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Episode 148 – Rudi & Quinn
What do you do when you find yourself trying to figure out your next move in life? How does a trek through the jungle in Vietnam prompt you to pursue a career in medicine? Why is it important to have a strategy that works best for you when applying to medical school programs? What is like to do a couple's match into the same residency program?
Today on Talking Admissions and Med Student Life, I interview couple, Rudi and Quinn, both former fourth-year medical students who recently graduated from the University of Utah School of Medicine.
Dr. Chan: What do you do when you find yourself trying to figure out your next move in life? How does a trek through the jungle in Vietnam prompt you to pursue a career in medicine? Why is it important to have a strategy that works best for you when applying to medical school? What's it like to do a couple's match into the same residency program?
Today, on "Talking Admissions and Med Student Life," I interview a couple, Rudi and Quinn, both former fourth-year medical students who recently graduated from here, the University of Utah School of Medicine.
Announcer: Helping you prepare for one of the most rewarding careers in the world, this is "Talking Admissions and Med Student Life," with your host, the Dean of Admissions at the University of Utah School of Medicine, Dr. Benjamin Chan.
Rudi: All right.
Quinn: Here we go.
Dr. Chan: Well, welcome to another edition of "Talking Admissions and Med Student Life." I've got two great guests today, Rudi and Quinn. How are you guys doing?
Quinn: Doing well. You know, COVID life, doing what we can.
Dr. Chan: Yeah. Fourth-year med students, who recently matched, and don't say where you matched just yet. We're going to do a reveal at the end, all right? But I want to go back to the beginning, and let's start with Rudi. So, Rudi, when did you decide to become a doctor? Was it one moment, was it a string of moments, and how old were you and what did that look like?
Rudi: I am a person who has many ideas going at once. Actually, graduating high school, I was like, "Oh man, what should I do? What should I do in life?" And I was able to shadow a general surgeon during my last year of high school, and I was like, "Oh, this is really neat, but I don't know. Do I want to be a teacher? Do I want to be a lawyer? Do I want to be a chemist?" Because I really liked my chemistry classes.
So my first year of undergrad at the University of Utah, I took this careers exploration class that pretty much you could try out all these different careers from bankers, lawyers, business people. I was able to also shadow another physician in a primary care specialty. And I just noticed that every time I was in a medical setting, I was interested. There were fun stories to listen to. I really didn't know what was going on, so that was also something that was particularly interesting for me.
It spoke to me more than most of the other careers, so I was like, "I think I should embark on this mission to become a physician and go to medical school." But I also knew that I had a lot of other interests. So, in undergrad, I think I did a million different clubs, tried many different coats on, and ultimately, I just really enjoyed the medical field.
I was able to volunteer at Primary Children's, both as a music volunteer as well as interacting with children. And that reinforced that I just really enjoyed the patient contact, a bit different from bench work that was in my chemistry undergrad.
So it was pretty immediate. I had thankfully early insight into what I wanted to do. Yeah, I don't really have an interesting of "I did this and this and this," but I just tried a whole bunch of different coats on and the physician cap worked the best for me.
Dr. Chan: That's great, Rudi. How about you, Quinn? How did you come to decide to become a doctor?
Quinn: I was a career changer.
Dr. Chan: Yeah. I'm pretty sure you have a different path than Rudi. I'm nearly positive about that.
Quinn: A little bit. Yeah, where do we start? I didn't know what I wanted to do. I found out that my high school German credits were going to count for a lot of saved time and money, so why not? So I studied German.
Well, that same mentality kind of led to actually a bachelor's degree. But I found myself kind of in the same boat. I didn't know what I wanted to do. So I worked a little bit, retail and then management for . . . well, actually, I guess I should pause there. I ended up going around the world for a bit. I lived in Thailand for four years, and that led to an MBA.
Dr. Chan: What were you doing in Thailand? You just kind of brushed through that. What was it . . . four years in Thailand is a lot.
Quinn: So it was four years. I like to divide it into . . . there's a first year of just exploration and travel throughout Southeast Asia, and then the second year was an MBA because, honestly, I started to feel the pressure from family and kind of like, "All right. Great. What are you doing over there? Hey?" And obviously, I liked school a lot, so I was kind of missing that learning environment.
So I entered into a Thai MBA program, but then finished it as a Thai exchange student back here at Duke. So it was kind of fun, flying incognito. I fell in love with finance. I loved it a lot. I took every finance class my university offered and completed the MBA and then went back to Thailand for that fourth year, where a lot of my friends were getting married. There was just a lot that I had on my bucket list to do. One was Vietnam, for example, Myanmar, that kind of thing.
So that sort of ties into the aha moment because right about then, I had been sending out applications for management consulting positions, and I had a job offer out of Kuala Lumpur. And I was all set up to do it. I was pretty stoked. Wasn't really sold on it though. I guess you could say my heart wasn't into it. This was something that all my peers were doing. They're going to Microsoft, Google, like all the big names.
I solidified this position, and I was traveling in Vietnam, and I had this . . . traveling leads to some unique experiences. And I had this guide, who we're going through the jungles of Vietnam, and she basically . . . she hurt her toe essentially is what happened. We had bonded, so she knew my life story, and she knew I had all this education. And then at that point, she thought, "Well, okay, if someone can help me, it's going to be this guy who went to school for so long."
And so she came up to me and said, "Hey, Quinn, I really need your help with this. What do you think is wrong? What can I do?" And that's sort of when I had the . . . I guess you call it an aha moment. Yes, I love business. Yes, I love finance. I love numbers. I love math, but kind of the impression I wanted to leave was more of a direct personal, more of a one-on-one helping the environment, instead of a really laid back, balancing spreadsheets, and PowerPoint presentations, and things.
So that's where I kind of had the, "Oh my gosh. Wow. I don't regret anything that I did, but this is, I realize now, only a very small piece of the puzzle that I'm putting together."
Dr. Chan: Wow. So much more circuitous route through the jungles of Vietnam and Thailand. I can't get the sense . . . did you own a factory over there? I don't know how this business part . . . like, were you an entrepreneur or what did you exactly do? Quinn, were you CIA? Were you a secret government infiltration kind of thing?
Quinn: I can't really comment on that. I did make multiple trips to the U.S. Embassy. We can say that.
Dr. Chan: All right. That starts to clear it up some more.
Quinn: Right. I know it's murky. It's intentionally murky. I'm sorry. Yeah, my superiors don't allow me to elucidate that anymore.
Dr. Chan: This explains a lot, Quinn. All right. So jumping forward in time, when you both started applying to med school, what was your strategy? How many schools did you apply to? Where did you look at? What was your strategy going into the med school application process?
Rudi: For me, the med school application process is actually something that was a bit undefined and defined itself as I went. I knew you had to take the MCAT and I was like, "Oh, man, I hate taking tests." And so I got that over with. And then I actually looked at the application, and I'm like, "Oh, wow. This is a lot more than the MCAT."
So, for places to apply, I really wanted to stay close to my family. My parents are in North Ogden, Utah, so Utah was one of my first choices, but I wanted to also just apply broadly to places that I thought were within my benchmark. So I think I ended up applying to 10 to 15 schools. Not as many as most people.
And then in terms of the application, I heard just through the grapevine that you should present yourself as best you can with as diverse of experience as you could. I thankfully had a passion for doing multiple things, from volunteer work to leadership. And so I dug through my resume and was like, "Okay, these are fitting within the app."
And then for the personal statement, I actually recited it to my friend, and she wrote it down because I noticed that when I spoke, it was a lot easier for me than writing things down to get the thoughts I wanted out.
Dr. Chan: Rudi, what kinds of activities were you doing that were kind of unique and different?
Rudi: One, I was on the MUSS board leadership, which is the Mighty Utah Student Section for sports, because I loved sports.
Another thing, we have a wonderful thing at the University of Utah called the Bennion Center, and I absolutely love that center. It's involved with multiple volunteer opportunities. And one you can do is you can start up a volunteer sustainable project, and mine was with an elementary school in West Valley that was focused at maintaining childhood fitness and getting kind of the lower socioeconomic status schools involved in a sustainable way that they can stay fit and healthy in an after-school program. Because many of them there, they sit at school for like a couple hours while their parents finish up work, and I thought that was a wonderful opportunity to kind of get people involved.
Another is . . . there were just a bunch of random things. I really liked University Housing. I was involved as an RA, as a programming assistant working at alternative solutions to alcohol-related activities, more of safe activities to prevent binge drinking, and just anything on campus. I think I signed up for pretty much anything.
Dr. Chan: That's awesome, Rudi. That's awesome. Quinn, how about you? What was your strategy in the application process? What did you do?
Quinn: So it all started . . . taking it back to Vietnam, I ran into a U.S. physician there, and this was just after I'd had this aha moment. And he said, "Oh, interesting. You're thinking about it?" I said, "Yeah. What do I have to do?" He's like, "Oh, well, you have to take this test." "What's that called?" "It's called the MCAT." "Oh, is it hard?" "Oh, just study for it. It's [inaudible 00:11:57]"
Dr. Chan: "Is it hard?"
Quinn: He's like, "No. I mean, this is one you need to study for, but no. Your pre-med classes prepare you well." "Oh, okay."
So fast forward, came to Utah. I took the old MCAT actually, and then wasn't quite satisfied with my score so I wanted to retake it. But that was when we shifted to the new version of the MCAT. So I actually studied for both and took both. That was not fun. That was a really bad time.
But what I did after that, so as far as schools I applied to, for me money was a little bit of a problem. As you can imagine, life in Thailand for four years leads to . . . it doesn't build the bank account so much. So I was really balancing my own little formula, kind of similar to residency choices actually. So cost of living, first of all, of course, and then a name. Nothing ridiculous, but I wanted to be able to have options moving forward, so trying to balance name with cost of living, and then, of course, what can I do outside of med school.
And I happened to have some friends who lived here in Salt Lake, so that was a huge in as far as cost and who I could live with. I had a small friends network here already, so I actually live with three guys I already knew.
So once I sort of ran that formula, Utah came out on top really as far as all the pros. I mean, it maybe didn't knock out any one category, but when you combine them all, it was sort of the clear choice.
But then as far as activities, everything I did was guided by Mayumi in the pre-med advising office. It was fantastic. So I went into her. When I first got here, I went into her and said, "Mayumi, hi, I'm Quinn. Nice to meet you. I'm going to apply to med school in one year." And she said, "Hi, I'm Mayumi. No you're not."
Dr. Chan: That sounds like Mayumi.
Quinn: So I kind of had my eyes opened. She's like, "I'll show you why and you'll understand." And she was right. That is absolutely not what I did at all. I took the other route. I went most thorough. So I ended up doing a second bachelor's because I was really close to a B.S. in Biology by the end of it. So I just went really thorough with my pre-meds. I didn't want to get to med school and not have seen anything that wasn't specifically, like, medical curriculum. And that really helped. I mean, I had immunology. I had the upper-level genetics. I had all that stuff, so it did definitely help.
And then as far as activities go, I don't know why, I always was drawn to the ED. So I had heard, just through the grapevine at The U, the pre-med kind of culture, that the ED was a fun place to volunteer. So I decided to jump on that. Everyone loves the kids' activities. To be honest, I'm an only child. I don't have a lot of exposure there, so I knew I'd be a little more uncomfortable in that environment, and I wanted to do something I enjoyed.
So I was able to get into the ED, and yeah, I loved it. I thought it was great because you have . . . well, first of all, you can see everything that's going on. So you can see the level one traumas come in. You can see how physicians interact with patients. You can see how residents interact. You can see how physicians interact with residents.
You get the chance to actually talk to families, and it's not just talking to them. And this isn't coming up for diabetes checkup. This is the ED. So obviously, they're not happy to be here. They're really stressed out. They're really worried about it. So it was a really, really fun, high energy, in a way demanding . . . I mean, it ebbs and flows, but when it's busy, it's really busy. And I really enjoyed that environment.
So that was my primary volunteering, but then shadowing . . . I had no idea what I wanted to do, so I tried to be as [inaudible 00:16:20], but just due to some family circumstances, oncology had kind of a . . . I don't know, I would say it was close to my heart, but it's not. My mom passed from a cancer diagnosis. So I think it was familiar. I had dealt with oncologists before, and I had been the person receiving the bad news and not having an optimistic outlook, and that was actually really, in a strange way, familiar territory for me.
So I shadowed a bunch at the Huntsman Cancer Center, and that was really rewarding. I stuck with one physician, I didn't want to bounce around, and it was great.
Kind of like you learn in med school, when you work with one preceptor or one attending, it's excellent because their teaching can build on itself. They already know what they taught you. They already know where you stand. They know your history. I definitely support the diverse approach. I definitely think that's recommended. But what I really did was just kind of went wild with this one physician, put a bunch of hours in.
Dr. Chan: Quinn, that's great. Does Rudi know the Pep Boys story? Are we ready to talk about that now, Quinn, four years later?
Quinn: Yeah. We can definitely talk about that. I was so shocked. I had absolutely no idea what was going on.
Dr. Chan: Let me go first. Let me tell my perspective, all right? So people might not know this, but I actually don't live in my office. I go out in the community because I have a life. I had some issue with my car, and I remember I had to go to Pep Boys, the auto parts store. I think it was a battery issue or something.
I remember standing in line, and all these other people around, and then all I hear is like, "Dr. Chan," and I'm going, "Oh, boy." Then I see the Quinn right there, and you just start talking to me, and I was just . . . I think I remembered your name. I can't remember how it went. But I think I just mentioned Duke or something. I think it blew your brain that I remembered a detail about you.
I don't know if you had been accepted at that point. I felt it was a really strange interaction. And I just remember I walked away going, "That was like the most memorable Pep Boys visit I've ever had."
Quinn, what was your perspective? How do you remember that story? I always associate you with Pep Boys. Every time I drive by that place, I just think of you hanging out there.
Quinn: Well, actually, it's interesting because I also associate you with Pep Boys.
Dr. Chan: Oh, boy. Yeah.
