The Official Anti-Clinical Medicine Thread

[deschutes]

We had Thai. I observed that the green curry wasn't green. He said it was, slightly. I told him he probably shouldn't be a pathologist.

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[beary]

Now in addition to the numerous "pseudoseizure" patients on our floor, we have added some drug seekers. I have a lady now with super severe headaches who only wants IV demerol. We explained that narcotics aren't effective for headaches over the long-term, and then proceeded to offer her the 50 million other treatments we use for headaches. She refused every single one, and then in a very dramatic fashion was moaning about how we just want her to lay there and suffer since we refuse to help her with her headaches.

 

[yaah]

Now in addition to the numerous "pseudoseizure" patients on our floor, we have added some drug seekers. I have a lady now with super severe headaches who only wants IV demerol. We explained that narcotics aren't effective for headaches over the long-term, and then proceeded to offer her the 50 million other treatments we use for headaches. She refused every single one, and then in a very dramatic fashion was moaning about how we just want her to lay there and suffer since we refuse to help her with her headaches.

We had a lovely patient on my medicine rotation who had a very bad cellulitis from skin popping heroin. He basically had to be tied down so he didn't hurt anyone who came in to give him anything other than narcotics (since his pain was terrible they gave him occasional morphine, which was apparently far too little for him).

 

[b&ierstiefel]

We had a lovely patient on my medicine rotation who had a very bad cellulitis from skin popping heroin. He basically had to be tied down so he didn't hurt anyone who came in to give him anything other than narcotics (since his pain was terrible they gave him occasional morphine, which was apparently far too little for him).

Yes, I remember vividly my first patient on the floors. He was a fat guy with bad cellulitis. He didn't bathe and he smelled like ****.

 

[deschutes]

Do I really want to spend my Friday pumpkin-carving with a bunch of clinicians?

 

[b&ierstiefel]

Do I really want to spend my Friday pumpkin-carving with a bunch of clinicians?

Do I want to spend my Friday night drinking with a bunch of colleagues?

HELL YEAH!

 

[deschutes]

You live in Boston. And your best thing to see in Boston is the inside of a bar??

 

[b&ierstiefel]

You live in Boston. And your best thing to see in Boston is the inside of a bar??

Yes puppy. A BAR! Very pretty bars! Bars with many pretty beers!

Nah, our department is having a TGIF...drinks in the hospital. This is one concept that is new to me since U of Michigan hospital is f*cking lameass and doesn't allow alcohol on the premises.

 

[deschutes]

Crazy Americans. Beer and Wendy's in the hospital. Isn't this like, conflict of interest?

btw, did you know that PUPP is a diagnosis?

Pruritic Urticarial Papules and Plaques of Pregnancy...

 

[b&ierstiefel]

Crazy Americans. Beer and Wendy's in the hospital. Isn't this like, conflict of interest?

btw, did you know that PUPP is a diagnosis?

Pruritic Urticarial Papules and Plaques of Pregnancy...

We don't have a Wendy's here. Thank god! I was so sick of Wendy's after my 7 years in MI.

 

[yaah]

Yes puppy. A BAR! Very pretty bars! Bars with many pretty beers!

Nah, our department is having a TGIF...drinks in the hospital. This is one concept that is new to me since U of Michigan hospital is f*cking lameass and doesn't allow alcohol on the premises.

They do now. I guess since you left they aren't worried about anyone abusing the privilege.

 

[b&ierstiefel]

They do now. I guess since you left they aren't worried about anyone abusing the privilege.

boo

 

[beary]

Taking care of headache patients all day has given me a splitting headache.

 

[Pingu]

Do I really want to spend my Friday pumpkin-carving with a bunch of clinicians?

Do I really want to spend Halloween night sitting in the back of an SUV at the end of my driveway, waiting to hand out candy to overprivileged children who ride around on trailers collecting candy because it is too far to walk?

At least my laptop works at the end of my driveway! Yay wireless internet!

 

[yaah]

The clinical history on the bone marrow biopsy patient we saw today said that her pain was a 15 out of 10. Whatever.

 

[b&ierstiefel]

I love it when there is an operation going on and then you get called down to the frozen room. Waiting for you is a uterus, 2 ovaries, and 2 lymph nodes and they want frozens for every one and expect an answer in 20 minutes!

