Monday, October 29, 2007
...anyone know a good lawyer?
*** Update: I was elected into AOA! Found out a couple days ago, but have been too busy to post recently.***
Friday, October 26, 2007
The poll is a little down on the sidebar, below the disclaimer. You can vote as often as you want.
Between 1st and 2nd year I had a research project that fell through. Since this occurred late in the year I decided to just get a job and work over the summer. I don’t really like research anyways and my Orthopeadic frenzy had significantly subsided so I didn’t feel research was absolutely mandatory at that time.
I returned to work for the company I’d been with prior to med school and was given a job in the backroom where I would stock and pull items for the salesfloor. This entailed some heavy lifting which aggravated my back already damaged from poor weight lifting during high school. I began taking Aleve in the mornings before arriving to work in order to move better and decrease the stiffness I was appreciating in the morning. This seemed to be working well until 4 weeks into the job.
One Saturday morning I awoke with a great deal of pain. I found that I had a significant amount of trouble getting out of bed and walked bent over since straightening caused a great deal of discomfort. Some NSAIDs and attempts to stretch out my back resulted in little improvement. Deciding to rest my back, I laid down for a period of time, hoping for a “miraculous” improvement. Instead my decreased range of motion and pain only increased.
I found that I couldn’t stand up at all. In fact, trying to walk resulted in me crying out briefly a rather nasty curse and falling to the floor. Wife found me crawling on the floor, unable to get out of this position, heading to the living room to sit. She decided that there was something very wrong and that I needed to go the ER. I resisted, thinking it weak and pointless; after all this wasn’t an emergency – right?
She persisted and I finally caved. The ride to the ER was torture, with every bump knifing through my back. In order to decrease the pain I was in the fetal position the whole ride. On arrival I tried to get out of the car, only to fall on the sidewalk from the pain. Wife ran in and found a volunteer who brought out a wheelchair. Humiliated, I again resisted, but eventually had to sit and be wheeled into the ER. They wouldn't let me crawl.
The staff was courteous and quick (not very busy at that time of day), but I continue to feel that they thought me a druggie. I rated the pain a 5/10 since I didn’t want the stigma of being a “seeker” and tried to be as helpful as possible in relating my history, but when everyone who wants drugs mimics this kind of pain I just knew they were talking about the “drug seeker” with lower back pain in room 12. It was frustrating to know that I was in very serious pain, had fought seeking treatment, and just wanted to be able to walk without severe shooting pain, but that because of parasites in society I was most likely considered an addict.
After some x-rays, a perfunctory exam by an NP (I wasn’t even taken seriously enough for an MD to waste his time on), and a shot of narcotic in the ol’ butt, I was discharged to follow up with my doc.
The narcotic and muscle relaxants worked wonders, allowing me some increased motion, but I was unable to return to work. An MRI done later per my PCP showed osteoarthritis of the lumbar spine with small herniations. I was informed that the kind of work I was performing was out of the question with my back and physical therapy was eventually needed for me to regain my normal mobility.
Now, I tell this story not as a lesson to be learned for all ER docs. Rather it is the reason that I find so many of the patients I’ve seen - who claim 10/10 pain, want Lortab or Dilaudid since they have “allergies”, and abuse our system - completely abhorrent.
It is the reason I decided to opt out of Emergency Medicine. I was just too jaded. It is because of patients like these that those who truly need the services of the ER are often initially considered addicts. It's because of asshole patients, cyring wolf constantly, who abuse our system that ER's are practicing defensive medicine. It's the reason I think ER's should get a free pass for all frequent flyers who they don't believe who present with an actual problem. You weren't believed? Too fucking bad!
Thursday, October 25, 2007
“Wait a damn minute!” I said out loud to no one in particular. “I was going to dump you!”
I sat there for a few minutes, pondering over the short, formal, and quietly condescending letter informing me that I wasn’t good enough. The tone was professional, but at the same time I perceived an underlying sensation that they’d looked at me and scoffed.
“What the hell does he mean applying here? Doesn’t he know we’re [Rocky Mountain Program]?! Begone with all inferior applicants!”
This letter was unexpected. While not being completely egotistic, I did feel that the programs I’d applied to would be offering me interviews – every one of them. I felt that I had a notable application which, like the airbrushed women on magazine covers, made me more appealing than perhaps in real life. At least you'd want one date before deciding otherwise.
