Families, Health care workers, Patients, PLEASE...
Stop fucking wearing isolation gowns all over the hospital. So much for universal precautions. These gowns were designed to protect your clothes from patient pathogens, and the patient from your pathogens. If agents get on these gowns and you leave the room with them on and masquerade around the hospital like dumb-asses, then you're theoretically stirring diseases around in the general public.
I fucking hate seeing this shit.
Tuesday, December 22, 2009
Wednesday, December 9, 2009
Bull Shit
Inpatient Peds Rotation
1) I hate it when you get two different instructions from two different higher-ups (residents). Then, invariably when nobody is around to help you when you need it, you do whatever you think is safest (note-writing procedure, for example). Then you get bitched out by the resident for "doing it wrong." Now you can't argue back or they'll make you out to look like a condescending and haughty med-student.
Too many times, mis-communication. You get mixed signals or incomplete communication and you just do your best. And too many times you get bitched out by some stressed out resident who has noone better to take out their anger on than you.
It's an annoying and long rite of passage and I'm sick of stuffing my pride to bend over and take it from cheese dicks. And I hear this happening all over my institution and at other institutions. It's part of medical education and you learn to let it roll off your back.
1) I hate it when you get two different instructions from two different higher-ups (residents). Then, invariably when nobody is around to help you when you need it, you do whatever you think is safest (note-writing procedure, for example). Then you get bitched out by the resident for "doing it wrong." Now you can't argue back or they'll make you out to look like a condescending and haughty med-student.
Too many times, mis-communication. You get mixed signals or incomplete communication and you just do your best. And too many times you get bitched out by some stressed out resident who has noone better to take out their anger on than you.
It's an annoying and long rite of passage and I'm sick of stuffing my pride to bend over and take it from cheese dicks. And I hear this happening all over my institution and at other institutions. It's part of medical education and you learn to let it roll off your back.
Thursday, December 3, 2009
Do it over again
3rd year here. In clinical rotations. If I were time-warped back to freshman year of college now, knowing what I know, would I do it all again? No.
I'm not sure what I'd do, but I'd try going into physics or computer science and finding my way to a reasonable job near a big city. I don't know, maybe 75K/year and I'd be plenty happy. Because in that non-medical job...I'd potentially have...
-Colleagues/Co-workers that were actually like me
-Weekends off
-Weekends off
-My 20s
-Did I mention my 20s?
-The freedom to fully explore my hobbies and interests
-An actual time to clock out and go home
I'm not saying medicine gives me no pleasure, or that I won't be a passionate physician that truly cares for his patients and his work. I can do that. But the sacrifices are so much, so great, that it is just barely, barrreeellyy worthit.
Even in medical school, hell all four years, you are asked to give up time and energy that very few your age are also giving up. There's worse...there are those soldiers who put their lives on the line for our country, who leave their families and stay abroad for months and months at a time in dangerous places for their stints. There are many who have to work many jobs to support their families in the hard economy.
So I am not saying medical students' lots in life are particularly difficult or unfortunate, not at all. I'm just saying man...we made a choice and we really do give up a lot for that choice. For the hope and promise of job security, prestige, financial security, and a great job, we go through so much.
Cuz you know what sets physicians...a "profession"...apart from "jobs"? The fact that we don't clock out and go home at 5pm. We are beyond the basic "job" where you come and do your work and go home. We are professionals...we do our jobs as doctors and care for patients. We don't watch the clock. In this profession, 60 hour work-weeks are touted as "nice", "light", "easy", and to some older docs, even as lazy. Especially when in training, a 60 hour week is considered extremely easy, and even 80 hour work weeks are considered normal and people lie about their hours to exceed even that. Weekends are never to be had off and families are rarely seen for many.
It's ridiculous. I'm getting so jaded already. I'm on an inpatient peds rotation, it's asking a lot of hours, weekends, staying until 10pm when I came in at 7am. And this is nothing compared to my up-coming surgery rotation...or actual internship.
It's so easy for kids in college to sit there and say "yeah, I want to be a doctor. I want to help people and save lives. I'll go through whatever it takes to get there, I really want to do it."
Do you really? Really? I'm amazed that as many accepted med students follow through and graduate, but I suspect a large number are disappointed, and "held hostage" by their mountain of debt, and knowledge of the time they invested.
