Doing the Dance of Joy (aka = Why Clinical Medicine Blows Part VI)

cookypuss3 · Aug 19, 2004

I just had to share with all my pathology friends! I was looking at my rotations schedule, something I try to avoid doing at all costs until it's the last minute and I have to find out where I need to be on Monday morning. Usually it's very depressing. However..... upon closer inspection I realized that as of next Friday I will have completed my VERY LAST INTERNAL MEDICINE ROTATION EVER!!!!!!! OMFG!!!! Over the moon with joy....

quant · Aug 19, 2004

Congratulations cooky!!!!!!....just imagine!!! you are one more step closer to path!!!!.....(an optimist s way of looking at things... :laugh:

)

b&ierstiefel · Aug 19, 2004

cookypuss3 said:
I just had to share with all my pathology friends! I was looking at my rotations schedule, something I try to avoid doing at all costs until it's the last minute and I have to find out where I need to be on Monday morning. Usually it's very depressing. However..... upon closer inspection I realized that as of next Friday I will have completed my VERY LAST INTERNAL MEDICINE ROTATION EVER!!!!!!! OMFG!!!! Over the moon with joy....

Cooky I'm totally with ya there [andy gives cooky a high five].

I just changed my schedule such that my last month is no longer a internal medicine consult month. My last rotation in med school (after my path rotation next month) will be Pharmacology independent study! Woot woot!

Cooky, next friday we are both done with internal medicine ever! We shall down a case of bud light at 5 pm Friday 8/27/04 SHARP! STAT!

deschutes · Aug 19, 2004

Pharmacology independent study?

That is a stroke of genius! Do they make you clock hours for something like that?

The week is going to fly for you both!
5 pm Friday 8/27/04 I will just have been done with a whole day's worth of Internal MCQs/OSCEs. Drink one for me, wontcha.

b&ierstiefel · Aug 19, 2004

deschutes said:
Pharmacology independent study?

That is a stroke of genius! Do they make you clock hours for something like that?

The week is going to fly for you both!
5 pm Friday 8/27/04 I will just have been done with a whole day's worth of Internal MCQs/OSCEs. Drink one for me, wontcha.

I'm drinking a bud light now cuz I'm at home (we capped, we work up patients, we go home). This bud's for you!

I don't know if the pharmacology course makes to log hours. Probably not. Anyways, 50% of the time is spent in lectures (sleep time) and 50% of the time is spent in independent study. That means...I get to go back to my PhD thesis lab and do experiments one month early.

yaah · Aug 21, 2004

deschutes said:
5 pm Friday 8/27/04 I will just have been done with a whole day's worth of Internal MCQs/OSCEs. Drink one for me, wontcha.

Aren't you glad that you are taking all of those OSCEs and you still have to take the Step II CS? Clearly, the OSCEs you are doing will not properly assess your ability to interview a patient and palpate how far down above the costal margin the liver edge is.

b&ierstiefel · Aug 21, 2004

Yeah I had to take an exam like that a lil more than a month ago. It was called the CCA here. We had like 12 stations where we had to ask questions and listened to what fake patients had to say 'n sh1t. We had to be all sensitive and crap, nod our heads like we were really caring, and be all empathetic. We get our results in 2 weeks and I probably failed a station or two (or three). Fortunately we get to repeat those stations at a remediation day so it's no biggie.

And then we have to take the Step 2 CS...oh damn I'm not gonna get started on that again.

yaah · Aug 22, 2004

AndyMilonakis said:
Yeah I had to take an exam like that a lil more than a month ago. It was called the CCA here. We had like 12 stations where we had to ask questions and listened to what fake patients had to say 'n sh1t. We had to be all sensitive and crap, nod our heads like we were really caring, and be all empathetic. We get our results in 2 weeks and I probably failed a station or two (or three). Fortunately we get to repeat those stations at a remediation day so it's no biggie.

