Her brain

Now this was pretty awesome.
On Monday we dissected out the brain and identified various cranial arteries, nerves, and non-brain structures. The skull had already been sawed for us, exposing the brain. We essentially have to snip some nerves, cut the brain-stem, and roll the brain out. When do people ever get to the roll the brain out?
We all took turns holding the brain -- absolutely crazy. So much of what makes humans human - unique in our complex thoughts, advanced creations, and metaphysical pondering - is in that brain! In my hands! With just a lesion there or a cut there, you can completely change the personality and identity of an individual!


And we found the masticles.

Let me share the story of the masticles (which isn't an anatomical part).
While we were dissecting the face, we kept getting confused with the masseter muscle and the zygomaticus. One guy at my team slipped up and said "masticles." We laughed because of the sound of it... and we all wondered if there is a body part called masticles. Must be. Sounds like such an anatomical name.

And so, when we rolled out the brain, the guy yelled: "hey i found the masticles!" *roar of laughter*
He was absolutely right. The cerebellum looks awfully like some testicles.
Isn't it amazing how goofy and immature med school students can be.... :D

Elephant Orphanage - Nairobi, Kenya

The "Obesity Epidemic"

I was just pre-reading for tomorrow's biochemistry lecture on fatty acid synthesis, regulation, and mobilization, and was amazed yet again about how fat the U.S. is


We've all heard these stats but let's refresh ourselves:

~325,000 deaths in the US are obesity-related. Second highest preventable deaths next to Tobacco being #1

A child born in 2000 will have ~35% life-time risk of developing diabetes. That prevalence is THREE TIMES higher than current 2010 rates

In 2003, ~75 billion dollars were spent directly treating obesity-related diseases. ~100 billion dollars if indirect costs related to obesity are included


And what was absolutely shocking!
In a Dallas County study, 34% of residents had non-alcoholic fatty liver disease. 34%!



Oh, and here's the line-up for this year's Texas State Fair (courtesy of thebradsblog.com)

Another amazing creation from 2009 TX State Fair: Fried Butter

picture courtesy of Kevin Brown, MSNBC


Update! (10/5/2010) CNN.com also wrote about this year's TX State Fair.
I really want to try a fried frito pie now...

アメリカの医学部への道

This is a (heavily peer-edited) Japanese essay I wrote earlier this year.

やっと来ました。８ヶ月の間不安と緊張と希望とが入り交じり、びくびくしながら待っていた返事。全米各地の医学部８校に受験したのは大学卒業後の２００９年の夏。全国統計 によると、１０人が複数の医学部を受験した場合、約４名しか入学する事ができません。実際に私がいたプリンストン大学では、医学部志望者の~９４％はどこかの医学部に入学する事ができるのですが、アイビーリーグの大学を出たからといって安心してはいられません。そんなことを８ヶ月いろいろと悩みながら、今年の２月にやっと来ました：第１志望校からの合格通知。

日本とアメリカの医学部進学で一番違うところは、日本では高校卒業後に６年間の医学部に進むことに対して、アメリカでは４年制の大学を卒業してからさらに４年間の医学部に行くところです。つまり大学の卒業証がないかぎり医学部には行けません。また大学卒業後すぐに医学部に行く人もいれば、何年か働いたり医学の知識を深めてから医学部に受験する人もいます。

私の場合は、基礎生物医学関係の研究経験が足りなかった為、医学部を受験する前に第一志望の医学部の基礎研究室で、１年間技術員として働きました。もう一つ大きな違いは、医学部は大学受験と同様に何校でも受験することができるということです。 高校３年の時、私は１８校の大学を受験しました。医学部受験は学部受験に比べて費用 (interview guide) がかかるので一般的には５−１０校に出願しますが、人によっては２０校も受験することがあります。ですからすべて失敗に終わる場合や、逆に受験校にすべて合格する場合もあるのです。様々な大学の難易度統計をみれば、自分が合格圏に入っているかどうかはだいたい予想が出来ますが、自分の結果を確実に当てることは不可能です。なぜなら医学部の入試委員会は受験生を個別に評価し、その医学部にとって最も有益と思われる受験生を選ぶからです。つまり、アメリカの医学部は一日の試験結果だけで合格か不合格を決めるのではなく、一人一人の経験,才能、学習能力を評価し医者としての道を与えるのです。

