Author Archives: Samantha Francesca Sichenze

A Successful Surgery

While I was home last weekend, I saw an amazing story on the news.  It was about the successful separation of two conjoined twins at Montefiore Hospital in the Bronx.  It made me want to learn more about the back story surrounding these twin boys.

The McDonald boys, Anias and Jadon, were born to parents , Nicole and Christian, on September 9, 2015.  But these parents’ fear and anxiety began in May, 2015, when following a routine sonogram, they learned that not only were they having twins, but that they shared a head. Although the family briefly considered termination for the sake of the children, they knew in their hearts that these twin boys were meant to be theirs. They knew that their lives would be forever changed, and they set out to learn about the condition and what they were to expect in the future.  

Twins conjoined at the head, known as craniopagus twins, only occur in one out of every 2.5 million births.  Many children don’t survive the birthing process, and of those who do, only about 20 percent survive past their second birthdays if not separated. It is traumatic for the two babies to share an organ, especially one as important as the brain.  So, what was the family to do?  Prior to the mid-1980’s , separating these types of conjoined twins often relied upon saving the stronger twin at the sacrifice and death of the weaker one.  It was not at all uncommon for both babies to die, or for the stronger twin to suffer tremendous brain damage. 

So , this family set out to find the best possible doctor and team to perform this incredibly difficult surgery – and they did.  They discovered Dr. James T. Goodrich at Montefiore Hospital in the Bronx.  He is known as the doctor who has pioneered the field in the separation of craniopagus twins.  Through his work , he has discovered that the odds of saving these babies increases if he breaks down the procedure into several smaller procedures.  Otherwise, these twins are left facing a fifty hour surgery.  There have only been 59 craniopagus separation surgeries performed in the world since the early 1950’s and Dr. Goodrich has performed seven of them.  The McDonalds moved their family from Illinois to the Bronx to be able to work with Dr. Goodrich and his team. The twins proceeded to have three operations to begin the separation process for their shared brain.  Various vessels were separated and spacers were slowly inflated in their heads to stretch the skin to cover the skulls when they were finally separated.


On Thursday, October 13, 2016, however, the doctors and the twins underwent a huge surgery to separate the remaining brain tissue and their heads. In preparation, the surgeons studied several 3-D models of the twins’ heads, brain, and vessels. Dr. Goodrich worked closely with plastic surgeon, Dr. Oren Tepper, who was responsible for reconstructing and closing the twins’ heads.  Following two hours of prepping , these conjoined twins were on their way to being separate for the first time.  Five surgeons worked tirelessly for over sixteen hours, cutting and separating vessels and tissue, turning the conjoined twins carefully, until these two, small boys who were always together, were finally apart. The final stages of the surgery were harrowing for the surgeons.  They had to deal with tiny blood vessels that were intricately intertwined and susceptible to heavy , uncontrollable bleeding.  Unfortunately for the boys and their family, this was only the beginning.  Each twin, now separated, had to undergo many more hours of surgery to repair their skull caps and skin. 


The boys both survived the surgery, although Anias has had some post procedure complications.  But no one, including the doctors can predict exactly what long term consequences there will be to separating and removing portions of their brains. The boys remain under heavy sedation for the time being, but will eventually have to learn how to sit up, crawl, and possibly walk. Their future is uncertain, but this surgery has definitely increased their odds of survival.  The family continues to rely on their faith and the prayers of the world to pull these boys through.



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Do Red Heads Feel More Pain?

This might seem intense, but being a redhead has affected my life in so many ways. I stand out like a sore thumb. I’m always getting called ginger, Shirley Temple, Annie, or carrot top. If I stand in the sun for more than five seconds I burn and gain fifty more freckles. We, redheads,  only make up 2% of the world population. I thought I knew everything about being a redhead. I was wrong. The other day I was walking and I stubbed my toe on the side of the chair. I yelped because for some reason it felt like the most painful thing in the world to me. My friend responded, “don’t feel bad that you’re a baby, red heads feel more pain.” I was so confused. Skeptical on whether or not her statement was true, I decided to do research. 