In order to stop this from happening again I withdrew from another program that I’d grown less fond of over the last month and had been harboring thoughts of disatisfaction. I knew full well that the distance and cost was going to be more than I wanted to take on and had planned, if invited, to regretfully decline anyway. Instead I drew first blood. I didn’t want to be the loser in that break up as well.
Wednesday, October 24, 2007
For me it’s always been cumbersome and rather weighty around the neck. After 12 or more hours that relatively light piece of equipment begins to bore into the back of my neck, causing stiffness and discomfort. For a while I tried to just keep the ear pieces wrapped around my neck while the heavier piece dangled around my stomach, like a tie. However, apart from feeling like I was being strangled, I found this quite absurd when trying to write and bending over a patient during exams. Swoosh. Careening completely out of control whilst knocking the shit out of a patient or two.
I’ve seen those who favor wrapping their steths around their waists, using the drawstrings of their scrubs as a type of belt. It seems, however, that unless you are a tall, yet petite female, a very effeminate male, or have an instrument that’s so absurdly long you couldn’t hear a train while auscultating this just isn’t feasible.
There has been a resident or two whom I've seen wear a type of device they clip onto their belt or scrub pants that allows you to “holster” your steth. Apart from being a little odd looking I found this a fantastic device; keeping the cumbersome, yet completely necessary tool at one's side without taking up much space. Considering this, I have still not procured one for my own use - yet.
What I currently prefer, based on a surgical resident’s insight that "surgeons don't wear stethoscopes", is to just simply wrap it around itself as demonstrated below, and stuff it into my large white coat pocket. Out of sight, out of mind.
Now there are some disadvantages to this - like getting the ear pieces hooked on a piece of furniture and getting pulled to the floor as you run for that code, or eventual damage to the tubing necessitating another purchase - but for the most part I find it a helluva better alternative than wrapping it around my neck or having an episode of vasovagal syncope from bilateral carotid massages.
Tuesday, October 23, 2007
As we have often done recently we talked about the discouraging condition we find ourselves. Unsure of what’s coming, our future, and the potential of any stability that we once knew I find myself wishing it was March 20th already and I had opened my letter just to have this done and over with.
The season of interviewing is at the worst time for us – retail being extra hard on their employees during the 4th quarter (aka The Holidays). Comments of a job “required” and “puts food on the table” were lobbed at me like dangerous hand grenades. One wrong move and it could all be done.
I tried to carefully navigate the mine strewn waters, avoiding my innermost desires to become defiant, upset, and declare my innocence in this plot against her. But I remained still, listening to her frustrations paralleling mine, all the while knowing that we’re both right while both being wrong.
For what it’s worth, 8 years have come and gone with her by my side and only one of us has “grown”. Long ago we agreed that her dreams had to come when and where they could, but that this path, the 12 years of medical training, was first and foremost. This was discussed pointedly before we married, before Daughter was born, and before residency interview season approached.
This still doesn’t assuage my appreciation of her sadness and feelings of imprisonment in her job. Requisite, though it may be, every day slowly kills her. Hopefully as I progress in residency and Daughter enters grade school she can begin to branch out more, find what she wants, and discover her passions. Otherwise what’s the point?
Monday, October 22, 2007
Our apartment smells great after brewing a T-disc and it tastes grand! No need for creamer at all. Just a little sugar and you're solid.
If you have the chance to procure one, I highly advise you getting a Tassimo coffee machine. They are great and have a lot of good options – kinda pricey, but well worth it.
Yesterday the class of 2008 was asked to “vote” and comment on whom they feel should be elected into AOA. Goddammit.
Unfortunately I no longer have the events of my first nomination, but if you can remember, back in March I was freaking out about my class voicing their opinions on our AOA candidacy. This is based on several factors, but the fact that I ran for an executive office in our class 2 years in a row and was soundly defeated each year did not lend itself to a feeling that my class was enamoured with me. Since I had contact with limited people last year I hope some of those feelings have lessened - maybe.
Personally I find it stupid that the class gets to vote at all for an honors society. There are people who hold grudges, don’t like people for various reasons, and are vindictive assholes who can make you look bad with their comments.
