To my Future Patients and my Colleagues

Wow, third block of 1st semester is almost over. Where did the first semester go? Amidst the brachial plexus, cranial nerves, trilaminar plate, and "Dom's double rainbow", it's really easy to get bogged down in the details of medical school. This just means that it is more important now than ever that medical students not lose site of the forest for the trees. Let's regroup for a moment: we will see patients someday. They will bring with them their thoughts, fears, maladies and humanity. All of this we must synthesize and interpret in order to provide them with unmatched care and healing.

So, what's the point of all this? Well, it's really quite simple. Begin caring for your future patients today.

Go vote.

I will be voting because the health of my patients matters to me. I will fight tooth and nail so that they have access to the best health care there is.

To my future patients: you are my primary concern although I have yet to have the honor of meeting and caring for you.

One of the real travesties I've noticed during undergrad is that while many premed students are notorious for being real go-getters - the ones that (admirably) shadow physicians for added experience, organize community service projects and readily volunteer to help others - they are often driven by an ulterior motive: the almighty resumé. Accordingly, more subjective achievements like participating a democracy are granted less importance in the battle for extracurricular time. This is not to say that the things I listed are not important, much instead they are all well, good and fine and are a testament to the tenacity of tomorrow's doctors. However, what I ask of myself and the future physicians around me is to channel that energy into other arenas as well, such as advocacy. Put simply:

Go vote.

Whether we like it or not, the fate of the American health system as it stands did not happen overnight. Nor can we ignore the fact that institutions such as the AMA, ACP and others have been advising and influencing legislation during this process and will continue to do so for the foreseeable future. The decisions coming from the chambers of Congress have real effects on our patients, doctors. Additionally, we have a say in who we will work with in making those decisions in the future.

Fight for your patients. Go vote.

Volunteer. Work the Saturday Free Clinic. Be a helpful person. But also, be an active member of the democracy you are in. Your vote is absolutely vital to the outcomes of your patients.

True, this is a heavy burden to bear, but then again, who said this whole process was easy? This is our profession now. We must be active in it. The time to create change and institute policy is not twenty years from now when our patient hopefully asks you "well, what can you do for me, Doc?" It is today. Go to your local voting poll, grab a pen, and check off the names of those that represent your interests and will enable you to best answer that question. No one expects you to know everything about politics and this election. But they do expect that you put forth an effort. Don't know who is who? Well, there are some good resources for just that (see below). Take a break from studying for exams and spend the twenty minutes to make a decision. Research the candidates, even if briefly. Ask other people around you for their thoughts. Talk to your advisers. Hell, grab a physician in the hallway and ask them about this whole "health care reform thinga-majig".

The same is true for patients. Physicians are not the only ones who should have a say in your health care. The best medical care is always prevention, but in this case, advocacy is a very close second.

Please, go vote.


Sincerely,
Raman Kutty
Medical Student
The Medical College of Wisconsin


Resources

For the Wisconsinites: Journal Sentinel Online ballot summary

ACP/AARP summary of the effects of the health care law

General advocacy site of the American College of Physicians (ACP)

Current topics in advocacy courtesy of the American Medical Association (AMA)

Messin' with Suppliers

Normally, the freebies at conferences suck, but for some reason SFN was pretty good last year. Anyway, Thermo was handing out 4 gig flash drives, Sigma had rat-shaped t-shirts and Kent Scientific was handing out coffee mugs.

Which was good until my mug broke.

After a few months, I produced this e-mail in a fit of unproductiveness. As a sidenote, I intentionally dressed this message up for the occasion. I'm really not that attached to the mug, but for the sake of principle, I figured, eh, why not. Here you go:

*****
To Whom it May Concern,

I've had a Kent coffee mug that I have been using faithfully - it's my absolute favorite. The problem is this: it got chipped at work today and a hairline crack now stands between me and my daily Joe. I know this isn't a normal request, but here it is anyway: may I have a replacement? For most this seems trivial, but trust me, it is anything but. Aside from the fact that I am useless without my coffee, I've found it impossible to come across a mug of that weight, volume and quality. Not to mention the fact that the neat Kent logo on the side gives a sense of purpose to my otherwise unproductive routine - something the boss hasn't caught onto just yet.

I've included two pictures below...it's such a pity that such a small crack is such a huge problem.

If you could find a way for a replacement to come my way, I would be SO appreciative. Thank you very much!