Surprisingly, she was right! But how could a hair color affect your nerve cells? Scientists believe that redheads are more prone to pain due to a mutation in a gene that affects the actual hair color. The mutated gene produces a protein that accounts for pale, white skin, red hair, and freckles. This regular gene produces a protein, known as melanin, that allows those with hair color other than red to allow the skin to darken. Additionally, more symptoms from this mutated gene include perception of pain and the effect of specific drugs used to get rid of the feeling of pain and discomfort. In other words, we, redheads, are more sensitive to things like anesthesia and drugs that are painkillers. For example, it has been found that redheads require twenty percent more anesthesia than people with other hair colors.  Continuing on with more effects that the mutated gene has on us, redheads are very sensitive to warm and cold temperatures. Surprisingly, colder temperatures harm redheads more than warmer temperatures. In fact, redheads tend to become more sensitive and feel more pain in temperatures ten degrees warmer than the average for blondes and brunettes.  


Redheads’ extreme resistance to anesthesia has caused most of us to avoid dentists in fear of having to undergo dental work that requires a large amount of anesthesia. In addition to fearing the dentist, we also have to ensure that, if a procedure requires anesthesia, that the doctor goes into the procedure aware of the fact that an excessive amount of anesthesia will be necessary. The type of pain that redheads are most effected by is thermal pain. Now, when people joke with me saying that redheads experience more pain than others I know that this is a real thing , and will not be taking it as a joke. Also, when I suddenly get sunburn and even more freckles, I can attribute that to our increased sensitivity when it comes to pain. It amazes me how I have been able to go this long without ever realizing or stumbling across the proven fact that redheads are more sensitive to pain and experience a greater amount of pain than blondes or brunettes.

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Party on Mars

    As a hospitality management major, I may someday be involved with party and event planning.  I never, however, considered the prospect of planning a party on Mars, but maybe I should.  President Obama recently wrote an op-ed and delivered a speech where he encouraged the United States to send people to Mars by the 2030’s.  This prompted people to ask whether this was even possible.  Most believe that it is, but not without help from the private sector. 


Let’s begin by taking a look at some of the history of the space program in the United States and why we haven’t accomplished this trip to Mars already.  For the most part, it comes down to money.  Everyone remembers growing up watching the various moon trips and landings.  In fact, President Obama was always touched by a memory of watching astronauts returning to his childhood home in Hawaii. Not long after the Apollo trips, it was believed that a Mars landing may not be far off in the distant future.  But then President Nixon cut back funding for NASA, leaving only the space shuttle in operation. President George Bush indicated a desire to send astronauts back to the moon and hopefully to Mars, but was discouraged and the project was eventually halted due to the unbelievably high cost of the plan.  The combination of political forces and access to money led to the decline in the space program.  The portion of the federal budget allocated to NASA has dropped from 4.4 percent in the 1960’s to 0.5 percent today.

So this is where the private sector now comes into play.  NASA realizes that it will need the help of commercial partners if it wants to succeed in its mission to Mars.  NASA recently developed the Next STEP program – Next Space Technologies for Exploration Partnerships.  NASA Administrator, Charles Bolden , recently discussed how the Next STEP program is reaching out to private companies to design various space habitats.  He is also looking for creative ideas and ways to use the existing International Space Station .  The United States is committed to funding the Space Station through 2024, so it makes sense to try to find ways to utilize its laboratory functions. After 2024, the United States can then use that money and those ideas to move forward on its Mars exploration.

There are also American companies that believe it is their technology that will eventually take the astronauts into space and on to Mars.  Boeing’s CEO has been quoted as saying that he believes the first astronauts to land on Mars will arrive their on a Boeing rocket . Elon Musk, the CEO of Space X, believes that his company will be able to take people to Mars by the year 2025.  William Gerstenmaier, a NASA administrator, is not quite as optimistic.  He believes that it will take until the 2030’s for a mission to orbit Mars, and until the 2040’s for a Mars landing.

What remains to be seen is whether the next administration will be as excited as President Obama about the future of our space program , and whether they will be willing to fight for the funding necessary to see it happen.  It goes without saying that the space program inspired many young people in the past to focus their studies on many fields involving math and science.  With the addition of many private companies and commercial  ventures  into the space market, one can assume that the demand for scientists and engineers will grow in leaps and bounds.  Presumably , this will encourage children to once again focus their studies in the direction of science and math.  With the pool of resources and knowledge present and growing in the United States,  I’m certain that someday I will be planning a Super Sweet 16 on Mars!


