iCame, iSaw, iConquered: Steve Jobs

You might be wondering what is Steve Jobs doing in a blog that revolves around Medicine and such things. One reason is that personally I happen to be greatly inspired by this man and another more important reason is that we’re not gonna talk much about computers and gadgets here but about the kind of person he was, how he was different and how he made a difference to the world.

Steve Jobs for Dummies

First let’s get a little idea about the achievements of Steve Jobs. You’ll find many websites that list his achievements but here I’ll try to write such that people who don’t know much about computers can also appreciate it.

1. Founded Apple

Apple Inc. is richer than the government of USA. The company doesn’t need any introduction. It is the personification of “brand following”. Millions of people buy their products simply because “Hey, it’s an Apple product.” This image was not formed overnight. No one had more job in this than Steve Jobs.
2. Invented the Computer

Though this is gross exaggeration, it is almost as if he did it. Computers before him were just big IBM machines used only professionally in big institutions. It can be said that he played “the” major role in making the computer a “personal computer” (though he never used that name and this name became famous as a rival to his Macintosh)

3. Founded Pixar Animation Studios

These people make a lot of animated movies we enjoy.

4. iPod

There were portable music players earlier but they weren’t good enough. It wasn’t a runaway success and people started criticising him, but soon they knew that it was after all Steve Jobs, we all know whether any other music player is as popular as the iPod.

5. Invented the touch-screen smartphone

This too is exaggeration, there were touch-screen phones and also smartphones earlier but they were as good as not being there at all. The day he announced the iPhone, he changed the mobile phone industry.

6. Invented the Tablet PC

This is the perfect example of his innovation. Again he showed the world what was good for them. This product (the iPad) was highly criticised. Everyone said that it was nothing but a giant smartphone. They saw it again. A whole new segment of electronics took birth. While other companies were releasing or just developing their first tablets, Apple was releasing it’s second version.

So, What’s the big deal about him?

Steve Jobs doesn’t remind me of a person who toils hard to achieve a bit of success, he reminds me of an artist who took pleasure in his work. He made his customers happy and simply took his money. He thought out of the box, did things people would find ridiculous. He didn’t let anything get in his way, he had to leave the very company he founded, he didn’t give up complaining but made himself such that the company itself called him back. He not only made new products but made them beautiful. He started the trend in everything like using graphics instead of boring DOS commands, beautiful fonts on computer screens, good looking and colourful computers and laptops. The rivalry between Apple and Microsoft is famous but he didn’t let it get in his way. When Apple was at a huge low and he needed to do something, he called up Bill Gates and made a deal with Microsoft.

I personally don’t use any Apple product simply because I’ve never felt the need or been able to afford one. I won’t buy one even if I have the money. I know that the brand name adds to the cost and for a geek like me, something that works so easily and effortlessly would be devastatingly boring! But it is the person Steve Jobs was that inspired me so much.

His speech at Stanford was one of the best I ever heard, his keynotes can be watched even for the sake of entertainment! And no one will be able to forget his “One more thing…”

Steve Jobs’ Medical Condition

Okay, so as this blog is more about medicine, I feel obliged to pay some attention to this aspect too. Though I never knew much about it, after some research I found it quite intriguing. Jobs has not been very open with the media about his health (and rightly so). One funny fact is that a newspaper actually published his obituary when he was alive! It had actually been prepared in advance as there were rumors about his bad health.

In his Stanford speech, Jobs says that he was diagnosed with some “extremely rare form of pancreatic cancer”. He was actually speaking about a neuro-endocrine cancer of the pancreas. As you know, the pancreas is predominantly exocrine with the endocrine part (Islets of Langerhans) constituting only 2% of the mass of pancreas. Rather than exocrine cancer, for which survival rate is very low and which is the fourth largest killing cancer in the world, Jobs had the cancer of the endocrine part. Cancers of neural or endocrine structures are together called “neuro-endocrine” cancers which are mostly benign and constitute only 5% of pancreatic cancer cases (remaining 95% cases being cancer of the exocrine part). He preferred a treatment by alternative medicine in the beginning. Fortunately, the need for chemotherapy or radiation therapy never arose (which have terrible side-effects you know).

In July 2004, Jobs underwent a surgery to remove the cancerous part called “Whipple’s procedure” or pancreatico-duodenectomy in which, as the name suggests, the head of pancreas is removed along with the duodenum. The duodenum has to be removed in spite of being so important because the pancreas head and duodenum are supplied by the same gastro-duodenal artery and the removal of only pancreas’ head would stop the blood supply to the duodenum and cause its necrosis. After Jobs underwent this procedure, he started to look quite frail which is obvious because the duodenum, in which major part of digestion of food takes place, is lost.

