Five More Days!

yaah · May 19, 2004

I have started a personal "5 clinical medicine days left" countdown. Although, who am I really kidding, I have actually been having this countdown in my head for most of my 4th year. My last day is this coming wednesday, because I am not including thursday, since all I have is my neuro clerkship final.

Things I saw today that I will not have to deal with again, at least from the standpoint as a doctor/health care professional:
1) Lumbar Punctures
2) Consults for "Uncontrollable pelvic thrusting." (no fooling)
3) Vomiting old ladies
4) Incontinent old men.
5) Looking for medication sheets (like Where's Waldo on occasion)
6) Calling cat scan to beg for a study in the next few days.
7) Agitated people pulling out IVs, foleys, NG tubes, and EEG leads (ouch).
8) The %$!@&$# neuro exam. Tuning forks are meant for tuning instruments, not pressing against the inflamed and edematous bunion-scarred toes of little old ladies.

Ah, sweet bitterness, where would I be without it.

Hey, on the bright side, I met an IM resident today, told him I was going into path. His response: "Wise choice. IM is a continuous journey into hell."

joedogma · May 19, 2004

Congrats yaah and all fourth years! As a third year student I am living vicariously through you. Although I am looking forward to fourth year, I just wish I knew where I was going to be spending the next 4 years of my life.

At least I won't have anymore 12 week rotations and I can look forward to some path electives in the near future

I too long for the day where I don't have to turn the nursing station upside down looking for the freakin' MEDEX (a rather important document, you would think that people would actually know WHERE it is from time to time...) Again, congrats to all soon to be grads and for all of those who will never have to do another H&P, cheers!

Brian Pavlovitz · May 20, 2004

I am envious of BOTH of you! I have to begin studying for the gloriously annoying Step 1 (July 2 is the big day), then I get to look forward to all the aforementioned excitement!

Good luck on the Neuro Final, Yaah! Enjoy 4th year electives, JoeDog!

Congrats to all of you lucky graduating seniors!

cookypuss3 · May 20, 2004

Yaah, you bastard, rub it in, why dontcha!!! I'm extraordinarily and passionately jealous right now. I can't wait till my last day of clinicals when I will take the hugest mental dump of my life and get rid of all that clinical medicine crap.

As an aside, we had to do some stupid MOSCE exam today, where we all paraded from station to station for three hours, demonstrating how to start an IV or diagnose heart murmur X. The station that involved central line insertion, oh God, really, I laughed at the nurse at that station. I was like, I've never even SEEN this done, much less done one myself, so you might as well go ahead and take points off now. She looked at me like I was sprouting a third eye. Whatever. The whole thing was a giant painful charade. I'm really over intubating plastic babies, you know?

yaah · May 20, 2004

Eliminated the thumb today. Down to 4 days...

Cookypuss, you are probably not going to believe this, and may actually send me a virtual middle finger, but I have succeeded in getting through my entire med school experience without putting in a single IV. I include any practice sessions. No central lines either. I did have to put in a trach tube in the OR once, but no friggin IVs. I rule! During my medicine month I had to draw blood a few times because there were no phlebotomists on at certain times of day. By the way, cooky, just how "passionately" jealous are you? Hmm?

Never had to intubate a live person either. Just the dummies.

Joe D, the medex is always with the nurse who is taking care of the patient. And where is that nurse, by chance? Oh, she's on break. Well, who is covering for her? Mary. Mary, where is the med sheet on Mrs P? I don't know.

Curse your oily hides! If you weren't such a hot little ticket I would get mad at you now!

Actually, residents are worse. Residents are always trying to get out of doing things by "conveniently" leaving things hanging until they leave for the day (or for their clinic) so that someone else has to do the odious task. Either that or they somehow manipulate the system so that test results return just when they have left.

By the way, today for one of my last clinical medicine events, I cured a patient who was intubated and becoming hypoxic. Oh my god! His pulse ox is down to 85 and falling! I cured him. No problem. I moved the pulse ox from his index finger to his middle finger. I guess that made him breath better. Maybe I should have gone into pulmonary.

GMO2003 · May 20, 2004

yaah said:
Eliminated the thumb today. Down to 4 days...

Cookypuss, you are probably not going to believe this, and may actually send me a virtual middle finger, but I have succeeded in getting through my entire med school experience without putting in a single IV. I include any practice sessions. No central lines either. I did have to put in a trach tube in the OR once, but no friggin IVs. I rule! During my medicine month I had to draw blood a few times because there were no phlebotomists on at certain times of day. By the way, cooky, just how "passionately" jealous are you? Hmm?

Never had to intubate a live person either. Just the dummies.

Joe D, the medex is always with the nurse who is taking care of the patient. And where is that nurse, by chance? Oh, she's on break. Well, who is covering for her? Mary. Mary, where is the med sheet on Mrs P? I don't know.

Curse your oily hides! If you weren't such a hot little ticket I would get mad at you now!

