World of Shi*t theory

[Planktonmd]

So... I have been in this business for a long time and I have come up with a theory that have always worked for me and I would like to share it with all of you.
It's called the world of shiit theory which we will call from now on the WOS theory.
I theorize that in medical practice there are 2 groups of people: One that lives in the WOS and the other that doesn't.
The group that lives in the WOS is constantly swimming in it with their arms extended trying to drag the non WOS people into their warm WOS.
If you are a non WOS inhabitant then your main goal in life should be to stay out of that circle of misery, just don't let them drag you in.
Examples of WOS inhabitants are abundant and they are everywhere.
The surgeon who decides that a pilonidal cyst is an emergency at 9 pm, the GI guy who decides that an ERCP for chronic jaundice has to happen at 3 am, the vascular surgeon who after 12 hours of trying to revascularize a foot does not give up... all these are examples of WOS inhabitants.
Sometimes you get dragged into their world and there is nothing you can do to avoid it... but you should always be on the alert and try your best to steer clear.
There are many WOS people in anesthesia as well. These are the people who want a stress test before cataract surgery, or want to correct the A1C of 8 before a colonoscopy....
The examples are too numerous to count.
So, my advice is: always categorize people according to their WOS affiliation and try hard not to be dragged into the WOS.
Although it is warm and fuzzy in the WOS, it's not a good place to be.

---

Members don't see this ad.

 

[GravelRider]

So... I have been in this business for a long time and I have come up with a theory that have always worked for me and I would like to share it with all of you.
It's called the world of shiit theory which we will call from now on the WOS theory.
I theorize that in medical practice there are 2 groups of people: One that lives in the WOS and the other that doesn't.
The group that lives in the WOS is constantly swimming in it with their arms extended trying to drag the non WOS people into their warm WOS.
If you are a non WOS inhabitant then your main goal in life should be to stay out of that circle of misery, just don't let them drag you in.
Examples of WOS inhabitants are abundant and they are everywhere.
The surgeon who decides that a pilonidal cyst is an emergency at 9 pm, the GI guy who decides that an ERCP for chronic jaundice has to happen at 3 am, the vascular surgeon who after 12 hours of trying to revascularize a foot does not give up... all these are examples of WOS inhabitants.
Sometimes you get dragged into their world and there is nothing you can do to avoid it... but you should always be on the alert and try your best to steer clear.
There are many WOS people in anesthesia as well. These are the people who want a stress test before cataract surgery, or want to correct the A1C of 8 before a colonoscopy....
The examples are too numerous to count.
So, my advice is: always categorize people according to their WOS affiliation and try hard not to be dragged into the WOS.
Although it is warm and fuzzy in the WOS, it's not a good place to be.

I have a similar theory and it’s about people’s perception of their “cloudiness(?).” We’ve all heard people refer to themselves as “black clouds.” The presumption is that they have bad luck. Somehow trouble always seems to find them and the assumption is that they are just an innocent bystander and victim of some cosmic mayhem in the universe. Well, I’m here to tell you that “black clouds” are not victims of chance events. Black clouds are created. You have total control over your own “cloudiness.” Just as much as people build and live in their WOS, they create their own black clouds. In fact, if you combine both theories, the black clouds tend to cloak the people that live in the world of shiit.

 

[Ronin786]

I have a similar theory and it’s about people’s perception of their “cloudiness(?).” We’ve all heard people refer to themselves as “black clouds.” The presumption is that they have bad luck. Somehow trouble always seems to find them and the assumption is that they are just an innocent bystander and victim of some cosmic mayhem in the universe. Well, I’m here to tell you that “black clouds” are not victims of chance events. Black clouds are created. You have total control over your own “cloudiness.” Just as much as people build and live in their WOS, they create their own black clouds. In fact, if you combine both theories, the black clouds tend to cloak the people that live in the world of shiit.

Oh 1 bazillion percent. The same ones that always have difficult airways and terrible cases because they create messes for themselves.

I see them in the ICU all the time. Attendings whose patients are always so much sicker than everybody else. Yet most times that's because they overreact to the smallest of things and make the patient appear a thousand times more sicker than they really are.

KISS. The best principle to live by.

 

[epidural man]

So... I have been in this business for a long time and I have come up with a theory that have always worked for me and I would like to share it with all of you.
It's called the world of shiit theory which we will call from now on the WOS theory.
I theorize that in medical practice there are 2 groups of people: One that lives in the WOS and the other that doesn't.
The group that lives in the WOS is constantly swimming in it with their arms extended trying to drag the non WOS people into their warm WOS.
If you are a non WOS inhabitant then your main goal in life should be to stay out of that circle of misery, just don't let them drag you in.
Examples of WOS inhabitants are abundant and they are everywhere.
The surgeon who decides that a pilonidal cyst is an emergency at 9 pm, the GI guy who decides that an ERCP for chronic jaundice has to happen at 3 am, the vascular surgeon who after 12 hours of trying to revascularize a foot does not give up... all these are examples of WOS inhabitants.
Sometimes you get dragged into their world and there is nothing you can do to avoid it... but you should always be on the alert and try your best to steer clear.
There are many WOS people in anesthesia as well. These are the people who want a stress test before cataract surgery, or want to correct the A1C of 8 before a colonoscopy....
The examples are too numerous to count.
So, my advice is: always categorize people according to their WOS affiliation and try hard not to be dragged into the WOS.
Although it is warm and fuzzy in the WOS, it's not a good place to be.

I love this.

