Saturday, May 16, 2009


There is a big push in modern medicine to stop being so paternalistic. Doctors don't always know what is in a patient's best interest and we can't force them to do or not do anything. This principle gets harped on over and over and is the topic of many pop medicine articles. However, apparently there is one exception; heroin addicts: There is a new drug for treating heroin addiction called Suboxone. It contains Buprenorphine which prevents heroin from working, prevents withdrawal, comes in an easy to take pill, and only causes a fraction of the effect of heroin. It also contains Naloxone, which does nothing whatsoever when taken in the pill form. So why give Naloxone? Because when you get all antsy, try to crush your pills up, melt them down, and inject them, Naloxone becomes active and does the exact opposite of heroin, i.e. an immediate and intense heroin withdrawal. "That way, they'll only try that once!" Oh yeah, that sounds good. I mean it's the exact same thing we said about my dog and her electric dog collar, but whatever.

cheater part 3

On my walk home I pass house after house of the these undergrad frat guys, theater kids, athletes. Every time the temperature warms up a degree, the beer pong tables are out, grills light up, bubble dresses get sported. They always take up the whole sidewalk and it's like come on, some of us are PLEASE! Please ask me if I want a beer! I do! I do want a beer! Let me have a game. Fuck it, one throw, just one throw. I'm imprisoned in the real world, can't you see it on my face?!? I'm crying out for help here. One beer. Please...please

In the library, I was looking at big board of student ads and stumbled upon this poster (verbatim), "Build-your own STD bake sale!"...what? Wait, I...what? What am I building? How are baked goods involved? Is it like a choose your own adventure for STDs? "You have chosen Sarah. You now have herpes. Would you like to A) See a doctor B) Reenter the party C) Respond to another Craig's List ad." I'm going to have so many questions when I show up drunk.

During a sex lecture, someone in my class asked what douching was. I'll take this one Doc. Afflicting "adult" males, douching symptoms include popping one's collar, calling another human, "bro", and wearing a body spray of any kind. Although rarely fatal, Douche Flu can be severe and lead to aggressive behavior followed by hugs ("but not the gay kind"), a poorly used gym membership, and a bunch of friends who don't really like them anymore. Suspected individuals should be quarantined and told that a fraternity is not really forever.

I think 8 hours of work can best be characterized by the punctuated equilibrium model. Massive stretches of meandering, half-work punctuated by 15 minute bursts of intense productivity, quickly followed by several more hours of facebook and gchat. Don't fight it, it's evolution.

"To treat sleep disorders, one large component is to improve sleep hygiene. This includes using the bed only for sleep and sex. Exercise helps too, which of course includes sex. I think I'm going to be the leading prescriber of sex. "To be taken twice daily. Once upon waking and once before bed. Taken either orally or through direct injection. Rectal administration is neither indicated, nor contraindicated. Side effects include feelings of awesomeness and babies. If sex lasts for more than four hours, consult your physician for high fives."

Coffee lowers your risk of Parkinson's disease, contains the most anti-oxidants per volume of any food or drink, and can improve performance and alertness. Not to mention the acute health improvements associated with me not punching you in the face. I'm tired and I'm late, stop texting and move the fuck out of my way.

"Hey there are bagels in the back room if you're hungry!" Nope. I just went back there. There are no bagels. There is cream cheese. There are knives. And then there is a giant bag of round fluffy breaded things with goo swirled all around, diseased with raisins, pulsating with cinnamon-raisin flavored disappointment. Don't fuck with me, Leader of Meeting that Just Ended, I will stab you with a plastic smearing utensil.

Time for a pep talk, Body. We fell asleep in class today. 3 times. Once in small group. There were 6 other people in that room. I'm willing to overlook that, but then last night, we were in bed for like 2.5 hours just lying there, trying to fall asleep. And did you let us fall asleep? No, you kept jumping awake with a start. We just simply can't have that, Body, can we? This hurts you as much as it hurts me, but I'm going to have to drown you with alcohol this weekend. Ok? I'm sorry. I hate to be the bad guy. We cool?

