When Doctors Behave Badly (graphic article from Annals of Internal Medicine)

Jun 8, 2013
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Sadly, abuse by doctors is much more common than people think. The doctors abuse their power over the patient, and many of the patients who are aware that this happened to them are too afraid to speak up. Likewise, there are doctors that abuse their power over their employees, but the employees are too afraid to report them. Even when these things do get reported, unless there is sufficient evidence that abuse of a patient or employee occurred, nothing will be done to prevent the doctor from continuing that type of abuse on others. It is extremely sad that people that we trust with our lives would have such disregard for other human beings. :(

It is important for those of us going into this profession to keep a strong ethical standard. If we see doctors abusing patients or employees, we need to speak up. We need to remember that very intelligent people such as doctors can be very manipulative and good at hiding their true nature. They seem like upstanding people so when they victimize someone, no one will believe they did it...sometimes not even the victim.
 

Crayola227

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This is silly in this forum.

If you get to med school, you will need to be very careful about standing up to this kind of thing.

I'm a passionate patient advocate, but don't get yourself kicked out of medicine by a bigoted ahole.

Think twice, gently correct if you do, consider confidentialiaty in reporting.

Sometimes the soft touch is best until you get to attending. It would be a shame to try to make a stand when you have zero power only to get kicked in the can while the bullies co tinue on, and you, the caring doc we really.needed, forever sidelined where.you.cant really help.
 
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This is silly in this forum.

If you get to med school, you will need to be very careful about standing up to this kind of thing.

I'm a passionate patient advocate, but don't get yourself kicked out of medicine by a bigoted ahole.

Think twice, gently correct if you do, consider confidentialiaty in reporting.

Sometimes the soft touch is best until you get to attending. It would be a shame to try to make a stand when you have zero power only to get kicked in the can while the bullies co tinue on, and you, the caring doc we really.needed, forever sidelined where.you.cant really help.
What do you mean by 'silly'?

I think it's an interesting issue that everyone should be aware of, from attendings down to the premeds who are ready to commit their lives to this profession. I'm saddened by the idea of discouraging medical students from speaking out against their attendings because doing so may put their entire career on the line. At what point do we draw the line and call attention to this disgusting behavior when many patients may have already been affected?
 

Crayola227

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What do you mean by 'silly'?

I think it's an interesting issue that everyone should be aware of, from attendings down to the premeds who are ready to commit their lives to this profession. I'm saddened by the idea of discouraging medical students from speaking out against their attendings because doing so may put their entire career on the line. At what point do we draw the line and call attention to this disgusting behavior when many patients may have already been affected?
The silly is a cry to arms before you've been admitted.

And yes, what's made me the most sad in my career is how much **** you have to take and see done to aptients, because speaking up for patients and getting canned while the abusers continue is not exactly the help anyone is needing.

It's a reality I'm glad to.open your guys' eyes to so you know the culture and what you're getting into.

I should refer you to a recent "illegal questions interview" thread that is very recent if you look for it in my post history.
 

mcloaf

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Sadly, abuse by doctors is much more common than people think.
In the absence of you actually qualifying what you mean by abuse, how common people think it is, and how frequently it actually happens, this is kind of a meaningless and incendiary statement.
 
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all of my orientations are now coming to light. 1000% more aware now to not follow disrespectful behaviour just because everyone else is telling me to follow. It's still such a weird situation to be in though. #herdmentality

Normally what I do is I try to change the topic with a stupid/smart question. It's probably what most people should do to politely say #this is not cool/funny.
 

