Will an interventionist ever be able to do planned angios + stents?

[Steiner83]

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Have been looking into the field of cardiac intervention for some time now and have throughout the time wondered if there will come a time (or if it actually takes place now) where the interventionists perform planned catherization with DES (or as it looks now non-DES) as a preventive treatment even for people without symptoms?

Anyone who has any ideas about this?

 

[mellow yellow]

Of course not. The major drawback of stenting is in-stent restenosis which occurs reliably over time.

 

[Big Ben]

I would disagree. There is some data on stress tests in asymptomatic diabetics and virtually all would intervene if large reversible anterior wall abnormality were noted, regardless of symptoms.

 

[Steiner83]

Hmm with the ongoing debate regarding DES we will probably not see theese in extensive use for some time. However if DES wouldn´t have the troubles with thromboembolism and if they would show to be as promising in regard of not allowing reststenosis, would it at all be possible to see a future where interventionsit use stenting as a standard method (if not for the general population possibly the wealthier part) to prevent MI? This regardless of symptoms of an eldery/diabetic population.

 

[Qtip96]

Hmm with the ongoing debate regarding DES we will probably not see theese in extensive use for some time. However if DES wouldn´t have the troubles with thromboembolism and if they would show to be as promising in regard of not allowing reststenosis, would it at all be possible to see a future where interventionsit use stenting as a standard method (if not for the general population possibly the wealthier part) to prevent MI? This regardless of symptoms of an eldery/diabetic population.

i'm having trouble with not only your query, but also your assertions.

1. generally speaking, we refer patients for PCI of stenotic CAD to treat symptoms (angina, equivalent, dyspnea, etc.) or ACS. there are cases when we revascularize for "compelling" anatomy, i.e. LMCA, 3VD with decreased LVEF, and sometimes for tight prox LAD. the majority of MIs (>80%) occur in coronary regions with non-significant (<70%) stenoses. there is no technology as of yet that can identify the vulnerable plaque. if PCI is performed with an eye towards preventing MI/SCD in the asymtomatic patient, what portion of the coronary anatomy do you propose stenting? full metal jacket?

if not for the general population possibly the wealthier part

2. are you proposing a stratified preventative invasive approach for treatment of the WEALTHY? give me a break.

 

[Steiner83]

Qtip96: Thank you for clarifying the background of the topic.

I agree that the degree of arterial stenosis not necessary can predict the likelihood of myocardial infarction, however, as suggested ("full metal jacket") or methods of detecting vulnerable plaques significantly, is maybe not that far away.

2. are you proposing a stratified preventative invasive approach for treatment of the WEALTHY? give me a break.

Hmm, people with money concerned with their status of health tend to investigate (read screen) and, if possible, treat what is recommended to treat regardless of what screenings programs are available. Coronary arteries are somewhat crucial for one&#180;s life...

 

[Qtip96]

people with money concerned with their status of health tend to investigate (read screen) and, if possible, treat what is recommended to treat unregardless of what screenings programs are available. Coronary arteries are somewhat crucial for one&#180;s life...

WTF?

1. learn english.
2. learn medicine.
🙄

 

[salmonella]

Qtip96: Thank you for clarifying the background of the topic.

I agree that the degree of arterial stenosis not necessary can predict the likelihood of myocardial infarction, however, as suggested ("full metall jacket") or methods of detecting vulnarble plaques significantly is maybe not that far away.

2. are you proposing a stratified preventative invasive approach for treatment of the WEALTHY? give me a break.
Hmm, people with money concerned with their status of health tend to investigate (read screen) and, if possible, treat what is recommended to treat unregardless of what screenings programs are available. Coronary arteries are somewhat crucial for one´s life...

Could you clarify for us what you are trying to say? For some reason I am having some difficulty understanding your post...😕

 

[Big Ben]

and please tell me you are a third year medical student and not a resident...

 

[Steiner83]

WTF?

1. learn english.
2. learn medicine.
🙄

1. Exactly which part of my text did you have a problem to understand?
2. I would love to learn medicine, maybe you could be the one to teach me it!

