ndab Ah Yes, Medical School: February 2005

Sunday, February 27, 2005

The FIHTTTU Status Exam

After 1.5 years of getting away with doing nothing, reality has set in, and she's ugly, hungover, on her period, and wants to talk. What is this reality I speak of? Well, let me just put it this way: If you want to literally scare the shit out of any medical student, you need only utter five letters in succession: U-S-M-L-E. Yes, ladies and gentlemen, the grand United States Medical Licensing Exam is upon us, and life as I know it shall never again be the same. Granted, I've known that Step 1 of this exam was on the horizon since I entered medical school, but when an exam of this magnitude is a long ways away it is easy to just forget about it and continue slacking off. However, the real exam is now only a few months away, and it has occurred to me that I need to learn everything I was supposed to learn in the first two years of medical school in, oh, I don't know...THREE MONTHS. Now, you may think I'm currently wetting my pants. And you'd be right (actually, you'd be right about 45% of the time independent of anything else). But what about your more manly medical school friends? How can you truly judge what level of insanity they have reached as a result of this exam? What if YOU are a medical student, and you need to know how fucked up you've become after studying for this test, so you know how many of those free samples of Prozac you should be popping?

Given all this, I think it would be useful to come up with a systematic way to document previous, current, and future levels of despair as I begin my USMLE studying by descending into the bowels of the medical library, or, more likely, some crowded coffee shop where I can display my medical school paraphenilia with the hopes of catching the eye of one (of the many) attractive female undergraduates here (Ask me how many times that has worked out so far. Go ahead, ask. Hint: It rhymes with De Niro, and it starts with a "z".).

However, while this seems all fun and good, there is historically no real way to quantify and chart my USMLE progression into madness. Thus, what follows is a questionnaire that I have developed which, like the Mini-Mental Status Exam, has been scientifically standardized and is almost perfectly predictive (and, like parts of the Mini-Mental Status Exam, is also likely a total crock of shit - saying "No ifs, ands, or buts" has been scientifically proven to be a legitimate test for something? Please.). Feel free to answer each question, tally up your score, and see where you stand. Because I'm such a nice guy, I have provided explanations of some of the more obscure items, just in case you are a concerned friend who is not actually a medical student yourself.

The Fuck I Have To Take The USMLE Status Exam

1. How many hours has it been since you last saw the sun? If you are currently a medical student not on the West Coast, add 10 as a rickets-factor correction. If this number exceeds 72, enter 999 and head directly to the nearest spray-on tanning salon. You might blind someone with your pasty whiteness. ____

2. Record the number of times either you or someone you know has used the phrase "high-yield" in a sentence. What is this referring to? Well, it turns out that come boards time, medical students are obsessed with obtaining books or study guides that are "high-yield", meaning that you get the most/best information in the least amount of time. As a result, they begin using this phrase in every aspect of their lives, from "Ya I hear that biochem text is good, but is it high-yield?" to "That lecture was high-yield. I'm glad I was reading my high-yield embryology while I was in that high-yield lecture." Enough. Seriously. You're killing me here. ____
(Note: Do not count non-medical school usages of this phrase. For example, if you are me (SO sorry to hear that) and after 5 hours of studying your brain has fried to the point where you are wondering things like "If you were high and reading high-yield path at the same time, would your brain explode?" and "I wonder if my penis is high-yield", you cannot count those in this section. But feel free to add 100 to your score anyways, because you are obviously losing it.)

3. Remember all those times you felt like reaching across the table in PBL and beating the shit out of a classmate that was royally pissing you off? Add 5 points for each time you have that feeling during a one-week span. Board exam time brings with it a lot of animosity towards your classmates, whether their behavior warrants punishment or not. People see other people studying hardcore and freak out, thus leading to unbelievable amounts of stress, which leads to increasing animosity towards people you probably already hated in the first place, which leads to a decreased threshold of tolerance, which very well may lead to a serious ass-whupping. And yes, Frenchie, your ass-kissing warrants punishment. Asshole. Add 467 points if you actually beat the shit out of someone. Add 10 more if you tried to beat someone up but that person was too big and beat you up instead. Multiply your score by 99 points if someone else beat the snot out of you for whatever irritating crap you're pulling (and stop being such an obnoxious prick all the time). ____