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Sadly, abuse by doctors is much more common than people think. The doctors abuse their power over the patient, and many of the patients who are aware that this happened to them are too afraid to speak up. Likewise, there are doctors that abuse their power over their employees, but the employees are too afraid to report them. Even when these things do get reported, unless there is sufficient evidence that abuse of a patient or employee occurred, nothing will be done to prevent the doctor from continuing that type of abuse on others. It is extremely sad that people that we trust with our lives would have such disregard for other human beings. :(

It is important for those of us going into this profession to keep a strong ethical standard. If we see doctors abusing patients or employees, we need to speak up. We need to remember that very intelligent people such as doctors can be very manipulative and good at hiding their true nature. They seem like upstanding people so when they victimize someone, no one will believe they did it...sometimes not even the victim.
You don't know what you're talking about and there is no we
 
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IMO the examples in the article were a lot more tame than things I've heard of...

In the recent thread about the GI doc and anesthesia making fun of a patient while he was secretly recording them, I came down on the side that their talk was totally wrong and unacceptable.

But I also think that we've reached a point culturally where everyone wants to take offense at everything and extract their pound of flesh for said offense. I've seen people suggest in seriousness that every second of every operation be recorded in order to "protect" patients from unprofessionalism.

While this may sound callous, would any other profession hold up well if I recorded everything they said at the office all day?

The OR is our workplace, and I'm good friends with a lot of my coworkers including the scrubs and nurses. If we make a harmless joke, does that mean we don't care about the patient?

If my circulator nurse says thank god we got the hover mat for this next patient, does that mean she's being callous towards obese patients? Oh wait, I'm sorry, "Healthy at any size" patients. Because calling someone obese is body shaming these days.

We had a faculty get reported by a medical student last year because during a case he was explaining to the junior resident how exposure is really difficult for a particular operation in obese patients. Apparently the medical student was offended by this entirely educationally focused discussion.
hmm, I think that the first example that the student encountered in the article posted by OP was really downcasting. I think that is an instance for reporting.
 
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Oh certainly. I'm just saying I think they could have dug for far more inflammatory examples if they wanted to.

But on the larger scale, there needs to be a better differentiation of true abuse versus not.
true. I don't think I would take any offense at all by being called obese..that's absurd. Being obese affects your body so badly and it's a medical term...I wish there was a program of sorts that obamacare would focus on instead to rejuvinate people back to a healthy state.
 
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In the absence of you actually qualifying what you mean by abuse, how common people think it is, and how frequently it actually happens, this is kind of a meaningless and incendiary statement.
I meant a serious type of abuse like molesting patients, severely sexually harassing or assaulting employees, etc. The type of things that ruins people's lives. Acting rude, harmless jokes, etc. I would not consider abuse. I have a friend who was subject to sexual abuse by a doctor and watching her go through months of serious psychological and emotional affects of the abuse broke my heart. Another friend knows a doctor who molests patients, but the person who found out about it is to afraid to let authorities know because they are a afraid of what he will do to them. I suppose I should have said "abuse happen more frequently then I or some of the people I know thought it did."
 

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IMO the examples in the article were a lot more tame than things I've heard of...

In the recent thread about the GI doc and anesthesia making fun of a patient while he was secretly recording them, I came down on the side that their talk was totally wrong and unacceptable.

But I also think that we've reached a point culturally where everyone wants to take offense at everything and extract their pound of flesh for said offense. I've seen people suggest in seriousness that every second of every operation be recorded in order to "protect" patients from unprofessionalism.

While this may sound callous, would any other profession hold up well if I recorded everything they said at the office all day?

The OR is our workplace, and I'm good friends with a lot of my coworkers including the scrubs and nurses. If we make a harmless joke, does that mean we don't care about the patient?

If my circulator nurse says thank god we got the hover mat for this next patient, does that mean she's being callous towards obese patients? Oh wait, I'm sorry, "Healthy at any size" patients. Because calling someone obese is body shaming these days.

We had a faculty get reported by a medical student last year because during a case he was explaining to the junior resident how exposure is really difficult for a particular operation in obese patients. Apparently the medical student was offended by this entirely educationally focused discussion.
how can you be offended by something that isn't even being directed at you? absurd
 
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It sounds like both the examples in the article were about vaginas. Is it the fact that a vagina was involved that elevates the perception of this abuse? Both the storytellers were also men. Obviously not proper behavior, but if his hand had been inside of her chest cavity instead would it have been so ghastly?
 

