Signs

Recently on my drive home from picking up my kids, I see these people standing on the street, holding up signs saying, essentially, "Gay marriage is evil."

It angers me on a daily basis. I want to honk at that people, but that's a sign of support, so I can't do that. Is there a way to anti-honk?

Instead, I've been turning it into a lesson for my daughter about intolerance. Every day I point the people out to her and explain that there are some people who don't believe that two people of the same gender who love each other should be allowed to marry, and isn't that awful? She agrees, although to be fair, I could probably convince her of just about anything.

Pathology class

VA Receptionists

I spent a lot of time at the VA during my training. I think there are a lot of great things about the VA. But one thing that has been consistent is that every receptionist I've worked with has been terrible.

The main receptionist in our residency outpatient clinic, Lucy, was the absolute worst. She would constantly tie up the phone line with personal calls, show up late, leave early, and she didn't know how to do anything. On the days she didn't come in, we'd just sign the patients in ourselves and it honestly wasn't any harder.

She didn't room patients or keep exam rooms tidy. That was the residents' job. One time an exam room ran out of disposable paper for the tables, and she showed me where I could find more, but refused to do me a favor and help me change the roll, considering I was very pregnant and having trouble with bending. "That's not my job," she said. So it's mine? I'm in training to learn how to change paper rolls?

In fact, she passive-aggressively refused to do even one little thing to make our lives easier. For example:

Me: "I'm going to another floor to see a consult. Can you please page me if any patients shows up?"

Lucy: "Okay, I'll do that."

Me: [stops halfway down hallway and turns back] "By the way, do you have my pager number?"

Lucy: "No."

I mean, WTF? Clearly she had no intention of paging me.

There was one time when that exact situation happened with another resident, she failed to page him, and the patient sat in the waiting room for like an hour. The attending came to check on the clinic, found out the patient had been waiting a long time and the resident was absent, and he lost his shit at the resident.

Finally, Lucy confirmed the resident's story that he had asked her to page him and she didn't do it. Apparently, Lucy got reamed, which was satisfying for all of us.

Playing smart

There was a resident I worked with who would always ask some hyper-intellectual question during lecture. Like: "You say that Intervention X didn't work, but a study done in 1998 showed that Intervention X was effective in at least three quarters of men over age 50."

And you're like, "Guh?" And you're all impressed that he could just randomly recite studies on seemingly any topic. You think he's definitely the most knowledgeable of all the residents.

However, if you asked him a directed question where there is one right answer, you discover that he actually didn't know some extremely basic things.

It's amazing how good some people are pretending to be smart.

Weekly Whine: Wood chips

I'm sure the non-parents reading this will have no idea what I'm talking about, but I've become incredibly frustrated recently that every single park in my area is now paved with wood chips.

In my day, they used foamy cushions to line a playground. Or they just used regular pavement, I guess. Obviously, I don't want my kid to fall on hard pavement and break an arm, but I really really hate those wood chips.

Aside from the fact that if your kid takes off their shoes, they are guaranteed to get a splinter, if you have a kid under two who is still in that oral phase, you are guaranteed to spend your entire time at the park grabbing wood chips away from your child seconds before she swallows them.

Wash your hands!

In residency, I once watched an attending performing urodynamics on a patient.

The attending did a rectal exam on the patient, and after it was over, he didn't change his gloves. So he was using the same glove, smeared with poo and lube to touch other things, including the computer monitor.

When he smeared poo and lube all over the computer screen, I nearly lost it.

And then at the end of the procedure, he patted me on the shoulder with that same hand (thankfully, he had removed the glove, but not washed up). I had to go sterilize myself after.

Irregardless

Lately I've been noticing more and more people using the word "irregardless," and every time I hear it, I want to raise my hand and be like, "Oooh, Oooh, Mr. Kotter, that's not a word!!!"

(Except I don't because I know how totally obnoxious that would be.)

In any case, when people use the word "irregardless" they usually mean "regardless." Adding the extra negative modifier doesn't change the word.

Then again, the people I hear using it are generally very intelligent people. So you'd think people like that wouldn't use a word that was so blatantly wrong. So maybe "irregardless" has been used incorrectly so many times that it's now correct. Just like "flammable" and "inflammable" now mean the same thing and are both correct.

I checked Wikipedia, the source of all knowledge, and they seem to say that it's controversial whether "irregardless" is a word. Irregardless, it seems that people use it a lot.