4. Record the number of times you shouted "Thank You Jesus!" in front of the entire class after discovering that, after the boards, you will most likely not see the vast majority of your horrific classmates until graduation two years later. Add 1 for each shout out. P.S. I love you, Trish. ____

5. Document and record every time some outsider does something to piss you off, but you find your brain so drained and dulled after staring at something like the High-Yield Biochemistry (sigh) explanation of the Krebs Cycle for 5 hours that you are unable to do anything about it. For example, say you're me (again, apologies) circa last night and you just walked into the elevator in your building with Subway sandwich in hand, only to discover that you are sharing the elevator with a really thin seemingly benign elderly woman you've seen occasionally. For no obvious reason, she proceeds to hit the button for every floor, gets off at the first floor, and gives you an evil smirk on her way out, leaving you with the options of getting out and taking the stairs or stopping at every floor until you get to yours. Since your leg muscles have atrophied after days and days of sitting and studying, the stairs are not an option. Congratulations, you have just been punked by a 73 year old woman. Your life has reached a new low. I mean, Christ, does this happen to anyone else? Add 935.56 points. ____

6. A pneumonic can be a fun, useful tool to memorize what are otherwise useless pieces of information. Sexual pneumonics, on the other hand, are simply a cry for help. Add 10 points for every sexual pneumonic you have either read about and used or made up yourself. Examples include Cindy Is Kinky So She Fornicates More Often and, for any Arroyo people who might be reading this, Phil Masturbates All the Time. 100 points more if you actually know what these pneumonics stand for. 3,000 points if you managed to come up with a sexual pneumonic that summarizes something that might have anything to do with Pediatrics, you sick bastard. ____

7. Spending long days studying often comes at the cost of a decrease in personal hygiene. Ladies, record the numerical value of the length of one of your leg hairs, in centimeters. Gentlemen, use facial hair. If using hair from other non-sexual parts of the body is easier, use that instead. If you find it easier and more helpful to specifically use your back hair, there is an 86% chance your name is Matt. Also, if people would rather stand next to the homeless guy who hangs out around Starbucks than you, multiply the number you have by the amount of days it has been since you last took a shower. Record the numerical value you have obtained here: ____

8. Since you will still have class during the first part of your study-a-thon, you will still have lecturers blabbing on about something only to go "I guarantee that _____ has been tested in every board exam you will ever take", only to later say something like "And then there is this detail - Ha, I remember memorizing that for the boards, but I don't know it anymore!". Thanks, asshole, that really makes me feel a lot better. Add 15 points for every time that happens. If you call them on it later, add another 50 points for actually paying attention in class. If you cannot hold back your urge to beat the crap out of said lecturer and end up wailing on him or her, divide your point total in half and enjoy your newfound freedom, as you have now been expelled from medical school. ____

9. It seems like, for some people, the longer one stays in medical school (and, by extension, the longer one studies for boards), the dumber one becomes (I think I might have to devote a whole post to this theory). Every time you find yourself raising your hand in class to ask a question that goes something like "Wow...I have a question, but I don't know what it is." (Yes, that actually happened. Twice. By the same person.), add 200 points and consider transferring to culinary school, because at least in that school anything you might be dealing with is already dead. Good grief. ____

10. A lot of studying involves looking at picture after picture of patients with the diseases in question, because the exam is computer-based and there are likely many pictures involved for diagnostic purposes. If, after looking at some of the pictures of Turner Syndrome, Klinefelter's Syndrome, or Prader-Willi Syndrome (which almost always involve overt pictures of naked people), you find yourself sexually aroused, add 20 points. If you experience similar arousal with Testicular Feminization, add 0 points because it is undeniable that she still used to look damn good (even with that 80s hair cut!) despite the fact that she is really a he. If you experience similar arousal after viewing pictures of patients with Syphilis, Gonorrhea, or Chlamydia, you are truly evil and quite possibly the anti-Christ - add 666 points. ____

