Tales from Med School: The Cracker Incident

How I decided geriatric psychiatry wasn't for me:

During my psychiatry clerkship, I noticed that most of the patient population was pretty young. But there were a few older patients as well.

I don't remember what Mr. Smith's diagnosis was, but he was one of our few geriatric patients and he managed to annoy me beyond belief, despite not even being my patient. I guess he didn't mean to, but he spoke so slowly and always had so many complaints, I felt like I want to shoot myself while we were rounding on him.

One day, we came to his room and he held up a brown paper bag filled with crackers (where this came from, I have no idea) and complained that he "can't eat crackers because I'm a diabetic." I have no idea why he felt that as a diabetic he couldn't eat crackers, but the attending promised he'd look into a special diet for Mr. Smith (who seemed very agitated about these crackers).

We continued rounds and a minute later, Mr. Smith opened the door to his room and asked me if he could speak to the doctor. I said, "Just a minute, we're doing rounds."

He nodded like he understood, but then he held out the bag of crackers to me and said, "Take these crackers."

I said to him, "Just leave your crackers in your room. We'll come get them later."

That wasn't a satisfactory answer. Mr. Smith insisted again that I take the crackers with me, but I told him again to just leave them in the room. I tried to close the door, but as I was closing it, Mr. Smith slipped the crackers through the door just before it closed in an Indiana Jones-esque move.

So I was stuck with those goddamn crackers. I mean, he wasn't even my patient.

Top 8 Books I Used in Med School

This is a list of the best 8 books I purchased during med school. Why 8? Because I started making a list and when I finished, there were 8 books on it.

1. Surgical Recall

For most rotations, students would argue which book was best. Was it Blueprints, First Aid, etc? But for surgery, the choice was obvious. This little book had everything and fit conveniently in my white coat pocket, causing my shoulders to sag down only 1.5 inches.

2. Clinical Microbiology Made Ridiculously Simple

I think I still have a good understanding of micro due to this book. The only problem is that I still remember some of the mnemonics better than what the mnemonics actually mean. For example:

Be serious, Dr. Goofball!

I know this has something to do with B cereus, but what? Also, whenever I prescribe Amantadine, I think of "a man to dine" but also can't remember what it means.

3. BRS Physiology

This book allowed me to do well in physio without attending one lecture. Which is great, because the lectures were hella boring.

4. Dubin's Rapid Interpretation of EKG

I was an idiot about practically everything when I started internship, but thanks to this book, I knew my EKGs.

Cons: Dubin is a child pornographer.

5. Pharm cards

I realize these aren't a book exactly (or at all). I think they're based on Lippincott's Pharm book. But these cards helped me so much, they deserve a shout out.

6. Felson's Principles of Chest Roentgenology

There's no better book to help you learn how to read a chest X-ray. And maybe by the end, you'll know what the hell "roentgenology" is.

7. First Aid for Step 1

If you're a med student, you must buy this book. End of story.

8. Step 2 Secrets

This book basically summed up all of third year in 350 pages.

I went to med school a long time ago. I mean, I think dinosaurs were still roaming the earth back then, so you know that if I remember a book as being great, it must have made quite an impression on me. And I guess there were others that you sort of had to buy, like Netters, but I just didn't have the same kind of love for Netters. Sorry, Netters fans.

I could make a similar list of books that were useless, that I regret buying, but it would probably just say ROBBINS in big red letters.

Something in the water

During my last rotation of intern year, I discovered I was pregnant. I worked with a senior resident named Angela and my attending was a woman in her thirties named Dr. White.

In January of the next year:

I gave birth to a daughter.

Angela gave birth to a baby boy.

Dr. White gave birth to twins.

All within a couple of weeks of each other.

Coincidence?

Conditions you don't learn to treat in med school

Thanks to Alex G for the inspiration!

The President

Usually as part of a mental status exam, I ask patients who the President of the country is. If they don't know that, it's pretty bad. It's kind of annoying when a patient refuses to answer on account of not liking the President.

This was my favorite response to that question:

"An asshole."
--Said in 2005. I'll let you figure out who was President at that time.

My second favorite response:

"I'm from Canada."

A guy I worked with said that his two favorite answers were Ringo Starr and Bob Newhart. Not simultaneously, of course.

Happy Superbowl!

For those of you who still haven't purchased A Cartoon Guide: The Book, Lulu is having a sale for 20% off today with the code MORESHADOW, so you can pick up the book very cheap.

Good luck to both Giants and Patriots fans. And for those of you just watching for the commercials, I hate to disappoint you, but I don't think there will be any commercials featuring Betty White this year.

Weekly Whine: Anonymous

You know what really grinds my gears? When people make "Anonymous" comments on a blog.

I don't dislike it because I find it offensive or anything (although it's true people are more likely to be jerks when they're anonymous, which does not make a good statement about humanity). The reason it annoys me is that it is completely inhibitive to discussion, which is even more annoying when the Anonymous is asking a question. Or more likely, when there are multiple Anonymouses posting.

My replies always have to sound something like this:

Well, I agree with Anon@12:45, but I think Anon@3:45 makes a good point too. Of course, Anon@6:32 is being a complete jerk.

Annoying, right?

So if you comment on a blog, at least make up a name for yourself. Call yourself Joan of Arc for all I care, just please don't leave yourself as Anonymous.

Tales from Residency: Stupidest consult

As a resident, you're sometimes forced to call consults that you don't think are necessary. I mean, your attending is sort of your boss, so if they tell you to call a stat GI consult on a patient who obviously has hemorrhoids, what can you do?

This is the most embarrassing consult I was ever forced to call:

I had a patient during residency who was wearing a condom catheter for incontinence. He had a rash on his penis that I thought was very obviously a contact dermatitis from wearing basically a condom all day. However, my attending looked at the rash and thought it was kind of flaky. So he forced me to call dermatology and ask if the patient might have psoriasis (localized to his penis).

I was pretty embarrassed having to call derm and ask if this penis rash was psoriasis. I wanted to ask them, "Is this the stupidest consult you've ever received?"

Words of Wisdom

These are some random words of wisdom that I heard as a medical student from my residents. I committed these statements to memory and repeated them as much as possible. I want to reproduce these words of wisdom so as to preserve them for all eternity.

"When I was an intern I never knew what I was doing and I was always all over the place."

"Go home and study. Otherwise you'll end up matching in medicine like me."

"I miss being an intern because nobody expects you to know anything. You can make all the dumb mistakes you want and then just be like, 'What do I know? I'm just an intern.'"

"What does CHF stand for again? Is that like.... congenital heart failure?" (this is sort of like the opposite of wisdom)

"What sucks is when you go through all the work of medical school and then you can't even do the field that you want to do."

"Now that I've done three years of ob/gyn, I could become a malpractice lawyer and I'd clean up. I could look at the fetal heart tracing and tell you the exact second that baby should have been delivered. Of course, in real life, it doesn't work that way."

"What's the most common cause of right heart failure? Left heart failure. Whenever I ask a question, I always tell you the answer immediately so it's not pimping." (The wisdom is in the last sentence, since the first sentence is common knowledge. Except for that resident who didn't know what CHF was.)

The punishment fits the crime

Patient: "The nurses.. they woke me up..."

Me: "When?"

Patient: "During the night. They keep... waking me up. They should..."

Me: "They should what?"

Patient: "They should be sent to jail."

Me: "Oh. Well, I'm sorry they're waking you up all night and I'll try to get them to stop doing that."

Patient: "They should be sent to jail."

Me: "I really think jail seems a little harsh."