Move-Ed

Sorry that I haven't written for a very long time. A lot has been going on and I haven't had the desire to write much. Nevertheless, here is a quick update with a chance of a longer one later. I'm not keeping any promises...

I have moved on to a whole new part of my life. I was admitted in Mount Sinai School of Medicine's MD/PhD program! I moved up to New York last Friday and I have almost completed my first official week of school. I'll be in the city at least for the next 8 years. So far, I'm loving it here and I'm loving school. Everything that is currently happening to me is exactly what I want and need. Life is good right now.

Here are some keywords to describe my adventures in New York: apoptosis, programmed necrosis, Central Park, site-seeing, TNF, U-Haul, NYPD, food, DNA fragmentation, parents, and fireflies.

I Just Want...

Dear God,

The only thing that I want in the world right now is to be accepted at NYU.

Love,
Sean

My Voice

Beck, here is my voice again. I'm not sure what I'm going to write about, but here I go...

I know that some of you probably have been wondering what I've been up to and where I've been. Well, nothing too exiting has happen in my life. It's been very boring actually. I have had three MD/PhD interviews, and I feel like I belong in these programs or at least an MD/PhD program.

My first interview was at Boston University in October. BU was a great place. I really liked and felt like I fit in. My interviews went very well and the old Dean of Admissions told me that I would be "a good fit" at BU. I lOVE Boston and definitely could live there, so I wouldn't mind living there for 8 some odd years. The only problem with BU is that I don't receive my stipend all my years of school. The is a down side and I don't want to go into debt, especially when I will be starting my career around age 35.

My second interview was at Tufts University in November. It appears that the Boston schools like me and think I'll fit into their program. Tufts was also a great school. I fell in love with one researcher and his research. He is an up and coming researcher who is proving wrong many of the believed concepts of T cell activation. He would help my career go far. Also, Tufts is very keen on mentoring. They constantly have people checking up on the MD/Phds and helping them through the long process. Another benefit is that I am funded all of my years of school and I receive a stipend. One problem is the push to finish the program in 7 years. I wonder if moving through the program faster could be a disservice to students.

My last interview was last weekend at NYU. I absolutely loved NYU! The school is amazing, the people are amazing, the research is amazing, the immunology department is amazing, the facilities are amazing, and NYC is always amazing. Right now, I would consider NYU my topic choice. I was very impressed with their dedication to infectious disease immunology. They are currently expanding the immunology department, which means a lot of new, up and coming researchers will be at NYU. Also, I felt a strong sense of belonging at NYU. I was well received by all my interviewers and I made friends quickly with students. I also made a really good friend at NYU who was also an interviewee.

The first round of acceptances for all of these schools is in January. I hope I hear good news from all of them. I am still waiting to hear back from 8 schools. That means that I have had 3 interviews and 9 rejections. I'm pretty sure that at least half of the schools left will send me a rejection.

Ummm, that's my schooling life. I'm not sure what else to write about. I am very happy with where I am and I love what I'm doing. I have found peace and harmony in my life. I love the east coast and I love DC. I can't see myself moving back to the west coast anytime soon. I still consider myself churchless. I haven't gone back to church in a very long time. I have no desire to. I have allowed my home teachers to come and talk to me and the missionaries have started knocking on my door (I have yet to answer the door because they always come at the worst times). My home teachers seem only to be there to get their quota in because they don't put much thought into their lessons and make them specific to me. Also, they are trying to get me to come back to church. They have never asked why I no longer attend and they never ask if they could do anything for me. So yeah...

Political issues... Politics are politics and I don't care to talk about them. Also, I don't care to get involved either.

Yeah, I guess that is my voice right now. There isn't much to it probably because everything is going very smoothly for me. Things are working out and I feel really good about my life. The decisions I am making are what's best for me and I'm continuing on the path I've set up for myself.

Research Experience Statement

This is the research that I have been doing for the past 2 years. Read it if you are interested or just skip it.

For nearly two years, I worked in Dr. Gregory Burton’s laboratory at Brigham Young University. His studies focus on understanding the molecular interactions between follicular dendritic cells (FDCs) and HIV. Specifically, we examined the contributions of two FDC receptors, CD32 (FcγR) and CD21 (CR2), that played significant roles in the trapping and long-term maintenance of HIV.

My first project was molecular cloning of HIV. We received samples of lymph nodes from HIV infected patients. I isolated the HIV virons and the RNA, and performed reverse transcription. After making cDNA, I PCR amplified the products, inserted the amplimers into vectors, and inserted them into bacteria. I then sequenced the inserts in the vectors and performed phylogenetic analysis of the HIV genome. This work showed that the HIV genome from one lymph node is not the same as another, and that the genome in the same lymph node is very similar. These findings were consistent with past research. This project was used to train me in basic laboratory techniques, and double-check the findings for a paper that is still in the process of being published.