Bonus Question. You might find yourself venting about how lame this whole studying thing is, only to realize that the even lamer thing to do is to be whining about it by writing up a longwinded and marginally entertaining blog on a Saturday night instead of going out and drinking with your friends. Add 50 points and change your name to Eli. If all of your friends are medical students and are also studying, subtract 25 points because it's not completely your fault. If you have no friends, you are probably still recovering from the ass-kicking you received after annoying the same medical student one too many times with your stupid question-asking/arrogance/idiocy/physical appearance (see status question #3), so tough shit. Actually, add another 200 points because you just reminded me of how much you annoy me. ____


Your score < 5: Congratulations, you are not a medical student. In fact, you are probably a nice, normal, cool person. If you are also Jewish and female, I'm available.

5 < Your score < 100: You are beginning to let this test get the better of you. But for you there is still hope for you, as long as you put down your First-Aid book this instant, go out to a bar, hit on a member of whatever sex it is you find attractive, and get a phone number. Then, if it's a girl, give that number to me. Thanks, sucka!

100 < Your score < 1,000: Stand up from the chair you are currently sitting on and admire the permanent butt print have made on said chair. The people around you have been pointing at you for the last three hours. The library/coffee shop/seminary you are currently studying at has placed an air freshener under each of your armpits. Needless to say, you have been studying just a wee bit too hardcore with your USMLE studying, and it's time to give it a rest.

1,000 < Your score < 5,000: You have reached levels of neuroses not seen since Woody Allen used to be funny. Do not pass go. Proceed straight to your local nuthouse and commit yourself. If you are not currently a middle child, acquire the appropriate number of siblings to ensure diagnosis of Middle Child Syndrome. If you are me, remain calm - status quo has prevailed once again.

5,000 < Your score < 10,000: Wow. I'm sure you're going to dominate the board exams, but no one else is going to know it. Why? Because you haven't talked to anyone in three months, and everyone thinks you are dead. That's right. Check the obituary pages from last week's paper. According to your mother, you mysteriously disappeared sometime in February after telling her you were going to the library with a big stack of books. She also said you wet your bed and slept with a pink doll named "Muffins" until you were 21. Thanks mom!

Your score > 10,000: I'm not really sure what to say. Actually, how about this: IT'S NOT WORTH IT. That's right. You're probably gunning for the top residency program in the hardest field, which is the only reason that can explain why you have completely shut yourself off from the real world in order to study for one silly exam. Except you haven't realized that this is just part of the whole process - you have to still do two more years of school, and after going psycho for four months, no one is going to want to get anywhere near you ever again because you are a total freakshow. I'd like to think there is some hope for you, but I'd also like to think that Random House is going to stumble across this blog and offer me a million bucks for my medical school memoirs - so basically, there is no hope for you whatsoever. So go on. Study study study. I just hope you find meaning and happiness in memorizing the five co-factors of pyruvate dehydrogenase. Me? I'll take my $110 in Baja Fresh gift certificates and the porn magazine I got for my birthday.

So what is the great news in all of this? There are three parts to the USMLE exam, which means I get to take a new test in two years, and another one a year or two after that!

I'll drink to that. Right after I finish looking at these pics of Turner Syndrome...

A New Me

So rather than study for the boards (see above), I decided it was time to give my blog a face lift. I hope you enjoy the new, more modern and sleek design. I hope you enjoy the blue background, which matches my dreamy blues eyes. But, most importantly, I hope you enjoy the glorious future of further entries where I display my neuroses for all to read.

And if you do not enjoy it, I hope you enjoy www.beastclub.com.

Monday, February 21, 2005

Relativism, Las Vegas, and Inappropriately-Placed Fingers. No Seriously.

I think this blog, which is mostly just a means for me to vent about all the awfulness that is medical school, should also be a chance for me to show you all (and by "you all" I mean my mom) that the life of the medical student is not just about misery and rectal exams. And this blog is also not just about me whining. It should also be a chance to teach, just as I taught you how to search for your third nipple or how to react to being felt up by aging former celebrities. So without further ado, I give you...the next sentence.

