My 5 Favorite Abbreviations

1) s/p: Means status post. Meaning, something that happened. I use this so much. So much. I could use it like five times in a sentence:

Mr. Smith is a 63 y/o man with h/o CAD s/p cabg s/p fall with large SDH s/p R craniectomy s/p wound infection s/p I+D.

I really do try to limit myself to once per sentence though.

2) c with a line over it: Means "with". I use this probably more than s/p.

Husband: "What does c with a line over it mean?"

Me: "With."

Husband: "I don't get you doctors! Why don't you just write 'w' with a slash?"

Me: "Because this is Latin!" (cum is latin for "with")

3) @: Means "at", obviously. This saves absolutely no time over just writing "at" yet it looks immensely cooler.

4) 2/2: Means "secondary to".

Neurologist: "You know what abbreviation really annoys me? 2/2. Because why can't you just write out 'due to'? Is it really that much harder?"

Me: "Yes."

5) D/C: This is the greatest abbreviation ever because, especially in my field, it can be used to mean practically anything. If I wanted, I could write:

If there is no D/C from the wound, please D/C the dressing prior to D/C home.

And I did. And the nurse paged me and was like, "WTF?"

Ring

For some reason, my wedding band does not want to stay on my finger. It keeps slipping off. It wasn't too big when I bought it, but whenever I lose a little weight, it starts falling off.

Last year when I was pregnant, my ring kept falling off even though you're supposed to swell up. One time I honestly thought it was gone for good and was pricing replacement rings when I found it... in my pocket.

Question of the day:

How much do you think my wedding band cost?

Closest guess earns mad Fizzy points.

Tales from Residency: Formal language

Attending: "You wrote in this consult that 'The patient does not endorse receiving physical therapy'."

Resident: "Yeah..."

Attending: "Why did you say it like that?"

Resident: "What do you mean?"

Attending: "Why did you use the word 'endorse'? Why don't you just write it like you'd say it? Is that how you'd say it?"

Resident: "Um..."

Attending: "Well, that's not the way I'd write it."


Two minutes later, after attending has left the room:

Resident: "Oh my GOD, what an arrogant prick! I'm not allowed to use formal language in a consult??"

Me: "What does he want you to write? 'The patient don't want no physical therapy'?"

Resident: "Next time I'll write the whole consult in ebonics."

First Pelvic Exam

All these things were actually said by people in my class during our first pelvic exam. We made fun of the girl in the last panel for the next two years.

Thanks to Sharon, for the inspiration for this cartoon.

A bunch of shoutouts today to Doctors Terry, Are You Crazy?, The Medical Student, If These Scrubs Could Talk, Sleepy Doc, Eventually Dr. B, and No Shock Advised. You guys rock! It astounds me how many really great blogs there are out there.

Also, special shoutouts to one of the most interesting medical bloggers out there, Dr. Psychobabble, and to my personal favorite med student blog, The Long Road to Medical School.

And my final, extra special shoutout of the week goes to Dr. Grumpy, who endorsed my book a while back without asking for anything in return. He's a true gentleman. And if you're not reading his hilarious blog, you're missing out big time.

And this concludes the Week O'Cartoons! I hope you had as much fun as I did!

Weekly Whine: Boring!

Maybe some of you could help me out with this one:

What makes a person comment on someone else's personal blog, "This post (or this blog) is boring to me"?

I'd like to think that my writing is dazzlingly interesting, but occasionally, here and there, people have made that comment to me. And I've talked to other bloggers who were quite hurt by someone commenting that a post they made was uninteresting. I remember Michelle Au once posted that someone complained to her that all she talked about on her blog was work and her kids.

I get that some blogs are boring. Probably 99% of the blogs out there hold no interest to me. But considering I am aware that other people have different taste than I do and also that I'm not a complete asshole, why would I tell someone their blog is "boring"?

Are these people just so completely self-absorbed that if they don't find something personally interesting, they assume that nobody in the world could possibly enjoy it? I'm going to go with that one.

Sorry in advance if blog entry doesn't interest you.

Last chance to get a shoutout!

An excerpt from an email I got yesterday:

"Thank you for the mention on your blog today – it sent my views through the roof!"

This is your very last chance to put up a review and link to my book on Amazon and get a shoutout tomorrow!

