Sunday, February 27, 2011

Written quite a few weeks ago...oops

I ran into some MERP students today. MERP and 5th Semesters many days have class in the same building. As soon as we established our respective place in the medschool totem pole (doesn't really matter because we're all at the bottom) I was bombarded with questions about Dominica. My number one advice -- roll with it and just expect to have crap days, and chew on it.

Ok, fast forward to today:
I have had so fewer days like that!! Daily existence is not such a challenge here. Even though I'm not in a place where I grew up, or really had ever been before, I am comfortable here. I like it here. The culture here expects something out of itself, and isn't complacent with status quo or has the attitude "that's the way we do things here."

Frustrations with medical students

I have noticed an increasing apathy amongst many of my colleagues with respect to professionalism (which is HAMMERED down our throats, so I'll use that word). I have observed more and more of my colleagues leaving class after attendance (up to forty or fifty each session) with excuses ranging from they find it a waste of time to they are tired and can't pay attention. I find this dishonest and irresponsible. We, as medical students, are asking for and taking on a great deal of responsibility, and frankly, if I see my colleagues taking such a lackadaisical approach to simply attending class ( a simple requirement), how confident should I be in their willingness and desire to pursue thorough and efficacious treatment of patients I myself might be referring to for them. It also will forever raise the question in my mind that if you're willing to lie about your whereabouts and be dishonest about your presence, how do I know that you have actually done what you have documented. You are encouraging me NOT to trust you and your work -- BAD recipe for a physician. I spoke to a friend of mine who does not work in medicine about my concerns, and it alarmed her to think that the people she would be entrusting her health, well-being, and potentially her life couldn't be bothered to attend every lecture. Her exact words were "there could be something in that lecture that could save my life, and they don't have the mental fortitude to sit there for an extra hour? That bothers me!" Thank you Redd, it bothers me too!

Similarly, the approach taken by some to professional dress is embarrassing. I see flagrant disregard on an almost daily basis. Sneakers, tennis shoes, penny loafers, casual shoes of any nature, and especially flip flops are NOT professional footwear. Along the same vein, "evening wear," untucked shirts, and blue jeans are not professional wear. In a private place of work none of this would be tolerated -- why should it be here? Do I even need to address the issue of medical students falling asleep in class...All of this when viewed by outsiders only does a disservice to our class as a whole.

I believe that some of the discrepancy can exist due to the fact that many of my colleagues to date have ZERO professional experience, but now should be the time to learn and become aware of what is expected and required of us as doctors. A hospital with an overextended staff is a very bad place to learn lessons. By no means do my concerns apply to the majority of my colleagues. They do, however, apply to a minority that is more than a few individuals.

I am by no means attempting to deprive anyone of their individuality or freedom of expression, etc. etc. Simply put--do that on your own time. We are a group here, and we have chosen to become part of a group that is highly visible in the community. What each of us does and how each of us performs reflects on each and every other member of the group. So when people are lazy, leave early, and/or appear sloppily dressed, that is what is seen and that is the impression that will remain of us.

I'm not sure how much will come of the situation, but perhaps people will realize that they are indeed being watched, not only by outsiders, but their peers as well! If you don't like that, well tough, get over it. Because that's the reality of our society (and a job in general). Daily there will be something that is going to piss you off or ruffle your feathers or frazzle your good humor--and you just have to deal with it.

Thursday, February 17, 2011

Things learned in my subsequent ER shifts

Increased CPK means rhabdomyalosis.

Cuban Spanish is a different kettle of fish -- I'm not even sure one could call it Spanish.

Having been there since 7 (notice I didn't specify which seven...) 5:30 to 7 really sucks.

X-rays are almost a waste of time for anything other than peripheral. Almost...

Your friends who are too busy to do anything but school are either not interested, or just REALLY bad at time management...

Saturday, February 12, 2011

Some of what I learned from 12 hours in the ER

HCTZ does indeed cause hypokalemia

Lungs en espanol es "pulmones."

ALWAYS ALWAYS ALWAYS ALWAYS check the meds list...

The Baker Act is great.

I know more Spanish than I realize. I was able to do three interviews exclusively in Spanish and get most of the history. Most certainly the (Spanish-speaking) doctor was able to extrude more, but I was quite proud of myself.

Eat when you can, as much as you can, because you don't know if you'll have another shot!

Smoking cessation can actually cause a short term case of bronchitis due to epithelial regeneration. Rx: Guaifenesin, albuterl/salmaterol, prednisone, and an antibiotic.

Walk into the ER (or any other rotation I guess really) assuming that the doctor is going to dress you down -- that's what he's there for, to teach you.

Spontaneous abortions are the worst cases to work.