Actually, residents are worse. Residents are always trying to get out of doing things by "conveniently" leaving things hanging until they leave for the day (or for their clinic) so that someone else has to do the odious task. Either that or they somehow manipulate the system so that test results return just when they have left.

By the way, today for one of my last clinical medicine events, I cured a patient who was intubated and becoming hypoxic. Oh my god! His pulse ox is down to 85 and falling! I cured him. No problem. I moved the pulse ox from his index finger to his middle finger. I guess that made him breath better. Maybe I should have gone into pulmonary.

buddy are you telling me you went through an entire internship without putting in an IV, starting a central line...not even one friggin' ABG, throracentsis, or nothing?? BRAVO my friend you truly are the chosen one...please lead me into the promise land

cookypuss3 · May 20, 2004

Oh no, don't get me wrong, I am the Mistress of Clinical Procedure Avoidance. I may be just starting my 4th year now, but I also have never started an IV. I didn't place a single stitch during surgery. I didn't put in any central lines, Foleys, or any other distasteful similar act. I haven't done a fundoscopic exam. Haven't intubated anyone besides the plastic dummies. I haven't percussed a single liver. No ABGs. No injections. No thoracenteses. See, I can't even spell that. So Yaah, while I admire your tenacity, I'm right behind you, hiding in the bathroom when I should be heroically performing some icky procedure. All herald the wise!

And Yaah, but of course, I am extremely passionately jealous. I'm virtually panting with jealousy. Beads of sweat are forming on my forehead. I just want to be done so bad. I can practically feel it now, and I want it now, God I want it so bad. Just give me my diploma now, give it to me, give it to me... now...

joedogma · May 20, 2004

yaah I have succeeded in getting through my entire med school experience without putting in a single IV.[/QUOTE said:
LOL!!! I almost fell off my seat when I read that! Truly an accomplishment in its own right. That may be harder to do than ace the boards. Since you are going into path there is a good chance you will make it through your entire medical career without ever putting in an IV! Next I bet you are going to tell me that you have never done a rectal exam...that would be the icing on the cake

Cooky, you went through a peds rotation and you NEVER gave injections? Thats amazing! Definitely something to throw on the eras application!

yaah · May 20, 2004

cookypuss3 said:
No ABGs. No injections. No thoracenteses. See, I can't even spell that.

Darnit. I did TWO ABGs during medicine month. No 'centesis procedures either, although I did have to hold the bottle while the intern did a paracentesis. I only did one injection, that was a flu shot to a hockey player during my family medicine month when I worked with the UMass team doctor. None during pediatrics. I am daily thinking of new ways to get out of doing LPs in neuro. I finally told them I wasn't interested since I was going into path, and they actually listened to me and understood.

Oh, and GMO since you asked, I have not done an internship, just med school. I would be hard pressed to get through an internship without doing all that stuff. I did my sub-I without having to. I almost was forced into doing a femoral stick but got out of that by arguing that the risk of doing the femoral stick outweighed the benefits of knowing what the tests actually said. I am just proud of not having ever started an IV, fake or real. I want that on my diploma.

I did have to stich somewhat during surgery, but not as much as other people in my class. I tried to sign up for the procedures that I knew would result in closing with staples (like the GI operations or the GYN cancers). ALl the suckers sign up for stuff like vascular bypasses where they have tons of crap to close, or superficial excisions with lots of two layer closers. Me, give me the ex-lap with the 0 PDS and the skin staples. I don't care if you're doing a adhesion lysis operation, if you can promise me skin staples, I'm there. Unfortunately, operations with minimal stiching like laparoscopic stuff do have small holes that need to be closed and the surgeons always like to "reward" the med student who drives the scope by allowing them to close the holes. Thank you, master! May I wash your feet as well? Might I inquire as to your technique of choice? Shall I bury the stitch or shall I leave an external loop for easy post-op removal?

And Yaah, but of course, I am extremely passionately jealous. I'm virtually panting with jealousy. Beads of sweat are forming on my forehead. I just want to be done so bad. I can practically feel it now, and I want it now, God I want it so bad. Just give me my diploma now, give it to me, give it to me... now...

Wow that's pretty jealous. I wanted it pretty bad too when I was in your position. Now, however, since I have 4 days left it is almost palpable. Ready to explode. Just think, though, how special it will be when the climactic moment finally arrives. Even if you have to go through another year, all that time the excitement will be building. At least you know you won't be disappointed when you finally graduate. Just think, all those people going into clinical medicine have to go through all this crap, and then go into the cold shower that is internship. They work themselves up, getting all excited and jealous, and then once july 1 hits, they wish they were back in med school. Poor bastards.

There's a difference, you know. People who go into path think 4th year of med school is a waste of time. People who go into clinical medicine love 4th year because of all the free time and "interesting" electives. I think 4th year of med school is too long.

GMO2003 · May 20, 2004

Yaah,

You are very resourceful indeed. I think you deserve a round of applause from everyone. I'm not being sarcastic either. You played the system and you didn't let it play you. For that, you achieved your own personal means to an end and will succeed with your desired outcome.