Could you clarify for us what you are trying to say? For some reason I am having some difficulty understanding your post...

In reply to Qtip96:s post, my first two lines of text agrees to what has been stated by Qtip96. What I then try to say is that some types of medicine/surgery not necessarily is paid for by insurance policies, thus would only be affordable by people with more money.

 

[Qtip96]

again,

1. you have a dismal understanding of english grammar

2. your understanding of coronary physiology is even worse

this thread is DEAD, or rather, DOA.
unless you can find some way to make it entertaining or informative.

 

[Steiner83]

Qtip96: Give me a break. The only thing I have done here is to put out the humble question if cardiologists/radiologists ever will have the possibility to meet the demand of requested PCI, not based upon actual indications (symptoms, anatomy etc) as of today, but on the basis of "what-could-be-a-risk-factor-not-easy-to-tell-but-let&#180;s-intervene-anyways-just -for-the-sake-of-it".

When starting the thread I was far away from thinking that the level of maturity in the forum of IM-cardiology would be of the level of throwing **** at people for the sake of how they struggled to expressed themselves in a foreign language- Please open your brilliant minds, be innovative and bring something of value to what you utter.

 

[Qtip96]

now THAT's entertaining!

 

[Steiner83]

Qtip96: Another entertaining question is: How old are you?

 

[Qtip96]

awe come now. you can do better than that!

flex those linguistic muscles! fire off a few neurons!

what a pitiful display of witticism.

 

[Firebird]

i'm having trouble with not only your query, but also your assertions.

1. generally speaking, we refer patients for PCI of stenotic CAD to treat symptoms (angina, equivalent, dyspnea, etc.) or ACS. there are cases when we revascularize for "compelling" anatomy, i.e. LMCA, 3VD with decreased LVEF, and sometimes for tight prox LAD. the majority of MIs (>80%) occur in coronary regions with non-significant (<70%) stenoses. there is no technology as of yet that can identify the vulnerable plaque. if PCI is performed with an eye towards preventing MI/SCD in the asymtomatic patient, what portion of the coronary anatomy do you propose stenting? full metal jacket?



2. are you proposing a stratified preventative invasive approach for treatment of the WEALTHY? give me a break.

Medicine is full of treatments, etc. that only the middle to upper strata can afford. Even at the most basic level...poor people don't really have a choice as to whom their doctor will be. They are at the mercy of free clinics.

Hey listen Qtip...don't be that doctor who all the medical students can't stand. You're acting like the guy who ignores everything but himself, disregards the feelings of others, and is hateful for absolutely no reason.

I am amazed at how many people on here tend to make statements about other people's English. It is essentially a manifestation of racism, because you are criticizing a person for not being born into an English speaking culture.

Accept a bit of edification from Niles...

 

[Qtip96]

Medicine is full of treatments, etc. that only the middle to upper strata can afford. Even at the most basic level...poor people don't really have a choice as to whom their doctor will be. They are at the mercy of free clinics.

Hey listen Qtip...don't be that doctor who all the medical students can't stand. You're acting like the guy who ignores everything but himself, disregards the feelings of others, and is hateful for absolutely no reason.

I am amazed at how many people on here tend to make statements about other people's English. It is essentially a manifestation of racism, because you are criticizing a person for not being born into an English speaking culture.

Accept a bit of edification from Niles...

the topic of this thread is completely ignorant and incompatible with contemporary clinical practice and modern understanding of coronary physiology. i am not as you say hateful, which by definition requires an emotional response. i simply have disdain for utter stupidity and ignorance, irrespective of race, nationality, or creed.

while you sanctimoniously wax about prejudice, your friend is pressing an agenda proposing a medical strategy that favors the wealthy. irrespective of socioeconomic woes inherent in the american medical system, i care for all my patients with the same measure of dedication without regard to financial background.

YOU need to lighten up and spend less of your time judging others.

btw. nice quote. from the man who said...

Niles Crane: "I really am king of the ninnies aren't I?"