Find the Medical Student!

Thanks to Jacob for the inspiration!

(I apologize if you already saw this cartoon, even though it was never actually on the blog. I was trying to schedule it for this week and accidentally published it immediately. In the 30 seconds before I deleted it, the post managed to be picked up by stupid google reader. WTF, google reader?? Can't I have 30 seconds to fix my mistake??)

Also, a shoutout to Wayfaring MD, Living My Life, and Code Babe for their reviews!

Tamponade

Cartoon was inspired by Action Potential

And today's shoutout goes to Plans and Laughs and the Barefoot Med Student for their awesome mentions!

Great Equalizer

The movie theater is the great equalizer. No matter how rich or poor you are, if you arrive too late to a crowded movie, your seat is going to suck. I was reminded of that today. My neck hurts.

I have to say, it's kind of lame that they make seats that are that bad. I mean, the front seats in any theater are pretty ridiculously bad. There's almost no point in seeing the movie at all if that's going to be your seat.

I remember a few years ago, I went to the movies with three of my friends. It was some really popular Blockbuster movie, and we only got there twenty minutes early, so we got kind of screwed in the seat department.

We located four seats together sort of near the front. The seats were close to the front, but I didn't think it was that bad. So we took the seats.

One of my friends decided to look around and see if there were any better seats somewhere. She did manage to locate a single seat at a preferable vantage point in the theater, and decided to sit there instead of with us.

I have to say, that always irked me a bit. I can't imagine how bad a seat would have to be that I'd want to sit between strangers rather than with friends. Granted, you don't really talk during movies. But you can laugh together, exchange knowing looks, and maybe make jerk off motions when appropriate.

Tips for Med School: What Not to Wear to an Interview

Thanks to Dr. SPM for the inspiration!

And special shoutout to Dr. Lasermed, Vicki's Golden Birthday, and The One With the Red Stethoscope for putting up reviews!

Stages of Step 1 Studying

Good luck from Leah to all the medical students at the University of Vermont College of Medicine on your upcoming board exam!!!

Special shoutouts to Nerdy Premed Chick and to A Med Student Walks into a Bar for putting up reviews!

Tales from Intern Year: Code Creamsicle

One night on call during intern year, I purchased an orange creamsicle after eating dinner. It was a really big creamsicle and it took me forever to finish. But since I was on call, I couldn't just sit there leisurely eating my ice cream. So I finally took off with the creamsicle.

Of course, I felt mega-dumb walking through the floor holding a popsicle and I commented on as much to another resident.

"That's nothing!" she said. "I once went to a code blue holding an ice cream cone."

Apparently, she had just opened up her ice cream cone when the code sounded. She considered throwing it away, but she didn't want to waste it, so she brought it with her to the code blue. Luckily, it turned out to be an anesthesia code, so she didn't have to do anything.

Awkward Interview Questions

A thousand thanks to Justin at My Pre-medical Transformation for inspiring this cartoon and also for putting up a review! Double shoutout to Justin for extra awesomeness!

And a special shoutout to Rick of Little White Coats and Sara at Teich Does Medicine for their awesome reviews.

Another difference between men and women

One of my male colleagues has a two year old daughter and I found out that his ringtone is a soundbite of her crying (as an infant).

I said to him, "I don't know how you could voluntarily make that your ringtone."

"Why?" he asked.

The sound of my baby crying is NOT a happy sound to me. I mean, I may as well set my ringtone to sound exactly like my pager. Plus it might make me lactate.

I have a feeling that this guy did not do a lot of late night feedings. Baby crying probably just meant handing her off to his wife.

Bad Habits From Residency

Thanks to Dr. Alice for the inspiration!

A special shoutout to Veterinarians Behaving Badly for putting up a review. Thanks to veterinarians for taking such good care of our pets and also for allowing us to have the day off on November 11 every year.

And a second shoutout to SuFu PhD at Diabetically Mind Numbing, diabetic, parent, and med student!

Week O'Cartoons

Today commences the Week O'Cartoons. In exchange for you guys putting up 20+ reviews on Amazon, I am posting a new cartoon every day at 9AM (central time) for the entire week. Please "tune in" to see a new medicine-related cartoon every day!

Every day there will be shoutout to the blogs that put up reviews for me. If you sent me a link, it will be there!