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Don’t Take The Chance

    Want to feel “ soft, fresh, and comfortable?”  Johnson and Johnson would say to use a bit of baby powder.  But today, many people would say, “Not so fast.”  You see , although women have used baby powder for years, some now believe that it has contributed to ovarian cancer.  Just as many, however, would argue that there is no correlation between the two. As we learned in SC200, correlation does not always equal causation. So what is a woman to believe?  As it turns out, it may not be an easy answer.

Women have recently begun suing Johnson and Johnson claiming that their baby powder caused them to get ovarian cancer.  Juries in several cities and states have actually awarded plaintiffs hundreds of millions of dollars.  But scientists around the world are not in agreement as to whether the studies have sufficiently proven that talcum powder can cause ovarian cancer.  Dr. Shelley Tworoger, an associate professor of medicine and epidemiology at Harvard , has indicated that it is very hard to study cancer causes, because cancer develops over a long period of time and is actually influenced by many factors, some internal, and some external. Obviously we can never deliberately expose women to talcum powder and then wait to see if they develop cancer.  Instead, most studies question women who have already been diagnosed with ovarian cancer and try to determine if they all have some factor , like powder usage, in common.  In fact, a Harvard professor, Dr. Daniel Cramer, did just that.  He studied and compared 215 women with ovarian cancer against 215 healthy women.  He did in fact find that women who used talcum powder in their genital area were three times as likely to get ovarian cancer. He has been used as a paid expert by many of the plaintiffs involved in the law suits.    Several studies confirmed those findings, while several studies found no such results.  Critics , however, find that the results are often skewed, because women with cancer commonly look for an explanation for that cancer.  Dr. Larry Copeland, an oncologist from Ohio State University’s Medical Center,  and admittedly a paid expert for Johnson and Johnson, claims that when women with cancer are asked if they ever used talc, they tend to believe that it must be the cause of their cancer.  Dr. Sarah Temkin, a professor at Johns Hopkins School of Medicine, agrees . She doesn’t believe that the evidence is strong enough to force the manufacturers of talcum powder to place a warning on their labels. She believes that the link between talcum powder usage and cancer is nonexistent or extremely small and finds that it would be more beneficial for women to focus on more well established risk factors such as family history of ovarian or breast cancer.

You may be wondering what the link is between talc use and ovarian cancer.  Specifically, why would powder usage lead to cancer?  Even this is not abundantly clear.  Some researchers believe that the talc crystals move up the genitourinary tract into the peritoneal cavity and subsequently embed in the ovaries.  In fact, Deane Berg, a plaintiff with ovarian cancer who won a verdict against Johnson and Johnson , had talc particles found in her cancerous tissue.   Dr. Tworoger  believes that it may be that talc causes inflammation which can then play a role in the development of cancer cells in the ovaries.  The Food and Drug Administration has refused to require a warning label on the products, finding that there is no conclusive evidence to establish causality.


     So then, why does Johnson and Johnson keep losing lawsuits if the evidence is inconclusive that talcum powder causes ovarian cancer?  It seems possible that the jurors don’t know who to believe.  Both sides hire experts that put forth studies supporting their claims.  Perhaps the jurors just believe that Johnson and Johnson is a multi-billion dollar company that cares more about making money than keeping women safe.  Bottom line – why take the chance? Stick to a talc free, cornstarch-based powder which are considered safe when used anywhere on a woman’s body.  

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Naming of Hurricanes

     When I was little, I thought of Sandy as the pretty, blonde girl in Grease, or the shaggy dog in Annie.  But ever since high school, I  now  associate the name Sandy with the hurricane that destroyed so many of my classmates’ homes.  So recently, when I was listening to the news warning of the impending doom of Hurricane Matthew, it made me wonder how hurricanes get their names and why they have names at all.

I learned that the history of naming hurricanes is far more involved than I would have ever imagined.  Apparently an Australian forecaster by the name of Clement Wragge was the first person to not only track storms, but to give them names.  According to Chris Landsea at the Atlantic Oceanographic and Meteorological Laboratory , it was in the early 1900s when Wragge first started using letters of the alphabet to name the storms.  It was when the government of Australia refused to support his efforts, that he began naming the storms after local politicians that he did not like.




