The design

This first charm is intended to represent Kathy May’s time training at the Massachusetts General Hospital, which is the original and largest teaching hospital of Harvard Medical School. The design of the charm is inspired by the logo of MGH as well as that of Harvard. Because of the small size of the charm and the physical limitations of the 3D printing process, the details of the logos had to be stylized somewhat, but not too much that the logos were no longer recognizable. I also wanted to take advantage of having the third dimension to work with and make the charm more than just an extruded 2D shape. I thus took the graphical part of the logo, which represents the Ether Dome of the Bullfinch building, modeled it in 3D, and put it on the top of the charm like a roof. The Ether Dome is an architectural landmark on the MGH campus, but is also historically significant as the location of the first successful demonstration of surgical anesthesia in 1846. Before this, all surgery was done fully awake, if you can even imagine what that would have been like! Watch the video below for a look at the design and preparation stage of the creation of this charm:

Creating the 3D model

A digital 3D model of an object is needed to instruct the 3D printer how to make the object. I used Autodesk’s 123D Design to create the model. This program was free but unfortunately has been discontinued by Autodesk in favour of its other 3D modeling programs, TinkerCAD and Fusion 360, which are both free for personal use. The basic principles of the programs should be similar, though. 123D Design has a point-and-click interface that has a live rendering of the model, and it accepts keyboard input for more precise measurements. You start with primitive solids such as cubes and cylinders as well as with 2D shapes such as curves and text that are extruded or otherwise made into 3D solids. These are then combined and subtracted to create the final, complex model. The 2D drawing and text tools are adequate for many things but it’s also possible to import SVG (Scalable Vector Graphic) files from more sophisticated software such as Adobe Illustrator or the free/open-source Inkscape. 

For this charm I used Illustrator to extract the shape of the shield from a file of the MGH logo. I also prepared the text with Illustrator to make use of fonts and typography tools not available in 123D Design. These were saved as SVG files and imported into 123D Design. There is a problem with small SVG files being distorted when imported (it may be some kind of rounding bug) so to get around it, create the file with larger dimensions and scale it back down after importing. I transformed these 2D images plus some simple 2D shapes drawn directly in 123D Design into the model of the charm using the extrude, shell, revolve, combine, and align tools. For a necklace charm, it is also important to position the opening for the chain so that the charm is weighted properly to stay upright when worn. To do this, I divided the charm into a top and bottom half, and measured the volume of the halves to ensure that the bottom half will be heavier than the top. Finally, I engraved some simple lettering into the inside of the charm. Watch the video below to see how I created the 3D model in 123D Design. The screen capture runs at 4x speed to save time:

This is a longer, more detailed version where the screen capture runs at 1x speed if you are interested in learning the process step by step (note: the video runs about 30 minutes):

Printing the charm

Although the makerspace where we volunteer, Boston Makers, has several 3D printers, printing in metal is beyond the capability of a household desktop 3D printer since the melting point of metal is so much higher than that of plastic. I used Shapeways’ industrial-grade equipment to print the charm in sterling silver. Shapeways is a 3D-printing service that takes the digital 3D model and prints it in any of a variety of materials. They also offer a marketplace where artists can sell their work, which is printed on demand and shipped directly to the customer. Other similar services include i.Materialise and Sculpteo. These services make 3D printing of finished products available to anyone with a digital 3D model. In this case I exported the model from 123D Design as an STL (STereoLithography) file and uploaded it to Shapeways. 

