MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'The long road to medical school' source. Thu, 08 Jan 2009 11:39:50 +0100 http://oldmdgirl.blogspot.com/2009/01/some-drugs-create-awesome-knockers.html That's for the drugs that cause gynecomastia as a side effect. And they are:SpironolactoneDigitalisCimetidineAlcoholKetoconazolePants yesterday commented that we at Penn are lucky in that we get to take our boards after our clerkships. Because we've just spent the whole year doing pathophys on patients. Which kinda makes it stick better than reading it out of a book.Though, I gotta say, it does put us a WHOLE EXTRA YEAR away from things like.... Biochemistry! Pharmacology! Those kinds of things. I mean, I could tell you 5,000 different B-blockers. But Guanethidine? Seriously? Reserpine? Metyrodopablahblahblah?Exactly.And I'm also sort of like.... DNA polymerase? Right. That was more than 5 years ago. Yep, my med school skips all that. Which is probably fine but still. I keep thinking that ... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2087058 Wed, 07 Jan 2009 15:05:00 +0100 2087058 http://oldmdgirl.blogspot.com/2009/01/anxiety-blogging.html In T-1h I will be in my first meeting with an Epi person. I am petrified.She does really cool work..... ON THINGS I DON'T KNOW ANYTHING ABOUT. Hell, I learned what Friedrich's Ataxia was by reading a paper by her on the subject three days ago. Add to that, what if she asks me to talk about my previous research? Ack! It's been three years! I feel like I barely remember what I was doing last week, let alone what the outcomes were on my various papers of yore!I did review them this morning.... which helped. But I still know NOTHING about neuro-ophthalmology. What if she thinks I'm an idiot?Worse, what if she thinks I've wasted her time?I'd like to point out, that this concern was NOT alleviated by my other Epi advisor whom I asked to alert people that I was interested in possibly maybe workin... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2084125 Tue, 06 Jan 2009 13:18:00 +0100 2084125 http://oldmdgirl.blogspot.com/2009/01/oh-joy-oh-rapture.html Well, I'm about to head out the door for my annual cervix scraping.* I really hate going to the doctor,* and I especially dislike student health services (You broke your arm? Do you think you could have chlamydia?). I'm thirty-freaking-one, ok? I'm in med school. Do you think you could talk to me as though I had a brain?Alas, there are no male doctors in woman care (OMG why do they have to call it that?), but this time I specifically requested a doctor rather than a nurse practitioner. Because the NPs I've had the past two years have been oh so delightful.We'll see if it makes a difference.I have my doubts.Update: The appointment went fine. Not sure if it's because she was better than my previous NPs or because I didn't ask her anything. Notable quote of the visit was, "You're 31?!?!?!? Yo... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2081181 Mon, 05 Jan 2009 14:13:00 +0100 2081181 http://oldmdgirl.blogspot.com/2009/01/from-few-months-back.html My Family Medicine rotation was one on which I got to spend a lot of time talking to my patients, most of which whom were relatively healthy, a lot of whom were there for well-checks. Most of the time the conversation was pleasant enough. Occasionally, when it drifted towards my hair color, it became mildly annoying.More rarely, thank God, when it drifted towards my career choice, it became downright offensive.It was always the wealthy little old ladies who would dish on how wonderful things were back in the good ole' 1950s. And they were always so pleasant when they did it. "You know," one of them told me, "Things were so much better in the 50s when all a woman had to do was get married and have children," one such patient told me one morning. She continued."Her husband would take care of... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2078807 Sun, 04 Jan 2009 22:22:00 +0100 2078807 http://oldmdgirl.blogspot.com/2009/01/three-words.html Yay New Jersey! (Source: The long road to medical school) The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2078808 Sun, 04 Jan 2009 14:17:00 +0100 2078808 http://oldmdgirl.blogspot.com/2009/01/going-to-grocery-store-in-philadelphia.html When I lived in Chicago, I loved to cook. Every weekend, I'd look up a couple new recipes that I wanted to try, and take a short walk down the street to the fresh produce mart to get some fresh and cheap vegetables. Then I'd go to the co-op next door, which while overpriced and not fantastic quality, always had what I needed. And then I would go home and make bean salads, guacamole, meat dishes. And Luca and I would sit on the couch sipping wine and watching movies while eating my latest concoction. This activity is actually impossible to do in Philadelphia. Even with advance planning. Even if you allocate the whole day just to grocery shopping.Let me walk you through a typical day in which I have decided I want to make something requiring specific, but not particularly special, ingredient... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2078256 Sat, 03 Jan 2009 15:40:00 +0100 2078256 http://oldmdgirl.blogspot.com/2009/01/boards.html Technically, my vacation will be coming to an end on Monday.Technically, I will start studying for step 1* at that time.Technically, I have had 2 weeks of vacation.Technically, even after I take the boards, I will have the whole month of February off too.Technically, I will be finishing working on a paper during February.Technically, I will be meeting with various faculty in an attempt to figure out who I want to work with for my PhD.So if I have all this work coming up, why does it still feel like I have two months of vacation ahead of me?Oh I know why. It's because I don't actually have go be anywhere during the day. Sure, I may have mountains of reading to do, but if I don't have to set my alarm for 5:30AM, it seems like vacation to me.It will be interesting to see whether I still feel ... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2078257 Sat, 03 Jan 2009 14:13:00 +0100 2078257 http://oldmdgirl.blogspot.com/2009/01/dinosaurs.html I did 4 LPs* during my core clerkships this past year. I even got the first one!Alas, it was all downhill after that. My only consolation is that whenever I missed, so did at least one resident too. So I know that I can't *possibly* suck that much.:-)Anyhow, while attempting to do a particularly challenging LP this past block under the tutelage of a resident who LOVED teaching (almost TOO much, if that is possible) he started going into great detail about the anatomy of the spine. He said, "You just have to picture in your mind what the vertebrae look like when you position your needle."And well, it's true. The only thing is, every time I think about the anatomy of the spine while doing an LP, I think of stegosaurus. Now, compare the spinous processes (the big plates on his back) of the gi... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2074461 Fri, 02 Jan 2009 14:30:00 +0100 2074461 http://oldmdgirl.blogspot.com/2009/01/locked-in.html Learning about various drugs during anesthesia, I was struck by the way vecuronium worked. It is a depolarizing neuromuscular blocking agents, i.e. it makes you unable to move while preserving awareness. It was discovered by natives South Americans who would poison their arrow tips with the stuff and go hunting. The prey dies of respiratory failure. Well, in reality, they probably got clubbed to death after they stopped being able to move. But still, at the time I couldn't really think of many worse ways to go. It still ranks up there.In The Diving Bell and the Butterfly, we see a man who has a pontine stroke wake up and then live out the last months of his life in the hospital. He is unable to move any muscle in his body except the ones needed to blink his eyes, but has complete function... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2074462 Thu, 01 Jan 2009 15:07:00 +0100 2074462 http://oldmdgirl.blogspot.com/2008/12/what-are-you-doing-for-new-years.html Take the poll! (Source: The long road to medical school) The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2074463 Wed, 31 Dec 2008 18:11:00 +0100 2074463 http://oldmdgirl.blogspot.com/2008/12/buzz-kill.html I went out for drinks with friends a week or so ago when I was in CT visiting my parents. It was interesting to see what had become of them. It had been quite a long time -- up to 15 years -- since I had seen a few of them.We went to this bar/restaurant about 15 minutes away from my parent's house by car. I've since learned that this particular establishment is where all the dealers hang out. And you know, sell drugs. All I could tell at the time is that pretty much every single preppy kid in the area who was home from college was there drinking with his/her friends. They all looked kind of the same in their NorthFace fleeces, designer jeans, backwards caps, and hiking boots, as they sipped their pints one after the next. Not that I have anything against those things. I'm just saying.Anywa... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2074464 Wed, 31 Dec 2008 17:16:00 +0100 2074464 http://oldmdgirl.blogspot.com/2008/12/new-years-resolutions.html This morning, I decided to dig up my New Year's Resolutions from last year to see how I did.Behold, last year's list:1. Avoid as many people who drive me nuts as is humanly possible.2. Avoid making eye contact with the people on the running path (provided I have time to run) as they tend to look one up and down which is unnerving.3. Remind self regularly that I actually don't have to be a doctor if this year really sucks.4. Sleep as much as possible.5. Take self less seriously.6. Make friends who have no association with the medical field.How did I do? #1 - I did a great job at this one. This time last year, I was feeling suffocated by some people who I used to frequently hang out with. I am happy to report that we got together as a group exactly ZERO times this year. My guess is that they... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2074465 Wed, 31 Dec 2008 14:53:00 +0100 2074465 http://oldmdgirl.blogspot.com/2008/12/oh-yeah-that-phd-thingy.html I've started the absolutely terrifying process of setting up meetings with prospective slave drivers mentors for my PhD. I've been choosing faculty in Neurology, Critical Care, EM, and Oncology for the most part, with the help of my main overseer Epi advisor person. I've gotten a few replies and set up a few meetings.And holy crap! My first meeting is next Tuesday! I guess that means I should spend some time figuring out what that person does....Hello? PubMed?The scary part is, how these meetings go has the potential to shape what kind of doctor I turn into. If I end up working for the neurologist, for instance, the chances aren't so bad that that's what I'll end up being myself.Whew! Decisions are being made.Scary. (Source: The long road to medical school) The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2074466 Tue, 30 Dec 2008 22:08:00 +0100 2074466 http://oldmdgirl.blogspot.com/2008/12/i-am-ungrateful-child.html A med school classmate and I were talking a month or so ago. It seems her parents have been actively discouraging her from doing Peds because "they don't make any money" and "they are all unhappy." They were encouraging her to choose something like Radiology or Ophthalmology.I pointed out that she could always do Peds Ophtho, and she made a face.The scary part is: her parents are doctors. They (theoretically) know what they're talking about.Contrast to mine who are non-science people. This is what they told me after I mentioned I was doing an elective in Radiation Oncology. "I don't think you should go into Radiology. You'll get cancer from the rays."Huh?I (in my ever so pleasant way) asked whether they were at all concerned about me contracting Hepatitis C or HIV from a needlestick injury... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2074467 Mon, 29 Dec 2008 21:03:00 +0100 2074467 http://oldmdgirl.blogspot.com/2008/12/lost.html I found out recently that I am one of the University of Chicago, class of 1999's lost classmates.I found this out after receiving two emails from classmates on facebook to that effect. OldMDGirl! You're lost! Don't you want to receive information about our 10 year reunion? Here, why don't you give me your address.....Except that I'm not really lost. I know for a fact that they have my phone number -- I am on their do-not-call list. And I received a solicitation via (non-facebook) email to volunteer in career-day as a non-traditional medical person this January. Also, they can email me on facebook as clearly demonstrated here. I am very easily locatable. Obviously I am not hiding. And last I noticed, I was still alive (knock-on-wood). I don't see how this equates to being "lost." Lost to me... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2074468 Mon, 29 Dec 2008 16:35:00 +0100 2074468 http://oldmdgirl.blogspot.com/2008/12/on-luck.html Last night, Luca and I were driving home from CT. We spent last week there at my parents' house relaxing and it was time to come back to PA. We had decided to come back on Saturday night in order to miss holiday traffic, as well as to allow us to unpack, grocery shop, and clean the apartment today without feeling rushed before Luca went back to work tomorrow.So we're cruising along the northern part of 287 at about 65, making good time, when we heard a pop. This was not a very exciting pop. It sounded like a piece of ice had hit our car, actually. So we both decided to pay it no mind.And then the warning light came on.We had a flat tire. ANOTHER freaking flat tire. The third one in two years to be exact, and the second one on our new car with less than 10,000 miles on it.I'd like to point ... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2074469 Sun, 28 Dec 2008 13:23:00 +0100 2074469 http://oldmdgirl.blogspot.com/2008/12/and-now-for-something-little-lighter.html FACEBOOK!!!Warning: This post is intended to be tongue in cheek. So, I was one of the first people in my age cohort that I know to have a facebook profile. I got one because all of my med school classmates (who are 6-7 years younger than I am) were completely incredulous that I did not have an account. They were similarly incredulous that I did not have a cell phone when I was in college, but that is another point entirely.I started off friending anyone I knew. A veritable facebook s., I was. Now I am more selective. Any person in my class at school (old or current)? Automatic friend. Outside of my class? I'll friend them only if I was actually friends with them. Now I'm up to 400 or so. And counting. See how popular I am? Haha. More like, see how many schools I attended throughout my yout... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2065425 Wed, 24 Dec 2008 14:45:00 +0100 2065425 http://oldmdgirl.blogspot.com/2008/12/i-still-think-my-favorite-patients-are.html And I don't mean the irritating ones who just have some minor personality disorder and are merely nasty to deal with. I mean floridly crazy. The, "That man sitting in that chair isn't THE REAL SANTA CLAUS!! He is an imposter! Get him out of my room NOW!" (said of the patient's one-to-one) kind of crazy. You know: psychotic.I even find the patients who try to kill themselves interesting. Not so much when they succeed -- trying to keep some guy's heart going just so we can entertain the possibility of harvesting his organs is kind of a giant bummer. But when they come in having swallowed a bottle of pills. When you see their parents, sisters, spouses all clustered around wringing their hands over what their loved one has done.That's totally fascinating to me.I know that I am unique in this i... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2061139 Tue, 23 Dec 2008 22:13:00 +0100 2061139 http://oldmdgirl.blogspot.com/2008/12/now-youll-feel-something-cold-and-wet.html I heard that one when a nurse was straight-cathing a patient in the trauma bay a few weeks back. It's funny how it sounds out of context. Well, actually it's funny in context too, but that's another issue entirely.Another favorite of mine that I heard over and over again was what we said when we were teaching patients how to do do incentive spirometry. For the uninformed, when a person breaks a rib or has abdominal surgery, it hurts for them to take a deep breath. As a result they develop atelectasis* and become at risk of developing a pneumonia. Then they get intubated and transferred to the ICU. And then they die. To prevent this, we have these patients do breathing exercises (incentive spirometry) a) to see how much air they can move into their lungs on a single breath, and b) to get th... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2061140 Mon, 22 Dec 2008 14:31:00 +0100 2061140 http://oldmdgirl.blogspot.com/2008/12/everything-i-thought-it-would-be-and.html You know how sometimes you build an event up in your mind, and then when it happens you're not as happy as you thought you would be?Yeah, NOT the case with finishing my two exams this morning.It's pouring rain outside, and I didn't feel a drop as I walked home.Now all I have to do is pack.And clean, but that's a separate issue.