In the United States, the naming of storms seems to have begun with military forecasters.  Most often they named them by using the alphabet, but there were occasions when female names seemed to sneak into use. But why name these storms at all?  The true need for the names arose in the early 1950s.  During the summer months there were several storms brewing at the same time.  This caused major confusion during radio broadcasts when people were not sure which warnings applied to which storm.  So , in 1950, the United States Weather Bureau and the Interdepartmental Hurricane Conference named the fourth storm of the year, Fox.  In 1953, the Weather Bureau and the Hurricane Conference officially began using female names to label the storms.  Of course, only using female names led to some controversy.  As more women became meteorologists and as women’s roles in general began to change, there was a push to include men’s names as well.  In the 1970s,  Roxcy Bolton, the vice president of the National Organization for Women,  petitioned the Weather Service and requested that the storms be named after congressmen and senators.  Although her requests were denied for many years, by 1979,  Dr. Bob White, the administrator of the National Oceanographic and Atmospheric Administration admitted that it was the right thing to include men’s names on the list.

     Today, tropical storms are given a name when they develop a rotating pattern and wind speeds of 39 MPH.  At 74 MPH , they become hurricanes.  There are six lists of hurricane names in use for the Atlantic Ocean.  The lists rotate, with one being used each year.  This year’s list, for example, will be used again in six years. The one exception to that rule, however, is that the names of particularly deadly or damaging storms are taken out of the rotation.  Camille, Katrina, and Sandy, for example, will no longer be used.  A complete list of retired names can be found at the National Weather Service website. 

  This year’s Atlantic hurricane names include:  Alex, Bonnie, Colin, Danielle, Earl, Fiona, Gaston, Hermine, Ian, Julia, Karl, Lisa, Matthew, Nicole, Otto, Paula, Richard, Shary, Tobias, Virginie, and Walter.  I would guess that because of  Matthew’s strength and devastation, it will now be taken out of the rotation . So maybe someday soon I will be able to return to the days of thinking of Sandy as a dog.

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An Unforeseen Consequence of Zika

Remember Ebola two years ago? The disease that triggered paranoia and panic throughout the world. The epidemic started in Guinea, but was able to progress and spread rapidly to many countries, including America. However, hearing the phrase “Ebola” is like shopping at Aeropostale, outdated. The newest disease that you see on almost every headline or hear people nervously chatting about is the Zika virus. Just like Malaria, the Zika virus is spread by infected mosquitos. The Zika virus was first found in the Zika Forest, located in Uganda in 1947. However, it wasn’t a human who was infected, it was a monkey. In the beginning, no one was concerned that it would end up being a global scare until it started to spread to places such as South-East Africa, Philippines and Polynesia. Polynesia, being so close to South America, caused the virus to spread to a highly, populated area, Brazil. A couple of years later, the Zika virus crossed the Pacific Ocean and dispersed in Mexico and the Caribbean. Like Ebola, the virus has made its way over to the United States.

Florida, in particular, has been one of the states to have the most outbreaks. The Centers for Disease Control (CDC) gave Florida two million dollars in funding for the Zika virus. The CDC also provided Zika prevention kits to the residents living in areas of outbreaks. Pregnant women are in the most danger and should be extremely prudent. If affected, their babies could have extreme birth defects, such as Guillain-Barre syndrome. Due to the extreme danger of the Zika virus and the effect it can have on people, the local officials in South Carolina decided to take charge after four residents were diagnosed. Using naled, a pesticide used for mosquito control, they aerial sprayed 15-sqaure miles of a county near Charleston. This specific pesticide is extremely harmful to honeybees, and resulted in the death of 3 million of them.


What’s the big deal? Why should we care? Beekeepers businesses are being destroyed. Juanita Stanley, a beekeeper in Summerville, South Carolina, had to walk outside to see her moneymakers dead in clumps on the ground. Her business, Flowertown Bee Farm and Supply, had to destroy all the hives, honey, and equipment because it was polluted from the chemicals. She didn’t even have to wear a bee suit because there were no bees left alive. She just fell to the ground and sobbed. Click the link to watch an interview with Juanita Stanly. Jason L. Ward, the county administrator, decided to spray the pesticide on Sunday morning because less people would be out. He also stated that in order to protect the bees you shouldn’t spray the chemicals shortly after the sun has been up. The chemical states that it is very toxic towards bees and you should only spray it when the bees are less active, which is two hours after the sun has risen. Ward, defending himself, states that he followed those rules. He also reassures his decision by asserting that he notified the residents of the spraying and forewarned beekeepers as well. Stanley disagrees with Ward, saying that they only warned her of truck sprayings, but never aerial sprayings. She claims that if they did warn her then she would have told them to spray at night, not in the morning when the bees are busy doing their work. Dr. Dennis vanEngelsdrop, a bee researcher at the University of Maryland, was astonished. He believes that the spraying of the naled was pointless because there are plenty of ways you can control the mosquitos without murdering beneficial pollinators. Accident or not, this was an incident that could have been easily prevented. This was definitely a learning experience that ignorance should never be used as an excuse, especially when it comes to harming your very own community. Let’s hope other administrators learn from this unnecessary tragedy.