P.S.

Tomorrow kicks off the Week O'Cartoons! This is your last chance to put up a review and get a shoutout....

Weekly Whine: Kissing

Don't get me wrong, I don't dislike kissing. I like kissing people that I love. I sometimes will just sit there kissing my baby for like twenty minutes nonstop. (It's like kissing a peanut.) But what I don't like is kissing people as a greeting.

I can deal with shaking hands. I think shaking hands is a good greeting (except in the field of medicine, where is probably spreads massive germs). I can deal with hugging, I suppose. But to me, it just seems distasteful to put your mouth on someone you don't love (or lust). I wouldn't even want to kiss my somewhat close relatives such as aunts or uncles. It just feels so fake and awkward.

Worst things I ever had to do

During a particularly bad weekend call during residency, I made a list of all the things that were worse than weekend PM&R call, so I could feel thankful that I no longer had to do them:

1. 30 hour internal medicine calls. Where you're up all night and all your patients are in respiratory distress. And your resident is mean. And even though the call is officially 30 hours and officially you're not supposed to do more than that, the fact is that nobody is holding a gun to your senior resident's head to make sure you go home on time.

2. When I was in second year of med school and I had to take test after test after test. Basically every two weeks. And nothing was cumulative so you could have one bad day and end up failing an entire class. I didn't much like tests in college or high school either.

3. My least favorite subject in med school: metabolism. Memorizing every single step of the Kreb's cycle, all the enzymes, cofactors, etc. All of which was forgotten about an hour after the test. (Which I did pretty terribly on, despite my sacrifice.)

4. My least favorite subject overall: history. I hated history class more than anything, even though I usually did well in it because I'm a nerd. So boring. I really hated writing the papers too. It would hang over my head and I'd totally dread it for weeks before. I still sometimes have nightmares where I have to write a history paper. I especially hated having to go to the library to research the papers (there was no internet back in the olden days and also lions had riches). I was never into that whole library scene. I could never figure out how to find the right books. I guess now I'll never need to know.

5. The just immense amounts of standing that were required during third year of med school. Eight hours in a row was not uncommon. I remember all these tricks I used to use, like sliding my foot out of my shoe for a minute, or shifting my weight from foot to foot. Sometimes my feet would just feel like they were on fire. Sometimes it was so bad on rounds that I'd rest my butt on a sink for like a second just to get some relief.

So basically, I am thankful that I don't have to stay awake 30 hours straight or take a test in the next two weeks or memorize stupid pointless stuff or write a history paper or stand for long periods. Now let's eat turkey.

The shirker

There was a girl in my class named Elaine who got a reputation during third year for blatantly shirking responsibility.

I actually had no problem with Elaine and even sort of liked her. Even as early as high school, I've always somehow gotten along well with girls that everyone hates, though I'm not sure what that says about me.

Anyway, a typical Elaine story:

She and I worked together on L&D and one day I was waiting for the patient I was following all day to deliver, so I asked if she could cover a C-section for me even though it was my "turn" so I could see the vaginal delivery. She refused, but fortunately, the delivery managed to happen before the C-section, so it was all good.

As I came out of the delivery room, I said, "Well, I guess I'll do the C-section now." But things were so slow and boring that Elaine changed her mind and now she wanted to do my C-section instead. I'm sure this would have pissed me off if I cared at all about OB/GYN, but I didn't, so whatever.

What I liked about Elaine was that she was forthright about her lack of interest in anything. She didn't ever pretend to care, no matter who she was talking to. When our resident asked her to do a presentation, she said, "If I were interested in OB/GYN, wouldn't I have gone to the OB/GYN meeting the other day?" I kind of respected that.

One morning on GYN, Elaine and I were scheduled to alternately scrub with an attending named Dr. Rich for his four surgeries (stretching from 7 AM to 5 PM). She scrubbed on the first one, then I was supposed to scrub on the next one, then she was to scrub on the next one, then I'd do the last one.

When I came in for the second surgery, Dr. Rich made a really weird comment to me. He said, "When I ask you to do something, don't ask if someone else is supposed to do it."

I was like, "Uh okay." As if I'd ever do something like that.

Finally, at the end of the surgery, I told Dr. Rich that Elaine would be scrubbing in for the next surgery. He said to me, "No, you are."