There are several techniques for printing metal. For precious metals such as silver and gold, Shapeways uses a lost-wax casting technique. The object is first 3D printed in wax. Then, liquid plaster is poured into a container around the wax object to create a mold. After the plaster sets, the wax is melted out and molten metal is poured into the mold and the mold is removed from the object. Finally, the object is polished and shipped. The whole process took about ten days from upload to delivery. Did you know: metal Pandora charms are also made with a lost-wax casting technique – though the wax models are made using rubber molds rather than being 3D printed. Here is another photo of the final charm in sterling silver:

[See image gallery at www.kathymayandsilas.com] Although consumer-grade 3D printing was overhyped a few years ago, 3D printing is a technology that is unquestionably going to be increasingly important in the future. One of the things that 3D printing is perfect for is individualized, custom objects like Kathy May’s charm. The technology makes it possible for anyone to create a unique object at a reasonable price in a reasonable timeframe. If you want to see what other people have been doing with 3D design and 3D printing before designing something yourself, Thingiverse is a great place to look at other people’s designs, which you can download and print yourself. Have you designed and 3D-printed anything interesting recently? Do you have suggestions for improving the creation process? Leave us a comment and let us know!

Until next time,

Kathy May and Silas

Click on the thumbnails in the photo gallery below to see more photos of the finished product:

• Click here to read Kathy May’s article on KevinMD.com
  

• Click here to read Kathy May’s article on Mogul

– Silas

Click here to view this article published on MOGUL, an online publishing platform for women.

Click here to view this article published on KevinMD.com, a health blog for physicians about all things medical.

Friday was Match Day.

At 12 noon EST, medical students all over the United States simultaneously opened envelopes which revealed the destination of their residency training. The tradition is an exhilarating and emotional event for everyone involved. For medical students, it is a milestone that symbolizes a dramatic life change and a new adventure. It marks the culmination of years of hard work, the end of one thing and the beginning of another. For me, Match Day was an opportunity to reflect upon the difficulty of my medical school years and how those struggles changed my professional and personal life for the better.

My medical school years have undoubtedly been the most challenging ones of my entire life. There were long and endless hours of studying, filled with facts and jargon and medications and algorithms. There was self-imposed pressure not only to memorize but also, more importantly, to understand the pathophysiology of disease. There were exhausting days and nights in the hospital. All of that was difficult, but none of that was the hardest part.

During medical school, I came to understand the true meaning of responsibility and sadness that all adults – health professional or not – must eventually endure. I am not referring to the responsibility of paying tuition bills on time or the disappointment of not acing Step 1, but I mean the deep commitment and intimate concern we have for those dear to us. Part of this came with the realization as a medical student that one day the entire well-being of a person would be subject to my own medical knowledge and decision-making. Most of it was the actual experience of losing people who I cared for, on both sides of the doctor-patient relationship.

I had my first exposure to critical illness, the dying process, and finally death while working on the inpatient wards. I tried to be as objective, rational, and data-driven as a diligent physician-in-training could be, but I was wholly unprepared for the emotional toll that the loss of patients took on me. The first was a gentle, kind lady with whom I bonded despite an enormous language barrier between us. Our medical team made the diagnosis of a rare gynecologic cancer. I studied and learned the expected course of the disease; however, I could not fathom just how close a person could be to death even though we smiled in conversation via the translator phone each day. Just over a week later, she passed away. At first, I was in shock; by evening, I was hidden in a corner of the house staff workroom, alone in tears, mourning a beautiful soul that passed to the other side.

Since then, I have participated in the care of a number of patients who, despite the most optimal care and the most valiant efforts, have died. Every single one has impacted me. However, death burdened not only my academic life but also my personal life. At the beginning of medical school, I lost my uncle, whose son was also a medical student, to lung cancer. Soon after I lost my aunt to hemorrhagic stroke. My world came to a screeching halt when my own mom, my unconditional supporter, my strongest rock, and my greatest inspiration, passed away from colon cancer. I took a leave of absence so that I could share more precious moments with her in her last months. During that extra year, I also lost my dear friend, a young, charismatic person taken too soon by amyloidosis only seven weeks after we celebrated her wedding. I thought the heartache was over – at least for these five years of school – when our beloved family dog passed away unexpectedly just five days before Match Day.

Other doctors and student doctors are not immune to heartbreak. While in medical school, I have witnessed and shared in their grief of losing patients and loved ones. My husband lost his uncle, whose daughter was also a medical student. My best friend lost her dad. We were studying for a cardiology exam at his bedside when it happened. Another friend also lost her dad only last week. His spirit watched over her proudly at Match Day, as she opened her envelope and learned that she had successfully matched into residency.

