The Official Anti-Clinical Medicine Thread

Started by b&ierstiefel
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yaah said:
Just because someone is of a different ethnicity suddenly means we should start listening to them and considering their personal views? Aren't we supposed to do this with every patient?
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I agree. I don't think the emphasis on social awareness was meant to be divisive, in as much as it was trying to better the current standards of practice of patient-centred care.

35 hours in multiculturalism... ick. I am so glad those days are done. I had written similar comments on the course evaluation as yours.

The thing is, if med students lack role models since current staff physicians are generally perceived to be lacking empathy - then where do we go from here?

We know that every patient deserves our best efforts - but does it follow then that we have reached the limits of the patient-doctor relationship?
 
It never ends. Every week we all get emails from someone in the "cultural competency division" who apparently gets paid to come up with stuff like this. One of them, seriously, was about Arab patients and how some of their health needs may be different. Do you know what these listed health concerns were?

I will reproduce the message in its entirety, as I have saved it due to being impressed by the complete lunacy of someone being paid to do this.
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Pain Management among Arabs

● Many Arabs express pain freely, especially in the presence of family members with whom they feel comfortable.
● When helping Arab patients manage their pain, it may be useful to keep in mind that:
1) Pain is feared and may cause panic when it occurs.
2) Coping with pain may be easier if enough information about its source and prognosis is provided.
3) When the benefits of potentially painful medical procedures are understood, a higher pain tolerance may result.
4) Some Arab patients may perceive intravenous fluids as an indication of the severity of the situation; thus, an explanation may be needed.
5) Injections may be considered more effective than pills.
6) Explaining the differences between self-medication and prescribed medication may be valuable if patients are considering self-medication.
7) Arab patients may also use metaphoric symbols such as fire, iron, knives and rocks to describe pain. Inquiring about these symbols may be useful to further understand pain management among Arabs.

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What I wanted to do was reply to this email, change every instance of the word "Arab" to "A PATIENT OF ANY ETHNICITY/NATIONALITY OR ANY OTHER SUCH CATEGORIZATION" but I didn't have the balls to do it.

Because, as we clearly have learned, non-Arab patients never fear pain or like to have things explained to them.

Again, I reiterate. This is someone's job.
 
yaah said:
... emails from someone in the "cultural competency division" who apparently gets paid to come up with stuff like this.
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There is a "cultural competency division"?? Haha! Dear me. From the looks of that email it almost seems like someone in the division had just realized - well what do you know, Arabs feel pain, just like us! - and decided to share it with the world.

Sorry. Indulging in yet another bout of cynicism. As if there hasn't been enough of that floating around lately! I'll go put my nose back in joint now.

These interactions are a two-way street, really. I have often wondered what many of the patients I have encountered must think of me, who can't possibly look like any doctor in their imagination.
 
We got a message a couple of weeks later that reminded us that Chinese people feel pain as well. And that their families often want to know what is going on when they are sick. And that Chinese New Year is an important cultural event.

Amazing, this stuff I have learned. Here I was going around stabbing people of other races just because I thought they enjoyed it.

One of my favorite "real world" clinical cultural stories: Saw a patient on my IM outpatient rotation. A Cambodian man who was in (with his daughter as his translator) for a follow up visit, having been diagnosed with hypertension previously. He had all the pills he had been prescribed, but hadn't taken any of them. His daughter said that he didn't like to take pills and preferred to try home remedies, including a special diet. Clearly, the home remedies were working because his blood pressure was 210/120. The preceptor and I had a talk about how to go about getting him to believe in the need for his medicines.

The next patient was a 75 year old caucasian who had never been out of massachusetts except for his time overseas while in the military. He also had hypertension, plus diabetes. He brought in his pills as well, and hadn't taken them. He said he didn't believe in pills and was going to fix his blood pressure and diabetes himself with home remedies, including a special diet.

Med school didn't teach me how to deal with either one of these situations. It just taught me that #1 was possible.
 
yaah said:
Med school didn't teach me how to deal with either one of these situations. It just taught me that #1 was possible.
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Are you describing the presence of a sort of "reverse cultural insensitivity"?

Those situations are hard. They are essentially the same scenario - except that the first required an interpreter.

We were told in med school that patient compliance/adherence (or whatever the current buzzword is) with prescribed treatment regimens sits at what, 50%? Both your patients at least had their scripts filled! I remember having difficulty with just taking a once-a-day pill.

That talk with your preceptor - what sort of conclusions were made?

I have seen some doctors coax their patients into a trial of meds - "just for 3 months, and see how you do. What have you to lose?"
 
What happened to, "If you don't like the treatment, you don't have to take it!" Final answer.
 
AndyMilonakis said:
What happened to, "If you don't like the treatment, you don't have to take it!" Final answer.
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Because then they will die and their family will sue you for either not being adamant enough about the importance of the treatment or not explaining it well enough.
 
yaah said:
Because then they will die and their family will sue you for either not being adamant enough about the importance of the treatment or not explaining it well enough.
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Exactly! The overabundance of lawyers and increase in the litigious public have made doctors' lives difficult. And seeing all these lawyer commercials on TV is maddening.
 
I like the way we go round and round in circles, don't you? 🙂

At any rate, I am going to cross-post on this thread as responding to the original post on the Bush/Kerry/Nader thread would just have continued to keep things confusing.

AndyMilonakis said:
i hope you don't get too grossed out. there are some frightening and smelly things down there.
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A thousand comments rush to mind, but I will restrain myself.
 
deschutes said:
I like the way we go round and round in circles, don't you? 🙂

At any rate, I am going to cross-post on this thread as responding to the original post on the Bush/Kerry/Nader thread would just have continued to keep things confusing.

