"I am a Mole." & "Do you read?" Revisited

Sacrifice your life for the grade. Sacrifice your family for the future.

Light. Blinding light. My eyes squint, teary; blurred images -- silhouettes -- shift along a field of white. Months of living below ground in the dark are over, and I poke my head out of the hole. A mole above ground ... for a weekend.

In order to practice medicine in the United States you must pass three licensing exams. The first one, dubbed "Step 1," is taken after your first two years of medical school. This is because the first two years are predominantly class-based basic sciences, and the Step 1 tests student aptitude on these core subjects.

Due to quirks in the US system, the Step 1 exam has become the primary arbitrator of what residency you get, which in turn decides what specialty of medicine you practice for your life.

It's pretty important.

At UT-Houston, second-year classes are year-long, in part because studying for finals helps double as studying for the Step 1. This is when the moles dive DEEP.

My wife and son left for Utah mid-March, and spent a month there with family so I could study unobstructed at home. At the beginning of April I forwent all fun activities. It was total business. From sunup to sundown, studying was the game. My family returned as block exams rolled around, and I took my studying to school. After that came finals. After finals came five weeks of studying strictly for the Step 1.

Every day I'd wake up about 6am, get ready and hit the books by 7am. A friend, Marie, picked me up at 8am, and we studied at the library until 3pm. I had a review class from 3pm until 7:30pm M-F, and after getting home, ate dinner and studied some more until midnight. On the weekends it was the same, except no class in the evening.

Day after day went by. After reading the article that engendered "Do you read?" I started keeping track of the time I spent with my family. Typically, I warmed a bottle for my son when I got up in the morning, and spent 15 minutes feeding him about 7am. Although I saw my wife when I got home about 8pm, I really didn't spend time talking with her. Any "meaningful" time came about 11pm to 1am. Typically for about 1 hour, before I hit the hay.

That is the high pressure life of a second year medical student. Sacrifice your life for the grade. Sacrifice your family for the future. If you don't get two standard deviations above the mean, you can't choose what you do for the rest of your life. Imagine that...wanting to be an engineer, but someone else telling you that you'll be an electrical engineer versus a chemical engineer. That's the state of medicine today.

But now the exam is over. I have poked my head above ground. My wife and I spent four days in Corpus Christi to recuperate. Too bad on Monday I start working 120 hours a week during my General Surgery rotation. Here we go again...

Yo, Washington DC! Uphold the Second Amendment!

[Edited 26 July 2008 -- Absolute % of murders were transposed. Now corrected. The corrected error actually strengthened my argument. Sorry for the inconvenience.]

That, in effect, was what the Supreme Court said today when it ruled 5-4 that Washington D.C.'s sweeping gun ban was unconstitutional.

Two points interested me:

1. Chicago, IL was one of a few cities that have enacted gun bans similarly tough and filed amicus briefs on behalf of the defendant (Washington D.C.). Barack Obama comes from said city, and has made no qualms about his desire to limit gun ownership if he is president.

2. The writer makes the statement

City attorneys urged the high court to intervene [overturn appellate court ruling], warning, "The District of Columbia -- a densely populated urban locality where the violence caused by handguns is well-documented -- will be unable to enforce a law that its elected officials have sensibly concluded saves lives."

There were 143 gun-related murders in Washington last year, compared with 135 in 1976, when the handgun ban was enacted."

An astute commenter asked,

What I want to know is what point is being made by saying this statistic?

There were 143 gun-related murders in Washington last year, compared with 135 in 1976, when the handgun ban was enacted

Okay, so they had roughly the same number of murders 32 years ago before the ban as they did with it last year. Of course lets leave out the part about population change, culture change, increased drug usage, higher poverety (sic). This statisic (sic) doesn't say anything for or against guns, it's just a pointless statistic.

My sentiments at first also. However, after reading the comment, I wondered if his and my assumptions were true.

I won't tackle every variable, but I think the crux of the statistic quoted is population and murders.

Contrary to my belief, the population of Washington D.C. has actually decreased since the 1960s. In 1976, the population was 702,000 (according to these data). 188 total murders and of those, 135 gun-related murders (according to CNN). That's 1 gun-related murder per 5200 people. In 2006, D.C.'s population was about 581,530 and 169 total murders (143 gun-related last year). That's 1 per 4067 people.

So, by banning guns in 1976, gun-related murders increased from 0.0192% of the population to 0.0246% -- an absolute risk increase of 0.0054%. A small increase in murders for banning guns? For denying people a constitutional right?

Wait! Wait, you say. Total murders dropped. Isn't that a good thing? Possibly, except that 72% of murders in 1976 were gun-related and that rose to 85% last year.

In between 1976 and last year, murder rates actually ballooned (to a high of 481 in 1991) and then fell to current levels all while the population steadily declined.

My question is thus: If banning guns is so effective, why did gun-related murders rise during the succeeding 30 years? Why did the percentage of murders that were gun-related increase? Why did murders rise from 188 in 1976 to 481 in 1991 before falling to the current level? What happened in 1991 to reverse the trend?

I think the Supreme Court made the right decision today. Now let's find out what D.C. really did to cut down on crime.