Returning after a Long Hiatus

No, I’m not dead. These past few months have been fairly busy, and I haven’t had the time to post much of anything lately. Luckily, today marks a brief lull in the action, and I have returned once again! Hopefully my return is welcome to the two people who actually read my blog.

So my application cycle is finally officially over. The final tally isn’t necessarily something of which I’m proud, though I agree with the prevailing wisdom: It only takes one.

And I’ve got it!

Boston University accepted me in January, so I canceled my interview at SUNY Stony Brook, and have decided to attend BU. This means the final tally is as follows:

1. Warren Alpert (Brown)
2. Tufts
3. Boston University
4. Yale (heh)
5. University of Michigan (my father’s alma mater)
6. Washington University in St. Louis
7. Dartmouth
8. Medical University of South Carolina (more for the fiancee than for me)
9. University of North Carolina
10. Mayo
11. University of Vermont
12. University of Rochester
13. Georgetown
14. Baylor
15. SUNY Stony Brook (Interview offered, application withdrawn)

A few thoughts on my application strategy: First of all, as some have noted on SDN, the list of schools to which I applied represents largely a pipe dream, based upon my undergraduate GPA. I pulled a complete Icarus here, applying to several schools to which I had no business applying. I mean, really – Yale? Yale?! What in great fucknuts was I thinking?

That said, SMPs currently occupy a strange no-man’s-land of application-strengthening programs. Just how much can an SMP resolve issues from undergraduate performance? As my application cycle demonstrates, only so much. It won’t erase past mistakes, and it can’t convince schools to open your file if they wouldn’t have anyway (partially because the grades from a SMP are buried in your graduate GPA).

What an SMP can do is get you a foot in the door at the school offering the program. Thus, I got an interview at BU, and got an acceptance. In the coming days, I’ll post a more thorough analysis of the cycle, but I figured that as I’ve been remiss in posting for the past few months, I ought to at least check in.

Good luck to anyone still waiting.

Life as a Nonsmoker

Today is day four of my new life as a non-smoker, and with Chantix’s help, it looks as though I’ll be successful. I had, once upon a time, quit for six months (again with Chantix), but turned once again to the Dark Side upon my move to Boston for school. So far, all I’ve noticed is a little bit of grumpiness around mid-afternoon, and I tend to feel lonely for some reason, but otherwise, I’m doing pretty okay on the Chantix.

Everyone (at least, everyone who’s ever smoked) has seen the list of changes over time that occur once a smoker quits, I’m sure. It’s certainly an encouraging list, but it has little in the way of impact for me, as these changes aren’t something you can see, and aren’t really especially detectable in practice. Partially as an exercise for me, but also because I actually enjoy histology and pharmacology, I’ll do my best to contextualize them.

• After two hours nicotine begins to leave your system.

This one’s easy. Nicotine is a plant alkaloid, most commonly derived from the tobacco plant, but also found in certain members of the nightshade family (eggplant, tomatoes, &c.). It is a nicotinic acetylcholine receptor agonist (in contrast to one of its fellow nightshade derivatives, atropine, which is a muscarinic acetylcholine receptor antagonist).

Of course, the quote above is a little silly. Nicotine doesn’t start to get eliminated from the body after two hours. Nicotine clearance begins immediately after exposure. In fact, by two hours post-quitting, roughly half of the nicotine in the bloodstream is eliminated. Nicotine is metabolized in the liver by cytochrome P450 enzymes, embedded in the membrane of the smooth endoplasmic reticulum of hepatocytes.

This metabolism proceeds via first-order kinetics, which means that the relative rate of metabolism remains constant, regardless of concentration. If you were to measure the concentration of nicotine in a smoker’s blood over time after a cigarette, what you would find is that the concentration would drop logarithmically, meaning that the decline would be initially steep, but would eventually level out asymptotically. Plotting the natural logarithm of the concentration as a function of time would yield a straight line with negative slope, and that slope would be equal to the rate constant.

