Dr. Horrible’s Sing-Along Blog

So I finally got around to watching the episodes of Dr. Horrible’s Sing-Along Blog.  I’d heard about it a week ago, but only the incipient demise of the free streaming version (tonight) was enough to overcome my innate procrastinator.  It is, to put it bluntly, pure genius.  I like Whedon’s stuff anyway, but this was awesomeness on a stick.  That it co-starred Felicia Day (with whom I’m totally in love) made it that much sweeter.

I hope you watched this production, minions.  Now, you must go and purchase it.  Right now.  While I watch.

Except you, Felicia.  You and I should be getting ready for our date.

Coldstream’s Guide: Part One (Freshman/Sophomore)

Getting Started (the Freshman and Sophomore years)

Tell me the Basics

Right then. Now that we’ve scared off the weak, let’s get into the foundational stuff. This part is for Freshman and Sophomore pre-meds; if you’re a non-traditional student (e.g. military veteran, second-career, have ever said “get off my lawn”) then bugger off to the section entitled Non-Trads. You’ve got your own set of problems I’ll discuss, but this bit is for the people who are only now just discovering the joys of waking up drunk next to strangers.

If there’s going to be a time in their life that pre-meds repent (assuming they remember them), it’s almost without exception going to be their early undergrad years. Plunged into a new academic environment in which no one apparently cares if you show up to class, and everyone is drunk, naked, and dancing on a regular basis, it’s fall-on-your-face easy to have a good time and let the grades fall where they may. While this is doubtless a sound plan if you’re say, a philosophy major, it’s absolute murder on a pre-med’s prospects.

If you’re reading this late in your Freshman year or sometime during your Sophomore year and you already have a few party-fueled “C” grades on your transcript, don’t despair. Despite such grades causing frowny faces for some AdComs, most will understand that the first year of college is one of experimentation and will tend to look more leniently on poor grades in your Freshman year than they will on such grades in your Junior and Senior years. So, if you’re going to be a screw-up, earlier is better than later.

Should you have poor grades early on, it’s absolutely vital that you demonstrate improvement. Pulling a few “C” grades early on, followed by “B” and “A” grades as you progress onward is a sign of growing maturity, and will be viewed as such by AdComs. Of course, ideally you want to have good grades all the way through, but a “C” here and there won’t kill you (and shouldn’t make you want to kill yourself).

Does GPA matter?

Of course it does. Your GPA is second only to the many-headed beast called MCAT in the eyes of most medical schools. Medical schools (via AMCAS and AACOMAS, which are application services I’ll talk about later) see your GPA broken down into two numbers: your overall undergraduate GPA (uGPA), which includes everything, and your BCPM GPA, which is your GPA for your Math, Biology, Chemistry, and Physics classes. They do this because they want to make sure that your high uGPA isn’t full of touchy-feely easy-“A” classes masking an abysmal performance in science and math. If touchy-feely classes do it for you, that’s cool, but you need to do well in your science classes too.

Okay, so what classes do I take?

Well, mostly you can take whatever you like, as long as you get a Bachelor’s degree. There are some universally mandatory courses though, which I’ll get to in a moment. We should be very clear here: you can take whatever classes you want. There is no magical degree for medical school, and lunging toward a Biology, Chemistry, or Bio/Chem double-major isn’t going to impress anyone. Now that you’ve read this, don’t act all shocked if you decide to do it anyway and find yourself one of a teeming mass of Bio/Chem double-majors applying for medical school. It certainly won’t hurt you to have such a degree (except that you won’t stand out very much) but it won’t be as earth-shatteringly awesome as you hope, either.

The best advice is for you to take, in addition to the required courses, something that interests you. Me, I like aircraft, so I got a degree in Aeronautics. It was a talking point at interviews and definitely didn’t hurt my application. So if you’re fascinated by Politics, consumed by Philosophy, or delight in the creative arts, then by all means earn a degree in what you enjoy. Medical schools are increasingly looking for well-rounded individuals (i.e. not the pre-med zombie of yore) and more schools are doing the happy dance for non-science majors than ever before. The MCAT and BCPM will prove your scientific chops, so no worries there, and you’ll be an attractive candidate with a proven range of interests. Also consider the idea of mixing it up, such as getting a Chemistry degree with a minor in Philosophy.

