Hoping Beyond Hope

There are several items that I hope don't happen - even though I know there's a very good chance that they'll occur anyway. Like gas stopping its ridiculous and out of control move towards $4 and $5 a gallon.

What I really hope is just merely a rumor mill is this, a cut of work hours from 80 to 56 per week. I found this link from Medschool Hell - who, naturally, is in support of the move.

I've already blogged about this topic in the past, so I will allow you to read over that post and refresh yourselves. Clearly I do not believe cutting the work-hours anymore will lead to significant changes for the better.

What it will do is just lengthen an already long process with residencies adding additional years, create further punch-clock mindsets in residents entering the work-force, and leave a large topic of discussion still on the table: debt repayment.

Hell, as it is the government has been trying to get underpaid residents to pay back on loans by reducing the years that they can defer or forbear or simply removing the option of "economic hardship" from the list of reasons. So adding more years will do what? Create more financial burdens, reduce the chance to moonlight, make residency akin to a 40 hour a week job where-in doctors will become even more hesistant to do anything past 5pm? Is that what we really want?

Think about it before you'd say that working a few less hours isn't that bad.

Haven't Earned It

A recent conversation that Wife told me about went something like this:

Wouldn't know their ass from a hole in the ground guy: "You know you're husband isn't a doctor yet. Just because he's graduating doesn't mean he's a doctor."

Wife: "Umm, yeah he will be. He's getting an MD in a couple weeks. He'll be called doctor by everyone including patients, nurses, doctors, etc. He will be a doctor."

WKTAFAHITGG: "Well, he'll be called that, but he's not a real doctor. He hasn't put in his time yet. And I don't think they should be allowed to call themselves doctors either - it's like lying to patients."

Wife: "What the hell do you think 4 years of medical school is if not putting in your time? Just because he has to do a residency doesn't mean he can't be called doctor."

WKTAFAHITGG: "I bet he's going to get a real fancy-pants car, isn't he?"

Wife: "No, he doesn't like cars that much and would prefer to drive his for as long as it will allow. Then he might get a truck or something."

WKTAFAHITGG: "Yeah, so he can dump your body after he's found a few nurses to cheat on you with."

This was an actual conversation that Wife told me about while dealing with a vendor at her job. I have no idea why the guy is saying these kinds of things, but I warned her that if I ever run into him we're having it out. He's an ass, has been for too long, and this last bitty broke the camel's back.

It's like he thinks we're fighting over the same woman - who is MARRIED TO ME - and he feels that downplaying any accomplishment we've had will earn him points.

The other fact that just chafes is that he felt I hadn't "earned " the right to be called doctor. Then what the fuck is medical school for? What is the purpose of any post-graduate education that bestows a doctoral degree on someone if they haven't "earned it"? Just because he clearly feels inferior doesn't mean that 8 years of higher education doesn't count for something.

I'm serious - I'm going to have it out with him should I ever see him. Enough's enough already.

Sex, Drugs, and...

I knew that most drug reps were full of it before I started rotations. Working in an outpatient clinic as my first exposure to real patients during 3rd year was not completely eye-opening to their ploys despite this being an first interaction with them as well. I was shocked to see, though, that the office regularly received anywhere from 3-10 a day with the majority of female reps wearing outfits that were intended to attract the eyes in “sublime” locations (some were guys dressed to the nine's who didn't exude as much sexuality as their female counterparts). Additional interest developed from observing those who would regularly purchase lunches wherein they'd give "lectures" to their captive audience. It seemed like a Hollywood cliche gone awry.

This was, in all actuality, one of the worst I've seen in the last 2 years, but variations are regularly presented - and in all specialities.

Yet, until a few days ago, I was a little murky on their education.

That was until a rotund, bleached-blonde, large-breasted woman who, while wearing an overly-tight blouse to accentuate her natural gifts of adiposity, tried to hock a statin. She began by introducing herself, her aspirations, and educational background. I can tell you that a BS in biology and an MA in liberal arts do not impress me when it comes to pharmacology and her credentials didn't extend beyond. Since I graduated with a BS in bio and could have graduated with that liberal art degree as well – damn near minored in it from a community college before deciding to go pre-med – I thought it mildly amusing that she was here to "educate".

