First lab meeting

Today Nahir and Oleg gave presentations on their biochemical projects involving AdoMetDC, which is a pro-enzyme for which T. brucei needs in order to synthesize necessary amino acids. The sequence of this pro-protein at the N terminushas been concerved across several species excluding mammalian species including humans. This makes it a viable protein for drug targeting. Nahir's project involves creating a better way to produce more of this target protein in order to purify the protein in it's entirity for crystallography purposes. It seems her first problem was mainly getting the N-His tag to come off the protein without disrupting it's enzymatic activity--you need to be able to prove that and therefore you should be able to first cleve the N-His tag. She had problems doing that. So she cloned the gene into a vector in a new way that included a novel product known as th e SUMO fusion sequence. This sequence assists the protein in it's cloning and facilitates folding, therefore increasing the amount of viable protein. She first designed her primers and also designed primers to cleave portions of the N terminus off the gene, later testing for enzymatic activity. How to test for enyzmatic activity and not just folding? Immuno-assay. or is it co-immuno precipitation assay?

So to ensure the gene was in the new vector she ran a gel. Showing the reaction inserted. She may also may have had to do some mini preps. She then digested the vector to show that she could isolate the gene and put it back inside. Isolating the gene meant she needed to sequence it.

confirming the correct gene she then began the process of large scale bacterial cultures. She'd lyse the cells and then purify the protein with the Ni2+. Through a 2 step process of running the solutions through the column on a gradient, she was able to isolate the protein without the His-tag. She would run gels using affinity chromatography which elutes the proteins based on size. In some mutants with a more upstream N-terminus deletion she lost the pro-enzyme associated with AdoMet. Ideally you want a clean protein for crystallization purposes.

Oleg was having trouble eluting enough of his protein. Seemed that in purification processes he would lose more than half of his protein. It seemed that there was too much protein and the column was too old to handle becoming overloaded. It was recommended to run more batches but diluted and with a better column.

ER experience

Mistake. Big mistake being so friendly and easy to get along with. I forget that the purpose of networking is not to have friends but useful links.
It's not that I'm not naturally pro-active. Who is? It's a method of survival, and being likeable is just a natural gift to be remembered. I have personality for a reason, not to be an attention whore. Or any sort of monger.
But I learn from my mistakes and misuses of time. I need to remember to hang around the doctors when at all possible and to remain hard at work or look for things to learn about.
I'm sure I seem very aimless. Last night definitely proved that to me with what little was available to do at the ER. A despicable aura must weigh on my presence. I'd hate to have that sort of a reputation. This is something I have control over, and this is something to work on. This lack of focus is not something that will just disappear. Focus does not come to those who wait, she comes to those who seek her.
All in all yesterday at the ER was fail and I'm going to have to go back sometime soon this week, hopefully Friday morning, or so to regain my dignity.

Last night I had a hard time going to bed. Captain Morgan was the only one who succeeded in lulling me to sleep. I lost myself chastizing myself for my mistake last night, my lack of focus, general depression feeling lost in a world that is moving past me--like endless waves that keep passing me before I can ride them. How many more must I watch with my hands and legs bound frozen under me?
My romantic idealism is nothing to be proud of. This is a symptom I must rid myself of quickly if I am to survive sanity. I constantly doubt myself in every aspect. I don't feel I am a hard worker (I think i said this before). But I know that I am! What else am I to expect out of life if I don't work hard to make my living for my future? I am obviously not getting along well with all my free time to myself. There is no inspiration. I am not at all as creative as I thought I was. Remove the stressor and the joy found in the outlets of freedom disappears. I doubt whether becoming a doctor is the life I want for a family I may come to want. The troubles of a modern woman. However, I do know I'd go mad as a stay at home mother. This is not something for me.
Life is more than who we are. That ceases to amaze me. It comforts me knowing anything and everything around me can be beautiful and worth my time. Joyfulness uncovered beyond the bends leading to peace.
I doubt myself because I do not feel proficient in anything but solving the puzzles that are chemistry and biochemistry. I have a love of learning anything and everything. Is that not enough to last through Medical/Osteopathic school? I think so. My joy is in learning and becoming proficient is something amazing amongst talented and genius souls. I can't see what's beyond the winter time I am in right now, but it's only inevitable that the spring is on its way. In the form of purpose, not love with or for another.