NotASerialKiller

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It sounds like both the examples in the article were about vaginas. Is it the fact that a vagina was involved that elevates the perception of this abuse? Both the storytellers were also men. Obviously not proper behavior, but if his hand had been inside of her chest cavity instead would it have been so ghastly?
Well the first one is a sexual joke, the second a racist joke. It would have been just as idiotic and embarrassing during any other procedure.
 
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johnston9234

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It sounds like both the examples in the article were about vaginas. Is it the fact that a vagina was involved that elevates the perception of this abuse? Both the storytellers were also men. Obviously not proper behavior, but if his hand had been inside of her chest cavity instead would it have been so ghastly?
...yes? At the very least I would want to know so I could move my future operations to a different hospital where they may or may not act more professionally.
 
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...yes? At the very least I would want to know so I could move my future operations to a different hospital where they may or may not act more professionally.
I am not saying it would have been peachy and cool otherwise, but the "graphic" nature of this article seems to rely mostly on the fact that a vagina was involved.
 

johnston9234

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I am not saying it would have been peachy and cool otherwise, but the "graphic" nature of this article seems to rely mostly on the fact that a vagina was involved.
I dont see your point here. Yes it possibly was more graphic due to the event involving a vagina, but that is exactly what happened.
 
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touchpause13

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It sounds like both the examples in the article were about vaginas. Is it the fact that a vagina was involved that elevates the perception of this abuse? Both the storytellers were also men. Obviously not proper behavior, but if his hand had been inside of her chest cavity instead would it have been so ghastly?
Well if you don't realize that the vagina is a sensitive area, idk what to tell you. But singing and dancing with your hand inside a patient for no reason isn't exactly what I would call professional behavior
Plus, you know... racism.
 
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Well if you don't realize that the vagina is a sensitive area, idk what to tell you. But singing and dancing with your hand inside a patient for no reason isn't exactly what I would call professional behavior
Plus, you know... racism.
I obviously never said it was, and yes I realize it is sensitive, but both stories are about vaginas! I just think it is a bit odd.
 

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I also saw this on fb today and was disgusted. Obviously within the profession there are inside jokes, moments of silliness, etc. (and some which the general population can't understand, simply because they're not a part of this world) but I still think there's a time and place to express those. What makes me really angry is the flippancy both of those male attendings demonstrated toward their female patients... the fact that both women were in a vulnerable position (i.e. under anesthesia and not in control of the situation they were in) is what makes their behavior especially repulsive. I don't know how else to say it. It's so disrespectful and inappropriate, it's bad form, and it's just gross. Not okay.
 
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What makes me really angry is the flippancy both of those male attendings demonstrated toward their female patients... the fact that both women were in a vulnerable position
This is what I am trying to point out.
 

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This is what I am trying to point out.
And my point was that if it was a male attending with his fist inside of a man's dingus, it would still be very very wrong. The fact that it was female is only the the reason its wrong.

I dont understand what you are going on about. I really dont see your point. Your point seems to be that its only/partially wrong because it was done to a women. But why even assert that because thats exactly what happened.
 
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Your point seems to be that its only/partially wrong because it was done to a women. But why even assert that because thats exactly what happened.
Uh no, just because I am pointing out one aspect that I find interesting doesn't mean I find the negative to be 100% true. I have already said this above. I am not arguing for any point, just thought it was an interesting aspect. If you are looking for a fight then join a boxing gym.
 
