mary juanita stokes

Cambio. Venga!

2009-05-09T08:24:00.004-04:00

Hello?

Because I like change and avoiding chemistry studying, I'm moving the blog over to maryjuanita.tumblr.com, following the tumblr lead of two of my favorite people (macon and shannon), and hoping that the new format will inspire me to write more, especially as the new med school chapter begins.

I've exported all the old kenya posts to the tumblr, but will keep this one up, too--in case anyone is still out there and interested, that is.

Thanks.

On malaria recrudescence:

2009-04-11T19:38:00.008-04:00

I used to think (before I had done any significant reading on the subject) that eradicating malaria in Africa might be as simple as more widespread use of DDT, the pesticide that killed the mosquito vectors of the malaria parasite and helped to eradicate (an already diminishing rate of) the disease in much of the developed world by the 1960s. I figured that the environmentalists' DDT eradication campaign had won at the expense of thousands, now millions, of lives lost to malaria. But of course it's not nearly so simple as that.

From "Evolutionary and Historical Aspects of the Burden of Malaria":

The malaria problems of Africa were, and are, of an altogether different type from those confronted anywhere else, both in human terms and in the biological factors that underlie African malaria transmission. Above all, the stability and intensity of malaria transmission in Africa presented two huge, actual or potential, problems. When global campaigns for malaria control were being planned at the WHO in the late 1940s and early 1950s, there were many who doubted that even a tool as powerful as DDT could have a significant impact on African malaria because of the intensity of its transmission. Moreover, and by the same token, it was questioned whether it was even safe to try to reduce malaria transmission intensities in tropical Africa because of the eventual loss of immunity in the older populations and the consequent risk of epidemic malaria should control measures fail [--a situation that indeed arose in Madagascar in the mid-1980s, after the country had been essentially malaria-free for 20 years].

National malaria control organizations were nevertheless operational in many African countries by the 1950s. It must soon have become clear, however, that whatever may have been being achieved elsewhere by reducing malaria transmission using DDT, rather little effect was served by this approach in sub-Saharan Africa, except in certain limited circumstances and mainly in its southernmost parts. Nevertheless, a determined optimism reigned among the advocates of "global malaria eradication" and a policy of "intent to tackle the problem in Africa upon an eradication basis" seems to have persisted until at least 1996. In the end, however, and as the goal of "malaria eradication" collapsed in most other malaria-endemic regions of the world, this aspiration for Africa also, and inevitably, died.

...

...the 1970s marked the beginning of a period of trauma in the history of the struggle against malaria. The objective of malaria "eradication" had been abandoned. Some disarray followed as new strategies of malaria control and management were attempted. The difficulties were compounded by technical failures resulting form the development of resistance of parasites to the antimalarial drug chloroquine and of the mosquito vectors to the insecticide DDT, the two "wonder tools" through which the recent previous success had been won. Where, not long before, malaria had been reduced, in some countries almost to the point of extinction, renewed outbreaks began to occur.

...

In striking contrast to the outlook in the mid-20th century, there is an implicit assumption that malaria will remain with us indefinitely. This is, for the time being at least, a realistic and a constructive attitude. There are, as there will always be in these circumstances, two goals in the management of malaria. These are (i) to treat those who are infected and sick with malaria as quickly and as effectively as possible and (ii) to reduce to the minimum the numbers of those who are at risk of becoming infected and ill with malaria.

I'll stop pasting there, but suggest you read the entire article online (as I'm sure you're as fascinated by this as I am). In the meantime, I'll be digging deeper into the biological aspects behind the evolution of the parasite--and how our attempts to eliminate it have created more virulence--for an upcoming bio paper.

recrudesce:

2009-04-09T19:27:00.002-04:00

[recrudesce |ˌrēkroōˈdes|
verb [ intrans. ] formal

break out again; recur.

DERIVATIVES

recrudescence |-ˈdesns| |ˈˈrikruˈˈdɛsns| noun
recrudescent |-ˈdesənt| |ˈˈrikruˈˈdɛsnt| adjective

ORIGIN late 19th cent.: back-formation from recrudescence [recurrence,] from Latin recrudescere ‘become raw again,’ from re- ‘again’ + crudus ‘raw.’

