As interview season looms I’m reminded of my mock interview for medical school, four years ago. Carnegie Mellon (my alma mater) gets a group of faculty together, who grill you as if it were the real thing. They use the session as a template for a committee letter that gets sent off to med schools around the country, and you get to practice interviewing. It’s a fantastic way of doing things.

As a young, punk applicant I wore crazy ties, wrote about an abscess on a guy’s ass in my personal statement, applied to all the wrong schools, and figured that if they didn’t want to accept me on my terms, I didn’t want to attend. Somehow it worked out in the end, but honestly, it was a crapshoot. I should have listened to my advisor†. I didn’t prepare for the interview at all; why would I? I was flying by the seat of my pants! I was hot shit! I didn’t play by anybody’s rules! Not even my own!

I walked in the room, all smiles, shook hands with the group, and sat down, confident and ready. My advisor opened with the easiest, most basic of questions.

“So, Zac. Why do you want to be a doctor?”

I paused, suddenly realizing I hadn’t really thought this through. I mean, I had a gut feeling, and I really enjoyed volunteering in the ER… but I couldn’t put it into words. Why exactly did I want to be a doctor? I thought I knew, but I never really expected anyone to question me on it. What was this, some kind of interrogation? Hesitating, I spoke.

“Well… I guess… I guess you’ll just have to trust me on this one††.”

And that, friends, was the end of the interview. It didn’t go over so well. Luckily for me, my advisor is the nicest woman in the world and postponed it to a later date. The second time around – after preparing for hours – I passed with flying colors, felt comfortable and calm, and enjoyed myself. I guess it just goes to show you… chance favors the prepared mind.

†Hi Dr. Burkert!
††I exaggerate not. That is an exact quote. And it was the very first thing out of my mouth after “Hello, nice to meet you”.

I’m still having trouble sleeping; today I go into work with 8 hours combined for the past 3 days. Probably chump change compared to what I’ll go through in residency, but whatever.

So today, in an act of protest, I’m ditching the tie, wearing my least favorite pair of khakis, and using a beer shirt for my undershirt. Nobody at work will know… but secretly I’m rebelling against The Man. Take that, establishment!

The worst feeling in the world – and one that I get, often – is tossing and turning, trying to fall asleep, knowing that it won’t happen. It’s made worse by the knowledge that I have to wake up at 6AM tomorrow, and that even if I were to fall asleep right now I’d be running on 5 hours of sleep. I know myself well. I know I won’t be in bed until 2.

I know this isn’t a feeling unique to the medical profession, but it feels worse knowing that I have to interact with a different person every 15 minutes tomorrow. The schedule demands that I’m in top form at all times, an impossible feat for any person, more impossible for me when I’m tired.

So, I debate. Pop 50 milligrams of benadryl? Gives me a horrendous sleep hangover in the morning. The few times I’ve overslept have been because I tried that particular trick. I could steal prescription sleep aids (Rozerem, Lunesta, Ambien) from the sample closet, but that’s a dangerous path that leads nowhere I want to go. I’ve tried it a few times. Those meds treat the symptom, not the disease.

In the end, I’ll likely sit on the couch with the lights off, blanket drawn up around my knees, TV flickering in the dark, and wait for the King of Dreams to beckon. It’ll be a long night. It’ll be a longer day.

I just stumbled across this link from the Wall Street Journal about a man that was accidentally cured of his AIDS when his doctor treated his leukemia with a bone marrow transplant.

It is well documented in the literature that people homozygous for a mutation in the CCR5 receptor are effectively immune to HIV; the virus must use the CCR5 protein as a dock while it infects white blood cells. Kill off enough white blood cells and the Acquired Immune Deficiency Syndrome (AIDS) develops. However, one simple mutation in the cell and they are effectively impervious to the virus.

By giving his patient a bone marrow transplant from a donor who was homozygous for the CCR5 receptor, Dr. Hütter effectively insured that any new white blood cells made would be immune. The patient is still a viral carrier… but simply won’t develop the symptoms of AIDS.

Now, whether we should subject everyone with HIV to a bone marrow transplant – a costly, often dangerous procedure with significant longterm side effects – is a matter for another debate. But in the meantime, this is an overwhelmingly interesting development in the field of HIV research.

Thank you Barack, we needed this so badly. Now we can begin the long, painful process of healing this great nation.

In other news, tonight marked an outpouring of support and international goodwill; Darfur spontaneously stopped the horrific genocides, North Korea decided to abandon its secret nuclear weapons program, and adorable puppies appeared on the lawns of ecstatic children everywhere.

Vote! Vote! Vote!