Like Sands Through the Hourglass…

June 1 – June 8, 2015

This is my last LONG summer break until…retirement?

And, I am filling it up with sickle cell research and my Community Primary Care Preceptorship (CPCP). This is summer will be a profound emersion into the world of hematology and bioengineering research. I finally am added to my lab’s webpage! Check it out!  I cannot tell you how much of a privilege it is for me to study in the lab as well as in the clinic a disease that hits so close to home for me. It is really an honor. Let me dive into this week!

MONDAY – Back to Work

After my bumpy descent into Cleveland just a day prior, I still felt a bit nauseous as I walked the mile and a half to school. It was cool, 50 degree weather–unseasonably chilly for June in most places but predictably unpredictable for the Midwest. After meeting with my two research mentors, I learned more about my research project working on the HemeChip. We were recently selected as one of the finalists in the Student Technology Prize given by the Center of Integration of Medicine and Innovative Technology (CIMIT). We received $10,000 so that we can submit our proposal at the end of July and hope to be in the top 3 groups that could win $50-150,00 of research funding in the development of a chip that will be used to diagnose sickle cell disease in under-resourced environments! You can learn more about the project here as well as CIMIT, a nonprofit consortium of Boston’s leading teaching hospitals and universities.

I also am waiting on an IRB to be renewed for one of my other experiments as well as cord blood to arrive.

TUESDAY – Getting Trained and a New Project

Was a little more involved than Monday. I learned that I had been given an additional project involving neutrophils in patients with SCD and specific transcription factors expressed in said neutrophils. I was relieved to get an extra project since the week was a little slow with no cord blood for the biochip experiment and waiting on the IRB. That day, I learned how to use the newborn screening device and it’s so cool!

WEDNESDAY – First Day of CPCP! I felt a spleen!

Wednesday was my first day of CPCP. Dr. Little, the clinical director of the Adult Sickle Cell Anemia Center at University Hospitals is my preceptor, and she is such an excellent teacher! Sickle Cell Disease is so complex and effects people differently. Although all the patients had this underlying condition, they all had varying problems. The first patient, a 21 year old girl has had strokes since she was three years old, impairing the use of the right side of her body and many of her cognitive abilities. She was quite sick and somehow managed to have a one year old daughter. All my physical exams to date have been on healthy standardized patients so it was quite an experience to do a neurological exam on a patient who had severe neurological problems. I tested her cranial nerves, but later learned from Dr. Little that her stroke was in her cortex and cranial nerve issues have more to do with the brainstem…good effort but…not as useful. Still great practice, and I am looking forward to learning how the brain works next year.

Watching Dr. Little in the clinic also showed me how patients have more problems than what is simply “physical.” One patient who also had 2 brothers with sickle cell, recently lost one of them and seemed extremely depressed. He was not taking his hydroxyurea (only FDA approved drug for treatment of SCD) and was burning through his oxycodone prescription. I watched as Dr. Little patiently and carefully described her concern with his medicine usage. I know all too well that many doctors accuse their patients with SCD for being drug-seeking. If fact, I have seen it happen first hand when I shadowed an ER physician about 4 years ago. Her tone, however, was non-judgmental and full of concern/understanding. Yet, she was firm in saying that he needed to take his hydrea.

On the flip side, I saw a 42 year old who had never stayed longer than one night in the hospital because of his sickle cell. In fact, Dr. Little was more concerned about his cholesterol than his underlying disease. He was cheerful and explained to me that he didn’t want people to prejudge him just because he had SCD. He was quite sure of himself and doing very well.

My last patient was a 22 year old woman (crazy to think that we are the same age) who looked very healthy on the outside (not even had yellow eyes which is very common in people with SCD because of their red cells lyse) but she had extremely high blood pressure. I learned that her kidneys were not working well for reasons not exactly clear. She did have a history of interstitial nephritis due to a possible antibiotic allergy, but still her case was a bit mysterious. She’ll be returning next week and I look forward to seeing her story unfold.

All the patients were so kind enough to let me examine them, and the 22 year old patient had an enlarged spleen (which can happen often with people with SCD) and Dr. Little taught me how to feel it. When practicing on myself as well as other students I could not find the spleen, and it was a good learning experience for me!

