University of Youtube

Fourth year: Oh yeah, I learn everything from youtube. During a trauma the other day the resident asked me if I knew how to do this particular stitch. I told her yes and then stood in the corner of the trauma bay and quickly watched it on youtube. Then I was ready to go.

Not safe to drive

Patient, after the procedure done under sedation is finished:

Patient: But doc, I'm still under the influence!
Doctor: Under the influence of what?
Patient: The happy juice.

Someone is gonna get hurt

Teaching hospitals are a funny thing. You are going to get the best, top of the line care at the forefront of medical research. You are also most likely going to get poked and prodded by less than skilled hands (ie medical students and new residents).

I'm on my anesthesia selective for two weeks. In the week I have been there so far, an elderly woman woke up with an extra bruise on her hand from a botched IV, another woman woke up with a swollen lip from a botched intubation, and still another woman woke up with the back of her throat possibly more scratched than it had to be from yet another botched intubation. I asked if I could practice intubations in a sim lab and was told that it isn't at all the same. In the sim lab, the tongue stays put and doesn't flop everywhere. I need to practice on real people, I'm told.

I watched the attending leave the first year anesthesia resident alone in the room for ten minutes. The apnea alarm started going off. I asked why it was saying that, he had no idea. If anything bad had happened in those ten minutes, that woman might have been dead. I watched the junior resident accidentally bovie the stomach serosa instead of the fascial adhesions. If you told patients during the consent that their surgery might have a few mistakes, the anesthesiologist is new and doesn't know what to do if anything goes wrong, and a med student is going to practice with their veins to put in IVs and try intubation only to probably just scratch up their mouth, I'm unsure they would consent.

It's a necessary evil of a teaching hospital. And you know what? If one day I need to wake with a few extra bruises and minor abrasions from a surgery that maybe didn't go as smoothly as it could have because a resident messed up, then so be it. That is what it takes to make doctors of tomorrow. We have yet to find a better way.

First day of surgery clerkship

My attending had wise words. He said that it is a guarantee that we will harm people and we will be an instrument of some people's death. He also said that this career is amazing. In no other career will someone meet you for 15 minutes and then agree to let you cut them while they are asleep and vulnerable. His opening speech was much more profound than I can summarize in a few words, but it made me both excited and scared for the upcoming years.

Two tips for those starting third year:
1. Always roll up the sleeves on your white coat when you eat. It will avoid ketchup vs. sleeve mishaps.
2. Always carry cash with you so when the cafeteria is cash only, the attending doesn't have to pay for you on your first day.

Other than that, I start my anesthesia selective tomorrow. We will see how that goes.

I'm back!

Well hello there, people. I'm done with boards. No, I don't want to talk about it.

In other news, I got a kitten! Apparently it's a thing to get a "board pet". I didn't just get him for the boards, I had wanted a kitten for a while and now is a time in my life when I can finally have one since I'm done living in dorm-like atmospheres. His name is Jack and he's adorable and full of personality and cuddles. Let the cuteness commence.

He sleeps in ridiculous positions.

I don't really have anything to update because nothing has happened other than the kitten and the boards. I'm currently trying to pack up my stuff and prepare to move next week, but motivation is low since pressure is low so I mostly spend my days laying in bed with Jack and watching HGTV. 

I'm going on a short hiatus

The reason I haven't been posting is because finals are coming up in 2 weeks and then I have 6 weeks of board studying which entails 10 hour minimum study days. I don't have time to blog and nothing exciting is happening to me anyway.

I'll be back, I promise. If you are a new viewer, you should stay tuned because I start 3rd year in July and if you know anything about 3rd year of medical school.... Well, I'm going to have some great stories.

Wish me luck!

Don't ask questions unless you have a reason for obtaining the answer.

One of the doctors who gave a lecture told us that there are only so many good reasons to do a test:

1. The result will change the management of the patient
2. Prognosis
3. Reassurance (only if not dangerous, painful, or costly)

The other poor reasons include curiosity, covering your ass (not a good reason, but necessary sometimes), and financial gain.

I think it's good life advice to follow. Don't ask a question that you aren't prepared to hear the answer to. Most importantly, don't ask a question unless the answer will change the way you do things.

Simple example: Do we have milk in the fridge? If the answer is no, do I plan on going to get milk? Was I planning on having cereal and this answer will determine whether I have cereal or toast? If not, then why ask? If the answer is no, it is only going to annoy me and bother me that I don't have milk.

And the reassurance thing, well, my philosophy is fast becoming if the possible bad news is worse than not knowing, I'd rather stick with not knowing.