A thousand comments rush to mind, but I will restrain myself.
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In cross-posting you have now taken a statement of mine out of its context to suit your gutter-mind. Good job 👍 🙄
 
Once again, I would like to state that I think clinical medicine blows. Who's with me?
 
deschutes said:
I had totally forgotten about this thread. Dammit! All those plastic surgery rants gone to waste.
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You got plenty of chances left 😀

And more people who are suffering through clinical rotations need to post here too 👍
 
bananaface said:
I don't see the point of this thread. Just because you don't enjoy something doesn't mean you have to be against it. 😕
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blasphemy
 
So a few days ago I ran into an IM attending with whom I worked during my IM rotation during 3rd year. He asked me where I wanted to go for IM residency. I promptly told him I was going into pathology. Then he asked me why I had made that decision. "I like dead people." That pretty much hushed up that conversation.
 
I just sat here and read through this whole thread, and depressing as it was, actually had the effect of making me feel somewhat happy since I am done with internal medicine. I am all worried about surgery and especially ob/gyn, but at least based on this thread, it sounds like medicine is the worse, and I've got that out of the way!!
 
beary said:
I just sat here and read through this whole thread, and depressing as it was, actually had the effect of making me feel somewhat happy since I am done with internal medicine. I am all worried about surgery and especially ob/gyn, but at least based on this thread, it sounds like medicine is the worse, and I've got that out of the way!!
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Yeah...it is most excellent that you got that big IM bear rotation outta the way. Surgery and OB/Gyn was a bit palatable for me to be honest. The notes are short. And it's more doing than just sitting and farting around thinking and thinking of the 20 gazillion reasons why your patient has a bleeding bunghole.
 
At a peds exam I was supposed to check reflexes on a newborn, and managed to crash little Bobby's head into a steel table. Surprisingly, I did not pass...

At another time, I was doing some unpleasant intervention rads stuff, and the pt fainted on me. As the Master Clinician, I immediately dx'ed a heart attack, and started pounding his chest while at the same time alerting the entire dept. Whereupon pt. removed my hand and told me everything was ok.

PLEASE let the pt be dead or far, far away went I make my dx....
 
bananaface said:
"I like dead ppl sounds" like a description of necrophilia.
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In the continuum from reflecting upon thoughts and events towards a inherent and irrisistible urge to project abnormal sexual practises into otherwise innoculous discussions, I give you a rating of 75.

:laugh: :laugh: :laugh: :laugh: :laugh:
 
I think it is only necrophilia if you 'love' dead people...liking them just implies that you'll probably go for coffee or something but it probably won't go any further than that for some reason.....I mean, your date is unemployed, makes poor conversation, will probably start to smell in a few days, and he's just kind of stiff in posture so it's probably not going too far. 😀
 
Pingu said:
I think it is only necrophilia if you 'love' dead people...liking them just implies that you'll probably go for coffee or something but it probably won't go any further than that for some reason.....I mean, your date is unemployed, makes poor conversation, will probably start to smell in a few days, and he's just kind of stiff in posture so it's probably not going too far. 😀
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Even worse: The stiffness wears off, never to return. :laugh:
 
bananaface said:
75? On a scale of 1-10? 😉
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OK. Perhaps my confidence interval or sumthin got screwed up.... Good thing that I'm not in psych either....
 
Plus dead people can't talk dirty. Although in anatomy, my cadaver had a propensity to extend its arms out and touch people and the table was convienently at booty level
 
Pingu said:
I think it is only necrophilia if you 'love' dead people...liking them just implies that you'll probably go for coffee or something but it probably won't go any further than that for some reason.....I mean, your date is unemployed, makes poor conversation, will probably start to smell in a few days, and he's just kind of stiff in posture so it's probably not going too far. 😀
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If you can check into a hotel in certain states, you could get a common law marriage. This scheme could be a golddigger's dream.
 
Speaking of checking into hotels, I saw a hbo special a while back on unusual fetishes. There is a type of porn which involves checking into a hotel with a midget in a suitcase and then you get to the room, let the midget out and do them. This was one of the strangest things I have ever seen.

I've known some golddiggers who would definitely do a dead guy for the right amount of money. Truly crazy how skeazy some chicks are. 😱
 
Pingu said:
Speaking of checking into hotels, I saw a hbo special a while back on unusual fetishes. There is a type of porn which involves checking into a hotel with a midget in a suitcase and then you get to the room, let the midget out and do them. This was one of the strangest things I have ever seen.

I've known some golddiggers who would definitely do a dead guy for the right amount of money. Truly crazy how skeazy some chicks are. 😱
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i told my boss yaah's autoerotic asphyxiation story and she was like "yeah I kinda like that too. But, just a little bit." My boss is so wierd. 🙄 :laugh:
 
Pingu said:
Speaking of checking into hotels, I saw a hbo special a while back on unusual fetishes. There is a type of porn which involves checking into a hotel with a midget in a suitcase and then you get to the room, let the midget out and do them. This was one of the strangest things I have ever seen.

I've known some golddiggers who would definitely do a dead guy for the right amount of money. Truly crazy how skeazy some chicks are. 😱
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wasn't yaah in that hbo special?
 
AndyMilonakis said:
he wasn't the midget, pharmtard!
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AND exactly from where doeseth cometh your intimate knowledge of these affairs? YOU were perhaps in the suitcase that Yaah was carrying???
 
PathOne said:
AND exactly from where doeseth cometh your intimate knowledge of these affairs? YOU were perhaps in the suitcase that Yaah was carrying???
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i have HBO. i saw it on the telly.
 
Hmm, I guess it was just like bein' there for you??? 🙂
 
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