Heart Failure - Diary of a Third Year Medical Student

[mimelim]

Alright, I'm done with this. The more I read, the clearer it becomes that this guy is somewhere between Jenny McCarthy and Mehmet Oz.

I am not saying that there weren't problems in medicine 20 years ago or that there aren't still problems now. There clearly are. But this guy has next to zero credibility and is a sensationalist journalist. Hardly worth having a reasoned discussion over.

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[KnuxNole]

Apparently he did, as he graduated from Tufts with Honors, according to the preface.

Good, cause everyone rolls their eyes at those freaky peeps trying to "change authority". It's like "Boy please, you just one weeny random little person!".

I mean, it's nice to have a diary to express his feelings or whatever.

 

[DermViser]

Exactly. He just seems to have a maladaptive perception of his life. Like with the kid who ran out of anesthetic:
I held him down on command while he screamed. We were late; the pain-killer had worn off. We gave him more, but started in long before it could have possibly taken effect. A child's suffering sacrificed for convenience. I see it routinely.

The surgeon keeps telling him to relax - to relax as they hook an endoscope into the back of his throat through his right nostril. The nurse has to keep gagging him to suction out all the blood from his mouth. A teddy bear is shoved in his face while the surgeon calls him buddy. "Relax," he said. "Relax, buddy."

And Jacob will never forget me.

I think most people would just be like "Man...that poor kid. I'm not going to let that happen again."

How would you feel if that was your child? And you had to deal with his never ending nightmares on end?

 

[username456789]

Who is that?

It was a clear black night, a clear white moon . . .

 

[DermViser]

Alright, I'm done with this. The more I read, the clearer it becomes that this guy is somewhere between Jenny McCarthy and Mehmet Oz.

I am not saying that there weren't problems in medicine 20 years ago or that there aren't still problems now. There clearly are. But this guy has next to zero credibility and is a sensationalist journalist. Hardly worth having a reasoned discussion over.

I really think you're seeing this through the prism of General Surgery residency training, which can be even a more dehumanizing experience in and of itself, hence why it's easier for you to label it as being sensationalistic.

 

[VisionaryTics]

I really think you're seeing this through the prism of General Surgery residency training, which can be even a more dehumanizing experience in and of itself, hence why it's easier for you to label it as being sensationalistic.

I remember reading this as an M3 or M4. Ridiculously sensationalistic. The guy acted like M3 year was a re-enactment of the Bataan death march.

 

[DermViser]

I remember reading this as an M3 or M4. Ridiculously sensationalistic. The guy acted like M3 year was a re-enactment of the Bataan death march.

Or more a life changing experience.

Besides medical school, there is probably no other four-year experience - unless it be four year's service in a war - that can so change the cognitive content of one's mind and the nature of one's relationships with others.
- F.D. Moorse, Harvard Medical School

 

[mimelim]

Or more a life changing experience.

Besides medical school, there is probably no other four-year experience - unless it be four year's service in a war - that can so change the cognitive content of one's mind and the nature of one's relationships with others.
- F.D. Moorse, Harvard Medical School

Who is F.D. Moorse?

 

[mimelim]

And why does his/her name only appear in reference to this guy's stuff?

https://www.google.com/search?q=F.D...school&rls=org.mozilla:en-US:official&start=0

 

[pmarank]

Who is F.D. Moorse?

Its an anagram for "So Deform"...

 

[Winged Scapula]

How would you feel if that was your child? And you had to deal with his never ending nightmares on end?

Admittedly I haven't read the source, but is he claiming that the child had post-procedure recall? Most, even those that thrash about, complaining of pain during surgery or an endoscopic procedure, have no recall afterwards.

And "run out of anesthetic"; what sort of Third World country was he in?

 

[DermViser]

Admittedly I haven't read the source, but is he claiming that the child had post-procedure recall? Most, even those that thrash about, complaining of pain during surgery or an endoscopic procedure, have no recall afterwards.

No, I don't believe he said that. That was my inference (probably wrong) from the line, "And Jacob will never forget me."

 

[VisionaryTics]

Admittedly I haven't read the source, but is he claiming that the child had post-procedure recall? Most, even those that thrash about, complaining of pain during surgery or an endoscopic procedure, have no recall afterwards.

And "run out of anesthetic"; what sort of Third World country was he in?

Sounds like the kid was getting flexible nasopharyngoscopy/laryngoscopy. If you're doing it bedside, usually the nose and throat is numbed with lidocaine spray. It wears off after about 15 mins. Sounds like that is what happened here.

