gummy bears.

came home today after clinical coaching and watched some Kaplan videos while eating gummy bears.

and then i got a little bored and distracted.
>.<
ok. back to the books.

pushing my lactase enzyme limits.

now i'm not normally lactose intolerant. but i think 2¼L of milk in less than 15 minutes is definitely more milk than my gastrointestinal system can handle.

let me give you the story as to WHY i drank that much milk...
it was our friend mike's birthday so we had him and a couple of close friends over for dinner. after dinner we decided to play some poker. being poor medical students we decided not to play for money. instead we went for the positive punishment approach. you had the option of...
(a) eating pieces of cake

(b) eating teaspoons of salt
(c) drinking cups of milk (in 500ml cups)
(d) drinking cups of water (also in 500ml cups but times 2 because water is much easier to drink)
the amount depended on the order we finished in. so for example, the first place person just had to have 1 serving of a, b, c, or d. i tied for fourth (i had crap hands all game) and so i had to do 4.5 servings. i chose the milk cause eating that much salt is just disgusting, i was way too full for more cake, and 9 cups (close to 4.5L) of water was just way too much volume - remember this was just a few hours after a FULL dinner with cake and everything.


feeling alright after downing the milk.

although i don't regret my choice, i'm paying dearly for my actions of yesterday. the first couple of hours were alright. i was just REALLY full. but then the runs started. i went THREE times last night and already twice this morning (and it's only 7:30 in the morning!). good thing we splurged on the 3-ply-extra-soft TP this week.
uuuggghhhh.... this is almost as bad as a hangover.
>.<
good times though!

coffee? no thank you.

topic last week was drug abuse. while doing some of the readings i came across a little section on caffeine. i thought i'd share my new found knowledge with all you coffee addicts out there.

did you know that coffee is the second largest commodity traded in the world, only behind oil?!?!

caffeine is a CNS (central nervous system) stimulant which has a mechanism of action similar to amphetamines and cocaine! it increases dopamine activity within the brain and mimics adenosine. adenosine is responsible for the increases in alertness, concentration, cognitive function, blood pressure as well as mood elevation and anxiety.

with chronic toxicity you can get insomnia, GORD (gastro-oesophageal reflux disease - this is where the gastric acids from your stomach enter into your oesophagus and irritate your oesophagus), atrial arrythmias (where the atria of your heart beat in an uncoordinated/irregular manner) and difficulty conceiving. there's also an established association with babies of low birth weight.

caffeine is also associated with high cholesterol levels - lipids in coffee aren't removed by espresso machines or during the decaffeination process.

physical dependence can result in withdrawal symptoms. these include: irritability, headaches, restlessness, fatigue, poor concentration & muscle stiffness.

BUT there is SOME good news. withdrawal symptoms are usually seen when you consume more than 350mg of caffeine each day. how much is 350mg of caffeine?
a can of coca-cola contains ~40mg.
a can of red bull contains ~80mg.
a cup of instant coffee comes in at ~70mg.
and a strong cup of espresso contains ~120mg.
so as long as you're having maybe a cup of coffee in the morning, those withdrawal symptoms are unlikely. but if you're having 3 or more... well you might just be entering the DANGER ZOOOOOOONE!

green tea latte, glenelg, boxer shorts, brighton, clara's bday.

slept in on sunday morning and then headed out for breakfast by the beach. had a "lighter" breakfast and then went into to a starbucks to warm up and to sit & chat. we sat on the balcony that overlooked the ocean and the main square of glenelg. it was quite nice.

note to self. never get the green tea latte.

we then walked around glenelg...

look! it's a palindrome!
G-L-E-N-E-L-G... G-L-E-N-E-L-G.

while in search of a toilet, we stumbled across the town museum.

i'm not sure who this is but my guess is he found glenelg and pointed to everyone: "look! it's glenelg!" ok, so maybe that not EXACTLY how it went...

we then walked along the jetty and took some pictures.

...