But that’s OK – because rather than muddle her way through a memorized market campaign, she brought a video to deliver the information! A room full of residents, watching some hacky, 3-D video that was clearly marketed for the public. Embarrassing. But at least the food was good.

So now, armed with more than enough information about drug reps, I feel very little sympathy when I purposefully evade their handshakes, avert my eyes from their amply laden bosoms, phony smiles, and well-tailored suits, and eat their free lunches guilt free. All the while completely ignoring the rhetoric they spiel so blithely.

Just Had to Say It

It actually irritated me a little that someone would, anonymously – like a troll, suggest that I was second guessing my choice for residency. In part because they completely missed what I was trying to write about, but more from the idea that I was having some kind of reaction formation about choosing anesthesia over surgery.

I made the decision early in 4th year. Up to that point it wasn’t that clear – since I’d only ever had very minute experiences with anesthesia, but had multiple and impressionably profound moments of surgery throughout the previous 3 years. It’s always easier to believe that you’re fit for something when you get more knowledge about a field – plain and simple. Once I had a month of anesthesia under me my choice was not that hard.

But it is true that I also made the choice based on a desire to be with my family. An desire that didn't seem as feasible the more I was able to perceive resident and attending surgeons doing very little with their kids and spending countless hours at the hospital. Yet someone feels that I am trying to create a negative attitude about surgery simply to remind myself why anesthesia was the better choice. I tried to ignore this absurdity for a time, but it’s just gotten under my skin and I feel the need to just say "fuck off"! And that’s enough about that topic.

****

On a different note – I have realized that I will suck starting July 1st. Two days in the ICU have taught me that I unquestionably know dick. 4 years of med school and I still suck my thumb when confronted with sick-as-hell patients.

Wear Green and Pray

Back from vacation – visited the grandparents and spent a lot of money. It was fun and the kids were glad to see Wife’s parents again…it’s been a while. Can’t say that I’m really rested, but at least I had some time to not think about the match…which is, BTW, today…and I’ll find out about at 11 am.

Wife asked this morning for me to call her when I found out. She asked: “What will you do if you don’t match?”

Of course I instantly and with wide eyes told her to not even think such a thing.

“Are you superstititous?” she asked, incredulously.

“With medicine you have to be. A couple call nights where you discuss how slow it is only to get dumped on will make you change your thinking. Don’t talk about it. Don’t acknowledge that it might happen – then it will.”

Wise words indeed, if not completely based in magical thinking. Personally I think dragons and witches exist and that dwarfs are sissies.

Anyway, let’s stop talking about it. I’m starting to get worried. I'll update with the result later on.

So, after a week in Little Mexico (TONS of Mexicans in the city where grandparents live – about 50% of the signage was Spanish-only) I came home to a dead car. It wouldn’t turn over and I felt it was a battery problem. As I went to get it out of the car I decided to try once more and found that the car started without problem. Hrmmm….

After some detective work over the weekend I found that the battery is fine, but my connector to the negative terminal has cracked and doesn’t form a tight fit anymore. In case you were wondering, Hyundai’s have a combination of clamps for the positive and circular connections for the negative terminal. As of yet I have no idea how to fix this myself. It looks like you could just buy a part and plug it in, but then again you may have to change the entire cable – which I wouldn’t be able to do. Thus far I’ve had to push on the connector or wiggle it a bit to get the car to start more often than not. It’s not been fun.

Later today I’ll go and ask my local car repair store how easy it will be to fix, since I’m not very mechanically inclined. Perhaps I’ll even invest in a repair manual, since I’m sure there are things I can do, but just don’t have the proper guide. What I don’t want, is after spending a lot on that vacation, is to go to a mechanic and pay out the ass. Why can't I barter their price down like insurance companies do for doctors? Hell, only suckers pay what they're asked to pay for services rendered.

Not A Real "Doctor"

Dr. Jarvik is not a real doctor - at least in how the Lipitor ads were trying to make him appear.

Although he has a medical degree, Dr. Jarvik is not a cardiologist and is not licensed to practice medicine.

Learning about his history earlier when he began hawking the drug instilled in me the desire to never prescribe it. But at least now Pfizer has pulled the ads and I won't have to look at him talking to "real doctors" in the hospital or running with his goofy looking kid.