From what I’ve heard there are 8 slots open this year with 16 nominees, some from last year, but many new. I’m glad to see that one of my friends who wasn’t nominated last year was on the list, but saddened to see another nominated last time absent this year. I don’t know why he was dropped, but I think he is a helluva lot better than a couple students nominated.
Anyways, hoping for a better outcome and my class to be kinder to me this year.
Friday, October 19, 2007
Because medical students are already walking the financial tightrope there are loans out there for travel as well as relocation expenses. These are private loans that can be deferred during residency and a lot of students take them out in order to interview at enough spots to increase their chances of matching. Many students take out between $2,000 - $7,000, but a student I spoke with last year told me that she needed over $10,000 to interview! Without it she wouldn't have matched - lots of flying in December apparently.
So I've been trying to obtain one recently from various lenders and have been turned down repeatedly. Apparently they consider the fact that I have a large amount of debt including some from credit cards (alright – a lot of credit card debt) and tuck tail and run from this credit nightmare known as MSG. So I've been pulling my hair out trying to think what to do and what my best options include. Of course there’s the option to just get a cosigner, but that’s just so demoralizing.
Here I am, almost 30 years old, less than 7 months away from being called “doctor” and I still have to call mommy and daddy for help. Embarrassing and irritating all at once. I wonder if other students have had this trouble. If I’m not able to get a loan I’m going to be very limited in where I can apply and basically run the risk of “suicide matching*”.
So now I'm just going to have to bite the bullet, call up my parents, and ask for some help. Up till now I've been able to do everything on my own and this just hurts the ol' pride a little. But it's necessary, so I need to get over it.
*Term used by med students and residents when talking about interviewing at 3 or fewer programs. The more you interview at and rank the better your chances to match – law of probabilities.
Thursday, October 18, 2007
And here is the driver's side door handle on my car. Broke off a while ago during winter - just popped right off when I pulled on it in the morning. Lovely. I just absolutely love this vehicle (sarcasm - in case you couldn't tell). Everything has fallen off, broken, or just looks bad. Everything that is except the engine. 125,000 miles and it's running great. I hope to get 4 more years out of it for residency purposes. If not then I'm buying a clunker - no more new cars for a while. It's been nice not having a car payment.BTW: this car is almost 6 years old. I drive a lot - especially when I was working and going to undergrad - over 100+ miles roundtrip 7 days a week for 1.5 years! I think that's where most of the miles were added on initially.
Usually I think that Viggo Mortensen does a great job and Naomi Watts has been quite good in some recent films. However, despite the movie being pretty interesting I’m wondering where we’re going with R rated flicks.
This is based on the high degree of nudity, sexually explicit scenes, and description of rape that the movie seemed to center around. I honestly felt like I was watching soft-core porn at sometimes and the pseudo-homoerotic naked steam-room fight sequence was a little more than I wanted to see. Beyond these troubling scenes I felt the movie was quite well done and could have garnered a 4 or 5 rating, but the overtly X-rated feel that encompassed a great deal of the film forced me to lower it down to 3/5. I just can't overlook the feelings I got watching.
So, with that being said I'd like to ask: are we getting to the point where R will soon by X? Is it necessary to show such extremes when trying to make a statement about criminal behaviors? For whatever the reason I think that some filmmakers are pushing the limits on what should be shown. I wasn’t prepared for what was shown at points and it sure as hell wasn’t comfortable watching that with Wife.
Tuesday, October 16, 2007
What's sad about this is the distance that seems evident between your friends and you. That relationship, developed during stressful times when you could discuss your hassles, irritations, and the like over dinner and movies, is being broken. Now there's really not a lot of people that I can talk to who will understand - even if they are here - because we're on different paths, or in different places, or have different mindsets.
Consider the person who is freaking out over their Surgery sub-I who tries to relate their frsutrations to another who's upset about their Peds rotation. At one time or another these two could have talked, given some pointers, and been more beneficial to each other. Now it's harder.
Sub-Internships have different feels depending on where they're done, what specialty you're in, and whether you truly want to be in that field or are just "being a tourist". I've had some phone calls and run-ins with friends recently and have noticed that I have a hard time relating to their pain, anxiousness, etc. because I've nothing to compare. The same goes for them, I'm sure. What the hell do they care if I feel like shit if I didn't get an IV, or fucked up a patient encounter, or something?