My second project examined different pathways of FDC activation, and if FDCs up-regulate or down-regulate CD32 and CD21 through the different pathways. I isolated FDCs from human tonsillar tissue through positive selection using a FACS machine. To activate the cells, I incubated the FDCs with lipopolysaccharide (LPS), antibodies, complement, immune complexes, immune complexes+complement, neutralizing HIV antibody immune complexes, or neutralizing HIV antibody immune complexes+complement. After the incubation, I extracted the RNA from FDCs, performed reverse transcription, and then analyzed the cDNA with real time PCR. I found that each of these known immune system activators up-regulated CD32 and CD21 at differing degrees. During this project, I also incubated FDCs with alpha-1 antitrypsin. We found that alpha-1 antitrypsin deactivates FDCs, but we did not know why it deactivated these cells. These findings focused our group’s research on determining the intracellular pathways of activation through CD32 and CD21.

My third project focused on discovering the proteins associated with CD21 on FDCs. I hypothesized that CD21 on FDCs is associated with similar proteins as CD21 on B cells, meaning that the B cell co-receptor (CD21/CD19/CD81) is on FDCs. The B cell co-receptor could then activate FDCs in the same or a similar intracellular signaling pathway as B cells. The experimental protocol that I designed was to use fluorescently labeled antibodies to CD21, CD19, and CD81, and then use FRET analysis to determine if the proteins are associated with one another. If they were associated with one another, we would then perform protein cross-linkings and immunoprecipitations to determine the intracellular pathway of activation, and establish if it was the same or similar to the B cell co-receptor activation pathway. I grew hybridomas for CD21, CD19, and CD81, isolated the antibodies, and fluorescently labeled them. Then I isolated B cells from peripheral blood mononuclear cells (PBMCs) through positive selection using a MACS machine, and I isolated FDCs with the same methods as my second project. After separation of the cells, I incubated them with the fluorescently labeled antibodies, used a confocal microscope to perform FRET, and analyzed the results. When I left the laboratory, I had performed some preliminary trials without the α-CD81 antibody, because we were waiting for the α-CD81 antibody to be produced by another principle investigator. Despite missing the α-CD81 antibody, the preliminary results were promising.

My fourth project studied the role of FDCs in activating CD4+ T cells with a latent HIV infection. Studies have shown that FDCs and FDC supernatant can activate latent T cells, but the mechanism is not known. In efforts to determine the mechanism, I isolated CD4+ T cells from PBMCs through positive selection using a MACS machine. After activating the growth signal with IL-2 in the isolated cells, I would infect the cells with an HIV variant. The HIV variant has a faulty envelope gene that can be used to infect the cell, but its progeny can never bud off the cell. If the infection were not latent, the cell would die from viral overload. However, if the infection were latent, the CD4+ T cells would survive. After the latent infection was established, I induced viral protein formation with differing amounts of PHA+Ionomycin or IL-2+IL-7, measured p24 levels within the cells with α-p24 antibodies, and created dose curves comparing activator versus viral expression. These dose curves were then compared to induction of viral protein formation when the latent T cells were incubated with FDCs and FDC supernatant. When I left the lab, we were continuing to induce latent T cells with FDCs and PHA+Ionomycin or IL-2+IL-7, and we were performing mass spectrometry on the FDC supernatant to determine the protein that is causing latent T cells to form HIV particles.

Currently, I am working in Dr. Jeffery Gildersleeve’s laboratory at the National Institutes of Health, specifically in the National Cancer Institute for a year long post-baccalaureate. His research focuses on developing carbohydrate microarrays to assist in analyzing cellular markers, tumors, and vaccine efficacy. I am working on developing a microarray to test epitopes and specificity of antibodies formed by the HIV/AIDS vaccine. Developing this microarray would give researchers a rapid determination of the efficacy of the HIV/AIDS vaccine in the different stage trials of FDA approval.

MD/PhD Statement

I am pursuing the combined MD/PhD degree because I want to practice clinical medicine, teach, and perform research at an academic medical center. My initial interest in medicine was focused largely on practicing clinical medicine. I saw physicians curing people of diseases, and I wanted to be like them. This desire was further perpetuated through my shadowing experiences. I have shadowed a pediatrician, an oncologist, and a gastroenterologist. Interacting with doctors and patients has strengthened my interest in attending to patients. When I was shadowing the oncologist, I met a woman who had two mastectomies to remove breast cancer. At the post-surgical follow up, she was in tears because she said that she was no longer herself—I wished there was something that I could do. The doctor showed compassion for her, and helped her deal with her new situation. I want to be like him, and care for people in a clinical setting.