I later found out that Elaine had managed to piss Dr. Rich off during the first surgery. It was a laparoscopic surgery and he asked her to change the settings on the camera and she said, "Isn't someone paid to do that?" He didn't appreciate her comment. I thought it was sort of funny though.

You need to read more

Who has gotten an evaluation saying that they need to read more?

*raises hand*

Before internship, I never had. I guess I was reading enough as a med student or else nobody cared how much I was reading.

Then on my first month of internship, my resident Jessica seemed to mistake my lack of confidence for stupidity. I know there are people who march into internship being totally confident, but I wasn't one of them. I was terrified of harming a patient, so I probably asked way too many questions. I was scared to give Tylenol without asking if it was okay first.

After a few days (or hours) of annoying questions from me, Jessica couldn't take it anymore. She started yelling at me that I was the dumbest intern on the planet. And worse, I was dumb because I didn't care enough to learn. Really, it was kind of the opposite. I cared so much that I felt the need to verify every little thing.

Anyway, at the end of the month, this was Jessica's evaluation of me, which I saved so that it could still hurt my feelings decades later:

No attempts to seek additional information about patient care plan/disease process. No resources utilized for most patients. Was asked multiple times through the month how she was directing her self learning but no books/resources actually obtain. She stated she planned to get UpToDate, the red Stanford book/blue Harvard book.

By the end of the month Fizzy showed some improvement but overall her medical knowledge is insufficient. In feedback, I encouraged her to read vehemently, to seek pocket resources to guide her day to day, and to be more complete in her patient work ups.

Ouch, right? That was by far the worst eval I'd ever gotten in my life. I knew my knowledge base wasn't terrible because I did extremely well on Step 2. And the truth of the matter was that I actually had the "blue Harvard book" well before the end of the rotation and showed it to her in response to her pestering me. I also told her that I had ordered UpToDate, but along with the rest of the residents in the hospital, our order was delayed due to administrative bullshit. That was apparently my fault though. And also, I guess my palm pilot (remember those?) packed with information was totally useless if I don't have the two books she considered important.

Still, it made me feel pretty bad. But later I talked to many other residents who have gotten the "needs to read more" comments, and I've come to the conclusion that there are some people who simply think their underlings need to be reading 100% of the time. Like while eating, on the toilet, etc.

Opportunity for bloggers

Next week's Week O'Cartoons is likely to be a high traffic week for my blog. So I'd like to offer my fellow bloggers an opportunity that is mutually beneficial:

If you put up on your blog a brief book review or promotion with a link to my Amazon site, then I promise I will give your blog a shout out at the bottom of one of my cartoon posts next week.

If you're interested, send me an email with a link to the review/promotion on your blog. Great opportunity for any little newbie blogs out there! Or you can do it just because it's what all the cool kids are doing.

(Note: I do maintain the right to refuse to link to you if your blog is horrible in some way. For example, I will not be linking to any white supremacist blogs. Actually, if you're a white supremacist, I'd sort of appreciate if you didn't link to me and just didn't read my blog at all. Thanks.)

Tales From Intern Year: No-show

During intern year, I had to do a continuity clinic. I would get about four patients booked per clinic and try not to get too horribly behind.

So for four clinics in a row, I kept seeing the same name on the list: this patient who they kept scheduling for appointments and he NEVER showed. When I would see him on the schedule, I started to think it was some kind of joke or something and that this guy didn't even really exist. I mean, after he missed three straight appointments, there should be some kind of rule that he doesn't get a new one.

I came late to clinic one evening because I assumed the patient wasn't going to show and I didn't want to wait around for half an hour. Amazingly, though, I got paged and the nurses told me he had arrived.

When I walked into the room, I had already decided I was going to yell at him a little. I didn't want to give him a hard time, but the guy had missed THREE appointments in a row. "Sorry, I forgot," he said.

"It's not really fair to other patients," I told him. "There are only a limited number of spots and when you don't show up, you're taking a spot of someone who also needed an appointment."

"Yes, but the problem I'm here for is forgetfulness," he said.

Sure enough, the form did list "forgetfulness" as his chief complaint. Way to prove it.

Week O'Cartoons

Well, I said that if I got over 20 reviews on Amazon, I'd do a full week of cartoons. Being a woman of my word, since I now have 22 reviews, I guess I actually have to do this.