Kids absolutely hate getting scoped (so do adults), and and it's often done as an EUA in the OR for that reason.

 

[Winged Scapula]

No, I don't believe he said that. That was my inference (probably wrong) from the line, "And Jacob will never forget me."

Gotcha. I'll betcha the kid did forget him and everything about the event.

I'm loathe to comment on a source I haven't read (but when has that stopped a surgeon from talking about something she knows nothing about ) but medical students often misunderstand situations.

 

[Winged Scapula]

Sounds like the kid was getting flexible nasopharyngoscopy/laryngoscopy. If you're doing it bedside, usually the nose and throat is numbed with lidocaine spray. It wears off after about 15 mins. Sounds like that is what happened here.

Kids absolutely hate getting scoped (so do adults), and and it's often done has an EUA in the OR for that reason.

Agreed.

I never saw a pediatric ENT scope done in clinic (but admittedly only did it as an elective) or even without some sedation in the procedure room. YMMV I guess.

 

[DermViser]

Gotcha. I'll betcha the kid did forget him and everything about the event.

I'm loathe to comment on a source I haven't read (but when has that stopped a surgeon from talking about something she knows nothing about ) but medical students often misunderstand situations.

I'll admit, after going through and reading everything, it does seem like MS-3 was a very traumatic experience for him. I think esp. if you're someone whose parents aren't doctors, or esp. if you come from a culture that revere doctors as healers (and there are some that do) it's a huge shock when you see how doctors really are like and how they behave in their real environment. I think since most of us have health insurance, and go to non-teaching hospitals, that's a side you don't get to see.

Or esp. if you're someone that swallowed that professionalism stuff that medical schools throw at you in MS-1/MS-2, it's eye-opening when you then see the opposite displayed in MS-3. I guess it's the hidden curriculum at work that got to him, which is understandable.

 

[PL198]

And why does his/her name only appear in reference to this guy's stuff?

https://www.google.com/search?q=F.D. Moorse&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-USfficial&client=firefox-a&channel=fflb#channel=fflb&nirf=F.D. Moore harvard medical school&q=F.D. Moorse harvard medical school&rls=org.mozilla:en-USfficial&start=0

lol if he made up someone's name to provide quotes with, that's pretty lolzy. Also I agree with you on almost everything you say on a multitude of issues, so +1 sir

 

[Winged Scapula]

I'll admit, after going through and reading everything, it does seem like MS-3 was a very traumatic experience for him. I think esp. if you're someone whose parents aren't doctors, or esp. if you come from a culture that revere doctors as healers (and there are some that do) it's a huge shock when you see how doctors really are like and how they behave in their real environment. I think since most of us have health insurance, and go to non-teaching hospitals, that's a side you don't get to see.

Or esp. if you're someone that swallowed that professionalism stuff that medical schools throw at you in MS-1/MS-2, it's eye-opening when you then see the opposite displayed in MS-3. I guess it's the hidden curriculum at work that got to him, which is understandable.

It certainly sounds like the clinical aspect of medicine was traumatizing for him; I'm sure it is for many students every year (long story about how I came to SDN involves a medical student I was working with on another (his) forum who became disenchanted with clinical medicine; he's a Rad Onc at MDA now).

I think of myself as pretty sensitive but having neither grown up with physician parents or in a culture where doctors are revered, I guess I never got the idea that doctors were anything but average people: some noble, some jackasses. Then again, as you've pointed out to @southernIM and @mimelim , perhaps as a surgeon, my definition of what's appropriate and what isn't, is skewed (at the risk of looking like a jackass, and not having read the source, I'm still wondering what was so wrong with commenting on the beauty of a 5 year old).

 

[DermViser]

It certainly sounds like the clinical aspect of medicine was traumatizing for him; I'm sure it is for many students every year (long story about how I came to SDN involves a medical student I was working with on another (his) forum who became disenchanted with clinical medicine; he's a Rad Onc at MDA now).

I think of myself as pretty sensitive but having neither grown up with physician parents or in a culture where doctors are revered, I guess I never got the idea that doctors were anything but average people: some noble, some jackasses. Then again, as you've pointed out to @southernIM and @mimelim , perhaps as a surgeon, my definition of what's appropriate and what isn't, is skewed (at the risk of looking like a jackass, and not having read the source, I'm still wondering what was so wrong with commenting on the beauty of a 5 year old).