Ah, Dr. Jarvik. How you will not be missed.

Power Whore

There’s something about power that makes people crazy. The other day I had to take a senior OSCE that was supposed to help us get ready for Step 2 CS. However, many of the participants that day had already taken and passed the exam, therefore making this just another useless exercise. To add to this day was the fact that Wife was trying to get seen for an illness and I wanted to be there, but couldn’t.

The day started out on a bad note – those in charge were running around, barking orders, and trying to look organized while they were, in fact, the opposite. Threats of 5 points off the total grade were tossed at us because some students didn’t bring more than a stethoscope. The 10 students in attendance tried to remain in good spirits, regardless of the absurd nature of the requirement, but soon realized that we were dealing with power whores and this would not be fun.

The man in charge of the standardized patients was by far the worst. He actually believes he is a doctor – though I’ve never seen any proof beyond his proclivity to wear long white coats while he yells rules at students. He proceeded to yell at us about everything, claim that we weren’t being “professional” (once again, I completely hate it when anyone uses that as an excuse to blame students for being human), and told us that no one could talk. At all.

“No one should be talking. This is a serious exam and if you fail because you can’t keep quiet and remain professional, well…that’s on you.”

“Excuse me! I’m talking. Table all conversations!”

Various re-utterances were heard of the above for almost 2 hours while we were oriented. Yes, it took them 2 hours to get us through the orientation. We had 10 cases to get through at 25 minutes a piece. Everyone of us knew that it was going to be a long day. Preparation for Step 2 CS? Hardly.

And that’s where I get a little miffed. People in these kinds of positions have lauded their authority over us for the last 3.5 years. We’re close to being done. We’ve passed every examination that’s been required and we’re over the threats. What? You’re going to fail us because we wouldn’t sit in fear while you assaulted us with rules and regulations – all of which we’ve already heard numerous times?

Power corrupts. In this case it made people who have low self worth try to use it to swell their image. I see this quite a bit, but that day it was just a little too much to deal with.

I Don't Heart Today

Valentine’s Day. God, what a waste of time and money.

Let’s consider some of the inevitable, if not blatantly stated, perceptions about this “holiday”.

1) If you are a woman you expect to receive some romantic display of affection, even if that display is just a repeat of last years. As such you can expect to be disappointed more often than not.
2) Men don’t know how to be romantic anymore – we wait till the last minute and buy flowers and chocolates from the grocers.
3) Jewelry stores make a killing off stupid, cheap, and unoriginal heart shaped “diamond” necklaces and charms as men try to find something that doesn’t take a lot of time to do, but will get them some points.
4) If you receive said jewelry, expect that the person delivering it wants you to reciprocate physically. It’s the oldest exchange of goods in the book: money or valuables for sex.
5) Relationships on a somewhat rocky ground will be brought down by this one day.
6) Many people think that this day is special and should be used to cherish your loved one. Those of us who have been with their loved one for more than a few months know of much better ways and times to demonstrate their affection than to capitulate to the card gods on 2/14.
7) A lot of people hate Valentine’s Day.

Wife and I are of the #6 variety. We exchange cards, chocolates (since Wife really wants those every year), and will do something out of the ordinary for each other. Tonight I plan on cooking more than my usual spaghetti or hamburger dishes, but I won’t go overboard as I have in the past. I had thought about taking us to a fancy dinner, but Daughter came down with a fever and cough (again) yesterday and would have forced us to stay home anyway.

Personally I hate Valentine’s Day, but I’ll say it anyway – Happy Valentine’s Day everyone!

Obligatory Comment Induced Post

In reflection on my post dealing with Psychiatry I found the responses completely perceptable. Of course, having dealt with similar forms of misunderstanding or degrees of complete arrogant ignorance directed towards my chosen specialty I can understand the knee-jerk reaction towards my apparently incendiary comments.

They were expected. I anticipate more, perhaps as others are directed towards the jerk med student who knows nothing about psychiatry. Imagine if I’d bashed acupuncturists or homotherapeutics – we’d be swimming in the assaultive commentations.