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Sadly, abuse by doctors is much more common than people think. The doctors abuse their power over the patient, and many of the patients who are aware that this happened to them are too afraid to speak up. Likewise, there are doctors that abuse their power over their employees, but the employees are too afraid to report them. Even when these things do get reported, unless there is sufficient evidence that abuse of a patient or employee occurred, nothing will be done to prevent the doctor from continuing that type of abuse on others. It is extremely sad that people that we trust with our lives would have such disregard for other human beings. :(

It is important for those of us going into this profession to keep a strong ethical standard. If we see doctors abusing patients or employees, we need to speak up. We need to remember that very intelligent people such as doctors can be very manipulative and good at hiding their true nature. They seem like upstanding people so when they victimize someone, no one will believe they did it...sometimes not even the victim.
Spare me.
 

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What do you mean by 'silly'?

I think it's an interesting issue that everyone should be aware of, from attendings down to the premeds who are ready to commit their lives to this profession. I'm saddened by the idea of discouraging medical students from speaking out against their attendings because doing so may put their entire career on the line. At what point do we draw the line and call attention to this disgusting behavior when many patients may have already been affected?
You can only do what you can. If you make the wrong stands (even if they're very much for the right reasons) as a medical student, you'll never make it to being an attending that can actually change things. That's just reality. It's ugly and it's sad, but that simply is the way it is.
 

Mad Jack

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IMO the examples in the article were a lot more tame than things I've heard of...

In the recent thread about the GI doc and anesthesia making fun of a patient while he was secretly recording them, I came down on the side that their talk was totally wrong and unacceptable.

But I also think that we've reached a point culturally where everyone wants to take offense at everything and extract their pound of flesh for said offense. I've seen people suggest in seriousness that every second of every operation be recorded in order to "protect" patients from unprofessionalism.

While this may sound callous, would any other profession hold up well if I recorded everything they said at the office all day?

The OR is our workplace, and I'm good friends with a lot of my coworkers including the scrubs and nurses. If we make a harmless joke, does that mean we don't care about the patient?

If my circulator nurse says thank god we got the hover mat for this next patient, does that mean she's being callous towards obese patients? Oh wait, I'm sorry, "Healthy at any size" patients. Because calling someone obese is body shaming these days.

We had a faculty get reported by a medical student last year because during a case he was explaining to the junior resident how exposure is really difficult for a particular operation in obese patients. Apparently the medical student was offended by this entirely educationally focused discussion.
I wish I could like this thrice.
 

StudyLater

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Thank you for sharing this. I was just wondering who I could pass judgment on today from my armchair.

Unfortunately, it's not pure armchair judgment. I have been in this kind of situation more than a few times.

Key questions to consider:
1. Is this harming the success of the operation?
2. Is this harming the patient? (psychological damage I would assume is the concern, most often)
3. Is this harming the person(s) the physician is communicating with (i.e. the recipient(s) of the joke)?

I see #1 being a no nearly all of the time, #2 being a no most of the time (unless the patient learns about it after the fact), and #3 being the biggest potential issue. Causing harm is antithetical to the physician's mission. Therefore, if the answer to #3 is a yes, then the physician hasn't done his/her job properly. With that said, the patient's health is the most important thing. Even if #2 doesn't happen, it still had the potential to happen, like @SouthernSurgeon mentioned with the GI doc (or was it the anesthesia doc? Can't remember. Anyway) - therefore, even creating the possibility of violating #2 means the doc has failed. Reminds me of speeding. Even if you're only doing it some of the time, you're still creating that chance each time. It's bad practice.

And with that said, you've got the bureaucratic rules and the way things should be....and then you've got reality. I don't feel good about it either way. Tyranny against the patient's/listener's sensibilities, or tyranny against freedom of speech. On the one hand, the stick is revenge (sorry...I mean justice) for humiliation, and on the other the stick is the bill of rights. Both pretty powerful motivators. I don't particularly like being humiliated (though I'm cool with it if it's necessary for some greater benefit), and I also really like having my constitutional rights to say whatever I please without a Thought Police muffling my mouth with chloroform when I say the "wrong" thing. So I'm torn about it. You'll all probably come to some conclusion without me, because I can never decide on these things. Just make a rule and I'll follow it so I can keep my job.
 

touchpause13

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Also the article didn't seem to explicitly mention this for whatever reason but I assume it was a Hispanic patient which doubles down on the offensiveness.