It never ends - I had to take that test the first day of my residency, I guess to show that despite all of the crap I have been tested on over the years, no one still trusts any of the previous tests you have been through. Can you write orders? Well gee whiz I don't know...if I want to order an xray can I just write, "XRAY" or do I have to say more? If I want to order a medication do I have to put the dose down?

Can you talk to someone of a different culture? No, I am a racist bigot and think everyone that is not an Irish/Quebecois/Polish mix is incapable of carrying on a conversation and incapable of following simple instructions. Besides, everyone knows that when there is a partial language barrier the best way to talk to someone is to yell loudly while speaking in Iambic Pentameter and gesticulating wildly with your hands.

deschutes · Aug 22, 2004

Once you are a doctor, never try to get certified in another country - it will only give you grief.

Heaven knows all countries on earth have a right to be acutely suspicious of each other's medical training.

Let's start by multiplying all exam and licensure fees by 2.
Add the prospect of being the proverbial cabbie.
Oh, and make sure you get the local accent under your belt - that recent immigrant from Ethiopia might not understand "bowel movement", but lights up when you say "poop".

b&ierstiefel · Aug 22, 2004

yaah said:
It never ends - I had to take that test the first day of my residency...

And you go to Michigan right?
OK note to self.

I realize that this kinda crap will always continue and we can't escape the inevitability of this. Fortunately, we are free to have our delusions.

deschutes · Aug 22, 2004

AndyMilonakis said:
And you go to Michigan right?
OK note to self.

Man I can just see it - "Yes you took the Step 2 CS, but unfortunately the results haven't been released yet, so you will have to take our program's certifying OSCE."

And I'm not singling UMich out by my remark.

yaah · Aug 22, 2004

Actually, I don't think it has anything to do with the step II CS, I think it is just the hospital's way of making sure you know what the key skills are. A lot of it sort of serves as a teaching session, so you go through things and make sure you know how to do them, like getting informed consent or maintaining sterile technique. It wasn't really that painful. Didn't have to do any physical exams. They also teach you about fire safety and evidence based medicine and critical lab values.

deschutes · Aug 22, 2004

yaah said:
They also teach you about fire safety and evidence based medicine and critical lab values.

*nods* Fire safety is important. Don't ignore the Code Reds - least of all when 3 fire trucks are tearing up the driveway and you can smell the smoke in the ventilation system.

b&ierstiefel · Aug 22, 2004

yaah said:
Actually, I don't think it has anything to do with the step II CS, I think it is just the hospital's way of making sure you know what the key skills are. A lot of it sort of serves as a teaching session, so you go through things and make sure you know how to do them, like getting informed consent or maintaining sterile technique. It wasn't really that painful. Didn't have to do any physical exams. They also teach you about fire safety and evidence based medicine and critical lab values.

I'm pretty sure it's benign. What are they gonna do...kick you out of residency if you fail it?

I figure it's kinda similar to how ACLS training worked on my first day of M3 year...we take a stupid test at the end and if for some reason we fail, we just retake it. They don't like send us back to 2nd year or anything like that.

E Z Daring · Aug 25, 2004

AndyMilonakis said:
I'm pretty sure it's benign. What are they gonna do...kick you out of residency if you fail it?

I figure it's kinda similar to how ACLS training worked on my first day of M3 year...we take a stupid test at the end and if for some reason we fail, we just retake it. They don't like send us back to 2nd year or anything like that.

I'm still cracking up about the pharm indep. study. What other cool electives have you guys done?

b&ierstiefel · Aug 25, 2004

E Z Daring said:
I'm still cracking up about the pharm indep. study. What other cool electives have you guys done?

Actually I got F'd in the A with respect to the pharm course. The registrar said I couldn't take it because it wasn't "clinical" enough. So I have to replace it with something. Right now I'm trying to set up another pathology month. I refuse to do another patient care/internal medicine month.