...

yea. about that. justin had sent me boxer shorts that look like a canadian hockey jersey. to the horror of clara and stella, i showed my appreciation by wearing it around in public. can't possibly imagine what they'd be so embarrassed about.

we had had enough of glenelg so we headed to brighton.

another little beach. another jetty. and another meal. lunch was at primo's, an italian/seafood restaurant. it was good. i had the seafood risotto and felt like i was going to burst at the seams.

i'm pretty sure pat's full too.

after lunch, the girls' did the some shopping and pat & i snuck off to buy a cake for clara's birthday. on our way home we went up to windy point for a view of the city...

at least one silly jumping photo is mandatory on all trips.

funny thing.

in classic bogen fashion, there were several of these drive-thru liquor stores in adelaide.

of course there was one last meal left. dinner was at a restaurant/pub called the dublin. another great meal. i had a seared kingfish.
(sorry camera was out of batteries by this point).
it was some great tasting fish. we rarely have fish in brissy - beef is king at "home". so it was nice.

we capped off the trip with a song and some cake.

happy (early) birthday clara!

another early flight out and i was home in bris by noon on monday. cleaned up, showered and headed to lectures. i'm glad i didn't blow them off cause they were actually pretty good.

*****
when i first flew into adelaide i wasn't expecting a whole lot out of the city - especially considering stella refers to adelaide as a "cultural wasteland" and the in-flight magazine referred to it as "dullsville". but i gotta say i had a lot of fun. and i can definitely see why it'd be a tourist-worthy place in the summer time.
but maybe our next reunion will be somewhere else? melbourne? or even new zealand perhaps?

i think this picture sums up this trip.

noice!!!

marilyn, CBD, UofA, bratwursts, wine tasting.

saturday started off with a big breakfast at a place called "a cafe etc..."
food was pretty good - and they had marilyn monroe EVERYWHERE. it was like a shrine. the walls of the restaurant were completely plastered with pictures, posters and news articles about marilyn. they had plates with pictures of MM hanging from the walls, porcelain dolls of MM, even a elvis-like bust of MM. it was cool. sort of. all that really matters was that it was only 10:30 and i was completely stuffed.


we then drove into the city and walked around the downtown core. it wasn't very big. hm... the entire downtown seemed about the size of the UofT st.george campus.
we took some pictures by the state library, the art gallery and museum and eventually wandered onto the university of adelaide campus. now, the UofA campus was actually quite nice.


it was very harvard-esque. it even had a little river in the back - like harvard!


it reminded me so much of boston that i got a little carried away. i don't think this boot is as lucky though.


all that walking was making us hungry. we weren't really hungry but felt obliged to eat. afterall, it was past noon. so we drove up to hahndorf a little town with good german food. we stopped in a little place for some tea and coffee and then settled on a german restaurant. i proceeded to stuff my face with a bratwurst with lots of sauerkraut.

it was good.

after lunch we went for some wine tasting.

stella opted not to drink as she was driving so i dutifully had her share of wine.


clara - happy with the view.


me - happy with my purchase.

after the wine we went up to mount lofty but it was much too foggy and cloudy to see anything.


after mount lofty we were pooped. so we headed home. we recharged our batteries and then decided it was time for dinner. yes we were still full but the clock said it was 6:30. time for dinner. we ended up picking up some take out from a thai place nearby. pat made a very valiant effort to finish all 4 servings (the rest of us weren't very hungry) but was unsuccessful. i think there is enough leftovers from that dinner to last stella for another couple of weeks.

adelaide wrap up.

man. where to start. i can't believe my break is over already and pat is somewhere over the pacific ocean on his way back home. it's true. time flies when you're having fun.

so we flew into adelaide on friday morning, caught a cab and made our way to stella's townhouse. after dropping off our bags and catching our breaths, we started getting hungry so we decided to go exploring around the campus. no offense stella but flinders has got nothing on UQ. it reminds me of the UTSC campus back in the day. lots of green grass and trees but also lots and LOTS of CONCRETE.

pat with the bust of captain matthew flinders.

fortunately stella finished earlier than expected so we headed out for some fluids (at cibo) and dinner (at simply sushi). after dinner we drove into the city and did a quick tour by car. we then headed to the airport to pick up clara who was flying in from sydney. for some reason stella thought it'd be funny to embarrass clara by wearing party hats as we waited for her at her gate.

in case you don't know clara, she gets embarrassed very easily and is generally ashamed of all her male cousins. well, except for pat. and in this case, without justin and harri, i guess that just leaves, well... me.