--a new word for me, which I encountered in "Antimalarial Drug Resistance:"

Resistant infections are more likely to recrudesce, and eventually, as resistance worsens, infections with resistant parasites respond more slowly to treatment. Both increased rates of recrudescence and slow initial responses to treatment increase the likelihood of generating sufficient gametocyte densities to transmit, compared with drug-sensitive infections. Mathematically, it is this ratio of transmission probabilities in drug-resistant compared with drug-sensitive infections that drives the spread of resistance. The recrudescence and subsequent transmission of an infection that generated resistant malaria parasites de novo are essential for resistance to be propagated. If resistance is low grade (i.e., a small shift in the concentration-effect relationship), or combination treatment is given that is highly effective, then resistance may confer only a very small increase in the treatment failure rate, and a correspondingly slow rate of spread. As resistance worsens, failure rates rise, and the rate of spread accelerates. In the rare but important infection in which resistance arises de novo, killing of the transmissible sexual stages (gametocytes) during the primary infection does not affect resistance, because these gametocytes derive from drug-sensitive parasites. Gametocytes carrying the resistance genes will not reach transmissible densities until the resistant biomass has expanded to a population size close to that necessary to produce illness (>107 parasites). Thus, to prevent spread of resistance, gametocyte production from the subsequent recrudescent-resistant infection must be prevented.

Take home message: we don't want that malaria infection to recrudesce.

A Walk to Beautiful--

2009-03-30T21:38:00.008-04:00

is a documentary about women suffering from fistula in Ethiopia and their treatment at the Fistula Hospital in Addis Ababa. You should watch it if you can--I saw it via Netflix's "View Instantly"--though it will probably make you cry.

At one point the founder of the hospital, an older, British female doctor, remarks that only about 146 Ob/Gyn doctors practice in Ethiopia, which has a population of over 77 million people, and most of those 146 are in the city.

The film ends with a beautiful rendition of Amazing Grace.

Today the dentist found my first cavity ever.

2009-03-11T17:04:00.003-04:00

I must have indulged in too many Stoneys and Bitter Lemons back in Kenya.

The bad news didn't shake me too much, though, since last night I arrived home in Miami for spring break and then received the crazy good news that I'd been admitted to the University of Rochester Medical School, where I had interviewed on Monday. Oh wow! I'm still reeling.

Now that I know were I'll be for med school, I can go ahead and start planning for my trip back to Africa next summer (and, perhaps, for another cavity).

Story-telling matters:

2009-02-23T07:03:00.001-05:00

What drove her? One story is revealing. In Burundi, Rwanda’s neighbour, tens of thousands of civilians were slaughtered in 1993. The Western media barely noticed. Hutu officers in Rwanda concluded that they could do the same thing, and no one would give a damn. Mrs Des Forges wanted to document such atrocities so meticulously, and publicise them so persistently, that people would have to give a damn. Her book was called, after a killer’s cry, “Leave None to Tell the Story”. She knew that story-telling matters.

--from The Economist's obituary for Alison Des Forges

If I'm blogging,

2009-02-08T14:11:00.007-05:00

it must mean I should be studying. Funny how that works.

For my mom in Miami especially, here are some pics of beautiful Bryn Mawr in the snow from the past week:

Such snow remains a fun novelty for me, I admit. I wanted to build a snowman, but it was too dry.

In other, less cold news, I made two good local/East Africa connections this weekend at City-Line Church. Last night at the annual international dinner I sat next to a couple who worked with AIM in Uganda at the same time I was in Kenya. Then today at church I sat behind a guy who graduated from RVA in '99 and worked with Sam's Purse these last few years in Kenya. It took some time for me to settle on a church to attend here, and I'm thrilled to have found this church community overlapping so nicely with my former life. You should come visit sometime.

I made Picadillo, Miami-Cuban style, last night for the international dinner (as any Cuban dish would be a good representation of my home culture), and will serve the same tonight, along with frijoles y mariquitas, for my Sunday dinner crew.