Fingers crossed

yaah · Aug 26, 2004

Well, I for one did enjoy my time on clinical medicine and wouldn't trade my experiences, but it wasn't anything like the experiences I have had in path. I never felt quite as intellectually stimulated or enthusiastic. There were some good times on the other rotations though. OB, for example, I liked a lot better than I thought I would, and even surgery I got pretty comfortable with. There were some great days on IM when we had interesting conferences/case presentations, had a new patient come in with a strange presentation that I could get the full history (and do the obligatory cursory and useless physical exam), figure out what their lab tests and films were consistent with, and figuring out how to treat them. All of that was fascinating. I enjoyed those days a lot. But being paged in the middle of it so you can fill out page one and two on someone leaving to go to a nursing home, when you already filled it out earlier so that you wouldn't HAVE to do it then, then somebody loses it, well that isn't fascinating. Or being paged because phlebotomy couldn't get the blood and you have to. Grrrr...That is most definitely not fascinating. At the same time though, you have to admit that a lot of what you do in those fields isn't really much about medicine. Too much paperwork and rigamarole. Path has its share of it, like anything, but it's not to the same extent and not as objectionable. 3rd and 4th year of med school was a long 2 years, and I learned a ton. I would not, however, want to do it again, provided that I can keep what I learned in my head!

That being said though, I still didn't really like any of my pedes rotation except when the attending told me to go play with the kid and keep him busy or go distract the sibling or something like that. And I didn't much like reading about it either because it was all about developmental milestones and syndromes with names that were hard to remember.

I guess awesome is a strong term for me. Winning the lottery would be awesome. Learning about the clinical management of congestive heart failure, while somewhat interesting and fulfilling, leaves something to be desired.

b&ierstiefel · Aug 26, 2004

I sincerely hope that in the future I can better appreciate what I got out of clinical medicine. Sure, any profession has aspects that can be annoying. However, as of right now, I consider 3rd year of med school to be one of the worst times of my life. Maybe it's the fact that M3 year happened after some of the best years of my life (grad school). Perhaps I will reflect on things differently in the near future. But as yaah said, I would probably not consider doing M3 year again. SubI's too...never. My next and last two months of med school are pathology months...I am fortunate to end medical school on a positive note.

governaitor · Aug 27, 2004

yaah said:
Well, I for one did enjoy my time on clinical medicine and wouldn't trade my experiences, but it wasn't anything like the experiences I have had in path. I never felt quite as intellectually stimulated or enthusiastic. There were some good times on the other rotations though. OB, for example, I liked a lot better than I thought I would, and even surgery I got pretty comfortable with. There were some great days on IM when we had interesting conferences/case presentations, had a new patient come in with a strange presentation that I could get the full history (and do the obligatory cursory and useless physical exam), figure out what their lab tests and films were consistent with, and figuring out how to treat them. All of that was fascinating. I enjoyed those days a lot. But being paged in the middle of it so you can fill out page one and two on someone leaving to go to a nursing home, when you already filled it out earlier so that you wouldn't HAVE to do it then, then somebody loses it, well that isn't fascinating. Or being paged because phlebotomy couldn't get the blood and you have to. Grrrr...That is most definitely not fascinating. At the same time though, you have to admit that a lot of what you do in those fields isn't really much about medicine. Too much paperwork and rigamarole. Path has its share of it, like anything, but it's not to the same extent and not as objectionable. 3rd and 4th year of med school was a long 2 years, and I learned a ton. I would not, however, want to do it again, provided that I can keep what I learned in my head!

That being said though, I still didn't really like any of my pedes rotation except when the attending told me to go play with the kid and keep him busy or go distract the sibling or something like that. And I didn't much like reading about it either because it was all about developmental milestones and syndromes with names that were hard to remember.

I guess awesome is a strong term for me. Winning the lottery would be awesome. Learning about the clinical management of congestive heart failure, while somewhat interesting and fulfilling, leaves something to be desired.

But to understand how to treat CHF, you need to understand the pathophysiology of it and in particular the body's adaptive responses on the molecular, cellular and systemic level. That's awesome baby! It is extremely intellectually stimulating if reading about medicine/physiology is your thing.

Hustling on the wards to make things happen is fun too, drawing blood, transporting the patient in the middle of the night for an emergent x-ray etc...It is pretty special. I liked it a lot.

