What I Am Reading: Cake vs. Pie

(by whizbang) Jun 12 2013

Really I would rather just have a spoon and a bowl of frosting. Chocolate frosting. With chocolate chips.

Love the gold fish!

Of course, this post is not really about desserts. It considers the purposes of mentoring.  I suspect that every job in the US above the fast-food server includes some sort of mentoring. Corporations and academia noted the role of informal mentoring in career success many years ago, and mentoring programs have become commonplace. Gender inequity in the workplace has been attributed, in part, to the lack of mentoring for women.  Make the Most of Mentoring: Capitalize on Mentoring and Take Your Career to the Next Level explores the components of common formal mentoring programs and contrasts them with the informal mentoring that inspired them. It's author, Susan Colantuono, founded Leading Women™.

According to Colantuono, women have not benefitted from these formal programs because they get too much CAKE and not enough PIE. Mentoring, informal or through formal programs, can provide a lot of different types of support. Most formal programs focus on CAKE:

  • Confidence
  • Aptitude/Attitude/Advice
  • Konnection to resources (yes, this took a twist to make the acronym work; get over it)
  • Encouragement

These aspects of career development are important. Too many women take themselves out of competition for new positions and assignments because they are missing these components. However, to really crack through the glass ceiling to the next level, you need PIE:

  • Performance
  • Image
  • Exposure

Performance is not just how someone performs; it also considers the performance of the business. Someone may be doing a great job, but they will never scale the heights of a corporation until they have responsibilities and demonstrate competency in operations and strategic capabilities for the core business.

Image incorporates appearance and attitude. Unless you look and act like a competent, confident professional, others will not see you moving up to the next level of leadership. This competency is more than wearing the correct clothes; vocabulary, body language, and other personal traits influence how a person is seen by others.

Exposure involves seeing how work is done at higher levels. Who makes strategic decisions? If you aspire to these positions, you need to be at the table for these sorts of activities.

The book paints a vivid picture of these differences, using real-life examples from the work world. Making the jump to academia is a bit problematic; given the broad mission of an academic health center, what is our core mission? How do I position myself close to key operations and strategy?

Buyers of the book also get access to a number of free online resources, including worksheets for those entering into mentoring relationships.

Make the Most of Mentoring provides a quick read with a new perspective on the process of grooming new leaders. Click here to learn more about Leading Women™ and the books of Susan Colantuono.

 

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What I Am Reading: MDs Online

(by whizbang) Jun 06 2013

Click for Amazon

Right now, you are reading a blog. You obviously know something about the online world. You probably think of Web 2.0 as a generally friendly and useful place.

Your doctor probably thinks of it like those historic maps: "Here be monsters."

Enter this book by Kevin Pho, of KevinMD fame. His recent book provides a primer on the online landscape for medical practitioners. He outlines  the way patients use the internet and why it matters to healthcare providers. He reviews the usual social media platforms with their potential for good and evil. He also addresses reputation management for search engines; if you get your story out there it will rise to the top and trump what others may say.

For someone who is fluent in Web 2.0, the most interesting section dealt with various physician rating sites. He goes through a dozen of sites and outlines how you can monitor what your patients say. On most sites, physicians can see their information freely. I still haven't gone there; I mean, I have barely had time to write on this blog.

If you are reading this post, you probably do not need to read this book. You may know someone who could use this information, though.

 

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Null Hypothesis REJECTED

(by whizbang) Jun 04 2013

Hypothesis: Having 3 of us performing the patient care load of 4 doctors will interfere with my other activities, including blogging.

About 10 days worth of data support that puppy.

While I am settling into my new life of drama, please give to schools that need our help. Through the 7th, you can double your impact by using the super-secret SCIENTOPIA code at our Donors Choose Page . Also, feel free to donate to a general fund for the Moore, OK, schools that got wiped by an EF5 tornado on May 20 (widget in the right-hand column).

Now, I probably have another patient to see.