それでも医学部に受かる為にはいくつか要件があります。まず、医学部進学に必須な科目を多く履修しなければなりません。しかし専攻自体は、ひとそれぞれ興味がある、又は得意で良い成績が取れると思われる科を選ぶことができます。学部の時点で医学部進学希望者の半数が理系と文系とに分かれているのも特徴です。しかし、生物学から物理学までの幅広い高度な科学の授業や英文学も取らないといけません。医学部希望者の必須授業は、医学部で将来成功できるかどうかを篩にかけるために、必要以上に授業内容を難しくし、試験を厳しくしているらしいという噂もあります。４年間の平均成績(GPA)は入試査員会にとってとても重要な要素で、大学での成績がほとんどAの範囲でなければまず医学部には受からないといわれています。ですから受験生は大学４年間良い成績を保つ為に死にもの狂いで勉強します。医学部必須科目の授業は医学部をめざす学生の集まりで、激しい競争でした。

大学での成績以外に必要なのは、自分の実力と能力を証明できる教授や課外活動のスーパーバイザーからの推薦状。できれば３−５通の推薦状を頼み、その中の最低２通は大学の教授でないといけません。私の大学では卒論指導者が第一推薦者になることが一般的です。そして公式な条件ではないのですが、課外活動として病院でインターンかボランティアをするのも当たり前です。私は大学の近くにある病院のガン病棟で２年間毎週１時間から３時間ボランティアをしました。医者の世界をもっと知る為に、いろいろ専門の医者の下で彼らの仕事を見学しました。医者が働く場を知らないで医者になりたいと宣言する受験生の言葉はあまり信用されません。

そして最後に、受験生が一番恐れているのが医学部の全国標準入試（MCAT：Medical College Admissions Test). MCATは近年コンピューター化され、約５時間の試験です。内容は４に分かれており、物理化学（７０分）、生物学（７０分）、国語（６０分）、小論文２つ（６０分）となっています。試験では必須科目で得た知識を評価されます。試験結果は３年間有効なので、個人的なスケジュールといつ医学部に受験したいかを考慮しテストを受ける計画を立てないといけません。私は大学３年生の夏に卒論の研究をしながらテスト勉強をし、４年生が始まる秋学期の直前に受けました。結果は残念ながら自分では納得の出来ない点でした。もう一度卒業後に受けることも考えましたが、大学最後の期末試験と卒論でエネルギーを使い果たしてしまって、再び教科書を開く動機と意欲がなく、結局その時点のスコアで受験することにしました。その選択は今から考えてみると大きな間違いでした。医学部入試委員会ははじめにMCATの結果とGPAを考慮します。医学部によってMCATの点、GPA,あるいは二つの複合スコアを見て足切りを行います。

私のGPAは高い方でしたが、MCATの点はそれに見合った成績ではありませんでした。 すべてはあとの祭りですが、もう少し点が良かったならばもっと州外のいろいろな医学部も目指せたと思うし、８ヶ月の長い間やきもきしながら待つ必要もなかっただろうと思います。一旦医者になるという決意をした以上、疲れてやる気がない時も頑張って精一杯努力をしないといけないということを、この苦しい経験を通して学ぶことができました。

これらの受験のための要件は受験生に共通であっても、医学部へ向かう道はひとそれぞれ異なります。大事なことは、入試委員会の審査官が受験者の履歴書を見て、その人が将来医学の世界で成功するというイメージを想像できるかどうかです。医学と医療に対する情熱を持っている事が大切です。それを体得し表現できるようになる為に、学生は早くから臨床研究をしたり発展途上国へ行ってボランティアをします。しかし医学部は、学生の多様性も重視し、医療関係以外の点で一生懸命頑張る学生も評価されます。そして、人生の様々な領域で深い経験をしてきた人、大変な試練を乗り越えられた人も高く評価されます。私の場合医者になる決意をしたのが大学３年の初めの頃で比較的に遅い方でした。それまで私は色々な経験をしたくて、動物園の研究者の元でインターンをしたり、バミューダで海洋生物学を学んだり、大学のアジア文化団体の委員長をしたりしました。多様な私の履歴書の中で大学の四年間ずっと続けた活動もありました。一つ目は大学の霊長類研究所で四年間働いた事。卒業研究も同じ研究室を選び、マントヒヒの行動学を学ぶために、大学４年の冬には大学の援助でケニヤに行く事も出来ました。もう一つは大学のヘルスセンターにあるセクシャルハラスメント被害者の為の学生カウンセラーとして働き、１年その支援団体の学生会長にもなりました。その二つの活動を通して、私は自分の科学と学習に対する熱意と他人の助けになりたいという思いを表したかったのです。