Cheers,
Raman

Raman Kutty
MD/PhD Candidate
The Medical College of Wisconsin
rkutty@mcw.edu
****

The best part? Getting this in my inbox:

****
Dear Raman,
I am sorry about your mug
We can send you a new one but we do not have any in house at the moment
My associate is at a show in DC and has them with him
He will be back on Monday and I will be happy to send a new one out to you
****

Too easy. Maybe next I'll convince Thermo that a HPLC machine broke and I'd really like a new one. I'm sure they'll oblige. Small victories.

Maturity Regressing

Ok, study break. Back to undergrad for a second:



Yeah, I'll bet you wish you did!!

The bad news: 60% of exams still to go. 40% of which are tomorrow (blegh). Overwhelmingly GOOD news: OSU is stopping by MadTown on Saturday night and you better bet your ass that's what's getting me through this week.
Prospective schedule:

Wednesday:
Anatomy Lecture Exam
Human Development Exam

Thursday:
Cram 'n Jam

Friday:
Biochem Exam
MSTP meeting
Lunch
CRASH
Madison.

Saturday:
College.
Game.
Day.
Nobody does undergrad like UW-Madison.

Seriously...WTF Mate?

I woke up this morning and the first thing that went through my mind was, "The Ansa Cervicalis innervates the strap muscles of the neck, but what innervates the hyoglossal muscle?". My day is concluding with "So, wait, following a breakup people eat TONS of chocolate. Is this an evolutionary coping mechanism designed to to raise serotonin levels and thus make natural obsessive-compulsive thinking about a significant other diminish?"

Clearly, we left the realm of rational thinking a long time ago.

The good news is that the blog is finally seeing some love, so I guess it can't all be bad.

*Note: answer to morning question is: depends. Motor function? Hypoglossal nerve (Cranial XII). Sensory innervation (not special sensory as it's not involved in taste, though)? Lingual nerve, a branch of the Trigeminal nerve (Cranial V) - V3, to be exact. Bonus points if you knew it was supplied by the lingual artery. Unless you're an M1. Then..well...no soup for you. Sorry.

*Note2: with regards to night question - I highly doubt it.

Study Break

Exams suck.

In other news, I hear the Badgers are winning so that's a plus. I say "hear" because ESPN pushes updates to me and that's how I enjoy Badger games these days. Please, Bret, don't lose to Minnesota. For the love of all that is good and holy, keep this lead.

Sorry for being punchy. It'll pass after exams. Probably.

Wait...I still have a blog?!

Ok, so I didn't completely forget about this ol' gal, but in my defense, I've been pretty busy. And by that I mean really busy. And by that I mean, I'm not really sure what day it is. Actually, I take that back. I know that I have 8 days before my next exam block. Shit.

Med school has been like that. Each week is a different shade of "oh crap". Example: week after exams: oh-crap level(out of 10) = 1.5, week 2: 3.5, week 3: 7.0, week 4: 11. We had out first exam block already, and of course I was freaking out for that. Comparatively, however, it wasn't that bad. Only two courses, human anatomy and genetics. This time around, biochem (hello old friend!), clinical psych (I'm not really sure still what the purpose of this class is), human anatomy, and human development (odd, there's some sort of "human" theme going on here). So, 5 exams, 5 days - anatomy gets two because it's special).

So what's med school like? I'm searching for a befitting "Raman analogy" here but none really come to mind. It's pretty awesome, so we can start with that. We're learning some interesting stuff - did you know that cleft palate results from improper closure of tissues in utero - not unplanned separation? Down side: there isn't very much happening clinically though, which I suppose is good. We did have an afternoon on taking blood pressure, which I was allegedly good at. Great, I can correlate sounds starting and stopping with numbers. I take that back. I shouldn't be so down on it - after getting beaten over the head with basic sciences, this was a welcome reprieve. That, and I got to walk around with my stethoscope casually slung around my neck. SO PRO.

On that note, the MSTP has been a real gem. We've had two guest lecturers come to the College, and they've been pretty sweet. Numero uno: George Daley. This guy is a CHAMP. If you don't know much about it, seriously, look him up. Incredible. Numero dos: Stephen Archer. Another amazing research scientist who gave a really hilarious (and academic) presentation on hypertension. Cool to see that knowing the Krebs cycle has clinical importance!

Just like in high school and undergrad, we were welcomed with a speech that went to the effect of "we know all of you are smart, but this is different, some of you are going to really struggle". As usual, I didn't pay it much heed. Whoops. Med school is HARD. Initially, you laugh when people say that it is "like drinking from a firehose" - that is, until you realize it is true. Then you're not laughing because you're trying to choke down all the material they are throwing at you. It is a TON of work. Where one would normally say, "eh, they're not going to test us on that" or "we can't be expected to know ALL of that", you learn to say, "gee, gonna need to know that" and "Yeah. Know it."