recaps of the last several times I've been to the ER

I was never really good at listening to my own heart. This doesn't compute considering no matter where I am I cease to be happy. My mind is not busied enough to feel useful; it is caving in under it's own massive uselessness. In attempting to find myself in a latent limbo I have realized how much of myself I have lost. With each passing day I feel parts of me atrophying and dying. My flow has left me and so I become frozen. I have no friends or peers to bounce ideas, have fun, relax. I have no reason left to relax as I have no reason to work. The things I used to do to relax and fill my time cease to please me anymore as they have lost their meaning.
Whether I am meant to pursue a career in health-care I still don't know. What I do know is that having too much time to think is affecting my ability to process information at the top of my game. I struggle with identifying what it is I want and what it is I need. I used to think what I needed and wanted was to move out of this house immediately. But now perhaps the best thing is that I need to occupy my time immediately.
I remember way back I took a personality test dubbing me a Woo, Includer, and Communicator amongst many other things. This made me believe I would make a good teacher, an occupation I now despise. Perhaps I could be a teacher someday, but I believe I am destined for more. I enjoy the days when my mind could move at such a fast pace normal syntax could not contain my thoughts. Perhaps I was always meant for school; being a know-it and good at what I do is my goal.
I'd hate to say I'm not mature enough for this. What is breaking me down is being immature, not having a real goal in life, no work, nothing to busy my mind. If I can identify key reasons why I want to be a health-care provider I can settle on deciding to work as a scribe. Being a scribe can prove a lot to schools. It can teach me a lot about being a health-care provider. It is irrelevant if I want to do it. I prove myself able to and I go for it. To me a health-care provider has no one personality fits all. They are of any personality and only all present themselves professionally. They come from all walks of life. There's no doubt in my mind I can do it. I can't even imagine what lies before me if I do decide to take the plunge. I will be learning all about what we know of ourselves. A very philosophical sort of pursuit. I love identifying problems and solving them methodically. This is far simpler than designing something from thin air as research is to me. In school I have opportunities to dabble in a little bit of everything and find my niche. I love a job where I attend to the needs of people. Service for the most basic of needs: fellowship, entertainment, and health. These three things I believe no one should be without.
What makes me think I can make it in medical school? I have a passion for learning though I may not have a quick wit as I used to. I am an expert and learning and retaining that which I can use and will use. I want to know so much, but more importantly than that is the ability to become good at what you do. As I said earlier I like to know it all and know it well, be around people, serve, occupy my mind, achieve high goals of learning.

I've learned many things about myself this semester and summer. I've learned it's not that I'm not a hard worker, it's that I cannot discipline myself aside from work. I'd not make it as a musician for I don't have that kind of discipline. I must build off of what I know and not off of what I don't know. Though I may have interests in Yoga, Religions, Philosophy, Dance, Music, Voice, and Languages, building off these things will not give me a sense of accomplishment. My interests still lie in the purest of desires: how to maintain health in the best ways possible. My little interests lose their fire when I have actual time to get to them all. It's just not fun anymore. My balance I've known for myself for so long has been distorted. I've always wanted to be learning.

Commitment is not the absence of doubt but continuing despite doubt. I doubt myself that I can do it. I doubt that I will retain my sanity. I doubt that I have enough interest or initiative besides a silly little will to learn. I've lost myself along the way of what I thought was all I ever wanted. The ability to satisfy my every whim (if I had enough money). Of course it is the balance that keeps my energy going--it is why my Ch'i is lost.

Intimidation. I feel intimidated because everyone I know has already done so much toward becoming a doctor that I feel unworthy of the task. Suppose what I need to realize is that those are the few, not the many. I just happen to know the lot of people that do very much toward becoming a doctor. That doesn't mean that I can't shape my own destiny that is very different from theirs. We come from all walks of life with an equal opportunity to become someone great. To learn a way of life. And this is how I find myself. Not by fearing or believing what everyone tells me. By carrying on despite the doubts from others' and myself. Breathing, fluidity, this could be my path in life. I can't help but smile and choke up. I need to grow up and be professional about many things. My fear of being unprofessional now shan't keep me from knowing I will learn eventually.

Which brings me to recounting what I've learned or seen at volunteering. I've made more friends among the nurses and they have let me watch how they do things. I met a woman who has sickle cell anemia and therefore a port with which to sustain her life. We drew blood from her that way in a most sterile procedure. Before I also met a woman who worked hard her whole life only to watch her husband beat her month old child. Volunteering really takes one back to a grassroots level. They are all people worthy of your aid however you can give it. Working part of the night shift I saw Dr. McCarthy and followed him around for some rounds. He started medical school when he was 28 and had his first child at 30. He cited he felt immature and not ready for medical school out of college so he worked. Though the time is stressful he said it's unlike college because you are studying what you are interested in and focused. The very little stress relief time he had he'd do little but walk the dog. Next I'll have to ask him why he wanted to become a doctor. I realize that although I may not want a stressful environment as the ER to work in permanently, I can work elsewhere as a Doctor. Normal hours are nice and so might seeing the same patients on a regular basis.