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You Cannot Know Until You Know

(by whizbang) May 29 2013

Last night I received an interesting query via twitter:

Tweet

Many patients in nephrology present with 50-60% of normal kidney function. Even if we can stop the insult that produced this much loss of kidney, at this point the vicious cycle of progression occurs. The kidney tries to adapt to its losses with processes that cause more loss of tissue. In trying to get back to normal, the kidney commits suicide. Over the years, we have discovered ways to slow this process, but we cannot stop it. This is particularly unfortunate, because most people have no symptoms of kidney failure with minimal medication at half of normal function. If we could halt the process at that point, most adults would have relatively normal lives without needing dialysis or transplant! (Since we cannot do this yet, I do not yet know if we could get children to grow and develop acceptably at half of normal function.)

Thus, my answer:

AnswerTweet

Of course, this is a really broad answer that is likely more clinically oriented than whatever spawned the question. Kidney researchers have been working on progression for as long as I can remember, resulting in our current strategies that slow it down; however, we still do not fully understand the process despite at least two decades of research! And, while I can identify this as a really clinically important area of inquiry, I HAVE NO IDEA WHERE THE BIG BREAKTHROUGH WILL ULTIMATELY COME FROM. If more incremental work in the existing areas will do it, then we may get there in a few years. I suspect the real breakthrough will come out of left field, from completely unexpected directions.

You know, the risky, out-there research that will have more trouble getting funded right now.

It may also come from studies of other organ systems! Other diseases! Other organisms!

I believe this is true for most clinical problems facing us today. We really cannot know what particular basic science piece will lead to therapeutic insights and cures. Who would have thought that studying cilia would help us understand polycystic kidney disease?

That's the real tragedy of the current funding climate. As paylines drop, funding tends to get more conservative with projects having the best chance of "success," defined as fulfilling their hypothesis. This can result in incremental studies which may be valuable, but rarely shift paradigms. Those weird, unexpected results that can impact other fields may be missed completely.

Patch-clamping fruit fly neurons may sound like a ridiculous waste of  money to the general public (and congress), but from a basic science standpoint it could be quite important. If we want cures for diseases, we have to support scientific inquiry, not just clinically-directed research. Our current "best treatments" for the problem of progression arose from studies of South American vipers; I would guess that those investigators had no idea that there would be such practical outcomes from their research.

Let's put it this way: I am a physician-scientist with more than 20 years of experience in the field, and I have no idea what specific basic science questions may lead to the next big breakthrough. Our best hope is to fund as much as we can, all of it if possible. We then need to keep scientists and clinicians engaged, so those random sparks of imagination come together.

The process is messy and disorganized and unpredictable. You cannot script discovery.

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Monster Encounters

(by whizbang) May 28 2013

Yesterday the show River Monsters ran an episode that began at Lake of the Ozarks in mid-Missouri (my in-laws have a place there) and ended in Oklahoma rivers. Apparently, I have swam with monsters.

The episode begins with a family entering a boat for a ride on the Lake. The wind whips up foul waves, and the craft capsized, leaving four passengers missing and presumed drowned. A distraught father hired divers to recover the body, but they found nothing in the murky muddy waters of the Lake. What could have disposed of her body so quickly?

Jeremy Wade begins talking to locals about large fish that dwell on the bottom of the Lake (one guy has the most amazing mullet). He proceeds to attempt to catch some big catfish since both blue cats and flatheads can exceed 100 pounds. The fish he brings in on rod and reel do not meet the criteria for monsters that consume human corpses. He then snags a spoonbill, a plankton-eating fish of the Lake that can get big enough to scare a diver when it comes out of the turbid muddy depths, even though this fish could not engulf a corpse.

Click to learn more at National Geographic

To learn more about the strength of these fish, he then heads to Oklahoma to noodle them. For those of you new to the term, noodlin' (always drop the G) refers to getting your hand into the fish's mouth, then grabbing it by the gills and pulling it up. You may need to go underwater. You will have to shove your hand into the holes where big cats hide, even though you cannot see if there is a fish or something else in there. Something else could be an alligator snapping turtle, a critter that would find your live flesh delicious.

Below Jeremy Wade goes over the finer points of noodlin'. His team brought up 50-55 pound catfish using this technique.