But it isn't all studies, and that is probably the best part. MCW has a really good student culture. I.e.:
1. Gunners exist, but they aren't predominant or, really, prevalent.
2. There isn't any of this "that's my chair" ridiculousness happening. And yes, this happens at other institutions, even those greater than or less than 90 miles west...
3. TONS of student orgs. There's the usual lot, AMA, ACP, etc etc, but a bunch of purely leisurely ones as well. Speaking of which, you're talking to the new president of the MCW cycling club. In med school, it's the small victories. Mostly those that come after big losses (ahem, student assembly spots).
4. Really caring faculty. Best example is probably our newbie, Dr. Hoagland. Really awesome dude, and man, that voice can calm nuclear conflicts - which is good, because anatomy lab = freakout central.

Ok, update done, time to go study. Catch you on the flip of block 2, friends. C'est la vie.

The Times They are a Changin'

Howdy everyone, time for a quick little update on life here in the MSTP.

It's been a long time coming, and I'm still not sure I'm entirely ready for this. Still, though, I'm so excited! I've put a great deal of time, effort and, of course, blood, sweat and tears to have this happen. Tomorrow starts orientation for incoming medical students at the Medical College of Wisconsin.

So, here we go! This isn't undergrad anymore. Back then, if I screwed the pooch, that was on me and me alone. Now, though, someone else is going to feel the burn if I decided to put something off or ignore something important. The little tidbits are going to be important in a whole new way. Kind of a heavy thing to say, I suppose, but so is life in professional school!

Time for bed, need some sleep tonight. Tomorrow I wake up a medical student!

Momento Mori...volume II

Throughout this whole process, I've had a very positive beat. And why not? I'm being paid to do science and get a medical education.

Still though, us MSTP kids aren't machines. Amidst all this, I'm still an emotional person. I like people and being around them. Relationships are incredibly important, and I've been so lucky to spend the last year with a very amazing girl.

Yet, in the words of my friend Chester Bennington, "...sometimes goodbye's the only way".

There's a lot on my plate right now with med school proper starting soon and now the big changes in my personal life. Wish me luck. I'll need it.

Update Time!

Time for an update! This is for two really important reasons: 1) it's a desperate attempt to give this blog some much-needed attention and 2) I'm done with my molecular work for the day and I'm riding a wave of productivity. That and I can't really leave for another hour, so hey, why not.

So the last post was mostly about the work in the old lab, so time to talk about the new one.

As I mentioned before it's an auto-immunity lab, so let's talk a little bit about that. Obviously, people have an immune system so that we can fight disease and foreign bodies that have some how entered ours. Part of this exceptionally intricate system are the B-cells, who recognize an antigen (a molecule that the cell uses to recognize the things around it). If it recognizes the antigen, it engulfs the whole body and destroys it. In a normal person, 75% of the B-cells that are made recognize (and hence, target) the body itself! So the big question is this: what happens to those 75% cells? Turns out, they undergo B-cell anergy, where these harmful cells are essentially inactivated. In a patient with an autoimmune disease, this doesn't occur, or does not occur to the same extent that it does in other people. Solve B-cell anergy, solve autoimmune diseases, or so is the hope.

So where do I fit in with all this? Well, as I said I'm immunostupid, but I AM useful in that I know biochem. So, I'm working on a project to help the lab out by creating and optimizing a high-throughput western blot assay - like what I did last month but in a plate instead of an actual gel. Here's how it goes down:

1. Add cells to a standard 96-well plate and let them stick to the plastic
2. Fix the cells so they're not moving around, replicating and will stay in one place
3. Punch holes in the cell membrane (permeabilize them) so reagents can enter
4. Add reagent to reduce non-specific binding (antibodies aren't perfect, so they sometimes bind to stuff they shouldn't....bad antibodies!)
5. Add the primary antibody (the one that recognizes your protein of interest)
6. Wash it out and add the secondary antibody (the one that recognizes the one that recognizes your protein and has a fluorescent tag on it)
7. Scan it in an infrared imager where the secondary will light up

It should look something like....this! (Each red circle is one well and the red is the protein lighting up)

So, let's compare regular westerns vs. in-cell westerns, shall we?