What if I’m at a Community College?

The blunt answer is that you need to get into a four-year institution at the first possible opportunity. Sure, you can definitely have some courses from a community college, or even an Associate’s Degree from one, but medical school AdComs tend to get sad faces when prerequisite courses are taken at a two-year school. Don’t freak out, little friends, it’s not the end of the world if you went to Community College for a while (I did) but you’ll need to earn a four-year degree anyway and four-year schools usually have more rigorous science courses (hence the preference by AdComs).

What if I attended a bunch of different schools?

Meh, no worries. It’ll be annoying when you apply, as you’ll have to send a transcript in from every school, but as long as you get a Bachelor’s Degree from some accredited four-year institution, you’ll be fine.

So what are the required courses?

The prerequisite courses for medical schools are identical for a core group of courses, with some schools requiring additional courses. The gold standard for finding out what schools require what courses is a book entitled Medical School Admissions Requirements (MSAR). The MSAR is available at most bookstores (including the online ones) and libraries, and is an awesome resource. Browsing a copy during your early undergrad career is a good idea for planning out your academic schedule, especially if you’re already prancing around telling people you’re going to Hopkins or Stanford (incidentally, stop that). These schools have additional requirements you’ll need to plan for in order to apply.

The basic courses are:

General Chemistry with Lab – Two Semesters
Organic Chemistry with Lab – Two Semesters
General Biology with Lab – Two Semesters
Physics (Algebra- or Calculus-based) – Two Semesters
English – Two Semesters
Mathematics (College Algebra or higher) – Two Semesters

Lots of schools have additional requirements and most recommend (not require!) additional courses. Hopkins, for example, requires two semesters of Calculus, while the University of Colorado requires three semesters of English. Many schools require or recommend Biochemistry, Cell Biology, Information Technology, Genetics, and other such courses. The MSAR is the go-to resource for this information, and you should stick your nose in it anytime you’re planning your courses.

Can I leave all those courses until last?

Yes, but only if you’re an idiot, or if you have absolutely no choice in the matter. Ideally, get right into the sciences your Freshman year, taking General Chemistry and Biology. This will get you nicely prepared to take Organic Chemistry in your Sophomore year. Many science courses, especially Organic Chemistry, are extremely time-consuming and require a lot of effort to ensure an “A”. If you try to cram all of your difficult courses in at the end of your degree, you’ll screw up studying for the MCAT and find yourself exhausted.

If you’re already in your Sophomore year and you’ve avoided taking any science courses so far, jump right in immediately, especially on the Chemistry courses. Don’t dress in sackcloth and smear ashes on your face just yet, but realize that you really need to stay on top of your science courses, because they can bite you if you neglect them. By taking care of your science prerequisites at a steady pace, you’ll put yourself on a nice trajectory to finish everything and be well prepared for your MCAT and Application without burning out in the process.

Nice. So, do you have any other advice for Freshmen/Sophomores?

Of course I do, I’m not just a pretty face here.

The first and most important bit of advice here is to stay healthy. I’m not just talking about physically (although hitting the gym once in a while is definitely a good idea), but also mentally, emotionally, socially, and spiritually healthy. Undergrad is a challenging time in many ways, and it’s going to be harder on you because of your medical aspirations. Studying is important, but make sure you maintain friendships and family ties, keep up on hobbies and sports, and take some time for quiet reflection once in a while. You’ll be healthier for it, and your performance will be better. This stuff is the key to avoiding burnout, so neglect this advice at your peril.

Consider finding a mentor, preferably a pre-med in their senior year or a professor familiar with the pre-med process. Never underestimate the value of having someone who knows what lies ahead on your path, and what pitfalls are along the way. You don’t have time to make every mistake yourself, so learn from the experiences of others! In time, you’ll serve this role for someone else, perhaps.

Look into joining the campus Pre-Med group. Sure, some of the people will so self-absorbed that if they were any more self-centered they’d implode and turn into a black hole, but there will also be some awesome people in there too. It’s likely you’ll find some folks who are at the same point in their education that you are, and perhaps you’ll make some friends to share your undergrad pre-med journey. Such groups are also great places to find mentors, and the meetings will often have speakers or subjects of interest to you.

