Significance Of Foresight

[jetproppilot]

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Just an editorial here for colleague med students.

You are amidst a transitional period in your career. Time to reflect, and concominantly look forward.

Unlike the business major's in college with the great tans, party attendance, and hangovers, you pounded out the 3.5 gpa and commensurate MCAT score, resulting in medical school admission.

You survived the first year, coasted through MS 2 year, and now you're either an eager MS3 on a specific rotation just happy to be in the clinical phase, or you're experiencing the dichotomy of your MS 4 year....

As an MS 4, yes, you're at the top of your pyramid, enjoying a (relatively) cush schedule and accolades from MS1s, MS2s, and MS3s.

The dichotomy lies in the fact that, between your Corona hangovers/South Beach raves/sub-Is, you've gotta figure out what you want to do for the next thirty years.

Kinda cruel, huh?

In one emotional moment as an MS4, you're enjoying the ambience of The Clevelander on Ocean Drive, Miami Beach, on a bustling Friday night. Premium opposite-sex-flesh surrounds you. Such an eclectic place. Tomorrow off. Alcohol. Friends. Booty calls beckoning.

Then, in the middle of your wink aimed at the 5'2" 115 lb, 9.4-on-a-ten-scale seated ten yards from your position at the bar, it hits you.....

HOLY S HIT....WHAT AM I GONNA DO WITH MY EDUCATIONAL INVESTMENT THAT COST ME MY TWENTIES FOR THE NEXT THIRTY YEARS???

Big decision, I agree.

Been there.

Makes the MILF you're winking at seem dramatically insignificant.

Heres Jet's advice, looking back on experiencing the same thoughts/experiences that you're having at this very moment.

Relax. Forget that you are a stud MS4, at least for tonite.

Score the MILF. Forget about your career for 24 hours or so. Enjoy the moment. You certainly deserve it.

OK. Saturday morning. Awkward verbal exchanges...

"heh heh....HEY!!!...uhhh....gotta go back to the hospital.....I'll call you!....Thanx...have you seen my watch?...."

Back to reality.

You've gotta pick a specialty.

Aside: I didnt have the advantage of the internet during my med school years (1988-1992) and resultantly couldn't pump the minds of current-day, internet-savvy practioners who for-whatever-stupid-reasons, decidedly post regularly on the internet about their specialty...on an intimate basis....

I think current-day med students/residents take this for granted.

Dudes/dudettes, you have no idea what a resource you have at your fingertips that wasnt available even ten years ago.

MILMD. UT. NOYAC.

Current day rockstars of the anesthesia business, willing to answer ANY questions you have about ANYTHING. Clinical questions. Business questions. Partnership questions.

An invaluable resource.

Don't take it for granted.

Many facts posted on this website were previously clandestine, revealed only by experiencing them, usually with a negative outcome.

If you're smart, you no longer have to learn by mistakes in certain anesthesia clinical/business situations.

For whatever reason, private practice attendings post their clinical/business intimacies here, for you to learn from.

We are not paid for these posts, nor do we garnish any personal gain, other than the fact that we feel gratification by helping Venty/Think/Chica/Tough/Nite/RN3095/Trin etc along their career path.

It is rare in life that you gain the prize of an opinion that has no ulterior motive.

 

[ThinkFast007]

rock on daddy-o

That was a tight post. I'm definitely going to keep all of that in mind, especially the "o did you see my watch part "

I nominate this thread for STICKY status (no joke).

hahaha... I cant wait to hear Chica's reaction to your post JPP. She's either gonna call you a chauvinsitc pig vs. sexist vs. "how dare you put down woman and mk them into mere sexual objects"

Chica you know we love you 😉 👍

 

[supahfresh]

i give you props. thanks for answering all our questions. now what the hell happened to my 20's?

 

[jetproppilot]

i give you props. thanks for answering all our questions. now what the hell happened to my 20's?

They're gone, O G Showtime Man.

But your thirties will make you think you're Peter North.

 

[toughlife]

Aight where do I send the 12-pack of ice cold coronas with lime to?

Thanks Dawg! You are the man! If you ever in Cleveland and need anything you let me know. I really appreciate your honesty and forthcoming personna. Certainly the kinda guy I take the shirt off my back anyday for.