Now back to the exciting world of action potentials, or how your neurons are communicating even now. (Quiz tomorrow.)

p.s. I finally threw away my dead Miami palm.

Coldest Winter

2009-02-03T18:53:00.003-05:00

Sorry for the lack of blogging lately. I'll go ahead and blame winter (and maybe labs) for sapping my writing juices.

Winter (or the fact that it had no water during my month away) has also taken its toll on my houseplant--a small palm born in Goulds, FL, according to its label, a mere 11 miles from my own birthplace in South Miami. I guess it wasn't meant to live in such a climate. I just haven't had the heart to throw it away.

Despite my palm's sad condition, I am weathering the winter and start of the spring semester quite well. It took a couple of weeks for me to warm back up to classes and studying again after a month off; and it took several too cold runs before I perfected my layering technique; but I'm on my way to mastering it all, of course. In fact, I took an invigorating run post-physics lab today--complete with the gore-tex layer to block the steady fall of snow. And as I slushed over snowy sidewalks, I imagined that it was sand and not snow underfoot. Ha!

In case you've misplaced your TI-89,

2009-01-22T21:28:00.007-05:00

or the batteries have died,

google will solve all your physics calculation needs.

For example, google this: "2pi sqrt (2.82m/g)" [g as in the force of gravity~9.8 m/s^2],

and voila! You get the right answer--with the correct units!

Yes, it's an exciting life.

Like aunt, like niece.

2009-01-15T18:34:00.004-05:00

My niece Honor, age 2, and I share several passions: books, berries, and cooking.

We also, I am told, share a strong family resemblance.

Honor:

Me (during my blonder, toddler years, as archived in the family albums):

And just because it's a great picture:

Feeling better:

2009-01-04T16:48:00.006-05:00

We've been rather sick here in Austin these past couple of weeks. Aidan and Honor had a tough round with pneumonia just before Christmas; then Kellsey and I caught the bug and got sinus infections. I've been sick for over a week, didn't make it to Chicago for the IV grad conference I'd planned to attend, and am behind on my med school application. But I'm warmer here than I might be elsewhere, and continue to love being with my brothers and their wonderful families.

Because of the sickness, I didn't take too many pics of the fam over Christmas. But the wellness juices were clearly flowing today when I captured this--Macon dancing with Aidan and Honor to "Kung-fu Fighting":

And then these shots of Honor sporting her newly acquired kitchen and associated tools:

From "As an atheist, I truly believe Africa needs God:"

2008-12-28T20:46:00.001-05:00

Christianity, post-Reformation and post-Luther, with its teaching of a direct, personal, two-way link between the individual and God, unmediated by the collective, and unsubordinate to any other human being, smashes straight through the philosphical/spiritual framework I've just described. It offers something to hold on to to those anxious to cast off a crushing tribal groupthink. That is why and how it liberates.

Read the entire article by Matthew Parris here.

(Thanks for the tip, Macon.)

Merry Stokes!

2008-12-20T07:36:00.005-05:00

I have a friend who once made a mix CD entitled "Merry Stokes." It must have been a great CD, because I met one of the friend's friends, and upon hearing my name he registered immediate recognition--and he said, "YOU'RE THE M[er]ry Stokes? Amazing."

Indeed.

Anyway, I'm feeling much more m[er]ry (and myself) today, here on the other side of the fall semester. The blurry vision which had persisted through the physics exam yesterday has mostly lifted, the freezing rain has stopped, and tomorrow I fly to Austin to see my wonderful family and be warm. Merriment abounds.

Study Break,

2008-12-18T18:30:00.008-05:00

and this time no song, but a physics problem! I'll send a prize to whoever posts the right answer first. I'll make it easy for you with multiple choice. (And I know the answer already, so I'm not trying to cheat my way to the solution with this--I'm only trying to share the fun.)

While standing in a low tunnel, you raise your arms and push against the ceiling with a force of 100 N. Your mass is 70 kg (maybe a little too much egg nog lately, Walt?).

1. What force does the ceiling exert on you?
A. 10 N
B. 100 N
C. 690 N
D. 790 N
E. 980 N
F. Ask Yoda.
G. All of the above.