Develop good academic habits. If you’re struggling in a subject, ask for help. Don’t flail about expecting someone to run to your rescue; you’re a college student now and responsibility for your grades rests entirely on your shoulders. If your school has a tutoring center, use it. If your current study habits aren’t working, examine ways of changing them. Adaptability is vital for academic success.

Finally, keep your eyes on your goal. You’re going to have some rough times ahead, but try to keep it in perspective. Sure, that Chemistry exam is scary, but it beats the crap out of struggling to stay alive in some third-world hellhole.

Coldstream’s Guide: Intro

Welcome

The intent of this guide is, as the title suggests, to help you maintain as much of your sanity as possible as you navigate the path to medical school. Some of you reading this are already be in the process of applying to medical school, while others are still lying on the couch trying to decide if pursuing medicine is a good option. Possibly a few of you are actually in medical school and are reading this when you should be studying some esoteric factoid for the boards. Get back to work!

Regardless of your status, though, one thing is true for everyone reading this: the path ahead of you has been well-trodden by those who have come before. This guide will be broken into a number of sections, with the early parts aimed at new pre-meds, and the later parts focused on information useful to applicants. Cynicism will be aimed at everyone. Everything here has come directly from the experiences, problems, successes, and failures of your fellow travelers who share their hard-won knowledge in the hope of smoothing the path for those who follow.

Good luck to you.

In the Beginning, there was…

…uncertainty. The decision to pursue medicine is a highly personal one, and people’s reasons for doing so vary from the mundane to the spectacularly improbable. For example, some will tell you that it’s something they’ve wanted to do since they were fetus. Holding a tiny hammer in one hand and a stethoscope in the other, they toddled around some third-world country with their parents, building houses and providing top-notch medical care to the local people as a way to pass the time until they could get into medical school. These are the same people who will throw themselves off of a high building at the prospect of getting a “B”. More on those later.

For those of us though who spent our childhood being childish, our desire to pursue medicine likely stems from a complex mixture of our life experiences, intellectual curiosity, compassion, mature introspection, and a predilection for white coats. Television shows featuring stupendously attractive doctors who drive nice cars, have great apartments, and spend their time saving lives in-between torrid love affairs have, of course, absolutely nothing to do with it. I’m glad we got that straight.

The upshot of all this is that your reasons for wanting to go into medicine will be unique to your in some ways and utterly predictable in others. Doubtless you want to “help people,” “make a difference,” and “earn staggering amounts of cash…no, wait, I mean serve others.” Inspired by the suffering of your sick relative, you intend to become a doctor and cure the world.

Annoyingly, these are all excellent reasons for going into medicine that are so clichéd at this point that no one besides your mother will believe a word of it. You’re going to have to dig deeper, and find out what really drives you. What will keep you forging ahead when everything else has run out? When you’re studying while others are partying, when you’re facing at least another decade of education, when you’re so tired you just want to curl up and cry, what will be at the core of you? Don’t frown though; there’s a silver lining! This is excellent practice for your AMCAS application, wherein you’ll bare your soul to a group of people so jaded the air around them has a greenish tinge: the Admissions Committees (AdComs).

While you’re chewing on that, I’ll get started on the concrete stuff.

Coldstream’s Slightly Cynical Guide for Pre-Meds

Okay, after a fairly impressive number of requests, I decided that I’d start writing a guide for confused Pre-Meds and Medical School Applicants. I’m still in the process of writing it, but I thought I’d post sections of it as I went along. There may be some cynicism.

Average’s Song

The Damned

Once upon a time, in a land far away, I played a text-based adventure game.  Younger readers should understand that we engaged in such activities between riding dinosaurs and banging rocks together to communicate with distant communities.  In this game, there was a phrase that appeared with a frequency evidently designed to unhitch even the soundest mind from its moorings: “you are surrounded by many passages, all alike.  N, E, S, W?”  With the aid of graph paper, it was possible to sketch out the labyrinthine nightmare which one sought to navigate, stopping only when it became clear that the sketch actually culminated in a satanic rune which, upon completion, would suck the player’s soul screaming into the abyss.

Suburbia is much like that.