I mention the physician parents thing bc maybe if you happen to be a son/daughter of one, maybe you have a much more accurate idea going in of medicine and what it is like, so MS-3 is not as much a surprise (My parents aren't doctors either, hence no idea beforehand really).

I also have to realize that Surgeons will have a higher bar than the rest of us. I don't think that's a bad thing either (I might have implied differently earlier). I think it's almost inherent in General Surgery residency training that you have to be able to blunt your emotions in a way, in order to be able to function for 5 years on all 6 cylinders, as you have patients who are truly sick, you're on call frequently, and sleep is in short commodity. I'm sure after 5 years, it's hard to turn that switch "off" again. It would be hard to revert back and nothing really shocks you when you've been thru hell (i.e. General Surgery residency)

I don't think it was the beauty of it, but more the sexualizing of a prepubescent 5 year old, that might be nauseating to some.

 

[Winged Scapula]

I don't think it was the beauty of it, but more the sexualizing of a prepubescent 5 year old.

Hmmm…I guess I don't see the sexualization in the example given. The Baywatch comment?

 

[DermViser]

Hmmm…I guess I don't see the sexualization in the example given. The Baywatch comment?

Probably a combo: "She's cute", "Fourth generation Baywatch", "knockout and heart breaker", "I'd operate on her even if she wasn't so cute, that's just the guy I am." (realize she is naked and unconscious on an OR table, with her legs open).

Edit: Realized all surgeon's patients on OR tables are practically naked.

 

[PL198]

Probably a combo: "She's cute", "Fourth generation Baywatch", "knockout and heart breaker", "I'd operate on her even if she wasn't so cute, that's just the guy I am." (realize she is naked and unconscious on an OR table, with her legs open).

Edit: Realized all surgeon's patients on OR tables are practically naked.

TBH I have 0 problem with any of that. If it's what they need to function, then meh it's fine by me. I'm not a surgeon, nor have I even done a surgery rotation, but I imagine lightening the air a little would generally not be a bad thing.

 

[Winged Scapula]

Probably a combo: "She's cute", "Fourth generation Baywatch", "knockout and heart breaker", "I'd operate on her even if she wasn't so cute, that's just the guy I am." (realize she is naked and unconscious on an OR table, with her legs open).

I guess I still don't see it.

Physicians comment all the time on patient appearance; some of it is wildly inappropriate as it would be if they made sexual comments about her appearance/body. Adults often comment on the appearance of children; usually in the positive. I actually try and not comment on the beauty of little girls, not because its offensive, but because I think women need to be praised for things other than beauty, otherwise they grow up with the attitude that beauty and sexual attractiveness is their most important virtue.

Unless they were standing around, keeping her frog legged and only commenting on her appearance and making sexual comments, without actually prepping her for the planned surgery, I guess I fail to see what was inappropriate here. However, if anyone in the room found it offensive and spoke up, yet they continued the talk, then I agree it should have been stopped.

I am willing to admit that perhaps I am desensitized here.

IMHO there is far too much ease with which people take offense (and that attitude pre-dated my surgical training) or look for offense. We had a medical student recently who complained because an older male plastic surgeon, appraising my surgical skill, said, "pretty good for a girl". She thought it was offensive. I wasn't offended, as it was a long running joke between us, as I often tell him we need to hurry up because he's sooooo old that he might die before we've finished the case.

 

[DermViser]

TBH I have 0 problem with any of that. If it's what they need to function, then meh it's fine by me. I'm not a surgeon, nor have I even done a surgery rotation, but I imagine lightening the air a little would generally not be a bad thing.

I'm not saying it's not ok. I'm saying that for most who are not surgeons, they would find it quite creepy. Those of us in the medical profession, would more than likely understand due to the stress of the job, some level of crude levity is necessary, without which one would go nuts.

 

[Winged Scapula]

I'm not saying it's not ok. I'm saying that for most who are not surgeons, they would find it quite creepy. Those of us in the medical profession, would more than likely understand due to the stress of the job, some level of crude levity is necessary, without which one would go nuts.

Is it that she is frog legged? Would a comment about her beauty be ok if she were having a non-pelvic operation?

Not trying to be antagonistic; just trying to understand.

 

[DermViser]

I guess I still don't see it.

Physicians comment all the time on patient appearance; some of it is wildly inappropriate as it would be if they made sexual comments about her appearance/body. Adults often comment on the appearance of children; usually in the positive. I actually try and not comment on the beauty of little girls, not because its offensive, but because I think women need to be praised for things other than beauty, otherwise they grow up with the attitude that beauty and sexual attractiveness is their most important virtue.

