Fat in Baltimore

November 24, 2007
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It was wonderfully crisp outside today, these past few days (Thanksgiving, Black Friday, Recovery Saturday) have sort of ushered in the holiday season. I am not really into Christmas decorations, and I think the reason is because I believe that are too much work for what they are worth. Is that laziness or does this show some kind of intelligence for not being easily entertained by patterns of light?

So anyway, this season leads to tremendous amounts of eating, and I am making a concerted effort to control the amount of food going down my gullet. I broke my self-imposed calorie limit of 1,596 today because I was tricked into going to California Pizza Kitchen in the inner harbor. It’s okay though, I am within the healthy range of the much disputed BMI, even though I still feel fat. I want to reach the lower end of the BMI, so I’ve been exercising and controlling the amount of food that I eat. Don’t want Type II, cardiovascular problems, or cancer.

So even if I am not considered obese, 25.8% of the residents in Baltimore are obese, and we are tied for 13th with Nashville. Forbes discusses what each city is trying to do to curb their high levels of obesity, which again, to be fair, are based off of being above a BMI of 30. And we’ve all heard about BMI’s failure to discriminate healthy individuals from morbidly obese ones.

Issues like safety, poverty and food access have contributed to the obesity rate in Baltimore, which edged to 25.8% last year, a slight increase from 2005. Various groups, including the Baltimore Neighborhood Indicators Alliance and the Baltimore Neighborhood Research Consortium, are leading efforts to understand what aspects of neighborhood planning best contribute to healthy communities.

Well, at least there is a program. I am starting to respect Baltimore more for at least trying to do something (hooray). If you’re out by the Beltway, you do not really hear about the efforts Baltimore is making to turn around. It is stunning how little the public knows about nutrition and exercise, but I am not so surprised since even people with terminal degrees in their fields can not know a single thing about what they are supposed to put in their bodies. Other cities are implementing programs, and one part of L.A. is even going as far to limit the number of restaurants in a certain area to stem the tide of obesity. I do not think that this plan will work very well since L.A. is the prime example of unwalkability — people will just drive a couple of minutes further to get the specific type of life-threatening meal that they desire, the trick is to educate them enough so they feel guilty about frequenting such places.


Posted in Baltimore, Maryland
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PG County is fashionably ushering in a new era of public health

November 19, 2007
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“The goal is to get the kids in school”

So in D.C.’s backyard, Prince George’s County, my birthplace, there was some controversy after a circuit court judge sent a letter to the parents of 2,300 children demanding that they they produce records that their children have been vaccinated or face fines and up to ten days in jail.

This is not like this is Gardasil (the HPV vaccine) in which (unfortunately) parents in the United States believe that it will give their daughters license to fuck at will. It’s chickenpox and Hepatitis B. People trying to ride on the public immunity that the rest of the public has from actually getting vaccinations are endangering their children. How? For instance, if they contract chickenpox as an adult which is much more likely to cause complications, or somehow contract hepatitis B — whether from intravenous drug use or having sex with someone who is infected. These people are afraid of something where the risk of harm is extremely low.

People have been confusedly blubbering and complaining, “where in the constitution does it say you can force a needle in my poor child’s arm?” Methinks it’s the 10th amendment, and maybe a small treatise of laws regarding public health –IANAL so do not quote me on that. I doubt that most of the parents are anti-vaccinationists. The Washington Post had another article yesterday detailing Saturday’s mad rush to the courthouse to get vaccinations or show proof that their children had already obtained them. It seems that much of the cause of frustration was the paperwork. Parents felt like they were being accused of poor parenting, the works. Whatever the case, they reduced the number of unvaccinated students to 939 — a big improvement. I vote yea to this scare tactic. Now that PG’s got the students in their chickenpox and Hep B free schools, the county should be obligated to do better work in educating these students. We do not have a vaccine for poor SAT scores and high dropout rates.

