clinical medicine sucketh

[quant]

at least you haven't picked up quant's posting habits. he'll quote the same quote in two consecutive, different posts...sometimes three!

i wonder if he is aware that the edit post function exists...

dint do that!!!!!!!!!!!!!

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[yaah]

"One biopsy of pancreas, coming right up!"
Wouldn't you at least ultrasound first?

6:15pm and dinner is done. I never eat as early as I do when on call - if I get to eat at all.

Tonight I get to chase sodium instead of potassium and mycoplasma instead of Group A Strep. Woohoo!

Actually, they should just do a whipple so we can actually see the real lesion.

Being on call sucked for eating. Usually I either tried to cram something in around 5pm or more likely we were busy then with an attending wanting to do rounds so we had to order in at about 8 or 9 pm after the evening surgical case.

 

[deschutes]

Actually, they should just do a whipple so we can actually see the real lesion.

You are assuming that (a) there is a discrete lesion and (b) it is in the head of the pancreas.

I keep telling you, her LFTs are pristine

Goddammit despite taking like 2 hours on the ICU transfer I apparently did such a good job that I seem like a keener. Senior Med says to make sure I'm first call for ward call.

I cannot think of anything I am less likely to want to do.

I also cannot think of how to get out of this one.

 

[b&ierstiefel]

observing how you two bicker, I can confidently say that you two would make a lovely couple

 

[beary]

Goddammit despite taking like 2 hours on the ICU transfer I apparently did such a good job that I seem like a keener. Senior Med says to make sure I'm first call for ward call.

I cannot think of anything I am less likely to want to do.

Nice reward for doing a good job - more work!

More incentive for me to suck this year. Then nobody will expect anything.

 

[beary]

observing how you two bicker, I can confidently say that you two would make a lovely couple

I've got dibs!

 

[b&ierstiefel]

I've got dibs!

dibs on what? what can you expect to gain from this?

 

[beary]

dibs on what? what can you expect to gain from this?

dibs on yaah, silly!

 

[Mrbojangles]

You are assuming that (a) there is a discrete lesion and (b) it is in the head of the pancreas.

I keep telling you, her LFTs are pristine

Goddammit despite taking like 2 hours on the ICU transfer I apparently did such a good job that I seem like a keener. Senior Med says to make sure I'm first call for ward call.

I cannot think of anything I am less likely to want to do.

I also cannot think of how to get out of this one.

I thought I had it bad doing 11 hour days on my inpatient peds heme onc elective. Admittedly it was my fault for choosing it in the first place . I can't believe that your school makes medical students do overnight call every fourth day. Seriously what is the point? I think services that don't have a night float team are stupid.

 

[b&ierstiefel]

I thought I had it bad doing 11 hour days on my inpatient peds heme onc elective. Admittedly it was my fault for choosing it in the first place . I can't believe that your school makes medical students do overnight call every fourth day. Seriously what is the point? I think services that don't have a night float team are stupid.

yep...i told ya so.

 

[b&ierstiefel]

dibs on yaah, silly!

you two should wrassle for it

 

[quant]

Anyone seen "Friday night lights?"

anyone drink bacardi dark rum+ mango juice?

Im doing thst right now......

 

[beary]

I can't believe that your school makes medical students do overnight call every fourth day. Seriously what is the point?

My med school makes med students do q4 call as well.

It has absolutely no point.

 

[quant]

Anyone seen "Friday night lights?"

anyone drink bacardi dark rum+ mango juice?

Im doing thst right now......

......................

hic!...................................

 

[b&ierstiefel]

My med school makes med students do q4 call as well.

It has absolutely no point.

i think it is absolutely ******ed to have med students stay at the hospital 80+ hours per week while they pay tuition! what complete backwards ass logic is that?

 

[beary]

Anyone seen "Friday night lights?"

anyone drink bacardi dark rum+ mango juice?

Im doing thst right now......

I have seen "Friday Night Lights" - thought it was pretty good. I'm a huge football fan though so I usually like anything having to do with football.

I don't like bacardi rum so no on the second one.

 

[beary]

you two should wrassle for it

But deschutes and I have a fellowship of madwimmen!

I wasn't picturing wrassling being part of the picture when we hit up the Mall of America next year when I interview at Minnesota.

 

[b&ierstiefel]

But deschutes and I have a fellowship of madwimmen!

I wasn't picturing wrassling being part of the picture when we hit up the Mall of America next year when I interview at Minnesota.

well you two figure it out then. i've made my suggestion. further suggestions come at a price.

 

[Mrbojangles]

yep...i told ya so.

Actually I did both. But at least for the outpatient IM heme onc elective I felt somewhat useful and the hours were better. And I didn't expect that it'd be a total bitch dealing with families of pediatric patients.

