The program that saved me was Atomic Mail Sender, an easy-to-use program coupled with a lot of power. They have a free demo with most of the functions.

If you're in a situation where you need to send lots of customized emails but want more than Microsoft Office's built-in mail merge, then I encourage you to try it out.

A top concern of the premedical student is contemplating his tolerance of the sometimes gruesome process of dissection. Early in the semester we, too, split off into groups of four for each cadaver and nervously peeked within the black body bags, the pale lifeless body covered by a damp cloth. But it's true, one becomes quickly inured to the frankness with which we (respectfully) explore the body.

Dissection is a long process, taking roughly 3-4 hours three days a week over a dozen weeks, resulting in roughly four hundred hours total. Each day's dissection covers a specific part of the body - we might study the rib cage and the lungs one day and the heart another. Slowly we move throughout the body, placing organs in plastic bags and exposing muscles until what remains is a far cry from the intact human at the beginning of the term.

Rembrandt's "The Dissection." Sadly wearing frilled collars was removed from our medical curriculum last year.

Fat is an everpresent barrier, and indeed much of the day is spent digging through preserved globules of fat for items of interests (one of HST's groups had the fortune of dissecting a cadaver with virtually no visible body fat, which incidentally allows them to complete dissections more quickly). I therefore often find myself questioning the utility of dissection as we spend 20 minutes trying to distinguish the glossopharyngeal nerve from the vagus nerve in the neck and ultimately discovering that we nicked the glossopharyngeal earlier. In a three hour dissection, we could have potentially memorized far more than we discovered in the body that day.

Indeed, some medical schools are dispensing with cadaver dissection altogether and moving to an electronic modeling system. Arguably having a three-dimensional representation vividly memorized in one's head is as practically useful as seeing it on an actual body.

Yet there are some moments of profound discovery that redeem every last hour on the dissection. One came early when I cut the connections of the right lung to the body, lifted it out of the body, and held it in my hand, spongy and surprisingly heavy. A perforation of the lining of the lung - from a stab wound, say - would immediately collapse it, preventing air from entering. Bacteria can infiltrate them quite easily and build up fluid in the lungs. Yet it otherwise functions perfectly every normal day, supplying crucial oxygen throughout our bodies, without which we would die within minutes.

Another moment came from dissection of the arm and hand. Consider for a second all the possible motions of each finger. With your fingers outstretched and palm up, you can move your fingers left, right, up, down; curl and uncurl them; and all combinations of these. Think about what a complex task typing on a keyboard is, moving multiple fingers to precise locations in sync over and over again.

Each individual motion of the finger is controlled by a single muscle, such that operation of the hand requires over a dozen muscles. Yet the anatomy of the hand makes perfect sense. By pulling on the specific muscle, I could make each finger move according to the muscle's function. This reminded me of a very complex marionette, with an overseer rapidly pulling strings to make me type an email.

Muscles in the arm and hand control movements of the fingers. This is just the top most layer of the back of your hand.

The overseer is the brain, and when we recently cut out the brain from the cadaver's skull and held it in our hands, I realized that this pale, spongy mass was responsible for our recognition of our existence and all subsequent behaviors. Somewhere in this dense mess, neurons were connected with each other such that we could actually reason theoretically and make extraordinarily complex decisions. Yet you break open the skull or put a bullet through it, and that can all disappear. The brain begins to die irrecoverably from lack of oxygen within 5 minutes.

Dissection and anatomy have taught me a vast body of material that may be practical in the future. But more powerfully, it has also made me appreciate simultaneously the human body's complexity and fragility. I think it is a wonder that such a complex being resulted from gradual improvements from microbes, even if it took a billion years. That a spinal cord the thickness of a quarter can relay messages from the spongy mass of the brain and control millions of processes in the body is still astounding to me.

Knowledge of human anatomy is arguably more important in some specialties - surgery, radiology, pathology - than in others - anesthesiology, medical oncology. But a respect for the body is indispensable in all.