Inhaled Insulin

November 19, 2007
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The New York Times has an article about Alfred E. Mann, a billionaire who has a lot of money to spend, but he’s spending it on something I think is worthwhile. Pfizer created an inhalable insulin drug called Exubura and put it on the market earlier this year. On October 18th of this year, they decided to pull it off the market, because in their words from their website:

“This decision was not based on any safety problems with Exubera. Exubera is a safe an effective medicine and the feedback we had from Exubera patients has been very ositivy. However, Pfizer has made this decision because too few patients are taking Exubera and, since there are other medicines available that lower blood sugar, Pfizer will stop providing Exubera.”

So this is unfortunate, Pfizer looking to make money as blatantly as this. However, Mr. Mann is investing in his own pharamaceutical company in the hope that they can design a better inhaled insulin drug, they’re calling it Technosphere Insulin. Unfortunately, that sounds like something out of the 80’s.

Type I diabetes (formerly called juvenile-onset), the diabetes in which insulin needs to be injected two or more times over the course of a day, needs higher amounts of insulin, due to the pancreas shutting down. Pfizer’s Exubera worked pretty well with Type II diabetes (formerly called advanced-age onset), which is where the pancreas still makes an adequate amount of insulin butthe cells of the body have developed a resistance to it. Perhaps Technosphere Insulin can do a better job. Mann’s company, MannKind, claims that it works more quickly than previous products.

One of my friends is worried that her father is going to develop complications from his Type II diabetes because he fails to stay compliant with his treatment, and with good reason. Non-compliance is one of the biggest current problems with diabetes, with potential complications leading to coma, blindness, amputations and death. Many of the patients hate the management aspect of the disease: the daily pricks on the finger, the worrying about what you’ll eat, any perceived stigma about being diabetic. Unfortunately, the risk of developing complications seems to be tied to income and educational level. More has to be done to educate the general public about it, and I’ll be going on several rants about it

Lecturer’s License

November 15, 2007
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The best answer in the world is I don’t know.

So many questions in the world are safely answered by I don’t know. Safely does not equal satisfactorily, especially to intelligent human beings.

Philosophically, we don’t have the greatest idea about things that may currently seem so commonplace. For example, the chemical bond. With current methods, we can’t actually visualize them. Thanks to Linus Pauling’s calculations we can predict them. And math usually does an excellent job of telling us what’s going to happen, to a first approximation.


In a lecture the other day about protein structure, the lecturer railed against Pauling’s later stages of quackery, but failed to mention the incalculable number of contributions to nearly every conceivable scientific field that he was able to make over his short (90+ years) life.

Now these medical students who take everything these professors say to heart will now associate quackery with Pauling. They’ll “know” that Pauling wasn’t helpful.

How much do we know because of him? A lot. Just because he went overboard with Vitamin C’s efficacy and potential use doesn’t disqualify everything that he did beforehand. In general, this is the reason why people should try to present the complete picture, especially with facts. Things that are known, whether about human beings or science can be misconstrued far too easily with just the correct wording. We should be left to form our own conclusions. Please allow your listeners this pleasure if you have the gift of informing people (Except with politics, do whatever you want, ad hominem, accusations of adultery — that’s a different game).

A Baltimore hall monitor

November 13, 2007
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Walking through Baltimore, I find myself judging people and speculating on their nature in this world, trying to predict what they’ll do, where they’re going, why they’re doing it. Up until now, I reserved judgment only for people who had caused me harm, whether it was making fun of me, being mean to me, etc.

Walking through other cities does not elicit this response from me, but I conceive that the vacation effect is a big part of it. The only reason that I am judging people at such a rate is that I am depressed because of events in my life that also happen to take place in this city. For example, my involuntary celibacy due to the rigor of my self-imposed daily autoflagellation via studying. The incessant crime reports, and they’re the crime reports that I nonchalantly forget about, because I live here, and the dreams of going to a school in a perhaps more care-free zone.

Walking in Minneapolis (probably 1 million times safer than Baltimore) was carefree. I had intense amounts of work to do, but I was carefree. Things were in general cleaner, prettier, and newer. Baltimore has to deal with the fact that it is a city that died in the 1980’s and is slowly trying to recover. There are construction projects left and right — every day there are articles about Baltimore’s revitalization and efforts to make the city a place to want to come to, a place that you want to raise your kids, a place where you want to walk a few blocks to get to the bank.