To call or not to call

When I was an intern rotating in the ER, we got a patient who had recently been admited to the hospital. Unfortunately, we didn't have an EMR and there was no old chart available at that time.

The attending was Dr. Brown, not my favorite of the attendings. Dr. Brown suggested that I call the team that had admitted the patient and try to get information about her.

The team that had admitted the patient was post-call that day. And it was about 10PM. I did happen to have the phone number of the intern that had admitted the patient, but I really didn't want to bother him at 10PM on his post-call day. Finally, I told Dr. Brown that I'd be willing to page him, but being post-call, his pager was probably off.

That's when Dr. Brown started pressuring me to call the intern at home. He said, "If you were on a wards team and you had information about a patient, wouldn't you want to provide that information if you could to save the hospital trouble and save the taxpayers money, even if you were post-call? And if you wouldn't do that, maybe you need to be re-thinking why you're in medicine in the first place."

I was like, woah. I think I just stared at him. Finally he said, "I can see you're uncomfortable with doing this."

I handled the whole thing horribly. Mostly, I never should have admitted I knew that intern's phone number. I don't regret not calling him though. Calling someone on their post-call night is just mean.... especially when the next day you're short call and have to wake up very early... I would have felt awful if I woke up him or something.

I finally compromised by leaving a message on the intern's pager, which he never returned, of course.

I apologized to Dr. Brown. I think he felt just as weird about the whole thing as I did because he was trying to be really nice to me after that.

Horoscopes for Med Students

I wrote this in med school for our humor magazine:

Aries: Since you are still just a student, it doesn't bother you that your patients don't call you doctor, although you wish they wouldn't call you Spanky.

Taurus: The stars predict that today is a good day to learn how to give a rectal exam.

Gemini: Despite what you may believe, doctors (much less medical students) are not gods, so stop trying to smite your enemies with plagues.

Cancer: You will become an oncologist, in one last desperate attempt to change your astrological sign.

Leo: At first you will be horrified to discover you have shown up for your exam naked. Then you will make the happy discovery that this adjustment improves your scores, while significantly decreasing the scores of the people around you.

Virgo: Although the library may be a good place to study, try to remember that you are not permitted to shower there.

Libra: Your classmates are not so upset by the fact that your latest class transcript is 50 pages long as they are by the fact that it is 50 pages of the sentence "All work and no play make me go crazy," and that it is identical to your last two transcripts.

Scorpio: While some people may say that the hospital is a metaphorical "battlefield", it is still inappropriate for you to carry around a samurai sword.

Sagittarius: Fortunately, your fear of blood is limited to histological slides of erythrocytes.

Capricorn: Thanks to your basic life support training, you will be able to save a small plastic doll from choking.

Aquarius: Despite what you may have been told, open heart surgery can never be performed "off the record."

Pisces: The stars indicate that medicine is not really the career for you. They suggest belly dancing.

My freaking oven

So this weekend I attempted to bake a pumpkin custard pie. In the middle of baking the pie, our fire alarm went off THREE TIMES.

Believe me when I say that there was zero smoke. We had a guest over yesterday and he actually said, "Why is your fire alarm going off when there's no smoke?"

It went off...

1) While I was pre-heating the oven

2) When I opened the oven to put the pie inside

3) When I opened the oven to take the pie out

Basically, unless the oven is absolutely spotless (my cleaning it usually isn't good enough... it has to be a professional), the fire alarm goes off every single time I use it. There's a fan over the stove that helps a little, but the alarm still usually goes off.

I've never had this issue any other place where I've lived. I mean, yes, I've set off the fire alarm a few times, but only when the entire kitchen was filled with smoke. I remember at my parents' house when I was a kid, I actually set fire to the toaster and the fire alarm didn't go off. There were literally flames shooting out of the toaster and no fire alarm.

I'm not saying that I want to have a crappy fire alarm. I don't want to die in a fiery blaze. But it would also be nice if I could pre-heat my freaking oven without the fire alarm making us all deaf.

I called maintenance several times. They checked the oven and "it's fine." They checked the fire alarm and "it's fine."

I don't know what to do. How am I going to start my second career as a famous chef if I can't even turn on the oven?

Eyelashes

Lately, I've been finding a lot of eyelashes in my eyes. This week I've had to fish out at least four eyelashes at various times.

Husband: "Maybe you should start plucking your eyelashes?"