case in point:

adelaide is home to coopers beer. it's probably one of the better beers of australia but still doesn't compare to canadian beer. the funny thing is that coopers is a family brewery and one of the CEOs - Tim Cooper is actually an MD, well, i guess an MBBS.

after picking up clara, we picked up some pizza (yes, more food) and went home to watch some scrubs and fraser DVDs.

get your nerd on!

i logged some good hours of study in this week.
31 to be exact.
next week's goal will have to jump to 35.

i had a productive week but i'm not feeling so good about it. i'm a little stressed and a little... afraid. just a little.
i came to the conclusion this week that i've been focusing WAY too much on pathology and not enough on the clinical aspects. not to worry though. there is still just over 3 weeks until mid-years. enough time to make adjustments. this is good...

no really. it's good.
i've never really used stress and fear as motivators to study. they've usually been states of being. emotions that i feel just before and during the exam to provide the adrenalin to complete the given task.

just gotta keep on truckin'.

book of the week: davidson's priciples and practice of medicine. scratch that. that's the book of the month.
current gear: i'm looking for 6th.

on a slightly happier note:
mike dropped by for dinner on friday night. guess what he brought!?!?!

don't know if he's been reading my blog but darn this kid's good!

a blast from the past & a cash infusion.

my PBL mates were in a big ball of excitement about the first krispy kreme store to open up in Queensland. yes. i know krispy kreme stores in toronto are going out of business. but this is australia where things are about a decade behind north america and where the obesity epidemic ranks only behind the great United States of America.

i remember when the first krispy kreme store opened up in toronto. well, i think the first one was actually in mississauga, and i was in grade 11. people would drive all the way out to mississauga just for donuts! DONUTS!
now i can't complain too much cause our grade 11 bio teacher was kind enough to bring us krispy kreme donuts and we devoured them like no tomorrow.

for those of you interested in brisbane i'm told the new store is on albert street (seriously) and is open from 6am (SIX IN THE MORNING!) until midnight.

***
i've been waiting on some funds from my student line of credit. there was a bit of a delay but they were finally released. thank goodness. i was worried i'd have to sell my kidneys or something.

speaking of selling organs, this aussie nephrologist by the name of Dr. Gavin Carney caused a big huff & a puff the other day when he suggested that the government pay $50,000 to those willing to donate/sell their organs.

apparently australia has one of the lowest donor rates in the world at roughly 9.4 donors in 1 million people.

dr. carney's argument is that because of the huge donor shortage, australian citizens are paying tens even hundreds of thousands of dollars to go buy organs on the black market - usually in 3rd world countries with questionable medical infrastructure.
where would the government get this $50k in the first place? dr. carney goes onto argue that patients often spend more than 7 years on dialysis waiting for a donor. THAT alone costs the government upwards of $500,000. so from a financial perspective, it could make sense.

of course there are huge ethical & moral obligations that need to be considered. i'm not going to open that can of worms. but if i may, here are my suggestions:
- as an extension of our donor cards that come with our driver's licenses... give people (financial) incentive to sign those cards. if your organs can be used after you die, and you've signed your donor card then you'll be compensated. if you don't sign it, then you don't get money. not a penny. if you sign it but your organs can't be used, you get a smaller amount.
- or similarly give everyone the opportunity to sign donor cards when they turn 18. you still have the choice to NOT donate. however, this excludes you from receiving a donor organ should you ever need it in the future. it's only fair that you should be given a second chance if you're willing to give someone else a second chance.

in the interest of full disclosure...
i don't think i've signed my donor card.
>.<
hahaha... what a hypocrite! hahaha!!!

kiwi skins and pirated audio lectures.

i used to have a friend in undergrad that would eat apple cores. he'd sit in class and eat his apple. when he was done with the pulp, he'd chomp his way through the whole core - seeds and all. i thought that was pretty weird.