His body may have adapted itself to this as he later became healthy. In April 2009, he had a liver transplant but I can’t see any connection of this with his earlier health problems, which makes one suspect alcohol abuse leading to liver damage.

In January 2011, he again took medical leave and then resigned as CEO and passed away “peacefully, surrounded by his family” nine months later. The reason for his death hasn’t been explicitly mentioned. From the available hints, one can suspect nothing but a relapse of his cancer.

Legacy

Every soul has to taste death one day, yet a few continue to live in spite of going away. Steve Jobs will not live only in the name of his company and it’s products, but also in the minds of many whom he inspired and motivated to follow his footsteps.

As a final tribute, I would like you to watch this video which very fittingly attributes to the life of Steve Jobs, in the mesmerising voice of Carl Segan.

Here’s to the crazy ones. The misfits. The rebels. The troublemakers.
The round pegs in the square holes

The ones who see things differently. They’re not fond of rules.
And they have no respect for the status quo.
You can quote them, disagree with them, glorify or vilify them.

About the only thing you can’t do is ignore them.
Because they change things.
They invent. They imagine. They heal. They explore. They create. They inspire.
They push the human race forward.

Maybe they have to be crazy.
How else can you stare at an empty canvas and see a work of art?
Or sit in silence and hear a song that’s never been written?
Or gaze at a red planet and see a laboratory on wheels?

We make tools for these kinds of people.
While some see them as the crazy ones, we see genius.
Because the people who are crazy enough to think they can change the world, are the ones who do.

Mnenomics n Stuff


One of the things that is considered “bad” about medical studies and thereby the medical profession is that it is totally dependant on “memory”. All you need to do is “memorise” things and then recollect them at the right moment. While this cannot be said to be entirely false, it can’t be said to be entirely true either.

It is true that we need to “remember” a lot of things (I’m not using the word “memorise” here). Most of the things that we need to remember are “names”, names of body organs, muscles, arteries, nerves, diseases and conditions etc. But if you observe carefully, everyone has to remember names, not just medical people. In daily life, we have to remember names of people, names of streets, roads, buildings, cars and even things like gadgets, phones and websites. This apart, speaking of academics too, those professionals other than medical also have to remember a lot of names. For example, computer engineers use words like Java, API, GUI, CSS, HTML and so on, which are equally, if not more- the way I feel, intimidating than the “medical” terms. Medical terms are atleast intuitive and guessable as they use Greek and Latin roots but these abbreviations engineers use are simply not.

The point is that we need not feel that we’re faced with something difficult, because we actually aren’t. This apart, we can always try to make things easy. If we consider “memory” and “intelligence” as separate things (though I highly doubt whether they are) then I can surely say that intelligence can help memory a lot. Using tricks and shortcuts, things can become surprisingly easier to memorise.

One of these is the use of “Mnemonics”. It is a word or a sentence or anything similar which helps remember things. A mnemonic should be catchy- one should never be able to forget the mnemonic itself. The best mnemonics are those which produce some emotion- the most common emotion utilised is humour or disgust. It means that the funnier the mnemonic is, the better. Similarly, though many people might disagree, the more vulgar a mnemonic is, the better. It may look indecent or even disgusting, the reason they may not be taught openly by teachers, but over time you realise that the only things you don’t forget and remember for a long time are those for which you had really vulgar mnemonics :). I feel that mnemonics made by others are more effective than those you make for yourself though I don’t understand why. May be because the element of surprise is what helps us actually remember it.

The internet is the best place to find ready-made popular and time-tested medical mnemonics. Here I have mentioned some sources of medical mnemonics on the internet. I also plan to do posts in future in which I will mention my hand-picked mnemonics grouped by topic.

Medical mnemonics.com

This might be the biggest database of medical mnemonics on the internet. You can search for any topic you want. You can also download the whole collection arranged according to subject. I highly recommend you download it and print a few pages of the subject you are studying. You’ll be surprised to find mnemonics for things you didn’t expect at all.

Download the PDF here (Right-Click and select “Save Link As”)

Wikipedia

When you search a topic in Wikipedia you will usually find i mnemonic for it if it exists. Try searching “cranial nerves” on Wikipedia and you’ll understand what I mean 🙂

E-book: Mnemonics and Study Tips for Medical Students

This ebook also has good mnemonics. Click Here to download it.

Good old Google

If you can’t find a mnemonic on any of the above then you may try Google. You’ll find results from many forums.