Taking the natural logarithm of two and dividing it by the rate constant yields the half-life, which is the time required to metabolize half a given concentration of the nicotine.

For nicotine, this is equal to roughly two hours. So after about two hours, or one half life, the concentration of nicotine in the smoker’s blood would be one half of the original concentration. After four hours, 1/4. Six hours, 1/8, and so on.

It happens this way because in a first-order reaction, the rate depends upon the concentration of only one reactant, in this case, nicotine. If you imagine the CYP450 enzymes to work so quickly that they can handle an infinite amount of nicotine without getting backed up (they can’t, but that’s a post for another time), then the only thing that would limit the rate at which they could break down the nicotine (barring any allosteric regulation by metabolites or garbage like that) would be the rate at which nicotine finds its way to the hepatocytes. Obviously, the higher the concentration of nicotine, the more will be available to the CYP450 enzymes, the more nicotine per unit time metabolized, and therefore the higher the rate of nicotine metabolism.

What this means, therefore, is that, very roughly speaking, no matter how much a person smoked before they quit, no matter how high their mean level of nicotine, after about two hours, half of it has been metabolized. I say roughly, because this assumes that any upregulation of CYP450 enzymes as a result of chronic nicotine exposure is negligible, and that he or she doesn’t smoke menthol cigarettes, as menthol is a known inhibitor of CYP450 enzymes.

 

• After 12 hours, carbon monoxide disappears from the body and the blood is able to effectively carry more oxygen to the tissues.

Carbon monoxide is an unfortunate by-product of the incomplete combustion of tobacco. When a smoker breathes it in, he has unwittingly invited into his body a molecule for which hemoglobin, the protein responsible for transporting and distributing oxygen throughout the body, has 250 times the affinity of oxygen. This means that hemoglobin holds onto CO much more readily than it does O₂. This might not ordinarily be a huge problem, except that CO eliminates one of the really neat things about hemoglobin that makes it so good at its job: cooperativity.

Hemoglobin (Hb) is composed of four subunits, two α and two β. Each of these subunits contains a heme group, which is what allows hemoglobin to bind to and carry oxygen. This means that each Hb molecule can carry up to four molecules of O₂. Of course, in order to be a really effective oxygen transporter, Hb needs to be able to respond to different conditions in the body with some degree of sensitivity, grabbing oxygen efficiently when it’s present, but also giving it up easily wherever it’s needed. In order to solve this problem, the subunits of Hb exhibit cooperativity with one another. When one molecule of O₂ binds to a subunit of Hb, it “tugs” on the other subunits, increasing their affinity for O₂, and making it more likely that they’ll hold onto it when it binds. So in areas of high oxygen concentration, Hb will readily and quickly pick up oxygen and hold onto it for transport to other areas of the body.

But the opposite is also true! When Hb reaches an area of the body that needs oxygen, it can readily give it up, and each molecule of O₂ that leaves “relaxes” the other subunits, so that they’re much more willing to give up their oxygen, too. There’s other stuff at play here, like pH and CO₂ concentration, but for our purposes, the cooperativity is what’s important.

Here’s where CO comes in. When CO binds to Hb, Hb tends to hold onto it very tightly. This wouldn’t be too big a deal, except that just like oxygen, CO also tugs on the other subunits, increasing their affinity for oxygen. Not a big deal in areas of high oxygen concentration, but when it reaches areas of low concentration, it’s not as willing to give up its oxygen, because the CO stays bound and keeps tugging on the other subunits, making them a stingier. This is why CO is so dangerous at even relatively low concentrations: You could have plenty of oxygen and still your tissues would be starving for it, as Hb would no longer be very effective at distributing it where it’s needed most!

The only way to get rid of CO is to provide lots of oxygen, and wait for it to leave the body, which it does, albeit slowly.

 

• Within one week your senses of taste and smell sharpen.