You have no idea how lucky of a motherF#$%^&% bastard you are that path no longer requires a preliminary clinical year. You guys just basically transition right into residency from 4th year right? That is so friggin AWESOME. You get to forgoe the dreaded "intern blues." I think your precious streak of no procedures would've ended the day you stepped onto the medicine wards as the dreaded "tern." IVs, femoral lines, A-lines, IJs, thoracenteses, paracenteses, bedside echos, ABGs up the wazuu, all the GXT-mibis you can handle, sewing up a drunk guys hand at 3AM because some guy at the club called his wife a skank, running a code blue/red at 4AM in the morning...after paging anesthesia 3 times and the attending nowhere to be found...I could go on but you get the picture...I am truly envious...but also very happy that you will not have to experience this sweet torment that is called internship year...again, congrats and GODSPEED my young jedi...may you enjoy your nights sleeping

yaah · May 21, 2004

GMO2003 said:
You have no idea how lucky of a motherF#$%^&% bastard you are that path no longer requires a preliminary clinical year. You guys just basically transition right into residency from 4th year right? That is so friggin AWESOME. You get to forgoe the dreaded "intern blues."

Oh believe you me, I kneel in prayer at the alter of Virchow every day in thanks for this. Some residents I have worked with in clinical rotations are kind of surprised when I tell them I don't have to do an internship. Usually, they say, "why don't you do this procedure since you will have to do this as an intern anyway" then I tell them I don't have to be an intern. And they say, "well, then go to lunch, there's no point in spending a half hour learning to do this if you won't ever use it. Unless you're interested, of course," (they always add that last part). So far it hasn't cost me on the grading. The "procedural oriented" specialties I have done I have gotten all honors in, oddly enough. Except for family medicine, when my preceptor specifically equated my lack of asking him to do procedures (like pelvic exams, pap smears, injections, toenail removals) with a lack of enthusiasm and aggressive learning. (he wrote that on my eval so I know it's true). But I didn't really care. I always get good grades for documentation, mental knowledge, and paperwork.

Path people used to have to do an internship in medicine or surgery, but that changed to an optional thing a few years back. For years, you had to do a 5 year residency, which is like the current 4 year one except the 5th year could be either an internship preceding the residency or an extra fellowship like year at the end. Since almost no one did the prelim year, they ditched it and now path is 4 years. I think military residencies still require the prelim year though, so you can be certified to be sent overseas and remove shrapnel or something. Plenty of procedures over there!

I dislike procedures. I didn't have to do an ER rotation thank goodness.

cookypuss3 · May 21, 2004

When I found out a couple years ago that we didn't have to do an internship I almost wet myself with joy, and I knew then that pathology was my fate. Kismet, if you will. God bless it. Without it, I would be trying to get into law school by now.

Yaah, how come you got out of an ER rotation? We're required to do 4 weeks, yuck, but I scheduled it at the dippiest, most lame hospital in the area where the worst thing that comes in is a cut finger. I'm sure it will be mellow as hell, especially since I don't mind sewing lacerations for some reason.

yaah · May 21, 2004

Dunno. I guess my school just doesn't require ER as part of 4th year. Our only required 4th year blocks are medicine SubI and Neurology. No ER during 3rd year either except when we go down there for other fields to admit someone or consult. I think that should be on the UMass advertisements: We Promise, no ER! Odd because there are always tons of people in the class who go into ER every year and UMass has a great ER program, or so I've heard. I dislike the ER. If you are at a community hospital, you are a real doctor and have to make tough decisions, but if you are at a big university hospital, your job as ER physician seems to be to coordinate the consults and let other people take care of your patients. Unless they cut themselves, of course. But then again, a cut on the hand = hand surgeon for proper closure, and a cut on the face = plastic surgeon too. On my neurology rotation we have been called basically within 5 minutes of the patient signing in to see a patient, and cardiology is already there.

I am not trying to badmouth ER physicians, obviously they have good intentions and since my dad is an ER physician I obviously respect them, I just don't like the way things are done. That, and of course the idiot patients who come in with an "emergency" of a mild sunburn or a runny nose for a week.

3 more days! Tidbit: my neuro exam today included the phrase, "Heard patient singing to himself in the room alone before I entered." This guy also thought that the seizure he had was part of a conspiracy by the chinese government to keep him in the hospital longer. He was really paranoid that chinese people were going to show up again and asked me if I would be willing to look out for them.

my response:

I don't speak chinese, but I think that means "Yes!"

yaah · May 25, 2004

I can't wait for my last clinical day (tomorrow, wednesday, the 26th of May, anno domini MMIV). The sun will rise, except over new england which has of late become the northwestern UK. I will set the alarm for 5:55, arise sprightly, have a donut, make the 35 minute commute on 128 to Burling-town where we shall make rounds on seizure patients, aphasic unfortunate stroke victims, and the obligatory 2-3 patients who are simply faking it. I am anticipating a bell-ringing final day because as I was leaving I heard about a new admission, a woman who insists that she has multiple sclerosis (because she read about the symptoms on the internet) despite her negative MRIs, negative spinal taps, and negative physical exams and lab tests. "But you doctors just don't understand!"