Can you sense the sarcasm?

 

[yaah]

I love it when there is an operation going on and then you get called down to the frozen room. Waiting for you is a uterus, 2 ovaries, and 2 lymph nodes and they want frozens for every one and expect an answer in 20 minutes!

Can you sense the sarcasm?

That sucks. That's when you sic the attending on them. Or you can just do a crappy job grossing it in and go to tumor board with the case and say that examination of the specimen was hampered by the unnecessary frozen sections that were performed. Put it in the gross. I put in the gross description sometimes when they open the specimen or section it in the OR and ruin the margin.

 

[b&ierstiefel]

That sucks. That's when you sic the attending on them. Or you can just do a crappy job grossing it in and go to tumor board with the case and say that examination of the specimen was hampered by the unnecessary frozen sections that were performed. Put it in the gross. I put in the gross description sometimes when they open the specimen or section it in the OR and ruin the margin.

Oh that's not the best part...that day we had 3 gyn onc surgeons operating on 3 cases that started around the same time.

My beeper goes off at noon:
Me - "Pathology frozen section...how may I help you today?"
Nurse - "We have a omental biopsy specimen for frozen."
Me - "Bring it on down...this is the Price is Right!"

So I identify the tumor nodule and that gets frozen...

BEEP BEEP BEEP!
Me - "Pathology frozen section...for pickup or delivery?"
Nurse - "We have both ovaries for you on the same patient for frozen section and diagnosis."
Me - "OK then. Well, I'm in the frozen room so bring it."

As I cut into the first ovary which was some massive cystic thing with papilary projections from the surface (I knew what the diagnosis was at this point anyway without even looking at a single slide!)... BEEP BEEP BEEP!

Me - "Frozens. What do you need?"
Nurse - "This is OR #21...we need a frozen section for diagnosis on a uterus."
Me - "OK. Bye."

This goes on and on to the point when I'm now dealing with 5 specimens each for two cases...then BEEP BEEP BEEP!

Morale: What doesn't kill you only makes you stronger. I learned more in that one day than I have ever learned covering gyn frozens over the last few months!

 

[Pingu]

All of our gyn-onc surgeons operate on Fridays, sometimes late into the night.

It is annoying, I mean, isn't there a better day than Friday?

 

[yaah]

Today during bone marrow signout I thought of a way to get at this whole "10/10 pain" issue. Here - when a patient says they have 10/10 pain (or more), you tell them, "Well, 10/10 is the worst possible pain, and it can't get any worse. So are you saying you cannot imagine any worse pain?" Of course they will probably say yes or tell you that the pain is a 9.9 or something. So you then say since the pain is already as bad as it is going to be they wouldn't care if you tried to make it worse. Then you take out a large knife and slash their thigh or something. Then if they scream in pain, the original pain clearly wasn't 10/10.

 

[Pingu]

And if they say that their pain is 100 out of 10 or 15 out of ten, you get to jab the knife right through their eye, then kick them in the genitals.
That is the most annoying thing. okay people, the scale goes up to ten, it cannot be any higher. Just like giving 110%. It is impossible. We need more freaking math classes for these idiots.

If you can read a magazine or smoke or eat and drink, you ain't even pushing 5 out of 10. I've given birth to a child and that was maybe 8 out 10. I would truly hate to feel a 10/10 pain.

 

[deschutes]

All of our gyn-onc surgeons operate on Fridays, sometimes late into the night.

It is annoying, I mean, isn't there a better day than Friday?

Saving the world from a long OR waiting list!

 

[beary]

I started anesthesia today. I found it to be quite a painful day.

Attending: Do you want to go start an IV on that patient?
Me: I don't know how.
Attending: Do you want to learn how?
Me: No, not really.

I have still not started an IV as an M4! I am proud of this, though this seems to be in jeopardy over the next two weeks on anesthesia. At least it won't matter anymore, since I anticipate my written comments from that attending will be along the lines of, "needs to show more enthusiasm."

 

[AngryTesticle]

I started anesthesia today. I found it to be quite a painful day.