The CPCP day wrapped up and then I headed to lab to set up an experiment for the following day. It was quite a long day, and I left at around 8:30 pm and went over to a friend’s apartment for dinner.

THURSDAY – Heart, Lung, and Blood, Anatolia’s and Painting 

I am also a Heart, Lung, and Blood intern for the summer which means…lunchtime seminars! This week we heard from a recently tenured African American professor at Case who discussed his journey to pursuing a PhD and gave really frank advice about how to choose between a PhD and MD or even both. I loved his advice about mentorship. You have to be wise about selecting a mentor. First, ask yourself: “What do I want from this person?” Some mentors are like friends, others can give you connections, others can just give you extremely frank and difficult advice that may not make you feel spectacular. Finding a mentor takes effort and do not give up just because you don’t get a response from that first email!

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Following that, my lab had a goodbye dinner for a beloved member of the lab who is going off to California for grad school. This lab is so different from my former. My old lab never ate altogether at a restaurant with my PI present. My PI was never curious about what I watched on TV either! One of mine is actually a big Scandal fan. I’m still getting used to the culture of this lab but so far, so good! Also food was quite good at Anatolia’s Cafe, a Turkish restaurant. I prefer Dervish Grill in Tremont, though!

At Anatolia's Cafe
At Anatolia’s Cafe

After dinner, I sped over to Avia and Ify’ s place to get ready for Ify’s surprise party which involved painting! It was quite a success and a wonderful time!

Showing off our paintings!
Showing off our paintings!
Mine!
Mine! “Tulips in the Twilight”

FRIDAY – Wait, What Happened?

Went to a Step class at 1-2-1, watched a lot of Gran Hotel, worked in lab for sometime, and learned that I have to train a high school student on things I just learned…here we go!

SATURDAY – Far From the Madding Crowd and massive cleaning 

Two Emily’s, Christa and myself went over to Cedar-Lee theater for a matinee showing of Far From the Madding Crowd. I loved it! Really beautiful to watch, and it improves in my mind as I look back on it. If you watch the trailer and think you will like it, you probably will. Also this scene is just lovely! There is this interesting bit about the heroine being very independent. A very quite sheep farmer wants to marry her at the start of the film, and she kind of rejects him saying that he’d never tame her. Funnily enough, throughout the film he is the only man who doesn’t treat her only as an object to be desired-but a person. He also has the courage to tell her when she is wrong. “Independent”  women are interesting. We (assuming I am an independent woman) may be headstrong and independent, so naturally if a man wants to control us, this is a problem. We want to be free yet if a man has no backbone and cannot “tame us,” we don’t want him. It’s actually very confusing. Simply put, the movie showed me that often what we want in our heads is folly. People can complicate a good thing.  What we all need is mutual love and respect for one another, and this can tame the desire for “independence” and shift that feeling to one of interdependence between two people who want to honor each other.

1 Woman. 3 Men.
1 Woman. 3 Men.

So I cleaned my room, and it’s beautiful. See my desk? No papers on it or under it!!

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Later, Jen and I watched Lethal Weapon 2We have a spreadsheet of movies since rooming together in college that we have been meaning to get through. At first said spreadsheet was entitled, “Movies TOLU AND JEN MUST WATCH BEFORE GRADUATION.” It has since been renamed to: “MOVIES TOLU AND JEN MUST WATCH BEFORE BECOMING DOCTORS.” It’s a great film and Mel Gibson and Danny Glover are my favorite buddy cop duo. Their bromance is real.

SUNDAY – Jack Flaps, Step Class

Not much to report beyond that Cav’s game and having brunch with the lovely Emily A. I got to hang out with 3 Emily’s in one weekend! Dang, people most have loved that baby name in the early 1990s! Emily and I went to Jack Flaps, a brunchy place in Ohio City. So that’s week 1 in Cleveland this summer.

Kimchi fried egg sandwich was OK.
Kimchi fried egg sandwich was OK.

Time for bed and another week of work! More is to come and more shall be said!

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