When you name a formula, an disease, or a psychological phenomenon after yourself you are imprinting your name in the history books forever. You are also guaranteeing that every single student who has to memorize your stupid fucking name will hate you forever.

I keep learning about diseases and thinking things like, "Hey, Kenny's sister has Lupus! I should totally text him!" No. No I shouldn't text him about how much I know about his sister's devastating illness. I should sit here quietly and continue to learn about Lupus.

The other day I got to suture fake brain layers using a multi-million dollar surgical robot. When I was a kid I wanted to grow up to be a firetruck. Ding-ding, Fire!

From that first college final to that last annual report before retirement, it is the right of every man to display stress in his life by growing facial hair. Fuck off, Mach-3, I've got a deadline!

Hey Brain, how's it going? You doin' ok? You sure? You want a soda? No, you don't want a soda? Good, great, because if we ever spend 2 hours memorizing 25 different bacteria and their 6 important features, only to come back from lunch not remembering a single goddamn one, I will stab you with a fucking Q-tip. I'm not kidding, I will mess you up, you son of a bitch.

Feet, if you are going to be freezing, then Armpits, you cannot be sweating. You may choose one or the other, but not both. You have 5 minutes to decide.

"Diarrheal illnesses are often spread through fecal-oral transmission" ...Um, could you elaborate on that a little further? I get the fecal part, and the oral makes sense, it's the dash that I'm a bit curious about.

cheater part 2

It's hard to make small talk in med school. "So done with class...I guess probably since I'm also done with class. Uh, what are you working on..Besides the only subject we have. What do you think of the Bears' draft pick...I don't really have time to follow either. Boy this weather is nice...or it looks that way from the one window at the back of class. Anyway! Talk to you later I'm heading this way...and you are too. Because we are both going to the library."

Med school does not lend itself to studying in public spaces. I get really into what I'm trying to learn, and because it's on the body, I'm often the best demonstration. So as I try to figure out the dermatomal sensory distribution of the ulnar nerve, I end up looking up 30 seconds later as the entire library has stopped to watch me slam my elbow down on my desk trying to hit just the right spot to recreate the knocked out nerve.

In Guatemala, they were selling something called, "Fun Station". It looked like a playstation, but it was not. It came with one cartridge and advertised 9,999,999 games. Apparently it has small variations in each game, like game speed, that they count as a whole new game. Not a single house we went to in the entire area even has a tv. Now I'm not one to fuss over marketing, but I think this team of expert advertisers may have missed their mark.

I went hiking in Guatemala recently and our guide was a Mayan 26 year old with two kids, 13 years of paramilitary experience and just enough Spanish to communicate with our shitty Spanish. My hope for the world rests in the fact that he found our farts as funny as we did.

I was walking past a girl in the library who had something written on the back of her shirt that said, "You can always retake a test, but..." I walked past too fast to see what the rest said, but I liked where this was going.

It really bugs me when I meet someone busier than me. "Oh sorry, I can't do Monday, how about Tuesday?" "Oh really? Because I'm an attending neurosurgeon, my triplets are having their birthday this week and my NIH grants proposals are due this weekend. You sure you can't make time Monday?" "Well I guess I could just watch Heroes on It's actually just a rerun. Yeah Monday sounds fine John Storm MD PhD MPH JD".

A study following 1000s of people for 2 years determined, with complex statistical analysis, that the best indicator of future suicide, is past suicide attempts. That's brilliant. Thank you. The scientific community can sleep soundly knowing you all figured that conundrum out.

There are experiments where they hook an animal up to an IV and allow them to push a lever that will administer cocaine. If you allow the animal to self administer the cocaine whenever it wants, it will stop mating, stop eating, stop drinking, and push that lever until death in 2 days. It will take 2 days to seizure out and kill itself... Fucking best 2 days of his life! Whoo, Vegas, here we come! ...No, seriously, don't do drugs. Scrambled egg and all that.

