Wednesday, October 10, 2012

A Cloud's Silver Lining: How Depression May Help In the Long Ru

Depression is a debilitating disease that has cost our country billions of dollars and thousands of lives each year. However, despite the debilitating problems that mentally stressed and depressed people face, there is growing evidence that those persons may possess qualities that make them better leaders in times of crisis than “normal” people.

Nassir Ghaemi explains why in his novel, A First-Rate Madness: Uncovering the Links Between Leadership and Mental Illness. Dr. Ghaemi, a professor of Psychiatry at Tufts University School of Medicine, has studied the mental health of famous leaders including Winston Churchill, Martin Luther King, Jr. and Abraham Lincoln. Do some qualities of depressed or mentally distressed persons bestow good leadership skills?




Dr. Ghaemi says yes – especially in times of war or social oppression. "Depression makes leaders more realistic and empathetic," whereas non-depressed people, while they make great leaders in normal times, may be held back in times of crisis by what psychologists call “positive illusion,” a mildly high self-regard or a “slightly inflated sense of how much they control the world around them.”

Ghaemi suggests that this connection can be explained by the depressive realism hypothesis. This theory argues that "[depressed people] are depressed because they see reality more clearly than other people do." This may explain why one study showed that persons with a history of depressive symptoms usually score higher on tests for standard measures of empathy than a non-depressed cohort of college students. “This was the case even when patients were not currently depressed but had experienced depression in the past,” Ghaemi writes. “Depression seems to prepare the mind for a long-term habit of appreciating others' point of view.”

For example, social leaders like Mohandas Gandhi and Martin Luther King, Jr., who both are known for their overwhelming empathy in leadership, also battled depression. King had made at least two suicide attempts in his youth. As he became a social icon in the 1950s and ‘60s, his colleagues noticed periods of underlying psychological distress that Ghaemi later described to be “clinical depression.”

However, King’s depression may have been the key to his development of a radically empathetic strategy to achieving social change. He often taught his followers to approach their oppressors as psychiatrists approach their patients. They were suffering from racism, which King described as a psychiatric disease that should be treated using nonviolent methods – similar to the treatment tactics of a psychiatrist. This is one of the many examples of a leader using empathy in creative ways that can drive a population through troubled waters.

In addition to higher levels of empathy and realism, some professionals believe that the effects of treating depression with psychotherapy may also bestow benefits that non-depressed people often don’t access: self-knowledge. In her Healthy Minds blog, Dr. Gina Newsome Duncan, Associate Professor of Psychiatry at Georgia Health Sciences University, believes one crucial characteristic of mental health involves knowing oneself and being self-aware. She often tells her depressed or anxious patients that “they are in a position to be some of the most mentally healthy people around, because their illness has forced them to grapple with unhealthy patterns and learn new skills to cope with the stresses of everyday life.” This shows the importance of seeking professional help when one is suffering psychologically. It can save a life.

Though these qualities may give depression an upside, I don't want to misrepresent the suffering and pain that those with depression experience. If left untreated, depression can put a person on a slippery slope. "Suicidal thoughts occur in about half of clinical depressive episodes," writes Ghaemi. Ten percent of people with depression take their own lives. "The benefits of depression come at a painful, if not deadly price."

Sunday, September 23, 2012

Interview Day For Smarties: What To Expect

It's that time of year again: medical school interview time.

Every year a group of lucky medical school applicants are invited to their dream (or safety) schools to demonstrate how qualified they are. I had to do it, so do you.

When I was applying for medical school in 2008, I concurrently worked as a career adviser who gave mock interviews to other students--- some of whom were applying to my application cycle. It was an interesting (and slightly awkward) time. However, despite how stressful interviewing can be. Be sure it wont be like the interview below:

