Addiction vs. Habit

* * * Caution – contains small spoilers about the movie "Rent" * * *

ADDICTION: Compulsive physiological and psychological need for a habit-forming substance.  Habitual psychological and physiological dependence on a substance or practice beyond one’s voluntary control.  Synonyms: fixation, chemical dependency, obsession

HABIT: A recurrent, often unconscious pattern of behavior that is acquired through frequent repetition.  An established disposition of the mind or character.  Synonyms: inclination, tendency, routine

After seeing the movie Rent last night, A.J. and I had a brief discussion about addictions vs. habits, and how there really is a dramatic difference between the two.  In the movie, Mimi is a heroin junkie who is falling for Roger (who used to be a junkie, but got clean when he and his then-girlfriend found out they had HIV and she subsequently died).  Roger is interested in Mimi but seemingly repulsed by her drug use.  At one point during a musical montage, Mimi appears to be going through physical withdrawl, and Roger is there to comfort and support her.  Things appear to be going well for them, then Roger sees Mimi buying a stash from her old dealer, gets angry, and leaves.

When I watched this story arc, I was really irritated by Mimi’s behavior.  I mean, she had already gone through the terrible physical symptoms of withdrawal AND she had Roger there supporting her and starting this relationship with her… then she ruins it all by meeting up with her dealer.  Why?? This is where the addiction vs. habit conversation came from.  It seemed that Mimi had overcome much of the physical addiction part of her heroin use, but as they say "old habits die hard" and since she still lived and worked in they same neighborhood and saw her dealer and found herself in the places/situations she used to "use" in, it was too much for her not to give in to the old psychological habit.

Of course, at this point there can be a whole discourse on the semantics of the words used in discussions about this topic.  What is meant by the terms addiction, physical addiction, dependence, psychological addiction, tolerance, habit… For a very nice discussion on this topic, I like the Wikipedia entry on addiction.  I was also intrigued by the reference to "Rat Park" in said entry.  Rat Park was an experiment on addiction done in Vancouver BC back in the late ’80’s.  The colony was built to examine the hypothesis that drug addiction is a myth and that continued drug use, particularly the use of heroin, is largely, and perhaps entirely, the product of unhappiness, and not neurophysiological compulsion.  Investigators hypothesized that the addiction to morphine commonly observed in laboratory rats who are exposed to it could be attributed to the cramped, isolated conditions in which they are normally kept.  The environmental stress caused the rats to take refuge in the drugs they were administered.  It was thought that better surroundings would reduce or eliminate that dependence.  The results of this experiment appeared to support the hypothesis, but the work was not well received by the mainstream scientific community.

Life Check

Still alive and kicking… just wanted to check in and let you know.  🙂  There will be a real post sometime later this week.  Until then, the quick and dirty:

Residencies:
UCSF – okay
Children’s Oakland – loved it!
Kaiser Oakland – liked it a lot, not sure if i fit at this small of a program
Seattle Children’s – loved loved loved it!
OHSU (Portland) – loved it (a few nagging concerns about small-ish program and less well-known reputation – but i really liked it there!)
Denver – interviewing on Dec 9th
Stanford – interviewing on Dec 20th
(and that’s all folks, 7 interviews then 3.5 months of waiting to find out how i did)

Birthday:
18 days and counting  🙂

Exploring Berkeley

So, yesterday I had a day off from my San Francisco area residency interviews, and I decided to go check out the city of Berkeley (home of the UC Berkeley campus and infamous Telegraph Road).  When I discovered that the original very first ever Peet’s Coffee and Tea was in Berkeley, I had to make a visit… and here are a couple of pictures.  It’s in  a cute little area with shops and cafes all around.  (FYI – Peet’s is a place I first learned of while doing my rotation in Portland.  Berkeley reminds me of Portland, but a little more "out there" when it comes to the different types of people you see.  Still, very Portland-esque…)

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I had lunch at a palce called Jupiter.  It was quite nice out, so I ate in their courtyard right next to this pretty fountain:

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I had a house salad (with red peppers and kalamata olives, yum!):

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And also a pizza… that was plenty big enough that I had the leftovers for dinner.