 

[Steiner83]

Qtip96: Regardless of your tremendous verbal skills, compared to me, I think you have entered and responded to the thread with a somewhat distorted view of what I have asked, thought of or tried to contemplate about.

Nowhere in the thread have I stated that I care less for patients lacking funds. I have only mentioned the fact that "desperate" people with money tend to be the first patients with the ability to pay for treatments (promising or not) not yet accepted by insurance companies, FDA, social health care systems etc etc .

The core of the question of the thread is whether or not you think there will be any preventive methods of interventional cardiology before the onset of symptoms? As of today this is possibly not the case but how hard is it to discuss which fields within radiology, "ground research", clinical chemistry/physiology etc etc seem to be promising in regard of what I am asking for?

 

[salmonella]

Qtip96: Regardless of your tremendous verbal skills, compared to me, I think you have entered and responded to the thread with a somewhat distorted view of what I have asked, thought of or tried to contemplate about.

Nowhere in the thread have I stated that I care less for patients lacking funds. I have only mentioned the fact that "desperate" people with money tend to be the first patients with the ability to pay for treatments (promising or not) not yet accepted by insurance companies, FDA, social health care systems etc etc .

The core of the question of the thread is whether or not you think there will be any preventive methods of interventional cardiology before the onset of symptoms? As of today this is possibly not the case but how hard is it to discuss which fields within radiology, "ground research", clinical chemistry/physiology etc etc seem to be promising in regard of what I am asking for?

hmmm...I'm confused...May be my brain is just not built to understand run-on sentences...😕

 

[Firebird]

the topic of this thread is completely ignorant and incompatible with contemporary clinical practice and modern understanding of coronary physiology. i am not as you say hateful, which by definition requires an emotional response. i simply have disdain for utter stupidity and ignorance, irrespective of race, nationality, or creed.

while you sanctimoniously wax about prejudice, your friend is pressing an agenda proposing a medical strategy that favors the wealthy. irrespective of socioeconomic woes inherent in the american medical system, i care for all my patients with the same measure of dedication without regard to financial background.

YOU need to lighten up and spend less of your time judging others.

btw. nice quote. from the man who said...

Niles Crane: "I really am king of the ninnies aren't I?"

If you want to do semantic battle...

"Disdain" is defined by Webster as "a feeling of contempt for someone or something regarded as unworthy or inferior." Emotion is defined by Webster as "a state of feeling." You were indeed being hateful and you need to learn to temper your responses so that, as I suggested, you don't become "that guy."

 

[Qtip96]

If you want to do semantic battle...

"Disdain" is defined by Webster as "a feeling of contempt for someone or something regarded as unworthy or inferior." Emotion is defined by Webster as "a state of feeling." You were indeed being hateful and you need to learn to temper your responses so that, as I suggested, you don't become "that guy."

semantic BATTLE? my my my. how melodramatic.

i'm very happy that you know how to use the dictionary. and yes, that is "happy", as in "a state of feeling."

care to address Steiner's queries?

 

[deleted87716]

people with money concerned with their status of health tend to investigate (read screen) and, if possible, treat what is recommended to treat regardless of what screenings programs are available.

OK, then...what's the evidential basis for anyone to recommend invasive coronary angiography in an asymptomatic person, costs and ability to pay being immaterial?

 

[cfdavid]

Qtip96: Another entertaining question is: How old are you?

You know, it's interesting you pose that question. I sometimes frequent the cardio forum, and I can't help but notice that this dude is a constant instigator with a bad attitude.

Qtip, why don't you just keep it above board and professional? Most of us are humble enough to realize that we don't know it all, so if you have something positive to share, then by all means, please do. That's what these forums are for. But, why the abrasive attitude?