In addition to practicing clinical medicine, I want to educate others in medicine. While I have been a coach, a tutor, and a teaching assistant, I have developed a love for teaching. As a teaching assistant, I instructed a few lectures. These lectures were enjoyable to prepare and to teach. I liked sharing my knowledge with others and being able to help them understand the material presented. In addition, as a coach, I found satisfaction in teaching people of all ages how to swim properly and reach their goals. I know these attitudes will carry over into teaching at a medical school. I will find satisfaction in helping my students succeed inside and outside of the classroom, through formal instruction and through patient-physician interactions. Being an educator at a medical school will allow me to use my passion and desire for teaching to help others train to become physicians and properly care for their patients.

Another aspect of medicine that interests me is research, specifically researching immunology. I joined a biochemistry/immunology research group at the start of my junior year, and continued to work there for nearly two years. This group is focused on the biological mechanisms of HIV pathogenesis, reservoir formation in secondary lymphoid tissue, and increased infectivity with follicular dendritic cells (FDCs). The team is studying how to prevent or remove a reservoir of HIV from the body. We found a molecule that deactivates FDCs, which could possibly serve as a treatment for HIV/AIDS patients, and stop HIV reservoir formation in secondary lymphoid tissue. I have found research to be rewarding. It is challenging and I can discover something previously unknown, with the potential to help many who suffer from a particular disease. I want to continue to research to discover the unknown, and increase understanding of the human body and the diseases that affect it, given that basic research of the body and diseases will allow doctors to provide patients with a better quality of care and disease prevention.

Personal Statement 2011

It was the first swimming practice of my freshman year. I walked on the pool deck not knowing anyone, but determined to make the Brigham Young University intercollegiate swimming/diving team. The coach gathered us together and had us introduce ourselves. I discovered that I was one of ten people trying out for one position on the team. Fears crept in and I questioned whether or not I was good enough for the team. Despite my fears, I decided to try out because I knew I would regret not taking the challenge. For the next two months, I tried to prove to the coach that I deserved the one position. I remember the soreness of my muscles that were begging me not to jump into the water, run another stair, and lift another weight. However, I pushed through the soreness and watched as others quit or were cut from the team. The day of the last cut came, and the decision was between a diver and me. The coach pulled me aside to tell me the news; I did not make the team. I thanked him for the opportunity, and I was grateful for the experience and that I made it to the last cut. If I had quit that first day, I knew I would have regretted not trying out.

“I know I will regret not taking the challenge,” has been a saying that has guided me through my decision to become a doctor. At a young age, I watched my grandfather die due to complications from diabetes, and I was hospitalized and operated on for severe appendicitis. Throughout these experiences, I saw many physicians, and was in awe of their knowledge and skills; I wanted to be like them. When I entered high school, I enrolled in the medical sciences track, and learned the demands of the medical field. The coursework was challenging, yet I continued to develop my passion for medicine from the courses I took and my shadowing experiences. I loved learning about the human body and how to help people suffering from disease. Upon graduation, I was ranked first in the track, and I had earned a medical assisting license. A pediatrician I shadowed offered me a full-time medical assisting position. I knew that if I accepted this, I would have to postpone my undergraduate studies and medical school. I declined the opportunity because I wanted to play a more active role in medicine, even though this is the more challenging route.

Between being a biochemistry major, volunteering, researching, and shadowing, I had a demanding schedule in college. From this, I was learning how to be a doctor. However, it was not until I became head swimming coach that I fully understood how doctors feel after helping patients. While volunteering as the head coach, my demands were increased. Despite these changes, I found satisfaction in helping my team succeed and mature. I watched my swimmers improve their times, qualify for state, take third place at state, and learn life lessons. During this time, the stresses in my life seemed to decrease, and I enjoyed my busy life. This is how physicians must feel; they are satisfied with their challenging lives because they are helping others.

All of my preparation for medical school culminated in the early morning on January 1, 2010. After ringing in the New Year, I saw a man and a collapsed woman on the side of the street. They caught my eye and I told my friend to stop the car. The man ran up to us and explained that this woman was thrown out of a moving truck and was unresponsive. Seeing this man’s plight and the woman’s poor condition, I knew that I needed to help her. I ran to the woman and noticed that she was in worse condition than explained. She was foaming at the mouth, her eyes were rolled back into her head, and her breathing was shallow and labored. I used my knowledge from my experiences to try to help her, but it was not good enough. Following my unsuccessful attempt to wake her, I took her weak pulse and respiration rate and called 911. An ambulance arrived, and the EMTs quickly took over the situation. I watched them quickly regain her consciousness. As the ambulance drove off, I wished that I could have continued to care for her, and I was glad this woman received help. After this experience, I knew that I had made the correct decision to pursue becoming a doctor. There was no regret.