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Then I went and sat at a Starbucks and used my wireless internet to look up lots of information for my upcoming interviews.  So far now I’ve done UCSF and Oakland Children’s.  UCSF was alright, I thought I really liked it until today, when I was at Oakland Children’s and totally loved it and it just out-shined (out-shone?) everything from UCSF!  Anyway, I’m trying to keep good track of all the information I’m gathering so I can keep all the programs straight when it comes time to rank them.  I want to put little summaries up here to help me with that, but it’s a little much for me to do right now, so maybe over Thanksgiving, when I have a little more time (and 5 programs under my belt).

In San Francisco

I flew into San Francisco this morning to start the first leg of my interview trip.  I got in kind of early, so after picking up my rental car (this fine looking PT Cruiser)…

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…I decided to drive out to the 3 programs I’ll be interviewing at this week so that I have an idea where I’m going and hopefully won’t get lost.  UCSF was first, and it’s located at the top of a hill right by Golden Gate park.  The Children’s Hospital is actually a few floors located inside the general hospital – we’ll see how I feel about it tomorrow.

Next I headed out toward Oakland where the other two programs are located.  I stopped by Oakland Children’s, which is a stand-alone, community based hospital (meaning, not a big academic center, no general hospital affiliated with it).  Then on to Kaiser Permanente – Oakland, which is a smaller campus of buildings.  I have those two interviews on Wednesday and Thursday, respectively.

And now I’m sitting in my hotel room at the Fairfield Inn Oakland, which is pretty darn nice for a Fairfield… at an airport location… I have 2 beds, and a little sitting area (it’s really cute, see)

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… and I also have this little kitchenette with a microwave, a little fridge, a sink, and counters/cabinets.  That’s totally more than I expected and very cool.

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Anyway, so now I’m thinking about heading out to find a grocery store so I can get some things to put in my kitchenette.  Probably some milk and cereal, some fruit, some soda or tea or something and maybe some snack-y something or other.  Then I will resume preparing for my interviews – practicing answers and reviewing the questions I want to ask and making sure I have everything ready for the morning.  I’ll update again sometime this week and talk about how everything is going.

Until then….

Smelly Alley

I think someone set a can of dog poo on fire in my alley.

Yes, I said a can of dog poo.

I got home a little bit ago and parked in the back parking spots, and as I was maneuvering into my spot i saw what looked like an old coffee can with flames coming out the top sitting across the alley and a couple houses down.  When I opened my car door the unplesant odor of dog poo filled the air.  I can only guess the dog poo was the fuel for those flames, since the smell wafted through my yard and up into the stairwell since one of the outside doors was standing open.

Now I’m inside and everything smells fine in here.

Crazy dog poo burning people.

I want to blog…

… but for some reason I don’t have any clear ideas to carry a whole entry.  I have a million different compartments in my brain working on all different ideas / problems / dreams / plans but none of them are complete or really all that interesting.

Of course I’m thinking about my upcoming interviews

i have to review my application and re-learn about my undergraduate research project… i need to go over those "frequently asked questions" and start thinking over my answers… i need to finalize that rental car plan for san fran… i need to make a packing list and try on that "back-up suit" to see if it fits me now and decide if i’m going to check or just carry-on and what i need to pack up for aj to bring to seattle when he comes back… i need to go to the residency websites and look over the details of the programs so i can talk intelligently about why i want to match there (even if i don’t really want to…)… i need to e-mail the residents at the uw that i met during my rotation and keep those connections up… and probably more than all this, but really, isn’t it enough?

