The Mexican Fisherman

Here's a nice little story that I've been thinking about lately.  First read it at a Jimmy John's a year or so ago.  (The Ann Arbor area is jumping with Jimmy John's.  Personally, it doesn't really make much sense.  The business is basically built on the idea that people at home are so lazy/pathetic that they will order a sandwich and expect it to be delivered to them.  Honestly, who can't make a sandwich?  But then again, it is freaky fast delivery.  I can't ride my bike down Packard without passing at least one.)

Then the topic came up this weekend as Katy and I thought about "the future".  And then at church today we read President Uchtdorf's talk, Of Regrets and Resolutions.  These things combined make we wonder what I want to do with the future, and specifically a career.  Do I want to be the casual ER doc who works a dozen shifts a month and plays in the mountains the rest of the time?  Or is being the congenital heart surgeon at a prestigious teaching hospital more appealing?  I wish I knew.

An American investment banker was at the pier of a small coastal Mexican village when a small boat with just one fisherman docked.  Inside the small boast were several large yellowfin tuna.  The American complimented the Mexican on the quality of his fish and asked how long it took to catch them.

The Mexican replied, "only a little while."

The American then asked why he didn't stay out longer and catch more fish?

The Mexican said he had enough to support his family's immediate needs.

The American then asked, "but what do you do with the rest of your time?"

The Mexican fisherman said, "I sleep late, fish a little, play with my children, take siestas with my wife Maria, stroll into the village each evening where I sip wine, and play guitar with my aimgos.  I have a full and busy life."

The American scoffed, "I am a Harvard MBA and could help you.  You should spend more time fishing and with the proceeds, buy a bigger boat,.  With the proceeds from the bigger boat you could buy several boats, eventually you would have a fleet of fishing boats.  Instead of selling your catch to a middleman you would sell directly to the processor, eventually opening your own cannery.  You would control the product, processing, and distribution.  You would need to leave this small coastal fishing village and move to Mexico City, then LA and eventually New York City, where you will run your expanding enterprise."

The fisherman asked, "But, how long will all this take?"

To which the American replied,  "15-20 years."

"But what then?" Asked the fisherman.

The American laughed and said, "That's the best part.  When the time is right you would announce an IPO and sell your company stock to the public and become very rich, you would make millions!"

"Millions - then what?"

The American said, "Then you would retire.  Move to a small coastal fishing village where you would sleep late, fish a little, play with your kids, take siestas with your wife, stroll to the village in the evenigs where you could sip wine and play your guitar with your amigos."

My Morning Commute

Not much to say for this entry.  Just kind of a memory I want to be able to return to in the future when I'm in need of some good reminiscing.  Woke up to some snow falling, the house was chilly as I turned the thermostat down to 56 degrees in an attempt to lower the heating bill.  Outside it was in the low teens, so cold, but warmer than any other day this week.

About my commute.  I ride my bike to school. It's nice. I like the built in minimal amount of exercise required to get from home to school. I think you get a better sense of a place and a better relationship with a community by riding on bike.  You don't pass by the little things.  I've got an armada of bikes.  Currently we have the S-Works Roubaix (hung up in the basement with a busted rear wheel), the two-tone Centurion (on the trainer), the 2 cruisers (relatively out of use but a great online buy and some good memories of doubling up on the way to BYU), the tandem (my birthday present last year, runs like a gem), my touring bike (REI special in 2003, what I rode through Canada), the red Schwinn (craigslist buy, only $90 or so, a twinner to Jeff Edwards red Schwinn, and I mean come on, everyone needs a Schwinn) Tony the Tiger (with a matching paint design) and Katy's Specialized.  This morning I have a problem, my go-to for bad weather, the REI Novarra, is locked up at school with a bike lock that won't come off.  Need a bolt cutter to loosen her up.  Looking at the amount of snow falling I can't pull out a road bike because the tires will a) slip all over the place and b) throw up that grit down the back of my pants and shirt that says I ride my bike in bad weather and am too cheap/dump to get some fenders.  Tony and the Schwinn are out of comission with some flat tires and a wheel that needs trueing.  So, SixThreeZero beach cruiser it is.  I jump on her and have the best commute of the year.  Slipping and sliding all the way to school.

Some times it is great to slow down and enjoy the commute.

Beach Cruiser? Snow Cruiser.

The Fifteen Pound Cycle

Maybe I'm unique.  Maybe I'm not.  Maybe I am just like all of the other folks out there.  I think about food, I like talking about food, I like talking about others who like food and I'm fascinated by those who eat too  much food.  I spent the better part of last weekend researching (if you could call it that) the heaviest people on record.  Did you know that multiple individuals have passed the 1,000 pound mark? A thousand pounds?  You know it's pretty bad when instead of putting on 5 pounds over the holidays you put on 5 hundred pounds.  As a studier of medicine I am a little more fascinated by the human body each day.  A core piece of our first year medical school curriculum is human dissection.  Two of my buddies and I spend a couple hours a week dissecting a human.  It is fascinating. Most people out there believe that you have a heart and lungs inside of you, but not too many people have held one in their hands.  Perusing with all of the intestines (and they are about 20 feet long) is a real treat.  But what baffles me more than it should, and getting back to the point, is fat.  It's slippery between your fingers, a little bit shiny with varying shades of yellow.  When the hamburger and fries get consumed your body deposits these little globules of fat throughout your body in adipocytes.  I was particularly surprised at the amount of fat behind the knees and in the armpits.  Not the usual place I think of when I think about those 5 extra pounds.  And when you forget to eat because you've been studying all day or you just happen to be riding your bike across Canada then the fat is sent off to the liver to be metabolized eventually turning into electrons carried on NADH to the electron transport chain to generate ATP to allow for actin and myosin cross bridge cycling of muscle contraction.  It really is a miracle that 1) all of this actually happens and 2) that someone figured it out.