Again though not trying to excuse behavior but sometimes there is absurdity in the OR from the nicest people that taken out of context would sound awful. It's just an odd environment sometimes that lends itself to moments of silliness
Yeah, I understand that and I get the whole black humor thing.

At the same time, if you have your hand in someone's vagina, don't be a jackass. That's just like.. a basic life rule.
 

Crayola227

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Yeah, I understand that and I get the whole black humor thing.

At the same time, if you have your hand in someone's vagina, don't be a jackass. That's just like.. a basic life rule.
You have to careful becuz at what point are we going from clinical encounter to sexual assault?

At least I imagine that's what the lawyer potentially skewering someone for this kind of thing is-a gonna say.

When I was getting trained on these types of sensitive patient encounters, it was brought up how the language and draping and the whole thing is actually ritualizing things to create that distinction.

"Let your knees fall apart" rather than "spread your legs." "You'll feel my touch on the inside of your leg, then you will feel my touch as now I will inspect your labia" "Insert a digit" not "put my fingers". Tell a man to stand and "lean over to rest your torso on the exam table" "not bend over while I stick a finger in your ass"
"Lay on your side, place one hand lift your buttock so I may inspect the area" not "spread your asscheeks so I can get a better look"

It's important to de-sexualize the whole thing, I'm grateful the term "being clinical" has the implication it does.

No breast, ass, genital jokes. You can get away with a lot, make fun of their hair, but those topics are stepping into something else.

Especially if you are touching said parts when you open your dumb mouth.
 
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StudyLater

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Tell a man to stand and "lean over to rest your torso on the exam table" "not bend over while I stick a finger in your ass"
I'm sorry but I would just laugh if my doc ever said that.

That being said I've never actually had a prostate exam. I have witnessed many, though. Looks a little uncomfortable.
 
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touchpause13

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You have to careful becuz at what point are we going from clinical encounter to sexual assault?

At least I imagine that's what the lawyer potentially skewering someone for this kind of thing is-a gonna say.

When I was getting trained on these types of sensitive patient encounters, it was brought up how the language and draping and the whole thing is actually ritualizing things to create that distinction.

"Let your knees fall apart" rather than "spread your legs." "You'll feel my touch on the inside of your leg, then you will feel my touch as now I will inspect your labia" "Insert a digit" not "put my fingers". Tell a man to stand and "lean over to rest your torso on the exam table" "not bend over while I stick a finger in your ass"
"Lay on your side, place one hand lift your buttock so I may inspect the area" not "spread your asscheeks so I can get a better look"

It's important to de-sexualize the whole thing, I'm grateful the term "being clinical" has the implication it does.

No breast, ass, genital jokes. You can get away with a lot, make fun of their hair, but those topics are stepping into something else.

Especially if you are touching said parts when you open your dumb mouth.
Yup. Also for the love of god people watch your thumbs on pelvics. I had a doc who had that ish in the wrong place and it was so uncomfortable
 
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Mad Jack

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That being said I've never actually had a prostate exam. I have witnessed many, though. Looks a little uncomfortable.
Given that you're pre-health, I find that concerning. Either you've got a very specific porn subscription or you're doing some really weird shadowing...
 
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Crude? Yes
Actually racist? Dubious
 

Crayola227

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Crude? Yes
Actually racist? Dubious
When you realize "La Cucaracha" means cockroach in Spanish, it seems more unsavory.

Maybe not rascist in the sense of discrimination, but a racially motivated joke.

If she was Jewish and the doc sang Adam Sandler's "Hanukkah Song" with his fist in her vagina?

If she was black and he started singing Ice T's "Cop Killer"?

If she was Native American and he started singing "Colors of the Wind" as done by the character Pocahontas in the children's movie?