More than anything I’ve read in a textbook or heard during rounds, it is the intense personal losses during medical school that have contributed to my truly comprehending and absorbing the profound privilege it is to care for a panel of patients, each of whom is the center of someone’s life, just as my mom was the absolute center of mine and my friends’ fathers were the centers of theirs. In our personal lives, we medical professionals have focused our energy on caring for our own loved ones. Now in our careers, we care for an entire panel of someone else’s loved ones on a daily basis. Whether the situation is dire or not, we see our loved ones in the faces of our patients; we see ourselves in the faces of our patients’ families.

Sorrow is an inevitable part of life. My medical school years have shown me that death is not something I can escape in my profession and that I as an earthly doctor cannot fix every problem. Instead I can only strive to be a physician who cures sometimes, treats often, and comfort always. I can only hope to make an impact on every patient, whether that is improvement of symptoms, stability of health, or even peace in death.

At Match Day, I could see the end of my medical school years approaching and the next step of residency coming into focus. At my side was my husband; in my hands was a photograph of what was dearest to me – my mom, my brother, our dogs, our home. I looked at this two-dimensional representation of the blessings in my life, and my heart ached as I thought about how difficult medical school has been and how much has changed since I and others have lost loved ones. At the same time, I was comforted as I reflected upon their impact on me and many others, a legacy that extends far beyond their living and breathing and being on earth. The lives they lived inspire my life, my actions, and my work; caring for them at the end of their journeys shaped my growth as a person and as a doctor. I closed my eyes and dedicated my career to serving others in their memory. Then I opened my envelope, ready for the years that lie ahead.

1. Dillon AB, Myung JS, Tran KM, Tseng J, Wald KJ. A Modified Iris Suture Technique for In-the-bag Intraocular Lens Dislocation. Submitted for publication.
2. Tran KM. By any other name: eponyms in the modern medical language. Clinical Correlations. 2016 May 4.
3. Kazmi SM, Pemmaraju N, Patel KP, Cohen PR, Daver N, Tran KM, Ravandi F, Duvic M, Garcia-Manero G, Pierce S, Nazha A, Borthakur G, Kantarjian H, Cortes J. Characteristics of Sweet Syndrome in Patients with Acute Myeloid Leukemia. Clinical Lymphoma, Myeloma & Leukemia. 2015 Jun; 15(6): 358-63. Cited in PubMed; PMID: 25630528.
4. Smith KM, Maragnoli ME, Phull PM, Tran KM, Choubey L, Vaccarino FM. Fgfr1 inactivation in the mouse telencephalon results in impaired maturation of interneurons expressing parvalbumin. PLOS ONE. 2014 Aug; 9(8): e103696. Cited in PubMed; PMID: 25116473.
5. Komitova M, Dionysios X, Salmaso N, Tran KM, Brand T, Schwartz ML, Ment L, Vaccarino FM. Hypoxia-Induced Developmental Delays of Inhibitory Interneurons are Reversed by Environmental Enrichment in the Postnatal Mouse Forebrain. Journal of Neuroscience. 2013 Aug; 33 (33): 13375-87. Cited in PubMed; PMID: 23946395.
6. Smith KM, Maragnoli ME, Phull PM, Tran KM, Vaccarino FM. Fibroblast growth factor receptor 1 (Fgfr1) participates in postnatal interneuron development. International Journal of Developmental Neuroscience. 2010 Nov; 28(8): 698.
7. Tran KM, Broder M, Luft S, Schwartz ML, Smith KM, Vaccarino FM. Environmental Enrichment Contributes to Neurodevelopmental Recovery After Hypoxia. Yale Review of Undergraduate Research in Psychology. 2010 Mar; 1(1): 102-115
8. Smith KM, Maragnoli ME, Fagel DM, Phull PM, Tran KM, Vaccarino FM. Postnatal maturation of cortical parvalbumin inhibitory neurons is impaired in FGF receptor mutant mice. International Journal of Developmental Neuroscience. 2008 Dec; 26(8): 870.

