Saturday, August 30, 2014

Weekly Whine: Neighbors

I completely hate our upstairs neighbors, which is a couple and their teenage children. This is my list of grievances:

--they have screaming cursing arguments and the police have been here twice

--They gave us bed bugs

--they have a gigantic dog that barks at us when we come home

--they smoke on the porch and throw cigarette butts onto our porch and lighters onto the common lawn

--They are really loud, even late at night

--On several occasions, they have parked in front of our garage, blocking us in

The problem is, even though it's annoying that they smoke and curse on the porch right above us, it's not illegal. Enough people have complained about them that the management claims their lease hasn't been renewed, but they are apparently living there month-to-month. Or else the management is full of shit and their lease has been renewed.

The only good thing is that I was able to use their presence as a reason for a rent increase reduction.

Thursday, August 28, 2014

On a serious note…

I feel like I have to comment on here in light of the recent two suicides by medical interns in New York.

I feel like a medical intern committing suicide is one of those things that is shockingly sad. These are people who are so young, who worked so hard to be where they are, yet are so miserable that they are willing to end their life rather than face another day. As an attending who has a family and a good lifestyle, it's hard not to think, "How could they possibly do this?"

But at the same time, my intern year is not so long ago that I don't remember.

I was someone who was particularly miserable. I had worked really hard to be where I was, I did have a support system in that I was married, but I was still desperately depressed. I genuinely wished that a car would hit me on the way to work so that I wouldn't have to face another day of my internship. I don't think I ever had a call where I didn't feel like crying at least a few times. In fact, during at least 50% of my calls, I would go home and immediately burst into tears.

Why was I so depressed?

For starters, I worked with a couple of residents who were particularly nasty to me. But even when I had a really nice resident and coworkers, I was still unhappy. I didn't want to be at work in the middle of the night. I wanted to be home with my family. And treating sick patients, some of whom were dying, made it all that much harder and made me wish to be with my family even more.

On top of that, nothing I was doing felt incredibly important. It felt like everything I did involved following some sort of formula and not really thinking at all. If a patient had a symptom, you do the appropriate test, and treated the way the textbook told you to. It felt like a machine could do it just as well. It felt pointless. And the patients didn't seem at all grateful to us. (This probably wasn't made better by the fact that I was at a county hospital where a large percentage of the patients didn't speak English, were homeless, or drug addicts.)

But the crazy thing is, nobody knew.

Aside from my family, nobody at work had any inkling how miserable I was. I know this, because when I made the decision to leave my program (my alternative to suicide), my program director told me he had checked with my previous residents and attendings and asked them about me, and they all thought I seemed completely fine. So either I was really great at hiding my emotions, or every single intern was completely miserable, so we all basically seemed about the same.

So what can be done to keep tragedies like these suicides from happening again?

Well, I don't really know. But whatever they're doing now completely stinks. Despite the fact that all of us interns were under so much stress and pressure, nobody bothered to check in on our mental health at any time. During residency we had some sort of discussion group with a psychiatrist that we all went to, but that was useless and got canceled half the time anyway.

Maybe every program should be required to hire a good therapist to check in with all residents a few times a month and make sure they are doing all right. Maybe there should be worse consequences (or just consequences at all) for residents and attendings who are cruel to underlings. Maybe there should be more interns in every program, so if you gets sick and need a day off, you don't feel like everyone in the program hates you. (I will never forgive my co-intern who sent me a nasty email while I was having a threatened miscarriage for missing a few hours of a call.)

Even if most interns don't end up pulling the trigger, we don't want a bunch of suicidal interns responsible for patients' lives. I really think this is an issue that needs to be addressed seriously, but in the end, I sort of doubt anything will change.

Wednesday, August 27, 2014

Writing Contest

When I posted a while ago about a charity project in which I would make a book of funny submissions by my readers, there was a huge amount of theoretical interest. Theoretical interest, but not practical interest. People are still emailing to ask about the project, but I've only received a handful of submissions.

For this reason, I'm going to try something different:

Announcing the First Annual Medical Humor Writing Contest!

Here are the qualifications:

1) Must be at least 1000 words. There is no upper limit on word length.

2) Must relate to medicine in some way. I can be extremely flexible on this. It can be your experience as a premed, medical student, physician, nurse, physician assistant, or even patient. I would accept anything ranging from how you worked as a nurse treating ebola in Africa (or Colorado) to a medical school interview gone wrong.

3) Must have some element of humor. It does not have to be laugh out loud funny, but at least make me crack a tiny smile.

4) Deadline is October 15, 2014

5) Multiple submissions are permitted. There is no entry fee.

6) Must be HIPAA compliant (no patient identifiers)

What do you win?

First prize will be a $25 gift certificate on Amazon.

In order to have completely objective judging, Dr. Grumpy has agreed to help me by selecting among my favorite choices to anonymously pick the winner.

All submissions of reasonable quality will be collected and published in a book of medical stories that will be available on Amazon. By submitting, you are giving your approval to be included in this book. All profits from the book will be donated to Red Cross.

Email all submissions to fizzziatrist@gmail.com with the subject Writing Contest Entry. Make sure you include a title and byline.

Questions? Comments? Let's hear it!