Now it's time I bestow a few interview tips to the next generation of applicants:
  • First of all, if you get an interview to medical school, consider yourself lucky. An interview is a very good indication that the school is seriously considering you as an applicant. 
  • Beyond academic excellence, however, medical schools are generally looking for maturity, passion about medicine, altruism, exposure to the medical field, and strong interpersonal skills.
  • For most schools, an interview day usually includes two or three interviews with a campus tour, information session, and possibly breakfast and/or lunch.
    • Make sure to treat the whole day as an "interview," as if you are being watched closely by everyone--- including the secretary. 
    • Try to avoid intimidation from other applicants. You will encounter the "what scores did you get?" guy and the "I interviewed in x y and z." girl.  Just focus on you and keep your head level. It never hurts to make friends as well.
    • Make friends with the secretaries. They can be your best friends. Strike a friendly conversation with them about the weather, where you're from, the latest celebrity gossip, etc. Not only will this give you good marks in the admissions office. It can distract you from your nervousness. I often made an effort to talk about Jennifer Aniston and Brad Pitt.
  • Do:
    • Read and populate SDN's Interview Feedback Page: A comprehensive list of school-specific interview experiences--- written by interviewees. It even includes sample school-specific questions.
    • Ask Smart Questions: Yes, the school wants to learn more about you, but you should use the opportunity to learn more about the school. Many interviewers judge your interest in their school by the quality of your questions. What's a smart question? A question that isn't easily answerable on the school's website. (i.e. Does your school's curriculum include LGBTQ issues?). I prepared

Monday, September 10, 2012

The Birthday Bike Ride of The Century

As a birthday gift to myself (my birthday is today), I decided to take on the NYC Century yesterday-- it's the cyclist's version of a marathon. 100 miles of pure bliss and blisters.


http://nyccentury.org/sites/all/themes/adaptivetheme/nyccentury_2012/css/images/century-logo.png
That day, we rode a total of 108 miles, which spanned four marvelous Burroughs of New York City: Manhattan, Brooklyn, Queens, and The Bronx. From start to finish, our total ride took 12 hours-- including time for breaks and hydration-- thanks to a two-bottle hydration belt (below) I wore that enabled me to go for long periods without stopping. We rode along the ocean, through various parks, and across concrete bridges.


Before the race, I told friends, coworkers, and colleagues about the century, and I got mixed reactions: "How is that possible?" "Good for you!" "Are you sure you want to do that?" "I couldn't possibly do that myself." "You must have huge legs!" They focused on the idea of riding such a great distance.

However, I prided myself on choosing a goal and sticking with it until the end. It all started in June. I had dinner with a friend from church to celebrate his buying a brand new bike, at which I near-jokingly suggested that we ride 100 miles. Neither of us had done something like this before. We were both trying to get back into shape and lose weight. When we found out about the Century Bike Tour, we set our goal.


Then we trained. and trained. and trained. During our first bike trip around Manhattan, we covered an astonishing 33 miles, followed by a 45-mile trip up to Mount Kisko the following week. Our group grew. Another guy used an iPhone app to track our mileage and speed. I bought my first pair of  bike shorts, which left a stark tan line on my thighs a few weeks before the race. During my lunch break, I sneaked over to the gym for afternoon spin classes to strengthen my legs and keep up my endurance. 

After months of prep, I made it across the finish line at 110th street and Lenox Avenue-- and I wasn't last!

It forces me to reflect on other goals in progress: losing 20 pounds by Christmas, reading 10 books before the New Year, become a doctor. Yes, that medical journey is still in progress and doesn't show signs of stopping. I intend to cross that finish line soon.

Friday, September 7, 2012

Memoirs of an Obese Physician

To my fellow medical students who are on the heavy side: ignore the haters.



Three years ago I took an online sexuality course with the American Medical Student Association. We broached the topic of body image. In our small group, one of my classmates, who attended a nearby medical school, vented about how other classmates looked down upon her because of her weight--- especially during lectures on diabetes or obesity. She would receive dirty or arrogant looks from her slimmer classmates.

As someone who has always struggled with weight and body image, it struck a chord. Medical students are trained to not tolerate those who happen to have a BMI greater than 25--- a sign that one is considered 'overweight' by medical standards.

I get it. We live in America. People here are fat--- or rather, huge. There are also countless studies that show how obesity can increase your risks deadly diseases like diabetes, hypertension, heart disease, cancer--- you name it.