Yes all this vacillation and what is that I fear? My interests and thirsts for learning, critical thinking, and friendliness are uncontrollable and lose their strength when spread out amongst so many things. An opportunity I can make for myself is pursuing the greatest occupation I can think of. I just need to learn to ask more questions. It shows interest, not annoyance. Be able to think with them and analyze how they come to a conclusion. It's not just ordering random tests and gawking at them. I can do this too, what is the methodology. Not quite as intimidating once I realize this. Why not is a good question.

Why not is what will drive me. There needs to be a direction and for that there needs to be tenacity to survive, to experience, to leave footprints.

ER days cinco y seis

I'll be honest I'm not feeling particularly thoughtful what with the computer problems I've had all day long.

Yesterday was anticlimactic. Quite boring on the surface. Really just went through the motions and asked more of the nurses. Hung out with them to bond and establish rapport. Chatted with the PCTs. I paid attention that I could to the little children. And I began to smell the rankor that is the welfare citizens of America.

Today I became conscious of the friends I have made in the PCTs. The friendly Med Scribes were around and they made my day so much brighter! The nurses thanked me and Elena for my work. I had lunch/dinner with Percy. It was so refreshing to get to know someone new. It's been so long since I've made friends in higher places. I realize even now that though I am but a small person who really knows a lot of nothing, we all know alot of different things. It is only in taking life a stride at a time and surfing wikipedia and gobbling up information that I will be able to learn more about everthing.

Anyway, I was quite busy today and when I wasn't I hung out with PCTs and the new nurse at fast track. There were a fair amount of pelvic exams to take care of. No one was happy about those for we all vented about it. Which lead me to wonder, but not in full detail, of the use and abuse of the ER system. So many utilize the ER as their primary care. I can't help but wonder if the socialized healthcare would aleviate this abuse. I heard a doctor berrate a patient for complaining of waiting for so long for care. He said something along the lines of if you had gone to the primary doctor you wouldnt need to be here waiting when we have REAL cases here. I was held back 15 minutes because I was listening to a patient complain about her lazy nurse and slow care at Trauma. So I paid her attention and a pillow. She verbalized what I was pondering all day: the extremes in the ER. Does the wide spectrum of cases negatively effect patient care? Can health-care be fascilitated with the elimination of such areas as fast track. She proposed primary care work longer hours. Personally, I think she ought to be patient. It's the best we've got right now and there are plenty of other peope dying in the same room. The nerve of people thinking we wait on them only. I watched the PCT draw blood from her. All in all I spent a bit of a good time in Trauma. Even Twanda saw me. I moved my first stretcher today; that was quite a difficult experience.

So that was my deepest thought of the day. Can I really deal with cheap people in a setting where they think waiting for an hour is a travesty? In a world where money is constantly lost and the filth of the world come in for free food expecting to be treated with all benefits. It's a true test of what it means to work for the good of others, being a true servant upholding the purest and most difficult of virtues.

ER volunteering day quattro

It's been a few days since my shift. I worked what is affectionately known as the graveyard shift. It left me quite exhausted the next day with a neck quite depleted of fluids. In any case my time was well invested as I was able to shadow a Doctor and hang out with scribes as I watched medical care in action.
The advent of a new case is always an exciting one. Broken bodies come in on stretchers as the Doctor rushes over to communicate the causes and state of the patient. In one case we received a witnessed cardiac arrest patient. It was chaotic trying to get him to a pulse. There were actually two cardiac arrest patients. While I'd love to relate every single little thing that happened on my six hour shift, I am tired at the moment.
I need to relate the doctor's kindness in allowing me to follow him around. I was able to see how he approached a case from start to finish. I was able to bond with the scribes and see the relationship between the scribe and the Doctor. The bedside manner was impressive to see as well, as everyone in the room knew the truth but pretended not to know it. He played the role of counsel and informer in a careful and relaxed manner. It was most impressive to see someone take control of such delicate situations with the calm and cool of one sipping tea. He approached the family tending to the cardiac arrest patient no different from the Heroin addict in fast track. He diagnoses them on a biased level, but all judgment is put aside as attention is paid in full. This profession is admirable for these small insights I've made.
I must also relate that the Doctor provided further inspiration to us all as he suffers from ADHD. I can think of no better environment for such a person than the ER.
In future shifts I hope to open my eyes to the roles of other professionals such as the nurses as well as form better relationships with the Doctors running around. I need to be asking more questions as well as anticipating roles I can perform.

