The 5 Dumbest Things I’ve Said This Month

The best part of being a 3rd year med student is that you know all the arcane trivial diseases the residents have forgotten.  So I’ve been able to make 2 really cool diagnoses, answer a handful of obscure mechanism-of-action questions correctly, and look like a complete idiot the rest of the time.

I fully expect this to become a recurring feature.

5. Resident:  So, we could order a head CT, but we know she hasn’t had a stroke or a brain bleed, so what could we possibly see from that?
Me:  Parasites!
Resident: …

4. Resident:  Wait, why did the patient need a mitral valve replacement?
Me:  Because… the patient had…  *surreptitiously checks chart*  a St. Jude valve.

3. Me:  Wow, this is going to be a slow day, huh?

2.  Me:  On assessment, I’m most concerned with the patient’s morning blood pressure, which was  65 / 71.  … wait.  Hold on.  No.

1. Me: Just in case, shouldn’t we get a stool guiaiac test?.

My med school and I are fighting.

They aren’t aware of it – but I am.

And I have to admit, seeing as how I’m sleeping on a floor, hijacking the living space of some perfectly respectable people who didn’t expect to have a hobo camped out in their living room, trying to organize my clothes in neat piles next to their sofa – … looks like I’m not winning.

Some background:  Metropolis Med has a 3rd year ceremony this week – sort of “White Coat Ceremony: Part 2″.  It’s mandatory, and scheduled for the first day of rotations.  This is annoying for me because my rotation schedule requires me to move to a different city for the year (long story) – so because of this ceremony, my only option is to move cities on the same day my 1st rotation actually starts.

(I don’t ask for much in life.  It’s the little things, mostly.  The little things like desiring more than 12 hours to move my entire damn life from one city to another.)

But the real point is this: my dorm lease ended last week, and the new school housing I’m supposed to move into is still being renovated.  So where am I supposed to live until the mandatory ceremony? Am I supposed to move into a hotel for 2 weeks?  (Was I supposed to actually, I don’t know, give this some thought before the end of the semester?)

So, faced with a hell of a problem, I did what any sane person would: I ignored it.

I figure psychologically, it’s better to beg forgiveness than to ask permission.  And practically, I’m betting it would take the Housing Office longer than a week to change my locks.  And realistically, who would want to go to the trouble of forcibly evicting all of my boxes?

They’re heavy.

Anyway, I’ve decided to view my refusal to vacate my dorm as a symbolic protest of the 3rd year ceremony scheduling.  Because, in that sense, everything worked out perfectly!  The school scheduled the ceremony inconveniently, but I ignored their lease, so we’re even.  FIGHT THE POWER.  

To get to the point – now that all my stuff is stacked in boxes, there’s no longer room for me (or a bed) in my 60 square-foot apartment.

So my boxes are illegally living in my apartment (which, if we’re being honest, isn’t exactly 100% packed yet) and I am living on my friend’s couch, hoping I can get away with all this for just 3 more days until the U-Haul gets here.

Then, after 3 days, I’ll be home free!  And by “home free”, I mean “starting my surgery rotation in a new city”, so… the opposite, really.

Here’s to a new year filled with interesting problems to solve or ignore!

Rethinking my commitment to Being A Cat Person

I’m cat-sitting for two friends right now.  It’s great in every sense except for the one where I realize all my ex-boyfriends were right to prefer dogs.

The Limit to How Many Stupid Things A Cat Can Do In One Day:

Let’s tally it up.

1. Tried to eat a small stuffed Moses.

2. Knocked a glass jar off the counter.

3. Tried to eat the shards of glass that ensued from this decision.

4. Played a poorly thought-out game called “pouncing on the shards of glass”.

5. Tried to eat the shards of glass again

6. Bit and scratched me as I carried him away from the area of broken glass.

7.  Immediately ran back to the area of broken glass.

8.  Repeat 6 and 7 until I gave up and shut him in the hallway.

9. Whined and cried at the hallway door about not being allowed to eat the delicious broken glass.

8. After being released, immediately running off to the kitchen to see if there was any broken glass left to eat.

9. Despite the fact that the blood oozing from my hand was surely a little higher in actual nutritional value.

But it’s okay.  After all that, I decided to rebalance the forces of the universe myself.  Namely, by bravely commandeering the ice cream out of said friend’s freezer.  (If said friend is reading this, don’t worry – it was just the vanilla.  It was a necessary casualty.  It made up for the wounds I sustained in the line of duty.)

I hear dogs are nice.

Holiday Mistakes

No, I wasn’t exactly awake while showering, why do you ask?

I hope my OSCE patient is feeling festive.