Quinn: You're right. It blew my mind. I mean, you were a little humble. So I also had car issues. Like I said, saving money, so Pep Boys knew me pretty well. I happened to live not too far from there, by Nibley golf course. Yeah, I was a frequenter of Pep Boys, but I have not seen Dr. Chan there too often.
So I was doing my thing. I was in line. And you're right, I had not been accepted yet. This was kind of post-interview, that awkward time where you really don't get a lot of feedback, but you're crossing your fingers. You're not sure what's going to happen.
Then all of a sudden, I saw Dr. Chan. So like you said, "Hey, Dr. Chan. Hi." And you did not remember one detail. You remembered basically my whole file, which was wild. So you kind of said, "Oh, yeah. Quinn from Green Bay. Yeah, time in Thailand. Oh, Duke, MBA." I was like, "Oh my gosh. I don't want to read into anything."
Dr. Chan: I was your handler. I was your intelligence officer who just knew your file.
Quinn: And that's what you said later. You said, "Well, actually, in the meeting, we had just reviewed you relatively recently, which is why I knew," but of course, I had no idea that any of that was going on. I was just absolutely mind blown. All I wanted was a sign, just a small sign, like maybe someone from the admissions committee could give me a wink in the hallway or something. And then I had "the" Dr. Chan telling me the whole thing. I was like, "Oh my gosh. This is so . . ."
Dr. Chan: Quinn, are you ready to know the truth right now?
Quinn: Yeah.
Dr. Chan: Rudi was also in that store that night and watched us and that planted the seed.
Quinn: No. No way.
Dr. Chan: Yeah, I know. It's just . . .
Quinn: [inaudible 00:20:41].
Dr. Chan: I know. She was near the back, kind of . . . yeah. She was just watching this unfold.
Quinn: Oh my gosh. This is absolutely crazy.
Dr. Chan: I know. The truth comes out. So in all seriousness, I want to hear the story. How'd you guys meet? Was it orientation week? Was it anatomy lab around the table kind of thing? Let's hear it. Let's have Rudi go first. I want to hear the different perspectives because it rarely matches up. I want to hear Rudi's version.
Rudi: We actually owe it to our classmate, Scott. So I had received that wonderful phone call from you in the beginning of January of . . . oh, what year was that? 2016. Scott was also applying and he had not heard yet. So it was kind of this awkward tension. And he was like, "Oh, one of my buddies also got in. I should introduce you. Oh, actually, you'll get along really well because you both have Wisconsin background. So, yeah, I should introduce you sometime." Well, we walked out of the mutual class we had and little did I know, Quinn was outside. They had an anatomy test that day.
Quinn: There was light streaming down. Her hair was blowing in the wind. It was really nice.
Dr. Chan: Wait, so you guys met before med school? I thought I was somehow more involved in this matchmaking thing.
Rudi: I thought he was extremely stressed and not a person I would like hanging around because I think he looked at me maybe for, like, a second and then started talking to Scott about the anatomy test that was coming up. I was like, "Oh, boy, this is what my class is going to be like? What did I get myself into?" And that was the uneventful first meeting.
Quinn: [inaudible 00:22:29]?
Rudi: Well, that was second look day.
Quinn: Oh, wow. Well, Dr. Chan, we should amend your question then.
Rudi: So that was the first meeting, but I think the first conversation we had was actually at second look day.
Dr. Chan: I like this. I like this more. Keep on going.
Rudi: Yeah, so there was a group of us University of Utah students who kind of grouped together because you look for people who have commonalities. So it was Scott, the friend who introduced us, and then it was also Snehal, another one of our classmates, and we were eating our CafÈ Rio lunch in a very talkative room and it was just us four eating.
I have a Green Bay Packer phone case because I just love and bleed the Green Bay Packers. So I set it on the table and I saw Quinn laugh. I was like, "What's he laughing at my phone case?" And Scott was like, "Oh, yeah. Rudi, did you know Quinn's from Wisconsin?" I was like, "I think you had mentioned it, but not . . . oh, where are you from?" And Quinn's like, "Well, actually, I'm from Green Bay." I'm like, "Oh my gosh, do you love the Green Bay Packers?" And he's like, "They're okay." Oh, my goodness. I was like, "How are you from Green Bay and you don't love the Green Bay Packers?" So he impressed me twice on meeting.
Dr. Chan: All right. So it sounds like this doesn't have a good trajectory at the beginning. Quinn, do you want to defend yourself? Do you remember any of this?
Quinn: I'd like to start with the end and then work towards the beginning.
Dr. Chan: Sure, you can be a surgeon. Go for it.
Quinn: I think, as you know, Dr. Chan, a lot of it was tone and inflection. There can be the same words said but a very different meaning portrayed depending on how you say them.
Dr. Chan: Very poetic of you. Go on.
Quinn: I think that more along the lines of what I said about the Packers was, "Yeah, they're okay." And it was an optimistic, high inflection on the end, like, "Yeah, let's talk about this more." I mean, even my delivery right there, I think, was a little subpar. Bu I don't think it was as bad as she lets on.
So I was saying, "Yeah, yeah, yeah." The reason is because if you are from Green Bay, Wisconsin, you have the most . . . I mean, they're probably diagnosable. I don't even know. This is not my realm any longer. But wild, wild, wild fans. I mean, absolutely . . .
Dr. Chan: Yeah, cheese heads, the cheese curds, kind of some unhealthy living stuff going on there. Yeah.
Quinn: Absolutely. We're talking middle of winter and you might just have some Packers boxers on with a bunch of body paint, and this is Wisconsin winter keep in mind. So, to me, saying, "Yeah, they're okay," I guess in perspective relative here, I'm a raging fan to every other team. But for the Green Bay Packers, I'm pretty mild I think. So I just had to defend myself due to my roots.
But going back, she was absolutely right. I was in advanced anatomy. I was with Scott. Scott's the boy savant genius man, who could just look at a chart and be like, "Oh, yeah, dude, no worries. Yeah, it's totally these 10 nerves that I've never heard before, but now I can correctly identify and trace them through the human body." He's one of the most frustrating men to study with that I've ever encountered.
So I was with Scott. Scott was basically my advanced anatomy tutor throughout the course, although we were taking it together. Yeah, we did have an exam coming up and I was very stressed for exams. Unfortunately, that hasn't changed. That still happens.
Dr. Chan: It only gets better.
Quinn: Right. Exactly.
Dr. Chan: It just costs a lot more money. Yeah.
Quinn: They do. Oh my gosh, you have to pay for them. And that's when I met Rudi. So admittedly, I probably wasn't performing the best or focusing my attention where it should have been. But yeah, for the most part, given the Packers story and then . . . the first look was better. I don't think I had an exam coming up because I actually remember socializing and remember talking . . . wait.
Rudi: Second look.
Quinn: Did I say first look?
Rudi: Yeah.
Quinn: Oh, I guess that's the application process. First look would be the application process.
Dr. Chan: Very Freudian. All right. So did you to start dating before med school even started? I mean, when did you get together exactly?
Rudi: No. The summer before med school started, I actually was in Italy being a nanny and I kind of cut off contact from the U.S. So I think our relationship bloomed in the middle of Foundations.
Quinn: As I was sinking.
Rudi: So Quinn was always a class goer. I'm a class goer. So a plug out there: Go to class. You'll meet wonderful people that you might end up dating. But he became more and more stressed as the semester went on and his hair became more frazzled, and there was a day where . . . he always wears button-ups and his button-up was off by one button, so the collar was uneven and the buttons were all off. And Scott, our friend, again was like, "Rudi, you've got to help him out." I was like, "Why do I have to help him out?"
Dr. Chan: So I didn't realize Scott was such a key figure in this saga. So was Scott really trying to get you two together?
Rudi: I should ask him.
Dr. Chan: Or is he just really worried about Quinn's hygiene, or what was going on?
Rudi: He was worried about Quinn's mental status.
Quinn: Yeah, I think he was worried because he saw me in advanced anatomy and he was like, "Oh, you'll pull through this," and then he probably saw me in med school and said, "Wow, his buttons have never been off like this."
I was bad. Apparently, I was starting conversations and walking away and not completing them. This was dark times. That's when you need friends to rely on, and I think Scott wanted to make sure I was okay and thought this was a great opportunity for Rudi and I to get to know each other better.
Rudi: Yeah. So Scott and I sat next to him during one lecture. Usually, he's in the front row, and I was never a front-row sitter. So I was like, "Oh, man, this is really uncomfortable." So I looked over at Quinn, and he was scribbling every word that was on the PowerPoints. Mind you, we get the PowerPoints. You don't actually have to write them all out again. But Quinn decided he was. I was like, "Man, that looks really stressful."
And then he looked over at me and saw I was making flashcards because that is the save-all grace in medical school. And he was like, "What are you doing? How are you doing that?" I think after the lecture we started studying together, and I showed him that flashcards are a great tool and that maybe copying all the lecture slides may have worked in undergrad, but we are drinking from a fire hose.
Quinn: Yeah. We did a little show and tell basically, like, "I'll show you how I study and then you show me how you study." And unequivocally, she had the superior method of study.
Dr. Chan: That's a good cost-benefit analysis, Quinn. The MBA paid off right there in that moment.
So I know when I've talked to other students, there seems to be this weird coda or weird kind of feeling that if people date each other in the class, you kind of keep it on the down low for as long as you can. Were you pretty open, or how did that kind of . . . or because Scott was just kind of silently engineering all this, it was kind of well-known? When did you guys become public and when did your classmates know?
Rudi: So I absolutely [inaudible 00:30:46] don't let your classmates know mainly because I was like, "That would be weird if my friends all of a sudden started dating." So I don't think we ever went public. I think we just randomly started telling people. I think it was even second year. We started dating a week before our Foundations exam, which ended up being the most memorable exam of my lifetime.
Quinn: The final exam.
Rudi: We had just started dating. You're assigned seats for the final exam, and we were put right next to each other.
Quinn: Like, across the aisle. It was awful. I was totally aware of every move she was making while I'm trying not to fail out of Foundations.
Rudi: Yeah, with the nerves of the exam.
Dr. Chan: But you were worried because you weren't sure if this relationship was . . . you're kind of in that iffy stage, or why were you so concerned about sitting next to each other?
Rudi: I think I . . .
Quinn: I don't think I was concerned. I was actually probably thrilled.
Rudi: Yeah, I think we were both excited.
Quinn: It was just . . .
Dr. Chan: Oh, okay.
Quinn: . . . like a distraction I wasn't able to overcome, if you know what I mean.
Dr. Chan: Oh, okay. So you're in that exciting stage of your relationship.
Quinn: Yeah. Exactly.
Dr. Chan: You're three feet from them and you're just like staring at them and . . .
Rudi: Yeah. Exactly.
Dr. Chan: Okay. All right.
Rudi: There are hearts hovering above them and . . .
Dr. Chan: I hear you. I get you. All right. I love it. So jumping forward, to kind of focus back on more med school, Rudi, what were you thinking of becoming before med school started, and then how did third-year impact your decision, and what did you end up choosing?
Rudi: Oh my god. This is like the most beautiful question ever. So I went into medical school because I wanted to be a general surgeon. I thought that was my destiny mainly because the mentor when I was a pre-med was a general surgeon. He was just one of the most wonderful individual I had met. He said, basically, if you love what you do, you shouldn't have to work a day in your life. And he gauged that on how many times you look at the clock. So he said, "If you're always looking at the clock, that's probably not what you want to go into." And whenever I would shadow him, I'm like, "I never looked at the clock, so obviously I want to be a general surgeon."
And then third year hit. Up to general surgery, I loved every rotation. I started with OB/GYN. I was like, "Man, maybe I should do OB/GYN." I did peds. I'm not a kid person, and I absolutely loved peds. And then I did some electives that I also loved. And then I hit general surgery and it was such a letdown for me, Dr. Chan. I wanted . . .
Dr. Chan: What happened?
Rudi: I noticed that I hated how the patient was under for so long. I wanted to hear their story. I was like, "Why do they have that tattoo? What is their life story? Why are they actually here? I mean, I know we're taking out a part of their colon, but what was it that led to that?" And it went extremely slow. The OR, it's a beautiful place, but I was like, "We have been preparing to cut this person for the past two hours. When does the preparing end?" So it did not fit the Rudi mold.
And another thing, they say, "Find your people," and I just . . . the friends who were going to general surgery, I absolutely love them, but I don't think these are people who I want to work beside my entire life.
So I left general surgery borderline depressed. I didn't know what I was doing. I was like, "Why am I in medical school? I was supposed to be a surgeon and now I'm not."
And then I went to the wonderful rotation of psychiatry, where you talk a lot about what your purpose is, or how you're feeling, and how the rotation is going. And I think it was a great time to have some self-reflection on "What do I actually want to do? Where are my people? What are the people I want to serve? What is the patient population that I really want to work with?"
So I made a mini career exploration for myself and would shadow different specialties. And the one that I kind of did towards the end was emergency medicine. I remember going in there. I went in to shadow a physician at 8:00 a.m., and I didn't leave I don't think until 8:00 p.m. I just loved it so much. And that was the time that the clock did not matter. I got to see patients from people who were disadvantaged in life to people who had advantages, and they were all there for acute immediate problems that they did not know how to solve.
I just loved the jellybean bag, if you will, that there were all these different flavors. And I personally loved that I could not turn anybody away. You come to emergency room, you will be seen. And that just really spoke to even what I was doing an undergrad where I just really loved working with every patient population.
So that's really where . . . third year is so wonderful because it's like, "Oh, what do I want to do?" But when you find it, it's this beautiful aha moment, and that was what the emergency room was for me.
Dr. Chan: I love it. Yeah, you didn't look at the clock. I remember . . . so I did a psychiatry residency, but as part of my psyche residency, your intern year, I did a rotation in emergency medicine. Yeah, you go in and then I just remember a few hours later, like, "Oh, yeah, I need to eat and actually use the restroom." You had to find time to just do those basic because you just . . . literally, there are 20 rooms and there are all these people, nurses trying to track you down. Time goes by very, very quickly I remember. So I like what you said. It's about not noticing that the clock is there.
Quinn, how about you? What's your path? What were you thinking about before school started, and when did you end up deciding because of third year?
Quinn: So going into it, I didn't really have an idea. By going in, I mean med school. So I wasn't really sure. I don't know. I kind of had a . . . it was like a quest to prove myself and to choose something prestigious and kind of colloquially understood as difficult. I wasn't entirely sure. I thought general surgery.
So I started med school, started studying, decided to button my shirt differently, that kind of thing. As that progressed. I thought, "You know what? This surgery thing could work." But I was cautious because I worked in the OB/GYN department for a year before med school, and one of my mentors there, my boss/mentor, she would almost yell at me if I ever tried to figure out what specialty I was. She'd be like, "No. Absolutely not. I don't want to hear you talk like that. You'll figure it out third year. This is not something for you to stress about."