As someone who grew up around the lakes and streams of the Ozarks, I have been interested in the local fish and animals. I find the show quite interesting, given the locations he explores and the interesting variety of river and lake critters he shows the audience. He practices catch-and-release; while I am sure the fish would prefer not to get caught, showing them to people demystifies them, making them far less frightening.

I object to the term "monsters."

Even a 150 pound flathead that consumes a human corpse is NOT A MONSTER. It's a fish, and it evolved to dispose of dead and rotting stuff on the bottom of bodies of water. Yes, it has to get unusually large to take a human head in its mouth, but that just means it's a very successful fish. Other fish in the show may kill and eat children, but they are predators. That is what they do, usually to other creatures. In their minds, humans are nothing special (although the lack of fur and claws and shells may make us a rare delicacy).

Even Animal Planet's more sensational offerings ARE NOT MONSTERS. If we ever do find Bigfoot (or the creature in Loch News or a mermaid), then it will no longer be a monster, the stuff of legends. It will merely be another creature inhabiting the planet earth, even though it might endanger you during a wilderness encounter.

All the real monsters are people, those who bomb, shoot, kidnap, traffic, rape, etc.

 

 

 

 

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School: Not Out Yet

(by whizbang) May 24 2013

Next week is the traditional end of the school year, but our friends at Donors Choose want to end with a bang! They asked us at Scientopia to get the word out that all donations up to $100 will be matched between now and June 7.

How can you participate?

  1. Go to our giving page
  2. Pick a project
  3. On the payment page, key SCIENTOPIA in the Match or gift code boxMatchCode

That's it!

Unfortunately, the general fund for the tornado schools in Oklahoma does not qualify for this program :(

There are plenty of worthy projects available. Pick one and do double what you think you can!

 

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Another Way To Help Oklahoma

(by whizbang) May 22 2013

Click for original site

Whether you watched the massive tornado decimate Moore, OK, from 20 or 2000 miles away, you probably want to reach out and hug those survivors. And most of us want to help.

In case you're not close enough to volunteer your chainsaw skills, or your time in a cemetery wearing clothes you can throw away, there are other venues for official relief funds.

With two elementary schools completely destroyed and others damaged, I was delighted to receive an email from DonorsChoose this morning, asking for donations to a relief fund for teachers in Moore. Right now these teachers are dealing with the same adverse conditions as everyone else, so there are no specific projects to choose. If you like, the organization can show you similar projects funded through donation programs for Joplin in 2011 and Hurricane Sandy in 2012.

You can donate by clicking this link now. If you want to act later, don't worry; they made me a widget for my sidebar! Give early and often.

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Coping with Tornado Trauma

(by whizbang) May 21 2013

Here are links to resources suggested by our Psychologists for helping children and others deal with tornados and their aftermath:

Other Resources

Three new ones

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Tornado Alley Primer

(by whizbang) May 21 2013

Many US folks think of "fly-over" country where I live as a bunch of fields of crops or grass with cattle grazing. This area does include civilization, and I thought some of my friends and loved ones might like to know a bit more about where those pesky tornados keep dropping out of the sky.

Click to enlarge

Click to enlarge

This map shows interstate 44 which basically traces tornado alley. Point A is in Wichita Falls, TX, just over the border from Oklahoma. It extends to Point B in St. Louis. This route goes through Oklahoma City, Tulsa, Joplin (just over the border in Missouri), Springfield (where I grew up), and St. Louis (where my spouse grew up). As recent years have shown us, tornados can drop anywhere they want, not just in this hot region.

But this is the hot spot.

So let's focus on the Oklahoma City area where I live and where the current disasters occurred.

Click to enlarge

Click to enlarge

On Sunday (May 19) the twisters went north, approximately along the upper black line. My home is in the Edmond area, where the purple asterix lies. This storm first began as a wall cloud near Quail Springs, at the west end of the arrow. A tubular feeder cloud started circulating into the wall cloud, and we watched a ropy finger of wind drop from the sky, then break up. As the storm moved to the east, the process began again just east of the 74 symbol that the path crosses over. This time, the funnel formed bigger and began traveling along the ground toward us. We stood in our yard, on a high spot in the area, and watched. You can tell when the tornado contacts the ground. First a line of birds surges up in front of it, then scatters in all directions. The funnel then fills with debris, making it appear larger and fiercer. The extent of the high winds around the tornado can be estimated by power flashes as electrical lines get tossed about.

