Only one more month of the "Clinical medicine" garbage

Discussion in 'Pathology' started by yaah, May 3, 2004.

  1. yaah

    yaah Boring
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    Just one more month before I can officially be done with clinical medicine and move on to my chosen field. All I have left is neurology, which starts in 5 minutes so I better be brief!

    Anyone else have memories (or flash-forwards!) of their last clinical medicine experience? Yes, I know, some of CP has clinical areas. I'm ignoring that for now.

    It would have been nice if my ID elective was the last, because my last patient was a gem of a man, 60 years old, pericarditis, first started feeling symptoms after a trip to Ireland when he kissed the Blarney Stone! That's karma for ya! The patient and I had a good laugh over that one. I made him laugh about a bunch of stuff, and also made his daughter laugh and his daughter was pretty hot. Since I am moving in a month, though, I was just acting vicariously. Still a nice patient though. I bet my last neurology patient will be an incontinent, verbally abusive and deaf person who makes me realize that I made the right decision.
     
  2. Stinger86

    Stinger86 Intern year? Ha!
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    :thumbup:


    I have quite a few rotations to go until I get to craft my fourth year (which will be the easiest year in the history of medical school). No doubt I'll be starting a thread like this two Mays from now.
     
  3. Primate

    Primate Senior Member
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    Six months, two weeks, four days and 30 minutes (I've a little reading to do tonight) left of clinical work. Add 2 days if you count the ACLS.

    Not that I'm counting, or anything......

    :)

    Now on my second week of surgical path, and (for THE first time in all 7 years of med school - slow learner here) can actually see myself not only doing this, but ENJOYING it. I know there's another thread about the "aha" moment, but I just got carried away. Very happy.

    P
     
  4. yaah

    yaah Boring
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    Is that "Eureka!" yet? I was wondering where primate was! You don't like all that ophtho stuff anyway.

    So, my last clinical elective began VERY inauspiciously. My list of gripes: I missed lunch, I had to do a consult and write a note and orders without having the computer and chart system at the hospital explained to me, I have to park offsite and catch a shuttle, to get there I have to take 128 (massachusetts folks will understand that reference all too well), and of course I missed lunch (had to say it twice).

    On the plus side, this clinical site has an extremely high concentration of very desirable female nurses and aides. So it evens out.
     
  5. Brian Pavlovitz

    Brian Pavlovitz give me that marrow!
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    I'm jealous, Yaah. In just a few short months, I will embark on my two years of the clinical experience. :scared: Can hardly wait.

    Good luck with neurology!
     
  6. yaah

    yaah Boring
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    Good luck with the clinical activities or with the nurses? ;)

    I wish you luck as well. Clinical years are an eye opener in many ways. The time committment is significant, although for people who furiously study compulsively during first two years it might actually be a bit of a break. It also really shows you a lot about clinical medicine that you never could have imagined before. I complain a lot, but I really did learn a lot and had some experiences that have changed my life. It also served significantly to increase my self confidence and decisionmaking abilities. Thus, while I may not wish to do any more clinical electives, or go back and repeat any I have already done, I certainly am glad, in retrospect, for the experiences.

    But anyway, in neurology today I saw a patient with a vertebral artery dissection. Not too common. Also saw some really lovely dementia. A bit more common.
     
  7. caffeinegirl

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    I can't wait for my last clinical/non path rotation to be over..and which will that be..but my medicine sub-I (we're required to take a sub-I fourth year). The good thing is that it'll be after the match, so there's no feigning that I'm interested in the field, and they won't care about me anyway
    woohoo! A month of barely meeting expectations awaits!!
     
  8. cookypuss3

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    I've spent my entire third year not even pretending to feign interest in peds, family, OB, blah blah blah blah. It actually turned out well, because once the preceptor knew my deal they pretty much left me alone and didn't bug me to learn all kinds of little procedures and stuff I similarly don't care about. It was pretty much the same at every rotation:

    Preceptor: "So, Cooky, what do you think you'll end up doing?"
    Cooky: "Pathology. Absolutely pathology. No doubt about it. I love it."
    Preceptor: "That's..... interesting. Hmmm. I don't understand. You have such a good bedside manner, and the patients like you. Why would you do pathology? Why would you want to be in a lab all day? Isn't that boring? Wouldn't you miss people? Do you hate people or something? I don't understand!"
    Cooky: :sleep:

    And that was that. Peace and quiet for the rest of the rotation. For me, anyway.
     
  9. joedogma

    joedogma Senior Member
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    I have gotten the "what, you don't like people?" statement from more than a few people. I try to educate about the field (hard for someone who isn't in the field yet :) ) but usually get blank stares and sometimes the look of disgust. You probably got it right cooky, just listen and :sleep:
     
  10. yaah

    yaah Boring
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    Yes, I like people fine. I just don't like people in hospitals. I also don't like doctors very much. A lot of times, you're right, the preceptors don't seem to know how to respond when I say pathology. The quick ones sometimes make a joke about dead people. The smart ones realize how it is a great career and realize they should have spent more time considering it.