And generally, I think that could work, but for me not thinking about is actually more stressful. So this is something I was just always chewing on, wasn't really sure, probably general surgery. It's what I was thinking about, but I kind of had this cognitive dissonance. It just didn't fit right. I wanted that prestige in saying, "Oh, I'm a surgeon." But I already knew that's not the lifestyle I wanted.
So, in my head, it was kind of almost like a sad road of reckoning of, "Okay. Well, I guess I'll just work 80 hours a week for the rest of my life." It wasn't really a happy thought, like, "Yes, that's what I want to be, but no, that's not at all the lifestyle I want whatsoever. But that's okay because, ultimately, this is what I want to be."
So fast-forward to third year. I started with OB/GYN and the GYN part wasn't too interesting to me, which is more OR-oriented, but OB was so fun. I absolutely loved it. It was a party. I love the experience of being there with the parents in that moment. Like I said, no siblings, so this was all new to me. I mean, OB, I looked forward to those shifts. Got destroyed on rounds, but that's fine. It was really, really a fun time, positive energy. I was considering OB for a while, but then the GYN part, the OR part.
I moved on to family med, which was great, but then I found . . . we had one urgent care day a week, and I found myself looking forward to the urgent care day more than just the regular kind of day in, day out family medicine rotation. So I kind of liked OB/GYN, I kind of liked family med, but only aspects of both of them.
And then I hit psych and, oh my goodness, that was the hard part. For months, I thought I was going to do psych. I absolutely loved it. I loved going there. I guess Rudi can tell you. She's never seen me so engaged in my patients. I'd be looking them up when I got home. Overnight, I'd be looking them up before I even went in just to see what happened. Like, "Oh my gosh, someone threw a tray at a nurse. That's not good. I'm going to have to go ask them about that tomorrow. Wow. Okay. Yeah," and, "Hey, what happened about that tray?" "Oh, yeah, you saw the note, huh?" So it was really fun. Really, really, really tough.
And then I hit general surgery. And the first day, "What are you going to be?" "I'm going to be a general surgeon." "Okay, great." And pretty much by the end of the first day, I knew that was no longer what I wanted to be.
Dr. Chan: It sounds like a Rudi experience.
Quinn: Yeah. I mean, it's so hard because I'm trying to . . . I really don't mean to sound like I'm not grateful for the training because of course I am. And I'm definitely grateful for opening my eyes and pointing me to the direction I ultimately went on. But it was a cataclysmic just horrible experience everywhere. It just was not for me at all. It was a terrible fit. The learning style didn't fit.
Rudi: Pace.
Quinn: Right. The pace didn't fit. I'm in the OR, and I really quickly found out . . . for a whole procedure, I had the best experience down in St. George. It was fantastic. The two weeks were amazing. The autonomy there . . . there were no residents at the time, so it was just me basically as first assist to an attending with an incredibly capable PA, and that's it. That's your team.
And I found out, even in that best-case scenario, I really was only interested when things were going wrong. For example, all of a sudden I got splattered by blood. Like, "Wow, that's interesting. What's going on? You have my attention." But even then, as soon as that was managed, I just very quickly lost interest and it just wasn't a good fit, like I said, overall.
So, kind of like Rudi, I didn't really know what I wanted to do. Continued third year and just sort of went through the . . . I don't know. Went through the rotations and nothing was really working. There were aspects of everything.
Going into med school, because I volunteered in the ED, I had a little bit of exposure to emergency med, and I just said, "The one thing I don't want to do really here is emergency med. I don't want to have my schedule messed up. I don't want to not have a 9-to-5. I'd like some normalcy in my life." And near that end of third year, that kind of changed.
I took a little time for Step 1, which meant that I actually had to kick my peds rotation to fourth year. And then I took my typically four-year sub-i third year. So at the end of my third year, I was in my emergency med sub-i because basically I had deduced that there's nothing else.
I had exposure, my Vietnam connection, and then going forward, my volunteering. And I actually had CMC. That's our clinical skills course where we learn basically . . . I mean, initially we're pretending to be doctors, but we learn the physical exam skills. My preceptor was an emergency med physician. So looking back, I actually had quite a bit of exposure to emergency medicine, and it felt right.
The only thing that wasn't settling for me was the schedule. Everything else was great. So I decided, "Let's just do this sub-i. It is what I'm most interested in now. This is kind of where I think I'm going." And a lot of it came from my mentor, my CMC preceptor, of just seeing his lifestyle, asking him what he is. He's in academics, but he's not in the ED all of his shifts. He has multiple hats. That's definitely what I want to do, different degrees. So this was what I could see myself doing the most
Did the sub-i, and kind of the opposite of surgery. From day one, I knew I loved it. I love the high . . . I am pretty easily . . . I wouldn't say distracted, but I'm very easily bored. I lose interest in something very quickly. And EM absolutely held that interest. I mean, I don't think I've ever been bored in the ED.
I just love kind of the wild aspects I sort of hinted on with the volunteering experiences. You don't know when a level one trauma is going to be called in. You don't know what's coming through the door, and that's what was so fun.
And through volunteering, I learned that you can have an incredibly meaningful connection with a patient in a very short amount of time. So oftentimes it's said you don't get to know your patients longitudinally, and I feel that's completely false. Yeah, it's not longitudinal, sure, but you can have such a rich connection with your patients because you're seeing them in such a time of crisis. So I absolutely love that.
I love the fact that I'm not turning anyone away. I love the fact that I'm not getting flack for sending a test because I'm genuinely concerned about something. Really, I love all those components to it. And ultimately, it fit with my lifestyle. I mean, I love traveling. I want to be able to do that. I love being able to manipulate my schedule.
And then actually, to come full circle, one of my favorite things about EM now is the spontaneous aspect of the schedule. I love so much literally not knowing when I work the next time I work. It just helps me not be bored. Like, "Oh, wow. Okay, I go in at 6:00 p.m. Interesting. Well, I better prepare for that."
Dr. Chan: So both of you chose, kind of for similar reasons but different reasons too, emergency medicine.
Quinn: That's correct.
Rudi: Yes.
Dr. Chan: So I guess the last part, let's talk about the match. What was your strategy as a couple's match going into the same field? I mean, what did that look like? Was one of you in charge of the notes, the database, or was it more a gut feeling? Would you try to do combined interviews, or were you up front with people and say, "Hey, that person over there, we're together"? How did you navigate that trying to go into the same program?
Rudi: So when we first decided that we both wanted the same specialty, I was like, "Oh, I haven't heard of many people doing this."
Dr. Chan: You got it, Rudi. Correct. Honors for you. This is great. Yeah.
Rudi: What I do is when I don't know something, I am one who searches the internet in every corner to look for solutions. So I was able to find some people who did internal medicine/internal medicine, and then I was also able to find family medicine/family medicine. But I actually couldn't find any stories online about emergency medicine/emergency medicine.
So we both had the same mentor, Dr. Fix. She was extremely helpful. And she was like, "Okay, this is going a bit shooting from the hip, but we're going to have to apply broadly," meaning many programs across many states. And then in emergency medicine, you do away rotations, so she's like, "Those are going to have to be also casted broadly across the geography of United States." And so we're like, "Okay, we can do that."
So I did two away rotations, one at University of Wisconsin Madison and the other one at Maryland. And then Quinn did one at Pittsburgh. We also had to do one at Utah, so we thought that was more of the western region. And then we had the Midwest with Wisconsin, and then more of the Northeast with Pittsburgh, and then more of the East with Maryland. Neither of us really wanted the South, so we were like, "We're okay not doing a rotation there."
But we did our aways broadly. And then when we applied, we looked at the list of places to go and said, "We'd like to go here. We wouldn't like to go here." And we did that based off some reputation, some off of where family is. We're very familiar with the Midwest. And then some off of just word of mouth of like, "Oh, we heard this program is great," or, "This one is super hard to get into. It'd be shooting for you."
Dr. Chan: So a couple of questions pop into my mind. First, I know there are some four-year programs, but most ER programs are now three. And I assume you guys targeted the three-year programs, correct?
Quinn: A couple of four years snuck in there, but for the most part, that's absolutely correct.
Rudi: Both of us really want to continue our education and go on to a fellowship. And it was hard for us to deal with training for five years versus four years with a fellowship included, and both of us both felt that three years is kind of where we fit. That felt most comfortable to us. So, yeah, we were like, "Let's look for three years," and then my excitement ran away with me and some four years snuck in there.
Dr. Chan: And the hard part about the couple's match from what I can tell, I did not go through the couple's match myself, is that inevitably your application to residency is tied or yoked to another person's.
Dr. Chan: And it is rare in the world of med school, and admissions, and everything else that two applications are exactly the same. So there's usually one application, for better or for worse, that's a little stronger than the other person, and sometimes you can start seeing the interview offers kind of go more towards one person or the other. Did that start happening with you guys, and how did you navigate that as a couple?
Quinn: Rudi, she was the one with all the interview offers. So it was tough. I mean, honestly, psychologically, it was a little hard on me, until I started looking at how many interviews I had relative to other EM applicants, and then I felt good about myself.
She definitely had more. A great example is University of Washington. I really wanted to go to Seattle, and that was one where I didn't even get an offer. I didn't get an interview invite at all and she absolutely did. So that's when it came up that not only is it a good school, not only is it a location that we both like, but it just wasn't on the table only strictly because I was in the equation.
Rudi: I think both of us had to swallow some humble pie and be like, "We're in this together. It's not just one person. It's two people." And we had to also look at, "What do you want to gain out of residency? What do you want to gain out of essentially life? Where would you feel comfortable the most?" And both of us . . .
Just medical school is difficult. Sometimes you feel very alone, even though you have a very, very big peer support group, and what we were looking for the most was a residency family. So we always had to be like, "Does this have a residency family feel to it?" "No." And if they didn't want to have both of us interview, that's obviously not the program for us. We want to be part of a residency family.
Quinn: So we've kind of learned through medical school Rudi does better with large amounts of data, hence the fire hose. Rudi is really good at that initial filtering. So that [inaudible 00:51:49]. We had a mutual Google Docs spreadsheet that we were both adding to, both editing, both organizing. And what we did there, of course, is you do the reach, and then the probably solid programs that you have a good shot at, and then the safety. We did that. I don't remember what our . . . Seventy?
Rudi: Somewhere around 70, yeah.
Quinn: Seventy programs. I think 20% were reach, and something like 60% were actual "you're a good fit for this program," and the remainder would be safety. So we did that. Once we had that, then I could kind of step in. I do a lot better with decision-making, so that's when we started to look at, "These are these programs." We sent out the applications. We started to get feedback. It's coming in slowly.
One thing we can kind of . . . a little pro tip here. If you do do a couple's match, you absolutely unequivocally have to contact the program when one person does not get an interview. It was amazing.
Rudi: Communication was huge.
Quinn: It was amazingly successful at calling or emailing both multiple times, "Hey, I'm in this together. I'd love to go here. He would love to go here. Can we get an interview? I'm going to be traveling in the area." I was shocked. That was very, very successful and led me to having much more than the average EM applicant.
Dr. Chan: Interesting.
Quinn: And then Rudi, I mean, she had almost double me.
Rudi: We had a really good line of communication open. If I got an email, I'd be like, "Quinn, did you get this interview?" And he would either say yes or no. And if he said no, I would immediately email the program coordinator because they're the ones that have the most communication with the applicants. And then usually, about 10 minutes later, he'd have an interview offer. So communication was absolutely key with obtaining the interviews we wanted.
Quinn: Really, though, I think a big thing was . . . initially, it was a difficult decision because we didn't really know what we wanted. We knew we wanted a fellowship. So again, that sort of name is unfortunately an aspect of it. I mean, we needed to go to a place that people recognize. We needed to go to a place that produces fellows.
And they'll widely tell you this on the interview trail, that you can call, you can ask residents, but it's really easy to figure out how many fellows the program produces per year. And that was something that we really wanted to focus on because, like we said, we're definitely headed to fellowship.
So that was one important aspect. The other was just "Do we want to live there? Could we be happy there?"
Dr. Chan: With both of you going to undergrad here and then med school here, did you have this feeling that you wanted to leave Utah for your . . . because I call it the triptych, the triple undergrad, med school, and residency. For a lot of people, they love that because they have a lot of family here or culturally just they feel very . . . they just like being in Utah. But for other people, like, "I might practice in Utah one day and my residency program, that's the last hurrah to live somewhere else in the country." How did you guys feel about staying in Utah for residency? Did that come up in your discussions?
Rudi: That came up quite often actually. Quinn's story, as you've heard, he doesn't stay in one spot very well. So eight years in Utah was like, "Okay, I'm ready to move on."
Quinn: I mean, people would ask me this when I'm on my aways, "Hey, why aren't you focusing on Utah? It looks like a great program." And my answer just every single time was, "Guys, it would probably be top of my list had I not done undergrad and med school there." Really. Why not?
But yeah, I get antsy. I had to move. I was telling everyone else, "Yeah, you should rank this. I mean, top three for sure, if not number one, just from what you're telling me you're interested in. But for me, it's just not a good fit right now."
Rudi: And then, for me, it was a bittersweet tough decision just because I am pretty close with my family. My sister lives in Salt Lake. My parents are close. And we're pretty tight. We run every Saturday morning together and get lunch, so we're close.
And so that was kind of a tough pill to swallow because I do want to see other patient populations and I do want to have a different exposure. I think that would, for me, benefit in the long run. But it was definitely a bittersweet pill to swallow. And put aside COVID, travel is absolutely an option. You will still be able to see your family. So we had a . . .
Quinn: The airport, that's right. We wanted to be close to a major airport as well. That was actually kind of a major decision.
Dr. Chan: And then with your rank list, did you feel good about it? Did you go back and change it a bunch of times? How did that play out between you two?