	In-Cell	Regular
Time	Big props to ICW on this one. Since you don't have to lyse the cells, run the gel, transfer to a membrane and THEN start working, it's a huge timesaver	The pokey puppy of the two...
Scale	Again, points to ICW. You can run 96 wells at a time in one go, and that's a lot.	Regular western, not so bad. But, you can only run ~10 samples per gel, 2 gels per run...that's a TON of gels before you start matching ICW.
Cell Number	ICW is designed for low cell counts. The image about was done with 250,000 and 1,000,000 cells per well.	Regular western requires a ton of cells in order to produce enough cells for a sizeable cell lysate and high enough protein concentration. Think 5,000,000+
Antibody	Sorry ICW, you lose this round. Antibodies are really expensive, so the less you have to use, the better. Normal concentration here is between 100-200x dilution.	Depending on your protocol and the protein, could go as low as 5000x dilution, although I've personally only gone as low as 2500. Still, that's about 200x less antibody used each time, and that saves ca$h.
Specificity	Before you can really run an ICW, you have to run the corresponding western normally (gel/membrane western).	In a regular western, you separate out the proteins by size. Since you do that, you can see if you are getting non-specific binding really easily (i.e., the gel lights up way away from the protein it's supposed to bind to). You can't do that in ICW, so you have to do one of these first to know that your antibody is legit.

WAY overdue....sorry folks

Current location: 30 minutes from Spooner, WI, sitting on the patio overlooking the lake, celebrating Amuricuh day (the 4th). Considering the last post was well over a month ago, it may be well to admit that I'm not ready for the responsibility of having a dog, despite wanting one. So this is way overdue, but I've got a lot to talk about (even some science!) - here we go!

The last month has been absolutely INSANE. Fun, busy but absolutely INSANE. The CliffsNotes version, more or less in chronological order:

1. First lab rotation begun and finished
2. Fully moved into the new house
3. New roommate (Erich)
4. Trivia nights on Mondays
5. Eric Clapton live at Summerfest
6. Bought my first car
7. Ramani's engagement!
8. 4th of July reunion with the old roommates (and Kelly and Kim joined us, too!)

So, much has been going on. The big news is the first lab rotation:
I spent about 5 weeks in Dr. Park's lab in the department of biochemistry, studying the MAP Kinase (MAPK) pathway in cancer. Essentially, this is a series of proteins that are responsible for activating the ones below them, creating a chain reaction when the cell is properly stimulated. This translates into instructions for the cell to either replicate, stop dividing (senescence) or die (apoptosis). As one can imagine, this is hugely important in cancer, as the name of the game is get cells that are rapidly multiplying to senesce or, better yet, die. One of the big questions in the field is how this pathway can signal these opposing outcomes with the same machinery and activation. Think about it this way: you have one light switch and by flipping it you can either turn on a fan in one corner or turn on the light overhead. The lab recently found that one of the key proteins in the pathway, ERK, has both catalytic and, interestingly, non-catalytic functions, which may explain why this is possible.

So where do I fit into all of this? Well, I spent the last 5 weeks investigating the function of a drug that is currently in use clinically to induce cell death. They have found the drug to already be very effective in inducing apoptosis in cells that have a mutation in the RAF protein. However, in cancer where this mutation is not present, the drug causes the cells to hyper-proliferate (ruh roh, Shaggy!). So my job was to see if we can use this drug on RAF-normal cells. This is a fancy way of saying I cultured up tons of cells, treated them with the drug, collected protein samples and measured what happened to protein function in the MAPK pathway. Here is an example of some pretty neat biochemistry and ingenuity: how do you separate all of one protein from literally tens of thousands in a total protein sample? Well, it's actually pretty simple, and we do it every day in the lab. First, the cells are broken apart with detergent, allowing us to access the proteins inside. These proteins are then placed into a gel much like Jell-O (but not for eating) and separated by size using electrical charge. So, now the proteins are all spaced out, big huge ones at the top, small ones at the bottom, and everything else between. This sample is then transferred to another apparatus where the proteins are pulled out of the gel and put onto a membrane using, again, electrical charge. Now here is where things get really neat. For anyone who has ever been sick (i.e., all of you), your body developed antibodies for whatever it was that made you sick. Essentially, these antibodies recognize the proteins that are expressed on the outside of the bug you had. Somewhere, someone got a really good idea - these antibodies are VERY good at recognizing a VERY specific protein sequences. So, what if you inject protein, say ERK, into a rabbit? It will develop antibodies that are specific to just ERK! Collect a blood sample from the rabbit, separate the antibodies, and viola, you have an antibody for that protein that you can apply to the membrane! And, it gets even better! So now you have a whole sheet of proteins on the membrane, and all the ERK proteins have antibodies stuck to them. Now get another antibody, say from a goat, that targets rabbit antibodies. While you're at it, add a light-emitting molecule to the antibody and you'll be able to see the proteins on a long exposure camera or undeveloped film. Pretty neat, hey?