Homunculus · Aug 27, 2004

yaah said:
syndromes with names that were hard to remember.

you *are* going into pathology, right? eponyms are synonymous with all branches of medicine. besides, everyone wants to have something named after them-- why would pathologists be any different?

you'd be proud-- today we considered using a pathologist to look at some urine for us to tell us if there were any fibers in it . . . getting pathologists back into clinical medicine is tough

it's small, but it's a start

-- your friendly neighborhood on the ward caveman

deschutes · Aug 27, 2004

Homunculus said:
you'd be proud-- today we considered using a pathologist to look at some urine for us to tell us if there were any fibers in it...

Thought I had seen it all, but - why are there fibres in kiddie pee??

yaah · Aug 27, 2004

Homunculus said:
you *are* going into pathology, right? eponyms are synonymous with all branches of medicine. besides, everyone wants to have something named after them-- why would pathologists be any different?

Actually I don't mind eponyms. Pathology probably has more than most fields, it's just that I tolerate them a lot better

. Some of the tumors have like 6 different names.

deschutes · Aug 28, 2004

< -- Rant Warning -- >

So I wrote a nice email to the Internal Med clerkship director Dr. Someone saying that it was unnecessary to have an extra clerk on call in hospital when:
(a) there are already two junior residents on (one from each team); and
(b) there are no call rooms for clerks when two junior residents are on.

He responded saying this is a chronic issue which he is neither happy or proud of, and cc:-ed the message to the clerkship rotations coordinator asking her to look into it.

That was Wednesday.

I still have yet to hear any sort of acknowledgement from the coordinator lady.

Therefore I wrote to Dr. Someone again, pointing out that if this was a chronic issue, rather than having the ball dropped AGAIN when the clerks changed over every month, an executive decision needed to be made immediately.

I recommended AGAIN that the extra clerk be allowed to do home call, as there are few dire emergencies that cannot be dealt with when a fourth person responds within 20 minutes.

(Not as if the medical student would be any use in a dire emergency, but internists don't like to hear you say that.)

Unlike some clerks, I can be a pain in the you-know-where and do this because I am not applying to Internal Med (thank goodness) and I'm not worried about an internist getting pissed off at me and not being able to get a good letter of reference for my residency application.

Of course, this is Friday night and I am on call tomorrow with two junior residents. What are the chances that Dr. Someone is going to check his email in the next 24 hours and make up his mind to agree with me? Nil.

Just another reason why I hate Teams.

~
I apologize for the recent lack of variety in subject matter. My life is currently being lived from one call-night to the next. Maybe in three weeks I will be off Teams and recovered sufficiently to have clean clothes and a sunnier outlook.

yaah · Aug 28, 2004

deschutes said:
< -- Rant Warning -- >

I apologize for the recent lack of variety in subject matter. My life is currently being lived from one call-night to the next. Maybe in three weeks I will be off Teams and recovered sufficiently to have clean clothes and a sunnier outlook.

Ain't that the truth? During my surgery clerkship and to a lesser extent during my medicine clerkships I felt like I had to put my life on hold for a couple of months. Be at hospital all day. When you DO finally go home, you have to eat and catch up on important stuff like laundry or bills or whatever because you only get the chance occasionally. Then if you want to get a decent amount of sleep before a 30+ hour shift you have to go to bed at about 9pm. The day after my 3 months of surgery ended I woke up, said to myself, "What the **** (all capitals) was that all about?!?!?" Then I got out of bed, went outside, and saw the sun for the first time in 3 months.

If you're on q4 call, a "weekend off" means that you get off on friday afternoon after having been up for way too long, so obviously the rest of friday is shot unless you have a death wish. Then saturday you are so tired but you realize you need to do something with your day off. Then sunday comes and you realize you are back on call monday, so you better go to bed early. What the ****! (again all capitals). And this is only one weekend in four. And, like I said, that is if you have the humane q4 schedule. q3 means your weekend off is when you are on friday and go home on saturday!

