Sunday, January 30, 2011


Wow, two posts in one day!

Just to clarify something from my last post:

Of course, I assume everyone in the world knows I'm not a neurologist, so I thought it was sufficient to mention that med student was rotating on neurology to make clear that he wasn't my student. Apparently not. But he wasn't assigned to me and I had very little interaction with him.

Once you move on to a new level of training, you do earn the right to make fun of all lower levels. But I don't think anything gives you the right to abuse and ignore your med students. Personally, I don't take med students at all, because I feel the environment is less than ideal for learning. I promise I am not cruel to my nonexistent med students.

Asking someone you don't know to move their ass when you know they're in the way, but they're not necessarily in your way takes a special sort of person. If I saw an old lady teetering on the bus and nobody giving up their seats, I'd be pissed but probably not say something. I think it takes a sort of outspoken person to yell at a stranger for not doing the right thing for someone else. Sometimes that kind of person can be heroic. Other times they're just nosy. Other times they risk getting shot. In any case, I'm not that sort of person.


  1. Sorry, but I still think that you are the same type of tool that you love to make fun of in all of your other posts; just another pissed off resident/attending.

    Not that it matters, but I will no longer be reading your stuff.

  2. Yep, you're right, I am the same kind of tool I make fun of. We all are. Nobody is above it. That's the point.

  3. So then you realize what a thorn you were in Jessica's side?

    Oh wait.

  4. I guess what I find interesting (as a nursing student) is that had that med student been a nursing student, any of the nurses would have probably ripped him a new one for taking up a valuable charting seat. Actually, I've seen nurses bitch out attendings for taking their charting computer. Weird how hospitals operate with different social-dynamic structures.

  5. OMDG: I'm sure Jessica could fill two blogs with dumb and annoying things I did. I was an intern on my first month! Some interns are awesome right away, but I was hardly one of them. I mean, I got trapped in a staircase for christ's sake! I sucked but I don't know if making me cry every call was the right way to handle it.

    Hannah: I have to be honest, I took some liberties with that story because I want to maintain anonymity. The reality is, that guy wasn't a *med* student.

  6. ^This is even worse! You mean there's a nursing student on your unit that has time to study instead of filling in as a CNA?

    /probably the one quality that ranks nursing students over med students
    //who needs their 500 lb pt who is incontinent of both feces and urine changed and bathed, and can you empty out the overflowing suction canister and foley bag while you're at it? ;)

  7. Hannah: I didn't say he was a nursing student either :)

    Let's just say he was a student and he'd been there long enough to know better.

  8. Another med student here. By the way, I love the blog and most of the cartoons are hilarious. I have to say that it sucks being a med student and having to spend time in the same work room as residents so they don't think you are AWOL doing random stuff. We even had an attending on Cards that would NOT let us leave till 5pm everyday till he came back and just saw us sitting in the room. He wouldn't even do check out rounds, he just wanted to make sure we stayed in that room, bothering the residents, till 5pm.

    I won't go and say that I won't read your blog again but I did find the previous entry a little distasteful. It is interesting though, as you stated earlier, no one is above it and every now and then we are all going to pull the hierarchical douchebag move and berate someone below us (even though this student wasn't working directly below you). With that being said, I don't know if I would have acted differently in that situation, I sure as hell wouldn't have blogged about my honest thoughts :-p


  9. WP20: I am a fan of honesty. Perhaps it's easier to swallow in cartoon form though.

    I'm a little surprised at how offended people are by the post. I don't work at a teaching hospital. We're a very small private hospital that's in no way set up for teaching. I've been through med school (obviously) and I know there are situations where you can't leave. But this wasn't one of them. The situation was that there are three seats total and the med student was using one of them to do work that could have been done anywhere else. Why he did this is beyond me. My poor colleagues were standing there, stooped over charts while he was making notes on a powerpoint presentation. Why is it so awful that I was annoyed at this guy?

    I think what's hard to portray is how stressful it can be to work in an environment where you have to fight for a place to sit down. When you have serious work to do, you get upset at people who are sitting yet not doing any work (which unfortunately, mainly includes students). There is a physician who I saw literally start crying because it was late, she had ten notes to write, and she couldn't find a place to sit. So yeah, I get upset when someone takes one of those seats who doesn't need it.