Yet the fact remains – my experiences, my teachings in a school of medicine by residents, attendings, and social workers demonstrated a very sad state of affairs. The social workers were more involved in talking with patients than the doctors who, instead, spent a great deal of their time reading or leaving early. Patients improved here and there, but there were very rare circumstances where a physician actually worked hard at understanding the patient’s needs or point of view. Unfortunately, this is all too common in other areas of medicine, but damnable from a psych perspective. If my exposure has been insufficient to truly warrant a degree of opinion, I am aware.

Yet, even friends entering the psychiatric field have expounded on the degree of psychiatric training they've tried to avoid. They agreed with my perceptions of the residency we rotated through and noted some others where they'd interviewed whose residents actually would state: "we need to get a real doctor's opinion". That's where my concern for Psychiatry lies - in the apparent loss in some training programs in keeping their residents grounded in their medical school knowledge.

****

There have been discussions regarding the desire of psychologists to receive training to begin prescribing medications. If what I’ve heard, that being drug management is more lucrative than couch talk, I can understand their wishes. However, and let me be clear on this, I do not think that psychologists should be giving out drugs, regardless of my perception of the state of Psychiatry. If for what little medical treatment and disease pathophysiology psychiatrists actually recall, they received 4 years of post-graduate training revolving around the medical needs of patients in all arenas. Their understanding of pharmacology, side effect profiles, and dosing have been inculcated during this process and they are, therefore, more likely to be able to understand the toxic-therapeutic ratios, effective dose over lethal dose, and other nuances that a physician must evaluate when prescribing medication.

As little of the understanding of psychologist training I do know I don’t feel that they are as well prepared to be able to understand, nor be able to review, drug interactions and potential dangers as a psychiatrist. And perhaps it is the 4 years of residency training that I bemoaned earlier, focusing on the drug management more than psychoanalytical jargon, which further qualifies the psychiatrist from those who want to be included.

But what of the additional year or two that psychologists have suggested that will enable them to understand these concepts? They still lack the fundamentals, ingrained throughout 4 arduous years of medical school, that all physicians rely upon. Rather than being on the same footing they've already started behind and, worse yet, have years of training that have narrowed their mental process towards what they studied.

Overall, medical training allows the students and residents more capacity to understand where, when, and how to obtain vital information – regardless of specialty. What's more is the fact that these same students and physicians have a less focused perspective as they've been trained in broad strokes from the getgo.

Yes, we all forget how to manage certain diseases (I can’t for the life of me recall how to classify Salter fractures from surgery nor what the management would be), but we have studied them before and understand enough to be able to review with better efficacy. It's like riding a bike - you never really forget, but it's harder to teach an old dog new tricks.

What’s more is that through this process we’ve been able to interpret more readily what we don’t know. I’ve felt that a PhD enables someone a great deal of knowledge about a very precise and minute area of science. Truly they are experts in a small area. The problem that occurs is all too often someone with a specific focus begins to believe that they can do more without realizing their limits. I do not agree that a PhD enables anyone the option of performing as a physician – the training is to myopic. In fact, I find it disturbing to know that some professions are actively trying to erase or blur the fine line between the physician title of “doctor” and their own within medical settings. Because, unlike a rose, a doctor by any other name is not the same.

Wouldn't Know the First Thing

Rather than post about the continuing discussion regarding my rank list with Wife I will instead post about some other topics until I feel I can discuss the situation with more perspective.

With that being said...

A post from T at Anesthesiobiost (a rather interesting blog about an Anesthesiologist living in, I think, Philly, who is trying to learn the Oboe) illustrated a point that I’ve made to some of my colleagues regarding Psychiatry.*

Unlike Kris Kringle in Miracle on 34th Street who holds a great deal of respect for Psychiatry, I do not. Perhaps my experiences have been dominated with poor understanding or observation of the absolute worst form of practice, but I truly don’t feel Psychiatrists should be held in the same realm as physicians.

For that matter I don’t understand why they need to attend medical school in order to become head shrinkers.

Consider the experiences I’ve seen:

- Patients in an acute Psych ward were treated only by the nurse practitioner for diseases like high blood pressure, diabetes, and headaches. The psych residents and attending were unable to treat these diseases and frequently asked for “med consults” when these “problems” arose. They would then ask the students about the medications and what they did as they didn't know.

