Saturday, August 29, 2009

Why can't we all just get along?!

Apparently, I've crash-landed into the perennial feud between nurses and medical students.

Now that I've transitioned from my orthopedic surgery rotation at the county hospital (where all the prisoners and people from "low socioeconomic status" go) to my general surgery rotation at the tertiary referral center for children, I've noticed a stark contrast between the two. For example, one of my (lofty, I know) goals every day is to avoid getting yelled at. Well, I can't honestly think of any times I was yelled at on my last rotation, but I can definitely tell you I've been yelled at now! I doubt it's because I've suddenly become incompetent. Anyway, as always... I didn't even do anything wrong!

I'll spare you my rant about professionalism, truth, justice, and the American way. I will say I don't enjoy getting yelled at.

And for inspiration, I listen to "The Fray" every morning on my way to the hospital. Just kidding, now I have to be in so early that the BBC World Service is still on the radio when I leave... Nothing like a good London accent to wake you up in the morning. Though I don't know HOW they wake up in the morning over there if all the drink is tea--no coffee!?

Tuesday, August 25, 2009

Milk of Amnesia

Yesterday, I utilized a unique study strategy, one that will probably never work again. No, I didn't rewrite all of my notes in mirror image, although that is an idea for the next time I'm bored and feeling ambidextrous. What really happened was, I used the news to study.


I was studying for the anesthesia exam I had today. And Michael Jackson's death was in the news, because it was ruled a homicide (in case you didn't know). Anyway, as you've probably heard, he had been given some drugs by his doctor to "knock him out" (if you will), more specifically, propofol and some benzodiazepenes. Well, anyway, propofol is the most commonly used drug to put people to sleep for surgery induce anesthesia. So, when I went to the little gym at my apartment complex, someone had the news on. And all they were talking about was propofol this and propofol that. And since I was studying anesthesiology, and propofol's an anesthetic medication, I was like "hey, this is perfect!" So, I used the news to study.

Hopefully, later tonight I'll be able to use the Tonight Show to study. Although I start my pediatric surgery clerkship tomorrow, so maybe if I want to use the television to study from, I should wake up really early and watch Blue's Clues or something.

Or maybe since I'm starting pediatric surgery (peds surg, if you will...), I should go out and get ahold of some "Dora the Explora" scrubs so I can be as cool as all the nurses.

Saturday, August 22, 2009

Earlier this week, my attending anesthesiologist gave me the "fist pound" after I successfully intubated a patient. Not gonna lie, this was some of the best "positive feedback" I've ever gotten!

So, based on that, this week was a success! Plus, we had a patient ask if she was going to get the "Michael Jackson medicine" for her surgery... She did, because almost everyone does for surgery. But of course there's monitoring and such, so even though something bad might happen, usually everything goes fine.

So, it was a great week for me. Anyway, all this "fist pounding" reminds me of the guy from the Bahamas in my statistics class in undergrad who always wanted to "pound it, dog, cause that's sweet, like a diabetic can't have!" This was later shortened to "Pound it like a diabetic", a phrase which has yet to "catch on" with the general public. Diabetes (and it's associated testing supplies), on the other hand, has certainly caught on.

Tuesday, August 18, 2009

Titanium White

Imagine my excitement yesterday when I was told that I didn't even need to bring my white coat to the hospital for the next couple of weeks while I'm on the anesthesia team.

Can't imagine? Just think about it for a second; it's the middle of August, and 90°F or something. Still confused as to why a coat just isn't a good idea?

Monday, August 17, 2009

*Updated* 13th Edition (with ONLINE content!)

Viola! I've got it! "What is it?", you ask? Well, I'll tell you! I've discovered how to talk like a textbook.

I guess after years of absent-mindedly flipping through pages careful study, I've finally figured out just what it is that makes a textbook sound like a textbook. There's a few general things that really get the ball rolling. First, come up with your own names for everything. Be not content to call it "Kool-Aid", when you could call it sugar-laden beverage. Then abbreviate it to be SLB. Make sure that stays in bold, too, lest we forget it's a made-up word. AKA an MUW. And of course, if there's a figure which has this so-called SLB in it, don't hesitate to label it as something else entirely, and explain the new abbreviation you've used in the picture in a footnote or caption (preferably on the next page--or better yet, "refer to page x). Like carbohydrate-infused water, CIW for short. It's like I always say, "The more acronyms, the better!"

Innovative verbiage notwithstanding, you need to amaze and engage your reader with full-color diagrams and on-line content, respectively. Only when your humble pupils have mastered the cryptographic art of deciphering the "respectively clause" will you know that they are worthy of the secret knowledge that you alone possess. Sort of like a modern-day Illuminati or DaVinci Code. Speaking of which, if you devote a whole page spread to some sort of pop-culture reference with a vague relation to whatever you're talking about, you'll really add to the street-cred of you textbook. Like the physics and/or sociological implications of that one guy's hair in House Party. And we all know that street-cred (SC, if you will) is the only way to keep those darned college kids from pirating PDFs of your manuscript on bit torrents, or proxies, or Napster or whatever.

Next is the content. There have been hundreds of other textbooks written about this same thing. They are all terrible. Why? Because they aren't the latest edition--complete with updated Table of Contents! That, and, now we have this thing called the internet, and if you want the kids to like your book, you better have a cool silver scratch-off window on the inside cover that gives them a cool code like "DR07RR6G8HJ" (that's NOT an O, its a 0, get it right!) that they can punch into the website you've designed on Frontpage Express to make all your pupils feel like spies (with secret codes!). You might even want to make an online James Bond Case Study to really hammer home some of your key points, if you can get the copyright people to sign off on it--if not, you could make it a James Blunt Case Study about the evils of falsetto.