  10. As a 3rd year medical student, I gotta say I feel both of these students' pain. Also, these posts made me laugh. I too have taken a coveted seat in the dictation room to write my not-legally-usable-but-mandatory progress notes without noticing the room was filling up. The difference in my story is that a) I was technically doing some kind of work, and b) an attending I'd never met before loudly stood up and proclaimed that he would get out of his seat for another doctor to use because "Obviously it is important that the med student keeps a seat." Cue me turning bright red and jumping up to write my fake notes on the air conditioning unit.

    And while I was shadowing in the ER during undergrad hoping for a good recommendation letter, I was told by the attending to just follow him around. So I did. Right into a very private conversation with an orthopedic surgeon. When it became clear that it was a very private matter, what did I do? I stayed. I was promptly told to please leave. What can I say? By the grace of God I made it into medical school, clueless as I can be sometimes. I think the whole process of applying to and then being in medical school makes you kinda crazy. Unfortunately, sometimes common sense tends to be forgotten and embarrassing mistakes are made. Can I just plead temporary insanity due to lack of sleep?

    But I get it. It is annoying, and it's awkward. Sometimes we just don't get it...that's my flimsy excuse anyway. But what makes it all worth it is actually getting to be on the other side of it all eventually :)

  11. Plenty of people in all walks of life are annoying as hell because of a lack of self-awareness. When you aren't doing something important and can move out of someone's way, then MOVE! Geez! I've been through med school and residency and I was usually aware of when my presence was mandatory, when no one really cared, and when I was in the way. And I sure as heck didn't STAY in the way...for a month!

    Maybe I lost my sensitivity chip sometime in residency, but I don't see what was so upseting with Fizzy's story and remarks.

  12. Fizzy, you said that med students were a useless waste of space. Of course they're going to be offended and upset.

    Personally, I don't really see why it's such a big deal to explain to a med student or two, or even a "threatening looking" student that the area they are sitting in and using to discuss Grey's Anatomy is short on space and people need the area to chart/dictate. Even if it's not "my" student. Why? Because I view med students and residents as my future colleagues. A few of them are complete duds but I will give them the benefit of the doubt and interact with them on an individual level. If I have a problem with something they're doing, I'll approach them first instead of going and tattling to their preceptor.

    And really, if we want to come to down to it, the real issue is that your unit sucks. Only 3 spots for charting/dictating? I'd be frustrated too.

  13. To all the offended med students out there: just wait. Come back and read this post after you've been doing intern year for 6 months or so and then leave a comment.

    -intern who spent the previous two years complaining about standing around feeling in the way and having nothing to do.

  14. Liana: What I actually said was "med students on OUR UNIT are generally super annoying because the unit is already super crowded." I didn't say they're all annoying or a waste of space. I think some med students saw a few words they didn't like, didn't put it in context, and immediately got offended. We're all overworked and touchy, so it's easy for that to happen. I've been guilty of it before.

    But any resident or attending knows that most med students create more work for everyone else. It's a fact. When I was a med student, I'm sure I was super annoying. I've had med students that I loved, but all of them made my overall job harder. But it was balanced out (sometimes) if I liked the student and they did things to help me, and there was some gratification in teaching. But when they're not MY med student, none of that help or gratification is present and they're just people who are in my way at all times. It grates on you, believe me. And it grates on me that they leave early because they have nothing to do, whereas if I can't get my work done because there are people constantly in my way, I won't get to the daycare in time to pick my daughter up. This is stressful.

    If I were a different kind of person, I would have no problem barking at med students to get the hell out of seats. I might even enjoy it. But it's hard for me, because that's not my personality.

    Lindsay: Great stories. I guess the truth is that we've all been there in the clueless department.

    Melissa: I think as a med student, the most important thing you can do to make people like you is to know when you're in the way :) It's probably the best advice you can give a med student, sadly.

    JessJess: God, it's so true. I have new sympathy for some of my old residents.

