Obama's Address_Science is still a ideal mother of medicine

This speech revealed the quintessential nature of science.

Tool 6.2_Awaken the Giant Within_Pain and Pleasure

Dear all:
Now that we have made the decision, why do we procrastinate to take action? Tony Robbins address this issue deep down to the core. We, humankind, are still affected by the very primitive emotion circuit in our brains. The driving force to change is strongly connected to the pain and pleasure emerging in our brains. Yes, pain and pleasure.

Pain, minuscular or catastrophic, is produced by our own perception system. Do you see the movie, Lawrence of Arabia? Lawrence stunned his friends by pinching out the flame, a seemingly unbelievable gesture. How could he do that? Didn't he feel the burning pain? He has programmed his perception to accept that sensation which is not tagged as "pain" in his own system. So he could bear that. On the contrary, we can program ourselves to feel the catastrophic pain which would have been a little chafe previously when we procrastinate. In brief, we can devise an emotion circuit with the self-made emotional threshold. Try to augment the pain whereby we can avert procratination successfully for fear. Once established, this circuit could operate more and more efficiently. This sort of self build-up could ultimately lead us to success.

In the same vein, we can put 'pleasure' into the same device we made ourselves. A sparkling pleasure could flare up into a scintilating one for the sake of this positive feedback system.

Use this 'Pain and Pleasure' gadget to plan your approach and act out the decision you've made. Robbins said dauntingly: "If you don't have a plan for your life, someone does."

Tool 6.1_Awaken The Giant Within_The Decision

Dear all:
I promised my weekly summary of this book "Awaken The Giant Within" and here it is. Three pages each day. Through Page 1 to 27, I was shocked that how little I knew about the meaning of "Decision".
I have ideas and I live many outcomes. But, how many decisions did I really make in my life? "If there's no action, you haven't trully decided." said Robbins. Without action, the so-called decision is false whereby "Niagara Syndrome" would prevail and ruin one's life.
Niagara Syndrome denotes a devastating picture: no decision, no action, just float with the currents of the river; when one finds there's a waterfall ahead, (s)he is doomed to drop.
Don't be afraid to make decisions. Don't fear mistakes. Robbins asks us to remember: success is truly the result of good judgement. Good judgement is the result of experience. Experience is the result of bad judgement!
Interestingly, how frequently should we make or practice to make decisios? The more frequently, the better. Just be sure to learn every lesson from those bad judgement. Through the repetitive training of our muscle of decision-making, it's getting more and more natural to land better results. So, he encourages us to "enjoy making decisions" because how could we know the next page we read will change our life forever? The next person we stand in line could open another possibility of our career. This sort of relentless expectancy will drive our lives passionate!

Teacher 2_Professor Ming-Ching Shen and Hwei-Fang Tien

Dear all:
A happy day. The annual meeting of Hematology Society of Taiwan. Coming to the straight 4th year, I made a presentation in it. Months ago, Professor Tien gave me a bunch of clinical data about adult acute myeloid leukemia (AML) and asked me to find any relations between WT1 mutation and the prognosis of these patients. Fortunately, we found that the combination of WT1 and CEBPA is a good way to stratify younger adult AML. With these two genetic markers, adult AML patients can be separated into three groups of distinct prognoses. The statistical significance is agreeable. Not only presented in this meeting, this result is hopefully to be published this year. This work is somewhat a sort of hand-made micro-microarray.
This is a picture depicting the transition of our academics. At the right, with much white hair, is Professor Shen who is still the arbiter of coagulation research in Taiwan. At the left, Professor Tien, a thesis student of Professor Shen, takes the lead of MDS research in Taiwan. We went to the dinner party this evening and shot this picture. I'm fortunate enough to be edified by their teaching.

Tool 7_The Old Love

Dear all:
I admit I bought this Sony PDA, i.e. CLIE, in a psychological impulse.
That was a time of Palm, a popular platform for PDA around 2003. Umpteen medical residents had their Palm-PDA, checking not-easy-to-learn formula every time when needed such as looking up how to calculate body surface area, serum osmolarity, or Cockcroft equation to calculate estimated CCr, etc. I dreamed to have one Palm-PDA then but restrained myself in face of its popularity until a fiasco happened at Grand Round.
As for the content I presented, I don't think I screwed up my debut at Grand Round which is definitely the biggest show every week for professionals of Internal Medicine, NTU Hospital.
Almost every 2nd-year medical resident has to endure the bombardment from professors in that occasion. Of course it takes much time for every presenter to pick a case, collect clinical data, construct a seemingly reasonable clinical algorithm, review the literature, make differential diagnoses, and rehearse with the Academic Chief Resident. Strategically speaking, I made a mistake. I picked a patient with hemolytic anemia who was treated initially as having biliary tract infection. Surely this embarrassed the attending physician in charge and I remember our Chief, Professor Pan-Chyr Yang, lambasted the clinical management for this patient. "Why did it take so long to attain such a straightforward diagnosis? Don't disable yourself as over-subspecialization! (I remember clearly he used the word, castration) And, you can imagine, what I could do was just to keep grounded at the podium and to try hard stuttering out what I'd prepared. That was a disaster and I felt totally wiped out after stepping down the stage.
To heal that chafe, I decided to comfort myself with a complacent gift, buying a Palm-PDA. That's why this CLIE came to me. I did spend some good times with it despite its weight. It can display PDF smoothly, record a small clip, shoot photos, build memos and contacts. But my attention departed from it later when this MacBook came to me. I carry MacBook to work everyday and CLIE shriveled day by day. This week, when I packed up stuff for moving, CLIE pops out and guides me revisiting this memory.