The senses are truly amazing, and I am a little in awe of the ability of evolutionary processes to develop some rather complex functions. In this case, both taste and smell are picked up by cilia on specialized epithelial cells that are connected to the nervous system. It’s not hard to see the advantage bestowed to an organism by the ability of the cells lining its surface to give it information regarding its environment, but it is a little breathtaking to see the elegance with which these cells have adapted to do so.

Below is a picture of a taste bud, and while it’s really beyond the scope of this post to identify which cells are directly involved in taste sensation and which are merely support cells or stem cells, the take-home message is that business end is on the side of the taste pore, the part that projects out into the oral cavity.

The oral cavity would be to the left of this picture, and the tongue, obviously, to the left. In the middle of this picture, you can see a taste bud embedded in the tongue epithelium, with cilia projecting outward through the taste pore.

Cigarette smoke damages these sensory cells, however, which is why taste is typically blunted in smokers. Thankfully, this damage isn’t permanent, and shortly after smoking cessation, taste is largely restored.

There is a similar set-up in the olfactory epithelium, the specialized lining in the nasal cavity that senses smells. It, too, may be damaged by cigarette smoke, making the sense of smell less acute in smokers. A picture of the olfactory epithelium is shown below.

The white space traversing the upper portion of the picture is the nasal cavity, and the strip of epithelium shown traversing from the upper left of the picture to the lower right is the olfactory epithelium. As with the taste bud, there are sensory cells, support cells, and basal cells that act as stem cells, replenishing the epithelium as needed. The cells responsible for sensing taste have cilia-like appendages that project into the nasal cavity, and respond whenever they come in contact with particles of smelly substances by transmitting information to the nerve cells with which they are in contact.

So that’s where I am so far! My nicotine levels have dropped effectively to zero (three full days = 72 hours = 36 half-lives, meaning the concentration of nicotine in my bloodstream is less than 1/2³⁶. This may seem like a gussied-up Xeno’s Paradox type of situation, but trust me, eventually the concentration of nicotine is, in fact, zero), carbon monoxide is back to normal levels (it’s a by-product of a normal process in your body, meaning there’s always some floating around), and my taste and smell epithelia are regenerating.

Additionally, my blood pressure has returned to baseline levels (nicotine is, after all, a stimulant). There are other benefits, but in the interest of readability, I’ll stop here, and save them for an upcoming blog post (with pictures!) about alveoli and respiratory epithelia.

Source: Komaroff, A. L. (1999). The Harvard Medical School Family Health Guide. Cambridge: Simon & Schuster.

Another Disappointment

Sorry it’s been so long. I’ve been preoccupied, and time flew away faster than I would have liked.

So it is now December. I understand that there are still plenty of interviews to be distributed, but I must admit I am hard-pressed to feel that I will be the recipient of one of them. To wit, University of Michigan has passed on interviewing me yet (there exists, I suppose, the potential for a late-cycle interview to be granted to me as application review continues in the coming months, but with only 100 interviews left (a majority of which are dedicated to Michiganders), I have my doubts), making Boston University one of the only school so far that seems to have even opened my application.

The other school is SUNY Stony Brook, where I have an interview in January. I’m not particularly thrilled about this school, but at this point, I’m not in a position to be particularly choosy, and I am very happy to have another interview. Were it not for this, I’d be feeling a bit more desperate, especially since Dr. Wonderful was careful to warn me that my acceptance to Boston University was by no means assured, and that, in the end, it would come down to what can be a largely political process. So having another interview in the can is at least moderately reassuring.

In the meantime, upon returning home from the BU interview, I discovered that Grandpa Eventual had died on the very same day of the interview. This was not a surprise, mind you, as his health had been steadily deteriorating once a stroke had left him bedridden four years ago. And I was also not particularly close with the Grandparents Eventual, as my family lives at least 8 or 9 hours away; visits were therefore fairly seldom, and we more or less grew apart. But upon hearing the news, I was suddenly struck by a myriad of memories and emotions.