but now i have a friend that eats kiwis like they're apples - without peeling them. she'll grab them by the 2 ends and bite right into them. *blah* all that hairy fuzz on your tongue. every time i see her eat a kiwi, i subconsciously stick out my tongue & scrape the surface with my front teeth. and of course, i make fun of her.
;p

been listening to these mp3 files of this guy by the name of Goljan.
from what i know, Dr. Goljan is a pathology professor at oklahoma state university. he's also published several books and audio CDs on pathology - in particular pathology prep for the USMLEs. he's pretty good. he explains stuff better than 99% of my lecturers here at UQ.
it's a little sad that i'm paying all this money to UQ but get my learning from pirated mp3 files. oh well. you gotta learn, when you gotta learn. doesn't really matter how right?

speaking of which, lectures are utterly useless lately. you might have 1 good lecture out of 10 in a week. i've continued going to lectures cause:
1. it breaks up my day nicely - otherwise on mondays and thursdays, i'd never even leave the house.
and 2. i don't want to miss that ONE good lecture.
BUT at this point, i am seriously re-considering things.

speaking of USMLEs. i'm leaning towards not writing them at the end of this year. will re-evaluate this decision after mid-year exams.

was good about studying this week but need to do more. i'm going to start keeping a rough tally of the number of hours of study i do each week. last week (sunday to saturday), aside from lectures, tutorials, clinical coaching sessions, PBL group meetings, year 1 & year 3 tutorial groups... i spent about 17 hours of study.
goal for this week: 20+.

it snowed!

toronto had its first major snowstorm of the year.
our car got stuck in the driveway, my socks got wet from stepping into huge mounds of snow and traffic slowed down to a crawl... but i loved every moment of it.

and i'm pretty sure this guy was happy to see some snow too.

on saturday night, went out to this exquisite french restaurant called gamelle. it's on college just west of bathurst. it's this tiny little place where you can see right into the kitchen. the whole restaurant seats maybe 30 people at most. it had so much character. so much charm.
we started off with some calamari. then she had the risotto and i had the lamb. we topped things off with a "gateau chocolat". it's nice to have some upscale cuisine every now and then. back in brissy, splurging on food meant a trip to the local vietnamese restaurant for pho! haha.

speaking of my eating habits lately... my mother tells me that she's had to do her costco shopping twice as often lately because of all the food i've been eating. kekeke.

in other news. i've been listening to a lot of ol' school lauryn hill lately. released almost 10 years ago and it's still hot.

bananas for bananas.

i had my first banana today in like 10+ months. bananas in australia were so ridiculously expensive. if i remember correctly, they were like $12/kilo at one point.
i must've looked like a bit of a fool though. i think i had this huge grin on my face as i ate it.

something else i've noticed about food... i can't eat spicy food anymore. after spending basically all of 2007 eating bland, non-spicy food, i feel like my capacity to handle spicy food has diminished considerably. i first noticed it when i went out to eat some kimchee tofu stew out in k-town early last week. my lips started burning and i couldn't even finish the my whole meal. today i put some hot sauce on my chicken teriyaki for lunch and i couldn't handle it. i've become such a wussy.

in other news...
having a great time with the elective. i feel like i've got a good grasp of what's going on. i don't feel as overwhelmed and lost as i did during the first couple of days.
one thing that i have had some difficulty with is finding patients that are comfortable with a "male med student". i'm kind of divided on this topic. from the "male med student" persepective, i think it's unfair. first of all, that's reverse sexism. secondly, patients know that they are coming to a teaching hospital and they should expect to have med student (male or female) conducting/performing parts of the exam or at the very least just simply observing and learning - which i'm totally fine with.
however, i can totally understand and empathize that if i were a woman coming in for a pelvic exam or a termination, the last thing i need/want is an extra set of eyes looking at my private parts.
so where do you draw the line between being polite & letting patients have their privacy and being slightly selfish & looking after your own education? i mean what if i, as a male med student actually really wanted to study obs & gyne? how am i supposed to learn if patients aren't willing?

what we (the staff and i, the staff by the way, have been incredibly accommodating) find to be the best method is for me to take the patient into the room first by myself and take down their history - of course at this point i let them know that i'm a med student and that a "REAL" doctor will be joining us shortly. this gives the patients a chance to get to know me just a little bit - this is where i need to work my magic. i then report to one of the supervising physicians. we then go back into the room together to complete the physical exam. some docs ask the patient if it's alright if i stick around. others just introduce themselves and then re-introduce me as a medical student and just carry on.