I'm really missing the interactions I had with people the last 3 years. I liked our movie and game nights, dinners, and bar jumping after a hard exam. I think that more and more I'm realizing that, while we'll always be friends and will hopefully keep in touch, we're headed on different paths, growing apart, and ultimately breaking away from the group to accomplish "our goals".
For someone like me who doesn't make friends easily, it's hard to come to grips with the fact that I'll have to go through this process all over again in residency.
What concerns me, though, is that the rotation I did where I felt I wasn’t helping myself out has yet to invite me. I was told that almost anyone who does a rotation there is offered an interview, unless they completely sucked, and so now I’m worrying.
I was given a good review at the end, but I think I need to call them up and see what might be missing in my application (like the dean’s letter – perhaps they wait for those before offering?) or if they were just not interested in me after sucking all over the place for 4 weeks. Probably not the latter, but it still crosses the ol’ mind.
I’m also concerned because, though I’ve received 5 prelim offers none have been from the 2 programs that would keep us around Stepson for another year – if that were needed. So I worry. Not necessarily needed, but I still do.
Friday, October 12, 2007
I feel sorry for some of my peers who are alone in all of this. I’ve been able to deal with the complexities of medical training with a family who brings me strength and diligence while others have no one (relatively) for whom they’re responsible.
There’s nothing like the knowledge that someone other than yourself counts on your continuous determination, abilities to accept ridiculous situations, and the learned response of holding one’s tongue while being chastised for an unforeseen circumstance to keep you on the path towards the MD. I think without those faces I hope to see at the end of my days I might have said “fuck it” a few times. But then again, perhaps not.
What I’m trying to say, in the same alcohol-fueled way someone who’s had one too many tries to be eloquent while making a point, is that being married during these 4 years has been hard, terrible at times, but overall the most wonderful damn thing I’ve ever done.
If I’m nothing at all, besides a husband and father, then I’ve succeeded in life. I’ve felt for some time now that the greatest failure one can be is to fail as a partner and parent while the greatest accomplishment is to be a wonderful family man. It was for this reason that I left surgery and decided, once and for all, that Anesthesia would be the best fit for me.
Some people think that I’ve given up on a dream, but I think I’ve realized it already and have just made sure to always be there for it.
For one thing it’s not the doc who’s got a bad heart from increased salt intake and fatty foods, bad lungs from smoking 2 packs per day for decades, high cholesterol from too much fat-fried chicken, and the other various diseases that I’m so often seeing. It’s the patient. It's essentially their fault they're in this predicament and they need to take some responsibility with their care, their medicines, and to ensure that every visit is purposeful – not a waste of time for both involved.
Showing up, not knowing why you’re there, not knowing what meds you’re taking other than what they “might” be for, and getting all uppity because we’re asking you what your other docs have been doing or what a test showed is stupid. Just because you think we should have the results doesn't automatically mean we received them, nor does it magically make them appear.
You need to take some effort and ask what was seen, what it means, and what needs to be relayed to your primary physician. Not doing that...well... what kind of care do you expect to get? It’s your life - make an effort to care about it and it makes your doctor's job a whole lot more easier as well.
Thursday, October 11, 2007
Wednesday, October 10, 2007
This is a view of the hospital from the foothills of a mountain directly behind it (great for hiking after a long day). The city center is located beyond the building - obviously not a huge thriving metropolis.
A not so pleasant view from the back of a 48 seater airplane that took me on the last leg of my trip back home. The two "modestly proportioned" individuals had to be moved to a more "spacious" seat.
Tuesday, October 9, 2007
What has been amazing to me, after getting excited about yet another invite, is the complexity of scheduling. No one seems to work together very well, programs that are in within 100 miles of each other don't have dates close together, and some programs only have 3-4 days that they interview at all. It's crazy, confusing, and wonderfully unknown.
I plan on most being in December, if I can, since that's my month off. Wife might not like the conflict with her work schedule, but there's not much I can do - it's the time of year that interviews are offered. Don't hate the player - hate the game.
I think I'll accept a couple more Anesthesia invites and 3-4 more prelim positions before beginning to decline. It's just going to be too expensive if I do more than that - plus that should be a decent amount to get a good rank list.