    I had another nice 12 hour clinical day today. Lovely. At least I got lunch today. Sometimes I wish I started keeping a journal of my daily activities when I started med school. Today would have been good. I spent 45 minutes talking to a patient about how she may or may not have lost consciousness in the context of descending down some stairs at her house, and how she may or may not have finished eating an apple that she started eating at the top of the stairs. See, the thing is, she ended up slamming her head into something, woke up in bed with large bruises and bleeding, and the thing she was most interested in was that there was no sign of the apple! The last thing she remembers before waking up with the bruises is taking a couple of steps down while taking her first bite of the apple. "If I fell down the stairs, I would have thought the apple would be somewhere around the bottom of them. But I looked all day the next day, and it wasn't! So perhaps I made it down the stairs, finished the apple, then hurt myself somehow!" Great, so, this matters why? :sleep: :sleep: I could have looked at lots of histology slides in that period of time. Instead, I spent it trying to solve the mystery of the once-bitten apple. This whole apple conversation left me with one solid conclusion: This woman is getting an order for PRN Ativan.

    Wait a second...What if it was a green apple? Hmmm....That changes the differential diagnosis a bit.
     
  11. cookypuss3

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    That apple story ranks right up there with the types who describe the character and frequency of their bowel movements in excruciating detail. Look, I just wanted to know if it was runny, OK? Shut up, shut up, shut up. They seriously need a hobby, besides analyzing every little twinge of pain they feel or monitoring every drop of anything that ever oozed out of any orifices. Ugh.
     
  12. Stinger86

    Stinger86 Intern year? Ha!
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    When I tell doctors that I want to go into pathology, and they respond with "what, don't you like people?", I say "no", and then watch as they short-circuit, spark, burst into flames, and then bounce down the ward hallway screaming "DOES NOT COMPUTE!! DOES NOT COMPUTE!!"

    Seriously, sometimes other docs can be so predictable.
     
  13. yaah

    yaah Boring
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    That is their hobby. Some people collect baseball cards. Some enjoy jogging. Others volunteer at a shelter. But for many people admitted to hospitals, their hobby is cataloging and discussing bodily emissions, be they spittle, blood, mucus, urine, or feces. They play interesting matching games as well. "Ooohh! I had a good day today! My spittle was brown but my poo was yellow! What does that mean!" It's also a hobby that a lot of doctors take seriously. They always want to see the waste. I didn't spend all this time and effort to get this MD after my name so I can look at someone's foley bag and try to guess their condition.

    Today was interesting (another entry for the supposed journal). Guy with transient global amnesia. I met him 5 times. He had no clue. The attending actually stood their and discussed his condition with him. I rolled my eyes and was thinking if I was in his position, I would be telling the guy he won the lottery or something and see how he reacted.
     
  14. yaah

    yaah Boring
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    In case you all were interested, I met this guy again today, for the "first time." Well, I guess that time we spent discussing his condition with him was well worth the effort. I want that 10 minutes of my life back, darnit all. Compensate me!
     
  15. Seaglass

    Seaglass Quantum Member
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    My last clinical moment was when I walkked out of the OR after tubing someone . . . in November.
     
  16. Brian Pavlovitz

    Brian Pavlovitz give me that marrow!
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    Queen Cookypuss, I certainly hope this works for me in the Fall! :D
     
  17. cookypuss3

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    It works like a charm. Just be firm, but smile a lot. :)
     
  18. yaah

    yaah Boring
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    What an exit! Like that Seinfeld episode where George had to leave the office on a high note after telling a great joke. Unfortunately, my last clinical moment has already been preordained to be something lame, like a neuro exam on a demented person. Or doing a consult for "tingling sensation in genital area" (no fooling - we have a patient with precisely this complaint).
     
  19. Brian Pavlovitz

    Brian Pavlovitz give me that marrow!
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    Yaah--perhaps they heard of the soon-to-be Casanova Pathologist, and just have a "burning in their loins"?? Hmmmmmm??? :laugh:

    "that's it for me....!"
     
  20. yaah

    yaah Boring
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    I had an epiphany today. Pathologists NEVER have to deal with the obscene entity that is "fibromyalgia." The "tingling groin" lady today made a huge speech about how she had fibromyalgia and no one was listening to her complaints. Gee, lady, maybe that's because fibromyalgia is a BS diagnosis. The most effective medications are antidepressants. Coincidence? I think not. Trigger points my butt. Get a job and stop being a professional patient.

    Sorry if I offended anyone with fibromyalgia, but it is truly what those in the current field I am rotating through call a "supratentorial" problem. I am angry at the red sox right now. This lady patient of ours is faking seizures and stuck on our service getting video EEG monitoring. Guess what? Her "seizures" don't show up on the EEG. Surprise!
     

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