Me: "Ew!"

Husband: "What? Isn't that what all women do?"

Me: "No! Women don't pluck their eyelashes! Women want to have longer eyelashes."

Husband: "Yes, but don't women pluck them and then, like, draw new ones in or something?"

Me: "You're thinking of eyebrows."

Weekly Whine: 3D Movies

The 3D movies fad really, really pisses me off. I hope it's a fad, at least.

The cost of movies is already almost prohibitive. Maybe not for me, but think about a family of five going to the movies. It costs something like $40 without even factoring in the overpriced popcorn. So what can we do? Tack on $3 a piece for 3D.

And if you want to avoid 3D, it's not so easy because half the shows are now 3D. And of course, the kids will whine for it.

I might feel better about it if I felt like the 3D added something. But the majority of the time, you can barely tell the movie is in 3D. I've read that the brain already 3-dimensionalizes movies, so what's the point of the 3D glasses then? And it seems like these days, practically every kids movie and any adult action movie is made in 3D.

I just feel like the people who make movies don't care about using 3D to make the movie better. They just tack it on to raise prices.

A while ago, I saw this movie at the zoo called Dora and Diego 4D. At first we were worried that the other two D's were for Dora and Diego, but it turned out there really were 4 dimensions of effects. Aside from the 3D glasses providing some pretty cool effects, our seats go shaken and we got spritzed with water. Plus there was a smell at some point. Now that was worth it.

As for movies in the theater, the only one I've ever seen that I felt utilized the 3D effects to make the movie better was Harold & Kumar. I've heard Avatar did too, but I saw it in 2D and I thought it was so godawful stupid, I can't imagine that another dimension would have made that big a difference. Unless that dimension included a plotline that wasn't totally cliched.

Rewriting

The hospital where I did my internship didn't have EMR, so one of my super-important jobs when I was doing cross cover was....

Rewriting orders.

Any time a patient even sneezed, you had to rewrite all their orders. I'm exaggerating, but it happened a lot. Like if GI took them for a colonoscopy, they needed all new orders after. IVC filter placed... new orders. Room change... new orders. And sometimes just because.

The primary team was supposed to leave the new orders with the nurse, but a lot of the times they would forget. Or else, maybe the new orders got lost. Or else, they wouldn't realize that the patient needed new orders after, like, a particularly large bowel movement.

I remember one time on call, a nurse paged me and said that I had to write a patient's admission orders completely over. Like copy two pages verbatim. Why? Because the patient had been sitting in the admitting unit for five days and that's when the orders had been written, so they had expired. That seemed REALLY WEIRD that the patient hadn't gotten a bed for that long, but I grudgingly went to rewrite all these orders like a good soldier.

That's when I noticed that there had been nothing written in the chart that was dated earlier than yesterday. In fact, it turned out the patient had only come to the hospital yesterday. The intern had simply written the wrong date on the admission orders.

When I pointed this out, the nurse grudgingly agreed that I didn't have to completely rewrite every single order. "You're not even going to rewrite the insulin orders?"
She seemed really disappointed.

Fun with Mnemonics

Bonus points for IDing all the mnemonics!

Med School Love

In every medical school class, there are a few love stories. In my class, none of them belonged to me. But I can still totally steal other people’s stories. I've been hesitant to tell this story, but I've changed a few details to make things less identifiable.

In my class, there was a girl named Beth. Beth was a really beautiful brunette, and was also really smart. She got the top grades in the class, made even more impressive by the fact that she was also a mom. She had married very young and had a son at a very young age.

One of Beth’s closest friends in the class was a guy named Brian. Like Beth, Brian was a non-traditional student, a couple of years older than she was. Beth and Brian started studying together, which worked out pretty well because both of them were crazy competitive. (Beth matched in derm, Brian in ortho.)

Brian was single and out looking for the right person. I wasn’t friends with him, but on several occasions, I’d heard him spout out some not-so-flattering theories about women. For example, he’d talk about how he’d send emails to women he’d met to keep them on the hook, even though he wasn’t that interested. Also, he said that women are out to have a good time until they turn 27. At age 27, women become all about marriage and it’s freaking annoying. (How dare he generalize us all that way?!)

As first year went on, it became obvious to all of us that Brian was in love with Beth.

We all thought, “Well, too bad for Brian. Beth is married.” Except not so much.