We moved between the yard and the television where we could better see the storm's path. Our yard was windy but not necessarily more than any other spring day in Oklahoma. We could hear each other without problem in a normal tone of voice. Every once in a while we felt a sprinkle of rain, but nothing to suggest the storm just a mile or two away.

The tornado appeared to dissipate just to our west, but then had a second wind as it approached Lake Arcadia. There it formed a waterspout that we watched traverse the lake.

This twister rated EF1, causing minor damage - branches down, shingles blown away, but no buildings destroyed.

Monday (May 20) we saw the true power of nature. Moore is a southern suburb of Oklahoma City, lying between the city and Norman where the undergraduate campus of OU and the national weather center both reside. This storm once again began with a wall cloud and a feeder cloud that we watched on television, courtesy of weather helicopters and storm chasers. Once again, a ropy finger stretched out of the cloud to the ground. This time, instead of tenatively touching up and down a few times, the extension widened into a true funnel. The funnel continued to enlarge, becoming a massive wedge at least half-a-mile wide on the ground. High winds around it, estimated by power flashes, extended its reach to a mile-wide swath that slowly made its way through Moore.

I watched the devastation with people who live in Moore and have loved ones there. One woman talked on the phone with adult children in a storm shelter, wanting to know if they could come out yet.

Imagine that your child build a city with the houses and hotels from a Monopoly Game. Picture going through with a very wide vaccuum, sucking up much of the work and scattering the rest. Now envision this at full scale with real people and homes.

When we heard about the schools, I paid attention. Crush injuries often cause acute kidney injury and failure, so I anticipated having those sorts of trauma on my inpatient service today. Unfortunately, the kids fell mostly into two groups. Some had lacerations and bruises and minor physical injuries. The others did not make it. It is especially disheartenining to think of those children who got into the basement of their school, the best possible shelter for a tornado, only to drown.

As daylight comes again this moring, first responders pick their way through the debris trying to find those who may still be trapped in storm shelters. I do not envy them their grim task.

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Friday Fun for Fingers

(by whizbang) May 17 2013

Lately I have been going gaga for nail polish. I have no qualms about how it fits, and nail art scares families less than wild make-up or clothing on their doctor. It's a lot cheaper than shoes as well.

Julep delighted me by creating their Maven program. Julep nail polish comes in 8 mL bottles (drugstore polish usually measures 15 mL), and Sephora is their only retailer in my neck of the woods. Oh, and each bottle costs $14.99,  a fairly hefty price.

To become a Maven, you first take a style quiz that assigns you to a category - Modern Beauty, Boho Glam, Bombshell, Classic with a Twist, or It Girl. I am Classic with a Twist. Each month you get an email showing you your style selections for that month. You can choose your assigned category, a box from another grouping, opt out that month, or even gift your box to someone else. Each month includes 2 or 3 full-size bottles of polish plus a bonus surprise, like nail files, glycolic hand scrub, and other products.

Click to Enlarge the Starter Box

Click to Enlarge the Starter Box

The cost for this goody box is $19.99. You get at least $30 worth of nail polish if sold separately! As an additional bonus, at check-out you can order more bottles of polish at a steep discount. I added a sparkly bronze to my intro box for $4.99.

I like to change up my colors frequently, so I do not mind new small bottles each month. If I find a color I simply must have, I can always buy it again at a discount. So far, I do not see a downside here.

Another perk (yes, more!) are mystery boxes. Each month you can purchase a second box of mystery colors, sight unseen. That box should arrive next week for me.

You also earn points for spending on the site. 2000 Jules (their units) will pay for your $20 box. Referring a friend who signs up as a Maven gets you 1000 points; 2 friends and a month is free!

Classic with a Twist: Natalie and Debra

Classic with a Twist: Natalie and Debra

Everyone needs some fun in their life. For me, nail polish is a cheap thrill, especially at $20 per month. I just finished applying the pinky-coral Natalie (see lower image). I will let you know how it wears!

 

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