Different and unequal

Nicholas Kristof took a break from the third world to write a column on the public perception of women leaders.

This creates a huge challenge for ambitious women in politics or business: If they’re self-effacing, people find them unimpressive, but if they talk up their accomplishments, they come across as pushy braggarts. The broader conundrum is that for women, but not for men, there is a tradeoff in qualities associated with top leadership. A woman can be perceived as competent or as likable, but not both.... Professor Duflo and her colleagues found that by objective standards, the women ran the villages better than men. For example, women constructed and maintained wells better, and took fewer bribes. Yet ordinary villagers themselves judged the women as having done a worse job, and so most women were not re-elected. Professor Duflo asked villagers to listen to a speech, identical except that it was given by a man in some cases and by a woman in others. Villagers gave the speech much lower marks when it was given by a woman.

In response there were the expected anti-Clinton posts, the sexism-is-dead posts, and the not-feminism-again posts, but the one that pissed me off enough that I had to write was this one (by Nathan N):

To think that gender or race is even remotely relevant and anything other than a complete “red herring” is an intellectual confusion. To illustrate my point, it may be interesting to wonder whether horses or oxes as a group run faster. But when you have one actual horse and one actual ox and want to know which one runs faster, all the statistics and knowledge about how fast or slow the members of the two classes of animals generally run become completely useless. All we need to do would be to let them race and see which one runs faster.

Actually, Nathan, I believe you are intellectually confused. And to boot, you totally missed the point. In your horse and ox example, Kristof's point would most closely be translated to the observation that even if the horse and ox raced with the same time, the ox would be thought of as the faster animal. In fact, your argument is negated by the example in Kristof's article - in an objective measure of governing fitness women did better but were kicked out more often.

Not to mention the fact that in a timed race there is an objective standard whereas a public election is not only subjective, but filtered by the media. The effects of this subjectivity are seen for both genders; some of the most qualified candidates lost early in the primary season due to a lack of media exposure and having more substantive credibility than stylish panache.

And to all the people who responded to his column, Kristof wasn't making a case for Hilary. He was making a statement about how in some situations democracies can empower the very prejudices the system is trying to protect against. If you're going to respond to an article, at least read it first.

It's not all in my head

In medicine, we call it emesis. The other research assistants favoured the term "booting." Whatever you call it, I was holding the sides of a toilet and vomiting neon yellow bile yesterday one hour after watching a neonatal autopsy.

The baby in question was about one week old and died shortly after surgery to embolize a vein of Galen malformation. Basically, the baby was born with an extremely large vein in the brain -- this causes low blood pressures in the arterial system and high venous pressure (reversal of normal, also termed persistent fetal circulation). One potential repair is to fill the vessels feeding the oversized vein with glue (yes, literally glue) to lessen the amount of blood flowing through the malformation and restore normal blood pressures. This baby died shortly after surgery after two mysterious distended abdomen complications and difficulty ventilating.

An autopsy is not an elegant or a respectful procedure. The body is handled roughly, like an object, and no care is made to preserve the features that viscerally remind us of the corpse's humanity. The first part of the autopsy was an excision of the brain done with incisions from each ear to the center top of the head. The face is then peeled down and the skull cut into 4-5 triangles, which are peeled open like a flower to provide unhindered access to the entire brain. Unlike television, the baby bled when it was cut; this is not CSI, the bodies are not embalmed prior to examination.

Upon opening the skull it was immediately evident that there had been a substantial subdural and subarachoid hemorrhage (bleeding in the space between the brain and it's covering layers, the meninges). Thus, there was a lot of blood and it lots of gauze was required to visualize the venous system within the brain (you can see the vein of Galen by pushing apart the two hemispheres, gently). The spinal cord was then severed and the brain extracted and placed in diluted formalin to "set" for two weeks before the brain cutting (serial sectioning of the entire brain and spinal cord).

Once the brain is removed the face is pulled back up, but the skull is left open. The next question was what substance was filling the belly. To see whether it was air, the baby was submerged in a basin of water and a hole poked in the abdomen to see if bubbles would result. No bubbles. The body was removed from the basin and held upside down to let the (empty) skull drain (it filled with water when submerged: no brain, remember).

A Y incision was made, which is really more of a U from nipple to nipple and then a line down past, but around, the belly button. Care has to be taken not to cut to deeply, only skin and fat, not the organs beneath. Once you cut into the body, yellow liquid runs off - I think it's the water mixing with the fat (adipose) tissue.

A probe was used to spread the skin around the abdomen and below - the baby had no testicles in the scrotum so, where were they? Gently the intestines were pulled out (not all the way, just a bit) and nudged sideways so that there was a view of the interior of the body cavity. One of the intestines was brown (my guess: large) and the other more greenish (my guess: small), but both smooth and slimy. The testes looked like miniature pearl onions and they were floating off on the left side, not in the track they descend down so something was wrong there.

I didn't get to see then crack the chest because at that point we had to go see another (living) patient. Frankly, I think this was about as much as I could handle... I mean, this was a newborn and it didn't look dead.