Brian was, apparently, much more attractive than Beth’s husband. Beth’s husband was bald, for one thing. And he wasn’t going to be an orthopedic surgeon either. So Beth got a divorce so that she and Brian could be together. And then Beth turned 27 and Brian dumped her because she was too eager to get married.

(I’m joking. They got married.)

As a child of divorce who had one parent leave the other for a third party, it was hard not to watch Beth and Brian’s relationship with a little bit of resentment. Why couldn’t Beth have made it work with her husband for the sake of her child? Was Brian honestly that much better? He was kind of a jerk, actually.

Tort Reform

A while ago, I got in an argument with a lawyer about tort reform and health care costs.

The lawyer felt that tort reform would do nothing to control health care costs. Her argument was that it's incredibly hard to bring a lawsuit against someone (i.e. there are no frivolous lawsuits) and she cited studies that said that malpractice did not significantly contribute to health care costs. Specifically, this was her comment on why C-section rates are high:

"All things that are related to malpractice, including insurance and suits, account for less than half of 1 percent of spending. So tort reform wouldn't actually lower medical care cost at all, contrary to the cleverly-executed agenda campaigns driven by decisive interest groups. Especially given that when it comes to actual malpractice suits (the rare one that makes it through impossible standards of scrutiny) almost every state has a cap on what can be paid out, or what can be claimed.

Essentially, it has NOTHING to do with trial attorneys who are pro-plaintiff rights. It has everything to do with insurance companies seeking to maximize profit. Insurance companies get to decide the value of a medical procedure or how much the medical professional is worth. They get to determine how much it costs to insure a medical professional, a formula which is partially determined on risk, as in, how competent the doctor is, how many complaints have been filed, etc.

They figured out that C-sections mean big money. Treating labor and delivery like an assembly line means more productivity, and thus, more payouts. Why have one doctor waste twelve hours with a stubborn fetus when you can deliver twelve in one hour, with the added benefit of epidural charge, oxygen tank charge. You get the idea.

Are there frivolous lawsuits out there? Of course. But they are rare, and I really wish before people spouted off an uniformed opinion, they actually took the time to do the research to see how difficult it really is to get any kind of malpractice case off the ground, how strict scrutiny actually is, and that each restriction on malpractice or rights to sue only hurts the injured."

Without looking at any articles, I know that fear of malpractice raises health care costs considerably. I am a doctor. I know how many tests I order that I know will be negative that I only get because of the fear of liability in that teeny tiny chance that I'm wrong. But how do you measure that in a study?

Fatigue and residency

When I was in residency, we had to complete on online training course on fatigue and depression.

The fatigue training course was kind of depressing (although the depression course wasn't fatiguing). The moral seemed to be:

1) You're definitely going to be tired during residency.

2) You need to use every moment of your free time for sleep. In fact, the following was a question:

You should use your free time to
(a) catch up on sleep
(b) spend time with family and friends
(c) pursue your hobbies
(d) moonlight

The answer was (a). You're not supposed to spend any time with family and friends or pursue any hobbies during residency.

3) Use caffeine to stay awake. They actually gave instructions on how to "use" caffeine, like it's a medication. You know, meth might help too.

4) If a resident gets into a car accident in New Jersey due to fatigue, they can be criminally prosecuted. So how the hell are you supposed to get home?

Step 3 questions

This was a practice Step 3 question that made me go "Awwww...." (I am very emotionally affected by test questions.)


A 37 y.o. obese man comes to the office because he has been "feeling really bad lately." He says that for the past three months he has been having trouble sleeping and has not been "in the mood" to go out. He has even stopped going to basketball games with friends, which was his favorite hobby. He has missed many days of work and finds it very difficult to concentrate. He states that he feels "pretty helpless." All of his friends from college are married with kids, and he says that he "can't even get a date," so he basically gave up on having a family. He just feels "worthless". The most vital question to ask at this time is:

(A) Are you currently questioning your sexual orientation?

(B) Do you ever feel like "life really is not worth it and that you should end it all"?

(C) Do you think that your life would be that much better if you were dating?

(D) Have any of your friends ever tried to set you up on a blind date?

(E) Why haven't you tried to lose weight?

Back pain and pregnancy

During residency, I had a 39 year old female patient with back pain (what else?) who was also trying to get pregnant. She had no kids yet. I wrote her a prescription for a strong NSAID and told her, "Don't take it if you think you could be pregnant!" (The attending originally told her it was probably okay, but it's Class D, so not okay!)