Rudi: So I was a little contentious at first because we both had different wants. We were going to rank 15 programs, and so we split it into, "These are the top five we love, these are the five that we're good with, and then these are the five that are . . . we don't want to go there, but we want to go to residency so these will be okay."
Quinn: We didn't really know how to tackle it, and we were pretty overwhelmed. And we were starting to train for a marathon, so we just went for a run and by the end of the run, we were able to divide it basically into those three groups of five and then had a rough idea of our first rank list, the inaugural ranking.
Rudi: Yeah. We changed it a bit going from there, but I don't think it was anything that stressed the other person out or was something that the other person didn't agree with. It was like, "Oh, I was thinking that program, not really for me," or, "I really love this program," or, "Let's talk about this program." And so it started to evolve. I think a week before, we were like, "This is it. This is a good list."
Dr. Chan: And so you felt good about it between the month that you submitted it and the time you found out?
Quinn: We submitted like nine days or two days or something before.
Rudi: Six.
Quinn: Six days. Yeah, right between. Six days before, so we were tweaking it. There were a couple schools, not naming names, Ohio State, that were basically top of our list on interview day, like absolutely blown away. And then the more we learned about what they didn't tell us on interview day, it kept falling, like a rank every two days, essentially. And then it ended up being lower on the list. So things like that were happening. But for example, Madison, Wisconsin, was always top five, and if not always top three.
Rudi: It was Duke. We had ones that we're like, "That was such a good fit. That was a program that we would excel at." And so it didn't shift too much. And once we submitted it, I don't think we ever talked about it again, other than, "We're excited to figure it out."
Quinn: Yeah, there was no like, "Oh, shoot, we really should have manipulated that." No. I mean, once we sat down and actually figured it out . . . because it's difficult with the couple's match because it's not quite a factorial calculation, but you need to . . .
Ideally, you all want to be together. So your first 15 are all both of you in the same city, but then you need to figure out, "Well, if we can't be together, what's the next most important? Does someone really want this state school, but they'd be separated geographically farther away from their partner just to be at that school?"
So you have to really get creative with that list. Someone might want the next five permutations, for example, me at Pittsburgh, her at Wisconsin, and then the next one would be me at Pittsburgh and then her at Maryland, me at Pittsburgh and then her at another school. So that led us to have, I think, almost 260 permutations.
Rudi: Our list is very long.
Quinn: Yeah. So we didn't max it out. We didn't do the 300, but we did fill about 260 rows in the actual rank list algorithm.
Dr. Chan: Wow. And I guess a specific question for you two during this time . . . so the rank list gets submitted February and Match Day is not until March. In between, the COVID-19 pandemic starts coming in waves across the country, and ultimately, they switched a lot of curriculum and events, like Match Day, to an online kind of virtual format.
What was your . . . this is the culmination of eight years of hard work. How did it feel from your perspective just all these changes and just kind of the loss of control and the ambiguity of the last few months of your medical education? How did that look from your perspective as fourth years?
Rudi: Quinn is currently looking at me right now with a big smile on his face because I actually had a really hard time dealing with it. I am somebody who loves to celebrate. I think I throw way too many birthday parties. But I was extremely looking forward to Match Day and everything that people talk about. You hear you get this letter. You open it.
So we figured out the Tuesday before Match Day that it was going to be virtual. There would be no in-person event. And I think, initially, there are many emotions, anger, sadness. I was quite frustrated. I was like, "I realize this is a health problem, but why now? Why is there a pandemic right before our huge . . . what people call the golden time of medical school where you're supposed to celebrate and travel and just live freely? Why is this happening now?"
But Match Day turned out to be much better than I expected. It was a beautiful day of celebration. It was absolutely gorgeous out. We were able to celebrate outside with our two little dogs and plenty of food.
And then since Match Day, with quarantine, I think we've actually had quite a fun time. We made a quarantine list of things to do, from packing to just random board games, poetry match-offs. So yes, we're not able to travel like we wanted to. Yes, we weren't able to like celebrate in person with our friends. But we're making the best of it. And quite honestly, it is a golden time with medical school. We're having quite a bit of fun.
Quinn: Dr. Chan, your description was on point.
Rudi: Spot on.
Quinn: For me, I prefer to kind of exist behind the scenes. So Match Day in and of itself . . . there are two aspects of it. First of all, you know about this as a pre-med. I mean, you see it. You know what it is as a first-year. It's like, "Oh my gosh, those crazy fourth-years. Wow. They're geniuses. They know everything." Definitely not true, but it looks that way just from looking at a different perspective.
And each year, it gets closer and it builds. Oh my gosh. Second year, you're like, "Wow, two years this will be me." And then third year, you're like, "Holy man, I think I can do this. I got this. Wow, I have a lot of learning to do yet, but yeah, this is going to be me next year." And then fourth year comes and you're like, "Wow, this is it. I can't wait."
And then to have it . . . the four-year letdown was pretty severe, but at the same time, for me, I'm not that public figure kind of guy. So the idea of this really public display of this culmination of your work didn't . . . it's not exactly how I wanted to celebrate it, but I was ready to be there to support all the classmates and support Rudi.
So the initial cancellation wasn't a big deal for me. But what actually hurt me the most, what threw salt in the wound, was hearing how other schools were handling the complicated situation. There were just some really nice, really eloquent solutions to a virtual match that we weren't able to take part in. And that's when I kind of like, "Oh, man, that would have been . . ." Sort of missed opportunity. That one hurt the most for me.
Dr. Chan: I'm sorry. I mean, from an administration/dean's office perspective, it was so hard on our side as well because there was so much planning and thought, and it really is a beautiful ceremony. Not to take away what we were able to do through Zoom, but it's just not the same.
Quinn: Yeah. That was the thing. And it was all hindsight, so it's not like anything . . . I mean, in the situation, I doubt I would have done anything . . .
Dr. Chan: Yeah. And the hard part too is . . . you know, you're a diverse class. There are 125 of you. The original conceptualization of Match Day, I think, worked really, really well. But then when you start going down this road of, "Okay, we can't do that. What are the different ideas?" and people had large families or small family, and everyone started bringing forth, it's hard to kind of pick one and champion it through all this. Yeah, it's 125 different people. You put 125 doctors in a room, you're going to get 125 different great ideas.
Rudi: Right.
Dr. Chan: So where did you two match to? Where are you headed? Let's do the big reveal.
Rudi: We're going to University of Wisconsin Madison.
Dr. Chan: Woohoo. Go Badgers. This comes full circle with the Green Bay talk at the beginning of the pod.
Quinn: It does. Complete full circle.
Dr. Chan: So sell the listeners on this program. Why did you guys rank it as high as you did? What's so great about the Madison program? Let's talk about that.
Rudi: For me, doing an away rotation, it was precisely the family field. After night shifts, you go out to breakfast. After night shifts, you'd go have cheese curds and a beer at a bar. And it was an incredible . . . even as just an outsider, they brought you in. The attendings that I worked with, they knew me by name in passing. They just remembered you. It was a very good inclusive feeling.
And then I have goals to go into palliative care, do that on the side with emergency medicine, and they had just a phenomenal attending there who . . . he spoke and you just felt better about life. He was able to really articulate his thoughts and your thoughts very well. The feel is really what Madison did for me.
Quinn, on the other hand, has a childhood love of helicopters.
Quinn: I do.
Dr. Chan: I think I'm about to learn something about helicopters and Wisconsin. Go, Quinn. Tell me.
Quinn: Yeah. Here I go. So absolutely everything Rudi said. First, I have to say, having your partner do an away there is an incredible window into the program. I was actually accepted for an away rotation for the block after her. Obviously didn't do that, because as far as we described, the strategy doesn't really work well. But I was really excited to go there, really excited to hear what she thought. She loved it. She was super happy. She felt super supported. And those are major things. I really wanted to get a program that has a family feel, and she just time and time again said that.
On interview day, I was also blown away by their leadership. Dr. Hamedani there is just . . . I honestly was in awe. She was absolutely the kind of person that I wanted to learn under, and I am extremely excited to work closely with her, hopefully, and then in their department in general.
Now, helicopters. Justin was a wild man who worked through med school. I don't know if I'm supposed to say that or not. We can edit it later if we're not. But he introduced me to helicopter EMS. So he's a paramedic. He's a flight medic. And in med school, he kind of overheard that I was . . . he was just talking about what he does, and I said, "Oh my god, you have the best job in the entire world." And he just kind of laughed and he said, "Well, you can come check it out if you want." I said, "What? Are you kidding me?"
So you've got to go through some training and there are some restrictions and, of course, I made sure to make it through all the red tape. Yeah, I went to the Park City helicopter EMS base, got super lucky, had awesome calls. We landed on Snowbasin ski resort. I'm a skier, so I've seen helicopters come in. I was actually on the helicopter coming in, blowing snow. No one could see.
Dr. Chan: Wow.
Quinn: Yeah. So it was really dramatic. I actually wrote this in my personal statement to Pittsburgh. I know which helicopter is passing over my head just by the sound that it makes.
Rudi: It's disturbing.
Quinn: I know the different types of helicopters. I know what IMC uses or IHC, and Utah, two different types. So I really, really, really love flying.
I was actually super bummed about general surgery because I figured out surgeons don't really fly ever, and I kind of left it there. And then I figured out that emergency medicine does fly. Not always. I guess we probably should have mentioned that in our residency program. There's a whole list that we had on our Google Docs that I mentioned, whether or not they offer flight and whether or not it's just physicians who fly or residents can fly, and if residents fly what year do they fly.
And so that's actually why I ended up at Pitt. It has a huge helicopter EMS program that allows the residents to fly. I flew again in Pittsburgh. I had a shift, and it was fabulous. I loved it.
Dr. Chan: Just to clarify, Quinn, you're on the helicopter administering first aid and life-saving. You're not actually a pilot, correct? Or is that part of the . . .
Quinn: I would love to be a pilot.
Dr. Chan: Okay. This is where Rudi probably gets nervous.
Rudi: No. Exactly. I'm like, "Oh, man."
Quinn: But you're absolutely correct, Dr. Chan. Well, actually, I was doing nothing. This was an observer shift. But the trained residents and trained medics and nurses were doing exactly what you said. A lot of it was transporting. For example, we flew from Rock Springs back to The U just because someone had had a . . . well, a suspected STEMI that actually ended up being a stroke, a heart attack that ended up being a stroke, and needed a higher level of care. So transported them back to The U.
So I was very interested in programs that offer this, and Wisconsin is definitely known as one of the programs that flies quite a bit. So that was a column in our rank lists of which programs would permit me to fly and when would I be able to fly. And then more importantly, are you forced to fly? Because it's not everyone's cup of tea, and that's actually one thing we ran into. Some programs would really force EMS on all of their residents when that wasn't the best fit for them.
So the helicopter EMS, I am extremely excited about it, and that was a major factor. But then one kind of little "aw" moment was after I did my interview at Pittsburgh, I went to do my second interview at Madison. We had our whole list there, and we write notes after each interview. I highly recommend that. It just helps with thank you letters, with everything, and just your feel of the program, because that's ultimately what we went off of.
And in the box for Madison . . . I hadn't been home for 10 years. I visited, of course, but I haven't lived there for 10 years. And I just wrote, "I think I'm ready to go home." And that is actually what sort of . . . I never changed that comment and that was a big thing. So the leadership, the helicopter EMS, willingness to be close to family for a few years, training environment, the Midwest I'm familiar with, those are all what did it for me.
Dr. Chan: Quinn, that's beautiful. Rudi, this is beautiful. I think we just passed the hour mark, so, unfortunately, we're going to have to bring this to an end. But I want to circle back to you guys in about a year and just find out how your journey is.
Quinn: Yeah, man.
Dr. Chan: Beautiful. You guys have such a cool story. And from the bays that are green in Wisconsin, to the rice paddies/jungles of Vietnam, to the mountains of Salt Lake City, you guys have had quite the journey thus far. So yeah, let's stay in touch, all right?
Quinn: Absolutely. Love to, Dr. Chan.
Rudi: Thank you, Dr. Chan.
Dr. Chan: All right. I'm going to turn it off and then let's chat a little bit afterwards, all right?
Announcer: Thanks for listening to "Talking Admissions and Med Student Life" with Dr. Benjamin Chan, the ultimate resource to help you on your journey to and through medical school. A production of the Scope Health Sciences Radio, online at thescoperadio.com.
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Basseterre, St. Kitts (March 4th 2012) The St. Kitts-Nevis main opposition party the People's Action Movement held it's 47th Delegates Convention (CAUCUS) ON Sunday March 4that the Party Headquarters. The main agenda item of the perennial activity was the election of officers to lead the 47 year old party over the next year.
Scores of delegates from all 8 constituencies voted in what was a very spirited election. The coveted position of Chairperson was an extremely tight race in which Mr Sewlyn "Rusty" Liburd was elected.
The post of Deputy Chairperson for the first time in party history will be shared between Lawyer Jonel Powell and Dr Charles Warner after both equally split the votes and the membership decided to have both serve as Deputy Chairpersons .Mr. Valentine Lindsay and Ms. Rhyllis Percival were returned unopposed as Treasurer and Assistant General Secretary respectively. The officer elected to spearhead the party's public relations team was Mr. Antonio Nias.
Other positions that were up for election were the two spots for Deputy Political Leader, and the delegates demonstrated their confidence in MP's, Hon. Eugene Hamilton and Hon. Shawn Richards, whom they returned unanimously.
The post of National Political Leader was not up for election this year, given that the incumbent, Mr. Lindsay Grant was elected for a 3 year term in2010, which means that his term is not due to expire until 2013.
The new executive will assume office after the Annual National Convention to be held on Sunday March 18th .
Reports were presented to the Caucus by representatives of various arms of the party, including the National Women's Group, the Treasurer, the eight constituency groups and the Young Pamites.
A number of far-reaching recommendations were also tabled by delegates for the consideration and implementation of the National Executive.
Speaking after the meeting, Mr. Liburd expressed appreciation to the delegates for placing their confidence in him and praised the sacrifice of the last Executive,.
The Caucus was held under the theme, "Motivating our People into Action for a Stronger Movement".
The party will now concentrate on plans for the staging of the 47thannual convention which is expected to feature former Prime Minister of Jamaica Andrew Holness.