So from Sunday, January 22, through Saturday, January 28, there will be a brand new cartoon posted daily at 9AM.

Thanks to everyone who emailed me ideas. If I end up using your idea, I will give you a shout out, or a link to whatever you asked me to link to. (Last chance for ideas!)

My First College Interview

When I was applying during my senior year of high school, the first college that offered me an interview was MIT. For those of you who don’t know, I was a bit of a math geek in high school, so MIT was actually a perfect choice for me. It was basically the math team expanded into an entire school. Wow, heaven.

The other great thing about MIT was that since there are not many girls interested in math, you don’t have to be nearly as competitive as the male applicants. You basically just have to be okay in math. For example, if you could calculate the postage on your application, that’ll do. So I, being a straight A math student, a math team captain, etc., thought MIT would be salivating over me. I thought they’d be offering me cars and jewels during my interview.

My interview was given by an alumnus of MIT named Alyssa, who worked at one of those large investment firms with two names (Goldman-Sachs, Smith-Barney… can’t remember which one). I figured Alyssa and I would bond over our mad math skillz, and she’d try to convince me to pick MIT over the much more sunny Cal Tech.

It didn’t really go like that.

Alyssa kicked off the interview by informing me that MIT was now half female, so that there were lots of girls there and they totally didn’t need me at all. So there. I didn’t entirely believe her, but I wasn’t about to start arguing.

I got the feeling that Alyssa felt that she was in competition with me, for some reason. I deduced that when she said something along the lines of, “You got the top score in the city on XYZ math competition? Wow, that’s impressive. I was only second in the state on ZYX math competition.” I don’t know why Alyssa felt she needed to compete with me. I mean, I was a high school kid, for god’s sake, and she was an adult.

But then the best part was that before the interview was over, Alyssa gave me a math problem to do.

And it wasn’t just a math problem, which might not have been so bad. It was one of those puzzles where you have five people and they have to get across a river with one canoe in three tries or something like that. Doing a puzzle like that during an interview with a catty i-banker watching you is not fun. It was a lot of pressure. I sort of felt like John McClane in Die Hard 3 with those stupid buckets of water. Anyway, I couldn’t figure out the answer, and Alyssa had to show me how to do it.

Just in case you’ve never been on a college interview, you should know it’s not standard practice to be given a math problem. None of my other friends who interviewed at MIT got math problems. And that wasn’t even a math problem. It was just stupid.

By the end of that interview, I was pissed as hell at Alyssa. In my opinion, that is not an appropriate way to run an interview. On the bright side, at least she didn’t sexually harass me, I guess.

Anyway, in case you were wondering what happened with MIT, I ended up withdrawing my application after I got in early somewhere else. I always wondered if I’d still get in after that interview, but it wasn’t worth the application fee to find out.

Unusual medical condition

Patient: "Hey doc, can I ask you a question?"

Me: "Sure."

Patient: "This friend of mine went to the hospital--"

(Because I have nothing better to do besides answer medical questions about people I never met...)

Patient: "And my friend was telling me that when they tried to draw his blood, there was no blood. They couldn't get out a drop. Then they got some expert to try to draw the blood and they couldn't do it either! And they told my friend that he has no blood left. Like, no blood in his whole body. Does that sound right to you?"

Me: "No."

Patient: "Well, I didn't think so either. But they couldn't get any blood out of him. And he can't walk."

Me: "Without blood, you can't live."

Patient: "Yeah, you're probably right. He probably at least had a few drops."

Weekly Whine: Facebook

I have a Facebook account. Of course I do. Everyone does.

I find it useful at times. Facebook has helped me to reconnect with old friends, learn about social events, find out who recently got married, who's having babies, etc. I log on at least once a day to get an update.

But I'm not a heavy Facebook user. I rarely post. I generally only friend people I either know very well or who have friended me first, so I have less than 150 friends. I put up a photo when my baby was born, then 2-3 more photos since then, and that's been pretty much it for the year. Mainly, I've avoided using Facebook (much) or Twitter (at all) because I know I have a tendency to overuse these things, and I didn't want all my real life friends to think I was a loser who was always on Facebook. Plus I just don't have time in my life for another internet diversion.

Maybe it's because I use it so rarely though that every time I DO post something on Facebook, I feel like such a loser.