If this is actually produced, I predict the show will be a new favorite amusement of HMS students poking at inaccuracies. This place looks nothing like our school! They don't have enough bags under their eyes! We don't sleep around that much! (as far as I know)

This may be indicative of an oversaturation of medical shows - ER, House, Gray's Anatomy, Private Practice, Scrubs - such that the process of becoming a doctor would actually be appealing. Who wouldn't want to see a version of the venerable Dr. House nervously botch his first patient interview?

I'm interested in seeing how they dramatize what issues they think medical students cope with. I also wonder how much of the medical education they will be able to show - dissection of a human cadaver in anatomy is one of the hallmarks of medical education, but is this even palatable to audiences?

As I've mentioned before, these shows have a responsibility to portray the field accurately as they mold public opinion. Portraying medical students as callous and jaded would almost certainly be detrimental to the patient-doctor relationship.

Some potential plot points:

-Student overwhelmed by the deluge of medical education resorts to Attention Deficit Disorder medications to catch up.

-Student brings emotions into the clinic (e.g. just had a bad breakup) and makes poor decisions.

-Leading to the grand finale when a medical student makes a mistake that costs a patient - or another cast member - his or her life.

By surveying viewers a while after the program, the show found that 60% recalled something about HPV and its risk for cancer, and 12% sought medical expertise directly as a result of the show. With a viewership of 50 million and syndication, Baer reasoned that an episode of ER could effect a tangible change in social behavior, this time regarding a virus and sex.

This is a great example of how the oft-secluded field of medicine can reach broadly to the public through popular media. This also means that there can be devastating effects from misrepresentations of medicine and science. The forensics drama CSI dazzles viewers with promises of DNA evidence pulled from every crime scene, magical clarifications of fuzzy video image. Here are two humorous parodies of the show's out-of-this-world technology.

While captivating, these misleading investigations have had a detrimental effect on evidence consideration in court. Jury members under the eponymous "CSI effect" are harder to please with forensic evidence gathered with realistic limitations.

Medical and scientific advisers to these shows therefore have a great responsibility to report accurately while employing dramatic license to gather an audience. Make the show too saucy and it can have a detrimental effect; make the show too dull and there will be no one to educate.

This picture, taken from this video, shows the heart swinging within the chest as it beats. Needless to say, this is not normal - the heart usually sits still within its cavity, happily pumping away.

This heart has gone wild. Arrows point to portions of the heart that have collapsed (not a good thing). From Kapoor JR, McConnell MV. NEJM 2009 Oct 29; 361(18):e37.

This happens because the chamber within which the heart usually sits - the pericardium - has filled with fluid when it should be snug against the heart. In this case, the space has filled with fluid because the metastatic cancer spread to the pericardium. The heart now has space to swing about as it beats.

When the pericardium fills with enough fluid, it increases pressure against the heart and can disrupt its normal function, leading to cardiac tamponade. In the picture above, you can see that chambers of the heart collapse after beating, a sign of too much pressure against the walls of the heart.

They eventually sucked out 1.6 liters of fluid, about 160x the amount of fluid usually in the space (10 mL).

Other reasons that pericardial effusion can occur include infection (with viruses, bacteria, or parasites) and inflammatory disorders.

Click here for a video of the swinging heart in action. It's well worth the time.

The problem is not that we lack interest in what is being taught, that the lecturer is monotonous, or that our water supplies have been poisoned with opiates. Instead, there simply isn't enough time in the day. When we finish the day at 6PM, having been in class since 8:30AM, the last thing we want to do is hit the books. So with dinner, a TV show, and some dilly-dallying, suddenly it's 8PM. There's the day's material to review, the next day's dissection to prepare for, problem sets to complete, cases to research. Now it's 1AM and time to sleep, but I rarely feel like I have had enough time to enjoy for myself.

A few older medical students warned me that there is simply too much medical knowledge coming in the first year to be able to learn everything. Instead, I would have to be selective and choose what I was most interested in. I was incredulous, as this had never happened before, even with some demanding schedules at Harvard as an undergrad. But it is slowly becoming more apparent.

I should stop whining about this since this is just the very beginning, and clinical rotations and residency should be far worse. But what a toll medical school can have on our daily lives, and how much stronger we will be (maybe in worse health) after we leave.