So that was 5 weeks, and there are some results that do look a bit promising. It's up to Johnathan, the next rotation student (and fellow MSTPer + past BTRL member) to pick up the project and make it shine. So, good luck to him, hope I didn't leave too big a mess for you, buddy.

So what else? Well, the house is all set up (whew!) and we're getting along great. Back to family dinners with the roommates and FIFA World Cup games on the weekends. Getting back into a rhythm of things, and it's good.

Of course, the really big news is that my sister, Ramani, is engaged! Emmanuel came to Milwaukee earlier this month to spend a weekend and popped the question...she said YES! Needless to say, we're all very excited and wish them the best. Stay tuned for more details and dates.

So that's it for now. And yes, this post was written on the 4th and published on the 17th. I know I'm behind, but whatever. I'll fill you in on Gauld Lab (new rotation) happenings in a short bit. But this should be enough (er, overload) for now.

You've Said it All

For those who aren't familiar, when you say Wisconsin, you've said it all. I'm not kidding

And it's true. I LOVE this place. Commencement exercises were this past weekend (so I'm officially a graduate!) and I can't really describe it, even 36 hours later. So, here's the story.

For a bit of background, I wasn't terribly excited about this whole "walking" thing. I've been to a college graduation before. It was boring. I listened to an unimaginative speaker blather on about how life was pointless - I'm not kidding - and then they read names. For an hour. BUT, the one thing that got me through it was seeing my sister graduate. So that made it worth it. At any rate, I wasn't pumped for this at all, and at a few points I was considering not even doing it.

As it turns out, our Chancellor is hilarious, the Provost is a riot, and I have a ton of friends that walked with me that I didn't even know were going to do it. Seeing them was a real treat. And then I got to walk and give whole Kohl Center a "go an' brush ya shouldas off" look via Jumbotron when they handed me that coveted red diploma holder (the real deal shows up in the mail 12 weeks from now...blergh). I got to see my parents and family thrilled, happy and excited. I got to sit next to John, a roommate I will miss terribly. I got to joke around with Mike, a classmate from the ol' Hilltop and a perennial source of smiles. I got to sing Varsity one more time and John and I belted that out louder than I think either of us ever have, football games included. Then, they played You've Said It All (colloquially, "Bud"), and I lost it. I hopped up on the chair I was standing in, fist-pumped the whole way through it, and wore one of the biggest smiles I have ever had.

And why not? I'm so excited about MCW, but at the same time, this is home. I love this place. Our speaker James Kass talked a bit about his experiences in Madison. I, too, lived on both lakes, walked the many miles through the snow between tests, went to 5th quarter (although the Badgers were at least better than they were in 1991), laid in the sun on Bascom, locked myself in cages in the library, sat for hours on the terrace - I, too, love this place.

I'm very fortunate. My parents paid my tuition. Taxpayers built the facilities I used every day. Professors and administrators fought tooth and nail for the grants that enabled me to perform my research. My professors spent hours editing and refining to give me the best they had. My classmates pushed me to do more. Many of them became my friends, and a few of them have changed my life in ways that I can't begin to enumerate (and not just due to my illiteracy, it's more than that). I'm going to a great medical school for my dream position, and SO many people here at UW made that a reality for me.

Maybe one of the best things of the day was having lunch with my family and then running around campus with my mom taking pictures in all my favorite places. I'll be home later this week, so expect pics then, but in the mean time, believe me when I say they are good.

Bottom line: I'm in a very happy spot. I graduated from a world university with honors, and am headed to a very enviable program to pursue my dream as a physician-scientist. But more than anything else, with this comes great commitment. I have a moral obligation to the public, my family and myself to make something of this. And that, my friends, is the great joy that stands before me.

U!
Rah!
Rah!
Wis!
Con!
Sin!