Unless they were standing around, keeping her frog legged and only commenting on her appearance and making sexual comments, without actually prepping her for the planned surgery, I guess I fail to see what was inappropriate here. However, if anyone in the room found it offensive and spoke up, yet they continued the talk, then I agree it should have been stopped.

I am willing to admit that perhaps I am desensitized here.

IMHO there is far too much ease with which people take offense (and that attitude pre-dated my surgical training) or look for offense. We had a medical student recently who complained because an older male plastic surgeon, appraising my surgical skill, said, "pretty good for a girl". She thought it was offensive. I wasn't offended, as it was a long running joke between us, as I often tell him we need to hurry up because he's sooooo old that he might die before we've finished the case.

Yes, but in that case, it was clearly a joke between the two of you (why the med student couldn't pick up on that, I can't imagine why, as the way you describe it, it seems pretty obvious).

 

[DermViser]

Is it that she is frog legged? Would a comment about her beauty be ok if she were having a non-pelvic operation?

Not trying to be antagonistic; just trying to understand.

I think it's more the naked + frog-legged, but more importantly also being unconscious (which I believe is not anesthetic induced, but I could be wrong). When I read the Baywatch comment - I was thinking a remark on her breasts.

 

[Winged Scapula]

Yes, but in that case, it was clearly a joke between the two of you (why the med student couldn't pick up on that, I can't imagine why, as the way you describe it, it seems pretty obvious).

In the student's defense, I just laughed and didn't make my "old man" comment; my POV was that she was quick to take offense when none was meant and none was taken (by me and the comment wasn't addressed to her).

Its not the first time we've had medical students take offense on my behalf.

 

[Winged Scapula]

I think it's more the naked + frog-legged, but more importantly also being unconscious (which I believe is not anesthetic induced, but I could be wrong).

I guess since patients are always unconscious in the OR, it doesn't strike me as odd but rather just making conversation.

When I read the Baywatch comment - I was thinking a remark on her breasts.

I could see that, although as female I guess when I think about Baywatch I don't necessarily think about breasts. But I can see how it could be interpreted as sexual in nature.

 

[username456789]

I could see that, although as female I guess when I think about Baywatch I don't necessarily think about breasts. But I can see how it could be interpreted as sexual in nature.

That's seriously like the only association there is to be made with that show.

 

[DermViser]

That's seriously like the only association there is to be made with that show.

 

[DermViser]

I could see that, although as female I guess when I think about Baywatch I don't necessarily think about breasts. But I can see how it could be interpreted as sexual in nature.

What do you think about when you think about Baywatch?

 

[PL198]

That's seriously like the only association there is to be made with that show.

That's seriously like the only association there is to be made with women... I kid I kid

 

[PL198]

What do you think about when you think about Baywatch?

"her hair so nice, I wonder how she got it like that"

 

[Winged Scapula]

That's seriously like the only association there is to be made with that show.

Yeah yeah, but I still fail to see that commenting that a 5 year old is beautiful and "4th generation Baywatch" is so horrific that it warrants inclusion in this guys book as evidence of the dehumanization of medicine. Is the recognition that she will someday have breasts offensive? I find the sexualization of breast feeding mothers worse.

But we will chalk it up to a disagreement especially since I haven't read the book in question.

 

[Winged Scapula]

"her hair so nice, I wonder how she got it like that"

LOL…no. I have nicer hair than Pamela Anderson already.

I don't know what I think as I was never a regular viewer of the show; probably as a former lifeguard it was more about the unrealistic nature of the show (sort of like when physicians watch Grey's Anatomy). I do remember thinking the red suits were cut pretty high on the thigh, even for the 80s.

 

[Winged Scapula]

See that's men for you; yes I recognize that breasts (both real and augmented) bounce when you run, but it wouldn't be something that I would even really notice/focus on. Men's balls bounce too when they run; just anatomy and physics but I don't sexualize it. <shrug>

 

[DermViser]

Yeah yeah, but I still fail to see that commenting that a 5 year old is beautiful and "4th generation Baywatch" is so horrific that it warrants inclusion in this guys book as evidence of the dehumanization of medicine. Is the recognition that she will someday have breasts offensive? I find the sexualization of breast feeding mothers worse.

But we will chalk it up to a disagreement especially since I haven't read the book in question.