She told me that she decided to put off trying to conceive until her back pain was resolved. The attending said that was probably a good idea.

I held my tongue, but I wanted to tell her to have the baby now and deal with the back pain later. She's almost 40! And it's not like back pain is something that goes away quick. We had patients with back pain since before I was born! It's not like she's waiting for a papercut to heal up. The back pain will still be waiting for her nine months from now.

As usual, I kept my mouth shut though.

Weekly Whine: Wrong Order

Lately, it seems whenever I get takeout food, they get my order wrong like 50% of the time.

At this Burger King drive-thru I use a lot, they were getting my order wrong close to 100% of the time for a while. It was almost a good thing, because I was expecting it, so I'd always check before driving away and catch any mistakes. I even opened every wrapper because sometimes they wrapped the wrong sandwich in the right wrapper. Then they hired some new, more competent people, but they still sometimes get the order wrong. I went there yesterday and the girl at the window gave me kind of a dirty look when I was rifling through the bag to make sure everything was there, but sure enough, she forgot one of the burgers.

I've also had issues with a local Panera Bread. The last two times I've gotten takeout there, they forgot part of my order or got it wrong. Like once they gave me the wrong kind of soup. And another time, they forgot the kids mac and cheese. I was so angry when I noticed that and had to go back and wait for the part they forgot. I said to them, "I'm taking two apples." They didn't try to stop me.

But the worst thing is when you don't check and notice when you get home that part of your order is wrong or missing.

Recently I got takeout from a fairly expensive Thai restaurant, spending close to $100 for a meal for my dad's birthday. When I got home from picking it up, I discovered they had forgotten the seafood salad, which was the main entree for my father. I was so angry that I spent all that money and they couldn't even get my order right. Then I drove back to get the salad, and they gave us the wrong salad.

Doesn't anyone care about quality control anymore??? Is that it? Have all restaurants just given up on trying to please the customers?

Sure sign of pregnancy

A conversation from a while back:

Nurse: "You look so young! How old are you?"

Me: "Huh?"

Nurse: "How old are you?"

Me: "I'm 27."

Nurse: "Wow, only 27? That is so young!"

Me: "Yep."

Nurse: "You aren't married, right?"

Me: "No, I'm married." (Holds up left hand)

Nurse: "Oh! But you don't have children yet, right?"

Me: "Actually, I'm pregnant."

Nurse: "Oh my gosh, congratulations! I couldn't tell... you're not showing yet, I don't think." (Starts sizing me up)

Nurse #2: "I can tell. Look at her breasts."

Me: (Hides under table)

Acupuncture

One kind of neat thing I got to do in residency was acupuncture. There was an acupuncture clinic once a week and an attending would supervise us in performing acupuncture on patients.

As far as procedures went, it was pretty easy. The attending would point to a spot and we’d stick a needle there. Even if we were doing it “wrong,” we had no idea. And the patients all liked it and were very grateful.

Here’s how you do acupuncture as a resident:

1) Stick needles where attending tells you

2) Turn out lights in room and set timer for fifteen minutes

3) Go back and take out needles

4) Wipe needle sites with gauze “to keep the chi from escaping” and simultaneously roll eyes

At some point, I thought it might be nice to learn acupuncture for real and incorporate it into my practice someday. When I mentioned this to my father, he said, “So you want to be a quack then?” But I don’t believe acupuncture is quackery. At least, not entirely. If it’s done right, I don’t think it is. I have to wonder how many people in this country do it right.

I located a physician in my area who did primarily acupuncture, to learn more about it. She told me about a course for physicians who want to learn acupuncture, which involves several training sessions as well as hours of self-study. She recommended a book to me called The Web That Has No Weaver, about Chinese medicine.

She also told me that acupuncture isn’t “worth it” financially. That the only reason to do acupuncture is because you love it.

I finally decided that I didn’t love it enough or believe in it enough. That’s why I lost interest in acupuncture.

The only way I currently use acupuncture is when I’m doing EMGs. Apparently, the place where you put the needle to assess the first dorsal interosseous muscle is “a powerful acupuncture point” according to one of my former attendings. So I always tell that to patients, although I recognize that any effect my sticking a needle in there has is purely placebo.