👍

 

[SLPI]

new to the forums and still not sure what specialty i want to go into but have to say that the anesthesiology forums do have some great people giving advice even though some of the more in depth stuff i dont understand quite yet. but for all the docs on here giving advice... way to help out the up and comers. 👍

 

[Noyac]

It is now even more apparent to me that in your future life you will be a writer/author. 😍

 

[The_Sensei]

[/B]

But your thirties will make you think you're Peter North.

He's right.........Unfortunately, I look more like Ron Jeremy 😎

 

[jetproppilot]

It is now even more apparent to me that in your future life you will be a writer/author. 😍

Hey Noy,

Know how many people showed up for John Grisham's first book signing?

ONE.

And it was a buddy of his.

I may need you to come to my book signing when The Calling is published.

And you'll probably be the only dude there.

I'll give you a heads up.

Sure hope you can make it.

 

[automaton]

i have a few questions, how much enjoyment do you guys get from the work itself, especially 10+ years post residency? sure it's exciting to improve skills and knowledge during residency, but how about once you are done? does it get too routine, and if so, does that bother you or does that just make your life easier?

if you had the same compensation and hours as an internist, would you still be relatively satisfied?

do you get enjoyment from being on top of your game when **** hits the fan, or do you get enjoyment from the other more routine aspects as well? if it is the former, then how often do you get challenging cases that interest you?

is there intellectual satisfaction from pre-op evals or is that more of an annoyance more than anything?

how much variety is there in the types of management you do? do patients pose enough variety of challenges to keep you interested?

i'm asking these things because gas obviously affords people much free time to pursue other interests, but i think many of us have limited experience about the field itself, and wonder what you guys look forward to every morning before you go to work. to be honest, the thing i worry most about is waking up one day when i'm 50, in my big house, next to my well endowed trophy wife, and wondering what i've really accomplished. of course i also worry about waking up in a hospital from my beeper when i'm 50, but i'll let people from other specialties answer that one.

 

[jetproppilot]

i have a few questions, how much enjoyment do you guys get from the work itself, especially 10+ years post residency? sure it's exciting to improve skills and knowledge during residency, but how about once you are done? does it get too routine, and if so, does that bother you or does that just make your life easier?

if you had the same compensation and hours as an internist, would you still be relatively satisfied?

do you get enjoyment from being on top of your game when **** hits the fan, or do you get enjoyment from the other more routine aspects as well? if it is the former, then how often do you get challenging cases that interest you?

is there intellectual satisfaction from pre-op evals or is that more of an annoyance more than anything?

how much variety is there in the types of management you do? do patients pose enough variety of challenges to keep you interested?

i'm asking these things because gas obviously affords people much free time to pursue other interests, but i think many of us have limited experience about the field itself, and wonder what you guys look forward to every morning before you go to work.

Geez. Where are these posters coming from?

Again, another very nice post, with sincere, significant questions.

I'll do my best to answer them, Auto.

I still enjoy my work ten years outta residency.

I'm on my second gig after residency. I relocated in May 04 for family reasons.

My first gig was in a relatively undesirable location. I was there for almost 8 years. That gig allowed me to pay off all my debt, and put a buncha money in the bank.

Am I jet plane rich?

Nope. Not possible in our line of work.

But money isnt the driving factor in my life anymore, thanks to the fact that I elected (sacrificed) to live somewhere where I didnt really want to for quite a while. It was worth it.

Would I be happy as an internist if our pay was the same? Geez, Dude, what a question.

And I consider that a great question cuz I'm not Dr Jet . I'm Bill. Yeah, I'm a doctor at work, but family/flying/writing/no-limit-hold'em/the gym/big trucks/friends/watching movies on my 70" 6.1 Dolby surround sound system/fishing/travel is who I REALLY am.

I work to live. I dont live to work.

BUT, internal medicine isnt me. So the answer is no. I like to DO s hit. Not rule out stuff/write notes/take care of chronic diseases caused by bad lifestyles.

Does it get routine? Absolutely.

But heres the kicker that med students/residents don't get.

ANYTHING, after 5-10 years, gets somewhat routine. And I can testify to that since. like any other private practice doc, I associate with docs from other specialties.

