Is EM for me?

[eadysx]

Well, I'm good at reading lables, anyway. As for being a guy, hold on, let me check.... ummm, nope.

In that case, want to grab a beer?

E-

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[GeneralVeers]

We used to have a few beers in 1st year at the local pub before going to our Introduction to Clinical Medicine group sessions. The group sessions were definitely made more enjoyable. The year after us, a "no drinking before class" policy was built into the schedule. What to do they want us to do? Indiana is just a party medical school!

 

[NeuroSync]

I have to say that I feel a true sense of pride. This is my first official hijack, and of such a serious thread, too. YIPPIE!!!

As for having a beer, E, FO SHO! And if you are a regular SDNer of the EM threads, you do have a duty to respond, regardless of my alcohol consumption habits.

 

[Sessamoid]

4 years of intense study during the prime of your youth seems a bit much just so you can learn enough to be able to understand your relatives' medical problems. I hope you're independently wealthy, because $100,000+ in school debt is not something to be undertaken lightly if you never intend on practicing.

I'll defer the arguments about whether it is even ethical to take up a medical school spot if you don't intend to practice.

I'd like to cover something else though. The point of medicine is not "the pursuit of knowledge." That is the point of science. Medicine, while partly based on scientific discoveries, is clearly not itself a science. The point of medicine is caring for people. Knowledge is not the goal, it is merely a tool and not even the only one we have.

Perhaps you would be happier in medical research? That seems far more concordant with your personal goals than the practice of medicine.

 

[NeuroSync]

Yikes. In all seriousness, I agree. Medical school is a HUGE undertaking, not only in terms of money, but also in terms of effort. I don't just mean effort in terms of study, but true effort in trying to help others...all the time, not matter what, just because they need help.

This is a huge digression, but when I was much younger, I worked as a mountain bike cop in Boulder as a way to help pay for my undergrad education. It was an unusually rainy spring in Boulder, and we got so much rain that they actually closed Boulder Creek to tubers and kayakers. That's saying a lot, because in all of my time growing up in Boulder that had never happened. So we got a call of "a floater." My partner and I set out to try to find this poor person. We did, in fact, find him. We got him out of the river and revived him (we had both worked for the ambulance service before this job). We were ridiculed to no end by the other cops. They thought we should have just left him there, and certainly not touched him. Why? Because the man was homeless. He had passed out on the side of the river, rolled in, and nearly drowned. So why was his life worth less than the life of say a kid? Earning potential? Contribution to society? If this had been an "important" person, would we have gotten a commendation? Probably.

It used to be that we allocated organs to those who were "most socially worthy." That system just doesn't work. Who are we to decide who is more worthy than the next is? Who are we to know why the person is where they are? We all have a different set of experiences that have gotten us where we are. But I GUARANTEE that if the right set of circumstances presented themselves in our lives, that WE could end up in a similarly bad situation. We all have a breaking point and some, unfortunately, know where that breaking point is.

The upshot is that medical school, I agree, ought to be reserved for those who want to help another life, regardless of the background of that life. Sometimes it is unpleasant, I'm sure. No doubt. Not everyone is as grateful or as clean as we would like them to be. There are some really gross things that happen out there. But what is more pervasive? The sense of disgust or compassion? It had better lean STRONGLY toward compassion.

Now, can we please get back to a discussion of microbrews? I'm interested in doing some home brew, and I'd like to know about different hops...

 

[typeB-md]

4 years of intense study during the prime of your youth seems a bit much just so you can learn enough to be able to understand your relatives' medical problems. I hope you're independently wealthy, because $100,000+ in school debt is not something to be undertaken lightly if you never intend on practicing.

I'll defer the arguments about whether it is even ethical to take up a medical school spot if you don't intend to practice.

I'd like to cover something else though. The point of medicine is not "the pursuit of knowledge." That is the point of science. Medicine, while partly based on scientific discoveries, is clearly not itself a science. The point of medicine is caring for people. Knowledge is not the goal, it is merely a tool and not even the only one we have.

Perhaps you would be happier in medical research? That seems far more concordant with your personal goals than the practice of medicine.

for me, i wanted an in-depth understanding of how the body works as well as being able to use clinical skills. of course this is all information i could learn on my own, but the problem is access. As a medical student i can basically go wherever in the entire hospital w/o questions being asked. I can learn as much as i'd like and not have to worry about limits being set.