  15. It goes without saying that med students create work and often get in the way. That is unquestionable. What is questionable is how one responds to it. Perhaps its my management background prior to entering medicine, but I do not see a need to "yell" or "bark" at the student as you do; however I do see good reason to simply tell him this is a bad idea. One need not take an authoritarian tone to do so if it's not your personality, it can even be done as a friendly hint to the guy so as not to be "yelled at or barked at by the authoritarians who may take offense". These are people skills, which humorously enough you jest about someone else not possessing.

    As for this being your private must be new to the internet. You are aware that it's being read by attendings, residents, med students, nurses, etc....and has been posted to So yes, you have done many people a service by educating them that this manner of behavior is poor form; but it's also entirely plausible the student will hear of it and it's conceivable that they may realize who it is posting.

  16. I think like other comment said up there that the last post was rather distasteful, I thought you have learned from your own experience how to deal with med students, I have laugh really hard with your comic strips, but this time I didn't even smile :(
    It's hard to be a med student, we all know that, and sometimes people around you in an hospital enviroment make the experience even harder.

  17. Ah Fizzy, you never fail to educate and entertain!

    Personally I have politely asked cellphone-addicted students to give up their seats for an elderly lady in the reserved seating idea. I know what you mean: in the *real* world, though, sometimes the hero isn't always appreciated.

    We can't comment with name/URL?

  18. See, that's the thing. It doesn't grate on me. I agree that having med students and residents tends to make more work for me, but I just view it as another part of my job. To get annoyed because "my" med student is requiring my supervision/teaching and making more work for me would be like getting upset because the patients are getting sick and that's making more work for me. I also don't necessarily feel that they make my job "harder". They make the day more interesting, they may ask good questions, and like you said, it can be rewarding to see them developing and improving.

    If the student's not "mine", and I was really bothered by something they were doing, I would just talk to them. Not sure why you seem to think that the only options are to be silently annoyed, to complain to the student's preceptor, or to scream at/humiliate the student. And again, they don't grate on me. They're actually paying to be there and hopefully get a learning experience, and if they're not being taught I feel sorry for them. It's not their fault that the unit is poorly designed or that it's a crappy rotation with little learning value for them.

    Note that this is not the same as saying that med students never annoy me, but simply being clueless is not enough to do it for me.

  19. David: I'm confused... I just said I *didn't* yell at the student and now you're scolding me for taking this approach? Furthermore, if you looked at some of the earlier comments I made on this post, you'd see that I changed significant details about the story.... he would never recognize himself in a million years (if he is even a "he" at all). And since "he" wasn't even a med student, I doubt he'd be on SDN.

    If I could make an analogy for those of you who are still med students: say you have a huge test to study for tomorrow and every time you got up from your desk, somebody took your seat and you had to ask them to move. You might start to get annoyed. I'm human.

    For the record, I mentioned it to his preceptor today. She laughed knowingly and said she'd pass on the info. It was such a small thing.

    I'm not going to continue to reply to these comments but suffice to say, I think if you have enough readers, a percentage of them are going to always find something to be offended about. They fixate on a single sentence they don't like and blow it way out of proportion. I have certainly been dissuaded from posting anything further on here about my current life (I only did it the one time to create context for the other story, which everyone totally ignored). Anyway, lesson learned by me.

  20. I am stating that a point can be made, or even a reprimand given, in a nice way that is still effective. Then, if the point has not been taken, you step up the interaction or involve direct superiors. IMO, that would have been the better approach as it probably would have instantly relieved you of an annoyance, been beneficial to your co-workers who needed a seat, and delivered an educational point to the person (who I am still assuming at this point was further down the food chain than yourself). To my way of thinking, the only reason to involve a superior/supervisor is if the situation is significant enough to actually warrant it.

    My apologies for coming off a bit harsh though, at times, I need to remember the point I'm trying to make applies to myself as well.

  21. This comment has been removed by the author.

  22. Hi, Fizzy;

    I'm a med student, and I thought your post was funny. I've seen (and probably have been a few times) the clueless med student. It's good to see written out what we know the residents and attendings must be thinking. Don't be discouraged by all of these people who apparently take things WAY too personally. I think the vast majority of us love your postings!