 

[Qtip96]

...Qtip, why don't you just keep it above board and professional? Most of us are humble enough to realize that we don't know it all, so if you have something positive to share, then by all means, please do. That's what these forums are for. But, why the abrasive attitude?

as you stated, this is a cardiology forum. though with pitifully little "cardiology" in its content. most topics thus far concern money, unwillingness to make the work and time commiment, and garbage science (mostly money driven). some "insitgation" i have exercised thus far in this forum have been with posters who:
1. emphatically propose that the physical exam is not a skill to be cultivated by physicians-in-training
2. believe women cannot achieve both professional careers and desirability.
3. do not believe in ethnic diversity in medicine
4. give poor advice to academically inclined students/residents who want to be cardiologists
5. are insensitive to the academic guidance of physician-mothers while advocating lying as a general strategy for getting into competitive fellowship. (i have imparted some advice in private correspondence)
6. propose overall nonsensical clinical strategies

i have made a few posts without my usual incredulity ( IABP insertion technique, ECHO and severe MR, PCI and surgical backup) when the threads' topic was not utter garbage from the outset.

whether you recognize it or not, i inject a small amount common sense and clinical relevancy into otherwise ******ed threads while admittedly keeping myself entertained.

this forum is NOT PROFESSIONAL. it is about ENTERTAINMENT and about sharing information from anonymous sources (taken with the commensurate amount of cognitive weight). high yield clinical information and professional advice should come from personal experience, reading publications with a critical eye, and cultivating relationships with dependable colleagues and mentors. do not confuse this cyber mish-mash with grand rounds.

am i abrasive? yes. sarcasm is fun.

so long as you are in the mood for imparting advice, let me return the favor. having a thin skin and taking life too seriously does not mix well with a career in medicine. try to contemplate this between your ~1,300 posts.

 

[IceMan0824]

am i abrasive? yes. sarcasm is fun.

That's why I love you. Maybe not love, but really really really like...reading your posts.

Can't we all just get along. I'm here to read a little about others opinion about cardiology but a little fun and humor along the way is well appreciated.

Keep the info going. Hopefully I'll remember all this these when I do my cardiology fellowship in 2016👍

 

[cfdavid]

so long as you are in the mood for imparting advice, let me return the favor. having a thin skin and taking life too seriously does not mix well with a career in medicine. try to contemplate this between your ~1,300 posts.

yeah, you know me really well, i'm sure. i'm taking the high road. good luck dude. i don't feel like getting into some futile internet arguement.....

 

[Firebird]

semantic BATTLE? my my my. how melodramatic.

i'm very happy that you know how to use the dictionary. and yes, that is "happy", as in "a state of feeling."

care to address Steiner's queries?

Call me melodramatic if you want. Joke about me being able to use a dictionary. That can be your defensive mechanism if you wish. However, I'm just glad to have shown you your inconsistancy in your previous statement. In case you missed it, let me repeat:

I said you were being hateful.

You said you weren't hateful because you weren't being emotional. Instead, you said you had disdain for ignorance.

I showed that disdain was an emotion with my particularly honed dictionary skills [please note sarcasm].

Now, I suppose the other interpretation of this conversation could be that instead of you being inconsistant, you just simply don't know the meanings of the words you use. But that can not be the case because you are the Queen of English.

At any rate, just go ahead and have your disdain for those who have not yet learned things. Just don't go into an academic setting. You are completely unfit for a learning environment and therefore have no place in the education of medical students or residents.

 

[Qtip96]

semantic BATTLE? my my my. how melodramatic.

i'm very happy that you know how to use the dictionary. and yes, that is "happy", as in "a state of feeling."

care to address Steiner's queries?

response, with some minor corrections...

Call me melodramatic if you want. Joke about my being able to use a dictionary. That can be your defense mechanism if you wish; however, I'm just glad to have shown you the inconsistency of your previous statement. In case you missed it, let me repeat.

I said you were being hateful.

You said you weren't hateful because you weren't being emotional. Instead, you said you had disdain for ignorance.

I showed that disdain was an emotion with my particularly honed dictionary skills [please note sarcasm].