In the intervening weeks between my last post and this one, I was also turned down by University of Rochester, which was a disappointment. I know that it’s a challenge to get into any medical school, so there are no sure bets, but still… I figured with my SMP grades, I’d at least get an interview there.

But today, I got rejected pre-interview from my top school, Brown. Surprisingly, it doesn’t hurt all that much. At least, not as much as I’d thought it would. I think I was pretty resigned to the fact that Brown was a long-shot to begin with, so it wasn’t as acute a disappointment as it would have been had it been a total surprise to me. Brown is notoriously selective, especially with a significant portion of the spots going to Brown students from other pathways.

So here’s the count:

1. Warren Alpert (Brown)
2. Tufts
3. Boston University [Hooray!!!]
4. Yale
5. University of Michigan
6. Washington University in St. Louis
7. Dartmouth
   
8. Medical University of South Carolina
9. University of North Carolina
10. Mayo
    
11. University of Vermont
    
12. University of Rochester
13. Georgetown
    
14. Baylor
15. SUNY Stony Brook [Interview!!]
16. Duke

The results of this experiment are, of course, a long way off, but I must confess that preliminary data are inauspicious.

On the positive side, I’ve decided to quit smoking once and for all. I’ve started taking Chantix recently, and hopefully I’ll be a nonsmoker as of next Monday! Wish me luck!

Will post more soon, I promise!!

And the Hits Just Keep on Comin’

Recently, on an undisclosed date, The Eventual Doc ventured to Boston for his very first interview, at Boston University. If you recall, this was not only his first interview of the application cycle, it was, in fact, his first interview out of three cycles. So this is what you might call a Very Big Deal to him. The drive was fairly pleasant, actually. Driving through Vermont and New Hampshire, the leaves were a fiery, golden blanket across the landscape, and with a few This American Life podcasts saved to his iPod, little in the way of traffic, and nearly ideal driving weather, The Eventual Doc made excellent time.

Just as he reached the outskirts of Boston, however, his Palm Prē buzzed to indicate an incoming email. A glance at the email subject, which was all The Eventual Doc could read (as he is a Very Safe Driver, and doesn’t text or email on the road) indicated that the Dartmouth Medical School admissions office had reached a decision on his application. With the GPS device indicating at least another 10 minutes before he reached the hotel, The Eventual Doc excitedly imagined parking at the hotel, flipping open the phone, and reading the email in which Dartmouth would exclaim that they’d never seen as impressive a student as he, won’t he please come on down at his earliest convenience to interview.

This, of course, was decidedly not what the email said.

The Eventual Doc was assured that his application was considered with care, but that wherever he went to medical school, it wouldn’t be there. One more down.

The interview at Boston University was great. Having been a GMS student, it wasn’t necessary for him to attend a full interview day, sparing him the student-led tour, lunch, etc. Actually, he was pretty bummed about not getting a free lunch. But otherwise, the prospect of a one-and-done interview day was a pleasant surprise, and that would mean he could return home to Snowville, NY much earlier than he’d feared. Then he got the Red Folder.

Ah, the Red Folder. Countless times, The Eventual Doc had seen herds of somberly-clad interviewees on the medical campus at BU, clutching their Red Folders nervously. He had never seen the inside of one, but imagined it had to contain untold treasures, and that the mere fact of holding one admitted a person to an elite, secret club, like the Masons, or Scientologists. Turns out, it just contained some facts and figures about the school, some financial aid information, and the like. Nothing too spectacular, and no magic membership to the BUSM Cabal. Still, he found himself unconsciously holding it so that the embossed “Boston University School of Medicine” was conspicuously visible wherever he went.

Secretly, he imagined mothers leaning over their children and whispering, “See? That man there is Going Places. He’s On His Way to doing Great Things.” Old men would look on admiringly as The Eventual Doc passed, nodding in approval. Of course, in reality, he appeared, more than anything, just like those herds of self-conscious interviewees he had jealously despised the year before. But damn it, he finally had his Red Folder.