For example, on my post where I announced my baby's birth, 15 people "liked" the post and 8 commented. In contrast, someone on my friends list recently posted a picture of a cereal box and got more comments and "likes" than that. WTF? It really makes me feel kind of bad.

Then again, I finally made my birthday public this year and I've never in my life gotten so many people I barely know wishing me happy birthday.

First JIR publication!

I just wanted to share that my groundbreaking article "All Research is Actually Made Up" has been published in the current issue of the very excellent Journal of Irreproducible Results. I won't spoil the conclusion of the article for you.

Right after it was accepted, I sent a copy of the article to my father, who generally likes my writing because "most women don't write funny stuff but you do." I thought to myself, "He's going to love this!"

He didn't. He said, "Well, this is just silly."

I'm glad though. It shows he was being honest about liking my other writing.

Tales from Med School: Oral exam

Dialogue following a mock oral exam administered by a surgery atttending in front of the rest of the med students:

Attending: "So how do you think you did?"

Student: "I think I did very well."

Attending: "You do?? You know, you forgot a lot of things. You forgot to ask for the vitals, the oxygen..."

Student: "Are you wearing two different shoes???"

(He totally was.)

Tips for Med School: In the Bathroom

One of your most important duties as a medical student is helping your attending in the bathroom. Even if they don’t look like they want your assistance, they absolutely do. When a good medical student sees their attending enter the restroom, they stay close behind.

The first important job of a medical student is to make sure the bathroom stall is fully equipped before the attending enters:

If the stall is in any way inadequate, it is your duty to correct it. Bring paper towels to clean off the seat. If the floor is very wet, put your white coat on the floor so the attending does not ruin his shoes. If your attending is female, you may be asked to hold a purse or dispose of a used Tampax product.

Now look at the following case study, in which the attending seems displeased. What is the medical student doing wrong?

You guessed it: a good medical student would have replaced the urinal cake without having to ask! You should anticipate your attending’s needs in advance, as this honors-level student did:

You are now ready to accompany your attending into the bathroom and earn a glowing recommendation to the residency of your choice.

Need ideas

In a previous post, I promised to do a full week of cartoons if I got 20 reviews on Amazon. Since I now have 18, it looks like there's a chance I might actually have to do this.

So since you guys got me into this situation, maybe you can help me out.

If you have any ideas for cartoons I can draw, even half-baked ones, send me an email at fizzziatrist(at)gmail.com (note the extra Z). If I use your idea, I'll give you credit however you like (tell me how).

Are you malingering?

This is a test I learned for malingering brain injuries in patients that come into your office.

Let's find out if you're malingering. Look at the following picture for 10 seconds:

Stare at this for 10 seconds

Now copy the image you just saw onto the paper. It doesn't have to be in the right order.

Getting less than 9 of the 15 items in the original image strongly suggests that the "brain injured" patient is actually malingering. Yes, there are a lot of people that wouldn't get 9 out of the 15 items. I've had a lot of patients who wouldn't even be able to stare at the drawing. But the key is, if the patient walks into your office, is basically functioning but just complaining of symptoms like decreased memory, attention, etc, they should still be able to copy that picture.

If they can't, they're faking it. (Maybe)

Copy and Paste

As a doctor, huge amounts of time are spent documenting things. For this reason, templates can be very helpful as a time saving device. But the most important thing is to make sure to edit the template carefully.

When I was a PGY2 rotating at the VA, I admitted a woman for rehab for a right hip replacement. I used the "Hip Replacement" template in writing up her H&P, which was basically an H&P that had been done on a prior hip replacement patient.

A few days later, I was looking over the woman's H&P and to my horror, I realized that I had referred to the patient in the physical as a "Pleasant Somoan gentleman." And since I had already electronically signed the document, it was not editable, so there was no way to correct it. To my second horror, my attending had written an addendum that said, "Correction: Patient is a Caucasian female and not a Somoan gentleman."

Here's the worst part:

About a year later, I was rotating at the VA again, and that same woman came back to have her left hip done. I had my templates ready, and even though I told myself about a dozen times to be careful, I somehow managed to forget to edit that part again. So now I had written two separate H&P's on this woman referring to her as a "pleasant Somoan gentleman."

In summary, sometimes it's better not to use a template.