2. What force does the floor exert on you?
A. 10 N
B. 100 N
C. 690 N
D. 790 N
E. 980 N
F. Your mom.
G. I don't believe in floors.

Hint: You should consider Newton's Second and Third Laws.

Hint: Acceleration due to gravity is 9.8 m/s^2.

Hint: Play the song below while you're thinking.

Study break,

2008-12-17T17:28:00.006-05:00

to share with you my current favorite song:

I Can't Stay--It's making the physics flow, and making me ready to go...

I like tension.

2008-12-14T12:37:00.008-05:00

My American Heritage Dictionary defines tension as:

1 the state of being stretched tight : the parachute keeps the cable under tension as it drops.
• the state of having the muscles stretched tight, esp. as causing strain or discomfort : the elimination of neck tension can relieve headaches.
• a strained state or condition resulting from forces acting in opposition to each other.
• electromotive force.
2 mental or emotional strain : a mind that is affected by stress or tension cannot think as clearly.
• a strained political or social state or relationship : the coup followed months of tension between the military and the government | racial tensions.
• a relationship between ideas or qualities with conflicting demands or implications : the basic tension between freedom and control.

Tension has benefits and drawbacks. Because our muscles have tension they hold up our body and support our bones; because the cables in the bridge have tension we can cross the water; because I feel tension/stress about my upcoming exams I will learn the material necessary for success. But too much tension can cause muscles to tear, bones to break, perhaps even my migraines and blurry vision.

The physical and physiological implications of tension are interesting enough; but I mostly like tension because of how I see it function in a good poem and in the Christian life.

Two poems, in which tension functions through ideas with conflicting demands or implications--

Death, be not proud (Holy Sonnet 10)
by John Donne

Death, be not proud, though some have called thee
Mighty and dreadful, for thou are not so;
For those whom thou think'st thou dost overthrow
Die not, poor Death, nor yet canst thou kill me.
From rest and sleep, which but thy pictures be,
Much pleasure; then from thee much more must flow,
And soonest our best men with thee do go,
Rest of their bones, and soul's delivery.
Thou'art slave to fate, chance, kings, and desperate men,
And dost with poison, war, and sickness dwell,
And poppy'or charms can make us sleep as well
And better than thy stroke; why swell'st thou then?
One short sleep past, we wake eternally,
And death shall be no more; Death, thou shalt die.

A Christmas Carol
by Christina Rossetti

In The bleak mid-winter
Frosty winds made moan,
Earth stood hard as iron,
Water like a stone
Snow had fallen, snow on snow,
Snow on snow,
In the bleak mid-winter,
Long ago.

Our God, Heaven cannot hold Him
Nor earth sustain;
Heaven and earth shall flee away
When he comes to reign:
In the bleak mid-winter
A stable place sufficed
The Lord God Almighty
Jesus Christ.

In the Christmas story, our glorious God humbled himself and became flesh--in "a stable place." In his flesh he died on the cross yet rose three days later so that we have life. We live in and are saved by this grace (itself a tension-filled idea in its unmerited favor) and transformation of death to life; yet we still sin, limited by our flesh. And while suffering remains in this life, the gospel fills us with hope--making our souls well despite our sin and suffering.

Ahh, Christmas! Come, Lord Jesus. (And we wait, too, for the tension-free glory of heaven.)

O Davidson:

2008-12-14T08:21:00.007-05:00

I'm sure I don't have to remind everyone to be on the lookout again for Davidson this basketball season. They're off to a great start--a top 25 ranking, and Stephen Curry playing so strong. It's nice to be on this side of the world for the action, though without a TV I'm not sure I'll actually see more of the games than before. I'll at least be with the brothers (and a TV) in Austin for the Jan 7 Duke game. (And to my Duke alum readers: I'm confident your loyalties now lie with the red and black after investing three kids and 12 years of college tuition in the fine institution. No conflicts here.)

As Walt used to eloquently shout: Go Cats!