Med Student in India : Ist Year Books Advice (#2)

In the previous post I wrote about gross anatomy books. In this post, I’ll talk about the other subjects within anatomy, physiology and biochemistry.

Anatomy – Related Subjects

Embryology

It is not very important in terms of weightage in exams but of most  importance among these 4 sub-subjects. For those who want to understand things and derive the pleasure from learning, this is “the” science. More about this my another article – “From Cell to Man” (Sorry, unavailable)

The books are: IB Singh: This is most widely followed. It is a decent book, it has good  diagrams and separation of matter into basic and advanced. Can be  read.

Langman’s Medical Embryology: This is a great book. It’s strength is its diagrams and photos. If you  are a visual learner then this is the book for you. As with other  books, it has many details which are unnecessary for undergraduates  which can be skipped. The text is very compact so could be a problem  for those who can’t easily frame their own sentences but since only a  few questions are asked in Embryology, this will be sufficient.

Another book is Keith Moore’s “The Developing Human” which looks  similar to Langman’s. It’s author is the same scientist Keith Moore  who discovered the Barr body along with Barr, Betram et al.

Histology

Histology is more important for practicals than for theory and diagrams are the most important. diFiore’s Atlas of Histology This can serve as both an atlas (for drawing in records) and also a  textbook because the text is in sufficient detail. It’s quite a good  book.

IB Singh This is followed by some as a textbook for histology. I don’t think  that is necessary. I can’t comment on the book because I never used  it.

Gunasegaran Don’t know much about this book. Saw it once and liked it. It is also both an atlas and text.

Neuroanatomy

This is taught at the end of the year, it’s basically the anatomy of the brain, along with spinal cord.

Any book can be followed. IB Singh was a bit annoying for me because  the matter isn’t properly organised. Chaurasia is not sufficient the  teachers say. Vishram Singh is a good and widely followed one and would be enough for both a basic understanding and making it through the exams. AK  Dutta is just too detailed. Snell’s Neuroanatomy is the recommended reference book.

Genetics

Don’t ask me about it. I don’t even know the names of books in this.  The weightage for exams is very less. It basically includes two  things- chromosome basics and their disorder syndromes. The syndromes  can also be found in Langman’s Embryology, the rest I managed from a few notes  given by our teachers.

Physiology

There are a lot of physiology books out there. I tried so many of them because  never found one that is perfect.

Guyton

This is the classic textbook followed widely throughout the world. It  is known for it’s simple language yet good explaination of concepts.  If you want to build concepts then this is for you.

Ganong

It’s text is lucid and compact. It is very good for a few topics like  nerve-muscle, cardiovascular etc but bad for some like endocrine.  Sometimes the author strays off into way too much of molecular detail.

Indian books

The Indian books are L Prakasam Reddy, Sembilingam, Chaudhari and AK  Jain. I found LPR most suitable as it had good explanation plus facts  for exams. So, I can say LPR is a little better than all of these. AK Jain was decent but I didn’t like it’s language.  Sembilingam and Chaudhari had so many mistakes that I could hardly  concentrate on what actually was the matter written.

Best & Taylor

This was highly recommended by our HOD as it apparently had a  “theoretical” and “conceptual” approach towards physiology. I heard a  lot of praise for the book and looked like just another textbook on reading one chapter :P. I searched all over the internet for an e-book but couldn’t find one, so a  physical book would be necessary.

In the end I would recommend reading LPR as the main book but at the same time referring  Guyton very very often.

Biochemistry

Vasudevan

I took this book in the starting because it was not as thick as the  other books and didn’t find any problem till the end. The author is an  MD from AIIMS (OMG! From AIIMS!!). I felt that he explains things very  well though I didn’t see other Indian books to compare. The only drawback about this book may be it’s small and irregularly placed diagrams.

Satyanarayana

This is the popular book. I didn’t read it so I can’t comment much  about the contents. Just saw it from friends and it looked good  enough, but it thickness wasn’t very encouraging for me 😉

Chatterjea & Shinde

It is a detailed book but I think it would be more suitable for  post-graduates rather than undergraduates.

Lippincott’s

The diagrams in this are beautiful. Almost everything has been  presented in diagrams. This may be an advantage or disadvantage. After  using this book for some time, I felt that I spent more time searching  for things in the diagrams than actually learning anything. It looks  very flashy and like they’ve done too much.