I would've liked to become a paramedic but the program about 2 years from start to finish. So i decided why not go med where i could maybe someday work an ER as a physician rather than 'under their medical direction.'

you see, i have not committed to anything. I have just said that if it comes down to me not finding a niche in medicine, then no big deal. I will try my luck at something else if nothing piques my interest of if i do not match a wanted specialty.

as far as ethically, i don't see a problem. back a hundred years ago, there was no such thing as HIPPA and i would be able to learn by going places and observing. Now, everything is highly regulated. I have worked hard to attain my admission just like everybody else.

Is it unethical for 1/4 of the Duke class to go into research since we need clinicians? Is it unethical for 5 people in the Stanford's 4th year class to go into Dermatology while pediatric residency spots are going unfilled? Is it unethical for my school to admit a 38 year old man who will be 45 upon graduatin residency?

I consider it a privilege to learn the stuff i am. And as far as $100K in debt...this is a small price to pay for the excellent learning experience. I have the rest of my life to pay off loans, but only so much time to apply my brain. I'm not really a bad guy. I just like to learn and as such i am slowly learning about the political morass that medicine is currently in.

 

[NeuroSync]

you see, i have not committed to anything. I have just said that if it comes down to me not finding a niche in medicine, then no big deal. I will try my luck at something else if nothing piques my interest of if i do not match a wanted specialty.

Is it unethical for 1/4 of the Duke class to go into research since we need clinicians? Is it unethical for 5 people in the Stanford's 4th year class to go into Dermatology while pediatric residency spots are going unfilled? Is it unethical for my school to admit a 38 year old man who will be 45 upon graduatin residency?

You have to love what you do for a living. It encompasses such a big part of your life. You make an excellent point: is it ethical to take a specialist residency when there is a greater need for primary care? Was it ethical for me to go through law school and not want to be a lawyer? Oh, wait, we HAVE enough lawyers and we ought to be reducing their numbers.

The bottom line is that if you don't like something, then don't do it. If you do like it, then you will serve your patients well. I think it would be unethical to go through med school, hate medicine and then practice, just because you are in debt. Who can know what we will or will not love until we have experienced it? I think that's why so many people start med school believing that they will practice in one area, but end up practicing in another. I say that I want to do EM, but what if I find something else that makes me happier? I'll do it.

I hope you truly enjoy this education. I know I will.

Cheers.

NeuroSync

 

[Sessamoid]

Is it unethical for 1/4 of the Duke class to go into research since we need clinicians?

It's an interesting question. One might argue that since they'll be developing new techniques and drugs that they'll have an even greater benefit as researchers than clinicians however. In any case, the system is set up that it's hard for a medical researcher to get funding without the "M.D." as well as the "PhD" after their name. In any case, it's clearly not a wasted education as it would be if they just did it for the education and never intended to use it for anything other than personal enlightenment.

Is it unethical for 5 people in the Stanford's 4th year class to go into Dermatology while pediatric residency spots are going unfilled? Is it unethical for my school to admit a 38 year old man who will be 45 upon graduatin residency?

Same question. The distribution of residents is too big a question here. But at least they'll going to medical school for a bigger reason than just for the hell of it. A 45 year old has at least 20 years of working life ahead of him, which is better than admitting somebody at age 22 who has no intention of ever practicing medicine.

I consider it a privilege to learn the stuff i am. And as far as $100K in debt...this is a small price to pay for the excellent learning experience. I have the rest of my life to pay off loans, but only so much time to apply my brain. I'm not really a bad guy. I just like to learn and as such i am slowly learning about the political morass that medicine is currently in.

The state subsidizes medical education to a large degree, so the question is whether the investment the state (and society on a larger scale) is going to be wasted.

 

[NeuroSync]

The state subsidizes medical education to a large degree, so the question is whether the investment the state (and society on a larger scale) is going to be wasted.

This IS an important ethical question. It is the reason why ADCOMs require significant clinical exposure. They want to ensure that the large investment that they make will not go to waste. So if you think about it in terms of tax payer money to help fund your education, then there is an ethical obligation to become a physician post-education.