Today I consulted on a patient who thought that I was Santa Claus. She was also restrained to the bed and difficult to understand because she was edentulous. They had to restrain her because she kept trying to get out of bed to go look for "some booze." Of course, I also have the patient who thought the chinese were out to get him. And another lovely lady who said she would rather die than get a lumbar puncture because it might hurt. And the lady who says the only thing that will cure her seizures is more Klonopin (she is not having seizures). And this is not a psych rotation. These are normal, non-psych patients.

Hoo boy. Last patient tomorrow. We'll see. I'm debating whether I want my last patient to be interesting, a flaming psychotic, a rude demanding loudmouth, or simply a sweet older individual. As with the rest of my life, it will probably end a bit anti-climactically. Consult for a TIA. Negative MRI. Negative neuro exam. Recommend full dose aspirin. Hand in pager and key, drive off into the sunset singing "Glory Days."

cookypuss3 · May 25, 2004

Oh God, it brings a tear to my eye. Onward, young man, shed your shackles of clinical medicine. We salute you.

yaah · May 26, 2004

It's shed. Shackles released. Broke free successfully today at 5:34 pm EDT. Struggled forth from the patient care wards out into the sunlight, blinking as my eyes adjusted, tears streaming forth down my face as I experienced true freedom. Kissing the ground outside the hospital. An army of angry and demanding patients followed me, intent on making me go over their histories one last time. My reflex hammer struck one between the eyes and he fell to the ground stunned by the jaw-jerk it induced. My ophthalmoscope struck another in the solar plexus and he collapsed. The tuning fork collapsed the lung of another as it passed through his chest. My eye chart caused another to slip and fall, taking out several others as he went down. My clinic handbooks and clipboards formed an impenetrable boundry that the rest could not pass. I hung the white coat on a tree as a distraction while I slipped away into the woods, never to be seen again.

Last clinical experience was spending some time in the SICU with the rest of the team seeing a patient who had a syncopal episode. My last patient was actually an ER consult for a guy who had prior strokes but this time had a syncopal episode. I am kind of mystified now that I have no more med school left. Fittingly enough, my last neuro exam was completely normal.

Brian Pavlovitz · May 26, 2004

Congratulations, Yaah! I tip my Chardonnay in salute

...make that, Congratulations, Dr. Yaah!!

cookypuss3 · May 26, 2004

Oh. My. God. Laughed so hard my stomach hurts. A beautiful ode to the very best day of your life. I just thank you for being the witty and eloquent bastard that you are, bringing love and laughter into my sad, little, clinical life.

I don't know yet what tonight's cocktail is going to be, but you can bet your sweet ass I'm tipping it to you!!!

yaah · May 27, 2004

Thank you brian and cookypuss. Take heart, your clinical time has a finite limit to it. Soon you will be solely in the realm of pathology! Those of you who are about to embark on more clinical electives, I wish you luck. It has been two long years for me, with an occasional break for a nice path elective. I should say, I did learn a lot on many of my clinical electives, but the fact that almost every day I was doing a countdown in my head of how much longer I had to finish indicated to me that clinical medicine might not be for me.

My last day, I felt like Henry V. My most-liked Shakespeare play.

Once more unto the breach, dear friends, once more,
Or close the wall up with our (clinical) dead!
In peace there's nothing so becomes a man
As modest stillness and humility;
But when the blast of war (perhaps clinical medicine?) blows in our ears,
Then imitate the action of the tiger:
Stiffen the sinews, summon up the blood.

--William Shakespeare Henry V , Act 3 scene 1

Ah yes, we Band of Brothers (and sisters). He that dissects with me shall be my brother, from this day to the ending of the world.

gungho · May 27, 2004

Alas, my shackles remain-psychologically and physically. As I prepare to launch into Path after 21+ yr. of clinical medicine (including residency), I am experiencing true ambiguity. Sadness marks my features as I discard various texts for which I have no more use, staid friends thru the years. Yet, elation breaks forth as I realize no more requests for early refills of Percocet and Lortab, no more "headache every day for the last 15 years", no more "I have no energy", no more "How 'bout a penicillin shot for my sore throat, doc?", no more "gimme one of them kenalog shots for my allergies like my other doctor", and so it goes ad nauseum. Guess I won't be totally free, though-still have to moonlight to pay the bills. But, those incontinents and constipateds will be someone else's problems.

Primate · May 27, 2004

No more, "Doc, what do you know about fibromyalgia?"

P

gung ho, indeed

yaah · May 27, 2004

Fibromyalgia. What a crock of $%@!.

A lot of clinical medicine makes kind of wonder, "Why the heck did I go to school for more than 20 years, and spend all this money, time and effort, to do this?" I mean really. Talking to people about their bowel movements? Does it hurt when you urinate? Except you can't say urinate. You have to be crude, because many people don't understand urinate. You can try to say "void" as kind of a weed-out test. Any patient who understands what the word "void" means is either 1) a health care professional, or 2) a professional patient who is never ever ever going to get better no matter what you do, and you are also never ever going to find anything seriously wrong with them.