On a given eight block walk, I will probably be asked for money eight times. I do not know how I feel about this. Most of the time, I do not have cash, which in reality is a dumb thing to do in a poorer city like Baltimore, where vendors are less likely to accept credit cards. If I have it to spare then I’ll give it to them, but I cannot help but wonder what they are going to do with the money. I’ve heard it all in the past few weeks, from “I just got out of prison and I need to take a train home tomorrow,” to people prefacing it with “I ain’t broke man but…” My friends tell me stories about their parents who immigrated here, and how the parents behave once the family visits the country of origin. One of my friend’s mom is quite vicious to the beggars, because she feels that she knows the name of the game that they play. My friend’s father is more apt to help them out, because pennies to us is a week’s worth of sustenance for them, even if they are playing with our heart strings by doing a masterly begging performance (they have to).

On a walk I think about all that I have, and how I wish I could have more – then I glance 100 feet ahead and see the homeless person attempting to make eye contact with me. I am rarely bold enough to look them in the eye, because they remind me of how much I can disappoint myself – and how lucky I am that I have the ability to be disappointed in myself.

Posted in Baltimore

My pledge to not follow Terrapin sports for at least the next thirty years

November 11, 2007
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I never really understood the alumni connection to a university. I’m probably just very jaded, and maybe I will come to regret this pledge. I was a Biochemistry major stretched too thin, and the the unfortunate circumstances of 2003-2007 did nothing to activate my love of Maryland football and basketball. and perhaps I will have to duel myself to regain my honor, haha.

Anyway, I don’t care. Even if my future wife is an enormous fan, she will understand that I do not give a damn.

It’s more than just being a person tinctured with venomous hate for his own alma mater, though. The NCAA has created a system of whackiness like the BCS and the way that money gets distributed to the coaches that perhaps I will expound upon when I feel a bit less lazy. Most of my dislike for it has to deal with the fact that it is such a weird reason to get young adults to attend a school. It’s also a weird way of allowing students to get a free ride. The only plausible argument is that it works to build community, which is dubious because of the high number of schools that seem to do fine without sports every which way. For students to pin all of their hopes in these athlete-student (99% athlete) hybrids is a little sick. We’ll fix this problem America.

Open your mind, you see the circus in the sky

November 11, 2007
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On Friday during a cordial discussion with my contemporaries, I made an off-hand comment about seeing patients in the hospital, regarding me coming to the realization that the majority of the patients really are in the hospital for things that they have done to themselves. They can show you all the statistics in the world about preventable deaths, it doesn’t strike you until you ask a patient how long they had been addicted to a certain drug. One of my colleagues (I’ll name her Of-Baltimore, OB) proceeded to lecture me about being aware of people that are different than I am. I rarely procure this type of reaction, and it was refreshing. The method by which she tried to show me my so-called prejudices grated me in such a way I became something that I rarely am, defensive.

I found myself trying to defend my comments against OB, whom I severely doubted had a better grasp of the world’s differences and the differences between human beings, although I did concede that she did understand Baltimore’s issues better than I had. She grew up here, mere blocks away from the hospital, and I had grown up in my cushy D.C. suburb, speculating on which city was more terrible, Baltimore or Washington. In general I would always play devil’s advocate about Washington, D.C. and espouse its wonderful characteristics, but Baltimore I would unfairly mentally incarcerate and incinerate.

All things considered, OB probably lectures several people a week about the good characteristics and bad characteristics of Baltimore, which to its credit, has more of the former than the latter. She recommended that I read The Corner, which of course I feel obligated now to read since it was the second time in a week that it was lorded above me and to me as Baltimore’s bible.

OB’s Baltimore lecture to me really didn’t do anything to educate me about Baltimore, but I think it did do two great things. She broke through any prejudice I may have had about a person in medical school who claimed Baltimore as their hometown. From undergrad I had learned to assume that they were from Towson, or Lutherville, or anywhere else in Baltimore county. I qualify this as a person from medical school, because all of you may be thinking due to Baltimore’s demographics, she’s probably African-American, like me, but no. She’s Irish-American, which probably led to my initial grating against her light haranguing. Anyway, she showed me that she was much more sensitive to subjects like this, which is a relief. She at least temporarily stopped my encroaching jadishness against patients, the United States, and the world. So, thank you OB.

