Archive for January, 2008

a brief reminder on why i hated surgery

Posted in random rants on January 31, 2008 by whenispark

i had a momentary scare today consisting of getting back my surgery grade.  i hadn’t been expecting it, thus when i looked at it, i initially thought it was my internal medicine grade, which i had been told to expect from my old clerkship director.  i tore open the envelop, hungrily reading the comments left by my clerkship director, and my heart drops.

“this student is certainly progressing appropriately.”

i would accept this as a comment if it wasn’t already clearly stated by the box he checked.  i was expecting a lot of average marks because of barely missing honoring, but i wasn’t expecting the lame comments to.  after reading more thoroughly, i also wasn’t surprised to find it was my surgery clerkship.

only on a surgery clerkship could you consistently wake up at 4-5 am (depending), study your ass off, etc and be told your doing appropriately.  however, i am well aware of the fact that had i gotten only two more questions right on my shelf, this man would have been singing a different tune. 

unfortunately, this is how medical schools work.  you can be socially retarded and still be considered one of the top students.  ironically, the top students are generally socially retarded because instead of interacting with human beings, they hug and molest their books continually.  there are exceptions, but it’s the most common system. 

i miss the robots

Posted in medicine, random rants on January 31, 2008 by whenispark

as my time on electives winds down (all two weeks), i am looking forward to returning to the general psych ward.  i miss my delusional d/o and schizophrenia patients.  i miss being called names.  i also miss feeling like a i contribute in some way.

 unfortunately, on the gero-psych unit, i am mostly in the way.  my day begins with reading the patient charts to see what happened through the night.  if the doc hasn’t arrived, i may or may not see patients – this part is up to me.  he will in no way use my note, no reading or co-signing.  if i talk to the patients and write a note, it is only for the practice of writing a note and practicing the mse (mental status exam).  unfortunately, this is what most of third year is like.  you have to be extremely proactive, which isn’t always a bad thing, but to some degree, i would like someone to tell me what to do – what my responsibilities are.

anyway, after i have seen several patients, i sit around and wait for the doctor to show up.  if it’s a day like today, he doesn’t.  i wait and wait, study a little, wait some more.  finally, at noon, i get fed up and leave, telling the nurses that i have lecture in the afternoon at another hospital, which is true, but my lecture isn’t until 3 pm.  at first, i felt bad doing this, but when the doctor isn’t there, and i have fulfilled my obligations, i’m not going to hang around when i could go eat lunch, then spend the afternoon studying and being productive in other ways as well.

don’t get me wrong, the doctor is a really nice, and he’s a good doctor, but he’s not a good teacher.  i also admit he’s a very busy man.  he is often there until 8 pm seeing patients and making sure they’re all doing well.  i have seen him sit down for 30-40 minutes with families to discuss care goals regarding their parents.  he is an exception to the rule, and clearly loves his job. 

oh the irony

Posted in random rants, tangential/circumferential on January 30, 2008 by whenispark

one would think that while on a psychiatry rotation, medical students would invariably improve their ability to read subtle facial expressions, let alone outright anger/sadness/happiness, etc.  apparently, such is not the case.

it begins with our first lecturer not showing up – which we’re all like, whatev – we can just study the nerds we are.  at some point, one of the residents comes in, and at first evaluation of his personality, i assumed he was rather laid back.  my basis, while irrelevant to this story, was that he was extremely nonchalant and withdrawn.

based on this assessment, i assumed he wouldn”t make us sign a sheet to take attendance.  for our lectures, it’s rather hit or miss who makes us do this.  i stated this to the other students, saying that, “oh, i could have skipped, he probably isn’t going to take attendance.”

it turns out, this particular young resident is very ocpd (obsessive compulsive personality disorder – diff from ocd) and was going to take attendance.  this is how the drama begins:

“oh p, how do you feel about that?”

“about what?”

“well, you’re wrong.”

“so, who cares?”

“oh, don’t you always have to be right?”

and that’s where the nonsense begins.  i do not know many would not be offending by such a statement.  i find there to be quite a distinction between three things: 1. being right often in an academic setting 2. not liking to be wrong 3. actually always needing to be right.

undeniably, for this rotation, i have worked very hard and qualify for number one.  this is not to say that i’m always right.  but, i have worked hard to attain the knowledge i have now.  if you don’t meet number two, then you must be a mutant, because i don’t know many people who enjoy being wrong.  and really, i don’t know anyone offhand who meets number 3.  i don’t know someone who has this need to be right driving them.  i don’t think this is something altogether common.

so here i am, sitting, waiting for a lecture to begin, having to listen to 5-10 people think that they actually know me well enough to draw conclusions about my personality.  these are people who have no concept of my life or personality except that which i have decided to share with them.  they clearly don’t know me well enough, because as i progressively became more and more pissed, they continued.  it took someone who does know me very well (meg) to not so subtly change the subject.  it’s strange.  in medical school, people just assume because they’re your classmates that they’re entitled to not only know about your life, but also that it’s open to discussion with them.

facial expressions 101 – if a person is not smiling or laughing along with your jesting, that’s a big hint that they don’t think it’s funny.

does a body good

Posted in random rants, tangential/circumferential, the poopers on January 29, 2008 by whenispark

and i don’t mean milk.