In several studies, patients who smoked or consumed caffeine daily were significantly less likely to have Parkinson's Disease. Furthermore, increasing the smoking or caffeine dose further decreased the risk.

Of course, this is not to say that one should smoke purely to avoid Parkinson's. But it does raise the question of the mechanism of this effect. Parkinson's is a deficiency in dopamine-producing neurons in the brain. Dopamine is a neurotransmitter that is essential in maintaining reward (which is mainly why smokers become addicted) and muscle movements. Take away dopamine, and you no longer have smooth muscle movements, showing Parkinson's symptoms.

So might it be that overusing the reward circuit has a protective effect on dopamine-producing cells? Or are there other chemicals in smoking that prevent dopamine-producing cells from dying? To find this out, a scientist might investigate whether any other addiction showed decreased risk of Parkinson's. Clarifying interesting mechanisms like this one can lead to new treatments.

This man might not get Parkinson's.

Bonus: I came across this site claiming many more benefits of smoking, some with more dubious data. The organization behind that site wishes to rid government intervention in "personal lifestyle choices" of diet and habits. In the case of smoking, intervention was clearly needed to dampen the effects of secondhand smoke. But it's often  useful to try to understand opposite viewpoints and critically evaluate evidence.

It's been a painful and long illness, and I have two salient thoughts on it:

• People actually want to avoid you. This is somewhat obvious and logical, but it actually made me feel alienated. I would quarantine myself in a corner of the classroom, but other times students would purposefully avoid being around me. This is nothing compared to the stigma HIV/AIDS patients faced in the 1980s/90s, and I am so happy that education has changed much of that, at least in some areas. Experiencing what a patient endures can really make you a more understanding doctor.
• An itchy throat is annoying, the tiny little scratch in the back of the throat that forces you to cough but won't disappear even when you do. I was often in situations when I really did not want to cough repeatedly - in lecture or in public - and could go red in the face just trying to suppress the cough. Fun fact: this itchy sensation is caused by irritation of the mucosal membrane, often when there is insufficient mucus.

I'm glad to be somewhat healthy again, and I hope it doesn't repeat later in the winter.

WIthout any context, this man looks like a doctor. What a powerful symbol the white coat is.

One answer seems to be that the knee-length coat is indicative of a scientific approach to medicine. It had traditionally been used to ward off chemicals in the laboratory. In the 1900s, scientific medicine competed with homeopathy and traditional remedies, but the development of more powerful drugs established the power of science to treat humans. As a result, doctors adopted the white coat as symbolic of the role of science within medicine and to claim legitimacy in their roles.

Alternatively, my TA in anatomy had a bloodier story. In the early days of surgery, there were very few ways to see inside the patient's body to know exactly what to operate on and where other things were. As a result, the surgeons practiced their procedures on dead bodies right before trying their hand at the real patients. The white coats were thus worn to shield the doctor from the dead body's fluids before transitioning to the live patient. I couldn't verify this story, though it certainly is meaty.

Nowadays, there is debate on the appropriateness of the white coat. Some say it can increase infection and is an unnecessary symbol of medical hubris. However, the white coat has become such a clear marker of the doctor that patients are much more likely to trust physicians wearing the white coat.

Personally, I also find its pockets useful to hold pens, electronic devices, and a stethoscope.

Fun fact: Medical students wear shorter white coats that extend to the waist, while doctors with their MD degrees have longer coats extending almost to the knee. Often patients address me as doctor despite my shorter coat, which is giving me far more credit than I deserve.

There's a slight possibility that it's the dreaded H1N1. In April, a few students at Harvard Dental School were verified to have H1N1. The (unverified) story goes that a student's boyfriend had visited Mexico, returned, and the two of them visited parties without showing symptoms. In response the school was shut down for several days.

The H1N1 flu is common enough now that cases do not need to be sent to the Centers for Disease Control (CDC) for verification, but it is still a looming threat in the coming flu season.

In any case, I'm going to take it easy for a while until I recover more.