Harper’s

It is the standard reference book. Surprisingly, unlike other reference  books, it is very student friendly. It also has many diagrams which  are both good and minimalistic and not overdone like Lippincott’s. But  in case of both these Western books, there are a few topics missing  completely from these books but present in Indian books, which are  asked in exams (eg. Chemistries of biomolecules, Biotransformation  etc). So, these are best used only for reading metabolism and other  major topics.

A Final Word

Do not be overwhelmed by such an enormous choice of books, just find  one that suits you and read it. Different books may suit different  people. Don’t think that if I choose the wrong book then I’ll learn  nothing, because this is not a matter of choosing the right or wrong  book but choosing the most suitable book. And don’t worry, your own  experience will teach you much better than anything I’ve written.

Med Student in India : Ist Year Books Advice (#1)

People have a misconception that there is only one thing in the life of a medical student- books. But only after becoming one yourself you can know that it’s not true. In fact, many a time, there is more learning from other sources than from books. These are things like dissection, practical experiments, discussions, pictures, charts, videos and the ultimate source of knowledge of medicine- The Patient . Nevertheless, it would be unfair to say that books are insignificant- they are a very important part of a medico’s life. They are the primary source of information, other sources are just secondary to it.

There are gonna be a lot of books. Cunningham’s, Chaurasia, Dutta, Gray’s, Guyton, Ganong, Jain, Sembilingam, Harper, Lippincott, Satyanarayana- these names are enough to leave a student dumbfounded for days together when he hears these for the first time. I’m sure that never before in our life did we refer books by their author’s name but from now onwards it’s gonna be only this way. This is one of the unique things you’ll find in a medical college – a lay man would indeed be very confused when he hears someone say- “Hey, have you seen my Chaurasia?”.

The fear new students usually have is that all these books are for them and they have to read “all” the books. But as common sense suggests all these books are not for everyone. One can use just a single book or a few more and that single book too is not necessary to read from cover to cover. Some books are to be used only for “reference”, some are good for a few topics and so on.

Here I’ll try to review a few books of first year subjects and give a piece of my mind regarding which one to choose.

Anatomy (Gross)

Cunningham’s Manual of Practical Anatomy-
You’ll be required to hold this in your hands all the time in the dissection hall. The dissection part given in the itself is a bit tricky and not easy to understand, forget about the theory. But for some reason the department doesn’t allow any other book. You can keep it with you and read it for an introduction in the beginning   but don’t read it as a main book- reading other books would be much more useful.

BD Chaurasia-
This is undoubtedly the most popular anatomy book in India. More than 95% of students may be following it and most seniors recommend it, but here is my sincere advice- DON’T READ FROM CHAURASIA. Especially when exams are far away. At the outset the book looks good- it has plenty of diagrams that are easy to understand, the language is compact and the introductions to each chapter are fairly good, but the problem is that it hardly has any sentences- the entire book looks just like a synopsis, the book seems to have been designed only for the purpose of memorising- and that too just rote memorisation. You understand nothing when you read something for the first time. It just lists out the things and writes a few points about it. This is suitable for revision before exams but not for understanding the subject. The reason I feel that most students find anatomy difficult is because they follow the wrong book. The more descriptive a book of anatomy is, the better. Chaurasia fails here. You can use it for revision before exams- start reading from it some 1 week before a small exam or 1 month before the final. But you can also manage completely without it and I recommend that.

AK Dutta-
This book is more popular with postgraduates than undergraduates but it doesn’t mean that it’s not for us. This it the book I highly recommend. Especially if you want to develop a good understanding of the subject and derive pleasure from learning. There may be quite a few things in the book that are not necessary- for example along with liver description there is a detailed description of its microscopic structure, anthropological description of skull etc. but you can just skip it if you’re not interested. But believe me, if you follow this book from the beginning, then your knowledge will be far better than others and you’ll be way ahead of your friends who followed Chaurasia.

Edit (15-10-2014): I had my Anatomy in 2010, when Vishram Dutta books for Anatomy weren’t released. There was only his Neuroanatomy textbook which was very popular. The anatomy books were released in 2011 and their second edition came out in 2013. Now I see a lot of my juniors reading Vishram Singh, making me think that will this book replace Chaurasia? Anyway, I haven’t read them and can’t say much about them. DO try them out too. Their ebooks are available on the internet if you know where to look.

Western books-
These are not as detailed as Indian books but can be read when you’re not reading for exams. Gray’s Anatomy for Students is a good book. Other popular ones followed in many countries are Moore’s Clinically Oriented Anatomy and Snell’s Clinical Anatomy for Medical Students. These books focus less on facts, more on application, they have very good diagrams and are good overall but may not be perfect for exam point of view. Many of the things asked in exams will plainly not be there in these books. So an Indian book is essential for exams.   The e-books for these Western books are easily available, you can see if you like them or not, then you can get them from the library or bookstore.