If she was Amish and he started singing Weird Al's "Amish Paradise"? (Double entendre here)

If she was German and it was "Du Hast"?

If he started singing "It's a Small World" from Disney might be easier to argue that it isn't a racial joke, although they say Disney was a bigot. And that might be a more complimentary double entendre but still disgusting.

There's just some jokes about some people or body parts you shouldn't make. Simple CYA. Same concept as having a chaperone for some exams, documenting PARQ, patient refusing treatments, singing and dating stuff.

It won't matter what you think or mean, but how bad it sounds out of context by an attorney and what the jury wants to hang you out for
 
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When you realize "La Cucaracha" means cockroach in Spanish, it seems more unsavory.

Maybe not rascist in the sense of discrimination, but a racially motivated joke.

If she was Jewish and the doc sang Adam Sandler's "Hanukkah Song" with his fist in her vagina?

If she was black and he started singing Ice T's "Cop Killer"?

If she was Native American and he started singing "Colors of the Wind" as done by the character Pocahontas in the children's movie?

If she was Amish and he started singing Weird Al's "Amish Paradise"? (Double entendre here)

If she was German and it was "Du Hast"?

If he started singing "It's a Small World" from Disney might be easier to argue that it isn't a racial joke, although they say Disney was a bigot. And that might be a more complimentary double entendre but still disgusting.

There's just some jokes about some people or body parts you shouldn't make. Simple CYA. Same concept as having a chaperone for some exams, documenting PARQ, patient refusing treatments, singing and dating stuff.

It won't matter what you think or mean, but how bad it sounds out of context by an attorney and what the jury wants to hang you out for
Singing the star spangled banner for an American? Racially motivated? Please
 

Crayola227

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Singing the star spangled banner for an American? Racially motivated? Please
I just recently read a bunch of court documents about race/ethnicity and discrimination. That might slide since it's a majority group here in the US.

If they were British and it was a Monty Python song, I'm telling you, there could be a legal reckoning.

And if it were a jury, let's face it, even if they're not taking you down specifically for it being rascist, it can only add to their general sense of you being a douche.

Just be sure whatever song you sing with your fist in a patient doesn't have any overtly racist, ethnic, sexist, violent, ageist, religious, or whatever overtones. I would say go for Tibetan throat singing but that could probably be turned against you.

I'm trying to come up with a song. Any ideas?
 

Crayola227

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I'm thinking the refrain of Poison's "Welcome to the Jungle" with its promise of fun and games you might argue as intended to give a welcoming vibe, although I'm sure Jungle would be construed by the prosecution as an uncomplimentary euphemism

Yep, there's no winning on this one.
 
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The_Bird

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I would maybe pretend that something terrible was being done to my hand while grabbing my wrist and yelling, "Give it back!!"
 

StudyLater

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Given that you're pre-health, I find that concerning. Either you've got a very specific porn subscription or you're doing some really weird shadowing...
Mix of uro & ER cases. I shadow quite a bit (basically carte blanche at a top hospital), which is why I see quite a lot of different stuff. I dress either professionally, or in scrubs, and I'm always introduced as "one of our students." Therefore, the patients are usually quite comfortable with me being there. Especially in uro, I am surprised at just how casual and open the whole thing is with most patients. It might be partially because the hospital is predominantly serving much older patients who just don't care about appearances etc.

Who pays for porn?
 

Mad Jack

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How bout we just don't burst into song and dance whilst wrist deep in a post-partum woman? Like as a general rule.
Unless your patient is a muppet and you happen to be participating in some sort of hospital-themed muppet musical, I'm going to have to agree with you on that general rule.
 

StudyLater

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One man's normal is another man's tedious and conventional.
True true. But there's a limit, right? Por ejemplo, once we start going south of 18, and some have serious issues with the kind representing nonconsensual acts/murder/torture.

Point being: Porn is evil and God is watching.
 
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