And the most important thing to surgeons seems to be getting people out of the hospital. What gets people out of the hospital? Feeling better? No, that takes too long. Making an accurate diagnosis? No, often it's ambiguous. A healing incision? Nah. The correct answer is: Passing gas. AKA flatus. AKA breaking wind, cutting the cheese, letting one rip, faaahting. BRAAAAAAAAAAAAAAP!

So thus, after 20 years of higher education, you show up at 6am, put on a suit, review intensely laboratory values for any clue as to the process of disease, and step into the room and ask the patient, "Did you pass gas today?" And if they say yes, everyone in the room cheers, shouts "hurrah for flatulence," congratulates the patient on their success, and wishes them luck in the future. "But doctor, I have this searing pain in my side!" That's ok. You've passed gas. You are going to be alright. My goodness, that is truly a career to be proud of. Mental gymnastics all around. Then you move on to the next patient. On this patient, you measure the amount of urine they made, and stare at it until you are convinced it is the proper dilution signifying hydration. Then you go to the next patient who caught c-diff, MRSA, VRE, and probably gonorrhea from being in the hospital too long with people who don't wash their hands. Let's look at that decubitus again, please. OH! It smells slightly less putrid this morning, and the greenish color is now mixed more with runny yellows and reds instead of a black crust. Beautiful! OH yeah. Clinical medicine is stunningly rewarding. It's a gas (severe pun intended).

Clair de Lune · Jun 7, 2004

I am also so jealous of all of you who are almost finished! I have yet to start my clinical rotations. In fact I'm studying for the boards right now...so discouraging

. But this thread has been really inspiring because I can actually (sort of) see the light at the end of the tunnel!

Congrats, yaah!!

Brian Pavlovitz · Jun 7, 2004

Clair de Lune said:
I am also so jealous of all of you who are almost finished! I have yet to start my clinical rotations. In fact I'm studying for the boards right now...so discouraging . But this thread has been really inspiring because I can actually (sort of) see the light at the end of the tunnel!

Congrats, yaah!!

I'm right with you, Clair! Step 1 on July 2. I hate studying!!!!!! Good luck!!

Clair de Lune · Jun 7, 2004

Thanks Brian! Good luck to you too! I have a feeling we're both going to rock step 1!

(I'm trying a new positive thinking approach while preparing for this exam

)

Brian Pavlovitz · Jun 8, 2004

Hooray! That will replace my previous "did I even ATTEND medical school over the past 2 years" thinking!

cookypuss3 · Jun 10, 2004

Well. As I re-emerge from my packing-moving-unpacking hell, I am simply awash in fresh waves of jealously, much like yellow odiferous pus oozing from a festering abscess on the leg of an IVDU. I started an IM gig at the local county hospital this week. Much to dismay, it's actually a sub-I. Who knew!! Dammit all to hell.

I will have you, my pathology cohorts, hear my only brief glimmer of light so far: it was within six hours of stepping foot in the hospital. My stupid resident who thinks her **** don't stink was bitching about some liver biopsy not coming back, the thoughts of hepatoma consuming her wholly. Within five minutes she, another med student, and I were beating a fast track to the lab, the icicles thawing from my cold noncompliant ventricles as we grew closer. The pathologist, of course, was friendly and warm and invited the three of us to look at the liver together. A regular old love-in, if you will; all that was missed were the daisies in my hair and the bong in my hand. My breath quickened as he slid the first slide onto the stage. Ah! The fibrosis! The loss of normal architecture! The minimal degree of nuclear pleomorphism, the lack of mitoses, the small N/C ratio! He pimped the crowd; graciously, I allowed the others to share their thoughts before I exploded. A vast silence settled over the room. It dragged on for a few seconds till I could stand it no more and passionately moaned my diagnosis SEVERE CIRRHOSIS NO SIGNS OF MALIGNANCY. The pathologist looked up, blinked, and said to me, "You should go into pathology."

Ya think???

Brian Pavlovitz · Jun 11, 2004

AH! The Queen lives!!

I wish I could have been there to see the look on everyone's collective face. It must have been a great feeling.

Enjoy the rest of your sub-I! If your residents are smart, they'll be asking you to escort them to the Pathology Department more often!

yaah · Jun 11, 2004

What a wonderful story. So heartening to hear. I also like the analogy. IM rotation is to festering pus as......

Take heart. Your sub I will only be a few weeks. When you hang around the resident, if you pretend to look stressed and busy (always writing something or whatever) sometimes they will not give you a new admission. If you are efficient they think you're excited about it and want to "challenge" you more. See if you can handle this one. This guy has CHF.

The last couple of weeks I have been dealing with moving as well, albeit to a new state. I have my condo fully purchased, have my keys, it's all ready. Just have to move in now.