miss saigon...

went out to see miss saigon at the queensland performing arts centre (QPAC) today. it was a sad little story. did i cry? nah. do i look like a softee? don't answer that.
it was good. i enjoyed the show. had a good time, met a few second years...
but i was a little disappointed with the theatre and the turnout. we went to a sunday matinee show (cause it's cheaper!). we were in the first row of the 3rd deck. but seriously, 95% of the seats in the upper deck were empty. that was a little disappointing.
also you know how back home, you get a little free program? with pics and background info about the cast? here? nothing. we got nothing. i don't even know the name of the actress who played kim (the female lead).
also the QPAC has a really small stage. probably seats like 2000+ but the stage was TINY! and it had no character. kind of like the Toronto Centre for the Arts (the one in North York, used to be called the Ford Centre for the Performing Arts - i think). it was really just a lot of concrete and really mundane. nothing like royal alexandra theatre or even the canon theatre.

went out for some korean food and gelato afterwards. mm... mm... MMM!

go...go...go...GOAL!

so i've been playing some mixed 7-aside soccer on sundays. our team is made up of mostly med students. appropriately we've named ourselves the "shin splints". i'll put up some pictures another time.
so far we've been playing exhibition games to rank ourselves into divisions. at our current rate, we're a shoe-in for group C. the lowest group. we're 1-3-2. our only win came via default because the other team didn't show up.
the upside is that i got my first goal yesterday. the downside? it was on the wrong net... :( haha.

nerdy fact of the day: did you know that marijuana is actually not a narcotic? a narcotic by the medical definition is a drug that has pharmacological properties like that of morphine. the term narcotic is often misused by the general public when referring to any drug that is illegal.
morphine's primary active ingredient is opium. opioids act on the periaqueductal grey matter (PAG) and the nucleus reticularis paragigantocellularis (NRPG) - say THAT ten times fast! - which then act to increase production of 5-hydroxytryptamine (5-HT) and enkephalin from the nucleus raphe magnus (NRM). 5-HT and enkephalin then act on the dorsal horn of the spinal cord to inhibit transmission and decrease the perception of pain. marijuana on the other hand has tetrahydrocannabinol (THC) as its active ingredient. you didn't know THAT did you?

had some domino's for dinner tonight. the power was out for a few hours in the afternoon today so my roommate and i decided to order some pizzas instead. haven't had pizza in a LONG time. basically had a whole large pizza by myself. ugh... i'm so FULL...

september!

last night i went to the E.S. Meyers Memorial Lecture. it's a lecture that was established in 1957 in memory of Errol Solomon Meyers who was, to put it briefly, one of the founders of UQ Medical School. this year's lecturer was Dr. Charlie Teo.

charlie's a neurosurgeons with some controversy. let's just say he isn't the most popular neurosurgeon amongst his australian colleagues. he claims to be the best neurosurgeon. let me clarify that. he claims to be the best at what he does. and what he does is what's called minimally invasive keyhole surgery. the basic premise is... instead of performing brain surgery by cutting up half the patient's head, he makes significantly smaller incisions and uses an endoscope. i think what pisses the other doctors off is that they feel this procedure is a more dangerous operation than what is currently the "standard". he is also accused of performing surgeries that are of greater risk and of giving patients false hope. charlie defends that his procedures have similar complication rates as the techniques used by other neurosurgeons. he also says that it is much more effective. as for false hope, he says there is no such thing as false hope. there are only false promises. and he says he never makes false promises and emphasizes the fact that he has never been sued by any of his patients.
i'm not quite sure why there is so much disdain for charlie. when i asked him about it, he said he wasn't 100% sure either. he says it's partly because he's never been very good at "toeing-the-line". i think part of it is also surgeons and their egos. charlie talks about one case in which surgeon X told patient Y that she had removed 90% of the tumour in her brain. as it later turned out in a consultation with charlie, less than 10% was actually removed. charlie basically then called surgeon X an idiot and proceeded to remove the rest of the tumour.
i really enjoyed the lecture. but when i try to pinpoint WHAT exactly i found so great... i can't. i don't really have any aspirations to be this world famous neurosurgeon. nor do i want to be a trendsetter and a person that questions and pushes the boundaries. no. i will (and have) always toe-the-line. maybe it's because he's asian. for as long as medicine has been a boys' club. it's also been a white-man's club. so maybe i find charlie so refreshing because he is so un-asian like. i haven't quite figured out where i'm going with this. but i'm on to something. i'll continue this another time.
if you want more info about charlie, read THIS or THIS or watch THIS. or just do a google search.