He learned that his interviewer would be none other than Dr. Wonderful, whom he knew by reputation and occasional interactions to be very nice and easy to speak to. The interview was extremely conversational, not in the least stressful, and left him with a cautious optimism for his chances at gaining acceptance there. That said, Dr. Wonderful candidly warned The Eventual Doc that nothing was certain, and that she could offer no guarantees or even any indication of which direction the decision may go. This will be a long winter.

Before he left, he remembered that he had a logo blanket he’d been awarded by his employer, DrugCorp. He left it beside a pile of blankets in the shape of a sleeping homeless person; it was getting cold, and surely others needed it more than The Eventual Doc. He didn’t want to wake the pile of blankets, so he just left it there. Would it be appreciated? He didn’t know.

Upon arriving in Snowville, The Eventual Doc settled down to his computer to check his email, and then status pages for his medical school applications. UVM had apparently taken advantage of his trip to Boston to update his status; rejected.

So here’s how things stand for The Eventual Doc:

1. Warren Alpert (Brown)
   
2. Tufts
   
3. Boston University [Hooray!!!]
   
4. Yale
   
5. University of Michigan
   
6. Washington University in St. Louis
   
7. Dartmouth
   
8. Medical University of South Carolina
   
9. University of North Carolina
   
10. Mayo
    
11. University of Vermont
    
12. University of Rochester
    
13. Georgetown
    
14. Baylor
    
15. SUNY Stony Brook
    
16. Duke
    

Things are certainly not looking good. Before the cycle began, The Eventual Doc had imagined the doors to highly-ranked medical schools swinging open to welcome him. Now, he’s hoping to get an invite to at least one more.

 

Undergraduate GPA: An Intractable Problem?

Today I sat down and looked over my UG transcripts. As most of the schools to which I’ve applied have been relatively silent, it’s given me plenty of time to start worrying about whether or not my application may have already been closed, whether I’ll even find out before the end of the cycle, and why it got rejected. Granted, there’s no reason for me to believe, at this stage of the game, that I’m already out of the running at these schools. Nevertheless, the experience of cycles past feeds a growing discomfort that I can’t seem to fully shake.

The most damning aspect of my application is my undergraduate GPA, which, as I mentioned in a previous post, is an unimpressive 2.82. Granted, that GPA is the one AMCAS calculated, and AMCAS has a habit of reporting one’s grades in as unflattering a light as is possible. Nevertheless, that’s the sort of UG GPA that will tend to land my application in the circular file without even so much as a glance at its contents.

For someone like me, where the strength of my application is my subsequent SMP GPA and MCAT score, this poses a problem.

So what am I to do? At this point, I have ~170 undergraduate credit hours. Any additional credits I take at this point will result in only a very modest improvement in GPA. To get to a 3.0 by AMCAS’ standards, I’d have to log 34 credit hours of undergraduate coursework, and not get anything under a 4.0 doing it. Is this realistic, as a near-middle aged applicant working full-time? After all, that’s at least two 18-credit semesters. I mean, it’s not the end of the world, as that’s a fairly decent course load for your average undergrad pre-med, but I’m not exactly young anymore; I’ve got a lot of time to make up for, and not so much in which to do it.

That is, in part, what motivated me to pursue the M.A. in Medical Sciences program at Boston University. My supposition was that earning a 4.0 in a program comprised primarily of medical school courses would demonstrate my ability not only to handle medical school, but flourish. I get that GPA and MCAT, while an admittedly imperfect predictor of medical school success, are currently two of the best tools we have. But should my UG GPA still be considered a better indicator than my grades in actual med school courses? I think not, but then, I’m biased.

So this brings to mind some questions that I’ve been kicking around in my head for some time now: Is it time to rethink AMCAS’ approach to non-traditional students (i.e., create a new “Non-trad” designation)? Is this best addressed at the level of individual medical schools? Is there a way to more holistically evaluate such applicants without placing an undue burden on medical school admissions offices? How much weight should be given to so-called Special Masters Programs?