医学部受験者は出願する前に自分の経歴、成績、試験結果を見て、自分が受験に勝ち進んでいけるかどうかを吟味します。受験は医学部入学の１年前から始まります。どうしてこのように長い過程を経るのかというと、入試委員会は受験者の一人一人を吟味し、その中でさらに選りすぐった学生を面接に招待します。面接のための費用は個人負担ですから、旅費だけでもかなりの額になります。何十校も受験する学生や海外からの受験者は、軽く１万ドルを超えてしまいます。面接自体は典型的な質問（何故医者になりたいか、現在の医療制度の問題は何かなど）も聞かれるし、とても独創的で医療に直接関係ない質問も聞かれます（最近読んだ本の感想は、一番親しい友人は誰かなど）。 そして面接のあとに受験生ができることは、辛抱強くただ結果を待つのみなのです。私の場合、今年の２月についに待ちに待った返事がやってきたのです。

医学部進学を決意してから今までの自分の考えと行動を振り返ってみると、最初は医学部に受かる事だけを考えていました。本当の事を言いますと、受かる事だけが最終目的になっていたようにも思います。先が見えない不安の中でやっと返事をもらった時、安心と喜びに溢れた途端、ジワジワと医者の姿の自分を思い浮かべることができました。願っていた人生の次の段階に進められる。つまり、私は将来医者になれる。多くの患者さんそしてその人の大切な家族や友達に安らぎ、癒しと希望を与える事ができる。必死で勉強をして色々な辛い思いや大変な時期を多く乗り越えていかなければならないけれども、人の命を預けられる医者になる為には当然な事。頑張ります。まだ始まってもいない医者への道はうんと長いと思いますが、ドキドキワクワク今年の８月まで待っています。

Related Topics for Future Discussion:
アメリカのメディカルスクールの学費




無関係な写真

(blurry) Meryl Streep as Honorary Graduate, Commencement 2009

Top Five Asian Ingredients

I was reading yesterday's 5@5 article on eatocracy (top 5 Asian Ingredients)
And I thought I'd add my own personal ingredients I always keep in stock.

I guess a more accurate term for this list would be 調味料 (choumiryou) - flavoring, seasoning.

1. Must start with the traditional Japanese flavors: soy sauce, mirin (sweet rice wine), and sake.

Adjusting the ratios of these three (with minor additions of some salt or sugar), you can create a wide variety of traditional, home-style Japanese dishes. The nice thing about these three ingredients is, in my opinion, their simplicity. They can really highlight the natural flavors of ingredients - kind of like the salt and pepper of Western cuisine. You can also begin to create layers of flavor with these base ingredients.

For example:
you can try adding some ginger (one of my favorite ingredients to work with).
Butter and soy sauce work surprisingly well
Addition of sesame oil for taste and the aroma
And of course, with the proper use of dashi (Japanese stock... many various kinds that I am not even close to mastering... for the easy way out, just use Hondashi) and right ratios, you can marry these simple seasonings with fresh ingredients and create a dish with flavors of subtlety and depth.

2. Secret ingredient for some delicious Chinese flavors: Wei Pa (味覇 ウェイ・パァー）

Wei Pa : Chinese soup stock (condensed paste form)

This ingredient here is a life-saver. Just stir-fry some garlic, ginger, vegetables, and add a spoonful of this magic (careful! can be salty!) and you'll really get some tasty and light "Chinese" flavor. You can stiir in a a bit of potato starch/hot water to thicken the sauce. Mix things up a bit by adding a little bit of oyster sauce, maybe some XO sauce, or add some chinese five spice - really, just experiment!

You can also put this in hot water for some soup - maybe add some chicken or pork belly. I added some chicken wings and shiitake mushrooms in my last soup.

3. Citrus-vinegar infused soy sauce: Ponzu
It's light, refreshing, and has endless possibilities. Mix with some spicy sesame oil for a dumpling sauce. Use as a light dipping sauce for hot pot or tofu. My mother covers chicken wings with this and maybe some extra salt on top then grills or throws the meat in the oven for a quick and easy dish. I like to boil and cut some okra then top it with bonito flakes and ponzu. You can even buy some yuzu-flavored ponzu. Also delicious

4. Sesame oil
The aroma of garlic and ginger sizzling in some sesame oil - yum. Also, drop some sesame oil on a dish after it's done cooking (any stir-fry, fried rice) for some rich aroma.

