the genetics of race

When I was in high school, I got into a debate at school. I said that if different races were separated long enough to evolve different skin colors, then other things could have evolved differently too. For example, blacks are stereotypically thought of as good athletes. Asians are thought of as good at math. I know this is really oversimplifying it, but it's certainly possible that over time, blacks developed a "strong muscle" gene (or set of genes) or maybe a "hand-eye coordination gene" and Asians developed a "math" gene (or set of genes). I'm not saying that's what happened... it's just what is possible.

I was watching a TV show (I think it was Without a Trace) and although I'm sure nobody really picked up on it, there was this one part that I think really made this statement. In this episode, there was this white kid who disappeared, partly because he was having an identity crisis. His mother was white and the father who raised him with his mother was white, and the kid looked white, but his father was black, and he just found that out. In one of the flashback scenes, they show the kid when he really young, and he's talking to his adopted father, saying that he doesn't "feel right". I'm not getting the words completely right, but he basically says that he feels different from his father and all the other (white) kids - they don't like the same things, act the same way, or even look the same. And after the flashback, the father says about his adopted son, "he always knew" (that he was different).

Now at first glance, this doesn't seem to mean much. But actually, what's it's saying is that even though there was no difference in skin color for this kid, there were other characteristics - facial or other body features, personality, attitudes, etc. - that made him feel different. And then he finds out he's half-black. The point is that this one scene in the show is suggesting that there may be other differences to race than skin color (whether genetic or otherwise). It's interesting to me that this was brought up, albeit in a very subtle way, on TV, while in reality, it's something that society as a whole isn't really ready to talk about yet.

Free pens and pizza for doctors

A couple of years ago, my hospital banned any sort of pharmaceutical advertising, including free pens, lunches, dinners, prescription pads, drug samples, anything. This was a huge deal. Half the resident lunches were paid for by pharma, and they always coincided with mandatory meetings and conferences, so residents could eat while the attended and knock out two birds with one stone. I certainly understand. For one, without the free lunches at these meetings, residents often don't have time to get lunch! They don't even take the time to go the cafeteria and grab something to go. Even from an outsider's perspective, I think this is understandable - why feed yourself when you could work more on your patients and provide better care? Perhaps even save a life? Secondly, residents do not make a lot of money. They make about $40-45K a year ($30K after taxes), and many of them have $200K in debt after medical school. They haven't saved anything for retirement yet, and some of them have kids and families to support, so the loans are often just gathering interest during residency. So actually, these free meals were a source of income for the residents! Sure you can bring food and eat cheaply (and be much more healthy too) but the average resident does not have time to do this. The alternative is eating at the cafeteria or elsewhere, where an average meal probably costs $5-7. However, if you eat a free lunch off of the drug company (which usually is just pizza or ordered in chinese food or sandwiches), you save that money. You may even have enough left over for dinner if you're working late, which you usually are. Taken over a week, that's $20-$30 you save. Taken over a year, that's $1000-1500 you save, which for a resident, is a lot of money.

Despite these reasons, I've always been hugely for this. I've always thought these free pens and everything else could easily influence (hopefully subconsciously) doctors' prescriptions of these drugs. For example, say you want to prescribe a proton pump inhibitor to a patient, and in your line of sight is your clipboard, with "Protonix" all over it. You might not even realize that you saw it, but the next thing that happens is that you prescribe Protonix for your patient, and they're on that for life... not a bad way for the company to get a patient for 30 or 40 years, huh? And it's even worse with the free samples. I completely understand that free samples are how a lot of poorer people get their medications, and I think that's certainly a benefit. However, if you have a sample of drug X, and it works for a certain patient, even after they stop giving out free samples, that patient is probably going to stick with it, even though it might be 10 times as expensive as drug Y. It's also a huge source of medication confusion - so many patients I've seen have switched from medication to medication, for, say, their hypertension. And it's basically because they switch to whatever is being given out for free for that particular month. That is bad medicine, and bad for the patient.

Of course, we never knew if this was true or not. These are just theories. But why would pharma keep doing this if it didn't work, right? I'm sure they've done their research, and I've actually heard statistics from some ex-drug reps about it. So it's real. And hospitals and practices should ban pharma from advertising in their space. Of course, that's just my opinion, and there are plenty of differing views on this.

Here's an interesting recent article by Art Caplan, a pretty well known medical ethicist.

Food and Personality

I think how and what someone eats is incredibly indicative of their character. In fact, in the past, I've used it as a way to decide whether or not I'll go on a second date with someone.

The trend I see is that the more adventurous someone is at the restaurant, the more adventurous the character. Someone who orders chicken all the time is not that adventurous. Somebody who decides to try the goat or the alligator (and they do not have to like it!) probably has a more adventurous personality.