Pain scale

Rescrub

Last week, I told a story about a med student who was told he wasn't sterile, and refused to re-scrub. This is a story that actually happened to someone in my class:

I was on my surgical clerkship with a guy named Dave, who was a bit of a character. He told me that soon after scrubbing and walking into the OR, he accidentally touched something, and was told that he was no longer sterile and he had to scrub again.

Dave left the OR, and he noticed that the sponge he had just used to scrub was still lying in the garbage. It wasn't IN the garbage, exactly. It was on the garbage. Hovering, like an angel. It seemed wasteful to him to open up a brand new sponge.

Long story short, Dave picked up the sponge from the garbage and used it to re-scrub.

As far as I know, nobody developed a horrible infection.

I'm not psychic

Long, long ago, I was doing a consult for the Medicine service, and I was trying to find out blood sugars on a diabetic patient. They were usually listed with the patient's medications, but I looked through the whole chart and they were nowhere to be found. Finally, I located the patient's nurse. "Where are the blood sugars recorded?" I asked her.

"They're in the chart," she told me.

I checked again. "I don't see them. I see blood sugars from yesterday, but nothing from today. Did you check them today?"

"Yes, of course," she said.

"Where are they written down?"

"I didn't write them down," she said, as if the idea were preposterous. She tapped her head: "They're up here."

Me (baffled again): "Uh... can I... see them?"

Weekly Whine: Rice

It bugs me immensely when restaurants charge you extra for rice with dishes that basically must be eaten with rice.

For example, when we get Chinese food, my husband usually orders chicken with broccoli. This is a very saucy dish which is always eaten with rice. But many times, the restaurant does not automatically provide that rice. The rice will be, like, two dollars extra.

Why do that? I guess it's to make the dish appear less expensive. But any deception achieved by subtracting the cost of the rice from the dish is eliminated by my anger at the fact that the rice isn't free. I mean, rice is really cheap. It should be free. They don't charge you for the butter when you get lobster.

But the absolute worst thing is when you get takeout from one of these restaurants, they don't inform you the rice isn't included, and then you open the brown paper bag and discover you have no rice at all. And then you're forced to, like, make your own rice or something.

Please, just give us the rice for free. Everyone will be happier.

Electrolytes

I don’t know how electrolytes always get so out of whack. Every day you replete them, then the next day, they’re off again. What happens when people are home and don't have daily chem panels?

When I did my ICU rotation as an intern, when you were on overnight, you always had to call the unit before coming over there in the morning to pre-round. Well, you didn't have to, but if you didn't do it, you were screwed. Because the on-call person was responsible for handling all the AM labs, so if you didn't call first to give phone orders, you'd get stuck handwriting a zillion electrolyte replacement orders.

Early in my rotation, I made the big mistake of physically going to the ICU before calling first, so the second I walked in, like five nurses came up to me with morning electrolytes that needed to be repleted on basically every patient in the ICU. Almost all the patients needed several things replaced. I gave all the orders verbally and after I was done, they said to me, "Okay, if you could just write those orders..."

I almost fainted. I wasn’t going to write 50 orders for electrolyte replacement on every patient on the ward, when I had a ton of work to do on my own patients.

Finally, I was like, "Uh, I don't remember anything I just said." Which was true. I think they took pity on me and allowed me to make them verbal orders.

How to get kicked out of med school

This was a story told to me by a visiting med student, about someone in his class who actually got kicked out of school. Just in case you were wondering what it takes:


The student was on his surgery rotation and was scrubbed in to a surgery with the chief of surgery. Somehow, he got contaminated.

Now staying sterile during a surgery is one of those mysterious things where you can touch one thing that seems disgusting (like bowel) and still be sterile, but you touch your chin and now you're contaminated. So you have to be very careful and a lot of the time you end up getting contaminated and sent out of the room to rescrub for reasons that you don't quite understand.

Anyway, the chief of surgery said to the med student: "You're contaminated. Go outside and rescrub."

The student replied, "No, I'm not."

Chief of Surgery: "Yes. You are."

Med student: "No, I'm not."

Chief of Surgery: "Yes, you are. Look, it's not a big deal. Just go outside, rescrub, then come back in."

Med student: "But I'm not contaminated. I'll prove it."

Then the med student proceeded to touch every single one of the sterile surgical instruments, and then stuck his hand into the patient's open body cavity in order to "prove" that he was still sterile. Although even if he had been sterile, I'm not sure what proof that provided other than proof that he was insane.