I’m convinced that if one drew out the many twisting roads, cul-de-sacs, and parks on a piece of parchment using an appropriate medium–say, the blood of virgins–it would reveal unto humanity the dark language in which the Damned will sing the song that ends the world.  Never have I been so cognisant of the swirling mass of mediocrity that inhabits these wood-and-plastic dwellings as I was when I chose to walk through such an area some days ago.   When the Damned sing their song, it will be to the refrains of minivan honks, ESPN commentary, the sobs of alcoholic wives, and the crystalline tinkle of shattered dreams.  Too harsh, you feel?

Know Your Role

Our society is sick.

More and more, I notice that people seem unable to break beyond the traditional roles and boundaries of society.  People have roles, we’re told, and to not fit into that nice little package is to be strange, untrustworthy, immature, or deviant.

Are you thirty and want to dye your hair some interesting colour?  You’re immature!   Grow up, and stop pretending you’re a kid.  Like animated movies?  Those are for children!  Don’t want children?  You’re selfish!  After all, everyone knows that the key to happiness is a house in the suburbs with a large mortgage, two or three children, and a steady 9-5 job that pays the bills.  Ignore that hollow gnawing inside as what’s left of your soul begs for the final mercy of a bullet’s oblivion; that’s just what it is to be a grown-up!

Bullshit.

There’s an excellent comic over at xkcd.org that rather eloquently supports my point: we should get to decide what adulthood is, not the people who come before.  Each generation has its own identity, and each generation before it tries to smash the newer generation into a shape that fits the prejudices of the old.  For some reason, the Boomer generation (which, as you all know, I hold in the highest esteem) has decided that their youthful activities were folly and happiness lies only in the most rigid conformity.  This is a lesson they have passed on to my generation, who are paying the price for so pestilent an idea.

Witness the endless sea of over-priced identical houses writhing through what was pristine farmland or wildland.  The curves, ostensibly to create a feeling of neighbourhood, are utterly wasted on individuals who gaze mindlessly out of their air-conditioned SUVs, ferrying their offspring to mandatory piano lessons and sporting activities.  There’s no sense of community, because a community requires individuals and everyone who lives there is a goddamned robot.  This is not a community, it’s a hive-mind.

A Young Boy’s Tale

Watch carefully as the little boy tries to run around, shout, and revel in his juvenile masculinity.  Once, he would have grown up and had his exuberance tempered by life experience and the responsibilities of manhood.  Despite this, he would have been a man and all that entails.  Today, he is drugged into oblivion.

Tired from working incessantly to afford the empty paraphenalia of a materialistic existance, his parents have no energy to deal with his antics.  Hoping to raise his grades upon which rests the desperate hope that vicarious success through their son (look how far little Timmy went!) will silence the bleak emptiness of their own failures, they drag him to whatever physician will diagnose ADHD.  Drugged into a compliant stupour, the spark of creativity and zest for life lost, the child will doubtless grow into the next generation of people who believe that a quiet life and fitting-in are appropriate long-term goals.

Or Not

What the hell happened?  When did we decide to surrender our individuality?  Sure, living in a community requires a bit of compromise here and there, but why the hell are you so threatened by the guy with green hair?  Why do you feel the need to scoff at someone being “so different”?  Is it really so scary that a young woman has no desire to have children, instead choosing to travel the world and work in a global effort for some cause?  Why is “childless” an acceptable term, but you get so pissed off at “childfree“?  Why does dancing in public embarrass you?  Why are you so afraid of others witnessing you taking an almost childlike joy in something?

You don’t really need that SUV.  Let’s face it, that thing will never leave hard pavement and the snowy days you invariably bring up are, what, a few times a year?  Odd, most non-SUVs seem to do just fine on those days.  Did you really need that big of a house, crippling yourself financially?  How is that adjustable-rate mortgage working out for you?

What about your dreams?  What happened to them?  That thing you always imagined yourself doing, why aren’t you pursuing it?  Having kids isn’t an excuse; it’s not a social duty and you won’t always be at their beck and call.

Go Be Magnificent

Our lives are so ridiculously short that it’s a tragedy to not make the most of them.  Stop being safe, secure, and mundane.  Take a risk: do something scary, or new, or thrilling.  Screw getting that new giant TV; use the money to visit somewhere you’ve never been, invent something new, or fund something beautiful.  Compose a song or poem, and then go perform it in your local park.  Get out of the damned vehicle and try walking to the store, even if it’s miles away.  Wear daring clothes, walk along walls, and make those around you laugh just for the hell of it.