Yes, neurosurgeons, heart surgeons, orthopedists jobs become somewhat routine after a while. As does our job.

Funny thing though, as your career progresses, you prefer routine.

I'm sure there are docs out there that prefer the catecholamine-producing cases all the time. And I respect them. Most of the stay in academia; tertiary centers that take care of the one-foot-in-the-grave patients on a routine basis.

Again, uncommon. Most docs prefer routine. Don't misinterpret this, though.

I consider an ASA 4 CABG routine. So I guess even "routine" is relative.

There is no intellectual gain on my part from a pre-op eval. I don't resent it, though, since I enjoy talking to people.

Yes, I am gratified by being at the top of my game when the sh it hits the fan.

On my last night week we did a leaking AAA...pt arrived to the OR with a 50 systolic BP...even though we were up all night trying to save this dudes life (he died 48 hours later) it was a satisfying experience. I know I gave him the best shot, from my point of view. I was able to perform the technical part of our job (intubation, bigger peripheral, A-line, 9.0 cordis) thanks to my residency and experience (uhhh...getting an a-line on a dude with a 50 systolic BP takes some skill, dudes 😀 ), I gave him an anesthetic taylored to his critical state, kept up volume wise (31 units PRBCs, in addition to FFP, cryo, platelets) 😱 , and provided pressor support when necessary.

Lets not fool ourselves.

Not all anesthesiologists can feel comfortable doing cases like that.

SDN gets a skewed version, since the frequent posters here (Mil, Noy, UT) are rockstars of our profession. Seriously. Yes, there are many MDs that feel comfortable with cases like this. But there are just as many anesthesiologists out there who are not capable of handling major vascular/CABGs.

So yes, its gratifying to deliver patient care in a case that is very difficult, where a life is literally on the line. I wouldnt wanna do it every day, though.

So, to summarize, I still enjoy my job. I get enough critically ill cases to gain gratification from, but I prefer routine.

And I wouldnt wanna be an internist.

Hope I've answered your questions.

 

[automaton]

thanks for the responses. just to clarify, i didn't ask if you want to be an internist. i don't want to be one either. god bless people who do. i was just asking if you would enjoy the job if you had the same crappy hours and crappy pay of an internist, i.e. stripping away the peripheral benefits of gas. from your response i think it's yes, and that is reassurring, especially since we know that compensation fluctuates, and there is no guarantee that gas will be as good as it is now.

the reason why i posed this question is because i can imagine myself doing crap on the computer all day if i got paid 250k for 60 hrs a week. that wouldn't really bother me. but it would be nice to actually enjoy the job too, and that's what i was getting at. anyway, it's clear that the job itself is fun to many people. i guess it's something i'll have to see for myself.

 

[bigdan]

Jet-

Real good look, as always. You "grown ups" give us noobies something to work for, and help set a pathway for how to get to where we want to be.

And I'd definitely go to a book launch. 'Specially if you big up SDN.

The only objection that I have is you've stopped giving me shout-outs...but I'll get over that.

Seriously, guys...thanks for taking your time here, and thanks for all the advice.

dc

 

[Noyac]

Hey Noy,

Know how many people showed up for John Grisham's first book signing?

ONE.

And it was a buddy of his.

I may need you to come to my book signing when The Calling is published.

And you'll probably be the only dude there.

I'll give you a heads up.

Sure hope you can make it.

I'll see you there.

 

[militarymd]

let me know when and where

 

[jetproppilot]

Jet-

Real good look, as always. You "grown ups" give us noobies something to work for, and help set a pathway for how to get to where we want to be.

And I'd definitely go to a book launch. 'Specially if you big up SDN.

The only objection that I have is you've stopped giving me shout-outs...but I'll get over that.

Seriously, guys...thanks for taking your time here, and thanks for all the advice.

dc

BIG DAN IS THE F U KKING MAN!!!!!!!

sorry bigd. theres a shout out for ya.

so i'm ridin' high...i'll have mil, noy, and bigd at the signing...

thats TWO more then Grisham had....

Thanks, Dudes.

 

[bigdan]

...that's more like it.

dc

 

[bigdan]

And, Jet, I forgot to mention that I'll also BUY a copy of the book.

Holla.

dc