- During an ECT day while on an Anesthesia rotation, we were forced to wait for the Psychiatrist to arrive 30 minutes late for the last ECT (consider that we were scheduled in another room after we finished). Once he arrived we were once again appalled to see him spend another 30 minutes talking to the patient about why they were happy having not eaten that morning (as per OR guidelines – NPO after midnight). Then, without alerting the OR team or anesthesia team, this guy allowed the patient’s family to enter the room and observe the procedure. Afterwards he described what they had done and feebly tried to recall the reason for the anesthesia team’s involvement. He fucked up the basic physiology and pharmacology so badly I lost absolute respect for him.

- Whenever a Psych consult was requested at my main teaching hospital additional measures had to be taken in order to get a resident or attending to see the patient within the week. On OB/GYN we had to personally track them down and walk them to the patient floor in order to see mothers before they were discharged. They always acted put out and asked ridiculous questions about the patient’s disease or status (like did they look tired when they delivered – of course they did!).

- An attending stated that psychologists are better talkers than psychiatrists. The job of the psychiatrist had moved from “the couch” to the pharmacy. “Let the psychologists handle the psychoanalytical discussions with the patients, they’re better trained at doing that now than we are anyway. We deliver the drugs that help people”. No, really, he actually said that.

- I spent 2 days being lectured on Freud despite many of his ideas being disproved. They guy was a fucking coke addict with a major sexual compulsion – why are we still being taught about him?

I completely agree with T’s anger over the issue she describes. I don’t understand psychiatrist’s need to attend medical college – because they sure as hell forget about disease processes when they enter residency and apparently are just glorified drug pushers.

* I am not sure what T's opinion of Psychiatry is and am not trying to make any references to the like. Her post only allowed me a moment to reflect on the level of absurdity I feel with Psychiatry.

That’s How It Is In The Hospital

So Stepson has a little quirk about him: he loves the TV show House, MD. God, what a shame.

The other night he was watching while I was next to him on the couch reading my Currrent’s Medical Diagnosis and Treatment. I’d seen some diseases in the SICU that morning that I was a little unfamiliar with and wanted to get boned up on them before tomorrow. During a commercial he turned around and asked me:

“Are you seeing what he has in your book? What do you think it is?”

I stopped, looked at him, and pointedly said:

“I hate House. I don’t know what this guy has, nor do I honestly care. I’m studying some stuff I saw today and need to know for tomorrow.”

He shrugged his shoulders, turned around, and said:

“Well I freaking love this show. It’s so awesome! I bet that’s how it is in the hospital, huh?”

To which I had to inform him that there is no way that a doctor, no matter how talented, gets to walk into an OR where the patient’s abdomen is wide open without a surgical cap, mask, and sterile gown and be allowed to place their hands directly into an open wound – even if he had on sterile gloves - which he didn't (event occurred just prior to commercial where he made these remarks). So, no, it’s all crap and that is what I hate about it.

He didn’t seem to care, and watched the remainder of the show intensely. At least he enjoys himself, but damn! Why does he have to like that show?

Automatic Automatons Part Deux

“Sweeping generalizations should not be made about any [field of medicine]”.

I couldn’t agree more with that statement. The premise to the last post was not to slam nurse practitioners and physician assistants, but rather identify the flaw inherent in the retail clinic model of healthcare reform.

Often these clinics are staffed by younger, less seasoned professionals who are not well supervised and often work within the shadow of the behemoth that employees them. They feel the pressure to move patients, treat them similarly based on error prone algorithms, and give drugs for anything that looks infectious. That is not simple hyperbole, but a fact. I’ve been informed by several people who’ve either worked in or for these types of clinics of these types of pressures and have experienced a similar form of medicine early in my third year of medicine in an office that employed two PAs and 1 NP so that the doctor could manage his “businesses”. The pressures levied on those three providers to get as many people in and out as possible was tremendous. I could understand, as faulty as it was, to give amoxil for a 12 hour case of sore throat.

What scares me is the fact that you are being treated by people with less education than I’m at currently and have to deal with administrative bullying. When I enter the medical field as an intern I will have some autonomy, but leveled with so much restriction and guidance it will make me feel powerless - like a med student again. By it's nature, a residency allows young doctors the chance to improve slowly, while their training and skills are evaluated and redirected as needed by more experienced faculty. They are taught to be brutally critical of their and other's performance as it related to outcomes and current clinical practices.