You’re beautiful, passionate, and bursting with potential.

Sod the Damned, go sing the song that moves the world.

The Absence

Yes, yes, I’ve been away.  But never fear, I’m back in a position to expose you to the searing brilliance of my mind.  Expect more posts soon.  Incidentally, posts for the next month will be of a general nature, and will then gain a far more medical flavour in August.  Enjoy.

Exposed

Of the many trials of moving, getting rid of books is perhaps the most torturous for me.  Ordinarily, you’ll get one of my books only by dint of an elaborately planned operation utilising a crack team of ninjas, special forces, and high-rent prostitutes.  But today, I came to the conclusion that most of my academic books, along with a smattering of rarely-read paperbacks, would not journey forth to the promised land with me.

Of course, actually throwing away a book is unthinkable–an unspeakable crime in my mind that ranks right up there with burning books or, say, wiping out an entire species.  Thus bound, I resolved to donate them to the local library, bolstered by the delighted (and dare I say dulcet) tones of the librarian who received my inquiry as to how they’d prefer to receive of my plenty.  And so it was that I set the stage for one of the most gut-wrenching experiences I’ve had since that odd-tasting hamburger from the airbase chow-hall.

Such was the level of my beneficence that I required a little library cart in order to transport my books into the library.  Not that the librarians (none of whom were as lithe as I’d fantasised about on the phone) would have minded watching my rippling muscles straining under the load of humanity’s acquired knowledge, you understand, but such distractions in the past have proven hazardous, with many a keeper-of-the-books bearing the scars of past papercuts.

Acquiring said cart, I pushed it towards the door and briefly imagined myself as a librarian, smiling benevolently down at the young seekers of knowledge dragged into the library against their will by well-meaning mothers.  Occasionally, I passed a genuinely enthusiastic young user of the library, and wished him the strength to bear the inevitable mocking of his peers until he possessed the power to crush their day-labourer future selves though the sheer power of his superior intellect.  And then, sunshine.

I begin to remove the (my!) books from my vehicle, and place them on the cart.  It is then that the horror begins, slowly rising up my throat to gleefully strangle my brainstem.  For there, laid out to see for any passerby, are my books.

I’ve never felt so violated.

Each time I return to the cart with another stack of books, I see them there, forlorn, with bright spines bravely displaying their titles to a cold world.   The people walking by barely spare them a glance; there is nothing special here for them.  For me, it is though I have stripped off my clothes and spread-eagled myself on the pavement for the amusement of strangers.  A brief check of my own sobriety and the hurried repression of rising memories of unrepentant inebriation assures me that this is not the case, and that I’m just feeling that way.

Carrying the last of my books to the cart, and wheeling it towards the waiting door of the library, I feel that I’m abandoning well-loved companions.  These books have been with me for longer than most of my friends, and haven’t borrowed nearly as much money.   In the cool of the library proper, surrounded by library patrons murmuring in quiet tones their requests for directions to the Starbucks, the sensation of the surrounding books is palpable.

I tell myself that here my books will find new homes, and be loved by new readers.  That, though I will miss their titles on my shelves, I do a good thing by passing on books to others.  I remind myself of how heavy books are to move, and of the hernia the moving guy got when he tried to lift my box of books I’d forgotten to mark as “heavy”.  I laugh, and feel better.

Goodbye, little friends.

Irony

I’m not going to get into the habit of writing brief comments on current news stories, but I had to throw this one out there. Alanis, this is irony. Oh, how I laughed and laughed.

Killers

You know, it’s funny how things can strike you.  I’ve always been far less tolerant of cruelty or violence towards animals than I have towards humans.  Of course, I’d prefer that neither humans nor animals were on the receiving end of such behaviour, but such is the world we live in.

Accordingly, I’m more than a little irritated by a video reportedly showing a puppy being tossed over a cliff by a couple of Marines.  Now, I understand that they’re in a high-stress environment where normal rules of civility are often non-existent, but they knew what they were doing.  Evidently an observer even commented that it was “sick”.

To be blunt, someone should have tossed those bastards over the cliff to see if the dog was okay.  They’re clearly not worthy of being called Marines.   What an embarrassment to the Service.