and I’m thinking a lot about the Distinction in Community Service project I am working on

i need to update my "steps to completion" sheet… i need to contact my new advisor (dr. frankenstein, heehee, it’s her real name but pronounced franken-STEEN) and go over my project idea with her since my last two advisors in that department have left or changed positions… i have to research tobacco use trends in st. louis teens and find evidence-based journal articles discussing types of smoking cessation programs that work for teens and then compile that info and come up with a database of programs that pediatricians can use to help their teen patients kick the habit… i need to make an outline for my paper so i know what other information i need to look up…

and I also have my schedule for the rest of the year to work on

i really need to e-mail my developmental peds course directors and let them know i won’t be around during the first week of the rotation since i’ll be off interviewing (luckily part of the week is thanksgiving vacation anyway so i’ll only miss 3 days)… i need to e-mail the anesthesiology department and find out if i can do peds anesthesia for just 2 weeks (instead of the normal 4) so i can put it in at the very end of the year; and then i need to get registered for that and drop cardiac auscultation since i know a self-directed elective like that will not work well during my last two weeks of school…

then there’s the Admission’s Committee responsibilities I have

i have to plan to attend some of the committee meetings this year and i have to remember to pick up the applicant info cd’s before the meeting so i can review who we’ll be talking about… i need to make sure i get more tour guides scheduled for the weeks between now and christmas break and let the admissions office know who will be doing them… huh, i guess this thread of thoughts isn’t that overwhelming…

and I also have this new tutoring gig with a second year student who had taken some time off and wants to get back into studying mode

we’re going over cardiac physiology at our next session so i really need to review that since i only vaguely understood it in the first place and now i need to be able to teach it and i don’t want to look stupid… and we’re also going over cardiac embryology which is a bit easier to grasp but definitely something i need to review… but the valvular disease and congenital diseases, those should be okay… oh and i have to stop by the student affairs office and figure out what forms need to be filled out so that i can get paid for doing this… and i have to make sure i get a system going for keeping track of my hours so i can get paid… and she wants help with step 1 as well, and i don’t remember a whole lot about step 1… and i just don’t want to look stupid…

and besides all that there are the fun and entertaining things that are on my mind too

aj and i went to the driving range last night and i did pretty well and i would love to go again soon… i really want to go see a movie at the moolah but "jarhead" is there and i don’t have a strong desire to see such a realistic war movie right now and "shopgirl" is at the chase and that would be fun but i really wanted to go to the moolah… i miss playing racquetball regularly and i had so much fun playing 4’s with aj and 2 of his law school friends this week and i wish i could do that more often… i’m glad i’ve been working out at curves regularly, even if i didn’t go today because i’m feeling kind of sick… i heard about this restaurant called "1111 mississippi" and i wonder what it’s like, people say the food is awesome, but the menu looks a little eclectic and i wonder if there’s anything on it that i would really like… i want to try more new restaurants around here but it’s hard to decide where to go and it takes a bit of courage to just walk into a new place for dinner…

and, of course, that little to-do list that’s always in the back on everyone’s mind

i’ve got to get those clothes out of the dryer and it’s probably time to do a load of towels again… the garbage needs to go out and the kitchen could really use a thorough cleaning, especially the refrigerator… the living room is getting clutter-y… i need to get my oil changed and the air pressure in my tires checked, and since i’m going out of town now would be a great time to get the tailgate and mirror and stuff fixed so i really need to go in to get a quote first so i can leave it there when i leave, although now that i think about it aj could always drop it off sometime after i’m gone… oh and i need a ride to the airport since aj won’t be back from seattle yet when i have to leave, i should ask jill, maybe at star trek night on monday… i want to pick up some more allergy medicine from costco and we’re almost out of milk…

So there’s a few cars on my train of thought today.  Enjoy the ride?

The Interview Trail

The Interview Trail.

That’s what everyone calls this section of life I’m about to embark on.  This whilrwind of departures and arrivals, checking-in, wearing a suit, smiling till my cheeks hurt, trying to make a good impression but still be likable me… I hear I will run into many of the same people on the trail and that we might get to know each other pretty well, since people tend to apply to residency programs regionally.