But back to the fat.  It fascinates me when I hold it in my hands in the anatomy lab and I love that it has seemed to seep into so many aspects of daily life: The Biggest Loser, Skim Milk, the countless Infomercials and my goal for February and March - Insanity with Shaun T.  My research this weekend was very exciting.  The highlight was the following tidbit of information.  The fifth heaviest person on record, Walter Hudson, states the following was a typical diet for a day: "two boxes of sausages, 1 pound (0.45 kg) of bacon, 12 eggs, a loaf of bread, four hamburgers and four double cheeseburgers, eight large portions of fries, three ham steaks or two chickens, four baked potatoes, four sweet potatoes, four heads of broccoli, most of a large cake, and additional snacks. He also drank an average of 18 US quarts (17 liters) of soda every day." Sweet Mylanta! Most of a large cake? Four heads of broccoli? Who was this guy kidding?

Now about myself.  Every year something interesting happens.  I roller-coaster about 15 pounds.  Basically from January to September I am in weight loss exercise mode and from October to New Years I am in get ready to hibernate, eat everything in sight mode.  So I run between 165 and 180 pounds.  180 is the cutoff.  I don't let myself go over, that's a rule.  So I am currently in health mode.  And that doesn't just mean smaller portions, it means revamp the whole diet.  Currently I'm on a smoothie kick - a banana, some yogurt, some kale, a handful of berries and a couple almonds.  Blend that up and voila.  I'm pretty good at staying on top of my game until my wife invites me over to Google for lunch. Then smack.  Flood gates rush open and I'm back to eating everything in sight.  It sure is delicious over there at Google.  Chef Tom sure knows how to cook up the good stuff.  Today was no exception.  Tomorrow will be another smoothie in the morning, and likely overeating at Zingerman's Deli for dinner.  And my love affair with food will continue.  But all in all, these 15 pounds of adipocytes that is mysteriously stuck behind my knees and in my armpits will metabolize and the cycle will continue.

Banana, Kale, Yogurt, Berries, Almonds

Breakfast

Google Lunch

7:59pm on a Wednesday

With so many things on my mind, I don't really know where to begin.

The biochemical pathway of statins inhibiting HMG CoA reductase (which sold for $12.4 billion in 2008) and cholesterol synthesis which leads to possible cardiovascular disease, diabetic ketoacidosis for people with uncontrolled Type 1 Diabetes, the recently marketed Olesta which tastes like fat but contains no calories because the fatty acids are bound to a sugar moiety instead of a glycerol  backbone preventing absorption in the gut and weight gain (but with the possible side effect of steatorrhea, diarrhea's nasty cousin, the fact that the gastroduodenal artery (a branch of the proper hepatic and common hepatic artery) runs right behind the duodenum and is at risk for erosion with duodenal ulcers, the liver if functionally separated into 3 zones between the portal triads and central vein and zone 3 is most subject to necrosis with portal hypertension, the pentose phosphate pathway can be upregulated without insulin via xylulose-5-phosphate to create NADPH necessary for fatty acid biosynthesis, alcohol will induce cytochrome P450 and when taken with excess acetaminophen can cause hepatotoxicity and even death, the reason my grandpa and father (and I guess myself) have to use the restroom after a meal is due to the gastrocolic reflex whereby food entering the stomach sends a neural reflex to the colon calling for peristalsis which increases the urge to defecate and upon relaxation of the external sphincter (skeletal muscle: voluntary) a stool is passed, HDLs are the good cholesterol because they have a high density (lots of protein with a little fat) and carry cholesterol and fat away from the tissues to the liver for synthesis into bile and excretion.  I guess I could go on forever.  Only, next week we will have more lectures, I will likely forget most of what I learned this week and learn something new.

I really enjoyed my previous blog (or maybe I only enjoyed what I was doing during my previous blog), but I thought I would start another one up.  After all, it's not everyday you go through medical school and one day in the future I guess I would like to remember some of what went on here in Ann Arbor.

Right now I am in the LRC, medical student central.  And they routinely have leftovers out on the main table in the hallway.  As one friend said, "It's great, they feed you if you will study." It consists of a bunch of computers and people that stare at the computer for hours on end, only to occasionally take their smartphone out of their pocket, cruise through the latest on FB and Instagram and return to learning.  Most classmates aren't here though, they are at home streaming.  Streaming is the bees knees of medical school.  It means I can sleep in.  I can watch tomorrow's lectures early or procrastinate an entire week of material.  I can watch lectures on my bike in the basement.  It really is a pretty good gig.  The other nice deal about school is pass/fail.  I only need a 75.  So don't push it.  And besides, who wants a doctor that knows everything.  Duh, that's what specialists are for.

Well, this is just post number one (hopefully).  The hardest thing about anything, is getting started.  So, I've started and if I can commit to writing on here instead of cruising on my smartphone like the others I will hopefully have a nice collection in 4 years.  Off to my bike and ride home, it was 3 degrees when I left this morning, sure hope that it has warmed up a little bit.

Biochemistry lecture notes.  The overly complicated workings of the body.