However, does this give us the excuse to be such assholes? (Pardon my French)

Joseph F. Majdan, MD, a cardiologist at Jefferson Medical College, doesn't think so. In his Memoirs of an Obese Physician, he recounts the negative experiences that has continuously shattered his self-esteem throughout his career:


"I vividly recall that during medical school, a physician approached me as I stood with my tray in the cafeteria line. He said loudly for all to hear, 'You know you should watch what you eat. Don’t you see yourself?'"
"While putting on my scrubs during my surgery clerkship, an attending surgeon looked at me with disgust and sarcastically bellowed, “Hey, hey, hey, it’s Fat Albert!”
"During my internal medicine residency, staff physicians would often— unilaterally and in the presence of colleagues and nurses— offer me their unsolicited opinions on how and why I should lose weight. I wondered why physicians would be so insensitive and callous."
"A surgeon stopped me on the floors and told me I needed gastric bypass surgery; another internist sat down next to me at a nurses’ station and openly guessed my weight, then pontificated on what my approach to weight loss should be."
"A fellow cardiologist stopped me on the street to tell me I looked “disgusting” and asked whether I 'had no shame.'"

His memoirs, which was published in the Annals of Internal Medicine, revealed many doctors' perceptions of the obese: "ugly, weak-willed, sloppy, and lazy." However, this may not be the case.

A recent study published in the European Heart Journal discovered that obese persons who have an adequate level of physical fitness were "metabolically healthy" and had "no greater risk of developing or dying from cardiovascular disease or cancer than normal weight people."

In their study researchers measured height, weight, waist circumference, and body fat percentage on 43,265 obese participants. They also assessed physical fitness with a treadmill test. They initially found that nearly half, 43%, of individuals were already metabolically healthy according to the cardio exercise tests. After following them for several years, they found that these metabolically healthy obese people didn't develop the deadly diseases that the metabolically unhealthy participants developed.

Based on the study, Dr Francisco Ortega, PhD from the University of Grenada made these comments to Science Daily, "Physician[s] should take into consideration that not all obese people have the same prognosis. Physician could assess fitness, fatness and metabolic markers to do a better estimation of the risk of cardiovascular disease and cancer of obese patients. Our data support the idea that interventions might be more urgently needed in metabolically unhealthy and unfit obese people, since they are at a higher risk. This research highlights once again the important role of physical fitness as a health marker."

...so not only may some physicians' callous remarks and opinions about the overweight/obese be just plain rude, it may also be unfounded as well--- nearly half may be as healthy or healthier as you.


Hence, to my fellow medical students on the slim side: Don't be a hater.

Dire Apologies

It's been 759 days since my last post--- I can't believe it's been that long since my African road trip.


Since then: I've read many books (skimmed some of them), saw many patients, gained more friends (and lost some), shed many tears, had at least two breakdowns, and took a 18 month trial of antidepressants. 

But who said medical school was easy anyway? ... aside from the satirists and the compulsive liars, of course.

Now, I'm a different person--- wiser, braver, fatter, and more realistic than before. I look back on my eager first days of medical school with nostalgia and a twinge of embarrassment. I have finished my third year of medical school, and I'm closer to being a doctor than ever. However, I'm taking an "academic" leave of absence to take a job as a medical journalist--- to get away from the perils of school and develop my interest in writing.

I couldn't be happier with my decision; with no academic commitments and a full salary, it's nice to be a real person again.

Now, it's time to start where I've left off. I still want to build this blog into a good resource for medical students and pre-med students.

Sorry for the delay.

Click here for my brand new post--- I dare you.

Wednesday, August 11, 2010

Kisumu

Back to day 4 of my backpacking trip: Kisumu (point C, here), smaller than Nairobi, resides in the region where Barack Obama, Sr. grew up. Our bus left an hour late from Nairobi, but I was still able to arrive to Kisumu around 5pm – before dark. After I checked into the Sooper Hotel, I knew what I had to do: see the infamous great lake – the purpose of my entire trip. Fortunately, the hotel had a terrace at its roof. 38 steps later I was there – at least at one of its many bays.

I made it.