Now, I suppose the other interpretation of this conversation could be that instead of your being inconsistent, you just simply don't know the meanings of the words you use. But that can not be the case because you are the Queen of English. (incomplete)

At any rate, just go ahead and have your disdain for those who have not yet learned things. (what things?) Just don't go into an academic setting. You are completely unfit for a learning environment and therefore have no place in the education of medical students or residents.

i'm sorry. i was wrong. you DON"T know how to use the dictionary. you also need some work on syntax and grammar. i'm still happy for you !

my friend, you just proved my point regarding melodrama.

**yawn**, i'm getting bored with this. take care. 😴

 

[TransFatsRgood]

For the past 2 years I have been monitoring these message boards. Qtip is blunt but has perfectly summarized his (or her) reasons for being brash as above.
I find Qtip's post to be the most insightful and really enjoy reading them. From what I gather, Qtip has completed his/her fellowship at a top academic institution, is a writer (likely clincal research) and remains active in academic medicine. I suspect he/she is very accomplished and worked VERY hard to get there.
I guess what I enjoy the most is the humor in the replies. Take this thread for instance. Keep up the good work Qtip. After (and if) I get my spot, I hope to talk to you in person...
👍

 

[cfdavid]

For the past 2 years I have been monitoring these message boards. Qtip is blunt but has perfectly summarized his (or her) reasons for being brash as above.
I find Qtip's post to be the most insightful and really enjoy reading them. From what I gather, Qtip has completed his/her fellowship at a top academic institution, is a writer (likely clincal research) and remains active in academic medicine. I suspect he/she is very accomplished and worked VERY hard to get there.
I guess what I enjoy the most is the humor in the replies. Take this thread for instance. Keep up the good work Qtip. After (and if) I get my spot, I hope to talk to you in person...
👍

i'm sure he's very accomplished, as you say. assuming that's the case, it all the more reason (winners that accomplish their goals are traditionally helpful and happy) to be more patient with STUDENT DOCTORS on this thread that simply lack being around the game for as long as he. But, the constant "brash" attitude isn't really that impressive. Anyone can be a cock (especially on some annonymous studentdoctor forum where the likely hood of repurcussions for pissing people off are admittedly remote). But, the real man, and real pro is one that takes people under their wing, and provides a positive mentor-like experience. That is, true winners traditionally behave that way. And even if HIS particular program tends to reward the "hard ass" mentality, that doesn't mean he must hop on the band wagon. Again, leadership.....

 

[Qtip96]

i'm sure he's very accomplished, as you say. assuming that's the case, it all the more reason (winners that accomplish their goals are traditionally helpful and happy) to be more patient with STUDENT DOCTORS on this thread that simply lack being around the game for as long as he. But, the constant "brash" attitude isn't really that impressive. Anyone can be a cock (especially on some annonymous forum where the likely hood of repurcussions for pissing people off are admittedly remote). But, the real man, and real pro is one that takes people under their wing, and provides a positive mentor-like experience. That is, true winners traditionally behave that way. And even if HIS particular program tends to reward the "hard ass" mentality, that doesn't mean he must hop on the band wagon. Again, leadership.....

i appreciate the love iceman and transfats. thanks.

cfdavid. a couple tips.

1. brush up on your english. it is not much better than Steiner's.

2. the same anonymity affords you and Steiner equity in this interchange. i don't think you would call your attending a "cock" in his/her face. further, i would PAY MONEY to see Steiner tell a cardiologist in person...
"Coronary arteries are somewhat crucial for one&#180;s life..."

3. remove the chip from your shoulder (or the proverbial stick from your a$$) and lighten up. it's just a forum for chrissakes.

 

[cfdavid]

i appreciate the love iceman and transfats. thanks.

cfdavid. a couple tips.

1. brush up on your english. it is not much better than Steiner's.

2. the same anonymity affords you and Steiner equity in this interchange. i don't think you would call your attending a "cock" in his/her face. further, i would PAY MONEY to see Steiner tell a cardiologist in person...
"Coronary arteries are somewhat crucial for one&#180;s life..."

3. remove the chip from your shoulder (or the proverbial stick from your a$$) and lighten up. it's just a forum for chrissakes.

actually, those were more a result of 1) typing too fast and 2) not hitting the space bar (again, typing too fast).

i don't spell check my posts, and i'm sure you've made some spelling errors as well, so easy on the cheap shots. and, that's exactly what they are.
and as for the chip, i'm NOT the one with the chip on his shoulder.

if you're so experienced, why don't you act like it? also, be a man. try mentoring those that are either less experienced (all that takes is time though, dude), and/or are still students. that's what real winners do. but, no, you'd rather be the tough guy, wise a.ss on the anonymous internet. as for the anonymity affording all of us the same "privilidge", well that's why i don't go around being mr. "brash". it's futile and rather pathetic.

that being said, i'll admit that i got a bit torqued at what i'd imagine is a minority of your posts. so, from here on out, i'd rather keep it cool with everyone, including you. so peace. also, internet arguements are about the dumbest thing any of us can allow to perpetuate. and, i'm sure most of us consider ourselves on the brighter side....

 

[Teejay]

i appreciate the love iceman and transfats. thanks.

cfdavid. a couple tips.

1. brush up on your english. it is not much better than Steiner's.

2. the same anonymity affords you and Steiner equity in this interchange. i don't think you would call your attending a "cock" in his/her face. further, i would PAY MONEY to see Steiner tell a cardiologist in person...
"Coronary arteries are somewhat crucial for one&#180;s life..."

3. remove the chip from your shoulder (or the proverbial stick from your a$$) and lighten up. it's just a forum for chrissakes.

Hello Qtip,
I must admit you've been awfully harsh to some people. I assume you are well accomplished and satisfied where you are now by just reading your posts. But do remember that you are here to teach, correct and enlighten the ones below you. I have a reason to believe that your mentors were polite and patient with you when you were training otherwise you won't as experienced as you are now. I hope you can do the same to others. You may think this is just an internet forum and consequently, gives you license to degrade others, but you"ll learn with time that words, even ones spoken over the internet can hurt people. Lets try and make this forum fun and educational while remaining sensitive to peoples feeling and background. Our words are a reflection of who we are in the inside because "out of the abundance of the heart, the mouth speaketh." Lets not make this forum an arena of insult and disdain.

 

[Qtip96]

...but, no, you'd rather be the tough guy, wise a.ss on the anonymous internet. as for the anonymity affording all of us the same "privilidge", well that's why i don't go around being mr. "brash". it's futile and rather pathetic.

that being said, i'll admit that i got a bit torqued at what i'd imagine is a minority of your posts. so, from here on out, i'd rather keep it cool with everyone, including you. so peace. also, internet arguements are about the dumbest thing any of us can allow to perpetuate. and, i'm sure most of us consider ourselves on the brighter side....

cfdavid,

your pretense of "peace" is hypocrisy. in one breath you propose "keeping it cool" and on the "brigher side", while in the other you belt out "cock", "ass", and "pathetic". is this your idea of diplomacy? taking the higher road? although i am "brash" as you say, i am rather transparent and straight-forward. as for the futility of sarcasm, my goal is self entertainment, which is easy to achieve. if your goal is diplomacy under a pretense of higher morals, i would consider your entries unsuccessful and rather futile in their execution.

your getting "torqued" about my entries betray a distorted world-view as well as an unhealthy predisposition to anger. in truth, i should have anticipated the degree of your emotional investment (and transferred sense of realism) to this forum by the number of entries and countless hours you have already spent here. for my lack of sensitivity, i apologize.

Teejay,
well spoken. much appreciated. though without the fun, participating in this forum would be bereft of entertainment. so, i will no longer visit this site. good luck to you, and have a happy new year.

and there was much rejoicing...😀

 

[cfdavid]

cfdavid,

your pretense of "peace" is hypocrisy. in one breath you propose "keeping it cool" and on the "brigher side", while in the other you belt out "cock", "ass", and "pathetic". is this your idea of diplomacy? taking the higher road? although i am "brash" as you say, i am rather transparent and straight-forward. as for the futility of sarcasm, my goal is self entertainment, which is easy to achieve. if your goal is diplomacy under a pretense of higher morals, i would consider your entries unsuccessful and rather futile in their execution.

your getting "torqued" about my entries betray a distorted world-view as well as an unhealthy predisposition to anger. in truth, i should have anticipated the degree of your emotional investment (and transferred sense of realism) to this forum by the number of entries and countless hours you have already spent here. for my lack of sensitivity, i apologize.

Teejay,
well spoken. much appreciated. though without the fun, participating in this forum would be bereft of entertainment. so, i will no longer visit this site. good luck to you, and have a happy new year.

and there was much rejoicing...😀

so, you sensed some "hypocrisy" in my last statement. what, did you expect me to completely absolve you of past provocations? i too, am straightforward in that i'll call a spade a spade, when i see it. however, it all needs to end somewhere so that we can get back to having a productive thread.

also, you keep making these cheap accusations of misspellings (not just to me, but to others). that's ridiculous, and yes, pitiful. this is also the second time in our very few exchanges in which you've referenced the volume of my posts. again, very transparent, and another weak attempt at a shot at me. you should notice that i've been posting since 10/04. and relative to my "countless" hours i spend on this forum, at least my track record has been very supportive and helpful, as is easily verifiable based on my past posts.

regardless, nobody's trying to push you out. if you have information to share, in a constructive (and yes, fun) way, PLEASE stick around. that's what makes these forums great. but, not everyone appreciates it when, in this case, the OP posts what many would consider a legitimate question, and you, in all of your "wisdom" go on to berate him with the suppossed "leverage" of your experiences. and, here the rest of us are giving you the benefit of the doubt that you do in fact have such experiences.

so, if that's indeed the case, act like it dude. again, be a leader. embrace others, and correct misinformation with better tact. that doesn't mean you need to be a "shrinking violet", but just be a man, and a winner. you can have fun, and "entertain yourself" without attempting to belittle others with less experience and taking cheap shots at people you don't even know. why burn bridges? that's just sad, and i'm sorry you don't see it.

 

[augmel]

i don't think you would call your attending a "cock" in his/her face. further, i would PAY MONEY to see Steiner tell a cardiologist in person...
"Coronary arteries are somewhat crucial for one´s life..."

And I would pay to watch an attending giving his administration mandated apology after telling an ESL med student to "#1. learn english."

 

[cowbell]

And I would pay to watch an attending giving his administration mandated apology after telling an ESL med student to "#1. learn english."

Ummm... "ESL med student?"

...be a leader. ...just be a man, and a winner...

Dude, you sound like a bad Nike commercial. Also, you haven't contributed in any way to the topic of this thread, except to flame Qtip. At least he/she addresses the topic. So, poor english aside, do you think Steiner's questions make any sense whatsoever?

You guys take yourselves waaaay too seriously.

 

[cfdavid]

Ummm... "ESL med student?"



Dude, you sound like a bad Nike commercial. Also, you haven't contributed in any way to the topic of this thread, except to flame Qtip. At least he/she addresses the topic. So, poor english aside, do you think Steiner's questions make any sense whatsoever?

You guys take yourselves waaaay too seriously.

I was trying my absolute hardest to take the high road. I started reading what seemed like an interesting post by the OP. Then, out of the blue, Qtip comes out and berates the dude. Someone else noticed he was acting like an ass, and I concured. It was that simple. Seriously, go back and read some of the begining threads on this post. You tell me what's up with that.

I frequent the cardio forum more from a silent observer's point of view most of the time. But, I felt I needed to speak up on behalf of the OP, frankly. But, I'm usually over in Anesthesiology, where I contribute as much as I can given that I'm an MS1. Even there, my contributions are more in the form of asking questions. So, no, I'm not going to jump in here and speculate on whether or not angios and stenting procedures will become prophylactic in the future.

And yeah, I do stand by the premice that winners are more interested in being positive mentors, rather than blasting people for "stupid" questions or suggestions on some anonymous forum.