I start my "trail" on November 13th when I fly out to San Francisco for this:

Sunday (11/13): Fly to San Francisco, pick up my rental car, find my hotel, settle in, and prepare for my first interview
Monday (11/14): Interview at UCSF during the day, attend the UCSF "Dessert Night" to socialize with the current residents in the evening
Tuesday (11/15): Interview at Oakland Children’s during the day
Wednesday (11/16): Play tourist… or (hopefully) interview at Lucile Packard Children’s (Stanford’s program) during the day and maybe do a social thing with the Stanford residents in the evening
Thursday (11/17): Interview at Kaiser Permanente-Oakland during the day
Friday (11/18): Fly to Seattle, see my family, process all the San Francisco interview information then set it aside and get ready for the "Big Two" interviews at my top two programs 
Saturday (11/19): No plans  🙂  Just relax and have some fun
Sunday (11/20): No specific plans, but maybe do a social thing with the UW residents in the evening
Monday (11/21): Interview at the UW during the day, drive down to Portland in the evening
Tuesday (11/22): Interview at OHSU during the day, drive back to Seattle in the evening
Wednesday-Sunday (11/23-11/27): No specific plans…. enjoy family time and Thanksgiving and maybe go snowboarding if there’s any snow this year… then fly back to St. Louis on Sunday afternoon.

In addition to that jam-packed trip, I will interview in Denver on Friday December 9th.  I also have a couple of Southern California interviews scheduled at the end of January… but these are currently not my top choice programs, and I may end up cancelling those interviews.  We’ll have to see how these first ones go.

So everyone wish me luck and cross your fingers (especially on the 21st!) and feel free to send me happy text messages and/or e-mails to keep me upbeat and smiling during all this. 🙂

Things on my mind at this moment

60 days until my birthday. (check out www.jillcook.com for daily updates :-))

3 residency interview invitations: UCSF, Oakland Children’s (in the greater SanFran area), and Denver Children’s.  I’m trying to get one long SanFran trip scheduled so I can do 4 interviews there all in 1 week.  It’ll be an interesting week, being "on" all the time.. but much nicer than making 3 or 4 trips out there separately.

I love my job.  Okay, it’s not technically my job yet, since really I’m still paying for the privilige of working crazy hours in the hospital… but I’m going to love my job.  And that’s nice to know.  I’m also going to complain about it a lot, because it seems that that’s what residents do and I will get sucked in just as easily as everyone else seems to be… BUT, knowing that, I will try to keep the complaining to a minimum and remember all the great things that make me love my job. Here’s a few from this week:
Little kid smiles
When babies just look at you, all nice and content
The suggestion, from a 10-year-old patient, that I could be "a princess" for Halloween, "or a DEAD princess!!!" with a white dress covered in blood and half of a tiara
Being called "doctor"

Halloween – what to do for Halloween?  I want to have a little get together… a party… a soiree… an affair, a celebration, a fete, gala, occasion, function, bash – however you want to refer to it, I want to have people and food and decorations and maybe scary movies, or semi-scary movies anyway.

Randomness


Drum set at Costco

         
It’s a Billiken, the St Louis University mascot.  What’s a Billiken?  Good question.  🙂

         
A.J.’s birthday dinner at the Outback Steakhouse (do-dah-dah-dah-do-do-do).
Building architechtural materpieces with coasters is one of his favorite "waiting for food" activities.

ERAS and me

ERAS is the Electronic Residency Application Service and it is something I have become quite familiar with over the past few months as I’ve been preparing my residency application.  See, I fill out one central application with all my experiences, my awards, all that stuff… then I put in my Personal Statement and I list the people who will be writing letters for me.  Then I pick the programs I want to apply to and the system will automatically make all my documents available at each of the programs.  Well anyways – I have been slaving over this application and it has been a monkey on my back for a while – but finally today after one last proofread I finally clicked "Submit" (and of course entered my credit card number) and now it’s all over.

All. Over.

And all I can do is wait for the interview invitations to roll on in.