I'm not sure what I'd do, but I'd try going into physics or computer science and finding my way to a reasonable job near a big city. I don't know, maybe 75K/year and I'd be plenty happy. Because in that non-medical job...I'd potentially have...
-Colleagues/Co-workers that were actually like me
-Weekends off
-Weekends off
-My 20s
-Did I mention my 20s?
-The freedom to fully explore my hobbies and interests
-An actual time to clock out and go home
I'm not saying medicine gives me no pleasure, or that I won't be a passionate physician that truly cares for his patients and his work. I can do that. But the sacrifices are so much, so great, that it is just barely, barrreeellyy worthit.
Even in medical school, hell all four years, you are asked to give up time and energy that very few your age are also giving up. There's worse...there are those soldiers who put their lives on the line for our country, who leave their families and stay abroad for months and months at a time in dangerous places for their stints. There are many who have to work many jobs to support their families in the hard economy.
So I am not saying medical students' lots in life are particularly difficult or unfortunate, not at all. I'm just saying man...we made a choice and we really do give up a lot for that choice. For the hope and promise of job security, prestige, financial security, and a great job, we go through so much.
Cuz you know what sets physicians...a "profession"...apart from "jobs"? The fact that we don't clock out and go home at 5pm. We are beyond the basic "job" where you come and do your work and go home. We are professionals...we do our jobs as doctors and care for patients. We don't watch the clock. In this profession, 60 hour work-weeks are touted as "nice", "light", "easy", and to some older docs, even as lazy. Especially when in training, a 60 hour week is considered extremely easy, and even 80 hour work weeks are considered normal and people lie about their hours to exceed even that. Weekends are never to be had off and families are rarely seen for many.
It's ridiculous. I'm getting so jaded already. I'm on an inpatient peds rotation, it's asking a lot of hours, weekends, staying until 10pm when I came in at 7am. And this is nothing compared to my up-coming surgery rotation...or actual internship.
It's so easy for kids in college to sit there and say "yeah, I want to be a doctor. I want to help people and save lives. I'll go through whatever it takes to get there, I really want to do it."
Do you really? Really? I'm amazed that as many accepted med students follow through and graduate, but I suspect a large number are disappointed, and "held hostage" by their mountain of debt, and knowledge of the time they invested.
Monday, November 9, 2009
PMnR
Doing a month elective in PM&R (it's an actual board medical specialty, look it up) this month.
I should have taken a vacation month instead, it sucks.
I'm getting up at 6:30am stuff like that and getting home at past 5:00pm.
The attendings really haven't been nice at all; I can't imagine soliciting a letter from them at all, let alone if I wanted to do this field.
Ugh, screw this shit. I should have really taken a vacay.
I should have taken a vacation month instead, it sucks.
I'm getting up at 6:30am stuff like that and getting home at past 5:00pm.
The attendings really haven't been nice at all; I can't imagine soliciting a letter from them at all, let alone if I wanted to do this field.
Ugh, screw this shit. I should have really taken a vacay.
Thursday, September 17, 2009
Rant Blog
I'm starting to think this is becoming a rant blog. I really am enjoying medicine and med school overall. I still affirm my decision to become an MD and I have no regrets. That said, there is a lot of bull shit that goes on.
I hate...
1) Asshole nurses. There are way too many of them. Fucking nurses with a chip on their shoulder who think that as soon as they see the short, white coat, they can whip out their God complex of sorts and act like the shit. I'm here to learn and get through my rotation. You don't have to brush me off, act rude, or talk down to me just because you've been working your job for 2 decades and I'm still a doe-eyed student. Show some respect; we show you guys respect. I know it's hard work, we students don't have it much easier and we sure as hell don't have an easy path ahead of us.
Not all nurses are dicks. But I've had enough ass-holery that I'm honestly surprised and ashamed about them. Don't get me wrong. My dear Mother is a nurse and I honestly believe she's the best nurse there is. Many of them are good people. But the ones who are total fuck offs (and there's way too many like this) are the ones who need to be handed the fucking slip and booted out the front door. These shit bags don't deserve to be anywhere near patients. But then again, half the patients I've seen have been fuck offs, too.