After getting cut from the swim team, I had no regret. I did my best and I did not quit. By trying out, I learned that closing one door opens many others. If I had made the team, I would never have been able to volunteer as a swim coach, perform research, shadow physicians, or manage a store. These experiences helped me understand what the best physicians do—they responsibly work to help others, despite the chance of failure. In addition, I learned the strength of the mind. My mind became a powerful tool that was able to push my body past my perceived limits. I was able to swim farther and work harder than I had before. This attribute will be vital in medical school and as a physician, because having strength of mind will give me assistance to persevere. I have learned valuable lessons by challenging myself, and I am excited for the future challenges I will face. Just as I would have been unsatisfied for not challenging myself to tryout for the swim team, I know that I would have regretted not taking the challenge to pursue a career in academic medicine.

Welcome to the Future!

Welcome to the future! That's what I feel like my life is telling me right now. I'm a graduate from BYU with a BS in Biochemistry and a minor in Sociology as Magna Cum Laude. I'm headed off to the NIH/NCI in Frederick, MD at the end of June for a year long post-baccalaureate research position (basically it is a paid internship). I will be working on developing a microarray to test the efficacy of the HIV/AIDS vaccines that are being developed across the nation and world. It is really exciting! :) I'm also reapplying for medical school, but this time I am applying for MD/PhD programs, instead of MD programs. These are much harder to get into, but I'm hoping to receive a position. I would love to research, teach, and practice clinical medicine at an academic medical center. So yeah, that's my update for now. I'll post my application essays soon. Hope all is well with everyone!

PS I was recently diagnosed with Spasmodic Torticollis.

Columbia and Baylor

Last week was my first medical school interview. I headed off to the wonderful city of New York. I stayed there for five days (thank the Lord for a three day weekend) with a good friend who is working for Goldman Sachs, which was nice because my expenses were very low. All that I can say is that I love New York and would love to live in that city. It was magnificent. While I was there, I saw Wicked (amazing), the Financial District, Wall Street, the Wall Street Bull, the Meat Packing District, Chinese New Year in Chinatown, Little Italy, Times Square, the Metropolitan Museum, the Museum of Art Design, the Museum of Modern Art, and so much more! There was so much to do and I highly doubt I would ever get bored.

I thought that I would be overwhelmed with the city, but I wasn’t. When I first arrived at JFK, I was overwhelmed with getting on a bus to Manhattan and then getting my way to my friend’s apartment. After dropping off my suitcase, I navigated the subways to Columbia all by myself. I was very nervous about that, but it wasn’t as bad as I thought. I became quickly acclimated to the city.

Columbia is a beautiful place (I’m a sucker for huge hospitals). There was so much going on there that I loved. I loved the curriculum, the service opportunities, the free homeless shelter/clinic, the school, the people, the diversity, and again, much more. My interview was probably subpar. The reason for this was because the first question the interviewer asked me was why I wanted to become a doctor. I told him about my desires to help others, but I also told him about my desire to earn an MD/PhD. He then looked me straight in the face and asked me, “Why are you here then?” The reason he asked me is that an MD/PhD has a different application and interview than an MD. I told him about how my desire to earn a PhD recently developed. I then felt like I was fighting my way back from the grave for the rest of the interview. He was always questioning my motives of being there. I think that I had a decent interview, but not an amazing one. I hope that it works out so that I could go to Columbia, because I loved the school and the city.

I just barely returned from my trip to Baylor. I didn’t spend much time in Houston, but from what I saw, it reminded me a lot of Salt Lake City. This isn’t a bad thing, but I much prefer a bigger city and I prefer something that wouldn’t remind me of home. Don’t get me wrong. I do love Utah, but I am ready for a new place and a new adventure. Houston, being the fourth largest city in the US, didn’t seem like a big city. I still had a good time.