Companies in the same industry as Verndale, ranked by salary.
How much does Verndale pay?
Verndale pays its employees an average of ₹630,000 a year. Verndale employees with the job title Technical Trainer make the most with an average annual salary of ₹561,181, while employees with the title Support Engineer, Information Technology (IT) make the least with an average annual salary of ₹370,228.


Next year Line is introducing two new skis, the Vision 98 and Vision 108, that they're labeling as "freeride" skis. But these skis are very, very light. In fact, they're the lightest men's skis in Line's collection, and they're even lighter than the old (and very good) Line Sick Day Tourist, which used to be Line's dedicated touring ski.
But there's a lot more going on with these new skis than just their low weight, which is why we were so psyched about them at Outdoor Retailer last week. You can hear Sam Shaheen and I blab about them on our GEAR:30 podcast, and also find a bit more info about them in our Blister Outdoor Retailer Snow Show Awards.
But today, we're taking a closer look at the widest ski in the series, the Vision 108, because its design has some of us itching to get on it.
Well, I'll admit I have a hard time believing that this isn't an excuse to make weed references, but I guess I'll take Line's word for it. Beyond the name, the Vision's laminate construction sure sounds interesting.
I'm one of many people who has been a bit disappointed by lightweight touring skis that are packed full of carbon in order to make them stiff, but in turn, end up feeling very harsh on firm / rough snow. So if Line has managed to make a very light ski without that "pingy" feeling, I'd be quite happy.
While the Vision 108's construction is different from most other skis on the market, its shape is more traditional. It has a bit of taper in the tips, and a bit more taper in the tails. But the Vision 108 doesn't have nearly as much tip taper as the K2 Wayback 106 or Black Diamond Helio 105 Carbon, and the Vision 108's tail taper is still on the moderate side.
Overall, the Vision 108's shape looks very similar to a "Best Of" winner, the Line Sick Day 104. The Vision 108 has slightly less tapered tips, and maybe a bit more taper in the tails. But overall, the two skis look very similar.
The Vision 108's rocker profile also looks pretty similar to the Sick Day 104's, with the Vision 108 having a deeper tip rocker line and slightly higher tail splay. Overall, the Vision 108's tip rocker line is quite deep compared to many other 108mm-wide skis, and its tail splay is higher than almost all the other skis we've tested that come in at similarly low weights.
The recommended mount point on our pair of the 183 cm Vision 108 came in just a hair under -6 cm from center. That's much more forward than almost all the other touring skis we've used, and significantly more forward than the recommended mount points on the Sick Day 104 (-10.15 cm) and Sick Day Tourist 102 (-10.6 cm).
But the Vision 108's recommended mount point isn't crazy far forward, and we've been on a lot of skis with mount points around -6 cm that can be skied with both a centered, balanced stance and a more forward, driving one. So I'm personally very eager to see how the Vision 108 responds to different stances. And given its low weight and more progressive mount point, I imagine that the Vision 108 is going to feel super light in the air.
The Vision 108's flex pattern is on the softer side, though the middle of the ski is still pretty strong. The Vision 108's flex pattern is extremely similar to the Sick Day 104's flex pattern, with the Vision 108 being a tiny bit softer in the tips, and a touch softer in the tails.
Compared to the 19/20 Line Sir Francis Bacon (First Look coming soon), the Vision 108's flex pattern feels very similar, with the SFB's tips and tails being a bit stiffer than the Vision 108's.
I love the flex pattern of the Sick Day 104, so I'm glad to see that the Vision 108 shares a lot of similarity in this regard. I (and many other Blister reviewers) tend to prefer light skis that don't have super stiff flex patterns, as they seem to result in a slightly less harsh ride than very light skis with super stiff flex patterns. So I'm eager to see if the Vision 108's more forgiving flex pattern (and maybe its THC construction) can result in a more damp ride compared to similarly light skis.
The 183 cm Vision 108 comes in at just over 1600 grams, which is very light. It's not quite as light as more traditional touring skis like the K2 Wayback 106, G3 FINDr 102, and Black Diamond Helio 105 Carbon, but the Vision 108 is still coming in much lighter than nearly every other ~108mm-wide ski we've reviewed.
(1) Line keeps calling the Vision 108 a "freeride" ski, rather than a touring ski. So just how stable will it feel, and could it be suitable as a 50/50 or even dedicated resort ski?
(2) The Vision 108 has pretty deep rocker lines, fairly high tail splay, pretty soft tips and tails, and a progressive mount point. So could it finally be the lightweight, playful ski that less directional skiers like myself have been waiting for?
(3) Speaking of mount points, how well will the Vision 108 respond to both forward and more centered skiing stances?
(4) The Vision 108 shares a lot in common with one of our favorite skis, the Sick Day 104. So where will the two skis differ the most?
The Line Vision 108's design contains a combination of traits that we rarely see: a really low weight, moderate flex pattern, deep rocker lines, fairly high tail splay, and a progressive mount point. I and a few other Blister reviewers like Cy Whitling have been looking (read: begging) for that combination for some time, so we're extremely eager to get the ski on snow. Stay tuned for updates.
Blister Members can now check out our Flash Review of the Vision 108 for our initial impressions. Become a Blister member now to check out this and all of our Flash Reviews, plus get exclusive deals and discounts on skis, and personalized gear recommendations from us.
They look so great on both paper and photos. Really excited to read a full review on them. The only thing that would make me think twice is the tail(I don't like tapered tails in pow, and this one looks pretty tapered…), everything else sounds just too good.
Looking forward to the updates on the 108, but I also hope that you will be looking at the 98 Vison. There are a lot of days in the backcountry where a narrower, lighter, but still playful ski geared toward soft snow sounds very appealing.
Yep — we have the 179 cm Vision 98 in hand and will be posting a First Look of that ski soon (you can check out its measured weight in the Weight section above).
Why do you give 2 weights? Claimed and measured? If so maybe you need to calibrate your scale? Snapped my sick day tourists skiing park at seymour (def not what they were built for) and looking at these for replacing my lightweight mega day ski.
As we note in the "Specs" section at the top, the two weights we list for every ski represent the weight of each individual ski in a pair. It's actually pretty rare for both skis in a pair to come in at the exact same weight. And it's also very rare for a ski to come in at the exact weight that is claimed by the manufacturer (though Line's stated weight for the 183 cm Vision 108 is pretty spot-on based on our measured weights). Much of this has to do with how skis are manufactured and the slight variances that can occur during production.