Reviews, Attempt #2

So last week, I asked if people who bought a copy of my book (either from Amazon or Lulu) could put up a review on Amazon. A few people did it, which is great. But I'm aiming higher.

I realize that in life, you can't get something for nothing. So how about a deal?

I originally created this blog to post cartoons, but it's kind of hard to draw that many cartoons, so now I only get up maybe one drawing per week, if that.

However, if I reach 20 REVIEWS on the Amazon page, I will do ONE FULL WEEK of one brand new cartoon per day. (I'd promise a month, but I think my hand would explode.) And they won't be throwaway cartoons, like a picture of an ear or something.

I kind of think 20 is a lot, so I'm not revving up to draw a bunch of cartoons yet. But maybe you guys will surprise me.

The best co-resident ever

I've complained a lot about my co-residents during residency, but some of them were really great. Notably, there was a female resident named Gina that I was working with on a VA clinic rotation who was probably the most considerate and hardworking resident I've ever known. In spite of the fact that she seemed to hate residency.

For example, my daughter was just starting daycare then and I came down with a really bad stomach virus. I came to work looking completely green, throwing up between patients, and nobody sent me home (of course). Anyway, the next morning, I had clinic and Gina didn't, so she called me and preemptively said she was going to cover my clinic, so I could stay home and rest. Isn't that nice?

I tried to do my part by being considerate back to her. An attending noted that he'd never seen two residents work so well together.

Actually, what he really said was that he'd never seen two residents argue over who will see the next patient. Considering many of the patients at the VA pain clinic were kind of unpleasant and neither of us actually wanted to see them, the only reason we argued over this was to be considerate to each other. It was sort of like:

"Oh, I'll see this demented, alcoholic, homeless guy with back and neck pain."

"No, it's okay, I'll see him."

"No, I don't mind, really. You have a lot of dictations to work on."

"No, it's okay, you have epidurals in an hour and I want to make sure you have time to eat."

It's really nice working with someone who is genuinely considerate.

Top 10

According to z100 (my favorite station as a teen that somehow became a pop station circa 1997), these are the top 10 songs of 2011:

10. Maroon 5 F/Christina Aguilera - Moves Like Jagger

9. Lady Gaga - Born This Way

8. Bruno Mars - Grenade

7. Onerepublic - Good Life

6. Enrique Iglesias - Tonight

5. Adele - Rolling In The Deep

4. LMFAO - Party Rock Anthem

3. Britney Spears - Till The World Ends

2. Pitbull F/Ne-Yo - Give Me Everything

1. Katy Perry - E.T.

It makes me feel sort of old that I don't really like any of these songs that much. And I've never even heard the Iglesias song.

It makes me feel even older that my daughter actually really likes a number of these songs. I heard her singing Party Rock Anthem the other day.

(To be fair, I did like a couple of them before they got overplayed ad nauseum.)

Weekly Whine: Look it up!

A while back, I was rounding on the ICU service with a new attending who had just come on service. On her first day, she said to us, "If you ever have a question on one of your patients...."

She paused. I waited for her to complete the sentence, assuming she was going to tell us something like, Feel free to bring it up on rounds so we can all learn from it.

"Don't ask me the question," she finished. "Look up the answer yourself."

Ouch.

The mantra of "look it up yourself" is pretty prevalent in medicine. I remember on another rotation, I had a question about the dosing of steroid in oral vs. IV form, and I did look it up, and still couldn't come up with the answer. I asked the attending on rounds, and he said, "This is why you need to look things up." I tried to explain that I still couldn't find the answer, but he didn't want to hear it.

Why is there this culture in medicine of refusing to answer questions that trainees have? I can't imagine saying something like that to a med student or resident. Isn't part of being in a teaching program to actually, you know, teach?

Debauchery

During third year of med school, one student in my class named Alex decided to have a big party at his house and invited about twenty other guys from our class. He also decided to hire some strippers to come to this party. And naturally, word spreads fast when you’re having a stripper party, so everyone pretty much knew about it.

A few other (mainly female) students in the class were enraged by Alex’s party. They reported him to the dean and to our honor code committee, and said that his behavior was unprofessional for a future doctor. They demanded that disciplinary action should be taken against him.