The interview was yesterday and I felt like I rocked the two I had. The first one was with a doctor. She was an amazing, strong woman from Germany (I’m a sucker for strong women). She and I had a lot in common and so the interview flowed very naturally. I had a great time talking to her and she seemed to enjoy our conversation. At the end of the interview, she told me that she was planning on giving me a very strong recommendation to the admissions committee. I’m really stoked for this! The second interview also went well. This time it was with a fourth year student. He asked me some ethical questions and my opinion on health care reform. He agreed what I said in my responses and told me that I gave a good strong response, whereas other interviewees gave lackluster comments. This made me extremely happy. After the seven hour long interview session, full of interviews and tours, most of the applicants headed to an Irish Pub paid for by Baylor. We had free food and some good times. I enjoyed my time there, but I was surprised how many people were getting hammered and smashed. I thought that people in the medical profession would know better, but I guess the socialization of the norms for my age group is still there. It made me uncomfortable so I left, especially because all of the people that I made friends with during the interview session were completely drunk.

I really loved Baylor too! The school was amazing and beautiful! It had basically everything the same as Columbia, except it was in Houston. I really like both Columbia and Baylor. I’m not sure how things are going to work out, but I’m not sure if I would go to Baylor because of Houston. If it were between Columbia and Baylor, I would definitely go to Columbia. I would be happy at either place, but I would be happier at Columbia. I still have one more interview at The Ohio State, so things might change. I still haven’t heard back from the NIH either and that will definitely change what direction I go. If I get into the NIH, I will definitely reapply as an MD/PhD, which I am currently working on.

What happens next year still scares me because my future is still a mystery. I can’t make long-term goals to achieve because I don’t know where I’ll be, but wherever I end up will be the best for me and it will be the best route for me to take in life.

When I Grow Up

When I grow up, I want to be in a career of academic medicine. I have been pushing this idea around for the past couple of years and it has really struck me that this is what I really want to do ever since Christmas and it has been getting stronger and stronger each day. I want to be in a situation where I can practice clinical medicine, perform research, and teach at an academic medical center. That is what I truly want to do. I don't want to be just a doctor. I want to be someone who is looking for cures, teaching future doctors, and helping patients have better lives. I'm kicking myself in the head because I should have went with my instinct when I first applied to medical school. I should not have let others convince me otherwise because I only applied to MD programs when I should have applied to at least some MD/PhD programs. I guess that there is always next year.

Right now, I have three interviews for a MD. I have one next week at Columbia, one the week after at Baylor, and the last in March at The Ohio State. We'll see if I get in or not. To be honest, I hope that I don't get in and I am already starting my applications again. My hope of not getting in is because I am not sure if I can get accepted into an MD program and then switch to an MD/PhD program. If I can, that would be ideal, especially if I got into Columbia or Baylor. If not, I have my back-up plans. My back-up plan is denying admittance or postponing matriculation for a year and then reapplying. I already applied for a post-baccalaureate program at the NIH for a year. I really hope that I get into the program because it will really boost my résumé. The I can apply to MD/PhD programs and see what happens. If I don't get accepted into and MD/PhD, I have my MD to fall back on at one of the three schools above (that is if I get accepted into their institution).

Anyways, those are my plans for right now. I am really loving life. I work 30-40 hours a week in my research lab and then I am still coaching Timpview swimming. We won Region a couple of weekends ago and we are going to make a run for state this coming weekend. I hope that we can win! I am also really excited to be in New York next week for my first interview (It's my first time in the Big Apple).

Second Interview

On Sunday, I received another interview at Baylor for February 19th. I'm very excited about this one because I would like to go to Baylor more so than The Ohio State (the interview is on March 17th). I don't know if I will get in so I've started cementing my back up plans.

Currently, I am working on my primary medical school application again. This includes writing another personal statement and boosting my resume with more activities, research, service, leadership, shadowing, etc. This will hopefully make me stand out as a candidate. I am also working on an application to do a post-baccalaureate at the NIH (National Institute of Health) in Bethesda, MD (near Washington D.C.) this upcoming year. My research professor believes that I have a good chance of getting into their post-baccalaureate program since I have a lot of research experience and good grades. We will see what happens. If I do get into this program and by some miracle get into medical school too, I will postpone my matriculation to medical school and do my post-baccalaureate at the NIH. This might give me the chance to for sure decide if I want to only be a M.D. or a M.D./Ph.D. I've seriously been considering doing a M.D./Ph.D again and if I receive the post-baccalaureate, I will probably head the M.D./Ph.D route.

Anyways, there is a quick update on my life. It's good! :)

Interview #1

I got invited for an interview at Ohio State! I'm so excited! It's on March 17. It's not one of my first choices, but it is school that I could definitely attend without regrets. They have a great program and great facilities... I will see what happens and if they like me during my interview. Now it's time to prepare for the interview that is a couple of months away.

I'm hoping for more interviews coming up soon, since I have my first one.

I feel like I can breath a little now...