 

[b&ierstiefel]

Actually I did both. But at least for the outpatient IM heme onc elective I felt somewhat useful and the hours were better. And I didn't expect that it'd be a total bitch dealing with families of pediatric patients.

should've done pharmacology independent study.

4th year does not need to be this painful.

 

[beary]

And I didn't expect that it'd be a total bitch dealing with families of pediatric patients.

I am doing my sub-I in peds heme-onc. Sounds like it will not be a good time.

 

[b&ierstiefel]

I am doing my sub-I in peds heme-onc. Sounds like it will not be a good time.

get that changed.

gen surg endocrine. i have decreed this for you.

 

[Mrbojangles]

should've done pharmacology independent study.

4th year does not need to be this painful.

All right all right Andy. You were right and I was wrong. What can you say, I make bad choices .

 

[b&ierstiefel]

All right all right Andy. You were right and I was wrong. What can you say, I make bad choices .

finally!

now that wasn't too hard wasn't it?

 

[beary]

get that changed.

gen surg endocrine. i have decreed this for you.

If we do a gen surg sub-I, we don't get to choose which team - I thought that was too risky.

 

[Mrbojangles]

I am doing my sub-I in peds heme-onc. Sounds like it will not be a good time.

The families practically live in the hospital and can be very demanding. It's like the attendings and residents are treating both the child and the parent.

 

[beary]

The families practically live in the hospital and can be very demanding. It's like the attendings and residents are treating both the child and the parent.

That sounds extremely difficult (for everybody involved!) How much time do you have left on this rotation? I hope not much!

 

[b&ierstiefel]

The families practically live in the hospital and can be very demanding. It's like the attendings and residents are treating both the child and the parent.

agreed. do a family medicine subI instead then beary. I heard those are easier.

 

[beary]

agreed. do a family medicine subI instead then beary. I heard those are easier.

You and I have all the same ideas - I guess great minds think alike.

Unfortunately, nobody is allowed to do family medicine sub-Is here unless they are doing a residency in FP.

 

[Mrbojangles]

That sounds extremely difficult (for everybody involved!) How much time do you have left on this rotation? I hope not much!

Just one more week and I have to do a 45 minute presentation at the end of the week. But if pity were a limited commodity it should go to deschutes .

 

[deschutes]

I thought I had it bad doing 11 hour days on my inpatient peds heme onc elective. Admittedly it was my fault for choosing it in the first place . I can't believe that your school makes medical students do overnight call every fourth day. Seriously what is the point? I think services that don't have a night float team are stupid.

Presumably so that those same med students don't have a ruder shock when they become interns and have to figure out whether Mrs. X's SOB and fever is something new and worrisome or part of her daily anxiety and FUO routine.

This is Internal Med. They don't care if Internal Med doesn't figure into your career plans the teensiest bit.

**** it I should have gone to bed. Instead, I ate an ice-cream sandwich. Beep beep!

Going to see Admit #2 of the evening. 8 hours till I leave this place.

 

[deschutes]

Anyone seen "Friday night lights?"

anyone drink bacardi dark rum+ mango juice?

Im doing thst right now......

I am drinking club soda + orange juice. Finally found out what the wards keep club soda for.

 

[deschutes]

observing how you two bicker, I can confidently say that you two would make a lovely couple

Andy, you and I bicker all the time. No one confidently says that we two would make a lovely couple

 

[quant]

I am drinking club soda + orange juice. Finally found out what the wards keep club soda for.

hmmmm.........that sounds like an interesting combination!

 

[yaah]

Is it a good sign or a bad sign when your parents really like the girl?

 

[Pingu]

Is it a good sign or a bad sign when your parents really like the girl?

Both. There is a yin and a yang to parents liking a girl.

The good is that she probably appears respectable and has manners above the level of a poo flinging primate. She probably also has an appearance that does not suggest she spends time in various street locating soliciting strange men for companionship or swinging around poles dressed in a school girl outfit.

The bad is that your parents probably will wind up liking her better than you. This is sometimes good, because they will give you more money but they will also side with her on many things and at family events joke about the foibles of yaah. If you are really unlucky and she is a psychopath she will off you in a clever way and attempt to replace you with herself

 

[deschutes]

Both. There is a yin and a yang to parents liking a girl.

Indeed. The yang is obvious. The yin is that if you ever break up with her, the rest of your girlfriends will always be compared in the light of her.

 

[deschutes]

From call last night...

I am sitting writing up the ICU transfer. It is 9pm.

Unit clerk: My mother has been coughing x 3 weeks. I think she should go to Emerg and get a chest x-ray.
Night Nurse: Yeah she should. Has she been coughing up phlegm? Fever?
Unit clerk: No. No. It's just not getting better. I think I'll phone Emerg for her and see what the waiting times are like.

Me eavesdropping: GOMER! GOMER! GOMER!

(At least, I thought it. I didn't yell it.)