*******In other news, I decided to drop my pulmonary elective and to pick up radiation oncology. It just looks like a better class, and the pulmonary elective looked like it would be an awful lot of COPD, asthma, and stuff like that. Good for life knowledge, but not necessarily in deciding what I want to do with my life. Plus, I already have a month in the SICU to determine whether I actually like Critical Care medicine, so I decided it would be a better use of my ti... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2052917 Fri, 19 Dec 2008 16:32:00 +0100 2052917 http://oldmdgirl.blogspot.com/2008/12/day-is-finally-here.html In 5 hours, 48 minutes (roughly) I will be done with my core clerkships. I'm headed off to take my Surgery and EM exams in 40 minutes or so. Yesterday I turned in all my surgery paperwork. I also turned in my trauma pager.It was weird. I felt sort of naked sitting in the trauma bay for the last 10 minutes of my shift without it. I can't believe this year is almost over. The next time I head into the hospital, it will be as a student who is actually supposed to know something. It's funny, the amount I have learned this year is truly sick, but I still feel like there is SUCH a long way to go.Wish me luck! (Source: The long road to medical school) The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2052918 Fri, 19 Dec 2008 11:22:00 +0100 2052918 http://oldmdgirl.blogspot.com/2008/12/or-else.html This is the kind of email I LOVE to get two nights before my exams:You must register for this class by this date.... or else.You must take this online exam by this date.... or else.You must register for this other class by this date.... or else.You must submit your paper (what paper????) by this date.... or else.No mention of how to go about "registering," whom I'm supposed to submit my paper to or what it's supposed to be about, or a website that I'm supposed to go to in order to get these things accomplished.Just that it's MANDATORY.My personal favorite email of the day: how the elective lottery works days after our selections were completed and results given to us.Love it love it love it!!! (Source: The long road to medical school) The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2047066 Thu, 18 Dec 2008 00:12:00 +0100 2047066 http://oldmdgirl.blogspot.com/2008/12/schedule-for-next-block.html So my schedule for next block (for now anyway) is as follows:March -- Pulmonary (Presby)April -- SICU* (HUP)May -- Neurology (HUP)June -- Medicine Sub-I (Who knows where)At first I freaked. I didn't get either EM or Anesthesia. And then? I relaxed a bit. Because I was always planning on doing an EM sub-I when I came back from my PhD to remember how to not kill patients. Also I realized that the part of anesthesia I'm really interested in is the critical care part. Which I got.So that is that. I did add myself to the EM wait-list and the HUP pulm wait list. But I think it might be good to have kind of a chill month of pulm at presby, especially since the path to critical care via medicine is through pulm.Hopefully it won't be a colossal disaster!*Surgical ICU (Source: The long road to medic... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2040205 Tue, 16 Dec 2008 23:35:00 +0100 2040205 http://oldmdgirl.blogspot.com/2008/12/maybe-youd-like-this-retractor-in-your.html In the OR a few weeks ago, I was 4th assisting (hahahahaha) with a trach and peg* (double haha because med students can practically do a peg) in the OR. There was the attending, the senior resident #1, and senior resident #2 from a non-operative service. They were teaching #2 to do the trach.But the patient was very large. And the hole in his neck was very deep. And the retractors were woefully short for such a crevice. And the attending became frustrated, and also irate. Well, I should clarify. This particular attending's natural state of being is one of frustration and hostility. Particularly to anyone beneath her, and especially to medical students. I know this because I talk with other medical students, and we all agree: this attending sucks to work with. And so it was that I was retr... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2035889 Sun, 14 Dec 2008 18:10:00 +0100 2035889 http://oldmdgirl.blogspot.com/2008/12/books.html Can y'all provide me some suggestions for fun reading to do over Xmas? I'm afraid I don't have any idea what is any good these days. (Please don't suggest either Twilight or Harry Potter, though.)Thanks readers! (Source: The long road to medical school) The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2035890 Sat, 13 Dec 2008 19:24:00 +0100 2035890 http://oldmdgirl.blogspot.com/2008/12/only-1-week-to-go.html Until I am done with my core rotations!!!Which means I probably ought to get studying for my shelf. But that is another point entirely. I don't want to study. I want to play!I realized the other day that I have had a total of 3 days off out of the last 23 weeks. This includes the weekend in between my medicine block and my surgery block, as well as 1 weekend day off I took during medicine because I really needed it.Interestingly, this is not what makes me feel burned out. What makes me burned out is feeling like I am under the microscope all the time.*****And now I present the things I ranked for electives next spring. I only have 2 months to play with, but I still ranked a bunch of things since pretty much everyone in my class wants to do anesthesiology and EM.1. Anesthesiology2. EM subI3... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2035891 Sat, 13 Dec 2008 14:02:00 +0100 2035891 http://oldmdgirl.blogspot.com/2008/12/intubate.html Last night was busy. Among other things, we had a couple of emergency ex-laps* as well as some pretty major neurotrauma that ended up needing emergency surgery as well. In one of the cases, the anesthesiologists let me attempt intubating.This was my second one. The first one I got no problem, but this one.... I just had difficulty getting the blade in the patient's mouth around her tongue (still having trouble with the "sweep the tongue to the side" part -- there is no "sweeping" to speak of in my case).... and then I had some trouble getting the tube down the right hole.... and then she started desatting.As it turned out, the tube was in the right place, but just needed to be advanced through the vocal cords a little farther. Still, I felt like an idiot. I guess that just comes with the t... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2033350 Thu, 11 Dec 2008 14:54:00 +0100 2033350 http://oldmdgirl.blogspot.com/2008/12/last-night.html It's hard to believe that I'm entering my last shift of nightfloat of the rotation already! Even though I've been able to sleep for a few (sometimes up to 5) hours per shift I've still had no problems sleeping during the day. Today I was completely sacked out until 3:30!And so I go back for another round.It's been interesting. Even though the trauma aspect has been slow, I've still gotten to do some procedures and to learn about post-operative patient management, which I'd not seen much of before this week. I even clinically diagnosed a simple pneumothorax in the trauma bay!! I was overruled by the rest of the team (they all heard breath sounds), but the CT scan showed the patient's whole upper lobe was out. Maybe it was just luck, but I was pretty pleased with myself. And I got to cut the... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2027304 Wed, 10 Dec 2008 20:45:00 +0100 2027304 http://oldmdgirl.blogspot.com/2008/12/in-happier-news.html I had a conversation with my Epi edvisor to the effect of: Hey! I think I'm beginning to figure out what I want to do with my life! How'd that happen?I think he was relieved.We discussed my plans for this spring. Currently I'm signed up for a medicine sub-I in June and a Neurology externship in May. I'd like to do an ER sub-I as well, and also a month of Anesthesia, but also in my lottery selections I've put in Heme-Onc, SICU, and Radiology. We'll just have to see what I get!And I gave him a list of faculty I want to talk to about doing research with for my PhD for the next 3-4 years. Who will get the pleasure of my cheap labor? We shall see.So after Trauma is done in LESS THAN TWO WEEKS, I will go on Xmas vacation in CT, then study for the boards for a month, then I'll have the whole mont... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2017891 Sat, 06 Dec 2008 16:51:00 +0100 2017891 http://oldmdgirl.blogspot.com/2008/12/i-should-have-stayed-up-later-last.html Today at 5PM I start my week of trauma nightfloat. 5PM-9/10AM for 5 days. Oh joy. Actually, it should be ok though I suspect I will be very tired this time next week. If it's busy and there are a lot of traumas, I will have a lot to do, since medical students actually have a JOB on the trauma service. If it's not busy, I should be able to study and sleep somewhat. I wish I'd stayed up later last night though. I went to bed at 10:30 (late for me) and was completely unable to sleep past 8:30 this morning. Hopefully I'll be able to take a nap later today before I go in.In other news, I thought I'd bring up another point of irritation that I have with certain people. You see, every so often I'll say something like that I think it's sad that patients on the trauma service are dying preventable ... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2017892 Sat, 06 Dec 2008 15:34:00 +0100 2017892 http://oldmdgirl.blogspot.com/2008/12/naps.html Before clinics started, some classmates and I were talking about sleep, and they were always SHOCKED to hear that I usually got 8 hours/night.But then the commentary came:"Don't you think it will be hard for you once clinics start?""Well, *I* like sleep too. But I wanted to get used to giving myself 6.""Don't you ever go out?" As this year or core rotations comes to a close, and I enter what will probably be my worst week of sleep for the year, I am happy to report that I have actually been able to get MORE sleep this year than last year. Usually 8.5-9 hours per night if I so desire. Except when "on call." And then it was more 5-6.Also, newsflash people: you can't train for sleep deprivation. Oh, and yes I go out on occasion. Just not until 2AM.And again, when talking to classmates yesterd... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2017893 Fri, 05 Dec 2008 11:17:00 +0100 2017893 http://oldmdgirl.blogspot.com/2008/12/dc-to-jail.html Given that many of our patients have suffered gun shot wounds, it is perhaps not a surprise that many of them also have warrants out for their arrest. Often what happens is that the patient will get shot, he will be identified (it is almost always a he), go to surgery, and then on the way up to the SICU, some officers will meet us as we wheel the patient off the elevator. The next morning, he will be shackled to the bed with two more of them sitting at his bedside.Sometimes if the patient smells particularly putrid, or has an especially nasty looking injury, they will sit outside his room.I guess I understand this. They now have the prisoner in custody, and they aren't going to let him escape without justice being served. It can be amusing at times because the family will often become indi... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2011263 Wed, 03 Dec 2008 23:12:00 +0100 2011263 http://oldmdgirl.blogspot.com/2008/12/all-i-have-to-say-is.html All I have to say is, there's nothing quite like starting your day with a bedside thoracotomy and some cardiac massage.A friend of mine told me that he still hadn't seen someone pronounced* yet. I told him that all he needed to do was spend a few days on the trauma service and that problem would be solved. Does it bother me? Yes it bothers me. I don't like seeing people die. Especially when they're just young kids doing stupid stuff that young kids do. Or when they get shot 10 times and get dragged in by the police with no blood left in them. Or when they shoot themselves. And then you see their families and how distraught they are.So I present to you, my 6 life gems learned from this rotation. Bad things may happen to you anyway, but they are much much much less likely to. And if somethin... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2006018 Tue, 02 Dec 2008 23:03:00 +0100 2006018 http://oldmdgirl.blogspot.com/2008/12/trauma-is-good-but.html All this freaking paperwork is killing me!Still to do in order to not be penalized for this rotation:- 3 feedback cards- 2 formal H+Ps (with signature)- 2 formal notes (with signature)- see breast surgery -- seriously! I have to arrange on my own time to go to clinic to satisfy this rotation's requirement of doing a breast exam and seeing a surgery. All because it is unlikely that I will see this on Trauma.- log all said patients in logFortunately, I've been knocking out the feedback cards and H+P/presentations. But it always seems like there is something else.Oh well, guess I ought to get used to pointless paperwork.In other news, I truly felt sorry for my residents today. It was the first day of the month and the teams changed. Welcome to our service! You will be on call tonight! Oh, and... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=2006019 Mon, 01 Dec 2008 23:48:00 +0100 2006019 http://oldmdgirl.blogspot.com/2008/11/i-got-to-go-to-ct-for-thanksgiving.html And got to play with my parent's new puppy. It turned out that the other med student decided that he wanted to go nights this week. Which was very nice of him. So I got third week. After all of that. Now I feel guilty, but I suppose I'm being silly. One of us had to do the good week, and it might as well have been me.So yesterday Luca and made the 5 hour drive up to CT to eat some turkey and some pumpkin pie. And then I spent the rest of the evening curled up with a book.Pretest Surgery and NMS Surgery Casebook to be exact.And I realized just how little I know. Urp.It was made inifinitely more palatable by the fact that my dad was studying also in the next chair over. You see, 5 years ago or so, he discovered that he could take classes at any state college or community college free of char... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=1996490 Fri, 28 Nov 2008 13:49:00 +0100 1996490 http://oldmdgirl.blogspot.com/2008/11/md.html Whenever I do anything on this blog other than tell funny stories, heartwarming stories, introspective stories, etc., i.e. Whenever I bitch about something, someone asks me in the comments whether I regret having gone to medical school. Oh, and someone else will ask me whether *they* should go.So first part first: No I don't regret going to medical school. Each year is hard in its own way, and as every year finishes I think to myself, "Boy, I'm glad I don't have to do that again." On the other hand, every year I feel that I am really happy I did the previous year. I feel like I accomplished something. Not sure what that means other than to say, who ever really wants to repeat a year of work? Any kind of work. And I'm pretty sure most jobs don't leave you with the orgasmic feeling of, "WOW... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=1996491 Thu, 27 Nov 2008 12:29:00 +0100 1996491 http://oldmdgirl.blogspot.com/2008/11/trauma.html In the upcoming weeks, I have to do 5 overnights. These are when medical students -- allegedly -- get to be actually involved on the team. But the catch (ah, there is always a catch, isn't there) is that you work from 5PM until 9 or 10AM the following day. (Don't you love how you don't actually have enough time to get 8 hours of sleep in between shifts? I love it too. Supposedly you can sleep on the overnights *sometimes* but I'm not counting on it.)I also have some choices as to when I do these. My preference is to do all five days in a row so that I can avoid doing the post-overnight urge to vomit that usually ensues at about 4 or 5 AM and then lasts until I go to bed at 9:30/10:30AM more than once. This nausea is completely inevitable on your first night shift after being on days. Thus,... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=1990996 Wed, 26 Nov 2008 00:12:00 +0100 1990996 http://oldmdgirl.blogspot.com/2008/11/ha-ha-ha.html On Friday, the medical student who was just finishing up trauma told me, "The residents have been asking what you guys are going to be like next month. He said that, 'they better be ready 'cause I'm gonna work 'em like interns!'"yay.Looking at my schedule for the next four weeks makes me want to vomit. I especially like the part when my husband asked me what time I'd be home tomorrow. 7PM? 1PM the following day? Who. Knows.Or the fact that three days before T-day I still don't know whether I'll be able to go home for the holiday.Working weekends/holidays I don't mind. It's the uncertainty of it all. As well as the knowledge that if I ask, there is always the risk that I will be perceived as someone who doesn't want to work weekends/holidays. I.e. Someone who is a lazy person. Who has an at... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=1985031 Sun, 23 Nov 2008 19:32:00 +0100 1985031 http://oldmdgirl.blogspot.com/2008/11/today.html Today is Luca's and my two year anniversary! The time sure has gone by fast.....People sometimes ask me if it's difficult to be a married medical student. From my view however, it seems like it would be more difficult to be single. That is probably because I have the most amazing husband ever. Having a husband helps so much with the social support, it's not even funny. And you definitely need the social support when you're in med school. I can't imagine not having him to help me feel better after I've spent all day being defecated upon at the hospital.He is possibly the most understanding person I've ever met. And! He likes doing housework. If I were married to some asshole who insisted that I keep the house clean by myself? Cook him dinner every night? Who complained incessantly that I wa... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=1980966 Sat, 22 Nov 2008 17:45:00 +0100 1980966 http://oldmdgirl.blogspot.com/2008/11/anesthesiology.html So I just finished anesthesiology. And what did I think?It was a nice break in between my other rotations. The residents were unwaveringly nice, wonderful, positive people.Watching anesthetic take effect is undeniably profound. One minute the patient is talking, and the next moment they are no longer arousable.Intubating is fun. I got the tube in the right hole on the first try!Mask bagging a patient is more difficult than it looks. I wonder if your hand muscles grow stronger over time.The monitoring involved in cardiac surgery is insane. Swan-ganz catheters are cool.I met a resident who just finished a medicine residency and is now starting as a 2nd year anesthesia resident. He wants to do critical care, and opted not to do it via a pulmonary fellowship. The idea of doing 6 years of resid... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=1975351 Thu, 20 Nov 2008 22:03:00 +0100 1975351 http://oldmdgirl.blogspot.com/2008/11/sterility.html Anyone who has ever been inside the OR should be able to tell you about the sterile field. This area constitutes anything that is blue in the operating room, and usually includes the entire patient (draped under blue sheets and towels), the instruments that are being used for the operation (on top of blue towels), and the blue begowned people who are participating in the operation.Scrubs are not sterile.Latex gloves? Not sterile. Medical students? Definitely not sterile. Repulsive disgusting maggots. So not sterile, that they must remain 5x as far away from the sterile field when not sterile as anyone else in the OR. Often, said medical student will get reprimanded just for looking at the sterile field. (This type of treatment may have the effect of making the medical student want to hock ... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=1975352 Wed, 19 Nov 2008 12:25:00 +0100 1975352 http://oldmdgirl.blogspot.com/2008/11/em_14.html Yesterday was my last shift on Emergency Medicine. I had to say, it was the only rotation (save maybe for Psych) that I was sorry to see come to an end. And I think that probably says a LOT at this time of the year. Usually when a rotation is ending I really just want it to be over. Before I make some BIG MISTAKE that everybody uses to decide that I suck. I feel like I am sitting on a ticking time bomb.I didn't feel that way this block. Instead, I kept looking forward to the next patient I'd get to evaluate. Maybe it was because I really liked my resident. Maybe I just liked EM. In the end, I didn't even mind the pelvic exams so much.... except when the patient was really smelly.I daresay that I liked EM so much that it even made me reconsider my hatred for Ob/Gyn (note: it's only listed a... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=1960921 Fri, 14 Nov 2008 21:06:00 +0100 1960921 http://oldmdgirl.blogspot.com/2008/11/pregnancy-test.html A few months back there was a "bad doctor" article on the Well Blog in the NYTimes (my favorite) complaining about the use of pregnancy tests."Why doesn't anyone believe us when we say we're not pregnant?""Doctors think we're liars. Those assholes.""I can't believe that doctors think we're so stupid as to not know how babies are made. Sexist jerks!""My lower abdomen hurt, and some asshole doctor made me have a pelvic exam. And it turned out I had appendicitis! I'm suing the hospital."Well, I'm happy to report that if you have a uterus (and often times, even if you don't) and are less than 95 years old, your urine will be dipped if you come to our ED. No matter what your presenting symptoms are. Because if you're preggers, your course of treatment will likely change.Also, I've seen not just... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=1952077 Wed, 12 Nov 2008 01:32:00 +0100 1952077 http://oldmdgirl.blogspot.com/2008/11/angry.html The Emergency Room is full of angry patients. Some are angry because they hate being sick, others are angry because we can't seem to get an IV in them after 15 attempts, still others are angry because they are drunk or high, or because we won't give them IV Dilaudid.But the vast majority of people who are angry in the ED are angry because it's taking too long. "I've been here for 12 hours! Why can't I go home yet!" "I had my CT two hours ago and nobody has told us what I have!!""I rang the buzzer for the nurse OVER AN HOUR AGO and nobody has come by!!!""I'm leaving. You said Neurology would be by to see me, but it's been 6 hours. THIS IS RIDICULOUS. If I have a seizure and get hit by a car it's YOUR FAULT!!!!"Many patients get even more irate when it appears that some patient who arrived a... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=1952078 Wed, 12 Nov 2008 01:09:00 +0100 1952078 http://oldmdgirl.blogspot.com/2008/11/heent.html Patient is a 32 year old woman who presents with laceration to the knee after she tripped on the curb this evening 1 hour ago. Patient has 5/5 strength in the lower extremities bilaterally, full range of motion, and equal sensation. No fevers. Patient admits to drinking "two forties" and smoking about $40 of crack this evening. The rest of her review of systems and past medical history is unremarkable. One might imagine such a patient to be somewhat belligerent, with slurred speech. Perhaps cursing at anyone who comes into her room or throwing things. One might document the following HEENT* exam:Disheveled hair, no ecchymoses facial lacerations, no facial tenderness, PERRLA*, pupils dilated, EOMI*, no masses, thryromegaly, or LAD*Or some such.But sometimes, in addition to the above, you re... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=1952079 Tue, 11 Nov 2008 16:35:00 +0100 1952079 http://oldmdgirl.blogspot.com/2008/11/mirror.html It's interesting how the patients who come to the ED reflect what is going on outside. Last Tuesday we had a slew of patients who had been in accidents/hit by cars on the way to vote. On Saturday night we had people who had been beaten up, shot, hit over the head with bottles, and in car accidents.And on Sunday night (my personal favorite), we had the people who didn't want to go to work on Monday. Ah, the back pain exacerbation. That is only relieved by IV morphine. And the pain that seems to get worse when the discharge document does not contain a script for Percocet and a note for a week off of work. The verbal abuse escalates when the Percocet is provided but only *2* days off work are provided. Funny how this patient morphed from a pleasant woman with some ankle pain (but no swelling,... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=1952080 Tue, 11 Nov 2008 16:21:00 +0100 1952080 http://oldmdgirl.blogspot.com/2008/11/because-i-was-born-yesterday.html "I was just sitting there, minding my own business, and out of nowhere two guys jumped me and started whaling on me!"Ok sir, if you say so. And I also believe that perforated nasal septum came from chronic sinus infections.Now can you please hold still so I can finish sewing you up?I also got to see a patient get a cardiac cath* last night. It was pretty cool.*For suspected MI.****MI=myocardial infarction=heart attack (Source: The long road to medical school) The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=1947353 Sun, 09 Nov 2008 20:45:00 +0100 1947353 http://oldmdgirl.blogspot.com/2008/11/nightshift.html My first EM overnight starts in 2.5 hours. In preparation for it, I slept from 11-11 last night, and then from 3-4:30 today.There is nobody, NOBODY, who is a better sleeper than I am.Though, my current self is still no match for my college self of 10 years ago. In those days, it wasn't uncommon to wake up at 1:20PM on a Saturday or Sunday, and then agonize for 5 minutes whether to get my butt out of bed and down to the cafeteria before it closed at 1:30. It's weird how 9AM feels really really late to me these days.Weirder still how quickly I can re-adapt myself to sleeping until 11.I was saying to my advisor yesterday that I'm not the biggest fan of shiftwork. Which is true, and a possible strike against EM for me. That being said, I am even less of a fan of 30 hours straight and Q4 call. ... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=1945357 Sat, 08 Nov 2008 21:36:00 +0100 1945357 http://oldmdgirl.blogspot.com/2008/11/em.html So, I just came out of a meeting with my Epi advisor. In which he tried to convince me that EM was a GREAT IDEA for Epi research. In particular outcomes research, which I've always been interested in but also trying to avoid so as to try something new.And you know, he was pretty persuasive,And he started telling me about this "great smart awesome attending" in EM name Dr. Willows* and how he did cost-effectiveness research and EM outcomes research. And I thought, I've worked with this dude on a shift before and he WAS actually awesome. And I do come off 12 hour shifts feeling relatively energized (I have gotten used to them) and not drained like on some rotations (ahem, Family Medicine). And you get to do procedures, and it's like the highlights of all the other rotations, but without the ... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=1943447 Sat, 08 Nov 2008 01:15:00 +0100 1943447 http://oldmdgirl.blogspot.com/2008/11/whats-hard-about-medical-school.html It's not the hours, the constant studying, the firehose stream of new material. I actually like to work hard, believe it or not.For me, the hardest thing about medical school is constantly being thrown in with new people to work with. You get a new team at least every 2 weeks or so. New residents, new attendings. On this current rotation, I get a new attending every 8 hours at longest.The problem with this system, is that as soon as you build credibility with one person, they leave and you have to start from scratch. Inevitably your old team will have wanted you to present your patients one way, but the new team will want it some other way. And any deviation from what they want is considered a sign of incompetence, even if there is no way you could have known what they wanted beforehand.Be... The long road to medical school blogs http://www.medworm.com/rss/comments.php?id=1939292 Thu, 06 Nov 2008 02:35:00 +0100 1939292