5. Cilantro
Japanese surprisingly don't cook with a lot of herbs, but I feel that most other Asian/Southeast Asian dishes go so well with cilantro. Seriously, I love cilantro so much that I can just eat it plain, even. I feel bad for the population of people that have an aversion to this wonderful herb.
But yes, anything with a hint of Chinese flavor, I'll throw in some cilantro if I have any. 



I have a wide variety of other seasonings with which I like to experiments: fish sauce, XOjan (Youki's XO sauce), to ban jan (spicy miso sauce), oyster and mushroom sauce, black and yellow bean sauce, hoisin sauce, kepap manis. Perhaps I'll dedicate another post to these.

My beautiful cats - RIP Kabo

Trauma

According to the Global Burden of Disease Report, the leading cause of death for individuals younger than 45 is trauma. Out of the possible injuries, Traumatic Brain Injury (CDC factsheet) is the leading cause across all age groups.

The young are dying of trauma.


Unfortunately, due to the nature of this Cause of Death (often careless mistakes, unforeseeable accidents, etc.), funding for research on better traumatic care is limited. Trauma lacks a clear and definable target of pursuit (like Cancer). Trauma surgeons, however, are eager to learn better how to care for patients rushed into the ER with not even minutes - seconds - to spare before critical decisions must be made. Unfortunately, with insufficient academic work, surgeons must rely on instinct and experience. These are necessary skills for sure, but instinct and experience backed by empirical evidence is even stronger.


I feel that slower, more detailed surgical work is better suited for me, but I also feel that I am very calm and rational in intense circumstances. That has never been tested in a life or death matter, so I can't fully say anything, but that may be a good attribute to have for trauma surgeons.

We will see.

Missing Loved Ones, WTC Memorial - New York City

Her face

We unveiled the cloth covering Gertrude's face today to begin the head dissection.
Again, I wasn't as provoked as I thought I would be. She did seem like a nice, old lady that one would see maybe sitting on the porch, drinking southern lemonade. She didn't have any teeth either. But, her lips were white, tongue discolored and deformed, eyes were glossed over, and her face was flat (perhaps because she had been on her stomach for so long.

I did enjoy the facial dissection - all of the careful cuts and maneuvers we had to do to clean around nerves, veins, and arteries was... fun. I think I'm pretty good at these detailed procedures. I was able to expose and preserve the internal jugular vein and its branches to the facial vein and retromandibular vein. I was able to find the common carotid artery and its branches into external and internal. And, with the help of David (TA), I was able to clear out most of the branches of the external carotid artery. What's cooler, I was able to take the facial artery from its branch-point from the external corotid and trace is up through the submandibular duct, across the mandibles, and into the cheek. It unfortunately got severed and my other tank mates started peeling away the facial skin. I'm pretty proud of that handiwork.

I'm also beginning to be able to immediately recognize a vein versus artery versus nerve. Small nerves and arteries are still a little tricky.

And here is a good mnemonic for branches of the external carotid artery:

SAL FO PMS
S = superior thyroid artery
A = ascending pharyngeal artery
L = lingual artery
F = facial artery
O = occipital artery
P = posterior auricular artery
M = maxillary artery
S = superior temporal artery



this post was more of an anatomy self-review than a reflection...
I do have a lot more acronyms for anatomy (many of them dirty for bigger mental impact).
I'll post those up later

View of Paris from Pompidou, May 2009

Science Watch Ranking

September/October 2010 (ISSN 1047-8043)
Rankings for Top Ten Universities In Biological Science Fields, 2005-2009
Criteria: Published Papers

(c) Science Watch Rankings

pass/fail

I got my results for the second biochemistry exam, which was this Monday. Again, I was just a little bit above average but nothing stellar. My scores did improve slightly - so perhaps not attending lecture and just studying/listening to the lectures online when I am most awake is a better way of learning for me. But still not good enough. Maybe it's a bit ambitious or arrogant, but I would like to be at least 1 SD above the mean.

Now, I know that many people will think:  Welcome to medical school! You are now surrounded by classmates who were all top 10-20% of undergraduate - and all 230 of you can't be in the 1st quintile.

Well, as of now, I don't know whether my grades are because I'm not pushing myself or because medical school is just that hard. And, of course I want to be as high as I can be in terms of rank. Call me a grade whore or a nerdy Asian, but let's face it - Residency programs care a whole lot about rank. At a surgeon-interest group meeting I attended, the chairman of general surgery said quite bluntly, the first two things that will open or close a residency program for you will be your rank and your USMLE scores (and also how these factors may significantly affect your salary -- say, $300K vs $600K). So, for better or for worse, I have to take grades seriously.