In honor of my final exams:

2008-12-13T14:13:00.005-05:00

1. I purchased (via itunes) music for the first time in long while: 1. the brand new Killer's album, 2. Coldplay's Viva la Vida (including bonus Prospekt March Edition tunes--which makes me glad I waited so long to buy this one), and 3. Live Your Life by TI, w/ Rihana. (I stopped there, mainly because I was thinking of the post below and couldn't in good conscience buy more; there's always Pandora, after all.)

2. I went for a long run, listening to #1, by way of the science building at Bryn Mawr to pick up some practice exam worksheets for Chem.

3. I mostly finished writing a final research paper.

4. I balanced my checkbook.

5. I wrote this post, listening to #1.

I'll study now, to some good tunes, well exercised, and ready for a break from writing (but still with the blurry vision from the migraine, alas).

A week until Austin!

Just another plug to buy school lunches in Kenya:

2008-12-12T18:54:00.004-05:00

Still Christmas shopping? You can still buy school lunches for kids in Kenya in honor of that special someone. Read this from Steve's latest update:

Nancy [Steve's wife] has started getting involved in a local orphanage for little girls, and we went over there the other day. To see how little they have and how happy they are can help you look at your life in a new way. They have 20 little girls and they live in the simplest way you can imagine. The government is supposed to help them, but they haven't quite gotten around to it yet. Edwin, the man in charge, told me `There are so many orphans.'

That was my cue to want to talk about all the need there is, and how this week, as headmasters called me and asked if we could add their schools, I was forced to say that no, I haven't been able to raise the monies needed to add any schools this year. To hear grown men cry is as horrible as anything I can think of.

But Edwin said `With what little we have, we are satisfied.'

And for the first time, I realized that I could be grateful for what we could do, and not bemoan my failures. We ended the year with 18,300 children being fed lunch every school day. Virtually every school had huge increases in how they were rated in their zones, and the dropout rate flirted with 0%. We have 15 computer centers operational now, and Bruce Kinzer, the force of nature who builds them, has started to add shelves to the centers, so they can also function as a library.

You can put your gift money to good use here.

Christmas Gift Idea:

2008-12-09T12:31:00.005-05:00

In case you're still looking for that perfect gift for your special someone--here's a great idea:

Help feed school kids in Kenya! (Via good friend Steve Peifer at RVA and AIM.)

I love the school kids; I'm sure you do too:

Good friends thwart more lost days.*

2008-12-08T08:02:00.012-05:00

I did lose Sunday--though I'm not sure it's fair to call a full day of rest a lost Sunday. Before my resting could stretch beyond the weekend, however, the friends helped bring it to an end. I'd invited them over for our weekly Sunday evening dinner/Bible study. When I didn't answer my door, they asked the apartment management to open my door to make sure I was ok. Once inside, they found me in a rather delirious state. After checking with my folks at home, a couple of friends decided to spend the night to make sure all was well. When they woke me up this morning, I had no idea what had passed these last 24 fours; but I was relieved to have a couple of friends to explain it to me. My mom had already booked a flight up here, but I was able to call and let her know I was OK in time for her to refund the trip. I'd rather save that trip for a time when I'm more able to enjoy her company!

I do sill have a pot of lasagna sauce made and aching to be used in my refrigerator. I"m hoping my friends will be able to come back and help me to finish that off.

I just need to make it less than 2 weeks to the end of our exam period: through 1 research paper and 2 finals.

Remembering this: Lamentations 3:22-23--Yet this I call to mind and therefore I have hope! Because of the Lord's great love we are not consumed, for his compassions never fail. They are new every morning; great is your faithfulness.

*Original lost days.

**Please excuse typos on this post--as my vision remains blurry.

O December.

2008-12-01T14:01:00.007-05:00

Two emotions: slight panic vs. great anticipation.

Panic: Less than three weeks remain in the semester: 2 labs, 1 long and 1 short paper, and 2 final exams to go. Ugh.

Anticipation: In three weeks time I will see my family in Austin, where they're already preparing for Christmas. I especially look forward to basking in the increase of my aunt-dom: as last week Felicity and Nautica became Walt and Morgan's beloved children and joined cousins Aidan and Honor in the next generation of Stokeses. Such joy!

