Thursday, September 22, 2005

Don't Say I Didn't Help

As thousands of fourth year medical students struggle with their personal statements for the upcoming match I thought I would take this time to suggest some phrases that may catch the eye of your favorite program's director and raise your chance of success.

Attempt to build these phrases into your personal statement depending on your choice of future profession (I take no responsibility for the fool who actually takes me seriously):

Medicine: "I really love treating chronic disease. I particularly enjoy Diabetes. It always fascinated me how blood glucose can go up and then down and then up, and then down. I find it particularly interesting how certain medications will help and then stop helping, and then I add another medication, and then that will help, and eventually it will stop helping. Sweet! (I mean that ironically)"

Surgery: "As a child I always wanted to cut things open. Especially animals and dead meat my parents brought home from the butcher. I remember those trips to the butcher shop. The smell of flesh and rotting blood reminded me of daisys blooming in springtime."

Radiology: "I equate x-rays with human nature in that they look through our exteriors and into the heart of the being. As a child, I always wanted to have x-ray vision. Especially during my puberty stage."

ER: "OK, let me say it like it is. Yes, I'd like to forget everything I learned in medical school. I don't like patients and this is a great way to make tons of money and have absolutely no responsibility what-so-ever. And the't get me started on the shifts" (scathing review for this one will appear in the comments section and at Gruntdoc and at Symtym, I imagine)

Dermatology: "Skin, oh warm..and...protective...and...colorful...and it changes colors, say when people suntan. Which they shouldn't do...I love skin, did I say that already"

Neurology: "I was born to test reflexes. As an infant my parents can recall how I quickly took to the hammer. Instinctively, I would chop away at the extremities of my siblings, swinging wildly at their knees and ankles. Today, as I strive to finance their evergrowing need for assisted mibility devices I realize that the field of Neurology is my true calling."

Pathology: "As a second year medical student nothing could top the rush I had when reviewing a slide of a cirrhotic liver or an enlarged spleen. The pathologist serves as the doctor's doctor. And the doctor serves as the pathologist's doctor. Such is completed a neverending circle of interdependence the likes of which I can only dream of."

Plastic-Surgery: "I dream of a better looking world"

Orthopedics: "This table on which I write my personal statement is lopsided. is no longer"

Urology: "I always felt people deserve two chances. Upon learning that there are TWO kidneys I understood my dreams had been realized. Oh, and urine...oh urine..."

Feel free to use any of the above in your personal statement. You need not thank me.

Thursday, September 15, 2005

A Small Percentage

I've been waiting for my two patients to show up for thirty minutes now. the only human contact I've had was a case I'm following. Today's case decided to discontinue all of his medications because he heard they could damage his liver.

"where did you hear this?"

It seems pharmaceutical advertising is having the beneficial effect of convincing patients that Death is not a suitable side effect. This makes the third patient this month who self discontinued his own medication. Well, you know what they say, patient rights.

"you know side effects only happen to a small minority of the patients taking a certain medication"

I bang my head at the wall, smile, bang some more. Why do they come to see me.

I've find this concept amazing. They come to see me. I give recommendations. They completely ignore my recommendation. And then they come to see me at the next appointment. I do my voodo spell, they feel all better. Completely ignore my recommendation.

"but doc, I don't want any medication that can damage my body"

And the search continues for the perfect medication that doesn't exist. I explain that it's a tradeoff. You take the bad with the good and you have to weigh the risk versus the benefit. I explain that I didn't get any last night, the wife had a "headache", the kid didn't sleep, she has a fever, I couldn't sleep. Please take your medication. I bang my head some more.

Thursday, September 01, 2005

I Am Back, Baby!

So, It's been a while.

September first today and this blog is 1 years old. It's officially the longest hobby I've ever kept. Judo lasted 7 months before I walked out in the middle of a session, learning french lasted 4 months, painting 2 months, tennis 5 months and the I can go on for the rest of this entry but I'll spare you.

Although I've been silent the last month I've been intending to get back to writing. Some really brutal rotations interfered. I'll post about these really soon. I also had some personal difficulties (nothing extremely serious) that I wanted to deal with and I needed a break from the blog or at least from the commitment to post.

Third year is so different than the second, I think mostly in the mindset. I'm actually starting to think about life as an Attending, finding a job, passing the Internal Medicine boards. Do I want to do a fellowship or not? If you remember I was a SYR (Second year reject) and so now I'm thinking about reapplying. I'de like to try for Cardiology. It would mean that I'd have to be a hospitalist for a year or two but the bright side is that I'de make some money before starting another slaveship fellowship.

Jordan is wonderful. She is becoming more interactive every day and she's such a daddy's girl.

I hope everyone has a wonderful Labor Day Weekend. I'll post when I return.

Some Responses to INTERNal Suffering

It seems that while I was away some of my readers got a chance to sift through the Friday Ten Random Intern scut posts. In fact, some bacame upset with my impatience, my lack of respect for the fresh M.Ds. Responses included some of the following:

You are such a narrow minded, obnoxious jerk to take revenge on the hapless intern. Or are you taking it out on the weaker party for what you suffered when you were an intern yourself?

Wow, I hope this all makes you feel better about yourself

Reading your blog entries over the past few months, it doesn't seem like you have much respect or camaraderie for the nursing staff you work with- why is that?

I would like to remind everyone that the "hapless" intern discussed is a 25-30 year old adult who has an MD.

Each Resident cares for twenty to thirty patients for whom he is directly responsible. That is a lot of patients, think about it.

The math: Resident gets one hour to round on everyone so that's almost impossible. therefore, I am dependent on my interns to report back about the sickest patients. Since each intern cares for only 5-10 patients they should be able to see them all before rounds and warn me if a someone's condition is worsening.

The "hapless" intern (remember, 25-30 year old with a "medical" degree) forgot to mention that his patient was UNRESPONSIVE!!!!

That is a pretty large "forgot". That's Mega-LARGE.

Of course I spoke to him about it, of course I pointed out the obvious. No, this is not about how I suffered when I was an intern because my internship was rather easy. This is about responsibility. He just started his internship and I felt he was a little too lackidazical so he needed to be put back in line.

As for respect for the staff. There are good nurses and bad ones. There are good doctors and there are lazy doctors. I know who's who.

What I am trying to get across is that in our line of work mistakes or forgetfullness can have extremely serious consequences. Once you've witnessed a few of these you never really think about this job the same way again. If that's what I have to do to make sure the "hapless" MD understands that "nonresponsive" is a serious medical condition than that's exactly what I'll do!