At least in breast-feeding mothers, it's due to breast engorgement, hence understandable. I don't think it's the someday having breasts thing though. The girl is old enough to be their daughter or granddaughter. She's only 5.

 

[tco]

See that's men for you; yes I recognize that breasts (both real and augmented) bounce when you run, but it wouldn't be something that I would even really notice/focus on. Men's balls bounce too when they run; just anatomy and physics but I don't sexualize it. <shrug>

I'm not interested in what they do while running...

 

[DermViser]

See that's men for you; yes I recognize that breasts (both real and augmented) bounce when you run, but it wouldn't be something that I would even really notice/focus on. Men's balls bounce too when they run; just anatomy and physics but I don't sexualize it. <shrug>

But you can't see that overtly in shorts (Thank God).

 

[VisionaryTics]

See that's men for you; yes I recognize that breasts (both real and augmented) bounce when you run, but it wouldn't be something that I would even really notice/focus on. Men's balls bounce too when they run; just anatomy and physics but I don't sexualize it. <shrug>

But you can't see that overtly in shorts (Thank God).

To be gender equal in this thread:

 

[Winged Scapula]

But you can't see that overtly in shorts (Thank God).

Uhm….yes you can.

You can see bouncing, anatomy outlines (Google John Hamm), and in the old days of short shorts (think 80s), it would be *visible* hanging out below at times.

In my hot yoga class, my eyes have seen things. Many things.

 

[DermViser]

Uhm….yes you can.

You can see bouncing, anatomy outlines (Google John Hamm), and in the old days of short shorts (think 80s), it would be *visible* hanging out below at times.

In my hot yoga class, my eyes have seen things. Many things.

John Hamm is apparently also well-hung, hence the visibility. Also, Baywatch is breasts bouncing in slow motion.

 

[tco]

Uhm….yes you can.

You can see bouncing, anatomy outlines (Google John Hamm), and in the old days of short shorts (think 80s), it would be *visible* hanging out below at times.

In my hot yoga class, my eyes have seen things. Many things.

I really should have kept my interview in Tucson.

 

[Winged Scapula]

I really should have kept my interview in Tucson.

Perhaps you should have; although that is a few hours away from where I am.

 

[Winged Scapula]

John Hamm is apparently also well-hung, hence the visibility. Also, Baywatch is breasts bouncing in slow motion.

I venture that with the exception of micropenis, visibility is underestimated by even the average man.

 

[tco]

I venture that with the exception of micropenis, visibility is underestimated by even the average man.

What about concealed penis? I would guess they would consider it a failure if you could see anything with that one...

 

[Winged Scapula]

This kind of stuff still makes me crack up because it just shows some medical students are pretty much expert b*tches. I mean, somebody hit me in the knuckles with forceps while we closed up, let alone hard enough to cause knuckles to bleed? I would have told that assh*ole that I'm calling the police so they can take pictures of the wound and arrest him for assualt. Some attending kicked me in the balls? If it was in a room with witnesses, I would have called the cops. If we were by ourselves, I would have punched that prick in the face and we could sort it out in court.

Sorry, I put up with some crap but I'm not in deep enough to let people physically abuse me. Anybody who is drank too much of the Kool-Aid in my opinion.

Seriously - if someone hits you hard enough to draw blood, you should say something. If they hit you TWICE and you still didn't say something, I'm appalled.

I'm all for respecting the hierarchy but let's be serious here; if you're being physically abused, say something FFS.

 

[DermViser]

This kind of stuff still makes me crack up because it just shows some medical students are pretty much expert b*tches. I mean, somebody hit me in the knuckles with forceps while we closed up, let alone hard enough to cause knuckles to bleed? I would have told that assh*ole that I'm calling the police so they can take pictures of the wound and arrest him for assualt. Some attending kicked me in the balls? If it was in a room with witnesses, I would have called the cops. If we were by ourselves, I would have punched that prick in the face and we could sort it out in court.

Sorry, I put up with some crap but I'm not in deep enough to let people physically abuse me. Anybody who is drank too much of the Kool-Aid in my opinion.

If there are "no witnesses" and in an OR room, who do you think they'll side with? You won't have a case.

 

[DermViser]

Uhm….yes you can.

You can see bouncing, anatomy outlines (Google John Hamm), and in the old days of short shorts (think 80s), it would be *visible* hanging out below at times.

In my hot yoga class, my eyes have seen things. Many things.

Hot yoga? vs. cold yoga?