ER part trois

This ER shift I made for myself lasted from 5:30 until 9:30 or so...actually until 9:45 when I completed the task I set for myself. I love being a volunteer because I can finish my task whenever I want and cater to patients or whatever else needs to be done. In short my multitasking is enhanced and utilized as well as my hearing and memory. True I don't get paid for anything but a $6 meal, but I am at liberty to talk to whomever I want when I want as long as I want. Though most patients have family with them.
Today I was able to see how Doctors interact with patients close up. Almost as if I were shadowing them. I still feel awkward around them, but I flow. The doctor has such compassion and really stays engaged listening to the patients; letting no sign of boredom, dividedness, or annoyance show. I waited with an older woman, whom I discovered is the same age as my dad. She was watching Glee and it interested me to see why she would be watching a younger show. The woman was doted for being patient waiting 5 hours for a room. In reality many patients there in medicine wait an entire day before getting a room. I thought I'd talk to her because she looked like she was expecting something. She asked me about myself and what I wanted to do. I asked her why she was watching Glee. We watched parts of it together. I told her of how I came to fall in love with Ella Fitzgerald. She now knows my goals to sing some of her songs at Scat. She described to me what sort of work she used to do in marketing before she semi-retired to a paraprofessional position at Arlington. I told her I was hiding from the other nurses and PCTs for I would rather wait for her until she got a room. She finally did get a room soon after Glee was over. But before she left Cassy came in to give her her painkillers. Cassy spoke with such compassion making the patient feel as if she had argued on her behalf for a room. Cassy spoke very assuredly in a manner I can only hope for at this point. I am learning though how to speak professionally as possible.
I was proud of myself today for I tended to a patient who apparently had a bit of a diarrhea problem. He could hardly speak, was older, and had only one good eye. I was stupid and thought he wanted to watch the baseball game. Really all he was wanting was another bedpan or something. Some sort of relief. I refused to keep myself out of the room for fear of the smell because I knew anyone no matter what condition deserved attention. Above all we are all to be treated humanely in this wonderful nationally acclaimed ER. So I braved all despite my cautiousness though I failed to provide him any more comfort than I felt. The experience made me wonder whether PCTs do what they do out of forced placement or if they initially had this dream to be helping people meet their immediate needs. I think of how beautiful it is to say I want to serve in a Third World country, yet why feel a need to go so far away from home? Afterall we are just people. I could go a year working in the ER not seeing the same person twice. They are all the same...bodies in need of fixing and upkeeping. Sure it's gross, but it's the basic need. Anyone anywhere on earth is just as needy as someone somewhere else.
I get in this zone once I've been in the ER for a while. I don't focus on what time it is. Merely on choices. I make choices to push myself into that smelly room. To talk with that odd patient. To learn about how to relate to patients best. To manipulate my speech into soothing and doting tones. Like I said before, my multitasking has a place. And my pace is what I want it to be.
Well after all that I took a break in the nurse's breakroom for William had come out with a cup of coffee I had only smelled in his breath and finally seen. He told me he spruced up the drip with cinnamon. I just had to follow him to taste for myself. But it was too hot, so I went to clean beds and restock the rooms--a task which took an extra 20 minutes. My coffee was finally cooled. I drank while watching Tosh.O and listening to the nurses comment about habits they hate their significant others doing. One woman had 2 children and wanted another. The other vowed she never wanted more than one kid and is stopping there. The younger one at 24 announced she could never marry anytime soon because she likes her life by herself. Three completely different women at completely different levels doing the same work. All kinds come together in this mini-city. In the end we are just regular people living our regular annoying lives, but by trade we are super-heroes of a different sort.
Note to self. Megan works as a Trauma nurse. She'll be graduating soon.
Another anecdote. Someone got arrested today for walking away while inebriated.

Day Deux at ER

Well to start of simply today Clarissa and I restocked basic items found in all areas of the ER. Bandages, cotton balls, tongue depressors, etc. Along the way we fluffed pillows and waited on patients. I talked with an adorable little boy named Speedy. I gave him crackers and juice.
That day I saw just how much more fun doing work with another person could be. Though I seemed to be a bit of a slacker as I'd spend my time talking to patients. I met one patient because I commented on his boots. He informed me of his and his mothers' health. That's when I found them both in the Trauma section of the ER. Along with a horrific smell that assaulted my nostrils to pain of death. And that's when I realized just how selfless or perhaps desperate or even calloused these nurse's aids are. It's all in a day's work to clean up the defecating patient. The smell was unbearable--like a sign of imminent death. It made my heart sore to see the family near by either embarrassed of their relative's condition or more likely frightened for his life. I wished there was a way to help him. And I wished there was more I could do than to just walk by almost carelessly. But what was I a mere 22 y/o without any life experience with which to offer counsel to do?
I found out more from Clarissa that day about where her heart lies. She spoke of counseling foster children. Dangerous line of work I think, and quite emotional in some cases. It'd be an intriguing experience, but alas.