Now I'm not one to say, pick a specialty because of lifestyle, and I'm not going to. If I ended up doing one of these fields I would have adjusted my life somehow and it would have been fine. But seriously, WHAT THE ****?!?!?

Fight the power Deschutes! When I did one of my surgery subspecialty rotations there were too many students on call so if you didn't get to the call room early enough you were stuck on the couch. That stunk. I think they just take pride in being able to lord over med students. No one, once they finish med school, ever seems to remember what it was like to be a med student. Suddenly, med students become stupid and whiny (which some of them are, but that's not the point, because these people become stupid and whiny residents and attendings who are the biggest complainers about med students).

b&ierstiefel · Aug 28, 2004

yaah said:
Now I'm not one to say, pick a specialty because of lifestyle, and I'm not going to. If I ended up doing one of these fields I would have adjusted my life somehow and it would have been fine. But seriously, WHAT THE ****?!?!?

Conversely, I will say don't pick a specialty because it is hard, the lifestyle sucks, and the fact that you'll be doing it will draw praise and prestige from an those who are shallow and ignorant.

I'm serious...everytime I tell somebody I'm going into path...people mention either the words, "lifestyle" or "slacker" or even "****off". So I redirect the question back to them..."are you doing internal medicine because the lifestyle sucks and you like being a busybody?"

Seriously...WHAT THE ****!

Stinger86 · Aug 28, 2004

So far in my short clinical life, I've been asked what I'm interested in probably 10 separate times. Each time I mention path, I'm told "Hey, that's a great field!" It's kind of surprising, seeing how I expect a lot more people to crap all over it, and call it not practicing medicine.

I think most people go into a primary or "better known" field without knowing anything about the other ones. Then, during their own private hell, they happen by the path lab to check up on a biopsy or something, and find the pathologists dressed nicely but without ties, just relaxed as could be, talking and joking with one another. And depending on their personalities, some people will get jealous (hence, the "dont you want to be a real doctor" attitude) and some people get envious ("I recommend that field").

Perhaps I've just had the good fortune of encountering the envious types. I'm sure that will all change on surgery.

b&ierstiefel · Aug 28, 2004

Stinger86 said:
So far in my short clinical life, I've been asked what I'm interested in probably 10 separate times. Each time I mention path, I'm told "Hey, that's a great field!" It's kind of surprising, seeing how I expect a lot more people to crap all over it, and call it not practicing medicine.

I think most people go into a primary or "better known" field without knowing anything about the other ones. Then, during their own private hell, they happen by the path lab to check up on a biopsy or something, and find the pathologists dressed nicely but without ties, just relaxed as could be, talking and joking with one another. And depending on their personalities, some people will get jealous (hence, the "dont you want to be a real doctor" attitude) and some people get envious ("I recommend that field").

Perhaps I've just had the good fortune of encountering the envious types. I'm sure that will all change on surgery.

Well I have had a fair share of attendings say, "Great field!" but then there is a long pause in the conversation. Do they really think path is a great field? Are they just patronizing me? Do I really give a damn what they think anyways? No attending could tell me WHY path was a good choice for me...they just say, "good choice" or "lifestyle" , etc etc etc. Very short shallow meaningless comments. Unlike you though, nobody has told me "I recommend that field." I tend to get the "don't you wanna be a real doctor" kind of response. Then I just let out a fart in the elevator and walk out. (nah i'm not that rude

)

rirriri · Aug 28, 2004

AndyMilonakis said:
Well I have had a fair share of attendings say, "Great field!" but then there is a long pause in the conversation. Do they really think path is a great field? Are they just patronizing me? Do I really give a damn what they think anyways? No attending could tell me WHY path was a good choice for me...they just say, "good choice" or "lifestyle" , etc etc etc. Very short shallow meaningless comments. Unlike you though, nobody has told me "I recommend that field." I tend to get the "don't you wanna be a real doctor" kind of response. Then I just let out a fart in the elevator and walk out. (nah i'm not that rude )

i can't even begin to describe how many times i've been told "oh, that's a great field!" and then 2 minutes later i get thrown a tired old lame-ass joke about autopsies or dead people

