iPhone: Sync in Progress: 4 hrs

I have mostly switched over from my Palm TX and Blackberry Curve to an iPhone 3G as my PDA. There are still a few PDA books / medical applications that are either not available for iPhone or that I don't use often enough to justify the expense of moving and thus I'm still hanging on to the Palm TX for now. The Blackberry is history for now. I do miss the Blackberry keyboard (no surprise that the new Palm Pre has one).

I must say the iPhone has been a hit for me. I love the thing; the applications are considerably faster than on the Palm TX and that makes a pretty big difference when it comes to clinics and speed counts. Also, iPhone has some amazing applications that just aren't available for the Palm (like the Netters flash cards, for example). Skyscape has many of the major references that I think I'm going to need for Internal Medicine coming up.

The big down side to the iPhone right now are the intermittent 4 hour "Backing up" times when the iPhone sync's. Yes, that's right, 4 hours. It seems like it does this when there is a major change, such as downloading an e-book. It's not really clear. I called Apple about it, and they had no idea why it was taking so long. The data on the device doesn't take that long to transfer. You could transfer the contents of the iPhone in far less time than that over a USB connection. Apple support made me an appointment with a "Genius" at a local Apple store, and he had the earth-shattering suggestion of removing the data from the phone -- hmmm, well given that he was sure that the backup times would go down after the pictures on my camera roll came off and there was no change in backup time status-post removal of the photos, I wasn't too interested in exploring that path until Apple recognizes what the issue is and provides a fix. These long backing up / sync times don't prevent me from using the device. They are just an inconvenience. Overall, I'm very happy with my new PDA.

Art Camp

Houston has a nice museum district that offers art classes for the kids in the summer. For the past several summers my kids have been taking art classes at the Glassell School of art. They attend fir a few hours in the middle if the day and they love it!









There are several classes for kids to sign up for. They work on painting, clay schulptures, and even cartoons... whatever they are interested in.

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Originally uploaded by lukner2000

Shopping at the Galleria is a lot of fun for kids and adults. The fun doesn't always stop when you come home. Here are one of my sons and one of my daughters enjoying a lollipop. Houston is a great place to go to medical school, particularly for medical students with families.

Picture (C) 2009 by Ralf B. Lukner.

iTunes Movie Rental -- no go with Windows VISTA

I tried renting a few movies on iTunes for my kids today. My hope was to view them on a Windows VISTA computer which has a nice screen. However, I couldn't get it to work; 3 Apple support people later and still no success. The Apple support people were nice throughout the process, even though there doesn't appear to be a simple solution ... other than viewing the movies on my iPhone, which I plan to try next. It will take a few hours to download those moves, but that's OK. Anyway, it's been nice being on vacation. My hope is study a lot of Clinical Medicine before I start that rotation in the fall.

Troubleshooting AT&T DSL Internet Service Speed (Pearland, TX)

One of the issues with being a medical student is keeping your computer and Internet connection in good working order. During basic sciences, there are tons of streaming videos to watch. During clinics, there is online research that needs to be done from time to time (and occasional videos to watch on various medical procedures). Everyone has their provider of choice, and I'm using AT&T DSL here in Pearland. I have tried Comcast and AT&T U-Verse about a year ago and was less than satisfied. Comcast was slower because they throttled download speed of files, and U-Verse was unreliable (a new gateway was needed every couple of months because they kept failing).

Here in Pearland where I live, AT&T DSL has been the best up to now. However, I have been noticing more frequent outages (connection cycling) and decreased speed, particularly during the day. AT&T has a site: http://speedtest-hstntx.hstntx.sbcglobal.net/speedtest2/page3.html for Houston (for other cities, Google at&T speed test dsl) that theoretically tests the connection speed. For example, the results as I write this are ... your Throughput Download = 5.072 Mbps Upload = 598.26 kbps . When I actually download a file, I do not see anything remotely approaching 5 Mbps. The max download speed I have ever seen with DSL in Pearland over about 2 years is around 560 Kbps; the usual is more like 120 Kbps max.

Because today I was having a lot of issues browsing the Internet while studying (web pages not loading, loading very slowly, and download speeds of ~1.1 Kbps on files), I decided to contact AT&T tech support via chat. I did not have much luck at first. The techs on chat disconnected after their speed test web site reported good performance. Because I was experiencing Internet browsing and download problems with several sites, I decided I needed an application that tests actual download and browsing data speeds instead of providing a theoretical number. I obtained Cisco Speed Meter Pro and then called AT&T support over the phone. The tech stated that everything seems to be OK based on the speed test above, but referred me to higher level support after I stated that I had a network performance program that showed the throughput at various parts of the network and it showed an Internet connectivity problem after the router. I'm sure there are other programs out there, but this one seemted to have a lot of features and was not too expensive (~$40). So, I decided to compare the specifications for the service, the AT&T report results, and the results from Speed Meter Pro:

(Currently DSL appears to be operating normally)

AT&T Elite DSL Speed per the AT&T Web site advertisement as of today, 5/28/09
Downstream Up to 6.0 Mbps
Upstream Up to 768 Kbps

Per the AT&T speed test web site:
Download = 5.072 Mbps
Upload = 598.26 Kbps

Per the Cisco Speed Meter Pro v1.9052.0-Pure0:
Download = 551 Kbps
Upload = 73.5 Kbps

At the moment my Internet connectivity appears to be typical / normal. Earlier, when I was having problems (there was an outage issue, apparently), the download speed was reported in various downloads and other applications as ~400-1200 bytes / sec (yes, folks, "bytes") and this corresponded with Speed Meter Pro's results at the time of those problems. Upload speed was around 13.5 Kbps; I did not test upload the the time of the problems today.

The reason I went through this long explanation above is that until I obtained the Cisco Speed Meter Pro software, AT&T kept telling me that the problem was with my computer instead of their network (or just hanging up the chat conversations). It wasn't until I obtained the Speed Meter Pro software and told them what it was reporting what I actually observed in terms of download speed that they took me seriously enough to put me through to their 2nd tier of tech support in Los Angeles, etc., who finally confirmed that AT&T did indeed have a DSL outage in my area and that they were working to repair it. My connectivity is back, and thus I'm happy for the time being.

Time for RR between MS2 and MS3

MS2 is over and I have a few weeks off before MS3. I have been going to activities with my kids like the pirate birthday party shown in this picture here. From a school standpoint, it has been a challenging year. The fall of this past year (MS2 midway) had tons of exams to study and Jan - May gave me my first taste of clerkships and clinics. The material is interesting and I like the patients. Exams en masse are just part of student life, but the clerkships are certainly a new experience for me and took a little getting used to. In the working world, there can be a fair amount of teamwork and everyone contributing is rewarded and appreciated. Clerkships do have some of this, but mostly it's a time where you are being assessed, and thus it's more of an exercise in impressing your attending and residents. I was hoping it would be more about caring for the patients, but that is less of a factor. Knowing a long differential diagnosis or correctly explaining a difficult treatment was where points are scored, so to speak. Also, it was generally better to take on a bit less work and do it perfectly than to take on more work and risk answering a question incorrectly or missing a fact about a patient. It's pretty much about perfection in terms of your image as opposed to how well your patients are doing.

Over the next several weeks, I'll be taking advantage of time with the family, studying, and losing a little weight. I'll take the kids to swim and art camps as welll weekly activities. I'll be studying for the upcoming medicine rotation and refreshing my memory on material for the step 1 exam that I'll be taking next year. I'm so happy to have a nice break. There is so much fun stuff to do; a bit of freedom before some tough rotations in the fall and winter.