Anatomy Atlas

An atlas is an absolute must if you want to learn anatomy properly and with less effort. I don’t understand how some people do without it. An atlas is basically a book full of diagrams. Anatomy is a visual subject and you can learn effectively only by seeing. I came to understand this quite late in my year. Just open the atlas, go to the part you’re studying and just stare at the pictures, then open your theory book keeping the atlas in front of you and try to search for the things you read- in the atlas. It may be time consuming but is very effective.

Netter’s Atlas of Human Anatomy-
Frank Netter was an artist and also a surgeon. I need not tell more, do I? Till today the computer-generated graphics have not equalled his brilliant drawings. It’s also well organised and good for learning. I feel pity for those who haven’t seen this book in the only year they could have enjoyed it. One can even have it just for the sake of appreciation of the beauty of the human body. I love the tag-line of this book-“If you’re studying the art of medicine, this is where you’ll find it”.

Thieme Atlas of Anatomy (Gilroy et al)-
Some people find Netter too flashy, over-coloured and complex with excessive labelling. This atlas is for them. (Though I highly recommend Netter over Thieme)

[This post has become too long- I’ll write about physiology and biochemistry in the next post- please comment if you have any other thing to add or share your own experience- this may be useful to unimaginable number of students who will join medicine in so many years to come].

Medical Student in India : The Beginning

“Vaidyo narayano hari”
This is a Sanskrit proverb that says “The physician (doctor) is equal to God”. Indeed, in India atleast, the doctor is treated equal to God (well, almost). There may be all sorts of incidents of physical attacks or such on doctors, but these do not show the lack of respect for doctors, it only shows the expectations of people from doctors and their frustration when these aren’t fulfilled. Lakhs of students dream of becoming a doctor since the beginning of their childhood. Many others take up this profession not because of their own interest but due to insisting, coercion or even force from family members (mostly in the “doctor families”). Some take it as a casual choice of career. Whatever the reason might be for the choosing of this profession, getting into it is not easy in any part of the world, but especially in India. In India, two things can get you into a medical college- hardwork or money.

As unfair as it might seem but it’s the harsh reality. It’s not totally unfair too, a medical college is not a very economical institution to run. It is said that the college has to spend lakhs of rupees on each student (though once you come into the college you start to wonder where the money is being spent). Those students who have gained admission on the basis of merit are supposed to pay significantly less fee than those merely on the basis of “donation”. Those who’ve entered by merit always have the good feeling that it is as if they’ve “earned” that huge amount that others have said to get in.

There is nothing similar between college and school, nothing at all. The enormous area of the campus, the number of different buildings, each housing a separate “department”, the number of people you see around- students in their groups, professors too in groups and numerous other people you wonder why they would be here, the gardens, the trees, the canteen, things that most of us wouldn’t have seen in our schools before- these both baffle the student and at the same time win his admiration. Not just the environment, but the method of working is also different. It would not be exaggerating to say that a student may take the whole of his first year to “settle” in the college- learn how things work, how to do things, who are the “important” people you must know to get things done easily, what to do if you are in trouble, when to worry and when not to worry. This is the case especially for those students who don’t know any other person who has had the experience before (like me). It is extremely important that the new students make as much contacts as possible so that they always have the right person if they have to ask anything.

According to MCI rules, there shall be no classes in the first month of the college. There shall be an “Orientation Programme” in which all the departments of the college introduce themselves. The students are given time to make friends, explore the college and make themselves at home. Though the idea seems good in theory, I didn’t find it of any practical use. If you do manage to make a few friends among 200 students (that’s the class strength in my college), you may have to leave them as the students are rearranged in the alphabetical order of their names and divided into batches as soon as actual studies start. And regarding exploring the college, every student will prefer NOT to do so, thanks to the intimidating looks from seniors. The canteen, library and playground also remain out of reach of the so called “freshers”, for the few initial months of college life. (Of course, all this is based on my experience and the situation may not be the same in every college).

On the whole, the first month of college can be described as an extension of the holidays after 12th, rather semi-holidays where you just in to college for a few hours and do nothing basically. No idea do they have of what they’re gonna be confronted with when they enter the portals of anatomy, biochemistry and physiology.

Hello World! (Original)

So, this is the first post. Don’t know much what to write in it. It will definitely take time for the next one. This is just the beginning, I’ll have to see whether it was a good idea to start this or not. Till then, will be collecting material for it and planning its future.

%d bloggers like this: