D'ya wanna rAvE?!

[deschutes]

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Has it been two weeks already??

I feel like I've had more fun and more real one-on-one teaching in 2 weeks than I had on my entire experience on Internal Medicine! Certainly never thought I would not mind getting in before 8 in the morning.

I love the fact that I can diff a blood smear while discussing the best lakes and parks in the Cities, and ask my officemate immediately for a once-over should I need one. I love the fact that I get to ask all the stupid questions in the world, because this chance is never coming again! And with every day that I come in I will learn more ways of getting the answers to the Eternal Question of "What The Heck Is This Anyway?"

It is just freakin' awesome.

So go ahead and bust my bubble - of course there are rough and downright miserable days - but I love sitting down at a scope and finding something that makes me go "COOL!"

 

[deschutes]

Oh, and in case anyone hasn't seen the Google satellite maps yet:

Where I am

 

[bananaface]

E is bad, m'kay?

 

[deschutes]

E is bad, m'kay?

deschutes says no to drugs. (Reference, anyone?)

 

[geddy]

Oh, and in case anyone hasn't seen the Google satellite maps yet:

Where I am

Those Google satellite maps are pretty cool - my wife looks at them before driving, so she can get a sense of where she's going.

 

[b&ierstiefel]

I've really enjoyed residency so far. It's been a fun two weeks. For a change, I wake up actually not dreading to going to work at the hospital. When I go into the hospital, for once, I actually like the work that I do. I hated doing history and physicals cuz many patients were stupid and didn't know wtf they were talking about which always made our **** harder. No more dealing with malingering drug seeking patients who are just manipulating you for a f*ckin' prescription for 70 grams of oxycodone which he was given a script for LAST week! Much of what I do now is very similar to what I did in the lab in a previous life. I love the environment...it is teh pwnz0rz!

My fellow residents here are nice, fun people and they've sure made my transition to PGY life quite smooth. It's funny how the mood changes from med school onto residency. It's OK to ask stupid questions as a resident. You don't have to worry about repercussions they have on your grade...cuz there ARE no more grades! The priority shifts to learning how to be a good pathologist rather than not getting a bad grade as a med student. It's quite a refreshing change. On a similar note, the motivation to learn solid diagnostic skills is what drives you through the day (the extra reading you do or the extra minutes you take while previewing a particular case)...not some stupid exam that you have to take at the end of the week/month. I mean look at geddy...that pimpass dude has read Sternberg 3 times already and I heard from a panhandler on Huntington Ave that he had finished volume 1 of Rosai already. See, that dude is going to be a badass diagnostician and 20 years from now when we talk about the infamous geddy, we will be able to testify, "yes, he really was a gunner during residency." (just had to throw my daily potshot at geddy). Anyways, fear of failing an exam is less of a motivator than fear of being a sh*tty diagnostician.

I'm cherishing these early moments of residency. This is the one time in life where you will see everything and say, "This is f*cking cool." (and I stress the word, "f*cking" because I never just say, "This is cool." at signout). Eventually, things will become more routine and you'll get bored of seeing normal/benign case after normal/benign case after normal/benign case and you'll really be itching to see those nasty ass malignant things that really pwn. But right now, everything is pretty new. Learning this stuff is fun. And I'm having a blast.

I hope the rest of my fellow noobie PGY-1's are enjoying residency wherever they may be. I had some other thoughts but my brain is still a bit joggled from Friday night. I guess I really am getting old.

Cheers.

 

[b&ierstiefel]

deschutes says no to drugs. (Reference, anyone?)

movie quote?

 

[Brian Pavlovitz]

I've really enjoyed residency so far. It's been a fun two weeks. For a change, I wake up actually not dreading to going to work at the hospital. When I go into the hospital, for once, I actually like the work that I do. I hated doing history and physicals cuz many patients were stupid and didn't know wtf they were talking about which always made our **** harder. No more dealing with malingering drug seeking patients who are just manipulating you for a f*ckin' prescription for 70 grams of oxycodone which he was given a script for LAST week! Much of what I do now is very similar to what I did in the lab in a previous life. I love the environment...it is teh pwnz0rz!

My fellow residents here are nice, fun people and they've sure made my transition to PGY life quite smooth. It's funny how the mood changes from med school onto residency. It's OK to ask stupid questions as a resident. You don't have to worry about repercussions they have on your grade...cuz there ARE no more grades! The priority shifts to learning how to be a good pathologist rather than not getting a bad grade as a med student. It's quite a refreshing change. On a similar note, the motivation to learn solid diagnostic skills is what drives you through the day (the extra reading you do or the extra minutes you take while previewing a particular case)...not some stupid exam that you have to take at the end of the week/month. I mean look at geddy...that pimpass dude has read Sternberg 3 times already and I heard from a panhandler on Huntington Ave that he had finished volume 1 of Rosai already. See, that dude is going to be a badass diagnostician and 20 years from now when we talk about the infamous geddy, we will be able to testify, "yes, he really was a gunner during residency." (just had to throw my daily potshot at geddy). Anyways, fear of failing an exam is less of a motivator than fear of being a sh*tty diagnostician.

I'm cherishing these early moments of residency. This is the one time in life where you will see everything and say, "This is f*cking cool." (and I stress the word, "f*cking" because I never just say, "This is cool." at signout). Eventually, things will become more routine and you'll get bored of seeing normal/benign case after normal/benign case after normal/benign case and you'll really be itching to see those nasty ass malignant things that really pwn. But right now, everything is pretty new. Learning this stuff is fun. And I'm having a blast.

I hope the rest of my fellow noobie PGY-1's are enjoying residency wherever they may be. I had some other thoughts but my brain is still a bit joggled from Friday night. I guess I really am getting old.

Cheers.

Andy--

Beautiful words! I am dreaming of the day that I can finally begin to do something I actually enjoy. Thanks for keeping my hope alive! 😉

It sounds like you're learning a ton and having fun at the same time; keep it up!

Deschutes--glad you're having fun, too!

 

[deschutes]

Yeah, hang in there 2006ers, it will be worth the wait!

Y'know, I remember that I did have a twinge of paranoia before starting - "What if after all the effort to get here, I end up hating the work, just like so much of clinical medicine?"

Maybe after many years I will become a sclerosed old LADoc00 and return to terrorize n00bs and wannabe-n00bs... The point though, is that I will have the time to do so 😉

 

[beary]

It is great to hear such good stories from the new R1s! 👍

I am loving my surg path rotation. Too bad it is only one more week. 🙁

 

[b&ierstiefel]

It is great to hear such good stories from the new R1s! 👍

I am loving my surg path rotation. Too bad it is only one more week. 🙁

med school f*cking blows.

 

[deschutes]

Those Google satellite maps are pretty cool - my wife looks at them before driving, so she can get a sense of where she's going.

Is that a slur in some weird cosmic geddy way?

 

[deschutes]

It is great to hear such good stories from the new R1s! 👍

I am loving my surg path rotation. Too bad it is only one more week. 🙁

Anything to keep you guys going... 😉

But yeah, okay, so maybe all my enthusiastic incoherence was just a bit over the top. We all have our own "I made it!" moments and this is one of mine.

First degree, first job, first paycheque (soon!), first car on the way, first unshared living space and all that kinda thing.

Some days I wake and blink and think "I'm here."
Most days I'm like "You guys let ME in? Hahahaha suckAHs!"
Poor unsuspecting populace.

So maybe you don't get it, but thanks for having me anyway. And oh yeah I do pay taxes too.

By the way beary are you doing your surgery rotation at the VA any time soon?

 

[beary]

By the way beary are you doing your surgery rotation at the VA any time soon?

I start surgery in three weeks. Woe is me. 🙁

I don't know if I will be at the VA or at the University hospital. I haven't got a chance to even indicate preferences yet.

Why do you ask? I mean, I appreciate the interest and all. 😉

 

[quant]

I've really enjoyed residency so far. It's been a fun two weeks. For a change, I wake up actually not dreading to going to work at the hospital. When I go into the hospital, for once, I actually like the work that I do. I hated doing history and physicals cuz many patients were stupid and didn't know wtf they were talking about which always made our **** harder. No more dealing with malingering drug seeking patients who are just manipulating you for a f*ckin' prescription for 70 grams of oxycodone which he was given a script for LAST week! Much of what I do now is very similar to what I did in the lab in a previous life. I love the environment...it is teh pwnz0rz!



Cheers.

N-I-C-E!!!!

 

[quant]

I start surgery in three weeks. Woe is me. 🙁

😉

Just hang in there Beary....there IS light at the end of this dreary tunnel!!!.......and its RESEARCH!!!....let the wars begin!!.....

 

[quant]

I forgot!!!....LaDOC is no more with us.....


RIP LaDOC.........please?!!!!!!

 

[deschutes]

I start surgery in three weeks. Woe is me. 🙁

I don't know if I will be at the VA or at the University hospital. I haven't got a chance to even indicate preferences yet.

Why do you ask? I mean, I appreciate the interest and all. 😉

A good friend of mine is a newly-minted R2 there. I know she's at the VA this month, not sure about August.

If you'd like, I could ask which would be the better and truer learning experience for a pathologist-to-be 🙂 My gut feeling tells me the VA, but then what do I know of the inner workings of surgical hierarchy...

 

[geddy]

I start surgery in three weeks. Woe is me. 🙁

I don't know if I will be at the VA or at the University hospital. I haven't got a chance to even indicate preferences yet.

Why do you ask? I mean, I appreciate the interest and all. 😉

You might find that you like the surgical rotations (including Gyn) more than you thought. Of course, it's definitely very, very close to path (at least AP). A good knowledge and understanding of surgery will definitely help you in path, so try to learn as much as you can - it'll be worth it.

I wonder - if you liked IM a lot, then you may find that you like CP. A lot of the CP stuff seems related to IM - coags, autoimmune panels, heme etc.

 

[beary]

A good friend of mine is a newly-minted R2 there. I know she's at the VA this month, not sure about August.

If you'd like, I could ask which would be the better and truer learning experience for a pathologist-to-be 🙂 My gut feeling tells me the VA, but then what do I know of the inner workings of surgical hierarchy...

Cool!! My gut feeling tells me the VA as well. Though I hear that every student here asks for the VA and peds surg, and only a few people get it, so most other people end up with colon and rectal or vascular or something icky like that. I think I'm going to ask for 1)VA, 2) cardiothoracic, and 3) peds. Just because I like cardiac stuff and supposedly almost no med students ever do that service. But this is assuming I ever have a chance to ask for what I want!

 

[beary]

You might find that you like the surgical rotations (including Gyn) more than you thought. Of course, it's definitely very, very close to path (at least AP). A good knowledge and understanding of surgery will definitely help you in path, so try to learn as much as you can - it'll be worth it.

Thanks geddy - I appreciate the encouragement. 🙂 I have heard similar things from other folks as well. It seems like lots of my MSTP classmates dread surgery and then end up liking it. The thing I am dreading the most about surgery is the physical aspect of standing there for so long, being up all night, etc. But otherwise I am looking forward to it.

 

[beary]

Just hang in there Beary....there IS light at the end of this dreary tunnel!!!.......and its RESEARCH!!!....let the wars begin!!.....

Yay!! Woohoo!! Research rules! 😎

 

[Brian Pavlovitz]

You might find that you like the surgical rotations (including Gyn) more than you thought. Of course, it's definitely very, very close to path (at least AP). A good knowledge and understanding of surgery will definitely help you in path, so try to learn as much as you can - it'll be worth it.

I wonder - if you liked IM a lot, then you may find that you like CP. A lot of the CP stuff seems related to IM - coags, autoimmune panels, heme etc.

I agree with geddy. I found surgery to be more enjoyable than I thought (sarcastic remarks and testosterone aside 🙄 ). Surgeons do rely an awful lot on the Pathologist, so I think it helps to see their perspective on things (however clouded that perspective may be ).

If the surgeon wanted a frozen section, I'd always offer to take it to Pathology for them. Some didn't want me to break scrub, but others were fine with it. I recall one of them saying to me: "sure...if that's what excites you, go ahead."

 

[quant]

I agree with geddy. I found surgery to be more enjoyable than I thought (sarcastic remarks and testosterone aside 🙄 ). Surgeons do rely an awful lot on the Pathologist, so I think it helps to see their perspective on things (however clouded that perspective may be ).

If the surgeon wanted a frozen section, I'd always offer to take it to Pathology for them. Some didn't want me to break scrub, but others were fine with it. I recall one of them saying to me: "sure...if that's what excites you, go ahead."

Briannnnnnnnn.....Howz you mon?

 

[deschutes]

If there was no pathology I just conceivably *might* have gone with surgery. But there's that darned lifestyle issue.

Yeah, you wanna avoid colorectal. Puh-leeze. It is for obvious reasons. You will get enough of the poo on weekends when you are cross-covering.

Try to avoid hepatobiliary as well - although you will definitely know your jaundice workup cold by the time you are done.

I did not have much vascular exposure, so no comments there. It can be quite interactive though, I hear. In the way that a ruptured triple A is interactive.

Thoracics would be genuinely interesting.

Cards was a different service from thoracics where I came from. They wear those microscopic glasses and put in tiny stitches. I am not sure if you will get to see much!

I guess it kinda depends what you want out of surgery... do you want to see and do, or do you want people to leave you alone? I actually had the best of both worlds on my surgery rotation - which was probably why I learnt so much technique and very little workup 😎

Apart from that, if you are open to stupid jokes and a healthy amount of cussin' you will do awesome!

 

[Brian Pavlovitz]

I somehow went through 12 weeks of my surgery rotation without seeing ANYTHING related to the colon!!

...can I get an "AMEN"??

 

[Brian Pavlovitz]

Briannnnnnnnn.....Howz you mon?

Let's just say that 4th year doesn't even compare with 3rd year!

 

[quant]

I somehow went through 12 weeks of my surgery rotation without seeing ANYTHING related to the colon!!

...can I get an "AMEN"??

A-MENNNNNNNNNNNNNNNNNNNNN........ 🙂

Incredible though!

 

[deschutes]

I somehow went through 12 weeks of my surgery rotation without seeing ANYTHING related to the colon!!

It's not the seeing, it's the smelling....! Pooh. *wrinkles nose*

Hey Brian have you always had that tagline? I only just noticed!

 

[Brian Pavlovitz]

Hey Brian have you always had that tagline? I only just noticed!

Hmmm. Perhaps I should change it. I read yours and thought it was cute, and it really DOES express my feelings (especially after trying these darn USMLE World questions. Cripe!!! Did I not do ANYTHING in third year??) 😳

 

[Brian Pavlovitz]

A-MENNNNNNNNNNNNNNNNNNNNN........ 🙂

Incredible though!

Thanks, brotha'! 😉

 

[beary]

I somehow went through 12 weeks of my surgery rotation without seeing ANYTHING related to the colon!!

...can I get an "AMEN"??

AMEN!!!! I can't believe you had 12 weeks of surgery - we only have 6!! (But then we have other required 2-week surgical rotations like oto, urology, and ortho).

 

[deschutes]

Hmmm. Perhaps I should change it. I read yours and thought it was cute, and it really DOES express my feelings (especially after trying these darn USMLE World questions. Cripe!!! Did I not do ANYTHING in third year??) 😳

That's fine with me - I like pairs 😀

I honestly think my IQ fell several percentage points from the time I got into med school to the time I graduated.

 

[beary]

It's not the seeing, it's the smelling....! Pooh. *wrinkles nose*

I got a poo-filled colon the other day in the gross lab.

I thought about resurrecting Andy's poo thread to mark the occasion but then my stomach turned every time I thought of the poo.

I can talk about it now that it has been a few days. 🙄

 

[Brian Pavlovitz]

AMEN!!!! I can't believe you had 12 weeks of surgery - we only have 6!! (But then we have other required 2-week surgical rotations like oto, urology, and ortho).

Well...it really was 6. We had 2 weeks each of Urology, Ortho, and Anesthesia. Still, it was quite an accomplishment. Ah, those 2 weeks of Anesthesia were fun...

 

[Brian Pavlovitz]

That's fine with me - I like pairs 😀

I honestly think my IQ fell several percentage points from the time I got into med school to the time I graduated.

Hooray! 🙂

It's nice to see I'm not alone in acquired loss of IQ points!

 

[deschutes]

I got a poo-filled colon the other day in the gross lab.

I remember one of the pathologists I worked with telling me how one of his grossly-distended colon resections had so much poo in it that he had to take it to the mens' room and empty it out and flush it.

 

[Brian Pavlovitz]

I got a poo-filled colon the other day in the gross lab.

I thought about resurrecting Andy's poo thread to mark the occasion but then my stomach turned every time I thought of the poo.

I can talk about it now that it has been a few days. 🙄

EEEEEEWWWWWWW.

 

[deschutes]

Ah, those 2 weeks of Anesthesia were fun...

Oh yeah. Anesthetists are a nice group too. Odd but nice (betcha they say the same thing about us). They made me laugh.

 

[Brian Pavlovitz]

I remember one of the pathologists I worked with telling me how one of his grossly-distended colon resections had so much poo in it that he had to take it to the mens' room and empty it out and flush it.

DOUBLE EEEEEEWWWWWW!!!!

 

[Brian Pavlovitz]

Oh yeah. Anesthetists are a nice group too. Odd but nice (betcha they say the same thing about us). They made me laugh.

I have a couple of acquaintences who are anesthesiologists. Very nice people.

When the anesthesia attending asked me what I wanted to go into and I said "Pathology", he said "I didn't think I was smart enough to go into Pathology..." I think everyone in Medicine is rather smart, but I hold high regards for the anesthetists.

More fentanyl, anyone??

 

[deschutes]

When the anesthesia attending asked me what I wanted to go into and I said "Pathology", he said "I didn't think I was smart enough to go into Pathology..." I think everyone in Medicine is rather smart, but I hold high regards for the anesthetists.

I just don't think that way. They think in lines and graphs and algorithms - I just don't!

My most self-depreciating comment came on IM Teams with a nice senior resident.
She: "Think. What people are not smart enough to do Internal Medicine?"
me: "Pathologists?"

 

[Brian Pavlovitz]

I just don't think that way. They think in lines and graphs and algorithms - I just don't!

My most self-depreciating comment came on IM Teams with a nice senior resident.
She: "Think. What people are not smart enough to do Internal Medicine?"
me: "Pathologists?"

Ugh. You couldn't pay me enough to do Internal Medicine. Blech!

 

[beary]

Ugh. You couldn't pay me enough to do Internal Medicine. Blech!

Me neither. I think I would do anything else before that.

 

[deschutes]

Ugh. You couldn't pay me enough to do Internal Medicine. Blech!

When there's no conference I follow my mid-level's example and come in at 9 o'clock after a leisurely breakfast at home. (I am thinking about going to get my driver's licence converted tomorrow...)

My pager hasn't gone off once since I got it.

I wear a white coat only to keep warm.

Said white coat does not contain granola bars in its pockets.

My stethoscope is hanging somewhere at home, largely forgotten.

AND THERE ARE NO MORE FREAKING WARD ROUNDS!!!!

 

[yaah]

WTF I'm the only one who thought colo-rectal was the best part of surgery? Big incisions and lots of staples to close. No ****ing suturing, the retractor is usually the buchwalter or however you spell it, and the anatomy is easier. You can all have your thoracic surgery trying to see through keyholes and such.

 

[b&ierstiefel]

WTF I'm the only one who thought colo-rectal was the best part of surgery? Big incisions and lots of staples to close. No ****ing suturing, the retractor is usually the buchwalter or however you spell it, and the anatomy is easier. You can all have your thoracic surgery trying to see through keyholes and such.

Ha! Endocrine surgery at the U was the sh*ttz0rz! Q6 baby! Come in at 8. Leave at 6. I feel sorry for the bastards who had to do Trauma/Burn, GI, or Vascular Surgery. I'm sure they would rather eat uncooked pig testicles than do some of the crap that they have to put up with.

 

[yaah]

Vascular surgery was the nightmare at UMass. Come in at 3am to do full H&Ps and prepare presentations on every patient and OR case (poor bastard patients). Get reamed for any small mistake. Berated in the OR.

 

[deschutes]

Vascular surgery was the nightmare at UMass. Come in at 3am to do full H&Ps and prepare presentations on every patient and OR case (poor bastard patients). Get reamed for any small mistake. Berated in the OR.

Yikes. Colorectal is preferable to this - I'll give you that much.

 

[yaah]

Neurosurgery was my personal demon. Probably because I kept getting stuck in 10 hour procedures where I was first assist because my school didn't have neurosurg residents.