Please feel free to sound off in the comments with your thoughts.

Oh, Snap! Interview Invite #1!

So today I finally received my very first interview invite! Boston University School of Medicine has invited me to interview toward the end of this month. I was at work when the email hit my inbox, so I had to be somewhat subdued, but believe me, I was practically doing cartwheels when I got the news.

Why so excited, you might ask? Well, first of all, it’s BU: Great school, great city. Additionally, I would, at the very least, know my way around the campus. I have made friends of several faculty, and I’m familiar with the first-year curriculum. Hell, I’ve already finished three-quarters of the M1 curriculum. I would love to go here.

Second, this is my first invite of the cycle. After the first three rejections (Mayo, Duke (who still hasn’t returned my email regarding appeal), and Georgetown), this helped to take the edge off a bit. I’m hoping some momentum will build from this, but regardless, I’ve got at least one invite. I just need to parlay that into one acceptance.

Third, and most important, this is my first invite ever. In three cycles, this is the first time a school as even gone so far as to invite me for an interview. First thing I did, I called Mrs. Eventual, and then Ma Eventual, to let them know that I do, in fact, have a snowball’s chance in Hell of getting into medical school. An American one, no less!

Still, I am somewhat discouraged by the fact that the only positive response I’ve received thus far is from the school whose SMP I attended, and that response came a full two-and-a-half months after submission of my secondary application. Yikes. The jury is still out as to whether success on the MCAT and in an SMP can translate into appeal at a wider range of medical schools.

I admit, I’m playing against a stacked deck. I recognize that I haven’t really applied very broadly, but in fact concentrated most of my applications at some very highly-ranked schools. It’s not exactly a recipe for success. At the same time, however, I think that it’s important that someone test the power for a program such as the one at BU to “remake” a person, academically. Why not me? As reach-heavy as my application is, there are nevertheless a few schools at which I have a reasonable shot. So long as I don’t blow those schools, I have a real opportunity here to find out what options a non-trad really has to shine after a decidedly unspectacular undergraduate performance.

Stay tuned for more updates. This promises to be a momentous week!

2009 Application Cycle Update

Today is a crap day. So far, Duke, Mayo, and now Georgetown have opted to pass on my application.

I’m really upset about Georgetown; not only was I excited by this school, but I also thought that, since Georgetown has its own SMP and knows how to properly weigh SMP grades, it would be a decent barometer of my chances at other med schools. If that’s the case, then I am well and truly screwed.

1. Warren Alpert (Brown)
2. Tufts
3. Boston University
4. Yale (heh)
5. University of Michigan (my father’s alma mater)
6. Washington University in St. Louis
7. Dartmouth
8. Medical University of South Carolina (more for the fiancee than for me)
9. University of North Carolina
10. Mayo
11. University of Vermont
12. University of Rochester
13. Georgetown
14. Baylor
15. SUNY Stony Brook
16. Duke

The time may have come to start thinking about adding some safety schools. I need a coffee and a beer.

Other Pursuits, and Musings on Behavioral Modification

I realized today that I’ve been so keyed-up about this application cycle that I’ve really neglected other pursuits; I’ve become a very unhealthy person, and it’s started to bother me immensely. I’m not the most out-of-shape person I know, but it should immediately be obvious to anyone who’s ever had the great misfortune to see me shirtless that I could use a trip around the block or two. But, like, literal trips around the block. Also, a tan would be helpful. And salad. Additionally, I’ve fallen behind on my personal reading, and playing music. The latter two I’m working to remedy by, well, just doing them. But changing unhealthful behaviors has proven to be an intractable challenge.