Here's my problem and my blessing: the double-edged sword of the Pass/Fail system.

Pro: eases you into medical school, allows experimentation with different learning techniques, and gives you time to secure a social base. and I'm relaxed and stress is minimal.
Con: I'm relaxed and stress is minimal

My main problem is that I find it hard to motivate myself and push myself to the max. In the back of my mind, a voice is telling me - it's Pass/Fail! You're passing! Relax! Make some friends! Enjoy the night-life! Enjoy your hobbies! Spend time with family and boyfriend while you actually have the stress-free leisure to do so. And I really have been listening to that voice, having lots of fun and being really laid back and relaxed. But, I also haven't been doing as well as I want to on tests (go figure). Don't get me wrong, I'm not hitting myself over my head for my passing grades, and I don't regret the fun memories and beginnings of friendships that I've made these first few weeks of medical school.

What I worry is that as of now, I don't know if I can reach the intensity that I had in undergrad. I don't know if I have that edge anymore. It's been over a year since I graduated undergrad, and I spent a year at a very social, laid-back lab, working 9-5, going to parties, dinners, bars, movies. I think I forgot that stressful feeling of time slipping through my hands. I stroll through lectures slides and readings,  continuously getting distracting. I don't even know if I can push myself to my personal limit anymore.
This is worrisome for two reasons:
1) substandard grades, of course
2) if I want time to spend time being a normal person, I need to study with higher yield, which means more intensity, more efficiency.

Now, I'm probably being a bit over-dramatic and exaggerating the situation. Come numerical grades, and I'll probably (I hope...) be back to my study-freak, work crazy hard/play hard self in no time. I just hope that the time I get that kick won't be too late.


I think what I need right now is that reassurance that I can push myself again and produce my personal best results. I need to know that I have the mental discipline to reach my maximum effort.

So for this next biochem test next Friday, I'll lock myself up in the study prisons from morning until late-night like I used to during finals period of college. And, we'll see how I do.

The Salt Lick - Austin, TX.  Featured on FN's Best Thing I Ever Ate. Bobby Flay, BBQ ribs

Flavors of Asia: Pork Bone Stock

This is a pork bone stock I've been making and using in a lot of experimental dishes since college.
It is extremely easy to make and in my opinion, quite versatile.
I don't have an exact recipe - just eyeball everything. It's never gone wrong.

Ingredients:
- A package of pork bones (neck, back, wherever. You can probably use other sources of meat as well)
- Garlic (a ton... how much I add always depends on my mood. Maybe half a bulb on average)
   Smash with knife and and put in whole or slice. 
- Ginger (1-2 square inch chunk), cut into slices
- Water and Sake or rice wine (maybe 1:5 ish ratio)
- 1 onion
- Scallions if you want
- Leeks if you want
- Some salt and white pepper

For a more Japanese twist:
- Use less garlic
- Add a square of Konbu (Japanese stock kelp)
- Dried shiitake mushroom
- optional: Hondashi

Don't add soy sauce or any other sauce at this point.
It could overcook and give a subtle burnt flavor, which is NG


Directions:
- Add everything to a stock pot
- Press on and let cook for 6-8 hours
- Strain stock and store in tupper-ware in the fridge
- The stock should congeal and become gelatinous and delicious smelling.
- The unnecessary fat from the pork should rise and solidify on top
   *I usually remove this fat... but you can use it for some creaminess in dishes or perhaps render it.


(Pictures to come soon... next time I make it)


Successful recipes using this stock to come soon as well

Examples:
- Stir-fried flat noodles with cilantro and whatever-vegetables-in-the-fridge
- Risotto-style porridge with ginger and sesame oil
- Soon dubu-inspired tofu soup
- Vegetable stir-fry with pork belly


Current Culinary Goal:
- Making a delicious Tonkotsu (Ton=Pork, Kotsu=Bone) Ramen (豚骨ラーメン)

The flavors of this stock, especially once you start simmering it, adding various spices/salts/sauces, can become really deep and complex; has a lot of body コクがある (Koku = body).
TIP: Definitely needs some herbs (like cilantro) or even just some, uncooked sliced scallions on top in whatever dish you make in order to cut some of the richness/depth of body

 

Flat noodle flavored with the pork stock. Picture courtesy of bf.

first standardized patient interview!

Was today.