A friend of mine was at the party and said that while there were strippers there, it wasn’t that debaucherous a party. Meaning, I don’t know what exactly. I guess no strippers were accidentally murdered and buried in the woods during the party?

Anyway, I don’t know the exact outcome of the situation, but I very much doubt any major disciplinary action was taken, since Alex matched in one of the top residency programs in the country in a super competitive field.

What do you think? Should Alex have gotten in trouble for his stripper party?

What to do when you're being pimped: An algorithm

Note: Cartoon inspired by Tony L

Review

To those of you who have purchased a paper copy of my book, just know that I think you're awesome. And if your kid got ahold of it and learned a dirty word from it, then I'm terribly sorry.

For those of you who did buy a copy and enjoyed it, please consider going to Amazon and posting a review. I'd be eternally grateful. Just click on "Create Your Own Review".

(If you didn't like it and post a bad review, I won't be grateful, but I suppose I'd have to grudgingly respect your honesty. (Although really, you knew what was in the book before you bought it, so it seems like that would be your fault, right? (Just saying.)))

The Pretty (Weird) Med Student

When I was doing an ortho elective during my residency, there was a med student also rotating with us named Chelsea. Chelsea had a lot going for her. First of all, she was really beautiful, not in an intimidating way, but in a really cute way. On top of that, she was also incredibly smart. She was probably one of the smartest med students I'd come across and she was from a stellar med school. She was only a med student and she knew way more ortho than I did. I figured this girl could do no wrong.

Interestingly, one afternoon, I heard two male residents talking about Chelsea while she was in the OR, and they didn't have good things to say. I was SHOCKED. I mean, here's a med student who's really smart and conscientious and eager and most importantly, HOT. Why weren't they drooling all over her?

The senior resident remarked that Chelsea was "weird." That when he addressed another resident to ask him a question about his patient, she would answer for him. That IS sort of weird.

The other resident remarked that Chelsea was "annoying." He was trying to interview a consult patient and she was tagging along, and she kept interrupting the interview to ask her own questions. She did that to me too and I found it really annoying too, but I thought it was a problem with ME, since she was clearly so awesome. It was a nice vindication to find out other people found her annoying too.

And in all the bitching about Chelsea, neither of them mentioned how hot she was. I have to say, I was impressed with those guys. I mean, they were orthopods.

Tales from Residency: Tooth pain

I'm very touchy about getting bothered while eating. I'm sort of like an animal, who gets very possessive of their food and doesn't want anyone to get near them while eating. Plus I feel like there are very few emergencies in rehab that should require me to have to stop eating and go running to see a patient.

Anyway, during an inpatient rehab rotation in residency, I was just sitting down to my lunch in the resident's office. Just as I was taking a bite of my nice hot sandwich, there was a knock on the door. It was one of the nurses.

Nurse: "I was just cleaning Ms. Smith's teeth and she seems to have tooth pain. I checked her mouth with a light, but I couldn't see anything."

Me: "Oh."

Nurse: "Can you take a look?"

Me: "Can this wait until later? I just started eating. You can give her some Tylenol."

Nurse: "Well, it really hurts her."

Me: "How is my looking at it going to help that?"

Nurse: [doesn't budge]

Me: [puts down sandwich, sighs] "Fine..."

So I went and looked in Ms. Smith's mouth. It turned out there was a huge cavity that I saw in one of her back molars. I got out my drill and filled it for her and her tooth pain was gone.

Oh wait, no I didn't. Because I don't know a freaking thing about dentistry, so when I looked in her mouth, I saw absolutely nothing and she continued to have tooth pain despite the fact that I heroically rushed to her bedside.

I've always been a softie and the nurses know it. I'd probably be better off if I were one of those doctors that the nurses are afraid to page when they're on call.

Tales from Residency: Tape

During EMGs:

Attending: "Can you cut me a small piece of tape?"

Med student: [cuts very small piece of tape]

Attending: "No, that's too small."

MS: [cuts microscopically larger piece of tape]

Attending: "That's still too small."

MS: [cut much bigger piece of tape]

Me: "Now that's TOO big." [pause] "Just kidding."

I will never get to be a surgeon, so that was probably my only shot to make that joke.

New Years

So it's 2012. What's your New Years Resolution?

Last of the holiday repeats

Tomorrow there will be a new (somewhat related) blog post per usual.