Bluehost is offering more module options (like Memcache) with this release too.

For those out there, PHP 5.3 offers “namespaces” – an elegant way to encapsulate different groups of related data (functions, constants, classes, etc.) I’m looking forward to writing much cleaner code in the future, but as with any new release of software, I’ll initially spend the first few days looking through error reports for glitches.

Earlier this afternoon while I was replying back to a comment, I noticed that RK.md’s main page was bumped to a PR of 4. I’m incredibly thankful for all those who helped me achieve this milestone by continuing to reference my posts, subscribe to my RSS feed, and follow me on Twitter. Hopefully, each one of you has gained insight from one of my tech walkthroughs, medical writeups, or blurbs about experiences from medical school.

Thank you, thank you, thank you!

I’d like to be very straightforward – most med students who utilize social media are amenable to suggestions and thankful whenever our colleagues, professors, mentors, or even the general public questions our postings. As a group of aspiring physicians, we share the same intention – to educate others while in turn educating ourselves – but we find ourselves challenging accords of professionalism from time to time.

“A 47 y/o Caucasian male with MRN # 123-456-789 presents with the only documented case of Condition X known to mankind” is obviously going overboard and a prototypic HIPAA violation.

But what if I write about seeing a patient with hypertension in clinic today? Given how prevalent hypertension is, would that constitute “identifiable information?” If hypertension were replaced with something less common ( take priapism, for example), am I more likely to offend someone? Where do we draw the line?

Extremely conservative individuals would argue that students shouldn’t write anything on public domains. Facebook, Twitter, personal blogs, and the like should be terminated at the risk of sacrificing one’s professionalism or image. My view is precisely the opposite. By stifling our adoption of social media into medicine, we’re inevitably working against the grain of where society is heading.

Over the last decade, social media has become a cornerstone for business, advertising, communication and it continues to permeate other fields. We need to embrace social media and utilize it to exercise our creativity, but at the same time, it’s important that we are each other’s whistle-blowers. If you’re a physician. Or a dental student. Or a nurse, PA, or tech. Even if you’re outside of healthcare – it doesn’t hurt to contact the writer (myself included) directly, voice your concern, and help mold our virtues of professionalism.

It’s remarkable how often as a healthcare professional, “one mistake” is all it takes – a slip of the hand in the operating room, an improperly dosed medication, and in this case, a single blog post or Tweet which can be inappropriately extrapolated to represent one’s entire career. I say we continue using social media as a learning opportunity to impart our knowledge and enthusiasm in a way that is both professional and efficacious, but it can only be done with appropriate guidance along the way.

First, you’ll need SSH access to your box. For security reasons, all Dropbox files will be kept outside of the public_html folder.

1.) Login via SSH to your box.

2.) mkdir ~/dropbox-exec

3.) cd ~/dropbox-exec

4.) wget -O dropbox.tar.gz "http://www.dropbox.com/download/?plat=lnx.x86"

We created a directory, navigated to it, and downloaded the latest 64-bit compliant Linux source for Dropbox.

5.) tar -xvzf dropbox.tar.gz

6.) rm dropbox.tar.gz

7.) ~/.dropbox-dist/dropboxd

Now we unzipped the tarball, removed the original compressed file, and executed the main Dropbox script.

8.) You’ll get a message like:

This client is not linked to any account… Please visit https://www.dropbox.com/cli_link?host_id=xxxxxxxxxx to link this machine.

9.) Copy and paste that link into a browser and navigate there. This essentially “links” your shared host to your Dropbox repository.

10.) BlueHost periodically terminates the Dropbox process, so I added a cronjob (under CPanel) to keep the process running every 5 minutes. The cron command will simply be the path to your dropboxd script. For example: /home/fill-in-your-username/dropbox-exec/.dropbox-dist/dropboxd

You’ll notice that under your root directory (/home/username) you now have a “Dropbox” folder with all the contents of your repository. Now you can throw things into the cloud whenever you want. For example, I have a simple PHP script which backs ups and optimizes my WordPress SQL databases every day, eliminating the need for a resource-hogging plugin and giving me the piece of mind that my database is stored in more than one place.

Let me know if this guide helps and/or if you have any questions!

Piwik is an open source analytics software which is self-hosted. This means that rather than storing data on remote servers, the information is stored in my own SQL database indefinitely. Piwik provides me with full control with both a web interface and mobile apps for Android and iOS. I can automatically e-mail myself weekly reports, embed widget objects on the site, have a live view of current visitors, and a lot more. The development community is highly active too!

My only concern is that as my database grows, I’ll run into performance issues when churning out reports. My preoccupation with efficiency and speed may ultimately get the better of me and bring back Woopra to this site, but for now, I’ll continue using Piwik.

Before beginning, you’ll need to have SSH access to your server for compiling the APC module and have your php.ini file accessible (usually directly under public_html). Once you’ve SSHed into your box, execute the following commands in order.