Attending: Do you want to go start an IV on that patient?
Me: I don't know how.
Attending: Do you want to learn how?
Me: No, not really.

I have still not started an IV as an M4! I am proud of this, though this seems to be in jeopardy over the next two weeks on anesthesia. At least it won't matter anymore, since I anticipate my written comments from that attending will be along the lines of, "needs to show more enthusiasm."

Pass = MD

Don't sweat it. They won't have the balls to fail you (knock on wood).

 

[yaah]

I never started an IV, don't worry about it. They can take their enthusiasm and shove it. If they would show enthusiasm for pathology, I would show respect for their inane procedures and algorithms.

 

[beary]

This isn't really anti-clinical medicine, but is anti-med school.

I got an email that I failed anesthesia. I had previously found out that I passed the exam, so I thought, wtf? I am an apathetic M4 and all that, but didn't think I was THAT bad.

It turns out that residents who you work with for like 5 hours (a different one every day) have to turn in evaluations for you, and these accumulate for your clinical eval points. Only one resident turned in an eval for me, so this didn't give me enough points to pass. How exactly is this my fault?

Anyway, they were "gracious" enough to give me extended time and make me contact all these other residents that I worked with to badger them to turn in evaluations for me. So finally somebody else did, and that gave me enough points to pass. Really the worst part of the whole thing was how they acted like they were doing me some big favor.

 

[CameronFrye]

This isn't really anti-clinical medicine, but is anti-med school.

I got an email that I failed anesthesia. I had previously found out that I passed the exam, so I thought, wtf? I am an apathetic M4 and all that, but didn't think I was THAT bad.

It turns out that residents who you work with for like 5 hours (a different one every day) have to turn in evaluations for you, and these accumulate for your clinical eval points. Only one resident turned in an eval for me, so this didn't give me enough points to pass. How exactly is this my fault?

Anyway, they were "gracious" enough to give me extended time and make me contact all these other residents that I worked with to badger them to turn in evaluations for me. So finally somebody else did, and that gave me enough points to pass. Really the worst part of the whole thing was how they acted like they were doing me some big favor.

Wow, that's unbelievable.

 

[AngryTesticle]

This isn't really anti-clinical medicine, but is anti-med school.

I got an email that I failed anesthesia. I had previously found out that I passed the exam, so I thought, wtf? I am an apathetic M4 and all that, but didn't think I was THAT bad.

It turns out that residents who you work with for like 5 hours (a different one every day) have to turn in evaluations for you, and these accumulate for your clinical eval points. Only one resident turned in an eval for me, so this didn't give me enough points to pass. How exactly is this my fault?

Anyway, they were "gracious" enough to give me extended time and make me contact all these other residents that I worked with to badger them to turn in evaluations for me. So finally somebody else did, and that gave me enough points to pass. Really the worst part of the whole thing was how they acted like they were doing me some big favor.

I can't believe this happened for you but I'm glad you ended up passing the rotation. Don't feel bad about the "favor" thing, just take what you can get and move on.

Our anesthesiology rotation was set up in the same way except we had to do an oral exam (we all got the case a week before the actual exam and it was the same one...so of course, we all got together at a bar to discuss what our answers would be) and write a short paper on a particular case we saw with an attending. The department realized that a lot of the evaluations forms weren't gonna be turned in but they hoped that a few would be (just to make sure that we showed up to the rotation). It ended up that those who were going into anesthesiology got honors and the rest of us got High Passes. I wonder if any of my evals got turned in because on my Dean's Letter, all it said for Anesthesiology was High Pass with no comments .

 

[drPLUM]

This isn't really anti-clinical medicine, but is anti-med school.

I got an email that I failed anesthesia. I had previously found out that I passed the exam, so I thought, wtf? I am an apathetic M4 and all that, but didn't think I was THAT bad.

It turns out that residents who you work with for like 5 hours (a different one every day) have to turn in evaluations for you, and these accumulate for your clinical eval points. Only one resident turned in an eval for me, so this didn't give me enough points to pass. How exactly is this my fault?

Anyway, they were "gracious" enough to give me extended time and make me contact all these other residents that I worked with to badger them to turn in evaluations for me. So finally somebody else did, and that gave me enough points to pass. Really the worst part of the whole thing was how they acted like they were doing me some big favor.

