No Macaron For You!

Having heard so much about the glorious French macaron in Europe and NYC, I decided to go on a macaron hunt of my own. Little did I know, the number of patisseries in my state roughly equals the number of calories burned by a cadaver. Given my unflagging tenacity (read: incredible boredom) for yummy French things, I finally stumbled upon a little gem called Silva's Patisserie. It's a small shop owned by Harry Sarkees, a former pastry chef at the Kennedy Center. With such a lofty title, one would think that he could only produce heavenly delights for the palate, but I was sadly wrong.

Beguiled by the lush, neon fruits-basket interior (you can't tell from the photo), I thought I had finally hit gold. Of all the tasty cookies that rested coquettishly behind windexed glass cases, I spotted miniature macarons of the pistachio and strawberry variety. They were small, and at $6.00/lb somewhat pricey, but man...I just had to try them.

And I did.

I bought a tiny little box wrapped up like so:










...and since I can't take decent photos worth crap, here's a stylized version of a whole, virginal macaron.

My first bite into faux-French deliciousness was somewhere between weeping and getting a root canal. Rather than being a soft, fluffy experience, my macaron turned out to have the crusty old consistency of rock-like nougat. Sure, the almond flavor was there, and perhaps even a hint of pistachio in the filling, but overall it was disappointing. What had looked so promising was ultimately a let-down--one of the many reasons why living can be so painful. Can you honestly look at the photo below and think "Ew, gross!!!"?!!

Somewhere out there, a tickle-me-Elmo doll is crying.

So in the end, my macaron quest was a miserable failure, not unlike many other ventures in my life. However, at least this was just a stupid dessert and not someone's life. If I ever screwed that up, I don't think I could say: "well, he was a shitty macaron anyway." That wouldn't do.

Have You Seen Me?

Authorities are currently looking for a prurient woman-of-the-night who is believed to be armed and dangerous. The suspect has been sighted in a number of cities along the East Coast luring young, unsuspecting males into unspeakable acts behind closed doors. Little is known about "La Ho*," as she is commonly known, but reliable sources say that she can be found lying in bed at ungodly hours of the afternoon when normal human beings do things like work and play.

Please, if you have any information on the whereabouts of this individual, contact 1-800-WAKE-UP-HO so we can return this waif back to the harem where she belongs.

A recent photo is provided below:

*Sorry, I couldn't resist.

The Sine Qua Non of Being a Great Doctor

Being a physician can be an intensely gratifying experience. After all, what other career allows you to poke, prod, and otherwise violate another human being for money? Whether it's looking up someone's rectum or down a person's gullet, there can be no end to the orifice-probing possibilities.

So, to become a great doctor, one needs to cultivate a habit of invasive voyeurism. How can you tell if your child has what it takes to succeed?

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First, your child may begin with an innocent curiosity about inanimate objects:

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Next, she may display increased obsession with living things:

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Finally, she will discover the overwhelming joys of dead carcasses:

In short, if your child displays one or all of these characteristics, then she may be on her way to a full, satisfying career in medicine. Or she might just end up as a mortician. It's hard to say.


disclaimer: while the photos do indeed sport a little asian girl, that girl is not me.

Medical School: an arm, a leg, a kidney, and oh...a piece of liver, too

Remember the first and only time you won the school's spelling bee? How about the titillating excitement of a first kiss? Or the proud satisfaction of learning how to ride a bike? You see, I don't consider myself to be a shameless hedonist, but I do enjoy the taste of success once-in-a-blue moon as much as the next guy. So, imagine the devastation and heartless cruelty of ripping that small shred of happiness from an innocent baby. For eternity. Over and over again.

That is what medical school tuition is like.

Let's take my school, for example. We'll call it IMPOOR SOM (or IMP, for short). This is a rough breakdown of what it's going to cost me to attend (figures are based on 2007. add 1-2% increase for this year).

Budget duration: 10 months [note: ways to save. Not even a full year]
Tuition: $39,957 [sell arms. Possibly liver]
Fees: $2,807 [very ambiguous. Sell kidney]
Rent and utilities: $10,000 [Plan A: crash on stranger's couch. Plan B: share heating grate with homeless man]
Food & Household supplies: $2,410 [Wal-Mart, free lunch from drug companies]
Personal Expenses: $2,620 [mooch parents]
Local Transportation: $1,200 [keep legs and walk]
Health & Disability Insurance: $2,500 [utilize classmates]
Books & Supplies: $1,516 [import from Asia]
Equipment: $990 [pilfer from practice exam rooms]

Financial Aid Budget 2007-8: $64,000 [consider starting strip bar on side]

What was formerly a happy time for me has turned into a hand-wringing, panic attack about how I'm going to pay off such astronomical debt. But having spent my entire year off surfing the internet and reading Fortune magazine, I have devised an ingenious scheme for funding my education: other people's goodwill! (aka donations)

Yes, I propose that for every person who sends me $1,500 now, I will waive that fee once I become a physician and open up my own concierge practice. After all, many doctors are choosing this route given its autonomy and opportunity for a normal, humanoid lifestyle. If you, too, would like 4-star medical treatment available only to the privileged, then don't hesitate! Donate to L.A.G's IMPSOM fund today*!