in the end, i'm the one laughing inside.....*shakes fist*

yaah · Aug 28, 2004

rirriri said:
i can't even begin to describe how many times i've been told "oh, that's a great field!" and then 2 minutes later i get thrown a tired old lame-ass joke about autopsies or dead people

in the end, i'm the one laughing inside.....*shakes fist*

Rirriri plenty of threads on that one too...I went on a rant (several rants!) sometime back in february because I attended some family gatherings with people I hadn't seen in awhile and of course they asked what kind of doctor I was going to be. Grrrrr.... Wouldn't want to be your patient! A bad day for you is when the patient wakes up! You see dead people! Grrrr...

b&ierstiefel · Aug 28, 2004

yaah said:
Rirriri plenty of threads on that one too...I went on a rant (several rants!) sometime back in february because I attended some family gatherings with people I hadn't seen in awhile and of course they asked what kind of doctor I was going to be. Grrrrr.... Wouldn't want to be your patient! A bad day for you is when the patient wakes up! You see dead people! Grrrr...

Fortunately, my family is pretty supportive of my decision and they haven't made any snide comments regarding it. They knew I always wanted to be a scientist anyway like my dad.

deschutes · Aug 28, 2004

Stinger86 said:
So far in my short clinical life, I've been asked what I'm interested in probably 10 separate times.

Most attendings and residents I work with, want to know. Sometimes because they're genuinely interested, and others because they have nothing else to talk about.

deschutes · Aug 28, 2004

yaah said:
The day after my 3 months of surgery ended

3 MONTHS!! *sweat drop* Holy crap. That's too long.

yaah said:
that is if you have the humane q4 schedule. q3 means your weekend off is when you are on friday and go home on saturday!

On our Teams month it's mandatory that everyone does one Saturday, and one Friday/Sunday.
With this night I have tipped the balance... I am now on Night 4 of 7. Woo hoo!

yaah said:
I think they just take pride in being able to lord over med students.

No kidding. Take today for instance. I got spazzed at by an attending for (a) not having my orders activated, and (b) not being visible.

This despite the fact that my orders were in 3 hours previously and I had asked 3 separate residents to activate them, and the fact that half the time the attending himself vanished.
I get my job done. I don't sit around. You're the one who's complaining about people being inefficient. WTF?!
*sigh*

I wish I could say it didn't affect me since I know I'm not responsible for his mood swings - but hell yeah it does.

b&ierstiefel · Aug 29, 2004

deschutes said:
No kidding. Take today for instance. I got spazzed at by an attending for (a) not having my orders activated, and (b) not being visible.

That's the best...getting yelled at for not being visible. Yeah and why not attach a leash to my neck and drag me around when you see all the patients. Even better, I'll wear a dog-collar with the word B1TCH on it.

yaah · Aug 29, 2004

I provided my attendings and residents with a small bell that rang at a frequency only I could hear. When they needed me, they were instructed to ring the bell and I would show up with plenty of extra towels, lab results, paperwork, or tubes of blood (it didn't matter whose blood it was). It sure beat having them page me all the time.

In regards to the being visible part, just stand or sit at the nursing station all day when you write your notes or make phone calls or read articles. That way you will be in the way all the time and they will complain you are too visible. Either that, or make your own "rounds" every hour or so. Walk quickly through the floor where your resident or attending is so that they see you looking busy. Then you can go back to word racer or reading penthouse or whatever you want to do.

deschutes · Aug 29, 2004

yaah said:
...sit at the nursing station all day when you write your notes or make phone calls or read articles.

I will now!!! I had thought they were being inefficient but now I see that they were simply being "visible"!

I volunteered to do a discharge summary in a bid to help the junior activate my orders quicker. I had to trot down to Health Records to do this because she didn't keep the file on the floor after the patient was gone. And I got screwed over anyway.