College Students and Anxiety

Although college is usually depicted in TV shows and movies as a life full of frat parties and sporting events, the sad truth is that many students, especially freshmen, find themselves suffering from anxiety and depression. Some students find the transition from high school to college to be overwhelming. Many struggle with feelings of homesickness in addition to issues  with classes, roommates, and workload. Although most students now have the freedom that they always desired, they are also pulled away from family and friends, getting inadequate amounts of sleep, and often using illegal substances. Without anyone present to supervise them, some students find this new lifestyle stressful. To make matters worse, they often spend their time watching other kids apparently having the time of their lives on Instagram.  The question becomes, when are these feelings normal, and when do they require intervention?

Mary Commerford, PhD, director of the Furman Counseling Center at Barnard College believes that this type of activity of comparing your college experience to what you believe are other people’s, leads to more anxiety and unhappiness among freshmen.  She counsels students to recognize that it is normal to take some time with making new friends and adjusting to their new living situation.  Unfortunately, some students progress from normal “freshman blues” to serious mental health issues, especially if they experienced them before college.  The director of counseling and psychological services at Appalachian State University notes that anxiety has become typical in today’s college students. A study at our own Penn State showed that more than half of the students who visited the campus clinics stated that anxiety was a health concern for them. In fact, most college clinics have seen a tremendous increase in the number of students visiting campus mental health facilities.  This may be partially due to a decrease in the stigma surrounding mental health diagnoses. Although most counselors see students seeking treatment as a positive change, it has caused tremendous strain for campus mental health centers. These centers can often treat the mild cases of anxiety with several early interventions. But there is always the risk that if a center is at capacity and a student can’t get an appointment for an extended period of time that their condition could worsen. Studies, such as one performed at Ohio State, have shown that students who receive counseling are more likely to stay in school.


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A student knows themselves better than anyone else knows them. They need to recognize the symptoms of anxiety and even depression in themselves. Certainly if the symptoms  of sadness, fear, lack of sleep , lack of appetite, or social disinterest are affecting a student’s ability to succeed, then intervention seems necessary. Carrie Landa, the director of Behavioral Medicine at Student Health Services at Boston University simply believes that it is time to seek help if your stress is turning into distress. There is no shame in reaching out for help.  The mental health centers, although busy, will make every effort to assist you.



Is Yawning Contagious?

Not that it would ever happen in Andrew’s Science 200 class, but did you ever notice that yawns sometimes go around the classroom like the wave goes around Beaver Stadium.  It made me wonder about why we yawn at all, and more specifically why we yawn when we see other people yawn.  I decided to look for some answers to those questions , but ultimately I just really ended up with more questions.  It seems that scientists and professors can’t even agree as to why people ( and animals) yawn in the first place. Some researchers believe that by sucking in that oxygen rich air during a yawn, that we supply oxygen to our bloodstream, helping to wake us up.  Others, like Steven Platek, a psychology professor at Georgia Gwinnett College, believe that theory to be a myth that is not supported by scientific proof.  Andrew Gallup, a professor at SUNY Oneonta, believes that yawns serve as a cooling system for the brain. A study involving mice showed that their yawns were often preceded by an increase in brain temperature. A decrease in the brain temperature followed the yawn. Thus, researchers like Platek believe this cooling down of the brain is the reason that we feel refreshed after a good yawn.

So, assuming you buy into the brain cooling theory behind yawns, then why do we tend to find ourselves yawning when we see others yawn?  Not surprisingly, there is no real consensus among scientists and professors on this question either. Before looking into the possibilities of why it happens, you can take a little test to see if it happens to you. Click here to watch the “yawn-o–meter” video to see how susceptible you are to contagious yawning.