Academic Abstracts & Posters

1. Tran KM, Winer A, Liu J, Taff J. Tuberculosis in single lymph node presenting as flank pain. Poster session presented at: Society of General Internal Medicine 38th Annual Meeting; 2015 Apr 22-25. Toronto, ON, CAN.
2. Tran KM, Winer A, Liu J, Taff J. Tuberculosis in single lymph node presenting as flank pain. Poster session presented at: New York University School of Medicine Department of Medicine 14th Annual Research Day; 2015 Jun 11. New York, NY.
3. Tran KM, Wang SL, Kontari I, Asimellis G, Kannellopoulos AJ. Evaluation of femtosecond laser-assisted combined Descemet’s stripping automated endothelial keratoplasty (DSAEK) and astigmatic keratotomy (AK) surgery. Poster session presented at: Association for Research in Vision and Ophthalmology Annual Meeting; 2013 May 5-9. Seattle, WA.
   • Tran KM, Wang SL, Kontari I, Asimellis G, Kanellopoulos AJ. Evaluation of femtosecond laser-assisted combined Descemet’s stripping automated endothelial keratoplasty (DSAEK) and astigmatic keratotomy (AK) surgery. Investigative Ophthalmology & Visual Science. 2013 Jun; 54(15): 3122.
4. Kazmi SM, Kantarjian H, Tran KM, Cortes J, Ravandi F, Borthakur G, Jabbour E, Faderl S, Garcia-Manero G, Kadia T, Daver N, Pierce S, Nazha A, Cardama AQ, Pemmaraju N. Cytogenetic and molecular characterization of Sweet’s syndrome in patients with acute myeloid leukemia. Poster session presented at: 54th American Society of Hematology Annual Meeting and Exposition; 2012 Dec 8-11. Atlanta, GA.
   • Kazmi SM, Kantarjian H, Tran KM, et al. Cytogenetic and molecular characterization of Sweet’s syndrome in patients with acute myeloid leukemia. Blood. 2012 Nov; 120(21): 2587.
5. Pemmaraju N, Kantarjian H, Tran KM, Kazmi SM, Kadia T, Borthakur G, Verstovsek S, O’Brien S, Garcia-Manero G, Estrov Z, Faderl S, Ravandi F, Pierce S, Cortes J, Quintas-Cardama A. Cytogenetic and molecular characterization of extramedullary disease in patients with acute myeloid leukemia. Poster session presented at: 54th American Society of Hematology Annual Meeting and Exposition; 2012 Dec 8-11. Atlanta, GA.
   • Pemmaraju N, Kantarjian H, Tran KM, et al. Cytogenetic and molecular characterization of extramedullary disease in patients with acute myeloid leukemia. Blood. 2012 Nov; 120(21): 2592.
6. Tran KM, Kantarjian H, Cortes J, Kazmi SM, Quintas-Cardama A, Estrov Z, Ohanian M, Kadia T, Borthakur G, Ravandi F, Faderl S, Pierce S, Pemmaraju N. Cytogenetic and molecular characterization of genitourinary extramedullary disease in acute myeloid leukemia. Blood. 2012 Nov; 120(21): 4326.
7. Tran KM, Wang SL, Kannellopoulos AJ. Contralateral eye long-term follow-up of prophylactic high-fluence collagen cross-linking combined with Lasik for high myopia. Poster session presented at: Association for Research in Vision and Ophthalmology Annual Meeting; 2012 May 6-9. Fort Lauderdale, FL. [View poster]
   • Tran KM, Wang SL, Kanellopoulos AJ. Contralateral eye long-term follow-up of prophylactic high-fluence collagen cross-linking combined with Lasik for high myopia. Investigative Ophthalmology & Visual Science. 2012 Mar; 53(14): 6817.
8. Smith KM, Maragnoli ME, Phull PM, Tran KM, Fagel DM, Vaccarino FM. Fibroblast growth factor receptor 1 (Fgfr1) in postnatal interneuron development. Poster presented at: Society for Neuroscience 38th Annual Meeting. 2008 Nov 15-19. Washington, D.C.