****Blank stare*****


Ok. That is unreal. In "all my years", I have never, ever, ever, heard of someone failing a 4th year rotation. I am sure that you were no less enthusiastic than any other 4th year not doing anesthesia. I can't believe that they had the balls to fail anybody, especially you. It is a gas rotation for crying out loud. I assume that since they let you contact folks for evaluations that an F won't go on your transcipt, but still... that is just unreal.

 

[miko2005]

I started a medicine sub-I today and I can already tell how painful this is going to be. I am doing it away from my homeschool so I can be with my husband. The course director briefly met with me and one of his first questions was why I chose my medschool. I just kinda stared at him...and said "uh...its a good school?". Its not like I am applying for residency there or anything. Its going to be a painful 2 months

 

[AngryTesticle]

I started a medicine sub-I today and I can already tell how painful this is going to be. I am doing it away from my homeschool so I can be with my husband. The course director briefly met with me and one of his first questions was why I chose my medschool. I just kinda stared at him...and said "uh...its a good school?". Its not like I am applying for residency there or anything. Its going to be a painful 2 months

Yes. Sub-I's suck ass. And pathology bound folks shouldn't have to do them!

 

[yaah]

I started a medicine sub-I today and I can already tell how painful this is going to be. I am doing it away from my homeschool so I can be with my husband. The course director briefly met with me and one of his first questions was why I chose my medschool. I just kinda stared at him...and said "uh...its a good school?". Its not like I am applying for residency there or anything. Its going to be a painful 2 months

Did you get ask the old, "What do you expect to get out of this rotation?" question yet? I love that one. Just answer: Migraines and hemorrhoids.

 

[AngryTesticle]

Did you get ask the old, "What do you expect to get out of this rotation?" question yet? I love that one. Just answer: Migraines and hemorrhoids.

"I love patients. I want to cherish every opportunity to spend time with patients, hold their hands when they're down, cry with them when they cry...before I never have to deal with them again."

"And boy do I looooove performing rectal disimpactions baby!"

 

[beary]

Its going to be a painful 2 months

2 months??!! Oh my gosh. I would die. I still have my sub-I coming up, but I am doing it in peds heme-onc. Thankfully it is only one month. Of course I still have my core ob-gyn rotation left to do.

16 weeks left... we can do it!

 

[AngryTesticle]

YOU CAN DO ITTTTTT!

 

[Aubrey]

Did you get ask the old, "What do you expect to get out of this rotation?" question yet? I love that one. Just answer: Migraines and hemorrhoids.

I love this question.. I just fix them with my best Clint Eastwood scowl and say "Whaddya got?"

 

[AngryTesticle]

I love this question.. I just fix them with my best Clint Eastwood scowl and say "Whaddya got?"

I call shenanigans!

 

[miko2005]

2 months??!! Oh my gosh. I would die. I still have my sub-I coming up, but I am doing it in peds heme-onc. Thankfully it is only one month. Of course I still have my core ob-gyn rotation left to do.

16 weeks left... we can do it!

Beary,

We are only required to do 1 month but I need another elective and its one of my only options if I want to be able to live with my husband . It doesn't seem like it will be that bad. I am only supposed to take call once a week and only till 9 pm and the residents are under the impression that its way too late for me to stay till 9 on that one day (I am not arguing with that ) soooo...it could be much, much worse .

I HATED ob-gyn -- good luck!!

 

[Aubrey]

I call shenanigans!

 

[beary]

I have been away from med school since Thanksgiving for interviewing. I have to go back tomorrow, and am filled with indescribable loathing and dread.

16 weeks left:
2 weeks rads
4 week peds heme-onc subI
4 week hemepath elective
6 week ob-gyn

 

[yaah]

Peds heme-onc always sounds like it should be interesting. Unfortunately it is not. The vast majority of your time is spent trying to figure out maintenance regimens and toxicities. It is also very sad, although some people thrive on being the one to go to in those situations.

6 weeks of ob-gyn, however, bleaargh. Try to get in on Gyn-onc, it is the only saving grace. Deliveries suck.