The lake and I needed to get more closely acquainted, so I immediately left the hotel and walked down Oginga Odinga road toward its end, where I found a shore-side car wash, a few fish restaurants, and the water of a lake fit for a queen – Queen Victoria. As I stood between the truck and the sedan and rinsed off my shoes with the murky water, this Great Lakes man had finally encountered the “other” great lake before the sun went down.

Tomorrow, during my less than 20-hour stay in Kisumu, I hope to take a boat tour of the lake before boarding a 12:30 bus to Kampala, Uganda. I also will be north of the Equator for the first time since June!

That initial view of the lake – one of many, hopefully – made my trip worthwhile. I can go home happy.

My flashlight saved my life.

The god of irony strikes again. I’ve been able to safely traverse Lake Victoria alone; however, the day I find my way back to familiar Moshi "home," a stranger almost attacks me on my first day back.

I went to my favorite internet café down the road to get more waffles and ice cream and skype a friend. As I waited for him to go online, it got dark, so I forfeited the skype and started my 20-minute solo journey back home down the rural, poorly lit Lima Road. I took one of those maglites to help guide my way.

Others were walking – a slight comfort. I noticed a white-shirted man walking behind me and allowed him to pass. As I kept watch, he turned down a side street and stopped. Pretending not to notice, I kept walking and soon found him jogging behind me. My light skin tone must've labeled me as a “rich” Mzungu (foreigner). I froze to let him run past, but he stopped beside me and asked something in Swahili.

“Si fahamu.” – I don’t understand – I replied as I increased my distance from this strange gentleman. He wouldn’t let up. I knew what was happening. It was dark. The road was empty. When he poked my left pocket, I had had enough.

“GET BACK!” I screamed multiple times as I charged him – maglite in hand. I took a few retaliation swings. They got harder. The man backed away. The screams got louder. He lifted his arms for self-protection. I could feel the adrenaline surging through my veins. Primal impulses returned after 2 million years of evolutionary dormancy. He realized my anger. I managed to strike his forearm before he ran in the opposite direction.

After checking the perimeter, I continued my journey– sweating and more freaked out than before. Though I was happy to be alone, I slightly regretted not pursuing this man and striking his head. At the moment, I was a Mzungu not to be reckoned with.

It was my fault, I shouldn’t have walked alone at night. I had learned my lesson.

As I write this, after four hours of cool down time, my nerves are still a tad shaky. Being a 6 foot tall half-black man from Detroit helped -- though I realize my luck. I tried to call someone to talk about it, but the connection was shaky, so now I write this to help process what happened.

Please don’t be freaked out by this post – I only have 3 days left here. I will post more updates on the backpack trip later.

Tuesday, August 10, 2010

Ten Medical Aid Workers Slain in the Line of Duty

Before commencing my African trip updates, I must halt to share an article that shared saddening events that took place in Afganistan:

http://www.nytimes.com/2010/08/10/world/asia/10aidworkers.html?_r=1&hp

I know there is a war taking place there, where soldiers and civilians are injured and killed almost daily. However, harming and killing someone who has come to help -- no matter the killer's initial assumptions of spying or Christian proselytizing -- astounds me.

Please take the time to read through each of the workers' altruistic accomplishments. Hopefully, it will aid in their memory.

Monday, August 9, 2010

More American Priviledge

Last night, I just arrived in Bukoba, Tanzania (Point E, here); however, I must update you on what happened last week in Nairobi:

As a privileged American who hadn't previously left the country, I forget about visa-related issues. As I travel more and more, the thought of having to pay money to any government to travel in any country (and spend money in that country) is next to egregious.

Those thoughts ripped through my head after being forced to visit the Nairobi immigration office when I realized I had made a drastic mistake.

I had entered Kenya on July 31st under the impression that my stay would last only three days, which qualified me for a three-day term transit visa ($10 US). After I decided to expand my desperately-needed urban stay in Nairobi, I was forced to ask the infamous $25-dollar question: Do I really need to purchase another visa to stay in Kenya for two more days? Will they give me that much more trouble at the border?

The blank stare of the officer compelled me to regretfully comply. $25 dollars and one whole passport page later, I left the office annoyed.