So in a move of scientific brilliance, chemists decided that since pot causes appetite increase, if they could create a molecule that does the exact opposite of pot, it could reduce appetite and be a diet drug. It worked. Oh, except for the fact that the exact opposite effect of pot is severe, severe depression. Probably should have seen that one coming.

I'm not going to steal medical supplies. I'm not going to write scripts for myself. I'm not going to discuss my patients tooth to tatoo ratio. But the instant I learn how, I'm going to hook my ass up to an IV to cure a hangover.

Great, so now oral sex can spread STDs. Can't a hedonistic brother get a break? Is there anything fun that doesn't cause STDs or cancer? I'm gonna be stuck with hand-jobs and "runners high" for the next 60 years until I hit 80, then fuck it, someone get me some heroin.

cheater part 1

This is super cheap, but in lieu of posting a real entry, I'm going to post everything from that is medical related or even school related and a few that I never posted on there because they were just rampant medical masturbation (that's a real disorder, it has to do with a defective G-protein or something. I wouldn't bother fact checking that and just trust me).

"Staphylococcus aureus (pronounced /ˌstæfɨləˈkɒkəs ˈɔriəs/)" Oh, that's how to pronounce it? Thanks Wikipedia. If it weren't for you I would have gotten up in front of my class and looked like a total idiot. I probably would have pronounced it exactly how it looks. I would have been so embarrassed when someone pointed out that it is pronounced like a string of fucking gibberish.

I see you in the hallway, we kind of know each other. I nod. You nod and follow with a, "Hey". I follow with a reflex, "How's it goin?" I'm like 20 feet past you by now. You fucking answer, "Pretty good!" Cool, fantastic, I'm glad you are doing well. Pause. "How are you?" Oh come on! I've opened the door. My jacket is zipped. Do I have to answer? I just put my hat on..."Good". I keep walking. Pause. "How was your weekend?" I don't even know your fucking name, you one-upping son of a bitch!

They say that the way to a man’s heart is through his stomach, but I just took anatomy and that is totally wrong. I would go through the chest. The chest is probably the best way.

If you don't have a Wikipedia article, I don't totally trust that you are a real thing.

One time I was reading a scientific paper and the words “matastable” and “susceptible” were close enough together that I thought it said “mustachable”. I thought I was about to read about the most exciting modern medical breakthrough. Turned out it was about stupid cancer. I hate cancer.

My parents came to visit recently and they were driving me and two of my friends around. I was showing them the sites around my house and kept referring to things as, “…best food truck in West Philly”, or “…busiest street in West Philly.” At some point my dad goes, “Why does everyone say West Philly, you can’t say West Philadelphia?” to which, without skipping a beat, all three of us replied, "...Born and raised. The playground is where I spent most of my days, chillin out max and relaxin all cool, shootin’ some b-ball outside of school...

All I really want to learn in school is the name of that disease where you can read two full pages worth of material only to realize you didn’t process a single fucking word. Because I definitely have that.

When there is free food offered at an event, people are always disappointed when it’s pizza. How can people hate freedom so much?

Coffee just makes me more alert while I procrastinate.

I’ve heard that we are the ADD generation and I totally believe that because about 25% of the time I call someone, by the time they answer, a mere 30 seconds later, I’ve forgotten who I’ve called and have to make awkward coughing noises while I look at my phone to see who I dialed before I end up saying “whats up, motherfucker?” to my grandma.

Sometimes, when I’m trying to get work done, I will offer myself a reward of distraction. For example, if I finish the intro section of the project I’m working on, I might reward myself with some YouTube. The problem is that the task takes 4 min. and the reward will go ahead and finish out the hour. I am bordering on doing a completely different task. At this point, my distraction is my project.