2) White coat break-down. Not trying to be an elitist, but what ever happened to the days when doctors wore long, white coats? They still do. But...so do Physician Assistants (PAs), Nurse Practitioners (NPs), Pharmacists, Pharmacy techs, Dietitians, Nutritionists..... Anyone who thinks they "went through" something and ends up working in healthcare thinks they're entitled to wear a goddamned white coat.
You ass holes try going through organic chemistry and fighting your way through college, brown-nosing every fucking Ph.D you run across in order to squeeze another A out of them for your GPA. Then volunteer, join clubs, do w/e you can to get in med school. Then go through 4 years of hell, do a 3-6 year residency. Now put on a white coat. Then walk out into the hospital ward and just wait....oh! There goes some numb-nuts in a white coat, and SHE just took a year of school after college. See where I'm going?
I'm sick of seeing it. Every fucking person and their aunt wears one, and many even throw a stethoscope on just to look even more toolish. If you went to college and thought that made you magically some mystic, professional doctor person, then go wear your white coat. I'm sick of seeing that shit on everyone.
3) Asshole residents. I had some residents during my medicine rotation who were complete shits. No surprise right? Well, I can still bitch about it. It sucks.
4) People. Patients demand drugs, procedures for every little thing. People go out and spend $150/week on "alternative" bullshit like chiropractors, herbal horse-shit, and god knows what. Then they bitch when their insurance makes them pay $40 on a PAP SMEAR. I'm SORRY we're saving your life from cervical cancer, ma'am.
Docs. Selfish and greedy, specialists want more pay, less hours. Everyone has something to gain and there's no such thing as truly "caring" for anyone.
I'd get sick to my stomach reading pre-med application essays. I can't believe the shit I spewed in mine. It makes me sick remembering the crap I wrote.
I hate...
1) Asshole nurses. There are way too many of them. Fucking nurses with a chip on their shoulder who think that as soon as they see the short, white coat, they can whip out their God complex of sorts and act like the shit. I'm here to learn and get through my rotation. You don't have to brush me off, act rude, or talk down to me just because you've been working your job for 2 decades and I'm still a doe-eyed student. Show some respect; we show you guys respect. I know it's hard work, we students don't have it much easier and we sure as hell don't have an easy path ahead of us.
Not all nurses are dicks. But I've had enough ass-holery that I'm honestly surprised and ashamed about them. Don't get me wrong. My dear Mother is a nurse and I honestly believe she's the best nurse there is. Many of them are good people. But the ones who are total fuck offs (and there's way too many like this) are the ones who need to be handed the fucking slip and booted out the front door. These shit bags don't deserve to be anywhere near patients. But then again, half the patients I've seen have been fuck offs, too.
2) White coat break-down. Not trying to be an elitist, but what ever happened to the days when doctors wore long, white coats? They still do. But...so do Physician Assistants (PAs), Nurse Practitioners (NPs), Pharmacists, Pharmacy techs, Dietitians, Nutritionists..... Anyone who thinks they "went through" something and ends up working in healthcare thinks they're entitled to wear a goddamned white coat.
You ass holes try going through organic chemistry and fighting your way through college, brown-nosing every fucking Ph.D you run across in order to squeeze another A out of them for your GPA. Then volunteer, join clubs, do w/e you can to get in med school. Then go through 4 years of hell, do a 3-6 year residency. Now put on a white coat. Then walk out into the hospital ward and just wait....oh! There goes some numb-nuts in a white coat, and SHE just took a year of school after college. See where I'm going?
I'm sick of seeing it. Every fucking person and their aunt wears one, and many even throw a stethoscope on just to look even more toolish. If you went to college and thought that made you magically some mystic, professional doctor person, then go wear your white coat. I'm sick of seeing that shit on everyone.
3) Asshole residents. I had some residents during my medicine rotation who were complete shits. No surprise right? Well, I can still bitch about it. It sucks.
4) People. Patients demand drugs, procedures for every little thing. People go out and spend $150/week on "alternative" bullshit like chiropractors, herbal horse-shit, and god knows what. Then they bitch when their insurance makes them pay $40 on a PAP SMEAR. I'm SORRY we're saving your life from cervical cancer, ma'am.
Docs. Selfish and greedy, specialists want more pay, less hours. Everyone has something to gain and there's no such thing as truly "caring" for anyone.