However, while walking down Kenyatta Avenue I realized that if I were a foreigner entering the US, the entry process would my much more complicated and expensive. A friend of mine in Russia wanted to visit her brother in the States. She had to travel several hours by train to Moscow for an interview at the American Embassy and pay $200 US to visit the USA. She had no choice. Before the interview, her entry visa was not guaranteed.

After putting things into perspective, I cooled down and continued to a swanky Nairobi cafe to enjoy a cup of joe and my novel.

Sunday, August 1, 2010

I left my heart in Nairobi

After a 7-hour bus ride, I have finally arrived at Nairobi, the first stop of my crazy lonesome journey. What a beautiful city! After being in small-town Moshi for 5 weeks, Nairobi with it's concrete, traffic lights, gridlock, and skyscrapers reminded me of New York -- there is even a Central Park here!

I took the impala shuttle, which left Moshi at 6:30am dropped me off in the city centre at 3pm, where I found the Terminal Hotel. I got an adequate single room for 1700 Ksh (Kenyan Shillings), which is around $27 US. Clean room, sink, hot shower -- I was in heaven!

One benefit (and curse) of this large city are the abundant restaurants. On the first day, I had lahmacun, a Turkish pizza. This morning, I found a shnazzy coffee house that makes banana walnut pancakes to die for!

Later this afternoon, I visited the 30-floor Kenyatta Conference Center, the second highest building in Nairobi. At the top (105 meters), I was able to see all of Nairobi -- including the former site of the US Embassy (bombed by Al-Qaeda members in 1998), which is now a parking lot.

I wish I could show you pictures, but my computer is still in Tanzania. I promise to post pictures at the end of my trip.

I still want to visit the National Museum, Village Market, and a few contemporary art centres. Soon, I will leave for Kisumu, on the coast of Lake Victoria!

Friday, July 30, 2010

Motivational learning

As I watch another hysterectomy, I can’t help but think of all the skills and facts I don’t know. Why does the surgeon cut the broad ligament first? Why did he make a vertical incision instead of a horizontal one? How does he select the #1 suture instead of the #2 suture? How can he stand on his feet for so long!?!

My motivation to study and learn grows every time I stand in the operating room or adjacent to patients’ beds during rounds. As my “trip” in East Africa winds down, a new motivation to study and academically succeed grows. Hit those books. Write those notes. Attend those lectures. Watch them again!

How do I maintain this energy in the middle of the school year when I’m filled with stress, fatigue, and junk food? My first year punched me in the face because I lost motivation to persevere. Though I did well enough, I could have done better, and I think the key to improvement involves reminding myself why I’m doing this. I need to get clinical exposure at least once a week throughout the school year.

Our hospital back in New York offers a plethora of opportunities to see patients – even if it is behind Plexiglas. I can watch surgeries. I can volunteer. I can shadow professors. I can conduct research. Also, a friend of mine from synagogue volunteers at the local HIV/AIDS non-profit and offered to get me in.

I never found the need to do this last year; I resorted to my usual undergrad habit of running several student organizations and planning events, which I enjoy. However, if I plan to stay sane during the trials of the next 10 months until my USMLE, I will need to switch my extracurricular priorities.

Thursday, July 29, 2010

Bike Challenge

You can always count on two things: family and connections. A nice doctor from KCMC connected me with a bike provider. Suddenly, my bliss knows no bounds.

Isn’t she pretty? She was placed in my care for love and good keeping for my last few weeks, and on the first day, daddy felt obligated to take this baby for a test spin around the block.

However, it wasn’t easy. During our maiden voyage, I realized that we weren’t living next to a mountain for four weeks; we were already on one. The roads either sloped downward in a crazy-fun death spiral or climbed painstakingly upward. At many points I had to stop and walk until I regained my breath.

How do I overcome this? Was the seat too low? Was I that out of shape? Is Moshi, Tanzania bike un-friendly? As I rode upward, I looked over and caught a glimpse of a 19,334 foot-tall friend in the distance. It finally decided (after a week) to poke it’s head out of the clouds. I was able to capture it from the seat of my bike.

That’s when I realized that climbing this hill will require more than a seat adjustment; it will require an attitude adjustment. I plan to keep riding this path as often as I can until I can make it up the hill without having to stop.