Tool 6_Awaken The Giant Within

Dear all:

Before the coursework begins at Hopkins, I decide to reread Anthony Robbins' "Awaken the Giant Within". It's an 378-paged eBook and I read it 3 pages a day. Just to finish it in this late August. One year ago or so, during the preparation of GRE test, I happened to get this book (the translated version in Chinese) in a local library in Kinmen. This book pierced through the mist in my self development and help me through the rigorous process for taking on GRE. Recently I got the electric version of it and I determine to finish it.

Generally speaking, the author Anthony Robbins has a deep understanding of human psychology. He learns weak points of humankind very well whereby his suggestions at how to conquer them are powerful. In my case, it helps me get rid of an old bad habit effectively. 

To get into a graduate school is by no means an easy task. To survive through it and even to strive in the process are harder. I know there're some missing parts in my psychological preparation. Therefore, I will establish a weekly specific topic named "Awaken The Giant Within X ( X is an integer, >0) and devote this topic to share its wisdom and my thoughts with you. It is posted every Tuesday. 

Enjoy it!

School 7_To lodge in Baltimore

Dear all:

This is the result of my applications for PhD programs:

Accepted: Johns Hopkins (JH)(Human Genetics), Duke (Immunology), Baylor College of Medicine (Immunology) and Dartmouth (Molecular and Cellular Biology, Immunology).

Suspended for funding: University of Wisconsin-Madison (Cellular and Molecular Pathology)

Interviewed but rejected: Harvard (Immunology)

Rejected: MIT (Dept of Biology), Yale (Immunology), Rockefeller, Columbia, Cornell, U Penn (Immunology or Microbiology), Washington University in St Louis, University of Washington-Seattle, Stanford (Immunology), UC Berkeley, San Diego (Molecular and Cellular Biology). 

I did hesitate between JH and Duke for an infinitesimal moment because those are different disciplines. But it's not hard to come to this decision because:

1. Aforementioned strength of JH-Human Genetics in this blog.

2. The versatile contacts provided by JH in the predoctoral training and multifarious outcomes in the postdoctoral years.

3. The full scholarship by which I can forgo my Taiwan Government Scholarship to retain flexibility for my postdoctoral years.

4. The proximity of JH to Washington D.C. where my wife and I hold our dreams to wander around Smithsonian museums, the Library of Congress and the National Gallery of Art. I'd been to these institutes 11 years ago and deeply impressed by their contributions to humankind. 

5. The physical and academic proximity of JH to NIH and National Institute on Aging. 

6. The Baltimore Museum of Art. My wife and I are eager to witness the beauty of the Cone Collection because we love Matisse, Mondrian and Picasso. 

7. Our good friends in Baltimore

8. To be found......

Then, its time to go deeper into what principal investigators do in their research.

Consilience 8_Heisenberg's Uncertainty Principle

Dear all:

Apart from its importance in physics and chemistry, Uncertainty Principle also depicts some predicaments we faced in bioscience. More accurately do we want to manipulate the property of cells, proteins, or genes to understand their mechanism, we have to confront with severer interference we created, the observer effect. This is why it's always necessary to be cautious about interpreting results of in vitro studies and its implications in the real world (in vivo status).

Heisenberg is my hero since senior high school. Once upon a time, I wanted to be a physicist because of the charm of quantum physics. At that time, only the smartest communicate with mathematics and quantum theory. Heisenberg is a prodigy with remarkable contributions for quantum physics in his late twenties. I wanted to emulate his success. He liked playing piano and hiking. I am compassionate for his Furtwaengler-like tragic role in World War II for complying to Nazi's menace. (I'm not a historian, therefore I make my comment here based on my understanding)

Why am I charmed by Uncertainty Principle ?

In classical physics, there's a demon called Laplace's Devil who can locate the exact locations of all particles in the universe at any time point. That means it's the arbitor of Fatalism. Once the initial coordinates of atoms and molecules are determined, Laplace's Devil can calculate the final results of articles' interaction by Newtonian mechanics. Laplace's Devil knows everyone's destiny ! How horrible !