Focal Point

November 7, 2007
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One of the things about making it in a post-graduate education is realizing the amount of information that they will attempt to pour inside of your head. I think one of the ways that I remember things best is to write about it, and then write about my thoughts on the subject. Some lucky (or unlucky) people do not have to worry about trying to fit things inside of their head because they do not have to even try. Their brain does it for them, no questions asked.

This article from last year from a group at Washington University in St. Louis confirms this — that people’s brains and memories are indeed different, and some may more successfully pursue certain careers than others.

That last part I inferred but hey.

Their key finding was that people who utilize visual inspection strategies (for example think about every inch of Charlize Theron’s body, I know you can), or people who utilize verbal elaboration (i.e., this blog [for me], sentences that you construct on your own) have better memory performance.


I want to reiterate that this is just memory. This doesn’t necessarily mean you are worse at understanding a blueprint of a skyscraper than any engineer, you can understand it just fine, but you’ll have to carry it around with you a lot. Unfortunately, using references in live situations is sometimes frowned upon. This is why you are not allowed to use your TI-83 on your damn Calc 2 final.

Those who utilize verbal elaboration more often tend to be more left anterior brained (they determined this using fMRI), and the visual inspection people are more left posterior brained. The group eventually wants to slow Alzheimer’s progression, which everyone alive probably thinks sounds like a superb idea.

How to look like a psychopath

November 6, 2007
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Wired has an article about Hans Reiser, the man who’s company invented ReiserFS. ReiserFS is a decent filesystem that you’d only be familiar with if you run a machine with a flavor of linux on it. He is being accused of murdering his estranged wife, whom he was going through a terrible divorce with.

The thing I like about this case is that Reiser’s intelligence is being used against him. i.e., He enrolled in Berkeley THREE YEARS AHEAD OF HIS AGE GROUP, WTF HE MUST’VE DONE IT. I admit, he does a good job of looking like someone who looks like he could get away with murder. And his freakish ability to memorize large amounts of information will certainly scare the jurors, because if there is anything that United States citizens fear, it’s people with brain…talent. This explains the president we have had for the previous seven years.

Reiser is arguing that his wife is probably still alive somewhere in Russia. One of the wife’s ex-lover’s happens to be a serial killer who confessed to eight murders, but denies murdering the wife. Only on planet earth.

Posted in Law
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November 6, 2007
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Along with television as one of the many things that I’ve cut out of my diet since entering medical school, there lies Facebook. Three years ago, during my sophomore year of college, I was one of the early adopters of facebook. I loved it, like 90% of the people who join it do, and I spent far too much time on it. Hell, I still remember when you had to type in to get to it.

Every now and then Facebook and I would get into a fight. Usually it was over privacy concerns, as I was raised to be a very private person. Both my mother and father are ultra-private, even about things I feel I should know about them. One of my bank accounts I share with my father, and every now and then he’ll say, “I see you’ve purchased blah-blah,” which deeply irritates me. So you can understand my ire when Facebook started to creep into my life even further. So I, in perhaps a fit of depression, said fuck Facebook, and cut myself out of its ever-growing loop.

I’ve had some withdrawal symptoms, that’s for sure. In the past three weeks, I’ve tried to log in 10 times, I know, I’ve got the “this is how you reactivate it” emails to prove it. Friends have come up to me and asked, why did you quit Facebook? I usually tell them it wasn’t good enough for me, or that I needed to spend more time reading, studying, sleeping, being alive etc. I’ve received a few visceral responses, “Why are you so weak-willed?!”, “You’re missing out!”. Both ironic yet mostly true. If I weren’t so weak-willed, I’d be able to time manage properly I’d be able to do everything I want. It was Jefferson who said to his daughter, “It is wonderful how much may be done by always doing.” Until I can win the battle over avarices like Facebook and television, they’ll have to stay in the corner.

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