Tuesday, August 26, 2014

Dr. Orthochick: Pampered

I did a bedside I&D of a patient's hand in the ER the other night. It really wasn't a big deal, I made an incision and rinsed everything out, then stuck a dressing on it. The whole thing took less than ten minutes but holy hell, the patient screamed. She started screaming before i touched her so I really wasn't in a huge hurry to continue with that, but she said she just wanted to get it over with so I did. She thrashed around like a jellyfish having a seizure. And that was just when I numbed her up.

Her: I can feel you slicing into me!
Me: I'm not touching you right now.

I finally got it done and the patient was either having an orgasm or Kussmaul respirations, either way, she as putting on quite the show. So the doting boyfriend asked if he could talk to me in private for a second, I figured he was going to ask about pain meds but I stepped outside the room with him.

Him: So now that this has happened to [patient], do you think I should pamper her a little?
Me: Sure, that's never a bad idea.
Him: Should I treat her really nice?
Me: I guess it wouldn't hurt.

He then walked into the room and yelled "HONEY! GUESS WHAT? WE'RE HAVING TV DINNERS TONIGHT!"

The two of them then started making out and I tactfully slipped out of the room.

Monday, August 25, 2014

99 cents

Don't forget to pick yourself up a copy of Suicide Med for only $.99 while the deal lasts!

PhD

Patient: "I see that your badge says MD. Do you have a PhD as well?"

Me: "No, I don't. Just the MD."

Patient: "Oh. You think you'll go for your PhD?"

Me: "No, I don't think I will."

Patient: "I guess an MD is good enough."

Me: ".... you know, MD stands for medical doctor."

He then proceeded to call me by my first name for the rest of the visit.

Sunday, August 24, 2014

Suicide Med -- 99 cent promotion tomorrow!

Suicide Med is having a promotion tomorrow! It will be on sale on the Kindle for only $.99 for a very limited time.

Please buy a copy! And if you're willing to promote the book on your Facebook, twitter account, or blog, let me know and I can gift you a free copy. The reviews have been very good so far, so you should check it out! Most people say they read it in only a day.

Saturday, August 23, 2014

Weekly Whine: Phonics

Even though we used pay like $700 per week for both kids to go to daycare ($40K/year), there were are all these extras that we always feel guilted into paying for. Like we signed Mel up for a phonics class that was an extra $125 per month. They also had a cooking class, soccer, math class, etc. We even signed her up for something called Splish Splash, which as far as I could tell, involved spraying the kids with a big hose for $40 per month.

They even had an extra class for Arts and Crafts! This seemed a little fishy to me because Mel was only four years old, so if they weren't already doing arts and crafts with her, what exactly were they doing with her all day? Trigonometry? (No, because that would be extra.)

Seriously, what were they going to start charging for next? Nap time? Outside time?

At first I was always looking for sheets in her mailbox about what she had learned in phonics that day, but eventually I sort of lost track of the class because I had a new baby and all. One day, I asked Mel how the class was going and she informed me that she hadn't had any lessons in a month.

Being a small child, she wasn't exactly reliable. So I finally went to the day care director and asked about it.

It turns out she was right. Due to a shortage in staffing, they had stopped having the phonics class. But they were still charging me for it and obviously didn't tell me that this was happening.

What really bugs me, is that if Mel were just a little bit younger, she might not have even been able to tell me that this was going on. And they would've just gotten away with it.

Thursday, August 21, 2014

Tuition

From what I've read, tuition of private medical schools is now upwards of $50,000 a year. I think that is insane.

When I started medical school at a state school, my tuition was about $10,000 a year. Very reasonable. I was almost able to pay it myself.

While I was in school, they decided they needed to raise tuition for state schools. Actually, to double it. They felt we weren't paying nearly enough. It had to do with earning revenue, although they probably would've earned more money from a $100 a year raise for college students than they did for doubling the tuition of a couple hundred medical students. Whatever money they made was peanuts compared to the enormous burden that it placed on individual students.

They didn't raise tuition for college students though. They didn't raise it for law students or graduate students. Only medical students.

There was some talk of raising it even further after I left, to maybe $30K. The exceptions would be:

--You get a (slightly) lower tuition if you stay in state

--You get a (slightly) lower tuition if you choose a primary care field

I'm not sure if this is fair. I guess that it's important to encourage people to go into primary care, but I also don't think it's fair to force medical students and residents to live in poverty. Many of us could have easily gone into investment banking or some other field where we could've gotten rich right off the bat. Why drain us dry preferentially over all other students?

Tuesday, August 19, 2014

Dr. Orthochick: Football

Dr. Sportsfem: So you're going to need to go to physical therapy for a month for your knee pain.

13 year old boy's mother: Will he be able to play football?

Dr. Sportsfem: Not until his knee stops hurting

13 year old boy: OK, I just won't play football this year

Dr. Sportsfem: Well you can still play, you just can't play for a month or so.

13 year old boy: No, it's OK. I understand. I just won't play.

Dr. Sportsfem: Your knee will probably be ok by the time school starts

13 year old boy: Yeah, but there's summer practice so I'm going to have to miss that. And I know myself, if I go back too early, I'll play too hard and then I'll just hurt my knee again. So I just won't play this year.

After we left the room, I turned to Dr. Sportsfem and said "I don't think he likes playing football too much." She said "I was thinking the same thing." I realize I am not an expert on 13 year old boys (and trust me, I am OK with that) but I've never seen a kid give in that easily to not doing a sport.