I love to eat, and I love to try different foods - there's no way I could date or see anybody long term who didn't share those interests. For example, I could never date a vegetarian, or somebody who didn't like seafood or red meat or something. Even somebody who was allergic to nuts, or shellfish, or something like that - I would get so frustrated! But that's just me.

I guess I actually know plenty of adventurous people who place limits on their food - often that's health-related, or because they're concerned about the environment, or religious. Sometimes it's because of taste, which I think is fair. And those people are fine - I can like them just fine. But I could never date somebody like that. :)

Tonight's Menu

Appetizer: cheese, crackers, and olives
First course: Mushroom soup (yum!)
Main course: Prime rib, with sauteed spicy broccoli and asiago cheese potatoes
Dessert: summer berry gratin

Korean food in Philly

We've been really getting into the Korean food lately. There's an asian grocery store called H-Mart near the 69th street station, and on the second floor, there's a Korean fast food court. It's great. There's Korean food, Japanese food (with a Korean accent), Chinese food (with a Korean accent), a Korean bakery, and even a place that sells fried chicken (with a Korean accent). We always go to the Korean fast food counter - it's soooo good. They have all sorts of barbecued meats, soups, fish, tofu, you name it. Some of it's not spicy at all, but some of it is pretty spicy (one or two peppers on the menu). I think my favorite is the marinated beef short ribs. TASTY. And it's so cool - all the dishes come with rice (or noodles depending on whether you get a rice dish or a soup dish), maybe soup, and about 3 or 4 other small side dishes. They always give you kimchee, and the other 2 or 3 might be things like pickled vegetables, broccoli, bean sprouts, tofu, whatever. Even better, they recently put up pictures with their entrees, so now I'm not stuck wondering if that's what I got last time, or if that's something I'd like to try. I had been thinking of starting to take pictures with my cell phone and labeling them with the menu order number. Not a bad idea huh?

So for Pete's birthday yesterday, we went to a new Korean place, in the same general vicinity. However, this was an actual sit-down place where you order and they take it to you at your table, and you get tea and water and everything. It's called Moo Jin Jang. I didn't even realize it had my name in it until I got the receipt. I think it was a good omen. It's not a fancy place - there's no alcohol, they serve the tea in big plastic pitchers (not even a teapot), and the menu is this laminated card on every table that lists about 20 choices. The one waitress was the only one that spoke English, and I think she translated for her mom and dad. But everything still looked good. I only recognized maybe half of the menu - all the other items listed things I had never heard of before. I was tempted to try one, but I stayed with tried and true. I ordered the barbecued pork (spicy) and Pete got the beef short ribs. DELICIOUS!! And unlike the little fast food counter, this meal came with about 8 different little side dishes - it was great. We got fish, broccoli, bean sprouts, kimchee, pickled vegetables, hot pickled vegetables, little meatballs (which I think were marinated hot dogs), pickled potatoes, I can't remember them all. It was a lot of food, and of course I took it home. I'm pretty sure we'll go back at some point.

When to have children? or When to have fun?

I've had this discussion with a few different friends on separate occasions lately, so it must be on our minds. When is the best time to have children? I don't know if this is right or wrong, but it quickly becomes a question of assuming you want to have children, when do you want to have fun?

A lot of my friends are having children, plan to have children, or may have children in their 30's. Maybe even 40's. I think that's relatively late.... but that means you get to play when you're younger! Sure you can argue that there may be genetic risks the older you get, but let's take that out of the equation by saying you can adopt. And you can do that whenever you want - even when you're 50! The good thing about having fun when you're younger is that you have more energy, and you're usually more accepting and experimental and willing to try new things - these characteristics are perfect for travel and having fun! The problem with having fun when you're younger is that you have no money. And this is supposedly the time when you should be saving for retirement, yada yada yada. Another drawback is that if you have children relatively late, when you retire, you may still have kids in college, or even high school! I don't know about everyone else, but I'd rather have the kids out of the house and out of school by then, or taken care of in some way so that I can travel all over and enjoy retirement. I'll know how much money I have left and how I want to spend it.

Now if you decide to have kids early, you can start saving early for their school, which may not only include college (or post-college stuff), but also include grade school and high school depending on where you live and if the public schools are okay or not. Not to mention day care for the younger kids! And when you retire, they're all taken care of and you can have your fun. And presumably you have plenty of money for that fun. The downside is of course, you don't have as much energy for the fun stuff (i.e. traveling) and because of that, you would probably do different things. Like, I doubt that when I'm 65 I'll go bungee jumping - not impossible, but I probably wouldn't do it.

After thinking through my options, I think I would rather have kids earlier rather than later - it'd be nice to have a lot of energy for the kids too, much less traveling and other fun stuff. But I guess it's too late for me to have kids early in life, so I'll settle for having fun now and having kids later. :)

Nerdy comics

This site is awesome. I've spent the last hour looking at the comics. Fits my inner nerdiness.

http://xkcd.com/304/