Members of a House subcommittee criticized the slow federal response to a pattern of extreme opioid oversupply in West Virginia, where there are more drug overdose fatalities than anywhere else in the country.
Members of a House subcommittee criticized the slow federal response to a pattern of extreme opioid oversupply in West Virginia, where there are more drug overdose fatalities than anywhere else in the country. Legislators at the March 20 hearing demanded an explanation for how national and regional drug distributors were able to dump more than 780 million doses of hydrocodone and oxycodone from 2006–11 in pharmacies of small towns with fewer than 3,000 residents. DEA should have flagged the activity, they insisted, and cracked down immediately. "This is an abject failure," declared Rep. Chris Collins (R-NY). "It means no one is watching." DEA Acting Administrator Robert Patterson acknowledged that his agency dropped the ball "by not proactively leveraging the data that is available to us." It has since moved away from the manual process it was using and adopted an automated drug-tracking database. DEA also is working more closely with states that have prescription-monitoring programs in place. "We use the data in a very different way today," he says.


text:
Q: List additional CUPS printer information How to display printer information, such as printer description or printer location using command line tools?
lpstat -t lists printer names, classes and devices for printers, but it doesn't list printer description or location. Is there a way to get this information without using http or GUI interface?

A: You can obtain this information with lpstat -l -p printername.
[root@Valley ~]# lpstat -l -p zebra2
printer zebra2 is idle.  enabled since Tue Jun  8 15:50:35 2010
        Form mounted:
        Content types: any
        Printer types: unknown
        Description: Zebra 105SL in shipping
        Alerts: none
        Location: Shipping
        Connection: direct
        On fault: no alert
        After fault: continue
        Users allowed:
                (all)
        Forms allowed:
                (none)
        Banner required
        Charset sets:
                (none)
        Default pitch:
        Default page size:
        Default port settings:

