Soooo, for two weeks I'm was with with a Family Practitioner.
What I learned:
South Florida also has a very large Eastern European population...so much for kicking myself to learn Spanish. It was useful when some of the hispanic patients came in, but obviously useless with the Romanian doctor, the Russian PA, and their patients. Oh yeah, and some Yiddish, too!
I can recognize a pill seeker from a mile away. Addiction specialty anyone?
I am pretty good at talking to people about their personal problems.
COPD is pretty easy to diagnose, lol.
Saw a case of Raynaud's. Two cases of SLE. A couple myasthenia gravis. Sickle cell.
Saw a mom who wanted to put her 13-year old daughter on BC.
Mothers have no business running the office for their sons.
I learned that I really really really enjoy talking to patients be they difficult or cooperative.
Sunday, March 27, 2011
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."
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.
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...
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.
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.
Thursday, January 27, 2011
Miami...Miami...you've got style
I am LOVING being back in the States. And I really like Miami. The traffic and pace of life is zany enough for me. I love my apartment, even if it is expensive, and I love being able to take the train into class/work. On that note, given that we are required to dress professionally and the nature of what we're doing it often feels more like a job right now. This does not bother me one bit because I enjoyed working. And I enjoy dressing professionally, frankly I have more professional clothes than casual. It's nice to get up in the morning, pull out a nice, crisp dress shirt and pair of pants, and put on a nice pair of shoes with a belt. Look good, feel good.
We only have class one day per week now. Thank God!!! that makes it much more bearable to sit and listen to somebody drone on and on and on and on and on for eight hours.
We only have class one day per week now. Thank God!!! that makes it much more bearable to sit and listen to somebody drone on and on and on and on and on for eight hours.
Thursday, January 13, 2011
Farewell Dominica
So I'm finally settled in Miami, for now anyways. It took two days of constant back and forth little trips consisting of an unmentionable number of bags containing a broad array of useless crap to get here! Getting the furniture turned out to be a bit more of a hassle than I would've liked -- I had to sleep on my couch the first night (but it's a great couch!).
It still feels a bit surreal that I'm not going back to Dominica. When I came back to the states on December 18th (I shall forever remember that day!) I knew there was a chance that I could be repeating, just because of my "stellar" success on Minis 1 and 3 pharm. PS, I rocked the pharm final! So when I got my grades it all came at once. Joy, relief, a minute tinge of sadness, but it was all there. Then I began reading all of my friends' statuses about how they're all going back to "The Rock"as it is known by some. And then the surreal feeling set in. I'm not going back. That blasted island dominated my life for about a year and a half, it was in my consciousness every single day that I was there and I had to alter a great deal just to accommodate to that fact. And then poof! just like that I'm gone. I'm greatly relieved to be moving on to something new, and living in a place where idiocy is not The National Passtime, but it is just strange nonetheless. This might be my last post to have the "Dominica" label on it! I met some great people there (some greater than others...) and hopefully I will be able to keep in touch with those still there and those that went to Michigan. But for now, "Forward, the Light Brigade!"
It still feels a bit surreal that I'm not going back to Dominica. When I came back to the states on December 18th (I shall forever remember that day!) I knew there was a chance that I could be repeating, just because of my "stellar" success on Minis 1 and 3 pharm. PS, I rocked the pharm final! So when I got my grades it all came at once. Joy, relief, a minute tinge of sadness, but it was all there. Then I began reading all of my friends' statuses about how they're all going back to "The Rock"as it is known by some. And then the surreal feeling set in. I'm not going back. That blasted island dominated my life for about a year and a half, it was in my consciousness every single day that I was there and I had to alter a great deal just to accommodate to that fact. And then poof! just like that I'm gone. I'm greatly relieved to be moving on to something new, and living in a place where idiocy is not The National Passtime, but it is just strange nonetheless. This might be my last post to have the "Dominica" label on it! I met some great people there (some greater than others...) and hopefully I will be able to keep in touch with those still there and those that went to Michigan. But for now, "Forward, the Light Brigade!"
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