Then, a new challenge was born.

Wednesday, July 28, 2010

First Year Going On Third.

Excitement. I’m preparing to present my first patient (and her newborn) during the daily morning report.

In lieu of my research failure, I’ve taken the opportunity to learn as much about Obstetrics and Gynecology as I can on the wards. I’ve watched many surgeries, seen many patients, and read many textbooks.

I’ve been reading the “First Aid for OB/GYN” – the bible for third-year students rotating in the OB/GYN department. I’m attempting to turn my “shadowing” experience into a mini third-year rotation, where I actually get involved. I can’t tell you how gratifying it is for your attending to mention the types of abnormal vaginal bleeding, which you have already studied a few days earlier.

Without formal training, I can’t do most tasks like IVs, blood draws, cleaning wounds, etc. However, two weeks ago I was allowed to scrub in and assist the surgeon with surgery. It was an abdominal hysterectomy and my first time touching a uterus. The entire experience filled me with excitement as I assisted the surgeon clamp, cut, and sew.

Yesterday, I was allowed to assist in a cesarean section for the first time. After observing a few (and years of hearing the story of my own cesarean birth), the speed of the procedure took me by surprise. The cutting didn't elapse as long as the anesthesia. After a few minutes of cutting and some blood-splattered scrubs later we were able to deliver a healthy baby boy amidst a sea of meconium, blood, and amniotic fluid.

It was both amazing and disgusting at the same time. I have joined the club of those who have placed their hands inside the uterus of a woman he or she didn’t know (though I did know her vital signs).

After the delivery, the hard part began. The surgeon delivered the placenta, and we both started the process of cleaning, patching, and sewing. After we finished and both patients were transported to the right places, I got the third-year honor of presenting this patient to the rest of the OB/GYN staff.

Monday, July 26, 2010

Simple Pleasures

When one settles in an unfamiliar culture in an unfamiliar country (especially a developing country), he or she finds refuge in simple pleasures to help with homesickness.

A popular source of refuge for me involves food – lots of food. In a sea of beans, rice, ugali, chili sauce, and mangos, I appreciate the opportunity to have a hamburger once in awhile – or even better… waffles and ice cream!

They sell this at a coffee shop down the road from our house. What I’ve really enjoyed about this particular dish is the richness of the waffle. They must put some form of cream or cool whip in their batter to make it extra thick. Yes, it is more expensive than the beans and rice we could have purchased (though still cheaper than New York prices), but tasting the comforts of home is worth the money!

Furthermore, what’s a lazy weekend afternoon without a nice, long run to remind you of home! In New York, my running paths took me either to Central Park or to the East River. Here, my running paths always take me to see Mt. Kilimanjaro among a sea of sunflowers, which makes it worth the sweat, fatigue, and panting.



The girls, on the other hand, have found their refuge in tea – for good reason. Most nights are often spent enjoying several cups of hot tea and a good novel. Par chance, I visited an attending physician’s house and spied his collection of Sex and the City DVD’s. I knew the girls in the house would enjoy a marathon of Seasons one through seven. I had only seen a few episodes, but seeing New York City again (even if its on a fake TV show) appeals to me. This is the third week of our marathon.

I don’t want to go back and start school!

Sunday, July 25, 2010

A Crazy Idea

I have a fantasy; let me disclose it to you. I want to circumvent Lake Victoria and visit the surrounding cities.

This desire probably stems from my admiration of road tripping – traveling on the go. Also, as a person who grew up near the Great Lakes in Michigan, I hope to see this “other” great lake they keep talking about.

My dream trip will probably go something like this (click on the photo for a better quality):

Day 1: Take a bus from Moshi, Tanzania (Point G below) to Nairobi, Kenya (Point B), get a hotel, and experience its infamous nightlife.
Day 2: Explore Nairobi during the day and learn more about its blossoming art scene
Day 3: Take a bus to Kisamu, Kenya (Point C) and see Lake Victoria for the first time.
Day 4: Take a bus into Uganda and travel to Kampala (Point D), it’s capital city – also known as the “Pearl of Africa” (courtesy Winston Churchill).
Days 5, 6, & 7: Meet up with a two medical school friends and explore Kampala. Also, visit Entebbe (on the cost of Lake Victoria) and Jinja (where the Nile begins). We’ve discussed the possibility of white water rafting!
Day 8: Via bus, trek around the western edge of Lake Victoria into Tanzania to Bukoba (Point E).
Day 9: Travel to Mwanza, Tanzania (Point F). In lieu of a bus as indicated on the map, I intend to take a cross-Lake-Victoria ferry.
Day 10: Set off on the final branch of the trip: a 12-hour bus ride back to Moshi, exhausted and gratified.