I don’t feel that someone with three years of post graduate education who receives little to no feedback on their patient performance beyond “move more meat!” can be expected to improve. In fact I feel that these clinics will only dampen the skills these providers have developed in order to get patients in and out more quickly.

Certainly there are physicians out there that are less than admirable about their patient encounters and prescribing practices (since I’ve worked with a few I should know), but I truly and honestly believe that once they completed their education they were far more capable of handling patient’s complaints and evaluating them properly using evidence based medicine than a 3rd year medical student. Because that’s honestly what you’re getting with a retail-clinic provider fresh out of school.

More Money

How much do I want to party? Is it worth $100 or more for a bash?

Our class dues this year were elevated to help pay for some items that the senior class has traditionally done. This includes a class gift, planning an event the day of match as a celebration for 4 years of hard work, etc. However, I have recently seen that the dues are to be increased by over 200% for the year to pay for these “responsibilities”.

I was planning on paying for the initial class dues this year, but more than $100 is way too much for this guy. I mean, God, I’ve had to increase my debt further in order to even interview this year since the school’s tuition hike killed any travel money I was set to receive. I have a couple private loans that will be due upon graduation and cannot be deferred through my residency. The fact that the “elected” class officials (ran unopposed) are now increasing the amount they want from us in order to throw some fucking party irritates me.

I guess I just won’t plan on going to our match celebration if this is how they’re going to try and fund it. Citing low class participation in fundraisers as a reason to increase the amount needed as an entry fee isn’t reason enough. There are people who are on aways, are too busy with life, and just don’t care anymore about helping “the class” out anymore. Personally, I’ve been trounced one too many times in the past to give a shit now.

It’s sad to think I won’t be able to hang with some of my friends and celebrate our accomplishments, but I thought the amount last year was ridiculous and we’re doing the exact same thing here.

Not Enough, Too Much

Since I am a member of AMSA I receive their monthly love-fest newsletter, The New Physician. Often this is just a sounding board for medical students trying to show that they care about patients more than the medical education system that tries to destroy that bond and are fighting “The Good Fight” for patients and students alike.

Mostly, however, I find it to be just a whine fest with people complaining about shit that I don’t care about. Their most recent issue, though, sparked some anger in me (yeah, I know, big whoop).

What got me upset was a short letter about a medical student who sued the NBME because she didn’t get additional time to pump her breast milk while taking Step 2 CK. On the outside it seems quite agreeable – I mean who wouldn’t want to have a few extra minutes to avoid soaking the front of your shirt all the while obtaining that precious fluid for your child?

The issue I had was the fact that she sued at all. Apparently this student has a some issues related to ADHD and dyslexia and had received 8 additional hours to take the exam, encompassing 2 days. Because of her concerns she took the test in an isolated environment and was allowed to have her breast pump with her in her room, all prior to her suing.

Her complaint? She wasn’t allowed enough time for breaks to pump her breast milk!

WTF? Seriously, what’s this girl's problem? How are you going to handle regular resident duties if you can’t handle 2 days, 16 hours, and accommodations that were more than reasonable to take a fucking exam? The fact she sued and the people at The New Physician are supporting her demonstrates a great deal of the medical student attitude that’s concerning medical educators. The whole "hold my hand with everything" demeanor.

The fact that she won her lawsuit simply shows how screwed up the legal system is in this country as well. Where has common sense gone? Why are we allowing crap like this to be taken seriously? For all of us who've taken this exam we know that the time she received was more than adequate.

So, to this princess, this coddled little bitch, I'd like to ask: How much more time do you need to take a damn test!?! Do you think you're going to actually be able to take care of more than one patient at a time while a resident? I'm sure you're residency programs will be dying to land you and your suing ways! GOD!

Waiting, Just Waiting

I still haven't heard from the AOA committee. I heard that they might have been meeting last week, but it wasn't for sure. I know that those elected are informed quickly, so I've begun to think I wasn't elected in - again.