A couple of things

1.  Sometimes people are the absolute best.

I just.. hold on.

Allergies. I just... allergies. I'M ALLERGIC TO LOVE.

2.  Sometimes I come up with multi-million dollar marketing plans in the shower.

Remember when you used to be able to just use face wash?  But now “facial care” is a 3 step process:  1. Exfoliate, 2. Clean, 3.  Moisturize.  You need 3 products.  (We’ll ignore the fact that I’m pretty sure Dermatology has taught me that exfoliating is a gigantic waste of time, money, and protective layer of stratum corneum cells.)

(Oh, also, I totally have my Dermatology test in 2 hours.  You can tell it’s real important to me.)

We could do the same thing for the haircare industry – increase profits by 33%.  After all, does anyone only buy shampoo, or only buy conditioner?  No.  We need a 3rd product everyone has to buy. (And by “we”, I mean “the haircare industry, if I was involved and got a payday out of this”.)

My ad campaign.

The Commercial:  “If you’re only using Shampoo and Conditioner, you’re missing out on a crucial 3rd step.  Take a look at any shower in France, and you’ll find a 3rd product – Pre-Conditioner.”

The actual name of the product isn’t important.  It just has to have a vaguely plausible sounding scientific gimmick like “providing a surface for conditioner to fully enter the hair shaft – because without it, conditioner only sticks to the outside and is mostly rinsed away!”  (Since 90% of the scientific stuff in hair commercials is made-up, this should be legally ok.)

If I were in charge of this ad campaign, I’d pin this “secret” on the French, because – at least in America – we seem to be willing to believe anything about the French, including that they’re all skinny and effortless.  Perfect hair goes with the territory.

If the hair-care industry successfully plant the seed of doubt in people’s mind that shampoo and conditioner are not enough, they could get $6 out of most of the women in the USA, and probably half of the men.  Millions of dollars.

No, I don’t know how tongue-in-cheek this idea is.  I hope you don’t either.  

Things I’m Fairly Certain I Can’t Do

It’s a long list.  But as far as a residency goes, I’d narrow down the list of thoroughly charming impossibilities to “surgery” and “pediatrics”.

Surgery’s awesome, but me standing still for 12 hours, so far, doesn’t seem to be biologically possible.  (Yeah, I realize I’m going to have to do it anyway.  My current plan involves salt pills, resourcefulness, and doing as much extra reading/scut as possible to distract people from my utter inability to get through a case without falling over.)

As for pediatrics, I don’t really have the personality.  I only love kids unconditionally when they’re under the age of 7.

(Hey.  Don’t look at me like that.  I don’t wish them any ill-will!)

(… Unless there’s 3 boys screaming their heads off and running around a restaurant while a smaller one throws a tantrum on the floor and their beleagured mother stares off into the distance with vacant, dead eyes and cheerios stuck in her hair.)

(I mean, hypothetically.  That’s definitely not something I saw every single day while waitressing at a popular family restaurant 6 years ago, but burned indelibly in my mind…)

Anyway.  Adult medicine isn’t exactly sunshine and roses either, so what the hell. I’ve decided to shadow a pediatrician today.  Maybe it will be fun!  Maybe I will fall in love with pediatrics!

Maybe I will not have a horrifying episode of waitressing-induced PTSD!

Objective? Structured? Clinical Examination?

“My First OSCE”: A Tragedy In One Act

Me:  Okay, sir, I’m just going to take your blood pressure and then we’ll move onto a physical exam.  *pumps cuff up expertly*

Gauge:  *briefly flutters around the 2 mmHg mark, then back to 0*

Me:  … *tightens valve*  Hmm.  Sorry, sir, I’m going to readjust this and try to get this working.

Valve:  No, you aren’t.

Me:  Or it may be a problem with the cuff – *spends an eternity checking for leaks and pumping*  

Patient:  Okay.

Me:  *I am now holding a puffed up balloon of a cuff in my hand*

Patient:  Aha, you fixed it!

Me: *releases valve*  *nothing happens*’

Me:  *awkwardly bats BP cuff balloon around*  No, I guess it’s a problem with.. many things.  Hmmm.

Me: Let’s see.. give me a sec?

Patient:  Oh, uh, no problem.

Me:  *runs to retrieve bag from waiting room*  

Preceptor:  What the -?

Me:  *pulls out brand new sphygmomonometer from bag!*  

Brand New BP Cuff:  *is still awkwardly wrapped in plastic*

Me:  *hastily fumbles with plastic*  Sorry for the wait, sir – since you’re having chest pain, it’s just very important to me that I get your blood pressure right.