A: This is a bit more global, for everything eliminate the grep statement.
for i in $( lpstat -v | awk '{ print $3 }' | tr ':' ' ' ) ; do lpstat -l -p $i | grep 'printer\|Location' ; done

redpajama_set_name: RedPajamaStackExchange


This week, Chicago Black Lives Matter activists questioned Hillary Clinton at a New Hampshire campaign event about America's mass incarceration problem, which undeniably bears racist undertones. Clinton provided a predictably calculated, talking-point ridden response, skillfully ignoring the crux of his point: that Clinton herself helped create this catastrophic dilemma.
In the exclusive video obtained by GOOD Magazine, an activist expresses his happiness that he is able to speak with Clinton.
"Mmmhmm," Clinton intones multiple times as she nods in agreement with his statement.
"Hillary Clinton lobbied Congress to pass the Violent Crime Control and Law Enforcement Act. Bill Clinton signed the act into law in 1994...The largest crime bill in history, it provided $9.7 billion in prison funding. From 1992 to 2000, the amount of prisoners in the U.S. increased almost 60%," it reads.
The activist asks Clinton to explain her recent "change of heart" on the issue and to discuss how what she learned could help America and black citizens as a whole.
She argues that activists today need a plan of action to deal with issues facing black America, all the while flattering their passion and efforts to elevate consciousness.
Ironically, she notes that "You can get any white person to pay lip service" to black concerns, which is exactly what she did to the activist questioning her.
Clinton failed to acknowledge his initial question about her apparent change of heart (read: opportunistic decision to jump on the trend against mass incarceration). She failed to so much as recognize the fact that she contributed to the problem she now claims to want to solve.
Clinton has helped create the world's largest prison population not only by lobbying for the 1994 law referenced in the video, but by accepting money from the private prison lobby which has even continued to flood into her 2016 presidential campaign. She has also supported the Drug War, which has indisputably led to America's over-bloated prison population, sending more non-violent black people behind bars than any other group per capita. She has also supported aggressive foreign policy, which has increased American militarism and provided a steady stream of military equipment to local police through the 1033 program, which began as an effort to bolster the war on drugs.
In part two of the conversation, the activist accuses Clinton of victim-blaming for the way she attempted to dictate how activists should present the issue and formulate a plan of action. Regardless of whether or not her observation was correct, he argues that if she stops telling black people what to do, they will stop telling "you all" what to do.
"I don't believe you change hearts. I believe you change laws," she retorts. "You change allocation of resources, you change the way systems operate." After finishing her statements, she hustles away with her handlers.
What Hillary Clinton ignorantly refuses to acknowledge is that laws have utterly failed to end racism and institutionalized racial disparity. The Civil Rights Act was passed in 1964, and while it ended state mandated racial segregation and sought to address social inequity, the fact is that segregation still exists in America's cities (especially in the North East) and racial inequality is nowhere near being solved.


text:
using System;
using System.Collections.Generic;

using Xamarin.Forms;

namespace HelloWorld
{
	public partial class GridPage : ContentPage
	{
		public GridPage()
		{
			InitializeComponent();

			//	var grid = new Grid
			//	{
			//		RowSpacing = 20,
			//		ColumnSpacing = 40
			//	};

			//	var label = new Label { Text = "Code Behind Grid" };
			//	grid.Children.Add(label, 0, 0);
			//	Grid.SetRowSpan(label, 2);
			//	Grid.SetColumnSpan(label, 2);
			//	Grid.SetRow(label, 0);
			//	Grid.SetColumn(label, 0);

			//	grid.RowDefinitions.Add(new RowDefinition
			//	{
			//		Height = new GridLength(100, GridUnitType.Absolute)
			//	});

			//	grid.RowDefinitions.Add(new RowDefinition
			//	{
			//		Height = new GridLength(2, GridUnitType.Star) // makes it proportional like in the XAML
			//	});

			//	grid.RowDefinitions.Add(new RowDefinition
			//	{
			//		Height = new GridLength(1, GridUnitType.Auto) // height of row calculated based on children
			//	});

			//}
		}
	}
}

redpajama_set_name: RedPajamaGithub


text:
Q: How to make _t version of SFINAE struct exposing static member value? I have that code that recognizes which GL type you need to use based on C++ types. I want to make a _t version of it (like std::decay_t or std::enable_if_t) but expose int constant value
template <typename T, typename = void> struct GLType {};

template <typename T>
struct GLType<T, std::enable_if_t<std::is_same_v<std::remove_pointer_t<std::decay_t<T>>, float>>> {
   const static constexpr int type = GL_FLOAT;
};

template <typename T>
struct GLType<T, std::enable_if_t<std::is_same_v<std::remove_pointer_t<std::decay_t<T>>, double>>> {
   const static constexpr int type = GL_DOUBLE;
};

My first try was
template <typename T>
using GLType_t = GLType<T>::type;

but that doesn't work. Is it even possible to return value instead of type in the same way?
In the end, I want something like
int a = GLType_t<float>;
// instead of
int a = GLType<float>::type; // which works fine btw

A: You appear to be looking for variable-templates which allow you to do this:
template <typename T>
inline constexpr int GLType_t = GLType<T>::type;

and then you can use it like this:
int a = GLType_t<float>;

Also, I strongly suggest that you name the int member something like value instead of type. Names matter, and type is just the wrong name for a member that is not actually a type.