Anticipation: we sang two of my favorite hymns in church yesterday:
first "O Come, O Come Emmanuel"--

O come, Thou Day-Spring, come and cheer
Our spirits by Thine advent here
Disperse the gloomy clouds of night
And death's dark shadows put to flight.
Rejoice! Rejoice! Emmanuel
Shall come to thee, O Israel.

and then "O the Deep, Deep Love of Jesus"--

O the deep, deep love of Jesus,
Spread His praise from shore to shore!
How He loveth, ever loveth,
Changeth never, nevermore!
How He watches o’er His loved ones,
Died to call them all His own;
How for them He intercedeth,
Watcheth o’er them from the throne!

Great anticipation definitely wins.

Thanksgiving action:

2008-11-29T18:09:00.010-05:00

I'm back home in Bryn Mawr after a good weekend at the Fleming/Dewhurst Thanksgiving festivities at Melissa and Scott's house in Florham Park, NJ. It was my first Thanksgiving on U.S. soil after 2 years away, and it bustled with exciting activity:

First, as soon as I arrived via train from Philadelphia on Wednesday night, the pie making commenced:

Then, on Thursday morning, I ran the Ashenfelter 8k Classic with Scott:

We followed the race with a grand feast (spread over the orange Masai blanket I brought to Melissa from Kenya):

Then we walked and swung the feast away at the local park:

Friday I joined Melissa on her commute to Manhattan, and wandered down 34th St and up 5th Ave to Rockefeller Center:

I did my part for Black Friday and bought a pair of soft, warm gloves at a great price at Lord and Taylor on 5th Ave.:

And, finally, Friday afternoon, I was guitar hero:

Now it's back to the grind--a couple of papers and exams to go before we Stokes gather for Christmas in Austin. I can't wait to see my family--especially my new nieces.

On the Bolt Bus:

2008-11-29T11:25:00.006-05:00

which runs Boston-NYC-Phila-DC. I'm taking the NYC-Phila leg, currently in the tunnel out from Manhattan, on the way home from Thanksgiving at Melissa's. Bus-riding with wireless, $13 a trip--not bad at all. (But not nearly as interesting as this bus ride.)

Quick race update:

2008-11-23T15:31:00.019-05:00

(*new stats added below!*)

Three signs it's too cold to be racing:

1. When the guy on the train to the race asks if you're going skiing, as might seem reasonable given the temperature outside (26 degrees?) and the ski wear that you are, in fact, wearing.

2. When the water stations have iced over, leaving slippery spots on the road.

3. When only after several miles of running do you begin to feel your toes again.

Four reasons to run despite the cold:

1. You can't get the Rocky theme song out of your head. (This is Philadelphia, after all.)

2. There are fans lined up along the route to cheer you on who are probably even colder than you.

3. You've got friends along for the race (two of whom ran very impressive marathons--Eric at 3:08 and PJ at 3:23).

4. You'd rather be running in the cold than warm and studying for a chemistry test.

Personal Race Stats:

-Forms of transportation taken to race: 5: car to Bryn Mawr R100 high speed rail station; R100 to 69th St. Terminal; bus (because el under construction along this leg) to Market/Frankford Station at 40th St.; el to 30th St. Station; taxi from 30th to start line; actual transit time about 35 mins; total elapsed time during transit (waiting for bus, el, etc.) about 1 hour
-1/2 Marathon time: 1.53.08 (vs. champion woman's time: 1.16.17; time to make up on next race: 36.51)
-Average spilt: 8.41 (shy of my 8.30 goal; I blame the cold and ice, of course)
-Overall Place 1093 / 5184
-Gender Place 438 / 3303
-Division Place 118 / 762
-Clif gels consumed: 1 (apple pie flavor)
-Water cups taken, icy spills avoided: 3
-Layers shed: 2 (first shirt left behind at start; second tied around waist)
-Friends found post race: 4 (impressive in a crowd of well over 18,000--the number of runners, not including spectators)
-Friends missed during race: 3 (2 watching somewhere along the way; 1 running the half, too)