
I know it’s supposed to make everyone feel good and ready for more, but I think I got used to a little more simplicity. We don’t have to dress everything up every night.
You like it? Well that’s fine, then you can do some of the work for once. You go cook dinner with three courses and a different sauce for each one and see how ready for action you are after all that.
Maybe if we do something a little different this time?
Try something new?
I don’t think I want something too new—oh, but that?
You know I like a little stage play and costuming once in a while.
All right then. Oh, and dear?
My headache’s gone away.
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It rained today, which was nice, since I got to sleep in.

I came across the book "Outliers" (Malcolm Gladwell, 2008), which talks about what factors go into the success of madly successful people. I only had time to read part of one chapter (besides, it was a book in a bookstore, and I thought it might be rude to read more than that if I couldn't buy it). The 10,000 hour rule (which I think everyone has heard of except me?) is more of rule of thumb that says that it takes 10,000 hours of practice to reach mastery in a given field, finance or music or hockey. I don't think it transfers to "medicine" the same way, but I can see why some of my colleagues seem so much farther ahead than others--they are the ones who have been able to spend more time on the specific area of medicine they're going into, and are starting to reach that 10,000 hour mark.

As Ix says, I have totally mastered reading books.

June 2014

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