Like the real doctor that I am, I played golf today, although I played like shinola. Only a couple of more weeks until I become an honest to goodness pathology resident.

So, cookypuss, this pathologist used a stage? A cautious individual? Or just someone who appreciates subtle movements?

cookypuss3 · Jun 13, 2004

yaah said:
What a wonderful story. So heartening to hear. I also like the analogy. IM rotation is to festering pus as......

Take heart. Your sub I will only be a few weeks. When you hang around the resident, if you pretend to look stressed and busy (always writing something or whatever) sometimes they will not give you a new admission. If you are efficient they think you're excited about it and want to "challenge" you more. See if you can handle this one. This guy has CHF.

Oh, I've mastered the way to behave in these situations. Get very stressed out, like you mentioned, ask waaaaaaay too many questions and act generally very nervous, and do everything from charting to the physical exam wrong. That way, no one expects jack from me and tends to leave me alone. By the end of the month, if I actually perform at an expected baseline level, it looks like I've made such stunning progress over the month that I inevitably get a great eval.

Moving sucks. I've lost my temper and yelled at at least three different utilities so far, compelling the 18 year old girl on the other end of the phone to say soothingly, "Now, Ms. Cookypuss, please... Ms. Cookypuss, I understand you're angry..." and I just get more worked up and I ended up hanging up on a couple of them. The problem with cordless phones is that you lack that statisfying SLAM when you crash the phone down.

OK. Off to have chocolate cake over the Sunday paper for breakfast, and pretend that I'm not on call tomorrow.

HotSteamingTurd · Jun 13, 2004

Awesome story cookypuss. Can't say that I've been through a situation like that. I did do my last month of surgery this past May...quote of that day (for me) on rounds was the senior resident say something like, "We're not gonna get the path results on that mass we took out; here they don't work on the weekends."

And there's me in the corner of the crowd snickering...it was great. Ahh...the days of asking patients, "have you passed gas or heavens forbid had a BM" is gone. But damn, like some of you all, I still got my 2 mandatory subI months left. I like some of your approaches to working as subIs...I wrote all that down on my Maxwell cards which I will be sure to burn along with my short white coat in 4 months

cookypuss3 · Jun 15, 2004

HotSteamingTurd said:
Awesome story cookypuss. Can't say that I've been through a situation like that. I did do my last month of surgery this past May...quote of that day (for me) on rounds was the senior resident say something like, "We're not gonna get the path results on that mass we took out; here they don't work on the weekends."
QUOTE]

Hell yeah. After I informed the aforementioned pathologist that I was, indeed, going into path, he snickered and with a dismissive gesture towards the resident and other med student he went, "Oh and you know we make so much more money than the medicine people!". Amen, brutha.

BTW, I avoided not one but TWO paracenteses today!!! Woo hoo! However, my karma must have been off, as the second one, a disgusting Hep C monster, dumped the cloudy, odiferous contents of his bedside urinal on my shoes. Fabulous. Just fabulous.

Brian Pavlovitz · Jun 15, 2004

eeeeew. I just can't wait until thrust into the open arms of clinical medicine!

Perhaps I should re-think my choice for footwear; I'm not sure Doc Martens will be economical. Maybe some lovely, plastic gardening clogs??

HotSteamingTurd · Jun 15, 2004

Ahh....my last day in anesthesiology. And I'm on call which means I'll get sent home at around noon-ish today and won't get called back into the hospital...THEN I have tomorrow off. I may be the only anesthesiology student who may go through this rotation without having done a single intubation. Typical scenario to illustrate this:

Anesthesiology resident - "So what are you thinking of going into?"
Me - "Pathology

"
Resident - "Oh, well you won't need to practice these skills."
Me - "Well I'd still like to do it but if I don't I'm not gonna cry to mommy about it."

Today I'm gonna try this:

Anesthesiology resident - "So what are you thinking of going into?"
Me - "Well hmm right now it's a tough choice you know between Pathology and umm...Anesthesiometry

)

yaah · Jun 16, 2004

HotSteamingTurd said:
Ahh....my last day in anesthesiology. And I'm on call which means I'll get sent home at around noon-ish today and won't get called back into the hospital...THEN I have tomorrow off. I may be the only anesthesiology student who may go through this rotation without having done a single intubation.

But did you have to put in any IVs? I checked my diploma, even though I asked, they wouldn't put any notice on there that I had not started an IV during the entire time I was there. I guess I could put it in Latin on the diploma myself.

Doctor Medicinae, Nunquam adito venae.

I'm sure my conjugation is way off. I had to look up "access" and that was the best I could come up with.

Sic transit gloria mundi.
(Thus passes the glory of the world)

Caelum videre iussit, et erectos ad sidera tollere vultus - (He bid them look at the sky and lift their faces to the stars). - Ovid

HotSteamingTurd · Jun 16, 2004

Nope, haven't done any IV's either. I haven't done any procedures on this rotation. The only procedures I've done was a single blood draw during my IM rotation. Interestingly, I could have participated in another procedure in IM but despite my screenname, I gracefully excused myself from that. It kinda went like this.

