This semester is relentless

As promised, I'd like to talk about my school schedule a bit. In specific, I'm going to whine about how MUCH there is.

So, in the first week, the schedule seemed pretty manageable. Monday and Thursday are full days but Tuesday and Friday are half days with Wednesday being a variable schedule. (We have our Interprofessional Ethics course, which meets five times, in the afternoon starting next month, and our Experiential Programs class, which largely meets off-campus and on our own schedule, in the mornings.) And with work Sunday, Wednesday, and Friday nights, I thought, this will be hard but not terrible. Well, there aren't any assignments in the first week.

In the second week, things started coming due and we had our first quiz. Still, the load was not terrible, and the Experiential class time was filled with our immunization training, which is very low-level stuff and review of the text we'd read over the summer. In the third week, we had no Skills class because of the Labor Day holiday. But in the fourth week, the tests started coming and Skills started having weekly assignments.

In the fifth week - last week - we were done with the immunization training and ready to start the actual Experiential experience. That was just an orientation lecture, which is no big deal, but from here on out we're expected to spend three hours in our assigned pharmacies each week. That's more to do. This week, we have two exams and a fairly major assignment due Friday. And another exam Monday. And the week after next, the Ethics class starts up. And my wife is due at the end of November. It feels like they're just adding layer after layer to my already over-full plate. I might explode.

Or, I might adjust, and be just fine. I'm consistently amazed at humanity's ability to learn to deal with the tasks placed in front of it. I was talking with a coworker at the casino who got a second job. We both agreed that the more time you commit to things like work and school - basically, the thinner you spread yourself - the more you're able to handle the increased work load. Someone who works 40 hours a week feels like they work a lot. But someone who works 60 hours a week often feels the same way, or even that they have more time available, because they learn to use that free time more efficiently. I don't spend five hours playing video games because I don't have five hours available in a chunk. And I don't think it's a special ability I have. People are always telling me that they don't know how I do it. Well, I don't either, but I do it, and not because I need less sleep than everybody else (that's far from the truth) or because my memory is so good that I never need to study (I definitely do, as witnessed by my first exam score). It's because humans are remarkably adaptable creatures.

So the biggest change in this year's curriculum is a switch in focus. In the first year it's all very fundamental stuff, much of it review or further explanation of required coursework we've seen before. In the second year, the Integrated Organ Systems (IOS) courses become therapeutics-focused. Therapeutics is the branch of pharmacy devoted to managing disease states with drug (and non-drug) therapy. It's not a regurgitation of facts or principles but an application of principles to a specific situation. You not only have to know what drug X does or the side effects of drug Y but which would be the best choice given a patient with condition Z and lab value N. And as you learn more and more organ systems, it gets more and more complicated. Right now all we know is neurotransmitters, the kidneys, and hypertension. By the end of the third year, we'll know the whole body, and the body is not as rigidly segmented as we like to think it is. All the systems interact. You don't have one condition in isolation in almost any patient. So how do you treat diabetes in a patient with impaired kidney function, high blood pressure, hypothyroidism, and crazy cholesterol levels? What if they also get a bacterial infection? I don't know that yet, but a pharmacist does.

Anyway, I feel like I'm learning at an incredible pace. Every week when I go to Kaiser I understand more about more drugs than I did the week before. It's really cool to be a part of that, and to recognize it, as it happens.

And what do you know, this was an incredibly on-topic entry. Did you like it? Don't be afraid to leave feedback, even scathing criticisms, and to ask for more of what you'd like to see.

Football!

Since my last post, the National Football League has returned to action. And the Bears are 2-0. Also, Carlos Gonzalez is the latest to fall victim to the Buffalo Pharmer curse (see also: the MLB.com survivor contest, Monday blog entries, the 2009 Chicago Bears, P1 class president, the Chicago Cubs as a franchise) . He hasn't hit a home run since I wrote the MVP article, and the triple crown looks like it won't happen this year. In fact, Troy Tulowitzki looks more like the MVP candidate than CarGo right now. Whatever.

A classmate of mine sent me a link to this article, in case I needed something to blog about. At first I thought, no thanks, I don't want to write about that. Then I remembered that I take requests, so I thought I'd chip in my two cents. The article admonishes Derek Jeter for acting hurt after a pitch hit the butt of his bat. The basic idea is that while this sort of thing happens all the time in baseball, it's not typical for Derek Jeter to behave like anything but a model citizen. I guess I agree with that, but I sort of don't care. A lot of stuff goes on in baseball that isn't really the most honorable. Pitchers throw at hitters. Players apply phantom tags, and get away with it. Matt Holliday slides right past home plate and the Rockies go to the World Series. This writer seems to be making a big deal out of nothing and, rather than showing Jeter to be a cheater, I think he shows the opposite. If this is the biggest thing we can get on Jeter, how much can we really say about him? A ball came close to hitting him, and he hammed it up enough to get first base. Chances are his reaction to the pitch had nothing to do with the call. My guess is the ump thought it actually hit him on the hand, and logically awarded him the base. I don't think major league umpires are in the business of making calls based on the player's reaction, for the most part. Also, all the bad calls and missed plays average out over the course of the season. I'm sure at some point, the Yankees lost a close call, probably even a wrong call, and ended up losing the game. So Jeter overreacts and ends up scoring and winning the game. Let's move on.

