Wednesday, March 31, 2010

Am I missing something?

I've been pondering this one for a while. Can anyone show me exactly what I'm missing?

Attending: Medical Student, this patient has bilateral pitting ankle edema, shortness of breath and borderline hepatomegaly. What do you think could be going on here?
Medical Student: Well, it sounds like it could be right heart failure.
Attending: I don't think so. It's most likely Cor Pulmonale.
Medical Student: (confused) oh.

This is the second time I've had this conversation. Lesson: Always use latin when available.

Saturday, March 27, 2010


I never thought myself one to enjoy the kids on my rotations, but they are starting to grow on me. They actually have quite a few qualities that I am jealous of. Mainly, they know how to say "no," they demand what they want, and they will do nothing for you until you give it to them.

Me: "Hello little 4 year old child, can I listen to your heart?"
Kid: "No!"
Me: "I really need to listen to your heart."
Kid: "I want to draw my name"
Me: "You know how to draw your name?"
Kid: "Yes! I'm the best at it! I want to draw it!"
Me: "Okay, okay, can I listen to your heart after?"
Kid: "mmmmmmmmm. okay."

So I give the kid a marker and await his masterpiece. He proceeds to draw a circle and a triangle.

Me: "Okay! Good job!"
Kid: (beaming) "I'm the best"

So to recap. I am 25 years old. Kid is 4. I have no control of the room. Kid has total control. I don't get to decide what my name is (usually I'm called, "move" or "I need to be standing there" or "watch out"). Kid gets to call himself circle triangle.  Ah, the lessons we can learn from children.

Saturday, March 20, 2010

Wash Your Hands!

Sometimes it's the patients that give you a hard time. I don't know if I just had a look about me or what...

Medical Student: Hi There, I understand you've been having some stomach pain and I came by to do a quick exam.
Patient: Okay.
Medical Student: Great. Let me just wash my hands and we'll get started.
Patient: Yeah, you better.
Medical Student: (nervous laughter) why's that?

(Why did I ask him that? I don't know.)

Patient: Cause I can tell by lookin' at you that you just sit around touchin' yourself all day. I don't want all your junk germs on me.

That's it. I'm shaving my mustache.

Friday, March 19, 2010

I'm so confused

Look. I can handle the pimping, the long hours, the belittling comments, the general craziness of it all... but can we please at least agree on what the heck I am supposed to be doing on this service?

Intern: Go pre-round now on these 8 patients.
Medical Student: (feigning interest) Okay!


Intern: Why did you do the physical exam? Only we do the physical exam. Just get numbers.
Medical student: (Hiding confusion) Okay!

Next day...

3rd year Resident: Go pre-round on these 8 patients.
Medical Student: (Feeling confident in his role) Okay!


3rd year Resident: Why didn't you do a physical exam on any of these patients? Did they teach you the proper way to write a soap note here? Don't forget that again.
Medical Student: (confidence shattered) Okay!

Next day...

Senior Resident: Go pre-round on these 8 patients.
Medical Student: (Hell No!) Okay!


Senior Resident: Please don't write your physical exam in the chart. It's not as reliable as ours. Just get the labs.
Medical Student: (Through clenched teeth) Okay!

Someone. Help me.

Monday, March 15, 2010


Today I realized that one of my Attendings has a superpower. Let me explain. Perhaps you have been in the situation where you need to get somewhere but someone is in your way. Usually in such a situation you would say something like, "excuse me" or "I'm sorry, could I get by you real quick?" Not so with this Attending. He has the ability to move you using only his eyes (or maybe it's mind control, I'm not sure.) Basically this guy walks up to you and stares at you until your body just moves out of his way. It works every time too. Not once have I had the balls to just stare back at him and not move.

Caveat: This does not work on nurses. I have tried.

Sunday, March 14, 2010

The Layers of the Abdominal Wall

I'm on Peds Urology now. Believe it or not, I have only been asked the layers of the abdominal wall one time on my entire 12 week surgery rotation. Being that I am now on subspecialties I felt I would be safe from this question. I was wrong.

Attending: What are the layers of the abdominal wall?
Me: Skin, subcutaneous fat, campers fascia, scarpa's fascia, rectus, external oblique, internal oblique, transversali...
Attending: Transversus abdominis, you mean.
Me: Oh yes, sorry. Then transversalis fascia, preperitoneal fat, peritoneum.
Attending: (silence)

So I mixed up one thing. Pretty good I thought. But no....

Resident: That's weird you don't know the layers of the abdominal wall
Me: I thought I just mixed up one thing...
Resident: I mean that's really important to know. Seems like you should know it.

Well, that's life. 91% just doesn't cut it these days.

Tuesday, March 9, 2010

What has medical school done to us!?!

So today one of my friends said:

Friend: I think I might have Otitis Media. When I exert medial pressure on my tragus I have 5/10 pain. There must some sort of infectious process going on.
Me: You have an ear ache?
Friend: Yeah.

I, for one, pledge to try and remain normal. In spite of medical school.