How did you do?  The majority of people studied yawned at least once during the video – and some yawned as many as 15 times in three minutes! Platek found that yawning is contagious in about 60 to 70 percent of the population.  Most researchers believe that this is due to mimicry and the social quality of empathy.  He has found that people who score high on tests measuring empathetic understanding tend to be more likely to be susceptible to contagious yawning.  A behavioral study from University of Pisa, Italy, further found that the rate of contagion was also determined by the relationship to the person observed yawning.  It was strongest with kin, then friends, then acquaintances, and least with strangers. Even dogs in a University of London study have been found to be susceptible to contagious yawning.  The dogs not only followed the yawn with a yawn, but also acted relaxed and sleepy after seeing a human yawn.  But Matthew Campbell, a researcher from Emory University, stresses that is has less to do with empathy and more to do with how our bodies and brains function.  A recent Duke study, “Individual Variation in Contagious Yawning Susceptibility is Highly Stable and Largely Unexplained by Empathy or Other Known Factors,”  determined that contagious yawning may not be as closely associated with empathy as previously believed.  They did find that contagious yawning seemed to decrease with a person’s age. But, the bottom line is, they really could not come to an ultimate conclusion about what causes this phenomenon. You may be thinking ,”Who cares?”  But actually, some of the research into this area of science may lead to other valuable studies.  For example, researchers from the University of  Connecticut found that children on the autism spectrum were less likely to yawn contagiously than their normally developing peers.  They also found that the severity of the autism directly corresponded to the amount of contagious yawning.  This has led researchers at Duke University to fund studies to examine the possible genetic influences involved with contagious yawning  as a means to better understand diseases like autism or schizophrenia.

So, next time you look around the room and contagiously yawn, maybe you’re really not tired or bored,  but just a nice, empathetic person! Who knows!




Stepping Out Of My Comfort Zone

My name is Samantha Sichenze and I am new to Penn State, actually to college in general.  During my NSO, I found out that being in the College of Health and Human Development meant that I was required to take a science class.  I was disappointed and nervous.  Science has never been “my thing” as long as I can remember.  From making dioramas of biomes in first grade to calculating the velocity of light in junior year, I couldn’t say I’ve enjoyed it.  Scrolling down the never ending list of science classes that I could take, I became overwhelmed.  Thankfully, my advisor , seeing the skepticism on my face said, “ Do you like science?”  I hesitated at first, thinking she was looking for a positive response, but then blurted out very frankly, “not at all.”  She said “Perfect!  SC200 is the class for you!”   She began to explain how the professor changes your entire perspective on the subject of science.  He makes you see it in a different light, in a way you’ve never seen or been taught before.  Coming from schools with poor science departments, I was doubtful.  Since first grade, I’ve had nothing but a negative outlook about learning science.  But I was up for the challenge – the challenge to see if this one course could make me love the one subject that I’ve always dreaded.  I’m now ready to take risks and step out of my comfort zone.


In high school, my experience in the science department was like a rollercoaster ride.  My results in biology and chemistry were adequate, but when I moved up to physics, my grades plummeted.  I tried so hard to maintain a good average in the course.  I went to Study Help once a week, in addition to hiring an outside tutor to come over and prep me for each test.  Unfortunately, nothing worked.  I would feel so defeated when my friends, who barely opened a book, scored significantly better than me.  Don’t get me wrong, high school isn’t the reason that I am not a science major, it just reinforced my decision to not pursue a career in that field.  I love to travel and meet new people, people with different backgrounds, experiences, and cultures.  This trait led me to choose Hospitality Management as my major.  The feeling of waking up each morning, knowing that my ultimate goal for that day is to help people will hopefully make me eager to start each day.  That’s not to say that there aren’t characteristics of scientists that I admire.  Their relentless pursuit to find cures for diseases or life on other planets, for example, inspires me.  That determination to make life better for people is something that I hope to take with me as I venture out on my career path. An issue I’m fascinated with is the ending of the world, as discussed in this article. People claim this to be true because it was written in the Bible, while others claim that to be false based on scientific facts. I would love to learn the actual truth behind this speculation. So I look forward to taking this class and possibly developing a better appreciation of the science that exists all around me.