The Price We Pay

I have, as I’m wont to do, been thinking a great deal lately. The topic over the last few days has been on the progression of life, and our relationships within it. I am, as I’ve noted elsewhere, starting medical school in August. My path to medical school was such that it ripped almost everything away from me that I’d had before then, for the promise of newer experiences to come.  A career, a relationship, financial security, friends, time, and a vision of myself–all have been sacrificed upon the bloodied altar of medical school admissions, mingled with the blood of countless others who have walked the same path or, worse, fell by the wayside, unable to summon the necessary strength to go on.

Holding On

I’m moving out of my apartment right now, and the experience is already wearing on me. Despite brutal cullings of my possessions in previous moves, I still have too much stuff. I understand now why those monks in saffron robes decline to own anything. It has nothing to do with spirituality, they just don’t want to move the crap when it’s time to change monasteries. Harder, though, are the reminders of my past.

Here, an origami flower, kept safe after she’d made it for me, just for fun. She didn’t know then that I liked her, nor that we’d end up in an eight-year relationship. Eight years, and the flower is less crisp than before, but it has travelled over 4000 miles and its colour is still bright. It’s a reminder of her, as she heads to the other side of the planet, and I disappear so thoroughly that I might as well have. Medical school was the final hammer-blow to that relationship, although the friendship that began our journey together somehow survived, and we part as friends with rueful glances.

A picture of my grandfather. An infantryman in the Second World War, he was so proud of my flying. Watching the aircraft overhead in the war, they’d represented a higher craft than he’d ever been able to do. He’d been almost a father to me as I grew up, and held me highest in his regard. I recall his disappointment when I stopped flying to pursue admission into medical school, and I was never able to express to him the driving urge, right at my core, that made any other path less fulfilling. He never heard that I got accepted–he died almost a year before that decision was made.

Piled high, endless textbooks, mementos of my academics over the years. Each yields a memory of where I lived when I took that course, and of the people I knew.

In a tin, military insignia, coins, and my beret. A host of images arises unbidden. Laughter, tears, struggle, and happiness. Voices from the past tease me, remind me of faces I knew in the service, scattered now across the country and the world.

My flight-bag. Old maps, a line marking the course of a flight. My headset. A set of wings. My log-book, most perilous of all.

Photographs–of friends, of family, of old lovers. Smiling at the camera, in eternal embraces in the light of yesterday’s sun. Each with its special feeling, each with a story known only to myself and one other.

I realise that, despite an almost pathological cynicism and well-accustomed enjoyment of solitude, my life is very much a collection of the things that have gone before. That each step I’ve taken has been witnessed by someone else, and thus the threads of our lives have intertwined. To do a thing is to simply do it, but to have one’s actions witnessed by others is to have meaning attached to what we’ve done. In some instances, the act of witnessing provokes little more than a laugh, or a frown of disapproval. In others–more rarely–our actions create a ripple effect that can quite literally redirect the lives of others. To reflect on those who have walked beside us for a while is, in some ways, to reflect on oneself.

Letting Go

And yet, despite this, one must eventually let go of the past, surrendering ourself to what we are today. Too often we live in the past, or in the future, never realising the full savour of the present moment. How strange it is that the gentle discipline of acceptance should be so wrought with difficulty and pain. To remember the happy times with past friends and lovers invites that heart-bound pang of regret that we no longer see their smiles or hear their laughter, and yet who would give up their memories to avoid that bittersweet pain?

Better then, to learn to appreciate what has come before without being bound to it.  To accept that even the most hardcore, cynical, and absolutist amongst us have been shaped in some measure by past experiences, but also that we are not constrained by them.  The ephemeral future contains immeasurable potential, and we cannot grasp it with both hands if we continue reaching one hand back into the past for what once was, or we wished once was.

When we have come to terms with our experience, when we have assimilated the lessons of past endeavours and come a place of peaceful gratitude for the good things we’ve experienced, then it is possible to live completely.  Unbound by what came before, we can freely walk our path, open to what will come next.

And should we sometimes stop a while on our path, to linger over a person or time from our past, this too is okay.  Though we have shrugged off the shackles of regret, we have not forgotten the value of those we loved or the experiences we’ve had.  And if, briefly, we still experience a moment of sadness, we should understand that it’s because a particular person or experience was especially meaningful for us, and such momentary sadness is the price we pay for so valuable a thing.