It was actually so much fun, and I am now even more excited about my future career!
I had an older gentleman who came in complaining of constant fainting spells. Important points to hone in were frequency, duration, activities leading up, side symptoms (chest pain, heart palpitations, stress, changes in lifestyle/diet, etc.), and relevant medical history. Other important points were affecting and associated factors, medication, alcohol and/or recreational drug use. Some things the patient later said I should ask more were social factors - does he have a good support system? How does the fainting affect his lifestyle?

But I was told I made good eye contact, made smooth transitions between the questions, showed empathy, allowed him to ask questions and state concerns. His actual comments were: "I liked your direct and caring manner, very engaging and this made me feel confident in you as a doctor. I felt that you asked good follow up questions and gave a good summary."
All of these things may seem so common-commonsensical (I know I did while I was reviewing the lecture on patient interviews). But first time in a real clinical setting with a patient (doesn't matter that he's an actor) really made me nervous! I almost forgot what to do after I shook hands with him.  But after talking to him, hearing his story, I almost forgot that this was a training setting and all I wanted to do was take his concerns away. Make him feel reassured that we will take care of him.

I know some students here don't enjoy patient interaction and want to go into pathology or anesthesiology, but this is something for which I really felt a calling. And I am glad I enjoyed it so much because I really think an excellent physician not only has technique and skill (which can be taught...) but has the patient-oriented drive and motivation. I also would like to be the physician or surgeon that has the right instincts and can be creative. think outside the box. Those attributes, I have no idea whether I have yet or not, but what I need first and foremost is a solid background and knowledge.

So back to biochemistry studying!

Summer in Japan: Red Lanterns and Fuurins (ふうりん・glass wind chimes)

Climbing Mount Fuji - Pilgrim Route

"Why do you want to climb Mount Everest?"
"Because it's there"
          - George Mallory


This summer of 2010, I ventured to climb two amateur mountains: Mt. Kinabalu in Kota Kinabalu, Malaysia, and Mt. Fuji 　(富士山）in Japan. The first mountain climb was with an intrepid tour group and was a breathtaking experience. However, due to heavy rains, we were not able to climb to the summit. So, I decided to climb Mt. Fuji alone during my travels in Japan.

Now, Mt. Fuji is said to be a mountain that one should gaze at from a distance - not climb. Nonetheless, thousands of people go on the climb a year (climbing season is from July-September). Needless to say, the mountain is very popular and can be extremely tourist-y. The usual route is to take a bus to the 5th station　五合目 of the Yoshida trail （吉田口） and to climb to one of the mountain huts　（山小屋）, arriving late afternoon. Then, climbers will wake up very early in the morning (around 2am) and climb to the summit to view the sunrise. So many people attempt this climb that during peak times, it is necessary to make reservations at the mountain huts, and the morning climb is more like waiting in an elevated line.

I'm not a huge fan of popular tourist attractions, but I really needed to climb to the summit of one mountain. So, I decided to make my Mt. Fuji climb as unique and personal as possible. And this is how I did it.

The Route

I looked into the oldest, most historical route used by Fuji Pilgrims (Fujiko 富士誇）in the Mt. Fuji pilgrimages, which is the now common Yoshidaguchi trail（吉田口登山道).

History of the shrine and the pilgramage. Fuji Sengen Shrine, Japan

However, what is not so common is actually making the full pilgrimage, which starts at the base of the mountain at the Fuji Sengen Shrine（富士浅間神社). From that point, the trail to the summit is about 18 km (estimated full ascent time 11 hours), and climbers will experience the quiet solitude within the lush forests of the mountain. Also, most people climb the mountain to see the morning sunrise. I decided that I also wanted to see the sunset.

Information on the distance and estimated travel tim

So, I started my journey (July 13) at Kawaguchi-ko （河口湖）Station Inn, where I spent the night before my climb. I took a taxi to the Fuji Sengen Shrine at around 4am the next morning (July 14) to start my journey. It was quite dark and eerie with the greenish lighting and statues, and especially since I was completely alone. Fortunately, I was able to text my family and boyfriend in the US as I waited for it to become a bit lighter outside. Thank goodness for cell phones and time differences.

View of a shrine Torii (around 4:30am)

Finding the trail was not too difficult (having a Lonely Planet guidebook with me was handy). From the shrine to the 5th station, the path was well-kept, peaceful, and shaded. The road was a steady, low incline, which can actually be quite tiring if you walk for hours on end. During this entire segment of my walk, I ran into maybe 2 other lone travelers as well as some actual monks! A serene experience... Once I got to the main mountain huts around station 5, the trail became more crowded as expected.