  23. Fizzy,

    I'm starting med school next year but I just wanted to add, I really love your blog. I don't think your comments were out of line and I think they're understandable for someone in your situation. I hope you continue to share, not just comics but about your life as a physiatrist. Thanks and keep up the good work!

    Future Med Student

  24. Fizzy,
    I am on your side here.
    I am starting 1st yr. medicine next Monday at a university in Australia; and it appears obvious to me that for me to get the most of my clinical day at the hospital each week in first year that I need to keep in the good books of the hospital staff who are after all trying to do real work in the hospital.
    I have had a full career in an non-health/medicine industry where I supervised / managed up to 10 staff; and it is so obvious that as the most junior team member that you come last in the pecking order. This blog item further reinforces what my attitude should and will be on my hospital clinical day even though I will likely be older ( and look older too with advancing alopecia) than most of the medical / hospital staff that I am assigned to.

    This story of the med student is akin to (in my previous corporate career) having work experience or graduate trainees rotate through my unit for a one day , and up to a week long. There is nothing that they can do to help the unit; but somebody must take time out from their daily work tasks to hold the work experience or graduate trainee’s hand for hours .

    I think your blog is marvellous , and I fully intend to keep on reading new blog items as well as the archives.
    Chin up and many thanks , okimura

  25. I'm totally going to keep reading your blog b/c it's awesome.

    I don't see the need for all the reactive drama your quite reasonable post inspired.

  26. Fizzy, seriously, you need to keep posting honestly. Like Adam said, we KNOW what our superiors are thinking and I found it funny that you simply confirmed it.
    We're there to learn, but our learning is to our advantage, not necessarily residents/attendings. And now you've confirmed it.

    Which takes guts.


  27. Thanks, all.

    I'm going to keep posting, of course. But I think in general, it's not the wisest thing to post about your current job on the internet. I thought I was telling a brief anecdote and disguising most of the details, but then I ended up divulging more than I meant to in the comments. I still have plenty of cartoons and anecdotes I wrote years ago. But I don't intend to ever again talk about anything from at least the last two years. If it didn't happen with this story, it would have happened some other way, so I'm glad I had my eyes opened earlier rather than later.

  28. At the risk of straddling the fence here (how terribly Canadian of me), I can understand your sentiments without necessarily agreeing to them.

    No matter what your job is, those who are less experienced are going to be a bother, so much more so if you're busy or cramped out. That's just a fact of life. However, the dynamic changes, I feel, in the hospital setting. Even if he's not at a 'teaching' hospital, the more important fact is that he's a learner. Generally, we're not trying to get in the way, and are actively looking for ways to help. True, our skills and experience might be lacking, but if pointed in the right direction, even the most unskilled worker can be put to some use, or at least shown how to least get in the way.

    At the end of the day, as Liana aptly put it, we're all going to be future colleagues (well, assuming my bribe to the associate dean goes through in time), and the experiences we have at this early stage of our careers goes a long way towards shaping our future interactions with other doctors and students.

    [Of course, if the person is being lazy or malicious, then by all means, slag away]

    Keep up the good work! I show your comic to all my classmates, and they love it.

  29. I feel like your frustration doesn't have anything to do with whether you and the other person involved was a med student/intern/resident/attending/nurse/pre-med etc etc. I think the fact that it happened in a hospital setting where hierarchy is very prevalent is mostly coincidental.

    The fact is (and others have alluded to it already with comments about letting the elderly have a seat on the bus) is that people are just OBLIVIOUS and stupid and didn't have the right kind of upbringing that would signal their brain to go "oh, let me get up so this elderly/injured/whatever person can sit"

    but that's just my two cents of it. I appreciate the honesty of your post, regardless.

    I do hope that "Jim" kid ended up pursuing a PhD route though...I remember when I was an undergrad volunteering as a translator at a clinic, I was always very careful to remember to ask the patient if they wanted me to translate from behind a curtain during a rectal exam =/ Even if they didn't care, I always felt like I should...somehow I doubt I was missing out on anything. :P