*subject to L.A.G. conditions like moral responsibility and duty to the disadvantaged. Don't let that stop you from donating, though.

Bliss on Mile Marker 6

There are few things in life that bring me unadulterated joy. Such things include music and running. And maybe alcohol. And warm chocolate chip cookies (post on that later). Ok, so maybe more than a few things make me happy, but a good tune and a pair of sneakers is a fail-safe combination.

In any case, I was listening to "Love Turns 40"* by Vienna Teng while jogging on an idyllic Sunday morning. Teng, a Stanford software engineer-cum-musician, gave up a lucrative career in Silicon Valley to write and sing a few songs. In short, every Asian parent's nightmare. But thank goodness she did it, because she's damn talented. From the opening lines of "LT40", Vienna's soft, passion-barely-contained crooning touches something delicate and visceral about relationships; in this case, a marriage-on-the-rocks. I don't typically pay close attention to a song's lyrics, but Vienna has an uncanny ability to perfectly match poetry with ethereal piano melodies. Here's a sampling:

"She's holding a truth that she'll never reveal
She's holding a truth that she'll never reveal
Cause truth this time is an ugly child
And mother and daughter may reconcile
But their faces will never heal

Don't go, she says, but he's sleeping
She says it to herself
Don't go, she sees herself rising
Packing her suitcase with all of her shoes
But something keeps you faithful
When all else in you turns and runs
Love turns 40"

There's always the perpetual sense that at any minute, she's going to break out and belt out a good one, but her voice is always restrained, controlled, deliberate. It's like being on the verge of a waterfall--not quite going over, but peering dangerously over the edge. This is bliss, my friends, especially when combined with 6 miles of pure pavement.

It's times like these that make me infinitely grateful to be alive and kicking.

*feel free to ignore the visuals. I have no idea what the anime has to do with the song.

"Docs Gone Wild" (Courtesy of Kevin MD)

I couldn't have said it better myself: "Doc Taped Ecstasy to His Privates."

The 80/20 Rule: Getting More with Less

Sometimes I enjoy foraying into lands unknown--principally, that of economics. Despite having never taken an Econ 101 class and somehow stumbling into a job as a financial manager (believe me, even I marvel at the miracle), the subject appears to inform a lot of what goes on in life. Would you believe that doctors make decisions about your health, brokers about your money, and lovers about their next lay using this timeless guideline? Much of this phenomenon is unconscious and masquerades as intuition, gut instinct, or a hunch, but a rose by any other name is just another damn plant.

Let me first describe this glorious little theory beloved by lazy bums the world over. The Pareto Principle, or 80/20 rule, states that "80% of the effects come from 20% of the causes." In business parlance, this means that roughly 20% of your customers account for about 80% of your sales, 20% of a whore's tricks account for 80% of your dirty pleasure, 20% of actual work accounts for 80% of your day, and on ad nauseum. What does any of this have to do with intuition?

Simple. We are wired to filter out only the most salient stimuli around us. When faced with a decision, it is not altogether natural to take into account every possible piece of data and meticulously analyze it in order to find the right course of action. Only economists do that--and as Vilfredo Pareto shows us--even they like to cut the occasional corner. So for all intents and purposes, we make lightning-fast decisions based on clues that we think are important or pertinent to a situation.

For doctors, this means taking careful note of the patient's appearance--whether one is pale, the movement of the eyes and mouth, the timbre of one's voice and how one breathes. As Dr. Groopman puts it, "[Doctors] all develop their hypotheses from a very incomplete body of information...These are called heuristics" (Heuristics being decisions made by "educated guesswork"). Although people would like to believe that physicians possess god-like powers of divination, in reality they are only able to come up with maybe 3 or 4 differential diagnoses upon first meeting you. 5 if they're good.

Why does this matter? For starters, it makes lawyers very happy (20% of whose arguments, by the way, make up 80% of their courtroom BS *coughJohnEdwards*). They can sue doctors if there is any reasonable doubt of an alternative diagnosis (read: must have 100% certainty), and with a few emphatic statements and a little play-acting, it's easy to see why malpractice insurance premiums are so high for specialties like OB/GYN and surgery where the victimized are cute, blubbering babies or your poor gramma. Resulting from all this chaos is the practice of defensive medicine, which drives up health care costs for all. You might not need a CT scan for that stomach pain after all that Tex-Mex and beer, but then again, your appendix could explode. It's just too risky. Better get that $500 scan.

The point of all this is that medicine is not an exact science. As such, we should enact some sort of tort reform that severely limits lawsuits based on misdiagnosis. Physicians are people too, and who's to say that gut intuition is wrong? It's worked on every standardized exam I've taken thus far. And anyway, doctors are aware of the dangers of uncertainty. There is a primal fear of this-- for interns especially.

So let that med student or intern poke the hell out of you. After 20% of the time, 80% of the pain will be gone.