Intern - "this 74 yo paraplegic man hasn't had a bowel movement in 4 days."
Turd - "wow that sucks, I usually crap 1-2x per day"
Intern - "so have you performed a rectal disimpaction before?"
Turd - "no"
Intern - "would you like to give it a try?"
Turd - "no"
Intern - "this is valuable clinical experience"
Turd - "i said no...you're on your own on this one, i'm gonna go grab lunch"

"Sic transit gloria? I didn't know gloria was sick."
- History of the World Part I

yaah · Jun 18, 2004

Isn't it great how they call it "performing" a rectal disimpaction? As if it is a task requiring education, training, etc?

Out of curiosity, inspired by that german training video, I had to look up what the term might be for rectal disimpaction.

Well, "rectal exam" is die Rektaluntersuchung
"Fecal Impaction" is die Impaktbildung
"Removal" is entfernen

So, can we say that rectal disimpaction is Die Rektaluntersuchung mit die Entfernung der Impaktbildung?

If so, that is freaking hilarious. Sorry, I'm busy. I have to go do a Rektaluntersuchung. That patient has an Impaktbildung!

HotSteamingTurd · Jun 18, 2004

So several days ago, an anesthesiology resident on OB anesthesia told me, "well it's not like you're gonna be doing epidurals on dead people."

What the hell is that supposed mean? Is this a passive aggressive cheap shot at my future profession?

cookypuss3 · Jun 19, 2004

Yes. Every snotty, quasi-sarcastic comment like that is a passive-aggressive stab at you, the young wise person who has already chosen path, from the old and bitter FP/internist/surgeon/etc. who only wishes they had had the common sense and forethought to choose path.

Crap. Is "forethought" a word? It's Friday, three large vodkas into the evening, annoyed at my boy because he's MIA as usual, and I can't even string together a coherent sentence. Seems as if my evening's amusement will consist of loading the cat up with catnip, browsing on eBay for weird random items, and drinking more vodka. C'est la vie.

yaah · Jun 20, 2004

cookypuss3 said:
It's Friday, three large vodkas into the evening, annoyed at my boy because he's MIA as usual.

Sorry! I was in the process of moving to Michigan. Didn't know I was expected!

Alas, however, I did not pack any vodka. At some point I will have to go out and buy some.

Mr ****/Turd, the Dead People remarks will NEVER end. I suggest you start getting used to them. Everyone thinks they are being inordinately clever by referring to pathologists as people who love dead people or hate living people. The one you will probably hear most often is, "Gee, I wouldn't want to be your patient!"

Here was a thread on that http://forums.studentdoctor.net/showthread.php?t=115609

HotSteamingTurd · Jun 20, 2004

Well yaah, I know these comments won't ever stop. Welcome to Ann Arbor BTW. My rebuttal is usually, "Bring it! Tell me how you really feel."

Anyways, hope you all had a great weekend. I should be studying for my surgery and anesthesiology orals but I ended up getting drunk instead. I just did like 200 questions from A&L Surgery tonight and man do I feel like a dumbsh1t. I'm so ****3d.

Mr.T

HotSteamingTurd · Jun 20, 2004

damn ****3d got bleeped out...i meant f-u-c-k-e-d.

yaah · Jun 21, 2004

I___t h i n k___ t h e___a u t o m a t i c___c e n s o r___n e e d s___s o m e___h e l p .___Y o u___c a n___b a s i c a l l y___s a y___a n y t h i n g___y o u___w a n t___a s___l o n g___a s___i t___i s___n o t___f o u r___c o n s e c u t i v e___l e t t e r s ! ! !___I f___I___w r i t e___m y___e n t i r e___p o s t___l i k e___t h i s___I___c a n___s a y___w h a t e v e r___t h e___h e l l___I___w a n t ,___w h e t h e r___i t___i s___a b o u t___s h i t___or___w h a t e v e r .___L e t ' s___s e e___i f___i t___w o r k s . . .

S o ,___ wo u l d___y o u___r a t h e r___b e___s t u d y i n g___o r___d e a l i n g___w i t h___m o v i n g___a n d___a l l___t h e___c r a p___t h a t___g o e s___w i t h___i t ? ? ?___I ' m___s t a r t i n g___t o___t h i n k___t e s t s___a r e___l e s s___p a i n f u l .

Hmm...I think there might be another way around the censor too...let's see.
shit

Just to test the censor...****

So, I have now given you 2 ways around the censor, in addition to turd's. I suppose you can also play with the size function and the bold, italic, etc. Have fun!

Sorry. If people object I will delete the cuss words.

yaah · Jun 21, 2004

Wow. I think we are isolated in our own little world. Just like real life. Everyone ignores the pathologists until they need something.

What would happen if I posted a naked lady picture? Too bad all those young college kids don't know about our forum, they could do whatever they want here. Naked ladies, severe innuendo, name calling, cussing, bestiality, whatever.

HotSteamingTurd · Jun 21, 2004

what about DVDA?