While I was in there, watching, I felt mostly fine. I had a low level of queasiness, but I was interested in what I was learning about anatomy and pathology. My brain was on board, but my body was apparently not. I think there is something primal within that rejects the desecration of your own species and produces a visceral reaction. I was told you learn to control it, but that it never really goes away and to be honest, I'm glad. I'm even a little proud that I got sick (especially that I held it together until later, when none of the doctors could see) because it proved that despite my ability to be detached, I have not lost my empathy.

You're probably thinking... but you're going to do this in gross anatomy. Well, yes and no. One, those bodies are preserved (less blood). Two, they are skinned (much less human looking). Three, the faces are draped (again, less human looking). Four, they are adults, not babies. But, yes, I will have to touch dead bodies again.
And if I "boot" when I do it, I promise to tell you all.

Why I sometimes don't like people

While waiting for the trolley this afternoon, I found myself standing near two young men and one older gentleman. In the five ish minutes we were waiting, all three of them spat at least twice. Which begs the question, when did it become kosher to spit in public? And not into a trash can, but onto sidewalks and public platforms. No one enjoys the spectacle of watching someone hock a lugie and I'm fairly sure no one wants to step on said mucus so why, oh why, do people spit in public? This is not the wild west - we are not all chewing tobacco and furnishing our living rooms with spitoons; I mean, come on, use a tissue, please?

Bill Gates never took chemistry

Microsoft Word spell check suggestion for a-l-d-e-h-y-d-e: b-a-l-d-h-e-a-d-e-d.

Get in the boat, fishes, jump in the boat!

First, 10 points to whomever gets the reference that is the post title. Not that the points are good for anything, but you can say you have them. Second, before I even describe the picture to the left: yes, I am aware that whales, even gray ones, are not fish. They are, in fact, mammals. Of the Baylean variety to be specific.

As you may have guessed by now the photo is of gray whales migrating off of the coast of California. The island shown is Anna Cappa, one of the Channel islands. This is about 15 minutes from where my parents live (well, the dock on the mainland anyway, it's another 40 by boat) so while visiting them we took a little romp on the ocean. Only one person on the boat got seasick, which is amazing, because it was so calm. Who gets seasick in calm waters on a sunny day?

The other photo is of sea lions (you can tell they aren't seals because they have ears): one male and one female. If you guessed the fat one is the male, you're right. I could insert a snarky comment here about why men are fat but in seals the women are the fat ones so it's a bit of a wash.

Next planned adventure in California: summer 2008: golf.

Oh, the things we loathe

Tomorrow morning, first thing, I will go to the dentist. I would rather walk naked through the freezing streets of Philadelphia, but no, I will go to the dentist. I would rather receive ten tetanus shots, but no, I will go to the dentist. I would rather give up ice cream for a month, but no... I will go to the dentist.

They will pick and scrape and drill and I will squeeze my eyes and fists shut. I will repeat (to myself) over and over: it's a few hours, it's only a few hours.

Freshly numb, yet somehow still in pain, I will walk the six blocks west and lie down again. My mouth will stay shut, but my legs will spread as another doctor will poke and prod inside.

Sore on two ends and probably still drooling, I will go to work.

Help.

Bummer

I had a little abstract prepared to submit to the Pediatric Academic Societies annual meeting (in Hawaii). It's customary to run these things by the Director(s) of the department(s) relevant to the abstract. Well, one of them killed my abstract. He won't let me submit it. Boo. And not because it's bad science, but because he's afraid we'll lose referral business.

Medical school admissions update

Left: Chasing sunset on a plane to St. Louis.

Applications completed: 23
Interviews offered: 12
Rejections: 3
Acceptances: 3

Organic Lab

Catalytic Hydrogenation of 4-cyclohexene-cis-1,2-dicarboxylic acid. We used a syringe to inject sodium borohydride while boiling the solution with chloroplatinic acid and activated carbon in a steam bath. The inflated balloon indicates that hydrogen gas is being produced and thus the solution is under pressure (sealed container).

It's exciting because I used a syringe. Twice.

THE reason to get a Wii

Guitar Hero.

I played it for the first time this weekend.

A Mazing.

Even XKCD commented: Comic 70

Song added to my playlist because of Guitar Hero: Monsters by Matchbook Romance

Le Nozze Di Figaro

On Saturday night we headed to the Metropolitan opera to see Bryn Terfel and Simon Keenlyside in The Marriage of Figaro. It was a spectacular performance, but Anja Harteros stole the show. She played the Countess and received a longer standing ovation than either Terfel or Keenlyside. Her act II aria "Porgi, amor" and act III aria "Dove Sono" were riveting. Ekaterina Siurina was a lackluster Susannah in the midst of such a powerhouse cast; really only shining in her act IV aria "Deh! vieni, non tardar." It was only too apparent in the act III duet "Sull'aria" which soprano was carrying the show. There were two hilarious moments; one when a prop rolled off the stage and hit a cellist in the head (she finished the act and left), and another when Figaro motioned to Susannah to spank him in Act IV. Clearly, the Met and Terfel have a sense of humor.