A: The @cigien's answer provided the way to go with variable template.
However, I would like to propose a less typing approach using c++17s if constexpr. The entire boiler-plate traits code will meltdown to simply, a template-function:
#include <type_traits>

template <typename T>
constexpr auto GLTypeHelper() noexcept
{
   // assert is the T is not either float or double
   static_assert(std::is_same_v<T, float> || std::is_same_v<T, double>, " T should be float or double");

   if constexpr (std::is_same_v<T, float>)
      return GL_FLOAT;
   else if constexpr (std::is_same_v<T, double>)
      return GL_DOUBLE;
};

// variable template for GLType_v
template <typename T>
inline constexpr int GLType_v = GLTypeHelper<T>(); // calls the `GLTypeHelper()`

You will use it like
constexpr int a = GLType_v<float>;
constexpr int b = GLType_v<double>;

and ofcourse, since GL_FLOAT and GL_DOUBLE  are values, not a types, change the ::type -> ::value, and _t -> _v!


In 2010, the World Association for Sexual Health (WAS) called all their organisations to celebrate, on each September 4th, World Sexual Health Day in an effort to promote a greater social awareness on sexual health across the globe.
The first World Sexual Health Day was celebrated with the slogan "Let's talk about it!" to start breaking fears and taboos surrounding sexuality.
World Sexual Health Day has been celebrated in about 35 countries with a wide range of activities from Round Tables of Discussion to Conferences and Art Exhibitions. Country organizers have taken WSHD activities to schools, media, hospitals, libraries, universities, public squares, art halls, theatre groups, etc.
World Sexual Health Day 2016 will focus on myths that stand in the way of achieving better sexual health and wellbeing.
WHAT CAN I DO TO CELEBRATE WORLD SEXUAL HEALTH DAY 2016?
As World Sexual Health Day (WSHD)is a global and volunteer celebration, the possibilities are limitless. You can use the theme of this year's WSHD and take it to wherever you find suitable, and in the ways that are easier for you.
You can organize playful activities that involve everyone, or choose from the ones we are proposing. Download the leaflet for local organisers below!
2016: Sexual Health: Eliminate the Myths!


Well i finally finished the colors for her! this took a lil while because of her tats. but i'm pleased with how she came out tho. hope you guy and gals dig! tell me whatcha think and any critiques are welcome. i'm still learning how to paint so i need the help.
She totally has an enigmatic aura surrounding her. Very outlandish also.. Think it's her hair and tattoos mainly. I have no idea why, but girls like this make me weak in the knees. I think it's because they're pretty much a personification of self-expression. That plus the rebelliousness and confidence is totally hot.. Gah! Why aren't there more women like this in the world?!
That looks friggin' GREAT MR.SIR!!!! Nice totally nice!
haha, glad you dig it!
that is some niiiice work, you colored it with photoshop?
why thank you, and yes i used photoshop cs2 and a wacom tablet. thnaks for looking!
nice one! great colors and line of course!
Oh Wow!!! Really Pulled This One Off!!!
Great colours--they really pack a punch.
OMG that's awesome! Puts my colored version to shame! Gonna use this one as my desktop, if you don't mind!
no way, your colors rock man! but if you want to use this as a desktop, thats fine with me.
Thanks for the compliment! And thanks for the permission to use your pic as a desktop. I love it.
Love the colors and the tats awesome work!
thanks alot man! any tips?
thanks man! yea if you could that would help alot!
Dude, you are amazing at that, I tried following what he was doing in the vids.. but i got lost, he never explained HOW to do it.. oh well, I'll get the hang of it someday, but you nailed this pic. Well done!!!
oh, and thanks a lot for the kind words!!!
i guess you kinda have to have some previous knowledge of digital painting. i'll break this piece down and email you a copy with some pointers.


Ypsilon Dresses has over 5,000 dresses in store, ranging through multiple styles, colors, lengths, and attitudes. With two warehouses full of different dress designers, shifting trends in ready-to-wear (that can drastically affect formalwear), and the fact that Ypsilon orders product six months in advance, you can bet the buying process is no easy task. Watch below to hear first hand about our buying process!


text:
namespace java {
  namespace lang {
    class Throwable;
    class String;
    class Class;
  }
}
template<class T> class JArray;

namespace java {
  namespace io {

    class IOException : public ::java::lang::Exception {
    public:
      enum {
        mid_init$_54c6a166,
        mid_init$_c5ec8ca4,
        mid_init$_5fdc3f48,
        mid_init$_01646a2e,
        max_mid
      };

      static ::java::lang::Class *class$;
      static jmethodID *mids$;
      static bool live$;
      static jclass initializeClass(bool);

      explicit IOException(jobject obj) : ::java::lang::Exception(obj) {
        if (obj != NULL)
          env->getClass(initializeClass);
      }
      IOException(const IOException& obj) : ::java::lang::Exception(obj) {}

      IOException();
      IOException(const ::java::lang::Throwable &);
      IOException(const ::java::lang::String &);
      IOException(const ::java::lang::String &, const ::java::lang::Throwable &);
    };
  }
}

#include <Python.h>

namespace java {
  namespace io {
    extern PyTypeObject PY_TYPE(IOException);

    class t_IOException {
    public:
      PyObject_HEAD
      IOException object;
      static PyObject *wrap_Object(const IOException&);
      static PyObject *wrap_jobject(const jobject&);
      static void install(PyObject *module);
      static void initialize(PyObject *module);
    };
  }
}

#endif


text:
<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE plugin PUBLIC "-//JPF//Java Plug-in Manifest 1.0" "http://jpf.sourceforge.net/plugin_1_0.dtd">
<plugin id="com.tle.web.workflow" version="1">
  <extension-point id="subsearch">
    <parameter-def id="bean" multiplicity="one" />
  </extension-point>
  <extension-point id="moderationView">
    <parameter-def id="id" multiplicity="one-or-more" />
    <parameter-def id="bean" multiplicity="one" />
  </extension-point>
  <extension-point id="bulkExtension">
    <parameter-def id="bean" multiplicity="one" />
    <parameter-def id="order" type="number" multiplicity="none-or-one" />
  </extension-point>
</plugin>


The Politico take is certainly consonant with the various accusations of presidential weakness that have accompanied Obama's policy maneuverings with regard to Syria. The pundits (some examples are here), plus politicians from left to right— Sen. Bernie Sanders to a collection of former Bush staffers —have certainly made their feelings clear on this point.
All this suggests Howell has a solid point when he argues that "in every policy domain, presidents must not only demonstrate involvement, they must act – and they must do so for all to see, visibly, forthrightly, and expediently. Deliberation must not substitute for action" (p. 6)…."Presidents who fail to act, even when the statutory or constitutional basis for action is dubious, face the prospect of a substantial political backlash…" (p. 105). (It's worth noting that Philip Heymann's experimental work on foreign policy decisionmaking had similar findings, showing "the powerful tendency" – even among experts – "to follow an individual who is more certain rather than more deliberative" (Living the Policy Process, p. 141)).
Note that Howell's book does not take a position on whether this is a good thing. I will: it's not.
It should be added that neither Syria nor the not-quite-extant Larry Summers nomination, the key exhibits in evidence here, necessarily lend themselves to the thesis of the article. "The common theme in both episodes is" supposed to be "that they were about projecting power, not summoning sweet reason." But projecting power in Syria in this case – whatever the merits – apparently meant acting without legal authority to do so; polls suggest the current track (which I'm not sure represents "sweet reason") is actually a plus for perceptions of presidential leadership.
Now… none of this is to argue that these issues were particularly well-handled by the President. Richard Neustadt's take on Presidential Power, fifty years ago, concluded that the default position of presidents – hemmed in as they are by others who do not owe their own position to presidential grace or gift - is weakness rather than strength. However, he notes that presidents extend their influence by always seeking, as they act, to enhance their "future power stakes." If they can rarely cleanly command a given outcome, they must at least create a favorable architecture within which to conduct their future bargaining. President Obama's 2012 discussion of "red lines" created a bargaining marketplace that confined his options rather than expanding them, in his dealings with Syria itself, with Russia, and with Congress. Likewise the trial balloon that the potential Summers nomination became floated by too many of Summers' adversaries, who had plenty of time to sharpen their sticks.
When Richard Neustadt and Will Howell come to the same conclusion… well, there is something wrong with Obama! But it's not something that can be fixed by gauging presidential "strength" against mythical standards.


T-Mobile collaborated with designer Benjamin Guthrie in order to create a very cool modular concept phone known as Mod. This handset is compatible with all sorts of different displays and keyboards modules, that can be sold separately or in various combinations.
Each accessory will make the phone evolve and bring extra features to it, plus you should know that Mod also bundles a stand, keyboard and trackpad. Its battery is built-in and in case the design looks familiar, it's true that the concept phone looks a bit like a Helio device, but one with a more modern look.