...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.***

Chips

I've noticed that there are a lot of people in health care that take shots at medical students and younger residents while they can. As a resident gains more seniority these people begin to behave differently and almost cower from their gaze. Being one of these students who has received harrassment from various nurses, techs, and assistants I can understand how one might get riled up when you're the object of another's fun.

But that's just how it goes during this process. We have almost no power over anyone, can't really get on someone for being a jerk, and have to simply suck it up. Or get flustered, let the person know they got the best of you, and realize that you've now become the "joke bitch" for that floor.

A friend of mine has been given a rather hard time during her Sub-I from just about everyone. The latest was from a tech who prodded her into anger by insinuating that she wasn't cut out for medicine after a comment she made. My advice, had I given it, would be to just suck it up, ignore the insults, and try to keep the chip on her shoulder from getting bigger.

Because if we were to allow every instance of humiliation at the hands of "lesser people" get to us then we'd be demon asses and bitches by the time we're finished with residency.

Part of training to become a boarded physician is to learn limits. When those above us do it, they do it in hopes of keeping us grounded, well aware of our limitations, and more vigilant the next time. When it's done by those below us (like techs, MA's, and the like) they're doing it while they can, because they know in a few short years they won't be able to say one negative word without being severely castigated.

So let the fuckers make fun and just continue to improve. Reacting simply makes them feel more justified and makes you appear insecure about your level of knowledge.

Ya Veo

So an experiment has been started. One that I’m directly involved with and the outcomes of which affect me directly. That experiment? Vision.

Yes, I went to see the optometrist over the weekend to get my eyes checked. I figured it would a wise idea before leaving for a month since I couldn’t see a computer screen 5 feet from my face in the hospital. Scary to think I was responsible for this patient’s vitals at the time.

So I was told I couldn’t pass a driver’s vision test with my current decreased visual acuity and received my first pair of contacts - ever. Wife felt they’d be a better option since we have a 3 year old, I’m always futzing with my face, I break sunglasses a lot, and the like. Plus she didn’t want to be married to a 4-eyed geek.

Now I’m 5 days into the experiment and have mixed feelings.

Pros: I love being able to see - it’s like HD in real life! Who knew there were details to all of the trees around us and that you can read exit signs across a store? I've been able to check vitals and physiological components from a distance and can actually read the suture boxes in the cabinets.

Cons: I hate the feeling of something foreign in my eyes. Hate. It. I’ve got eyelashes in my eyes all of the time and the environment of the OR only increases this discomfort - or that's how it feels. Plus I’ve lost them in my eye a few times and have seriously irritated the crap out of my right eye trying to locate the lost lens.

Thus far I’m thinking I’m going with the glasses. I know people have to get used to these, but damn if this doesn’t suck. Sometimes they feel fine, then I blink and “BAM” it’s back to the nuisance of hair again. My optometrist changed them yesterday to “lenses for those with sensitive eyes” (i.e. babies) but I’ve not seen any improvement.

Maybe glasses while at work, then contacts when at home? That ‘s an option, I guess.

What's That, Fucker?

Alright...calm down. It's going to be OK.

Really it is.

He's just a fuckwad.

To hell with that shit! He's a damn 2nd year!

What nerve!

I shoulda kicked his bitch ass all over the place is what I shoulda done.

Tardbucket.

Gahhhh!

Well, I just had an interesting run in with a 2nd year while studying. Apparently I was in "his chair" and was asked to leave. The room.

Yes, he actually asked me to leave "[his] room because this is where [he's] getting ready for a major test (didn't they just start) with friends and they always study here. If I wasn't a first year I'd have know that."

Serious. That's what he said.

Of course I was gracious and kind, the absolute picture of calm. Ha!

After 5 minutes of me tearing him a new one, telling him where he can put his study books, and what year I was (after all, being a senior makes me uber cool now, doncha think?) he got the message and left.

I'm not the only one to have a run in like this with the 2nd years either. A classmate apparently had a very similar run in when asking people to be quiet while studying. They told her about the "quiet rooms" for studying and continued to talk - since they thought she was a lowly 1st year.

Fucking underclassmen. Learn to respect your goddamn elders! I know where and how to stick shit in people now that will kill them quickly...Don't. Fuck. With. Me!