I would say, however, that WOS can be compartmentalzed.

People can be totally reasonable about a tons of things, then say something that makes you go “seriously?!!” My favorite is when they spew some BS about a drug being off-label so better not use it, or won’t put an intrathecal catheter after a wet tap because of some undefined and extremely rare risk of someone messing with your catheter.

 

[Ashers]

Now, I hold a reputation as one of the worst black clouds in residency because where I went cases followed. No one slept. Attendings didn't want to be on call with me. Residents did because they got more experience. A senior resident who owed a few months because she had kids asked to do an ob rotation with me because she heard I had the general c-section black cloud. She got her general section and then some she hadn't done until that point in residency. I don't know how Milwaukee knew when I was on call as a resident. The cloud followed me until I stopped taking call in 2020.

I was called "Hurricane Ashers (actually my last name)" in residency, and current residents still have heard of me. I've met a few recent grads doing locums who are like, "you're Ashers?!" So and so told me about you!" The OR teams knew if I was on call it'd be bad. One of the scrub techs would always ask me when she saw me. Fortunately, we got along.

I finished residency in 2013. My residency bff was the class white cloud. She slept most nights.

Edit: I've also had people blame me for their bad call nights because I popped up on their Facebook feed. I call not fair to that!

 

[deleted1147063]

Oh 1 bazillion percent. The same ones that always have difficult airways and terrible cases because they create messes for themselves.

I see them in the ICU all the time. Attendings whose patients are always so much sicker than everybody else. Yet most times that's because they overreact to the smallest of things and make the patient appear a thousand times more sicker than they really are.

KISS. The best principle to live by.

+1000. At least one fourth of my ICU work is about fixing the damage done by other doctors.

I always tell people that my CCM fellowship was about learning what not to do, and the more things one does to a patient the more I think that they don't know what they are doing.

Less is more.

P.S. I'm also a famously white cloud, but I find no merit in that. Better lucky than good.

 

[Angus Avagadro]

Now, I hold a reputation as one of the worst black clouds in residency because where I went cases followed. No one slept. Attendings didn't want to be on call with me. Residents did because they got more experience. A senior resident who owed a few months because she had kids asked to do an ob rotation with me because she heard I had the general c-section black cloud. She got her general section and then some she hadn't done until that point in residency. I don't know how Milwaukee knew when I was on call as a resident. The cloud followed me until I stopped taking call in 2020.

I was called "Hurricane Ashers (actually my last name)" in residency, and current residents still have heard of me. I've met a few recent grads doing locums who are like, "you're Ashers?!" So and so told me about you!" The OR teams knew if I was on call it'd be bad. One of the scrub techs would always ask me when she saw me. Fortunately, we got along.

I finished residency in 2013. My residency bff was the class white cloud. She slept most nights.

Edit: I've also had people blame me for their bad call nights because I popped up on their Facebook feed. I call not fair to that!

I don't know if I can beat the FB black cloud. I did have a very similar experience where people would switch call with unsuspecting colleagues after reviewing the call schedule, knowing they were going to work all night if I was on call too. I could always tell when that happened , whenever I arrived and saw the look of disappointment and defeat on their faces. One typical call, we worked all night, and were moving our last case off the table at 0615. The phone went off and a CABG had to come back to the OR emergently with less than an hour in our shift. My CRNA was a very calm ,organized person, who would not say poo, even if she had a handful. She looked at me, OR hat askew, make up smeared, with bloodshot eyes and said, you really are a Sh[t Magnet Dr Avagadro! My legacy.

 

[Ashers]

I don't know if I can beat the FB black cloud. I did have a very similar experience where people would switch call with unsuspecting colleagues after reviewing the call schedule, knowing they were going to work all night if I was on call too. I could always tell when that happened , whenever I arrived and saw the look of disappointment and defeat on their faces. One typical call, we worked all night, and were moving our last case off the table at 0615. The phone went off and a CABG had to come back to the OR emergently with less than an hour in our shift. My CRNA was a very calm ,organized person, who would not say poo, even if she had a handful. She looked at me, OR hat askew, make up smeared, with bloodshot eyes and said, you really are a Sh[t Magnet Dr Avagadro! My legacy.

As a CA3 taking 1st call night float for a week at the trauma center, I had a CA1 who was very eager at the start of the week tell me, "even if you don't need me, call me for any case, just so I learn!" At the end of the week, she told me, "if you don't need me, don't call me." She had done a bleeding laryngectomy by herself amongst other things (as just one example) because I was in a dying trauma with the attending because the home call resident and attendings weren't answering their pagers to be called in as back up. We had an amniotic fluid embolus that we had to send people to help with because L&D needed more people, dissecting aneurysm at the same time as the AFE. The bleeding laryngectomy and trauma that happened at the same time as an emergent IR case were on Christmas Eve.

I always took call on Christmas for better call schedule negotiations. One year we got a chainsaw to face. I didn't know why someone would be using a chainsaw on Christmas. (Christmas tree should be cut, and i don't think it'd be taken down until after.)

Separately on OB, an attending went over the worst calls she had had on the previous few years because we had just finished one of the worst we had both had. I was on call for all of them.

I told people to stop blaming me for their bad call nights because I showed up on Facebook. People in different specialties were doing it too!

Now I just hear about people having an "Ashers-like night."

 

[pastafan]

Not my circus, not my monkey.

 

[abolt18]

White cloud here. I was sleeping through probably half of call nights as a resident. I honestly was wishing for some of the crazy traumas and stuff that my co-residents described.