I'd get sick to my stomach reading pre-med application essays. I can't believe the shit I spewed in mine. It makes me sick remembering the crap I wrote.
Tuesday, August 4, 2009
Dammit.
I'm so sick of the bull-shit. And asshole personalities. I'm aware that there are rude, inconsiderate people in any field. And that medicine is also full of very kind and great people. I know all this and take it into consideration. But I'm done being Mr. Nice-Blog. I'm going to speak my fucking mind and I don't really care because this is here for me and if anyone wants to read it, it's their time lost. Things that annoy the hell out of me:
-One of my team-mates, a fellow medical student, really proved himself to be a rat today. We were doing walking-rounds. He started bitching about the fact that someone had erroneously placed my name on his patient's chart as the responsible medical student. "Who's in charge of putting our names on the patient's charts?", he asked. I just replied, "I'm not sure, maybe our interns?" Then he said it. I thought he was a nice kid, I really did, but he pulled a bombshell of assholery out of nowhere and it floored me and changed my opinion of him in an instant.
"I'll get in trouble."
"What?"
"I'll get in trouble, they need to change it back to my name. I don't want them mixing us up. You're going to get a bad evaluation." [the implication being that since he thinks I will, he doesn't want that on himself]
Excuse me? Since when do you have the right to judge me? You're not my resident or attending. You are entitled to your own opinions, but please don't push them on me, especially when you've been sitting there all month regarding me as an incompetent fool.
He had no grounds on which to base that accusation. I've received positive feedback from my "superiors" all month. Sure, points have been brought up of things to work on, but they're no different from what I've heard anyone else go through. No glaring deficits, not by any stretch. And how could my classmate know, anyway? He had no right to think that, no right to tell me that, and his smug attitude just served as a last straw in shattering my hope of there being reasonable people around this place. Damn. Ya know? Ridiculous.
-Bitch interns. Had one for the first half of the 4-week rotation. She wanted to get her work done and didn't care about our education one bit. She would repeat to me every time I went to go interview a new admit patient..."Oh sorry, I tend to not let the med-students do the interview. I kind of like to get it done myself and then they can go do what they need to after." She never smiled one the whole time I saw her, I don't think.
-Time ambiguity. It's about a daily occurrence. I'll be sitting in the team room in the late-afternoon. The other students are often in there, too. We don't know where our higher-ups are, and it'd be a rude idea to page them for no reason. We're not sure if we can leave yet, even though we could have easily left hours earlier, with no loss to patients or our own learning. Yet, the way it works, you just sit there. You hate being there because you've done your errands for the day. Yet you can't just leave, for there are constant fear of repercussions. The slightest misstep no matter how late into the game can tarnish your otherwise decent record in the eyes of a disgruntled resident.
-Brown-nosing. Our aforementioned male team-mate hero does this. He'll do anything to look good for the higher-ups. Anyone who will have a say in his grade will get the special treatment from him. He's even taken initiative on my patients at a few points, so he can interject his efforts during rounds. I don't know if its just him being a hard-working fellow, trying to undercut me, or a mixture of both (I'm going to go with the mixture idea).
The point of this point? In the pre-clinical years, the gunners simply fade into the background and study to get their high-scores. But now, when actions count, they become painfully obvious as they play the game of sucking-up, over-achieving, and trying to look good. Yes, there is a component of doing well that everyone should achieve. I'm not saying you shouldn't work hard and respect your higher-ups. But don't undercut your class-mates, don't insult them, and don't look down on them and pass smug judgments. That just makes you a tool in life.
You know what. In the end, I'm not the guy who's going to go 100 miles out of his way to get that top score, publish that paper, and rub the boss' balls. I'm proud of who I am and I'm in this to get through it and become the best doc I can be. I probably won't land a coveted plastic surgery or urology residency, but I don't care. If I wanted to be super-competitive and sacrifice my vital 20s for that, I would have. But then I wouldn't be who I am.
-One of my team-mates, a fellow medical student, really proved himself to be a rat today. We were doing walking-rounds. He started bitching about the fact that someone had erroneously placed my name on his patient's chart as the responsible medical student. "Who's in charge of putting our names on the patient's charts?", he asked. I just replied, "I'm not sure, maybe our interns?" Then he said it. I thought he was a nice kid, I really did, but he pulled a bombshell of assholery out of nowhere and it floored me and changed my opinion of him in an instant.