Monday, October 8, 2007
You see, he was an organ donor, and being a healthy male without any diseases (despite an apparently bad heart) he was a gold-mine. My uncle and aunt had opted to dress their son for his funeral, but were unprepared for what they found. Their description of the event, the nightmares it gave them, and the complete lack of “comfort” that my uncle had felt while getting his dad ready for burial was shocking to me.
His body was nothing more than pipes, plastic coverings, and a shell of his former self. His eyes were taken, his bones, his skin, his organs…everything had been removed leaving merely a morsel of his former self. My uncle said he wished that they’d cremated him instead because it was such a horrific experience.
Being an organ donor myself I find it hard to think about this and the toll it took on their grieving minds. Wife is very against my donating for fear that I wouldn’t be whole anymore. I’d often thought of this as silly, but have since reconsidered. Could I force my wife to bear that burden my uncle and aunt faced? Is it selfish to want something like that when it can damage your loved ones?
Whatever it is I have thought a lot about donating. I’ve not changed my card, but I continue to ponder what I should and shouldn’t donate. It’s a great choice, but far less simplistic than I’d ever considered.
Thursday, October 4, 2007
I am trying to keep on the down low a little and would appreciate no mention of the school or city and/ or state where we are located. It kind of narrows down who this is when people can identify where I’m at and what school I’m affiliated with.
Keep on reading, but just be a little more cautious when commenting – thanks a ton.
Wednesday, October 3, 2007
This can only mean one thing: He is a tool.
Worse yet - he parks in handicapped parking with a placard. I guess if being an idiot is a handicap then he's more than welcome to the spot.
Thanks to a certain anon commenter I’m freaking out now!
Seems like everyone on SDN has 50 interviews already.
I hadn’t delved into the world of SDN’s Anesthesia forums – yet – for this interview season. I’d read a little here and there prior, but hadn’t taken a gander since submitting my application.
Now seeing how many people have interviews, where they’re getting them, and the fact that I’m sitting on just one for an Anes program and one for a prelim year has really shaken me.
Thankfully we only had a half day today so I was able to go to the school and talk with the registrar’s office. They assured me (heard that before, but I’ll bite again) that they’d get the issues taken care of before the week was out.
It just scares me to see that a couple programs I’m interested in already have 10-15 SDN members with interview invites. How many more have they offered interviews to? I'm getting cut out here because of my school.
I’m competitive, with good Step scores, a very high GPA, but still continue to wait because my school likes to play turtle.
In this race the hare wins – every time.
Tuesday, October 2, 2007
We did have the living room, but that was lost because of sleep deprivation related to snoring. So now we’re all cramped into the kid’s bedroom with an air mattress stuffed between the two beds while Wife’s parents take up the queen sized bed and our couch.
Just a couple more days though…couple more days.
Monday, October 1, 2007
Essentially the main point I’ve taken away is that programs have a certain amount of time that they can run freely, undisturbed by the ACGME, and teach their residents as they wish. When the ACGME comes around programs will often try to make themselves look great, touch up on areas they’ve not looked at, and threaten their residents to lie on their behalf (kidding but serious at the same time).
If a program has a shorter time between these visits it suggests that there’s something amiss with the resident training experience: hours violations, not enough patients or not exposure to certain diseases, not enough teaching or conferences, etc. In essence it is a gauge to see how well a program has done teaching their residents...but won't allow you to see what the problems were if a program is on probation and such.
For instance, in my school I think a lot of the problem lies in the amounts and types of patients being seen. Because the residents have to travel a lot to get a more “well-rounded education I can understand there being some issue with not getting enough patient interaction or not enough procedures, etc.
Another program might have hours infractions, residents that decide to go against their program and rat them out for abuses etc. It is just a tool to help you decide where and whom you decide to rank when it gets to that time.
I for one would not skip an interview at a place just because they’re a little light on cycle years – unless their history shows small cycles. If that’s the case then you can bet that might not be a great program and you should probably look elsewhere – or use it as a safety net.
And yes, to HBCU - I have received some interview invites, but not a lot. I'm still battling with the school to let me know when they plan on releasing the class' transcripts since I've been told none have been sent out yet. So hopefully when this goes out I'll see more.