Mt. Fuji Pilgims, 富士誇. I could hear their traditional chanting from afar, frightening a little at first.

I arrived at the Goraikokan（ご来光館） on the 8.5 station at around 1-1:30pm that day. And yes, I was absolutely exhausted. Food is all instand, but the 800 yen kitsune udon tasted absolutely delicious. I was able to check-in for a sleeping space even though I didn't make prior reservations. Expect to pay maybe 6000-8000 yen (depending on whether you ask for breakfast/dinner) per night at the mountain huts. Also, you'll be sleeping very close to the other climbers.

Sign at Goraiko-kan. 御来光感。

Bunk-bed/cots at the mountain hut. Sleeping sardine-style.

I took a much needed rest and slept until about 5-6pm. In the evening, I ventured to the summit alone. With no one on the trail, it took my about 30 minutes. At the summit, I really felt as if the mountain was my own. There were only about 5-6 other people there around this time. I secretly followed a group of mountain hut employees who crossed one of the restricted areas to get to higher ground. Unfortunately, the sky was a little cloudy so I couldn't see the sunset very well. However, on my way down, I did see a optical phenomenon called 逆富士 (gyaku-fuji) where the mountain is reflected upside on the clouds.

Gyaku-Fuji 逆富士

It was a surreal experience.

That next morning (July 15), I could already hear climbers heading to the top at 2 am. Sunrise would be around 4:30 am, so I didn't venture out until 3:15 am or so. As soon as I started climbing, however, I understood why people started the climb so early -- the path was completely packed. The stretches of people holding torches and headlamps looked like a snake moving up the mountain. What took me 30 minutes the day before took over an hour the next morning. Luckily, there were points on the trail where people kindly split into the slow vs. fast line, so I was able to gain some time there. Besides the fact that lines in general are a hassle, the main problem with a slow line is that your body starts feeling the cold if you're not constantly moving.

One at the summit (again), I quickly found a good viewing spot for the sunrise amidst the swarm of people. Standing and waiting for the main event did get colder and colder with time, but the surrounding people were very social and talkative, so it wasn't all too bad. Also, cellular reception still worked at 3700 ft., so I was able to text and send pictures to family and boyfriend.

Waiting for the sunrise 御来光. One of the five surrounding lakes

Sunrise itself was definitely worth it. (I'll refrain from putting pictures up, so everyone can experience it for themselves). That quick moment where I saw the first bit of sun peak through the distant clouds lined with orange light --- incredible. I stayed up at the summit and watch the sun climb up the sky. The summit so bright and warm once the sun is up. And that day, the sky was a little cloudy still, but it actually added to the experience because the sun's light reflected from the clouds, making me feel wrapped in a warm, white light. Sitting on a bench, sipping on some hot cocoa, I basked in the light.

A warm world above the clouds

The descent was basically a run for me. I find that climbing down slowly actually tires me legs out more and it's easier to just use the downward momentum (granted, must be careful not to trip). I also wanted to be down at the base before noon time because I knew I would have to walk an extra 2km from the temple to the Fuji Yoshida Station (unless I could catch a taxi, which didn't happen).


Tips and Advice

I brought along with me one small backpack. Inside, I stuffed food, plenty of sunscreen, a notebook, and I also recommend buying one of those ziploc travel vacuum bags (available at REI/other travel stores). Inside, I put an outer hard shell jacket, a fleece jacket, an inner wool long-sleeve, two pairs of leggings, a ski hat, and gloves). Around my waist, I tied two thin jacket layers. That's all I needed, and I am very glad I packed and carried lightly.

Be prepared for a difficult climb starting around station 6. The inclined path is made of lava rocks, which offers little support or push for the legs. I was crazy and wore sneakers, but most people will definitely recommend some strong hiking boots

The rocky climb to the summit. 吉田口、富士山

What to wear:

For my ascent, I just wore a cap, long, cargo pants, a sports tank-top, and a thin layer over that to protect myself from the sun. Unfortunately, once you get to station 5, there is very little shade, so wear sunscreen or cover your body loosely if you don't want to tan/burn. From station 8.5 to the summit, I did switch my thin outer layer to a warmer wool layer, but even that got a little hot once I was moving around. In the morning, I really recommend wearing as lightly as possible in the beginning. I know it's really cold at first, but your body will warm up as long as you find a way to keep yourself moving. The worse things that can happen is for you to start sweating, which will make the summit even colder, especially while waiting for the sunrise. So for me, I wore two pairs of leggings, my cargo pants, a an athletic tank-top, my wool layer, hat, and gloves for the morning ascent. Once at the summit, start putting on your layers one by one. I would also recommend hooking your digital camera case onto your waist as well (easy to pull out and put back in).