On a different note, the dinner we had afterwards was also quite spectacular. Yum.

Go Blue!

I'm in!

Awww...

... he bought me flowers!

A common sight recently...

No plane.

Bacon or Chocolate?

In Vegas three of us discussed a theory that any food could be improved when accompanied by either bacon or chocolate. Some are an easy call: a turkey sandwich calls for some bacon while a cheesecake calls for chocolate.

Now I would have put Diet Coke in the chocolate column, but apparently I was outvoted because somewhere you can get Diet Coke with Bacon.

Question though... diet coke is kosher. Is diet coke with bacon?

In Boston?

This appears to be a wild turkey. He was just ambling around the block in the rough vicinity of MIT. I would posit that this is a dangerous time of year for a large, tasty turkey to be out for a stroll.

...awkward...

About five minutes into my (non-Harvard) medical school interview...

Faculty interviewer: Have you ever been to Boston before?
Me: Yes, once. It's a great city.
Faculty interviewer: Was it to interview at Harvard medical school?
Me: ... yes.
Faculty interviewer: What did you think? You're exactly the type of person they like.
Me: Well, I think has good and bad qualities like every other school.
Faculty interviewer: What about UPenn, when are you interviewing there?
Me: I don't have an interview there.
Faculty interviewer: Yet. My daughter went there. She lived in University city. You don't want to live in the ghetto though. She almost went to Columbia, are you interviewing there?
Me: They have not invited me either.

I actually ended up liking the guy, but what a stressful start!

A month of travel

Someone emailed to remind me I haven't posted in a month. True. And I have no excuse because my hotels had internet access. I was in Pittsburgh, Boston, and Atlanta to interview at medical schools and in Vegas to, well, blow off some steam.

For those of you keeping score, I have 9 interview invites, 2 rejections, and 12 haven't-heard-yets.

Tomorrow I have my neuroanatomy midterm (yikes) for which I am incredibly unprepared. This is partially due to travel and work and partially due to my going to Vegas instead of studying.

Vegas was phenomenal. I gambled (and won - Pai Gow!), first with someone else's money (what better way to learn) and then with my own. I ate (a lot), I sunned by the pools (tan = no, bikini debut = yes), I watched sports and drank beer in the sports book (go Steelers go Rockies), and I went clubbing (VIP, skybox: balcony over the dance floor = awesome). I took a red eye back, went straight to work and ended up in bed by 8:30pm (totally exhausted) for a nice 11.5 hour snooze. Four days of fantastic.

Flash back to now... sore arm from a flu shot, totally unprepared for a midterm, pre-lab to write and more travel to come. Oh, and I'm cold (not a surprise).

The next two weeks: Nov 5-6 Boston, Nov 7 NYC, Nov 12-13 Cleveland, Nov 15-16 Ann Arbour

If I get in somewhere (two letters potentially on their way) - you bet your cute little butt I'm gonna post.

Spinal Innervation

We did the entire spinal cord in one night in neuroanatomy lab. Granted, from a gross dissection point of view, a lone spinal cord is not much to look at. But when you consider the rather extensive innervation it becomes quite a daunting task.

Which organs, muscles, and body parts are innervated by which nerve tracts? How many interneurons for this system and what kinds of reflexes are involved? What will sympathetic or parasympathetic activation lead to? Which lamina of the vertebrae are receiving this type of input?

For those of you with some bio/neuro, recall that activation must also involve some reciprocal inhibition, so even a basic (monosynaptic) stretch reflex stimulates a cascade of firing.

I think next week we move up the brainstem to the medulla (mylencephalon). And we'll get our exams back. Ick.

Defending the men

Apparently there is a happiness gap between men and women: the women are less happy. When economists and readers of the New York Times were asked to explain the gap, the usual suspects were brought up: women are expected to do more (paid work and house work) and suffer under the societal standard of being and looking perfect. This whole problem was then laid squarely at the feet of the men and their apparent expectations and laziness.

This is totally unfair.

First, a huge percentage of what we do is to impress other women, not men. A decent proportion of these "standards" come from women's magazines - one big reason I don't read them. It's time to accept that you cannot and will not be perfect at everything and that the only person annoyed by that is you, not your husband/boyfriend/father.

Second, men do no expect us to look like supermodels all the time. In fact, there a lots of men who prefer a girl in jeans who will eat a burger and go for a hike than one who is in 3 inch heels, a mask of make-up, and refuses to eat non-lettuce items. And this cuts both ways, the perfect male physique is shown in movies (Brad Pitt) and on magazine covers, they have the same pressure we do.

Third, when was the last time you asked a guy to help with the housework? I am willing to bet if you sat down and divided the duties, you would be pleasantly surprised with how much they're willing to help out. In fact, I know plenty of men who are quite happy to stay at home more while the wife builds a career.

It's time we stop blaming men for our lot as women and shoulder some of the responsibility ourselves. Why are young girls unhappy? Because other girls are so mean (remember the book on sororities... girls can be vicious). Who is creating this pressure to be the perfect everything all at once? We are.