Some time ago, I had the brilliant idea that I would train for and run a marathon. Such a decision, I’ve found, is really easy to make. What is not so easy, however, is the extended application of willpower to get out the door and put feet to pavement. It’s much like the inverse of quitting smoking (which is another decision upon which I’ve been woefully poor in acting). With smoking, the short-term gain of satisfying a nicotine craving far outweighs the health cost of that individual cigarette, which is one of the reasons quitting is so hard. If every time I lit up, someone punched me in the face, I’m willing to bet quitting would be a quick affair. As it is now, it is hard to connect one individual cigarette with the eventual development of emphysema, chronic bronchitis, heart disease, lung cancer, &c., &c. Similarly, the short-term misery of conditioning my body to tolerate running (especially in an Upstate New York winter) dwarfs its contribution to the eventual high of finishing a marathon.

I think this is probably one of the major difficulties in changing behaviors like smoking, poor eating, and sedentary lifestyle. The investment of willpower and sacrifice of immediate minor pleasure required to effect such changes is felt far more acutely than the eventual benefit. We’re pretty amazing creatures, humans, especially in terms of our ability to pursue goal-directed behavior over an extended period of time. But that ability is nevertheless limited, and we often succumb to the same pitfalls as other organisms, for whom survival depends upon far shorter-term decision-making and activity. I’m sure if I hired Mike Tyson to punch me in the face every time I lit up, ate a cheeseburger, skipped a run, or sat on the couch watching TV for extended periods, I would be one healthy, lean, fit dude. Maybe not at first – I’d no doubt test Mike, just to show him who’s boss – but eventually (and, I suspect, quickly), the short-term consequences of these unhealthful behaviors would motivate me strongly toward more healthful choices.

If I had more readers, I might be motivated to follow some sort of plan based upon the fear of public humiliation through failure. As it is, this is much like writing to my secret diary, where the only person I have to worry about is my mom. Perhaps one of you would be kind enough to break my perfect record of posts, unsullied by comments. Let me know what has worked for you in changing behaviors. How have you stayed motivated, and overcome your poor, primitive, immediate-gratification-loving inner animal?

New Developments? Sadly, no.

It’s been some time since my last post. This is not least because there just haven’t been any new developments. For some schools, no news is good news, I suppose (e.g., Boston University, where I specifically elected for my application to be evaluated without waiting for this year’s MCAT scores). At those schools, rejections have already been doled out for my complete date and beyond, while acceptances have not yet quite reached my date. For others, however, this is not the case. At most of the schools to which I’ve applied, my effective completion date is September 1, or thereabout, coinciding with the release date of my scores. That being the case, I’m still (barely) within the 3-week post-submission range, and it is therefore way too early to predict what will happen.

The only school from whom I’ve heard is Duke. When I say I’ve “heard” from Duke, however, it’s more like if I went over to Mrs. Eventual’s Facebook page to learn that she’s dumping me. Their system is set up such that you get an email if they have decided to interview you, but if not, then you have to check the status page to learn the disappointing news. Money quote?

While we recognize that this decision may be disappointing, it is in no way a reflection of your potential as a future physician.

One immediately wonders what it is of which it is a reflection.

At any rate, after release of the most recent MCAT, I called their admissions office to enquire anout their appeal process (some schools–though admittedly few–have processes by which one may appeal an admissions decision), and was advised to contact Brenda Armstrong, the Director of Admissions. I still haven’t heard a response, and suspect I am receiving the digital equivalent of the cold shoulder. Ah, well.

While it would have been nice to hear an invitation for an interview for my first response this cycle, I must nevertheless accept that I won’t get into every school to which I apply. I may not even get into most. I’m just shooting for any. After all, I can only attend one, anyway.

Taibbi’s Take on Health Care Reform

I must admit that I’m getting worn-out by the political grand-standing that has come to dominate the health-care reform debate. Though I identify myself as a liberal, and am certainly disgusted with some of the right-wing pushback on reform efforts, I have to admit that I’m not particularly fond of the way the Democrats have handled this, either.

Matt Taibbi has a lengthy op-ed in the current issue of Rolling Stone that’s worth a look, though I warn you that it makes for some sobering reading. Money quote, however, comes right at the beginning:

Let’s start with the obvious: America has not only the worst but the dumbest health care system in the developed world.

Hat tip, Neuron Culture