Because transportation is often unpredictable, who knows if this plan will work or how long it will take, but I can’t give up the prospect of visiting all these cities.



However, there is a caveat. I will most likely do the traveling alone…

Part Three: Ngorongoro Crater

Formerly a volcano – now collapsed and inactive. Our campsite overlooked the crater and chilled us to the bone. The temperature at night fell to 12-15 F.


When we first arrived, we encountered a surprise: two thirsty elephants! They often visited to drink water from the campsite’s water tank (in between the two elephants in the first photo). One walked among the tents for a bit before leaving.



The following, bone-chilling morning we paid the crater a visit. Despite the chills, this place easily became my favorite of the three parks – abundant animals, endless clifts, and spectacular views – especially the sight of cloud shadows. Whenever I think of God, my mind’s eye pictures this:

Lions. Lions. Lions. They ruled the place and knew it. Though today must’ve been their day off because all they were all napping. We even found a couple lions lounging in the middle of the road. The approaching cars only succeeded at making these lions even sleepier. We had to drive around them, but again appreciated the proximity. Our guide, during lunch, described a scary moment when a lion once jumped on the hood of a truck and fell asleep – he apparently liked the warmth of the engine. The lion was so heavy that when it finally left a dent in the hood remained.


Again. Kings of the jungle!


And here are its subjects: wildebeest, zebra, ostriches – we had a fun time.


More photos:

Lion cubs!

Part Two: Serengeti National Park



Siringit = endless plains in Massaai. 14,763 square kilometers of endless plains grazed by tens of thousands of wildebeest during their annual migrations. We visited during the dry season (June to November) and easily spent two days here. Every tree, animal, cloud reminded me of the movie the Lion King. I’m not sure why they don’t sell it at the gift shops here.


Our first animal of the park: the superb starling. The metallic blue-green feathers caught my attention. However, I saw hundreds of them over the next two days, and the novelty wore off.

More elephants. We spied another grazing herd move through the plains. I adored the proximity.

More acacias. They never get old.


We arrived at our campsite for the night and caught the sunset while fighting off mosquitoes. Also, a hyena paid a visit to our campsite during the night. My classmates were worried, but I slept through the entire thing.

We arose early enough to see the sun rise and spy a few more animals. We saw lions from afar, though we saw most of them the following day at Ngorongoro Crater.

Safari: Part One

If given the opportunity, how would you describe the universe? Would you start with a physical description of its stars and move forward to the galaxies? Would you explain the universe in the form of a story from beginning to end? Would you be concise? Is that even possible?

If you replace “universe” with “safari,” you have my problem. We finished our safari tour of three national parks a week ago, and I’m still racking my brain to figure out how I can describe the amazing things I’ve experienced with you all.

I’ve decided to rely on pictures with a few highlights. Brevity is the soul of wit.

Part One: Lake Manyara National Park

Less famous than the other two, this park is known for its birdlife and abundant hippos. The park lies between the lake and a series of cliffs that resemble the hills of Los Angeles – we looked for the “Hollywood” sign.

We awoke at 4:30 to be picked up at 5:30 from our compound by the vehicle below. The first night we slept in a luxury lodge; we would camp the following two nights.

We (and our stuff) waited to start an adventure!


Hippo pond – with storks, hawks, wildebeest, zebra, and of course, hippos. This is what I call an ecosystem.

While driving around, we spied the rear of an elephant snacking on a nearby bush. While verbally coaxing it to turn around, we almost missed this family of elephants behind the truck! They sprinkled themselves with dust to “clean” themselves. How it works, I have no clue.