Patient:  That is so impressive.  I am so impressed right now.

Me:  Yeesssss.

Preceptor:  … yeah, you have 5 minutes left.

Me:  Noooooo!

“My Feedback”:  A Short Disaster

My Standardized Patient:  You know what I like about you?  You’re tenacious.  You just won’t give up!

Me:  Thank you!

My Standardized Patient:  No matter how bad things seem!

Me:  Oh. Uh, thanks!

My Standardized Patient: – and no matter how utterly hopeless it seems, you refuse to give up.  You have no ego. As an actor, I very much appreciate that quality.  I wish you were one of my co-workers!

Me:  That – hmm.  That means a lot, thank you!

My Standardized Patient:  What a fantastic experience.

My Preceptor:  

Yes sir, my preceptor’s request to “bring that cuff to clerkship tomorrow so we can practice” is certainly a good sign.  THINGS ARE LOOKING UP FOR LITTLE OL’ ME.

Thanks, dear.

Me:  Hey, quick question: what format do you use for the write-up of a neuro exam?

Boyfriend:  … Format?

Me:  See, I’m working on my write-up.  And in the “motor” category I usually list strengths for both flexion and extension of the major joints, then the same thing for DTRs.  But it takes up a TON of space.  Maybe I shouldn’t write them in list format?  Is that how you usually do it?

Boyfriend:  .. No.

Me: Oh, okay!  How do you write it up, then?

Boyfriend:  *scribbles*  Here.

Me: Thanks, let’s see wha- …. “Cranial Nerves II-XII:  Grossly intact“?

Boyfriend:

Me:  

… I should probably just be thankful for his help with pathology.

Medicine involves death? What?

Today, med school required that I spend an afternoon reading incredible poetry about the inevitability of dying alone, written by lonely patients who knew they were about to die.

Then I walked home.  In the rain.  And collapsed dramatically in a puddle, where I contracted tuberculosis and died.  (One of these things may be a slight exaggeration slash lie.)

The point is, it was depressing.  And my feelings about it remind me of a class back at Generic Midwestern U called Physics for Poets.  English majors loved the idea of it, but would always get all disappointed upon realizing it actually involved math.  They just didn’t see ‘math’ as being a necessary part of ‘physics’.

And now I’ve signed up for a class which is, essentially, Poetry for Med Students, and I’m disappointed that ‘poetry’ sometimes involves ‘sad emotions’.  I HAVE BEEN DECEIVED.

(… also, possibly, “whining.”  Or, “making poor life choices.”  Take your pick.)

But I’m scheduled to spend the evening leading fun, high-energy softball drills, so I grabbed something called a “Salted Caramel Latte” at Starbucks in the hope that chemicals and sugar would treat minor depression.

MORE ENERGY. LESS THINKING.

The barista looked at me with some serious side-eye when I ordered my Salted latte.  She explained that it might be a bit of a gamble, because all the baristas had just been trained on them.

But it was still delicious and comforting.  So, if my “poetry about medicine” elective is truly code for “poetry about death”, they’re all about to get some serious weekly practice.

You can’t go home again

My hometown is so under-construction that I’m afraid to even venture outside.  It’s like there was a national TV ad out there: “Got Spare Orange Cones?  Take them to AP’s Hometown: Home of the Orange Cones!  We’ll set ‘em up on our streets and pretend like we’re doin’ something productive!“

This would be a great place to play the "Finding Nemo" variant of "Where's Waldo".

But today I braved the rat-maze and successfully made it to the cell phone store, where I finally ditched my non-intelligent phone for an allegedly smart one.

I feel strangely guilty about getting rid of a phone that spent 5 years faithfully by my side (Must be Toy Story syndrome) – but it’s cool.  My new phone and I are already bonding over friendly topics such as: “How the hell do you turn this thing on?”, “Am I just an idiot? Is that the problem?  Am I just completely incompetent at life?”, and “OH!  There’s a tiny button!  Hidden on the side!”

Once I made it through that confusion (Internet, I am not even telling you how long it took me.  It’s embarrassing), I started figuring things out.  For instance – guys, did you know how many unbelievable medical apps there are out there?  My favorite is one from the US Department of Health.

It’s amazing how quickly I went from, “I need a smart phone for the clinical years” to “Wait, how the hell is this even allowed for the clinical years?  Will I have to hide it?”

Feels suspiciously like cheating.

In other news, my 2nd year at Metropolis Med starts in just 1 week, so anyone who’s wondering why the hell they’re still subscribing to a blog that’s apparently no longer about medicine – just hold on!  I’ll be back to lamenting my total lack of clinical skills in no time at all.  Pinky-swear.