 

[b&ierstiefel]

Just bring a sign saying "ER is closed for the evening." on your last call night. Go to the ER and place it in a conspicuous spot. No patients. No admits. Plenty of sleep. Ride into the sunset with a census of zero.

 

[yaah]

Or put up a sign that says, "we accept tips and will move you to the front of the line."

 

[b&ierstiefel]

Or put up a sign that says, "we accept tips and will move you to the front of the line."

**** that man. that means admits and more ****ing work.

 

[yaah]

**** that man. that means admits and more ****ing work.

It also means profit.

 

[deschutes]

My ONE last night of in-hospital call tomorrow. Just one more week of Teams with no overnight call. *grits teeth* Please in the name of all that is holy don't give me any hyponatremia patients to work up...

Dammit I will only have one week to study for Step 2.

Mrbojangles and his 45-minute presentation gets my vote of pity though While I enjoy doing the occasional presentation, they always seem to take up more time than they are worth, even when the person asking you to do it says to "keep it simple, just a handful of slides" and etc. No, they always take hours!

Imagine a 45-minute presentation on hyponatremia... *shudder*

Why do you measure TSH when working up hypoNa+? Because hypothyroidism is one of the causes.
Why? Dunno. Nobody knows.

Around 3am in the morning when I was done writing up Admit#2's 9-item list of Issues/Plans in Emerg, I had this delusional moment when I thought "IM is not so bad. I can do this."

Then the incredibly annoying orchestra of coughs started up again, and I kicked myself for the brainfart and thought "Who are you kidding."

I wasn't picturing wrassling being part of the picture when we hit up the Mall of America next year when I interview at Minnesota.

No, wrestling with or without Jell-o or mud or any other additive will not be part of the picture when you come visit.

The Boxing Day sales at the Mall must be spectacular!! I am much looking forward to shopping at Express. That was the one saving grace of Iowa's downtown mall - it had an Express.

 

[beary]

The Boxing Day sales at the Mall must be spectacular!! I am much looking forward to shopping at Express. That was the one saving grace of Iowa's downtown mall - it had an Express.

Yeah, the downtown mall here is pretty bad. I have never understood why though since it has such a great location with all the students right there. Though it has now been totally renovated and is much nicer - meaning that only about 80% of the stores are unoccupied as opposed to 90%.

 

[b&ierstiefel]

Dammit I will only have one week to study for Step 2.

That's all you need for step 2. The score won't matter. Just pass.

Mrbojangles and his 45-minute presentation gets my vote of pity though

Not my vote. He brought this hell upon himself. Should've done pharm independent study or forensic psych, buddy. *shakes head*

Why do you measure TSH when working up hypoNa+? Because hypothyroidism is one of the causes.
Why? Dunno. Nobody knows.

Maybe it had to do with the initial complaint. Did the patient come in complaining of fatigue? Was he/she like really old? Perhaps he/she was really appeared depressed but they wanted to rule out organic causes like hypothyro. Or maybe in Canada, TSH is a super cheap test and you folks order it on everyone. Kinda like if you presented to your doctors office complaining of cramps...your doc would order a TSH on you too.

Around 3am in the morning when I was done writing up Admit#2's 9-item list of Issues/Plans in Emerg, I had this delusional moment when I thought "IM is not so bad. I can do this."

No. A delusion is defined as a fixed false belief.

 

[deschutes]

What was said to me on review of my final rotation:

"Read more. Try not to come across as lazy with your daily physical exam. Be more organized with your presentations."

Internal Med Teams must be the only rotation in which you work your ass off like no other rotation and still come across as lazy. Asses.

I passed. I'm graduating. They can go fornicate themselves in unnatural ways. Toodleloo!

 

[b&ierstiefel]

That's why IM sucks donkey balls. No matter what you do, you'll get the same comments. Why? Cuz they got the same **** for brains comments when they were clerks. ****ing bastards.

Congrats for being done with IM. That rotation sucks big time.

 

[deschutes]

That's why IM sucks donkey balls. No matter what you do, you'll get the same comments. Why? Cuz they got the same **** for brains comments when they were clerks. ****ing bastards.

I am beginning to have a glimmering of understanding of their world. It is one where all problems are solved by working harder.

Oh, and by seeing the mythical JVP, of course.

Congrats for being done with IM. That rotation sucks big time.

Thanks. I left at 6:15pm. They friggin made me stay for a friggin tap. At least the resident let me leave after the needle was in.

 

[b&ierstiefel]

Thanks. I left at 6:15pm. They friggin made me stay for a friggin tap. At least the resident let me leave after the needle was in.

Screw that...you should've said, "Taps is where I draw the line...screw you dinguses, I'm going home."

 

[deschutes]

Screw that...you should've said, "Taps is where I draw the line...screw you dinguses, I'm going home."

It was a fascinating procedure