"I'll get in trouble."
"What?"
"I'll get in trouble, they need to change it back to my name. I don't want them mixing us up. You're going to get a bad evaluation." [the implication being that since he thinks I will, he doesn't want that on himself]
Excuse me? Since when do you have the right to judge me? You're not my resident or attending. You are entitled to your own opinions, but please don't push them on me, especially when you've been sitting there all month regarding me as an incompetent fool.
He had no grounds on which to base that accusation. I've received positive feedback from my "superiors" all month. Sure, points have been brought up of things to work on, but they're no different from what I've heard anyone else go through. No glaring deficits, not by any stretch. And how could my classmate know, anyway? He had no right to think that, no right to tell me that, and his smug attitude just served as a last straw in shattering my hope of there being reasonable people around this place. Damn. Ya know? Ridiculous.
-Bitch interns. Had one for the first half of the 4-week rotation. She wanted to get her work done and didn't care about our education one bit. She would repeat to me every time I went to go interview a new admit patient..."Oh sorry, I tend to not let the med-students do the interview. I kind of like to get it done myself and then they can go do what they need to after." She never smiled one the whole time I saw her, I don't think.
-Time ambiguity. It's about a daily occurrence. I'll be sitting in the team room in the late-afternoon. The other students are often in there, too. We don't know where our higher-ups are, and it'd be a rude idea to page them for no reason. We're not sure if we can leave yet, even though we could have easily left hours earlier, with no loss to patients or our own learning. Yet, the way it works, you just sit there. You hate being there because you've done your errands for the day. Yet you can't just leave, for there are constant fear of repercussions. The slightest misstep no matter how late into the game can tarnish your otherwise decent record in the eyes of a disgruntled resident.
-Brown-nosing. Our aforementioned male team-mate hero does this. He'll do anything to look good for the higher-ups. Anyone who will have a say in his grade will get the special treatment from him. He's even taken initiative on my patients at a few points, so he can interject his efforts during rounds. I don't know if its just him being a hard-working fellow, trying to undercut me, or a mixture of both (I'm going to go with the mixture idea).
The point of this point? In the pre-clinical years, the gunners simply fade into the background and study to get their high-scores. But now, when actions count, they become painfully obvious as they play the game of sucking-up, over-achieving, and trying to look good. Yes, there is a component of doing well that everyone should achieve. I'm not saying you shouldn't work hard and respect your higher-ups. But don't undercut your class-mates, don't insult them, and don't look down on them and pass smug judgments. That just makes you a tool in life.
You know what. In the end, I'm not the guy who's going to go 100 miles out of his way to get that top score, publish that paper, and rub the boss' balls. I'm proud of who I am and I'm in this to get through it and become the best doc I can be. I probably won't land a coveted plastic surgery or urology residency, but I don't care. If I wanted to be super-competitive and sacrifice my vital 20s for that, I would have. But then I wouldn't be who I am.
Monday, August 3, 2009
Medicine
I'm in the last week (week 8 out of 8) of my internal medicine rotation. The first month was out-patient which was really helpful and nice. This month has been inpatient, which has been really educational as well...very, very important, but also it has sucked on a lifestyle perspective.
Most medical schools will have 3 months of medicine rotation. We have just as much, but spread out. The difference with us is that we take a "sub-internship" in medicine during 4th year. Meaning I'll get to do this month again next year, only with more responsibility. For now, I'm really glad to have been through it, but I'm really glad to get it done with in a few days. Goodness.
Most medical schools will have 3 months of medicine rotation. We have just as much, but spread out. The difference with us is that we take a "sub-internship" in medicine during 4th year. Meaning I'll get to do this month again next year, only with more responsibility. For now, I'm really glad to have been through it, but I'm really glad to get it done with in a few days. Goodness.
Wednesday, June 17, 2009
Hierarchy
I had my first day of out-patient (ambulatory) Internal Medicine today. Before I divulge into that, I wanted to relay to you my new status...at the bottom of the medical teaching hierarchy. Like a private in the army, I get to be the MS3 (Medical Student 3rd Year). The chain of command goes as such, in descending order.