Working Break

Ok, so one thing you need to know (and most of you do, thankfully): I am a total nerd. I was born one, and dammit, that's one of the reasons I'm doing this whole MSTP thing. And I love it. Apple isn't just a media darling, I've loved these guys forever. Even in 1996. Still, I saw something today which gave me reason for pause (and yes, this constituted my study break today):

"The Android mobile operating system passed Apple Inc.'s (AAPL) iPhone in terms of U.S. market share during the first quarter, according to a report issued Monday by the NPD Group."
-Wall Street Journal

..This prompted the following response from my end:

**************************
Dear Mr. Jobs,

As you know, recent reports indicate that the iPhone OS has now dipped below Android for market share.
As a shareholder, I'm duly curious to know when Apple will accept that 68% of the market is not AT&T and move accordingly.

Thank you.


Most Sincerely,
Raman Kutty
The Medical College of Wisconsin
Class of 2018
262-893-5252 (Cell)
kutty@wisc.edu (Main)
r.kutty@neurosurg.wisc.edu (Work)
**************************

I doubt I will hear back from him. And if I do, I doubt it will be more than 2 words...likely something to the effect of "shut it". Still, I think it's important.

Apple has gone this path before. They used to have a dominant foothold in education and they lost it to the PC because of a great deal of arrogance on their part. History repeats itself, but this time it had better not. I hope they learned from that mistake - they're still feeling the burn from their past indiscretions.

Apple has some GREAT technology. Unfortunately, AT&T sucks. Take my position: I hate my RAZR. hate hate hate. But, I love US Cellular (these guys are pretty good!). I love the iPhone. love love love. But, AT&T's version of "service" leaves a lot to be desired.

Come on, Apple. Get it together and hookup with some new partners.

We're Halfway There!

Fortunately though, not yet living on a prayer.

...Yet.

Topping my to-do list for the last couple of years was "earn Biochem degree from Madison". Today, I can check that off. Handed in was the last assignment for the last class, a whopper of a lab report on ß-galactosidase. It's too bad, he's a hard working little enzyme, but often gets overshadowed on this campus by the BMoC, ADH. Anyway, all done with Kms, Vmaxes, Michaelis-Menten steady state kinetics...needless to say, I really enjoyed working on that for the last couple of days.


Still though, it's a nice feeling, having all that done! I really can't give the faculty here enough credit, it's a fantastic program. More than anything else, the courses I took for the degree I feel have prepared me more than anything else for the MSTP. I came in liking science, now I live it. And, I can say that truthfully.

Still though, we're not done just yet. At this point, it's all for show (no big). 2 more exams and a thesis from now I'll have a neat little stole with 3 cardinal bars on it. Really, it's just a handy little handle to grab and remind us to be humble. Honors students do need some reminding, after all.

Righty-oh, time to hit the books for a bit/enjoy this campus. 5 days left as a college student, time to finish right and make the most of it!

Memento Mori

The irony of being a physician is that in one's career, death will become a part of life.

I've been very lucky; I've accomplished many things this year that I never thought possible. And I'm so happy that my [adopted] grandmother, Loretta, was there to see so much of it. As for the rest of it, she'll be watching from above.

A golden heart stopped beating today, but after 94 years, it was time. This one's for you, Loretta.

Another Kutty on Pub Med? Oh, Brother.

A few weeks ago, Matt Clark offered this succinct review of the Cream City MSTP blog:
"...I, for one, would like to see some science content." Well, wish granted. Eat your heart out big guy:

Science!

So great news: it's a pub! My First! Granted, I have a long ways to rack of the star power of my dad but it's a good start! Of course, there's a lot more to go - first author will be key and on something novel (i.e. not review). But for someone just starting a research career, I'm more than pleased with it.

Big props to the lab, especially Mike, Paul and Jonathan for all the work they put into it. And of course, Dr. Kuo.

So here we go, more to come!

Wake Me Up When May Ends

Whoa boy.

I'm in the middle of a lab report for biochem at the moment (diligently, of course), so naturally a blog post is in order.

It's been a while since I posted, mostly because life is happening a little too fast right now and isn't showing too much of a break. So here we go:

Top of the month: revist at MCW. Got a great chance to meet some of the faculty and current students, as well as some of the prospective students. Here are the highlights:

Faculty:
Had a bunch of great meetings with faculty at MCW. The biggest problem I face is picking from them - all of the labs seem so superb. Lots of very passionate researchers doing tons of great things. A future PhD's dreamworld, really. I did get to meet with Dr. Stephen Gauld, and it was a pretty interesting talk. He works with autoimmunity (a la B-cell Anergy), a current interest of mine. Basically went something like this:

So, uh, you should be pretty familiar with this stuff...
Yeah, I'm not. I suck at Immuno. But I'm not completely worthless, I *love* biochem
Oh great, you'll fit right in.
Awesome, and learning some Immuno along the way can only make me a better doctor!
Great.