Next time I volunteer, it will only happen in the presence of an attending.

b&ierstiefel · Aug 29, 2004

No more volunteering. One should not ask to do more work. Here's my thinking (at least how things work at my school...but this probably applies to most places):

Option A - you can be the lazy student who does the minimum required work. this student never volunteers to do extra work. this student comes in to preround and then leaves after rounds. (Grade = Pass)

Option B - you can be the average student. this student completes all assigned tasks and does it cheerfully with a big sh1tfaced grin on his/her face. the student will occasionally ask to help out if needs be. (Grade = Pass)

Option C - you can be the above average student. this student does everything that student B does but will consistently stay late. he/she will constantly volunteer to do extra tasks. he/she will ask for extra patients to carry. he/she will do everything humanly possible to look busy and be busy.
(Grade = Pass...maybe High Pass)

Option D - this is the honors student. never got honors during 3rd year so i won't comment. maybe sexual favors involved...dunno.

My point is this. If you do average work, you get a pass. If you're like student C, you do extra work and that looks great. Right? WRONG! If you do extra tasks, the higher the likelihood that, one of these times, you will trip up and look like a *******. And attendings/seniors will be more likely to remember the one or two mistakes rather than all the asskissing you did. So, the moral of the story is to be like student A or B...get your Pass...and celebrate when your months of clinical medicine ends!

End rant.

deschutes · Aug 29, 2004

AndyMilonakis said:
No more volunteering. One should not ask to do more work...The moral of the story is to be like student A or B...get your Pass...and celebrate when your months of clinical medicine ends!

I am probably sitting between A and B, depending on what time of day it is and what time of week it is and what time of month it is...

The only reason I volunteered was because I took pity on the junior. But as she didn't treat me to my choice of candy bar from the the nursing station's pay-as-you-go jar, that will be the end of that. I will simply withdraw into my normal neutral state.

b&ierstiefel · Aug 29, 2004

deschutes said:
I am probably sitting between A and B, depending on what time of day it is and what time of week it is and what time of month it is...

The only reason I volunteered was because I took pity on the junior. But as she didn't treat me to my choice of candy bar from the the nursing station's pay-as-you-go jar, that will be the end of that. I will simply withdraw into my normal neutral state.

I only came out with that previous post based on experience. A classmate of mine was student A. I tried to be between student B and C. I strived to be student C. We ended up both hating medicine. We ended up with the same grade. We both are going into pathology. He was smart. I was dumb. I just wasted my time trying to be something I was not.

deschutes · Aug 29, 2004

AndyMilonakis said:
I only came out with that previous post based on experience...He was smart. I was dumb.

Sweet is the bitterness!

I think it's fair to tell in retrospect that one did too much for the wrong reasons. Within the rotation though, I confess to being somewhat lost. When I have been told that I am not visible enough, is the attending merely being a bully? If he has say on my evaluation, how do I know that this is not something they will fail me on?

Obviously I am not going to be able to demonstrate any sort of solid understanding of medicine, so we know how I will fare on that as an evaluative point.

Homunculus · Aug 30, 2004

deschutes said:
Thought I had seen it all, but - why are there fibres in kiddie pee??

suspected colovesical fistula. :scared:

--your friendly neighborhood e coli treating caveman

deschutes · Sep 1, 2004

When was the last time you heard the words "ventricular tachycardia" or "deep vein thrombosis"? Probably never.

There are no words more than 3 syllables long in floor medicine - hence VTach and DVT, Echo and O2Sat, GBS and Hep B, BiPAP and OSA, PICC and Art-line...

And everyone's supposed to know what the hell everyone else is talking about.

I am so convinced I don't have the mind of an internist when, at the mention of "cc" and "TPN" in the same breath, my mind goes quite quite blank.
How did doctors talk, and what did hospital charts look like before abbreviations were invented, I wonder.

Do the run-around putting out fires all day - that's me and floor medicine.
How do we deal with complexity? We add even more layers of complexity.

Some days it seems a miracle anyone gets better in hospital at all. What did we do, we made him pee? Whee.

Doing the Dance of Joy (aka = Why Clinical Medicine Blows Part VI)

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Intern year? Ha!

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