Food/Fluids:

Eat a hearty breakfast. Definitely bring snacks (nuts, chocolate, granola bars), a minimum of 1.5 liters of water even if you plan to buy fluids on the mountain (expect to pay 400-500 yen for a 500ml bottle of Aquarius) and sports drinks/jelly drinks they sell in Japan. I probably should have brought more than 1.5 liters, but I also did not want to carry too much on my back/shoulders. The liquids, I carried in the pockets of my jacket that I tied around my waists, and the water bottle I put in a waist bottle carrier I bought for 10rm in Malaysia. I personally like carrying heavier things around my waist than on my shoulders.


All in all, climbing Mt. Fuji from the very base may not be the easiest of adventures, but it's definitely doable, exciting, and memorable. You should be somewhat fit, though, and be able to enjoy walking and climbing for 9+ hours.

But yes, if you're even thinking about climbing Mt. Fuji, do it the traditional way. It is so rewarding in the end.

study habits

The medical school that I am currently attending - like most medical schools these days - has shifted to a pass/fail system for the first semester. This is to give students time to adjust to the new pressures and demands of medical school and to really ease the students in to their new roles and expectations.

I am fully appreciative of this shift. The undergraduate institution I went to was rigorous to say the least, but I feel the demands that I have been feeling as an MS1 are much much higher. They say we should treat our position as medical school students as our job. But I've had a job for a year as a research technician, and that life seems like an easy breezy heaven compared to this. The amount of material that is covered per day is much more than anything I've experienced. Monday, Tuesday, and Wednesdays are the longest days - 3 hr lectures in the morning followed by anatomy lab and lecture. Students are essentially on campus from 9-5 (like a regular job). And it's exhausting because our brains feel supersaturated by the end of anatomy lab. After that, however, we can't just go home and relax because we have to review the material we learned that day and the many recommend that we preview the lecture material for the next day. If we don't do these tasks or we get left behind, it becomes so difficult to catch up because the speed of progress per day is simply overwhelming.

I personally study best when I make myself stay in the student carrels (or study prison, as I like to call it). The handful of people that use this study space are very dedicated and focused, and the depressing atmosphere actually makes me more productive. I like to stay on campus because I have a gym nearby that I can go to when my mind needs a break. I also don't have the usual distractions of home - like a fully stocked kitchen, a bed, a kitten, a boyfriend, random household chores that seem so fun to do when all I've been doing is studying signaling pathways.

This semester, though, I would also like to try studying with friends and going to cafes. The nice thing about doing that is a constant source of coffee, of course, and if I am in a more social but still study-conducive environment, it's easier to ask friends about questions, form deeper friendships, and really, the carrels are just depressing.

One very important thing that we have to establish this semester is our personal best routines and high yield study habits. We have to figure out the best way that we learn, and the best way that we retain the information long-term. Most of us are good at cram memorizing, where we basically forget everything we learned by the end of an exam. However, it can't be like that in medical school. Information is really cumulative. If we don't solidify the material the first time around, we will really suffer the second time. My father tells me that how well we learn the material and create a "structured, conceptual memory" the first round will set apart the mediocre, good, and best the second time we encounter the material (which we definitely will again.)

But what is a structured memory? How do I get it? How do I learn the material in a way that I can memorize all of the details, understand the concepts, and then apply what I learn? I'm still trying to figure the trick out.

The first exam, I tried the usual: attend lecture, preview and review and review again, write notes by hand, and then quiz myself before the exam.

For the next exam, I am trying a different tactic: not attend lecture and study the material closely and carefully. Listen to the mp3s of the lectures at my own pace (speed up the playback, pause when I need to write down a lot of notes, and repeat if I don't understand).  I also wrote study questions for myself the first slow read that I did, and then answered them later on a review of the material. Hopefully, before the exam, I will give myself this "test" again, and I will be able to give the answers in detail with minimal reference to the syllabus. I also want to study in a group before the exam, asking questions and answering questions.

Hopefully, the pass/fail system of the first semester will give me the time and opportunity to explore various methods and via trial and error, and determine what works the best for me.


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completely off-topic. A memorable experience from my travels this summer.
Felt like I was riding a motorcycle in the air.

Power hang-gliding. Kauai, August 2010