oh! did i mention he's a rider? a bike rider. no not like lance. more like house.
so the next time you (won't name names) tell me i shouldn't ride a bike because its very un-doctor like, and then proceed to ask me how many doctors i know that ride motorcycles, i will say ONE! dr. charlie teo!

on a lighter note...
went to the law revue on wednesday night. it's a collection of sketches and songs put on by the law students. unfortunately i'm going to have swallow my pride and say that it was actually better than the MED revue. much better. it was more polished, funnier and more pleasing to the ear. not to take anything away from the med revue, and all the hard work everyone put into that, but you gotta give credit where credit is due.

6 weeks! 6 weeks left of classes. wow.

ps. i don't DISLIKE my short hair. but i miss my long hair.

pps. saw a girl eating a muffin the other day. and all of a sudden had this huge craving for a corn muffin from Coffee Time. add that to my need-to-eat list for when i'm back in toronto.

birthday STEAK!

my friends took me out for dinner last night.
actually they took a few of us out. my birthday was on tuesday. jon carter's was on the friday before that and susan's birthday is on the thursday coming up. so we decided to lump ourselves together and have one dinner.

we went to this place called the breakfast creek hotel. it was great. i had heard good things about this place but just hadn't had the opportunity (read: excuse) to venture out there.

in case there was any confusion as to who the august babies were, kim brought us birthday badges.

susan with her birthday badge.


my steak. i was so hungry and it looked so good that i forgot to take a picture until matt reminded me. that's why there is a piece missing.

before
& after!

i practically licked the plate down.

shannen made a cheesecake from scratch for us. it was delicious. they decided to play us for fools and put trick candles on the cake. we all had a go trying to blow them out.

jon spitting all over the cake.
tricia also made us cupcakes. but they disappeared so fast the i didn't even get a chance to take pictures.

a BIG thank you to matt for setting everything up.

and to everyone that came out.

this is the closest i had to a "group picture". although there are about twelve people missing.

i just had to. it was too tempting.

a year older, but clearly none the wiser or maturer. (and yes. maturER IS a word. i checked!)

fifth day (june 25th)

another short sail and we were at tongue bay (6).


there we had cheeseburgers for lunch...


and then headed up to a peak overlooking whitehaven beach to burn off the excess calories.


after the peak, we went down to the beach to explore the wildlife...


soldier crabs...


stingrays...

we then took some silly pictures...



and drank beers on the beach.


what more can you ask for right?

shower count since leaving brisbane: still 1.

back from the open seas...

i'm back! back from my sailing adventure.
oh man! i don't know where to start... i had such a great time.
the weather was a tad uncooperative to begin with (it was apparently the coldest that it's ever been since they started keeping records in 1860!!) but we got the sun we were looking for during the last couple of days.
we went with 7 people on board and came back with all 7. there was no mutiny on the seas. who were the players???

we had meera and shannen, 2 ladies to balance the testosterone on the trip.


we then had...
karsten aka "the crazy german"


bruno aka "free willy"


eric aka "big guns"


matt aka "old man yellow thumbs"


and your truly aka "skip"


and this was our everything for the last 8 days. our kitchen. our shelter. our toilet. our mode of transport.


first day (21st of june). you can track our process on this map.

we flew out of brisbane and into this little town called proserpine (1). the airport consists of a runway and a building that looks like a warehouse. the "baggage claim area" is just a driveway where they pull the baggage trolleys from straight off the plane. it was pretty neat.


we then took a shuttle to airlie beach. (2)

there we dropped off our luggage and then went grocery shopping! food for 7 people for 8 days ended up being quite a bit.


$744.39 to be exact.


after carefully squeezing all of our groceries into the fridge/freezer and different nooks and crannies of the boat, we called it a night and went to bed.

to be continued...