Attending
Resident
Intern (1st year resident)
Sub-Intern (4th year)
MS4
MS3
Woo! The climb begins! The basic philosophy of training at this early stage is exposure, exposure, exposure, and do, do, do. Then do some more. We've taken our pre-clinical basic science courses and consolidated our "knowledge" in USMLE step 1. Now its time to see it all literally come to life. I'll just say for now that this is a very exciting time in training, and it is where you make leaps and bounds towards becoming an actual physician.
Attending
Resident
Intern (1st year resident)
Sub-Intern (4th year)
MS4
MS3
Woo! The climb begins! The basic philosophy of training at this early stage is exposure, exposure, exposure, and do, do, do. Then do some more. We've taken our pre-clinical basic science courses and consolidated our "knowledge" in USMLE step 1. Now its time to see it all literally come to life. I'll just say for now that this is a very exciting time in training, and it is where you make leaps and bounds towards becoming an actual physician.
Monday, June 15, 2009
Oriented
Now I'm ready to begin. I guess.
Got my pager...my PDA is on the way in the mail. I have several "pocket guides" ready to stuff in my short white coat.
Today I heard that the nurses know full and well what our short, white coats mean. They mean that we're doctors in training. We are clinically very incompetent. I hope the nurses are respectful and kind to us...because I know we are to them. In a matter of a number of years, I look forward to the day when I really know what I am doing. Until then, it is in the bowels of medical education that I shall dwell, where I will, like every other physician, slowly and steadily climb my way up, day after day.
Got my pager...my PDA is on the way in the mail. I have several "pocket guides" ready to stuff in my short white coat.
Today I heard that the nurses know full and well what our short, white coats mean. They mean that we're doctors in training. We are clinically very incompetent. I hope the nurses are respectful and kind to us...because I know we are to them. In a matter of a number of years, I look forward to the day when I really know what I am doing. Until then, it is in the bowels of medical education that I shall dwell, where I will, like every other physician, slowly and steadily climb my way up, day after day.
Friday, June 12, 2009
It begins!
I feel a lot of similarities between now and (almost) 2 years ago. I'm starting 3rd year now...I was starting 1st year then. I'd much rather be where I am now, mind you.
We got the emails just a day or two ago that we are now officially considered MS3s. We, the class of 2011. It is a seemingly small matter, but to me it means a whole lot.
Later today (it is 1AM), I have a sort of survival skills workshop at school for getting transitioned into 3rd year. Skills like writing "SOAP" notes, presenting patients, and integrating into the teaching-hospital hierarchy. It shall be awesome.
In other news. I'm upgrading my computer tomorrow...by tomorrow at this time, I should have 1.5 TB more hard-drive space, and a vastly superior video card! For now...more cleaning as I just moved back to my place.
We got the emails just a day or two ago that we are now officially considered MS3s. We, the class of 2011. It is a seemingly small matter, but to me it means a whole lot.
Later today (it is 1AM), I have a sort of survival skills workshop at school for getting transitioned into 3rd year. Skills like writing "SOAP" notes, presenting patients, and integrating into the teaching-hospital hierarchy. It shall be awesome.
In other news. I'm upgrading my computer tomorrow...by tomorrow at this time, I should have 1.5 TB more hard-drive space, and a vastly superior video card! For now...more cleaning as I just moved back to my place.
Thursday, June 11, 2009
I Return! ...as an MS3
Wow.
Well that was fun. I kind of fell out of blogging for awhile there as I realized the the first two years (plus boards) were a real bear to tackle.
So I did.
And now I'm finally, finally here, staring 3rd year in the face.
I absolutely love writing, regardless of how my writing is perceived. I was going to start a brand new blog, but I logged in here and noticed that this thing had been sitting here for years with all my old posts and writings in it. So I took the easy route and decided to simply pick up where I had left off. I will post about the glorious pre-clinical years and boards, as I must express my thoughts on them!
Well that was fun. I kind of fell out of blogging for awhile there as I realized the the first two years (plus boards) were a real bear to tackle.
So I did.
And now I'm finally, finally here, staring 3rd year in the face.
I absolutely love writing, regardless of how my writing is perceived. I was going to start a brand new blog, but I logged in here and noticed that this thing had been sitting here for years with all my old posts and writings in it. So I took the easy route and decided to simply pick up where I had left off. I will post about the glorious pre-clinical years and boards, as I must express my thoughts on them!
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