Non-scientific Writing Publications

1. Tran KM. “Happy Mother’s Day… for daughters and sons who have lost their moms.” MOGUL (onMogul.com). 2016, May 5.
2. Tran KM. “After Match Day: a bittersweet reflection.” KevinMD. (KevinMD.com). 2016, Mar 19.
3. Tran KM. “The Bittersweetness of Medical School Match Day.” MOGUL. (onMogul.com). 2016, Mar 19.
4. Tran KM. “Tâm sự Tết xa quê của người con nơi đất Mỹ.” Báo Mới Newspaper. 2014, Feb 3. [Written in Vietnamese]
5. Tran KM. “Tâm sự Tết xa quê của người con nơi đất Mỹ.” Tiên Phong Magazine. 2014, Feb 3. [Written in Vietnamese]
6. Tran KM. “Habitat Means Hope to My Family.”  His Voice. 2006.
7. Tran KM. “A New Home Brings a New Future.” Houston County Habitat for Humanity Headlines. 2005.

Art & Photographic Publications

1. Tran KM. “Bridges.” Photograph. Agora Magazine. 2013: 6.
2. Tran KM. “Mom.” Graphite. Agora Magazine. 2013: 17.
3. Tran KM. “Celebration of Summer.” Photograph. Agora Magazine. 2013: 34.
4. Tran KM. “To the Market at Dawn, Nam Dinh, Viet Nam.” Photograph. Agora Magazine. 2012: Cover.
5. Tran KM. “Finding New Life in a Forgotten Place.” Photograph. Agora Magazine. 2012: 13.
6. Tran KM. “Cutaway View of Globe.” Graphite. Agora Magazine. 2012: 15.

Art & Photographic Exhibition & Honors

1. Tran KM. “Vertebra.” 2012. Graphite. Art & Anatomy: Drawings. MSB Gallery, New York University Langone Medical Center, New York, NY.
2. Tran KM. “Study in Texture and Color, No. 4.” Third Prize, 11th Biannual NYU School of Medicine Photography Competition.
3. Tran KM. “Finding New Life in a Forgotten Place.” Grand Prize. 10th Annual Biannual NYU School of Medicine Photography Competition.

We are Kathy May and Silas, a couple of normal folk temporarily located in Boston. We hand-coded our individual personal websites since our college years, but decided to combine them as www.kathymayandsilas.com in 2008. In 2016, our website underwent a major overhaul to what you see today! In addition to amateur web design, we also share a number of other hobbies and interests, including but not limited to photography, electronics, arts and crafts, exploring, volunteerism, healthcare, and experiencing new things in general! Most of all, we enjoy doing these things together!

Kathy May is currently an internal medicine resident at Massachusetts General Hospital. Silas is a comprehensive ophthalmologist and Instructor at the  Massachusetts Eye & Ear Infirmary. They met 12 years ago at Yale and have been sharing adventures together since… with many more to come!

We invite you to explore the links below to learn about aspects of our lives that we value. Afterwards, please browse our blog to see what we are up to! More updates will be posted frequently. Finally, keep in touch with us by commenting on any page. We would love to hear from you!

Thanks for visiting us,
– Kathy May and Silas

Our Loved Ones:

Kathy May’s Mom
Kathy May’s Brother
Silas’ Brother
Bucci
April
Mimi

Our Organizations:

Habitat for Humanity
ALIVE
AAAYA
Boston Makers

Our Hobbies:

Blog
Arts & Crafts
Photography
Japanese Shore Crabs
Lab Mice

Our Professions:

Silas’ Professional Website (Mass Eye & Ear Infirmary)
Silas’ Publications & Abstracts
Kathy’s Publications & Abstracts