Heisenberg crushed the existence of Laplace's Devil. According to his Uncertainty Principle, no one, nor Laplace's Devil, can determine the exact coordinates of even a single particle. Let alone the culmination of articles' interaction. What a relief !

However, for a would-be PhD student and researchers in bioscience, Uncertainty Principle undoubtedly teaches us humility. The truth is difficult to grasp. What we've done and will do is just a relentless pursuit to approach the approximation of the truth. Just like the Schroedinger's Cat. Don't be too bold or dogmatic to draw a conclusion. Be humble in front of the truth.

Consilience 7_Long Query

Dear all:

This is arguably the earliest mixed chimera in human history. Its name is Dragon-Turtle. It's said that Dragon-Turtle will eliminate disasters and bring lucks. My interpretation is that the head of dragon represents nobleness and boons and the body of turtle means longevity and peace. In Mandarin, "dragon" sounds like "long"; "turtle" like "query". Taken together, Dragon-Turtle can be taken as "Long Query".

Mixed chimerism is a crucial animal model in immunology and transplantation. Were it not for mixed chimerism, many progresses in the history of medicine would have been out of question such as bone marrow transplantation. In recent years, some novel phenomena were observed in mixed chimerism. Recipient lymphocyte infusion (RLI) is an example. Interestingly, like donor lymphocyte infusion, RLI has been shown to enforce anti-tumor immunity. Although there's much to explain and explore, RLI seems to hold a vast promise for its application. According to a report from Johns Hopkins, donor CD4 and host CD8 T cells are cooperating with each other to exert the "allogeneic effect" of RLI. Meanwhile, RLI gets rid of GVHD.

What we're doing is try to make people to keep the nobleness of existence. How? It's a long query.

School 6_Boston, I'm coming!

Dear all:

Boston is cold but immunology is boiling. This is my first time to see snow. After the almost 20-hour trip, I landed in Boston. Although I was wiped out, it's worthwhile. Why?

First, there's a sparkling conversation with Dr. Rossi. He was recruited from Stanford with his outstanding research of aging in hematopoietic and immune system. I called at his office at three this afternoon. He stroke up the conversation by mentioning his latest endeavor in myelodysplastic syndrome (MDS). I have to say that this scholar is extremely smart on asking scientific question. When he talked about his experimental designing and showed his "hot" data, I can feel the heat in his eyes. That's the typical enthusiasm shining from a passionate mind. In the beginning, I questioned about an inherent problem of his experiment model, heterochronic parabiosis, which could have the problem of dilution of certain humoral and/or cellular factors. And he admitted by explaining a bar chart. Furthermore, he proposed a potential psychological stress in this kind of model which could lead to some cytokine perturbation. Then he asked me about the role of lymphocytes in MDS. Well, because he suspected that MDS is a stem cell disorder, some abnormalities are expected to happen in lymphocytes. I could not agree with that because what we see clinically is lymphocytic infiltration in bone marrow in the early phase of MDS. He and Peter Greenberg are cooperating on applying for an NIH funding. The focus is the effect of azacytidine on MDS and Dr. Rossi said that he cannot imagine this application could fail. I'm persuaded by him because the result of azacytidine on MDS is solid. He suggested me consider a rotation selection afterward and I'm happy to take that. Hopefully, I wish myself to get involved in the summer if I'm admitted to Harvard.

Second, today, I met Scott Loughhead, a Californian, who is my "Buddy" in this interview/recruitment weekend. He shared his experiences of interview last year. Quite straightforward. His apartment nearby is cozy and he's a fan of San Francisco Giants. Interestingly, he invited me to join the luncheon with Mark Anderson who comes from UCSF to give a talk this evening in the Weekly Immunology Seminar. Mark, trained at Harvard, is always smiling and he raised two questions in his conversation. Because I have a background of medicine, I happened to answer his questions about IPEX (Foxp3) and a rare manifestation of some kind of autoimmune disease relating to Aire. 

Last, but not least, happily, I went to have a dinner last night with my three classmates: Hsienho, Ifan, and Shu-Hsien. They are almost the same as they were in college. Hsienho is on the edge to finish his thesis and going to get the degree these months. Ifan has got her post-doc job offer from Paris and she's taking it into consideration seriously. Shu-Hsien stills works as a PhD student of the BBS program of Harvard. They gave me some suggestions about interview generously and I shall follow their advises. I wish I can join in this Boston cluster later. 

Tomorrow, I'm going to visit Professor Megan Sykes' lab in MGH-East which located in the Navy Yard. Her assistant emailed me a detail about its transportation. A little bit complicated for a newcomer in Boston but I'm confident to find that place. According to Shu-Hsien, MGH has a strong reputation of pathology undoubtedly. What we read about the clinical case discussion in NEJM just come from MGH. Prof. Megan Sykes had mentioned an interesting phenomenon about recipient lymphocyte infusion and I'm eager to discuss about it with her later. 

Boston is cold but immunology is boiling!

John, in Boston