In other words, this isn't just about "your price," because your price is being subsidized.

Do you have any opinons about different types of hops, Sessamoid (come on, throw me a bone!)?

 

[Sessamoid]

Do you have any opinons about different types of hops, Sessamoid (come on, throw me a bone!)?

No. I've thought about doing some homebrew, but haven't really looked at it yet. Sorry for hijacking your hijack.

 

[NeuroSync]

No. I've thought about doing some homebrew, but haven't really looked at it yet. Sorry for hijacking your hijack.

LOL. That's OK. It was my first one, so I was happy that it lasted a few lines.

 

[GeneralVeers]

Does the type of beer you drink have any bearing on whether EM is a good career for you?

For example, I can't drink Bud, Miller, Coors, or Bud Lite (awful). But Sam Adams and most foreign beers are drinkable.

 

[NeuroSync]

Does the type of beer you drink have any bearing on whether EM is a good career for you?

For example, I can't drink Bud, Miller, Coors, or Bud Lite (awful). But Sam Adams and most foreign beers are drinkable.

I don't know if it really says anything about your abilities as an EM doc, but it certainly says something about you as a person. I once went to a "wine tasting" party. I, like a total idiot, brought a nice bottle of wine. Do you know what won?! BOX WINE!!! How can someone be friends with a person who chooses a BOX wine in a blind taste test? Now there may be an argument that you must treat alcoholics, drug adicts, and the like in the ER. But why should we have to treat people who have absolutely no taste? That's just wrong. And why shouldn't we be the judges of what's good and bad in that regard? After all, aren't we experts?

I really like this hijacking thing. It is super fun. I know I must have something better to do...

 

[benelswick]

Look I'm a premed throwing from left field here but since EM is a pretty competitive field and my prospects for it will determine how I try to get into med school and wherther or not I'll go out of the US. I wanted to ask about what type of person is successful in the job. I've worked as a tech in the E.D. and know for certain that I loved all the human aspects of assisting with patient care and the teamwork involved as well. I think E.R. people are the best people to work with because their all somewhat crazy and alot of them are hillarious, like the people on this board.

What concerns me though is if I'm really the type of person who can multi task at a 100 mph under alot of stress. I mean when I used to watch the ED doc's in my hospital talk on the phone to a consulting physician while a concerned family menber is on hold and one of their patients is coding and on their desk is about five open charts in various stages of work-up and they are doing this all at once.....I think to myself how the helll can they keep it together.

I am very good with patients and people in general one-on-one but I'm thinking that maybe there's a mltitasking limit that might preclude me from E.M.....Any thoughts appreciated.--Ben
I have a question for the

 

[roja]

turns off tv, puts down phone and closes three browsesr sites*



It is definately something that is personality thing. However, I never really thought it fit me until I started rotating on the floors. And finding myself grinding my teeth in frustration at the pace.

Once I clued into EM, I knew I was very happy.


Today I had a massive gi bleeder, an acute mesenteric ischemia, and a couple of simple patients. I had two pages out (two zone phones) and was screaming for another phone to page someone else (to admit). It was driving me crazy that I only had two phones. I was trying to sign out to get to hte Spurs Nicks game. *sniff*

Its something you learn. Which to pay attention too, how to triage, etc.

 

[Koko]

I was trying to sign out to get to hte Spurs Nicks game. *sniff*

Knicks? I'm worried about you...

Now if you were trying to get to Yankee Stadium, that would be understandable.

 

[colforbinMD]

"I don't think your clients belong in jail, but I don't get to make that decision! I represent the government of the United States without passion or prejudice,"

guess what movie this is from?.

I would tell you but.... "You can't handle the truth"

 

[Doczilla]

...I wanted to ask about what type of person is successful in the job. I've worked as a tech in the E.D. and know for certain that I loved all the human aspects of assisting with patient care and the teamwork involved as well. I think E.R. people are the best people to work with because their all somewhat crazy and alot of them are hillarious, like the people on this board.

What concerns me though is if I'm really the type of person who can multi task at a 100 mph under alot of stress. I mean when I used to watch the ED doc's in my hospital talk on the phone to a consulting physician while a concerned family menber is on hold and one of their patients is coding and on their desk is about five open charts in various stages of work-up and they are doing this all at once.....I think to myself how the helll can they keep it together.