 

[Teejay]

cfdavid,

your pretense of "peace" is hypocrisy. in one breath you propose "keeping it cool" and on the "brigher side", while in the other you belt out "cock", "ass", and "pathetic". is this your idea of diplomacy? taking the higher road? although i am "brash" as you say, i am rather transparent and straight-forward. as for the futility of sarcasm, my goal is self entertainment, which is easy to achieve. if your goal is diplomacy under a pretense of higher morals, i would consider your entries unsuccessful and rather futile in their execution.

your getting "torqued" about my entries betray a distorted world-view as well as an unhealthy predisposition to anger. in truth, i should have anticipated the degree of your emotional investment (and transferred sense of realism) to this forum by the number of entries and countless hours you have already spent here. for my lack of sensitivity, i apologize.

Teejay,
well spoken. much appreciated. though without the fun, participating in this forum would be bereft of entertainment. so, i will no longer visit this site. good luck to you, and have a happy new year.

and there was much rejoicing...😀

Hello Qtip,
Nobody wants you to leave this forum. I don't want you to either. Your suggestions and professional advice will go a long way in guiding us-future cardiologist. Do stick around even if it takes us absorbing your painful jokes and fun. We all have our different ways and style of making this forum informative and delighting. I guess we all must learn how to have fun even in the face of disagreements.

 

[cowbell]

I was trying my absolute hardest to take the high road. I started reading what seemed like an interesting post by the OP. Then, out of the blue, Qtip comes out and berates the dude. Someone else noticed he was acting like an ass, and I concured. It was that simple. Seriously, go back and read some of the begining threads on this post. You tell me what's up with that.

I frequent the cardio forum more from a silent observer's point of view most of the time. But, I felt I needed to speak up on behalf of the OP, frankly. But, I'm usually over in Anesthesiology, where I contribute as much as I can given that I'm an MS1. Even there, my contributions are more in the form of asking questions. So, no, I'm not going to jump in here and speculate on whether or not angios and stenting procedures will become prophylactic in the future.

And yeah, I do stand by the premice that winners are more interested in being positive mentors, rather than blasting people for "stupid" questions or suggestions on some anonymous forum.

I disagree with you. Although rude, Qtip's response was not unprovoked. He initially gave a very reasonable answer to the OP, then the OP pretty cheekily gave a nonsensical reply then said "coronary arteries are somewhat important for one's life..." How insulting is that to a cardiologist? For an eavesdropper in the Cards forum, congrats on driving away one of the few cardiologists who actially participate in this forum.

 

[cfdavid]

I disagree with you. Although rude, Qtip's response was not unprovoked. He initially gave a very reasonable answer to the OP, then the OP pretty cheekily gave a nonsensical reply then said "coronary arteries are somewhat important for one's life..." How insulting is that to a cardiologist? For an eavesdropper in the Cards forum, congrats on driving away one of the few cardiologists who actially participate in this forum.

This, coming from someone that's suggested I not take MYSELF too seriously? (as both Qtip and you have done). Come on. That didn't seem overly rude. To me, it sounded as if the OP was just stating the obvious. Who knows. That's one of the disadvantages of writing on the internet. There's no voice inflection or facial expressions to key off of.

Anyway, we can agree to disagree. Listen, I know how valuable it is to have experienced fellows or attendings contribute to these forums where I'm sure medical students and residents outnumber those guys greatly. They're great to bounce questions off of, and to learn from. But, I think there's a level of cordiality we need to maintain.

So, for that, I apologize for my part in allowing this to proliferate into some stupid arguement. Also, for name calling. I acknowledge that it was pretty childish.

 

[Steiner83]

Didn´t realize that uttering "Coronary arteries are somewhat crucial for one´s life..." would hurt someone (in this case Qtip) to the extent of him/her feeling such a need for verbal retaliation that it would generate a thread of 40 posts.

My feelings towards the level of the personal comments given are stated above and there is no need for further discussion about that. I am still intrested though in talking about the created topic. Please feel free to post your thoughts.

 

[tricophyton]

b

 

[Steiner83]

tricophyton:

I´m terribly sorry for making you feel that way...maybe we can look into other future plans together - two fools finding their way not to make people ignorant.