And so on. Really, really interesting work in an area that I am strongly deficit in. Time to branch out a bit and explore!

Also, sat next to the brand spankin' new dean of the graduate school, Dr. Ravi Misra at dinner. Very bubbly guy, very well informed and completely on top of things. Perhaps the best thing about the dinner was that I was instilled with a really strong sense of direction and purpose as far as the grad school goes. Really good thing.

You really can't say enough about the students at MCW. They all LOVE what they are doing and they seem really interested in the future students. Obviously, a great sign for someone in desperate need of all the help he can get his hands on. Oh, and there's an MUHS grad to boot (LTF, Rick Lennertz).

Future students were a good mix, had a great group feel. Met a future roommate of mine, Chris, which is always great! It's always a bit unnerving to jump into a new group with no idea what to expect, but this was really smooth. As for the remainder, it's hard to say since I don't know who will actually be coming to MCW. All the same, they're all bright and motivated...blah blah blah, all the stuff you expect from Mud Fuds. We'll know the full list of matriculants, uh, soon. -ish.

Since then:
work work work! So much stuff to do at UW before I peace out. Topping the list:
Honors papers for Human Sexuality (exceptionally unstimulating), honors paper for African Storyteller (dear God, literary analysis makes me want to run for the hills these days), exam for Biochemical Methods, 3 lab reports for the same (and I want to do this the rest of my life?!), final exams, coordinating research rotations, finding a place to live, thinking about a car (well...that's slipped to the back burner for now), social life (a what now?)...the list goes on. And that's before the real work even begins.

The good news though: Ramani has been really on top of living arrangements for next year (did I mention we're going to live together next year!?), so that helps a ton. Might have found a place today, Ramani's going to go scope it out tomorrow and give us the deets on it. Praying it's not shady, because it looks like a good fit. Pray for us.

Also, they're going to give me a vacation! HURRAY! Probably the last one I'll ever REALLY get (completely free of commitments...well, ok mostly....ok sort of...yeah, no) for the rest of my life, so I'm hoping for a great week. Word to people staying in Madison: I'll be couch surfing, so show a brown man some love?

All for now, time to get back to this lab report so I can enjoy another great day in Madison tomorrow!

Officially, it's officially official.

Got the written letter in the mail yesterday. 100% in. Sent my acceptance note to Dr. Barbieri, so I'm 100% going to MCW. Now to let NYU know that I'm peacing out and we should be good. Whatever, I looked terrible in purple anyway.

Short aside: decided to scrap the house idea. Not functional right now, but maybe next year. Might have been a bit too ambitious for a start...so time to build some capital and credit, a la car payments and savings. Hold on to your hats, folks; this is about to get interesting.

Headed back to Mah'wakee later today for the tail end of break. Lots of people to see at MCW, lots of thank yous to dole out. So many people who helped me out in such big ways there!

Time for bed. So sleepeh.

Wake up Mr. West!

It's been about 26 hours since I received Carol's e-mail, and I've been contacting people left and right - so many wonderful people to keep updated! I got an e-mail from my mom this morning informing me of places I can go to look for housing and used cars (isn't she sweet?!). I guess this means this is really happening! In 27 hours my break has gone from hanging out and writing papers to looking for housing and shopping for cars.

This is completely surreal, I can't believe it. I'm going from being a meek undergrad with little more than a laptop and a bike to my name (mad props to Aglaea) to an MD/PhD student who is going house hunting and car shopping. When did this metamorphosis happen!? Granted, I wasn't standin' on corners and porches just rappin, but still. This is all happening so fast, thank God break starts at 1530h today!

A little scary but SO EXCITING!

Day 1...sort of

8,189 days ago, an MD PhD was born.

Wow, that's a lot to digest.

Where to start? Ok details first. No, strike that, let's jump into it and I'll fill you in later. For the last six months I have this morning routine. Alarm goes off, check e-mail. Hit snooze. Repeat 3 or 4 times, hoping that a juicy interview offer/acceptance note would be coming my way. For 3 of those months, nothing. Not a peep. At the VERY end of February, I. Was. Freaking. Out. What am I going to do? Should I apply for jobs? What about school again next year? Can I pay for that? Very Type-A, and very, very distraught. Ask Kelly, she'll give you the horror story - thanks for sticking with me, sweetie! For anyone applying to medical school, the end of February is sliding more towards hell than purgatory. Your chances of acceptance are slimming. Friends are getting accepted. Spots are filling. Rough days. Take it from me, send in that primary on June 1. Trust me.