 1. today i had my csa (clinical skills assessment) – very easy.

2. my new word shall be hot mess.

3. i went shopping. bought two pairs of editor pants for less than 40 dollars total. and i bought a shirt in there, too.  all still under 40.

4. i played basketball.

that’s what did this body good.  during my m1 and m2 years, i played continuously with the boys. with much sweat and countless floor burns, i began to improve.  as a girl, i was the typical slow shooter, taking enough time to allow a guy to easily come up and block me.  i had reached a point where many of my shots were quick.  let’s just say that tonight was proof of complete regression.  nevertheless, there is some hope.  i did manage some decent shots, and i had some great opportunities.

i will play again on thursday to continue my work-out regimen. it will at least offer me some variety.  they play again tomorrow, and i am debating joining for that session as well.

one note – things that are not cool, and i see this continually…people faking pain/injury in a completely unrelated spot.  for instance, i young man is blocked, and he walks off the flow limping a few steps. i mean, really.  what makes you think anyone is buying into that?  i saw the same thing in high school.  there was always the same girl doing it, and nobody was falling for it.  so for all the fakers – just man up and accept the blunder. 

lord knows how many turnovers and craptacular shots i had, but i have the integrity to admit i suck instead of pretending i missed because 5 years ago i sprained my ankle.

 ps – bailey died.

 pss – she didn’t actually die. but i’m pretty sure all those mini-strokes added to one big one, cause know that second eye-lid that dogs have is constantly blocking at least one third of her eye.   it’s pretty gross looking.

psss – as i was studying last night, she pooped right outside the office door. i think just to spite me.  she doesn’t even attempt to ring the bells or anything anymore.  she doesn’t in anyway want to go outside.  it’s warmer inside.  i’ll just say she’s lucky i didn’t step in it.

the nudist colony

Posted in medicine on January 28, 2008 by whenispark

or as most call it, the geriatric psych unit. or even shorter – the gero-psych unit.  while i haven’t yet experienced the nudity, it seems to be a pervading theme when other people tell me about it.  and don’t misunderstand me – i have no desire to experience it either.

apparently there is something about dementia that it correlates closely with the elderly taking off their clothes and running around the psych unit.  my first day was rather uneventful, but i’m looking forward to some of the oddities that i was able to see before on 6100 at general.

from my limited day (it was a half day today), i did manage to witness an elderly woman who would sneak into the other pts’ rooms and take their stuff.  she would then roll these things into a sheet and carry it around on the floor, the whole time denying she did this when the nurses questioned.

otherwise, i anticipate this to be a rather uneventful week. most of the time, it seems the old people just sit in their “geri-chairs”, as they are called, and watch tv.

tomorrow, i have my csa (clinical skills assessment).  this will consist of me interviewing two fake patients, “collecting my thoughts”, then presenting and discussing my findings with a psychiatrist who watched the whole ordeal. unfortunately (or fortunately), my interview is being observed by the clerkship director.  while the exercise itself is only pass-fail, it provides me one more opportunity to impress her. i will admit, i have been studying extremely hard, but i think a lot of it has to do with my basic interest in the material as opposed to an overwhelming desire to honor (that’s definitely still present though).  we’ll see.  regardless, it means i’m done at 2.

 update: apparently, there is currently one elderly woman on the floor who chronically and purposefully takes off her clothes because she likes the security guards.  her other method of getting security called on her to flirt?  hitting the other patients.  hilarious.

up close and personal

Posted in the poopers on January 26, 2008 by whenispark

delilah

this picture is currently my desktop. chewkie loves, as do i. more proof of my obsession.  you can click on the picture for a larger view. my favorite aspect is the reflection of the outside in her eye.

 

hitchin’ a ride

Posted in tangential/circumferential on January 24, 2008 by whenispark

while discussing the controversy of bigfoot on mars with meg:

“well if it’s bigfoot, how’d he get on mars? oh wait, don’t answer that. how silly of me. a nasa space rocket. of course.”

this is of course hilarious. until you read this in an online article on telegraph.uk:

‘And one more said: “It’s definitely Bigfoot. That’s why we’ve not been able to find him on Earth, he’s gone to Mars.” ‘

that’s one theory of bigfoot supporters.