Transcription Errors

What transcription heard:

This patient is taking up too much room.

What was actually said:

This patient was taken to the Operating Room.

Nannygate

Do you know who Janet Reno is?

Of course you do. She was attorney general under Bill Clinton.

Do you know who Zoe Baird is?

Probably not. She was Clinton's first nominee for attorney general. But she was withdrawn from consideration because she hired an illegal immigrant to be her nanny and did not pay taxes on them. "Her husband filed sponsorship papers at the time and sought the advice of counsel on paying taxes. She paid $2,900 in fines for the infractions."

Do you know who Kimba Wood is?

She was Clinton's second nominee for attorney general. Who also ended up having hired an illegal immigrant to be her nanny. Finally, Janet Reno, who was childless, got the job.

Maybe Baird and Wood were really immoral people. Or maybe this is just something that a LOT of women do.
After all, nanny's are very very expensive. Far out of a lot of working women's price range. Immigrants make the impossible affordable. And the taxes are a baffling ordeal that the government makes as confusing as humanly possible and only adds to the exorbitant cost.

As I've mentioned before, I paid 40K for daycare last year. It's pretty messed up that you have to earn well over 40K after taxes to make working financially worth it. I think we should examine that system before we vilify women who use alternative pathways to try to make it work.

What the dean says....

Please welcome guest blogger Orthochick, a friend of mine who is currently an orthopedic surgery resident. I'm hoping she's going to do a regular spot on the blog, so let's all make her feel real welcome!

In medical school we had the option of going to a monthly "dinner with the dean." At first they really filled up, then people figured out that it was just sitting around listening to the dean talk about how wonderful he was and how many articles he had published and we stopped having them for a while due to low turnout. In my last year of medical school we had one that was supposed to be about how to improve 3rd and 4th year clinical rotations.

Anyway, the meeting was between the dean, a couple of associate deans, and a pile of students. As is the case with everything in medicine, it came down to communication. Communication is a big deal. So while listening to the deans, I noticed that there were a lot of subtle nuances to the med student--dean relationship.

What Deans Say and What They Really Mean
(what they mean is bolded)
We are the only school in the country that does this-->The rest of them understand that it's pointless
We've had a good response so far-->No one's complained out loud
You received a lecture on this topic-->Someone talked at you for 5 minutes right before we let you go for lunch
We'll give you the email address of someone you can contact-->This will guarantee that it will never get done
We're always available to talk with you-->At these carefully structured hour-long meetings
It would be a good idea for you to-->Why the hell did you not think of this on your own?
I understand that this is difficult-->I don't understand why this is so hard for you

That being said, deans are not the only ones that require a little decoding. When you're in a room with a bunch of deans, you have to keep it tactful.

What Med Students Say and What They Really Mean:
(what they mean is bolded)
I don't think I'm the only student with this problem-->Whenever a group of us gets together, we complain about this
I know they mean well, but-->They're heartless creatures but they're in charge of my grade
I think that would be a great solution-->That's the worst idea I've heard all month and clearly you have no idea what it's like to be a student here
One thing I've heard of them doing at other schools-->In my dreams
I'm confused about the expectations-->I spent 8 weeks standing around looking and feeling dumb
I realize this might sound insignificant, but-->This has been an ongoing problem that's bothered me for the past 4 years
Thank you for your time-->I got nothing out of this

As you can probably guess, not very much was accomplished during this meeting or any other meetings. At the end of the meeting the dean started getting snippy and said it was up to us to take responsibility for our actions and our future already, and the other deans spent the whole time on his iPhone, and the other 3 didn't really say anything. So after 2 hours we called it a night and to the extent of my knowledge, they never had one of those again.

(and I left the state a few months later)

Stages of reading an ECG while on call

Stages of reading an ECG while on call:

1) Walk all the way across the length of the hospital to read ECG on patient so that I could rule out MI and let him finally eat

2) Arrive on ward only to be told by the clerk that the ECG never happened... she thought I wanted it for the morning.

3) Write a NOW order for ECG and walk all the way back across the hospital to admitting

4) Arrive at admitting and immediately get paged by patient's nurse, saying that there was a mistake and the ECG had been done

5) Go back across hospital to read normal EKG

6) Go back to admitting, collapse into a chair, and drank about a bottle of water.

Weekly Whine: CMEs

For those of you early in your training or not in medicine at all, CME stands for Continuing Medical Education. Basically, you have to earn a certain number of CME credits each year (each credit = 1 hour) in order to maintain your medical license.

The number of yearly CMEs you need varies from state to state. Some loser states, like Wyoming, only require 20 per year. (Just kidding, Wyoming! You're not really a state.) Other more awesome states like mine require up to 50 CME credits per year (in my case, it can be averaged over three years). Some states have crazy requirements for the CMEs, like you have to take 20 credits while, like, balanced on your head.

Now I do appreciate the importance of continuing medical education. I just don't see the importance of CMEs. I think it's important for doctors to constantly be reading and learning, but I question whether CMEs really contribute to learning. Here's why I think so:

1) I think you learn best when you read about something right after you see it. Seen a case of Klinefelter's Syndrome? Read about it! But you might not necessarily find something that gives you a CME for doing that, so instead you have to read about, like, Turner's Syndrome. Which is totally different.

2) CME courses are rough. I don't know about you people, but after being out of a classroom setting for close to ten years now, I find it very hard to sit in a lecture hall for eight hours straight several days in a row. By the end, it's less about Pain Management and more about Words with Friends.

3) It's WAY too tempting to cheat on online CMEs. Just sayin'.

4) I think I read a study somewhere that said CMEs don't contribute to doctor knowledge.

But I guess if we got rid of CMEs, there would be a very real risk that older doctors would be running around, trying to cure pneumonia with leeches or something, so I guess CMEs are here to stay.

Cirrhosis rumors

Me: "How do you know you have cirrhosis?"

Patient: "They told me I did."

Me: "Who told you?"

Patient: "Oh, you know."

Me: "Did you ever have a liver biopsy?"

Patient: "No..."

Me: "Well, the ultrasound and the CT in the computer actually just show that you have some liver inflammation, not cirrhosis, so I'm just wondering who told you that. Was it a doctor?"

Patient: "No."

Me: "Then who told you?"

Patient: "A friend told me she thought I had cirrhosis because my eyes are yellow."

And then it goes on her problem list FOREVER.

Mini-lectures for primary care

Things I Loved As a Kid But Now Hate

1. Being tickled

2. Roller coasters

3. Slides, especially long twisty ones

4. The 'Burbs (and mostly Tom Hanks)

5. Cotton candy

6. Twister, Operation, basically any board game

7. Care Bears

8. Play-dough

9. Bunk beds or anything other than a normal bed

10. Trampolines


Possibly yet to come:
Things I loved as a kid and still love
Things I hated as a kid but now love
Things I hated as a kid and still hate

Purposeful?

Do you think if someone gives their child a name where both their first and last name are other words for "penis", that is likely to be purposeful? I'd think it sort of has to be.

(e.g. Peter Johnson)

Many emotions

I recently discovered this collage I made:



Hmmm, guess whether I made this for my first or second kid...