February 22, 2010: I rub my eyes, and what is this? An INVITATION TO INTERVIEW?! At MCW?! FOR MSTP? In the words of Matt Eggert: AWWW YEAAHHHH! Finally, Raman Kutty is comin' home again (PS: throughout this journey together, expect lots of lyrical references. I live and breathe music...although I can't sing. Odd!). Anyway, time to go back to Milwaukee, the place that started it all. My home. The roots of my education. Where my research started (Shoutout to Dr. Patel, you're the man and a hero). Oh boy, I can't wait!

March 3, 2010: Well, I made it to Milwaukee. Mom gave me a ride, how sweet of her! Always has been there, especially in the clutch. Here come the biggest 7 interviews of my life, and I'm so excited! Papers to read, researchers to...well, research. Time to review 3 years of research experiences. Lots to do all before dinner!

March 5, 2010: Whew, all done. Things seemed to go well, I'll know from the MD side in 1 week or so about their decision. At this point, it is completely out of my hands, so I'm a little nervous. Still, it was SO nice to be back at MCW! I love this town and could certainly see myself here for 4 more years. 8? Now THAT would be a trip!

March 11, 2010: What's this? An e-mail from MCW...oh shit. Here it is.
"Congratulations. I’m pleased to inform you that the admissions committee would like to offer you a space in the entering class of 2010 at the Medical College of Wisconsin."
No. Words.
I'm going to be a doctor! I'll admit it, I cried. I cried like a little tiny girl. Poor Jeff, he's just starting his morning and I'm wandering out in the hall sobbing and fist pumping like there's no tomorrow. Sorry if I scared you buddy...
So many thoughts rushing through my head...I'll be able to prescribe medications? ME? Someone's going to put their life in my hands? Wait, am I really ready to do this? Ok ok, hang on. Wait, I should really rethink this thing, maybe I'm not cut out for this, really. But then again, 22 years of hard work finally paid off! I'M GOING TO BE A DOCTOR! I'm not sure who was more emotional about the whole thing, my Mom, Dad and Ramani or me, but one thing is for sure. I'm in. Time to make some phone calls. Lots of them.

March 21, 2010: Just got back from Milwaukee after watching the NCAA tournament with the Fearsome Foursome: JStepp, JPL, Silvio and some of our friends. What a blast! And what's this? A letter from UW-Madison Med School? Huh, they said "no dice". Meh.

March 25, 2010: It just happened. Checked my e-mail, nothing. Checked it after my shower (you have to understand, I can do the command-shift-N (check new mail) command in my sleep...and I'm pretty sure I have)...and there it was. A message from Carol the program coordinator of the MSTP with subject "You are being sent and accept...." Blackout. Literally. Before I even opened the message.

I finally made it. 8189 days after October 23, 1987, I made it.

I got accepted to a dream program. I'm going to be a doctor, yes. But on top of that, a doctor doctor. Just like the 11th, so many thoughts going through my head. Can I be a good physician-scientist? What if I don't get grants? A lot of people wrote a lot of letters and really worked hard to help me out here...I hope I don't let them down! Wait. No, I got in because I can do this. I can do this, I'm going to do it. In 8 years, I'll be Raman Kutty MD, PhD (or should I go maverick and go PhD MD? Can you do that?). This feeling is like 1000 Julys.

Ok. Whew. Thanks for being patient (PUN INTENDED). Here are the details, aka, what we know that we know:
Fall 2010-Spring 2012: Medical school years 1 and 2 (M1 & M2)
Spring 2012-Spring 2016: Grad school. G1,2,3,4. If all goes well.
Fall 2016-Spring 2018: M3 &M4.
Wow. 2018?!

The best part? Free tuition plus stipend. I think these guys are serious. Really serious.
PhD: No mentor yet, I'll do rotations in a couple of labs for the M1/2 years until I find one that's right. For now though, I'm thinking cell biology or biochemistry. Dr. Barbieri (The Director, the big cheese, all that) suggested computational biology...maybe! Decisions, decisions.

For those who know me, the fact I am starting a blog highlights how significant this is. I generally dislike hate blogs (no, I don't need to know your opinion about your cat's tail length and neither does anyone else), but I thought that this is going to be a bit of an adventure so I might as well document it while everything is going on. From a strictly scientific point, it seems like too much data to pass on. God, I'm a nerd. And absolutely loving it.