An acacia tree – the symbol of both East Africa and the movie "the Lion King." Often, we would break into song.

The velvet monkey. The first thing I noticed were the bright blue genitals. That’s how you can tell its aroused, apparently.

Tuesday, July 20, 2010

What I wish I had done differently

To anyone who is traveling to East Africa: bring a ton of cash in US currency! Not just cash, but $100 bills. Here’s why:
  • Credit Cards are useless here. Everywhere I ask about using a credit card (restaurants, stores, etc.) I just get laughs. Plus ATMs do not withdraw US dollars, only T shillings (T /=), of course.
  • ATM’s mostly Charge. This may come as a surprise to some people (it was a surprise to me), but there are ATMs in Tanzania, and you can withdraw money from them with your American debit card – for a fee. It depends on your bank, of course, but I (and my classmates) are charged a 3%conversion fee for every ATM withdrawal. Some banks, charge a flat fee of $5 dollars on top of a 3% conversion fee. Go figure.
  • The exchange rate is much stronger for $100 dollar bills. When I arrived in Dar Es Salaam, the best exchange rate I could find was 1465 T/= (T shillings) for $1USD, but that was only for $50 and $100 dollar bills. For USD$20, $10, $5 dollar bills, the exchange rate was a mere 1420 T Shililngs per dollar.
  • ...Furthermore, to buy back US dollars with T Shillings, you pay more: 1520 T/= per US dollar. For example, if you had $100 US and you wanted to exchange that for T Shillings, you would receive (100 x 1465) 146,500 T/=. However, if you wanted to take that same amount of T Shillings and exchange it for US dollars, you would recive only (146,500/1520) $96.38 – you would lose $3.62 for each 100 US dollars. This is illustrated in my next dilemma.
  • Many touristy expenses charge only in American Dollars. This includes excursions, hotels, hostels, travel agencies, and some (but very few) restaurants. For example, My classmates signed for a four-day safari to both Serengeti and Ngorogoro national parks. The Tanzanian-based company that is organizing our trip charged us $530 US dollars. However, I didn’t bring enough American currency with me from New York, which forces me to buy back US currency with T Shillings. The exchange alone will cost me an extra [(530x1520)-(530x1465)] 29,150 T/= (or $ 19.90 USD). I should have brought more American currency.

I think the last bullet point is especially strange. I never knew the power of US currency in this country. Even those from European and Asian countries who travel to Tanzania must exchange their euros, pounds, yen, etc. for US dollars before leaving their home countries if they expect to go on bike trips or safari trips.

That’s American privilege.

Wednesday, July 14, 2010

Research Failure

When I decided to work at KCMC in the Obs and Gyn department, it was with the expectation that I would assist with an ongoing research project that assesses methods to prevent mother-to-child HIV transmission. In New York, if a new mother is HIV positive, we would just encourage her to avoid breastfeeding her child (which can transmit HIV) and use a formula for her child instead. However, in a developing country like Tanzania, one can’t guarantee a stable, clean water source with which the mother can make formula. Hence, the mother risks transmitting fatal diseases, like cholera, from the potentially-polluted drinking water – especially if the infant’s brand-new immune system lacks the antibodies necessary to ward off these diseases.

To prepare, I’ve read a few studies from Malawi and Botswana that discuss the usage of prophylactic HIV medications to prevent the mother from transmitting HIV to the infant with good rates of success. I was hoping to participate in a similar study at KCMC, but to my dismay, I was informed that no such project exists anymore at KCMC! I must’ve come too late. When I asked about other research projects in the OB/GYN department (including the famous Pre-Eclampsia/Eclampsia project), they either have already been completed or were awaiting approval. I was in shock. My classmates, also hoping to assist with some sort of research project, experienced similar disappointments.

Now, I’m considering the possibility of spending six weeks shadowing physicians, which isn’t unappealing. The staff and faculty of the OB/GYN department have been really helpful. One physician offered to give lectures on important topics in OB/GYN.

I could also use the spare time to conduct research of my own in the library. Giant obstetrics, surgery, medicine, and physiology textbooks await.

Now, I'm updating this blog on real time. I go for a four-day safari tomorrow. Can't wait!