Anyway, since you asked, that's what I feel about it. Keep your requests coming! For my next entry, I'm going to talk about something I totally haven't mentioned this year, which is school. Isn't that a novel topic for my pharmacy school blog? Thanks for stopping by.

The case for Carlos

You should know right off that if you came here expecting anything other than baseball, you should turn around right now. It's September, and it's on my mind a lot lately.

Today I'd like to argue that Carlos Gonzalez deserves to be the National League MVP. Let's start by turning back the clock two weeks. With September looming and playoff races getting tight, the National League looks to be a six-team playoff picture: San Diego and San Francisco in the West, Cincinnati and St. Louis in the Central, and Atlanta and Philadelphia in the East. One of these teams, probably the loser of the East, will win the Wild Card. The race in the central division is particularly interesting because the first basemen for these two teams have emerged as legitimate contenders for the Triple Crown. Since about the All-Star Break, Albert Pujols and Joey Votto have taken turns leading each of the three Triple Crown categories (batting average, RBI, and home runs), with the occasional interloper displacing them in one category or another. As baseball heads into its stretch run, sports writers and media types begin to speculate about the end-of-season awards and it becomes evident that one of these two sluggers should almost certainly win the MVP. Conventional wisdom says that if one of them wins the Triple Crown, he'll be a shoe-in, and if not it will probably go to the player whose team wins the division. While the competition remains open (and fierce), it seems to be strictly a two-man affair.

Then something happened in Colorado. Carlos Gonzalez started hitting at a ridiculous pace. After yesterday's 7th-inning single, CarGo has a 16-game hitting streak during which he is hitting better than .500 with seven homers and 21 RBI. That streak has fueled him to a near-20-point lead in the batting race and made him the first player in the league with 100 RBI when he hit a three-run blast on Tuesday. If you're paying attention, you already know that this means Gonzalez - not Votto or Pujols - leads two of the three triple crown categories at the start of play today. And with 32 home runs, he is only four back of Pujols for the lead in that category, too. So if the Triple Crown is the metric of the MVP race, you'd have to say Carlos Gonzalez is the odds-on favorite.

But wait-- there's more. CarGo's ridiculous performance at the plate not only fueled his rise in the batting categories, it also pushed Colorado back into playoff relevance. While the Padres collapsed in late August and early September, the Rockies got hot and sit four and a half games back in both the NL West and the Wild Card. So if contribution to a team's success if the primary criterion of the MVP, there's a good case there, too, especially if Colorado can claw their way into a playoff spot.

CarGo can Go, Go, Go, too. He ranks fifth in the league in triples, with 8; Votto has 2 and Pujols has 1. He's 11th in stolen bases, with a realistic shot at being a 30/30 player if he can pick up seven more steals. That's a dimension the NL Central guys don't bring to the game. Nobody worries about Albert Pujols stretching a double to a triple, or Joey Votto swiping second and then third in the same at-bat.

Pitchers are starting to catch on that this guy might be for real. In the third inning of last night's game, with Dexter Fowler on first, Bronson Arroyo pitched delicately around Gonzalez, walking him on four pitches. Then he hung a curveball over the middle of the plate that Troy Tulowitzki promptly deposited in the left field bleachers. Without swinging the bat, CarGo added a run to the Rockies' score because the Reds were so concerned with not letting him hurt them that they let the next guy do it instead. That's a pretty valuable contribution.

And then there's his defense. In Tuesday's game, the speedy Brandon Phillips hit a ball into deep left field. Gonzalez tracked it down some twenty or thirty feet from the outfield wall, spun around, and threw out Phillips trying to stretch for a double. CarGo can play all three outfield positions, and his speed and arm are a great fit for the expansive outfield of Coors Field. Pujols and Votto may be roughly indistinguishable from CarGo when it comes to batting, but his contributions are so much broader that the argument becomes clearer the longer you look at it.

All that being true, there exists a certain bias among awards voters. In 2007, a Rockies left-fielder wearing number 5 also led the league in batting while leading his team to a playoff berth. He was snubbed in favor of an East-coast player, and so were the emergent rookie shortstop Tulowitzki and manager Clint Hurdle. That team went to a memorable World Series and got no recognition for it. Tulowitzki seems like the presumptive favorite for the Gold Glove (and Silver Slugger) at his position, but a DL stint could be the excuse voters need to pass him up. One-time Cy Young lock Ubaldo Jimenez has given a number of pitchers the opportunity to state their cases, and a player like Roy Halladay, Josh Johnson, or Mat Latos will probably win that award over the league's winningest pitcher. But the arguments against Carlos Gonzalez are weaker, fewer, and disappearing every day. As a fan, I hope MVP voters do the right thing and vote for the player who clearly did the most for his team down the stretch.