1. cd ~
2. mkdir modules apc
3. cd apc
4. wget http://pecl.php.net/get/APC-3.1.8.tgz
5. tar -xzvf APC-3.1.8.tgz
6. cd APC-3.1.8
7. phpize
8. ./configure --enable-apc --enable-apc-mmap --with-apxs --with-php-config=/usr/bin/php-config
9. make
10. cd modules
11. mv apc.so /home/BLUEHOST-USERNAME/modules

Steps 1-6 create the necessary directories we’ll be using, download the latest stable APC file, extract it, and point to the directory.

Steps 7-9 compile the APC module according to the PHP version your server is running.

Steps 10-11 move the newly compiled module (apc.so) to a readily accessible directory which we will define in our php.ini file.

Now FTP into your box, create a backup of your php.ini file (/public_html/php.ini) and proceed to edit the original php.ini with a text editor program (ie, Wordpad for Windows, TextEdit for Mac OS X, Gedit for Linux).

Using the “Find” function, search for “extension_dir.” Place a semicolon before the line to comment it out, and copy and paste the following code in the next line. Change “BLUEHOST-USERNAME” to your username.

extension_dir = "/home/BLUEHOST-USERNAME/modules"

Note that this step will knock out any other modules which are loaded from the default extension_dir path. I haven’t found a way to load APC otherwise (as a zend_extension, for example).

Next, search for “Windows Extensions” in your php.ini file. You will see a list of directives preceded by semicolons. Copy and paste the following set of parameters above the “Windows Extensions” line to configure APC.

extension=apc.so
apc.enabled=1
apc.ttl="7200"
apc.user_ttl="7200"
apc.shm_size="64"

Finally, save and upload your php.ini file back to your public_html directory. You’ll need to restart your FastCGI engine, so log into your CPanel, find “Process Manager” under the “Advanced” header, and kill off any /ramdisk/bin/fcgiphp5 processes. Once they’re dead, navigate back to your site (this will automatically “restart” the FastCGI process and incorporate APC into the engine).

To verify that APC is indeed loaded, create a phpinfo file, and navigate to it via a web browser. Scroll down and look for an APC section.

If you’re a WordPress user, be sure to download the APC Object Cache Backend to your computer, extract it, and move the object-cache.php file to your server directly under the /wp-content/directory (note, this should not be installed like a regular plugin since those are installed under /wp-content/plugins/)

Though I haven’t run any official benchmarks comparing APC to XCache and eAccelerator, the very fact that it’s incorporated into PHP6 and seems to currently have more active development were good enough reasons for me to switch over.

As far as content goes, I swept through all my posts and privatized any which I felt could be considered even remotely offensive. Keep in mind that I started blogging over five years ago, and a lot of the opinions I had then have been drastically molded by my experiences in college and medical school. I honestly don’t have the drive to go through each of those posts one-by-one and make the necessary corrections, so hiding them from public view is my easiest option.

I’m pretty sure people can’t get offended by posts about my experiences in medical school… unless I just overall suck at life… which is a likely possibility.

As always, thanks to everyone who drops in from time to time to explore my tiny corner of the Internet.

During today’s Christmas NBA games, I decided to whip up a site with my professional profile… sort of like an online résumé which I can reference to others.

You can find it here: http://rishi-kumar.com

I still have to populate the content and reorder a few things, but I’ve finished building out the framework and optimizations.

Hope everyone had a great Christmas! There’s something about this time of year which gives everyone an excuse to be happy. I just wish this feeling could last all year long.

In the two years since then, I’ve transitioned to a self-coded theme and written 381 posts, most of which directly concern medical school. The best part about keeping a journal/blog is having the luxury of going back in time to see how you overcame strife or found inspiration during hopelessness. I love being able to revisit these moments in my past to see how I’ve matured (and continue to mature) as an individual. Sometimes I reread things I wrote months ago and think: “Wow, what was I thinking? Medicine is nothing like that.” Other times, I find myself becoming more opinionated on fronts which I previously was ambivalent towards. Guess I’ll have many more of those moments once clinicals start in January.

I’d also like to take this opportunity to remind my readership that I sincerely appreciate the feedback you’ve submitted via site comments and/or e-mails. I genuinely enjoy answering the questions of aspiring pre-meds, revising snippets of code, or just talking about my experiences in general. Becoming a practicing physician is a long, arduous journey, but I hope chronicling my thoughts continues to help curious Internet-goers. Keep those questions coming!

The next time I renew this website (November 2012), I’ll be finished with the bulk of my clinical rotations, Step I will be a thing of the past, I’ll hopefully be interviewing at residency programs, and planet Earth will be one month away from total destruction on 12/21/2012.

As lax as that sounds (well, except for the whole Earth-going-kaput thing), the next two years are going to be extremely demanding in terms of long hours, preparing for shelf exams, and doing well on the USMLE Step I. Hopefully I’ll still find time to write about my experiences regularly.