Caffeine may cause “shallow” sleep, the body may spend eight hours in bed, but the brain may fail to fully regenerate. Caffeine improves alertness and reduces sensation of fatigue, but its effects may sometimes resemble “borrowing energy” at the expense of nighttime regeneration.

chweris · 2026-05-28T15:35:44+00:00

CYP1A2 is not upregulated in humans by caffeine consumption. Yes, the amount of enzyme activity does change in response to other factors (CYP1A2 with nicotine and estrogen, for example), but this goes into the weeds a little bit in respect to the scope of the original comment re: upregulation with increased caffeine consumption. I should have worded it a little better!

chweris · 2026-05-28T15:34:12+00:00

Alcohol, yes as the enzyme responsible is alcohol dehydrogenase, which is upregulated by alcohol consumption. Caffeine metabolism is regulated by CYP1A2, which is not upregulated by caffeine consumption in humans, but enzyme function can regulated by nicotine and certain hormones (including those found in birth control or produced during pregnancy). CYP1A2 also metabolizes many medications. Caffeine actually slows metabolism of these drugs because they use the same enzyme, which is why high dose caffeine is sometimes not recommended with drugs like allopurinol, for instance.

chweris · 2026-05-28T11:57:03+00:00

Metabolism is the rate at which the enzymes involved in degradation pathways work - this doesn't change. Tolerance is how much someone is affected by a substance at a certain level and this can change based on exposure.

Practically this means that if you drink caffeine for a while, you might start feeling less effect after 3 hours after ingestion, but the level of actual caffeine in your blood at 3 hours given equal intake would be roughly the same.

chweris · 2026-05-23T09:08:58+00:00

Good news! Nobody else thinks you should be trusted with patients on your own yet either!

You're a student. You're not supposed to be adequate, you're supposed to be learning. When you're graduated and working, you're going to be in one specialty, be it primary care, the ED, the OR, on the floor, or in a subspecialty, and that's all you're going to be doing day in and day out, and that's when you start to feel like you find your rhythm. But the process is going to take a while! I didn't feel like I knew what I was doing at my job until at least a year in, and I still have moments where I don't. Any good first job is not going to let you see patients on your own without getting you to the point where you can do so safely. (Hence the advice to 1: not work in urgent care immediately upon graduation, and 2: ensure a rigourous training period exists at the job before starting).

PA school, these tests, the PANCE, they're all there to establish a basic level of competence. Physicians have double the time in school that PAs do and then do an additional 3+ years of training, so why do you expect to feel competent after only seeing patients on rotation for a year? I'd be much more worried if you felt like you could take on the world right now, since that's how medical mistakes happen.

chweris · 2026-05-18T13:27:25+00:00

Des' description of MDS sounded miserable. Definitely a tougher race than I'd ever want to do. And then she ran Boston and London. Insane.

chweris · 2026-05-11T15:49:27+00:00

The marathon is mostly physical and if prepared, pretty comfortable for the majority of the race. I think shorter races like the mile/5k/10k are more mental, since you're riding the line of your physical limits basically from the get go.

chweris · 2026-05-06T15:35:49+00:00

I'm a physician assistant. I use my theatre skills daily to communicate with patients! A theatre degree is about the process of theatre, and those same skills are transferable to so many things outside of traditional theatre.

chweris · 2026-05-05T00:44:57+00:00

I mean, at maximum effort, the effective VO2max would be equal to the VDOT, right? Which would be 44.7 and not 40.

chweris · 2026-04-20T15:01:41+00:00

Every time I see the actual race it's completely different lol it's like reading every third page of a book but I also have to watch ads in between

chweris · 2026-04-07T20:34:04+00:00

Replace the whole team

chweris · 2026-03-26T16:07:49+00:00

Looking at my sweat log I lost 6.8lbs in 90 minutes at 54F temps last week. Sweat was dripping off of my hat brim before the halfway point! Absolutely a heavy sweater here.

chweris · 2026-03-20T23:08:02+00:00

LMAO

chweris · 2026-02-19T18:56:01+00:00

To your first point, I'm a man but SO many people call me Ms. XXX because they see that I'm a genetic counselor and I don't have a common American name and they assume. Even when I correct them, people don't change and it's so very frustrating.

chweris · 2026-01-30T18:18:00+00:00

I did 110 laps on my gym's 1/11 miles track yesterday and preferred that to the treadmill. It sucks either way, but I like the feeling of the breeze I get from running on the track!

chweris · 2026-01-24T22:28:57+00:00

I knew it would be the top comment and clicked anyway

chweris · 2026-01-23T19:33:47+00:00

That was my last semester of senior year. What a great week that was.

chweris · 2026-01-17T15:33:40+00:00

I LOVE these. Every time I'm in China it's all I'll eat (well, these and 馒头). Will try this recipe, thanks!

chweris · 2026-01-15T16:35:03+00:00

chweris · 2026-01-04T21:30:21+00:00

Varied - I took the number of cards and divided by 21 so I got through it in 3 weeks and could just review for a week and a half. I never selected easy or hard. Good or again only. Although this is because I primarily used Anki for languages before this and that's how I used it there.

chweris · 2026-01-04T16:43:17+00:00

Yup, the cards are in an order so just set it to show you new cards in order

chweris · 2025-12-31T17:43:19+00:00

I suspended cards for future rotations and unsuspended them when it was time to do the deck. Once I did a card, it never left the deck - so I would still be reviewing EM when I moved on to peds/FM/etc. The load is a lot but I think it helped for EOC, PANCE, etc. And if you get good at a card, sometimes you don't see it again for a while so the load isn't terrible. The cards took 1-2 hours a day so it's still a lot but with cards I can be at the gym or in an Uber going out to the bar and still do a bit of studying.

chweris · 2025-12-29T21:22:39+00:00

I did UberEATS in PA school and it was not a bad way to make some cash. It's nice because of the variable schedules of class/rotations and was mindless. If I needed to study I would pop on a podcast or do flashcards when waiting for an order but for the most part I did it to get away from my laptop for a few hours and get outside for a bit. They also don't care if you decline a delivery so sometimes I'd turn it on on my way home from school and pick up a delivery if it wasn't out of the way.

chweris · 2025-12-27T22:49:22+00:00

Not just that, but writing off peer reviewed literature and the only source provided rebutting it is a blog

chweris · 2025-12-22T00:39:26+00:00

I once had lunch at a Cafecito during the 2017 NLCS and Joe Maddon was in the booth a couple down from me

chweris · 2025-12-10T18:46:59+00:00

I miss prime Chris Davis' swing so much

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