So in case you were wondering, that's what it takes to get kicked out of med school.

Interview anecdote

During one of my interviews for medical school, I was taking a tour with one of the current third year students when an attending passed us in the hall and waved.

Med student: "That was Dr. Jones."

Me: "No, it isn't."

Med student: [looking at me weird] "No, that's Dr. Jones."

Me: "No, that's Dr. McFizz. He's my dad."

Med student: "..."

Me: "I'm pretty sure about that."

(It was, in fact, my father. And although I didn't end up going there, I did get into that school. Yay nepotism!)

Ask the patient

A lot of times people make the argument that when doctors refuse to call in sick (because we selfishly love working while sick), it harms the patient. A patient who is unwittingly being exposed to a vicious URI.

So I say, maybe we should ask the patient...

Say you are about to have an elective hernia repair. You have arranged to take time off from work and you're mentally prepared for the surgeon. You are on the way to the hospital when you get a call from the hospital, saying that your surgeon has a runny nose and can't do the surgery. And there is nobody to cover, so you'll need to reschedule your surgery for some point in the future.

Are you okay with that?

Say you're in the ER with a stomach ache. You've been waiting two hours. A nurse comes in to tell you that one of the two doctors in the ER has a runny nose, so you'll now have to wait twice as long to be seen.

Are you okay with that?

Say you're about to give birth. One of the anesthesiologists has a runny nose and wants to go home, and since the only other anesthesiologist in the hospital is in an emergency surgery, you won't be able to get your epidural.

Are you okay with that?

(Well, of course you are. Because medicated childbirth is evil!)

In any case, I think it's pretty clear why doctors try to work through illness. And I think most of those patients would chose a sick doctor over no doctor.

The Blizzard

During my second year of med school, there was a blizzard.

It happened on a Monday, right when we were getting ready to take our endocrine final on Tuesday. The snow was bad enough that the day before the exam, the professor emailed us that the exam would have to be rescheduled.

Fair enough.

After the snow had died down, we got another email on Tuesday morning, saying that the exam would be rescheduled for Wednesday because the weather had cleared up. Also fair enough.

Except for some reason, certain members of our class went ballistic. They said that when they heard the exam was being postponed, they stopped studying, not realizing that the exam would be the next day. One guy complained that he'd spent Monday playing in the snow with his kids instead of studying, so it was unfair for the exam to be so soon.

Of course, he still had that whole night to study. And it was freaking endocrine, probably one of the easiest systems.

So these people asked for the test to be postponed until the weekend, giving them several extra study days.

I thought this was completely ridiculous. I'd been ready to take this test for two days and I didn't want to spend my weekend taking an exam. WTF?

After much arguing, the professor finally agreed to give two exams: one on Wednesday and one on the weekend.

And this is why my class had a reputation as the crazy gunner class.

Wrong career?

Sometimes I feel like I blew it when it came to selecting a career.

While I’m doing okay in medicine, I feel like people who get a good education have a chance to have a career that makes them truly happy. While I might be able to tailor my practice to make me happier in the future, I often get the sense that I went down the wrong path entirely. When my daughter talks about what she might want to be someday, I actually feel jealous that she still has so many options.

I should have known this would happen. Science class was never my favorite. When I was in seventh grade, I took a Life Science class and I hated it. When I was in eighth grade, I took earth science and I hated that. Then when I was in ninth grade, I took biology and I hated that.

At that point, I had been considering going into medicine, but I told myself that if I didn’t like my next science class, this was really getting ridiculous. Fortunately, I did like chemistry. Then I didn’t like physics either, but at least I liked chemistry.

When I was in college, I again hated biology. And I hated medical school.

It wasn’t like I never liked anything. I'm not, like, some negative person who never gets any enjoyment out of anything. I liked most of my math and computer science classes. And I always loved my English classes in high school. But somehow I didn’t realize there was a way to make a reasonable career out of that, mostly because all my friends were either getting PhD’s, which I didn’t want, or going into investment banking, which I really didn’t want.

If I had it to do over again, I actually think engineering or actuarial work might have been a good career for me. But at this point, you don’t quit medicine to go into something boring like engineering. People would think I’m nuts. I’d have to quit for a really crazy dream, like becoming a chef. (I love cooking shows. Maybe a possibility??)

Anyway, who knows? Maybe I’d be a thirty-something year old engineer wishing I’d gone to med school?