 

[AngryTesticle]

Peds heme-onc always sounds like it should be interesting. Unfortunately it is not. The vast majority of your time is spent trying to figure out maintenance regimens and toxicities. It is also very sad, although some people thrive on being the one to go to in those situations.

Heme-Onc is quite depressing for sure. And there is a disconnect between the interesting things you can read about with respect to the different cancer patients vs. your actual daily work on this service. This is all based on hearsay...I dodged this bullet twice during 3rd year med school!

6 weeks of ob-gyn, however, bleaargh. Try to get in on Gyn-onc, it is the only saving grace. Deliveries suck.

I didn't mind doing deliveries. It was actually cool to do a couple. The sucky thing about the Labor & Delivery ward was that you had to be on the premises at all times during your workdays (i.e., be visible to the senior resident). They wouldn't let you run off and hide. And they got all bitchy at me when I sat down to actually READ. What kind of assbackward logic is this? You expect me to do an actual delivery if I can't read about the issues involved? Oh wait, that's right! I'm supposed to read during the 10 hours I'm at home. Yeah right. Get real!

Best place to hide is in the OR. There you just stand and watch and don't get crap from the ob-gyn residents on the L&D ward. If you're on the L&D side of things, try to scrub into as many C-sections as possible.

Agree regarding Gyn-Onc...especially if the attending lets you go to the frozen section room! That service was pretty sweet.

Surgeon: "Why don't you take this to pathology?"
Me: "You bet yer ass I will...I'm gonna be a pathologist baby!...oh do you want me to scrub back in when I'm done down there?"
Surgeon: "That's OK. You can scrub into another surgery if you want."
Me (thinking to self): Guess I can go home soon.

 

[uhoh!]

I didn't mind doing deliveries...

guess things are the same in the Labor wards of Med Schools throughout the world..esp from the point of view of the "lowest in the pecking order" Med Student.

 

[deschutes]

You guys gotta sit down and decide if by "deliveries" you mean baby or pizza.

 

[AngryTesticle]

guess things are the same in the Labor wards of Med Schools throughout the world..esp from the point of view of the "lowest in the pecking order" Med Student.

thank god those days are over! being everybody's bitch sucks.

You guys gotta sit down and decide if by "deliveries" you mean baby or pizza.

har dee har har. i just fell outta mah chair. omg that's the funniest thing i've ever heard. har har har. oh god, i think i'm gonna have a hernia...can't control myself.

 

[miko2005]

I have been away from med school since Thanksgiving for interviewing. I have to go back tomorrow, and am filled with indescribable loathing and dread.

16 weeks left:
2 weeks rads
4 week peds heme-onc subI
4 week hemepath elective
6 week ob-gyn

My medicine sub-internship so far has the best hours ever (I have yet to stay past 3 pm) and it is still soooooo painful. I think I have a total of 8 weeks of medical school left -- how awesome is that???

 

[beary]

My medicine sub-internship so far has the best hours ever (I have yet to stay past 3 pm) and it is still soooooo painful. I think I have a total of 8 weeks of medical school left -- how awesome is that???

That is fabulous. Good luck for the last 8 weeks!

 

[yaah]

My medicine sub-internship so far has the best hours ever (I have yet to stay past 3 pm) and it is still soooooo painful. I think I have a total of 8 weeks of medical school left -- how awesome is that???

My Sub I was not terrible either. Usually in around 6:30-7, finished by 4pm. The only problem is you have every 4th day or so where you have to stay late, and you have to do 6 days a week. Other than that, it's great.

 

[beary]

We ran out of tissues in our little office where we right orders and stuff. I looked around the nurses' desk and stuff and didn't see any. About half of us have colds, and I am having about 20 nosebleeds a day (seriously), so we need to have tissues around. So I went up to a nurse to ask where the tissues are stored so we can get some.

Nurse: They are locked in the med room.
Me (of course we don't have the codes for the med room): Ok, can we have a box please?
Nurse: Sorry, we're not allowed to give you any.
Me (thinking for sure she was kidding): Are you serious?
Nurse: Yes. It is a charge to the floor. You folks have to bring your own tissues.

 

[yaah]

Yeah right, like they don't stockpile their own crap for home from those closets.