Friday, August 27, 2010

And I don't get paid.

My non-med friends always ask me what's different about working in medicine from any other job?  In a lot of ways it isn't that different.  But then again, your boss can ask you to do some shitty things, but is one of them, "Go acquire fluid from that person's genitals and test it for STDs"?

Friday, August 20, 2010

All's fun and games til someone gets the clap

Nothing puts the "real" in "venereal" like a urethral swab.  Wrap it up, Guy, and I won't have to stick a Q-tip in your penis-hole.

Thursday, August 19, 2010


Part of the reason we take tests is so we can understand and handle the really important diseases of each specialty.  For instance in neuro, they want to make sure we never miss a burst aneurysm or stroke.  Or in Ob/Gyn, they don't want us to miss preeclampsia.  So they drill these into our head and make sure we never forget. But the funny thing is that although we never forget them*, we never really know them in the first place.  

For instance, a Tylenol overdose is something that was molded into my being during my peds rotation.  I've learned it literally 100 times. It was literally pounded into my head, where I literally had a subdural from this pounding, to use a certain drug for a Tylenol overdose. Except if someone ever walked in with a Tylenol overdose, I would be like, "Got it, I know this one, nurse, this diagnosis of Tylenol overdose should be treated with the Tylenol overdose antidote."

And the nurse would go, "Great job doctor, good catch.  Now what is that antidote?"

I know this too, because I've been studying very hard, "N-acetyl-something"


"I think so.  If you give me 3 other choices and label them A, B, C and D**, I'll definitely be able to pick the correct answer".

Then the nurse will say, "Ok, how much do you want to give?"

To which I will cooley and calmly reply, "I have no idea.  5?  50? 500?  What year were you born?  Give her that many."  Because dosing is something I'll learn in medical school II, or by magic, or maybe twitter.

"So 1,974? You want me to give her 1,974mg? And what route would you like me to use?"

"I would take the elevator in the Southwest hallway, It's not the closest, but when you get off, it has the signs to the pharmacy so I don't get lost"

"It comes in pills or IV.  Your choices are 6.58 pills, based on your dose, or we can just give IV."

"By mouth sounds good."

"The patient can no longer swallow because this has taken so long.  I've already started her on an IV with the correct dose.  I'm so glad you did well on your peds rotation."

*This is not true, I've already forgotten it.
**I realize this is my second joke about Tylenol overdoses and multiple choice tests, but since it's the only thing I've actually learned this far, I have to keep using it or I fear I'll have to learn something new, which will push Tylenol overdose right out of my head.  I can't forget about Tylenol overdose.  I can't ever forget about Tylenol overdose.

Tuesday, August 17, 2010

Disease: a new reality show

We did a differential diagnoses case in lecture of a woman with possible hypothyroidism manifest by some abnormal bleeding.  Then, later, I was working in the clinic, and a woman came in with possible hypothyroidism with some abnormal bleeding. It's almost like these things they talk about in class are...real...

Friday, August 13, 2010

Night of the living asystole

Many people bring in their own med list.  This is really helpful because then you can be sure that you aren't going to give a medication the person is allergic to or give two drugs that will interact; in general, it will reduce mishaps.

Except for one patient I saw.

She brought in her med list and on it was a list of allergies and her reaction to the med.  So it would say something like, "metoprolol- light headed", or "lisinopril- cough".  Then for one med it said, and I'm not making this up, "benadryl- zombie".

Usually the principle is, "Do no harm", but in this case it was, "Do no harm.  But if you do do some harm, destroy the brain 'til it don't get back up no more."

Wednesday, August 11, 2010

I'm denying that there are any conceptual errors in this, and if you disagree, you are a poopy head.

Some time long ago, some psych guy came up with the concept of defense mechanisms.  With a good grasp on defense mechanisms, you can pretty much annoy the piss out of anyone.

"How did your psych rotation go?"
"It was ok, I think I learned a lot and the patients were interesting."
"So you hated it and you are just using Rationalization to justify the time you put in."
"No, I really liked it."
"That's Reaction Formation, you're saying the opposite of how you feel."
"Ok I think I liked it."
"Don't repress your feelings, it clearly sucked."
"I'm not repressing anything."
"Classic Denial"
"I'm not in denial!"
"That's called Acting Out.  It's an immature defense you know."
"Clearly you are the one who hated it or you wouldn't be grilling me like this."
"Don't project your feelings onto me."
"Would you stop? You are annoying the shit out of me."
"You are displacing your anger about your rotation on me."
"Ahhh! Fucking stop! You are a fucking asshole!"

Sunday, August 8, 2010

Slim chance I'd get that shady

When I'm really fucking pissed, I like to listen to Eminem so I can be like, yeah ok, I'm not that angry.  Take a chill pill, Marshall.

Actually wait, you should stay away from chill pills.

Thursday, August 5, 2010

Anatomically correct smiley face

   o   o
 ( /  \ )
( )   <3)
( _)_ _
(    / { }
(   /_ _J
  | www|
  '    O  S

Artists Note: The urethra should be totally straight.  And probably not have a hole in it.  Definitely not have a hole in it.

It recently occurred to me that this face is not smiling, contrary to my title.  Probably has something to do with having his body splayed open in a display-like fashion.  Or the hole in his penis. That thing can't be comfortable.