Not So Cool Anymore

So I’m starting to understand why surgeons have such a bad name amongst hospital types. When I was rotating on Surgery I thought it very cool to be the macho, gun-slinging, cowboy who marches into “their” OR, orders what needs to be done for the patient, and takes control. After all, this is their patient and clearly no one has learned as much as the surgeon. Everyone else is inferior.

However…

Being on Anesthesia and hearing some of the condescension when being asked (or commanded) to do something irritates me a bit. Like, for instance, a puggy 3rd year gen surg resident who looks like she came straight from that Gardasil commercial (you know, that feminist, women’s power bitch at the end telling us about how you could be One Less? Evil men, spreading their icky, icky germs!).

She waltzes in, talking down to everyone in the room, because, gasp, we don’t react instantly to her commands, and wonders why the room isn’t prepared a completely different way than asked for by the attending’s card. An hour later (while the patient is under general anesthesia, mind you - bad, bad, bad), the surgery can finally begin. Had she been in the holding room prior to the procedure we might have dealt with this before hand. But what dumb fucks we were for not being all omnipotent! I cower at your Dansko's and beg for forgiveness.

I imagine that if I were on this rotation I’d think she was all cool and shit. Because I’d be internalizing like the mad-crazy medical student gunner I am. But I’m not. I’m on the other side of the curtain, dealing with blood pressures, respirations, keeping the patient from moving, trying to understand why the hospital scrubs have writing all over them (who do I call for a good time?), and other important, life maintaining items that anesthesia people do. Because people like to breath. It’s a good thing. Putting the patient in Trendelenberg at the instant a “request” is barked out does not imply that I need to be yelled at. I heard you the first time; pipe down their girly.

Since some of the surgeons have worked with me they have been quite nice about letting me wallow in my own brand of OAFAT (wah-fat: obligatory anesthesia fuck around time) before they get pushy. It’s been, for the most part, good. But girl-power chick needs to back the fuck off a bit and take a chill pill. You’re not god – yet. Though I imagine you think you are.

WMSE

Sorry again for the delay in posts and the rather mundane nature of the last several. Clearly my life has been put on hiatus while other, shall we say “more pressing”, issues were addressed (the sagging Sitemeter numbers I've seen clearly indicate that you're getting bored). I apologize, but life as a Medstudentgod is not always as fun and exciting as you might imagine. Sometimes administrative bullshit takes precedence. So, on with the show!

****

What do you say to someone that makes your skin crawl and, despite all attempts to convey your complete abhorrence of their "being", continuously tries to talk to you? Someone that, for all other purposes, makes you want to vomit upon them in a horrible, Exorcist-like way? Yes, the Worst Medical Student Ever (WMSE - yes all of these are about him) is on the surgery floor right now and I’ve been able to see him in action during one case (since the gen surg team is apparently taking a vacation this week and overall surgical cases have been sparse).

This student encompasses everything that I hate about politics. An absolutely absurd specimen of medical training who is, unfortunately, completely capable of appearing highly intelligent and competent; but only for very short periods of time – like the time it takes to drain a rectal abscess. After 45 minutes of bullshiting his way around his utter clueless personality his asshole can't be corked shut anymore and shit spews forth from his dumbass as though he'd been hit with a bottle of Mag citrate.

Lord knows how much I hate this guy. What irks me the most is the fact that he wants to be an Anesthesiologist. He aspires to the same specialty that I hope to match into one day and it makes my blood boil to think about him as a "colleague". Hopefully I won’t find out if he matches come March since he’s already 7 months or more behind in his 3rd year rotations (using some lie about doing an Anesthesia away rotation when he was called out for failing Step 1 his first go around). I think knowing that someone like that could actually get a job in a field that requires a great deal of quick thinking might make me physically nauseous.

Honestly I feel that if he were to be in a medical school whose sole goal wasn’t to crank out as many minority MD’s as possible he’d have been ousted long ago. But, here he is, almost 3 years down, no prospects of stopping, and with the undeniable truth that he's cheated, lied, and bought his way to this point. Certainly the fact that Daddy has significant influence (both monetarily and politically) hasn’t influenced his status here. But that’s OK. I hate him, I know what kind of a tool he is, and that’s good enough for me.