You are right that EM people tend to be very cool folks, a little nuts, laid back, and a fun group. It's a culture thing, one that I'm very fond of.

As far as the multitasking goes, Roja is right. It's a personality thing, but also a learned skill. Take the perspective of the consulting physician who comes down to the ER to admit a patient. Not knowing what is going on, the ER seems loud, hectic, and disorganized. It's a wonder that any kind of medicine is practiced at all down here. From the ER doc's perspective, though, things are going just fine. They know about each patient, having an idea about where each one is going and what is still pending.

A mass casualty incident looks pretty hairy from the perspective of the paramedic, but not so much to the incident commander, who has the larger view of the situation. The ER doc has honed his clinical skills to the point where a lot of the patient care is pattern recognition and reflex. He's not agonizing over the clinical decisions, as they come more easily through experience and training.

As your knowledge and clinical skills grow, you will be able to take a larger and larger view of the department, able to deliver good patient care and manage department flow at the same time. It's easy to be overwhelmed by your first chest pain patient that you've had to manage yourself. After seeing several hundred of them, it requires less effort to see all the different directions a chest pain workup can go. There's a reason that ER docs are so cool running a code and vascular surgeons are so cool with a spurting vessel. They know that if the worst possible thing happens, they can handle it. There is therefore not so much stress.

As a side note, it's okay to enter medical school with an idea about a career that might appeal to you, but there are many specialties out there that you may not have been exposed to that may be an even better match for you. You may find that surgery or opthamology or internal medicine is what really lights your fire. Don't let your envisioned specialty dictate if, how, or where you go to med school.


'zilla

 

[bartleby]

Excellent post by Doczilla above about multitasking. There is something addictive and zen-like about the rush of taking a wild, chaotic ED on the edge of sheer pandemonium in which even the jaded battle-axe of a charge nurse starts to break a sweat and being the sole calm person who keeps his cool and helps tame the beast.

it's not so much 'scammed' as i want the knowledge about myself and my family. i want to be able to suture up any wounds i get. i want to be able to self administer drugs and know their affects.

To borrow a phrase from the law, a doctor who treats him or herself has a fool for a patient.

 

[benelswick]

You are right that EM people tend to be very cool folks, a little nuts, laid back, and a fun group. It's a culture thing, one that I'm very fond of.

As far as the multitasking goes, Roja is right. It's a personality thing, but also a learned skill. Take the perspective of the consulting physician who comes down to the ER to admit a patient. Not knowing what is going on, the ER seems loud, hectic, and disorganized. It's a wonder that any kind of medicine is practiced at all down here. From the ER doc's perspective, though, things are going just fine. They know about each patient, having an idea about where each one is going and what is still pending.

A mass casualty incident looks pretty hairy from the perspective of the paramedic, but not so much to the incident commander, who has the larger view of the situation. The ER doc has honed his clinical skills to the point where a lot of the patient care is pattern recognition and reflex. He's not agonizing over the clinical decisions, as they come more easily through experience and training.

As your knowledge and clinical skills grow, you will be able to take a larger and larger view of the department, able to deliver good patient care and manage department flow at the same time. It's easy to be overwhelmed by your first chest pain patient that you've had to manage yourself. After seeing several hundred of them, it requires less effort to see all the different directions a chest pain workup can go. There's a reason that ER docs are so cool running a code and vascular surgeons are so cool with a spurting vessel. They know that if the worst possible thing happens, they can handle it. There is therefore not so much stress.

As a side note, it's okay to enter medical school with an idea about a career that might appeal to you, but there are many specialties out there that you may not have been exposed to that may be an even better match for you. You may find that surgery or opthamology or internal medicine is what really lights your fire. Don't let your envisioned specialty dictate if, how, or where you go to med school.


'zilla

Thanks...I feel like I owe you some money for the lesson. Hope I have an attending like you when the time comes.--Ben

 

[roja]

Knicks? I'm worried about you...

Now if you were trying to get to Yankee Stadium, that would be understandable.

Well, I was going for the Spurs.



Manu, live and in person. *sigh*



I think there were four spurs fans, including myself.