E Z Daring · Jul 8, 2004

yaah said:
Thank you brian and cookypuss. Take heart, your clinical time has a finite limit to it. Soon you will be solely in the realm of pathology! Those of you who are about to embark on more clinical electives, I wish you luck. It has been two long years for me, with an occasional break for a nice path elective. I should say, I did learn a lot on many of my clinical electives, but the fact that almost every day I was doing a countdown in my head of how much longer I had to finish indicated to me that clinical medicine might not be for me.

My last day, I felt like Henry V. My most-liked Shakespeare play.

Once more unto the breach, dear friends, once more,
Or close the wall up with our (clinical) dead!
In peace there's nothing so becomes a man
As modest stillness and humility;
But when the blast of war (perhaps clinical medicine?) blows in our ears,
Then imitate the action of the tiger:
Stiffen the sinews, summon up the blood.

--William Shakespeare Henry V , Act 3 scene 1

Ah yes, we Band of Brothers (and sisters). He that dissects with me shall be my brother, from this day to the ending of the world.

ha ha Yaah, you rock. you echo my sentiments exactly, except you are quite a bit more articulate (damn even quoting Shakespeare there). When I took some time off of 3rd year, I was more like Scarface in half-baked:

"screw you, screw you, you're cool (points to weird guy in corner), screw you, I'm out."

Hey so Path is the only residency that doesn't require the hazing year? Do you get a license after your first year like other pgy1's in internship or transitional year? yea path doesn't need to prescribe drugs or anything but I'm so unclear as to how it works, and google isn't my friend for this question IMO. TIA! and congrats!

yaah · Jul 8, 2004

E Z Daring said:
ha ha Yaah, you rock. you echo my sentiments exactly, except you are quite a bit more articulate (damn even quoting Shakespeare there).

It's all in the delivery. Now is the winter of our discontent.
Oh no! Run! - Ralph Wiggum

I think it's the only residency without the prelim year.

You do need a license. Anything you do related to patient care requires a license, whether that is a history and physical, listening to the lungs, grossing in a placenta, or even doing an autopsy.

And some pathologists have to write prescriptions. It depends on the program you are at. Usually it is probably pain meds after procedures or benadryl for people having allergic reactions though. Or, if you're Dr Jack Kevorkian, whose picture I found in the hallway yesterday (a Michigan med grad from the 50s, and michigan has the class composite pictures of every graduating class hanging in hallways) you prescribe lots of IV sedation followed by LOTS of potassium.

Since you like Shakespeare, did you know he wrote about doing a medical internship? Yup, it's true!

Life (during internship) is as tedious as a twice-told tale, Vexing the dull ear of a drowsy man, And bitter shame hath spoiled the sweet world's taste, That it yields nought but shame and bitterness.
-The Life and Death of King John

E Z Daring · Jul 9, 2004

yaah said:
It's all in the delivery. Now is the winter of our discontent.
Oh no! Run! - Ralph Wiggum

LOL, I remember that episode. Then he jumps out a window or something. Hmmm I never would have even thought about asking a path doc for pain medications, that's pretty sweet. Even more interesting - you can take time off before you finish medical school to do a year long path internship (at least it's the case at my school,) which counts as the first year of your path residency. I know someone who did this because she had 2 kids her sophomore year of med (*gulp*) and needed to do the mom mambo. So does this mean once she graduates medicine, she can already get licensed? hmmm.... contemplating a master plan....

And I don't like Shakespeare - Romeo & Juliet made me cry.

Brian Pavlovitz · Jul 9, 2004

E Z Daring said:
Even more interesting - you can take time off before you finish medical school to do a year long path internship (at least it's the case at my school,) which counts as the first year of your path residency. I know someone who did this because she had 2 kids her sophomore year of med (*gulp*) and needed to do the mom mambo. So does this mean once she graduates medicine, she can already get licensed? hmmm.... contemplating a master plan....

Unless something has recently changed, the ABP no longer counts the "year out" pathology fellowship towards your first residency year. But, I think it's still worthwhile to do, especially if you have little prior experience in Pathology.

HotSteamingTurd · Jul 9, 2004

Well, in keeping with the title of this thread "five more days", I say, "3 months and 3 weeks left!" Unfortunately, this is way too long

BTW, who here likes EBM? I personally can't stand it...

Five More Days!

Boring

Senior Member

give me that marrow!

Full Member

Boring

Senior Member

Full Member

Senior Member

Boring

Senior Member

Boring

Full Member

Boring

Boring

Full Member

Boring

give me that marrow!

Full Member

Boring

gungho

Senior Member

Boring

Senior Member

give me that marrow!

Senior Member

give me that marrow!

Full Member

give me that marrow!

Boring

Full Member

Membership Revoked

Full Member

give me that marrow!

Membership Revoked

Boring

Membership Revoked

Boring

Membership Revoked

Full Member

Boring

Membership Revoked

Membership Revoked

Boring

Boring

Membership Revoked

Member

Boring

Member

give me that marrow!

Membership Revoked

Similar threads