Of course, you're not really all that arrogant. We all know to fear the man who doesn't know what he doesn't know. But that's not you. You know what you don't know. But with that said, you might rather your pupils thought you knew everything. That's where my favorite textbook phrase comes in. If you have to say you don't understand, or have absolutely no clue, in order to sound superior, all you need to say is, "poorly understood".

For example--Question: why did the chicken cross the road? Answer: To date, these reasons are poorly understood. What if God was one of us? The implications of this are poorly understood. How do you fit an elephant in a Safeway? By a poorly understood mechanism. That's it. Just say "poorly understood", and you get to hide the fact that you have no idea what you're talking about! Just in case there's a lot you don't know, there are plenty of variations on this theme. You might say "under investigation", "remains elusive", "paradoxic", or "appears promising for further research". If all that fails to convince your readers that your mental prowess is superior to their own, say something in Latin. Like ad hoc. Or make up something that you think sounds Latin-ish, and put it in italic type. Like ex unstu, or in dyna, or really whatever combination of letters come up when you get on TextTwist.

So, I guess that's about it.

PS. For the next edition of your book, maybe you should start thinking about some Greek letters to include. Because nothing says "Higher Learning" quite like Greek letters.

And Twitter updates.

Thursday, August 13, 2009

The Devil?

Another one down, a whole bunch more to go! I had my last day of ortho today (I've decided I can go with the abbreviation now), and went out with a bang by spending the entire day in clinic, without setting foot in the OR once (lame...). And apparently, I just so happened to be the guy that got to see all of the people that were sent to this particular surgeon's clinic by an office mistake or by someone who didn't know what they were doing, or best of all: a prison infirmary. And I found out that these people are mad when the attending doctor doesn't see them. Well, except the prisoners, who are just happy to not be in prison for a little while. So, it was a wonderful day... I came home just absolutely thrilled to be in medicine, and wishing I could go back and do today all over again. Like in the movie Groundhog Day, except, I wouldn't change anything!

Well, enough sarcasm. I think communication would have saved quite a bit of anger and frustration for all involved. But it didn't happen. Oh well. With all these referrals to different doctors for different treatments, it's no wonder that everyone's frustrated. Some even wish for a simpler time when you could go to one doctor and get treated for just about anything that you had wrong with you, sans referrals to specialists. Including the Devil:
"And then what a way they have of sending people to specialists! 'We only diagnose,' they say, 'but go to such-and-such a specialist, he'll cure you.' The old doctor who used to cure all sorts of disease has completely disappeared, I assure you, now there are only specialists and they all advertise in the newspapers. If anything is wrong with your nose, they send you to Paris: there, they say, is a European specialist who cures noses. If you go to Paris, he'll look at your nose; I can only cure your right nostril, he'll tell you, for I don't cure the left nostril, that's not my speciality, but go to Vienna, there there's a specialist who will cure your left nostril. What are you to do?"
Of course that's from centuries ago, and the medicine we do now is more effective. But the frustration's still there at times, and I guess I found out today that it's pretty unpleasant to be on the "other" side of the equation as the one that says, "I don't cure the left nostril".

Tuesday, August 11, 2009

Snap, Crackle, Pop!

Well, over the past couple of weeks, I've become something of an "expert" in the arts of holding tissue retractors in surgery, cutting sutures, moving patients from the operating table to beds, and trying not to make a fool out of myself.

And now, a couple of thoughts about life, after having spent a few weeks on the orthopaedic service:
  • People shouldn't shoot each other so much
  • People are crazy. Not the "haha, its funny, you're crazy" kind of crazy--I mean actual mental disease
  • Sticks and stones can break your bones, but so can falls, osteoporosis, gunshot wounds, semi-trucks, motorcycles, tumors, zip-lines, etc.
  • When you move someone's leg around when they have a broken femur, it feels crunchy
  • There kind of is a femur ward
It's been pretty good for the most part, I've been spending most of my time in the hospital (which is OK, I guess), and not doing a whole lot else. Although I did go to the state fair last friday night, where I saw a whole bunch of people eating things like "chocolate covered bacon" and "deep fried pizza". I tried neither of these, but I do think my cholesterol level about doubled just looking at them.

In other news, this past weekend I got hired as a "medical student extern" at the emergency department at one of the hospitals on the north side of town. So, I'll actually be working, and making actual money! Although, not a ton of it, and I won't really be working all that often. And I won't even be starting until September at least. But at any rate, I think it will be a good experience, since the job is basically just seeing patients and treating them for whatever they have wrong with them (under an ER doc's supervision, of course).
So, that's about it... I'm still on the orthopaedic surgery service until Friday, and after that, I have 2 weeks of anesthesia. So, I've got a busy couple of days ahead of me, and then I get a couple of weeks that are reportedly pretty laid back. Like, come in at 7 and leave by noon kind of laid back. Can't wait!

Saturday, August 1, 2009

The Recession and My Favorite Cranial Nerve

I think everyone's aware that we're having a bit of an economic recession. And what better to do in a recession than look for work until you give up, then wander around aimlessly looking for something to do?

Enter the cranial nerves. The Vagus Nerve, to be specific. And to be redundant, Cranial Nerve X. It's known to Anatomist-Ornithologists the world over as one of the "Four Birds of the Mediastinum"!

Why the Vagus Nerve? Well, ever hear of a vagabond? How about a vagrant? Well, the Vagus Nerve is called that because it "wanders" all the way from the head (the brain, actually) to the lungs, the stomach, and the intestines (among other places), just like a vagabond wanders from place to place.

Anyway, whenever you're concerned about the "global economic downturn", instead of worrying about having all your "ducks in a row", just remember the Vagus Nerve, and then go hitchiking.