Upon returning from this weekend's Vegas extravaganza, I couldn't help but reminded of some things I learned in one of my philosophy classes as an undergraduate. During one class, we werw discussing different theories on truth, and the professor brought up Relativism, which holds that conceptions of truth, emotions, and moral values are not absolute but are relative to the persons or groups holding them, or that all criteria of judgment are relative to the individuals and situations involved (thanks dictionary.com). Huh? Essentially, there are no absolutes - everything is relative to somethign else. So you might be thinking, "Is this guy a jackass? 1+1=2 no matter who you are, asshole." And honestly, you are probably right. But because I am quite possibly the biggest dork on the planet and couldn't help but think of this as I was driving down the I-15 yesterday trying to drown out the latin pop music my roommate/car companion was playing, I thought this notion of relativism* applies when it comes to Vegas, and especially when it comes to gambling. Let me explain.

A little while ago one of my former roommates set President's Day Weekend as the day our entire draw group of six dudes, plus a few other great college friends, were going to go to Vegas and catch up on good times (and maybe gamble a little or something). Sweet. After a long, painful drive courtesy of some freak rain storms, our contigent (me, my current roommate, and my former roommate/current grad student in music) viewed the bright lights of Vegas, specifically the shining beam emerging from the Luxor, as we approached the strip. A short while later we arrived on the strip, starting at Caesars to grab some dinner, because for some reason the Subway we got in that mecca of civilizatino known as Barstow, CA just wasn't cutting it. Since there was an 80 minute wait to be seated, we hit the casino to let the festivities begin. Rather than jump straight for the tables (which might take a while), I decided to just throw a few bucks on roulette to kill a little time before dinner. I arrived at one table, ordered my Long Island, put ten bucks on red. And lost it. Put ten bucks on red again and won. Then I lost it again. Then I was down to the ten dollar minimum for that table, and as my drink arrived the nice dealer guy said I could just finish it out, so I put nine bucks on red and one dollar on 22, which is my lucky number (and also the number of the day of my birthday...which is also this month...which means my birthday is tomorrow...cough cough). Anyways, it hit 22. I actually won. Holy crap. Granted, that put me up a whopping 15 bucks, but I actually hit 22 with my last gasp of the original cash I put down. To help the philosophy along, you could say that, relative to your average Vegas money-loser, I was feeling pretty good about myself.

Post dinner, we gambled a little more, and nothing eventful happened until the night got later and we ended up at Barbary Coast, that fine repository of smoke, sleazeballs, and 5 dollar blackjack tables nestled comfortably between much classier hotels. Needless to say, I fit right in. I gambled for about two hours at a blackjack table and ended up down ten bucks, but up two Long Islands, so I was feeling good. Towards the end of the night, I lost some money on blackjack and then got 20 dollars in chips and, courtesy of the 1 dollar minimum roulette tables at this fine gambling institution, I played red and lost again. I was down to my last few bucks, and I put a dollar on 22...and it hit. You're freaking kidding me right? Relative to your average Vegas money-loser, I was feeling pretty fucking good about myself now.

Fast-forward to Saturday night. The whole crew is finally assembled and it's time to go nuts. And by go nuts I mean gamble what little pittance of money we all have, given that we're all either students with huge debt or currently unemployed. We show our Vegas-virgin friends a few classy hotels, lose a little at the Flamingo, and then meet up with a friend who was playing poker at the Aladdin. I begin by playing a little roulette again, somehow coming away up two dollars on a ten dollar minimum table (I defy anyone to explain how that happened - I still have no idea how the math worked on that), and then move on to play blackjack. I doing alright, and then I'm dealt two aces. Split. Dealt a 5 and...another ace. Split again. Dealt a 9 and...another ace. Split again. At this point the entire table, and the people watching, are all cheering me along. Dealt a King and a Queen. Holy shit. The crowd erupts. The dealer shoves a crapload of chips in my face and I get up. Relative to your average Vegas money-loser, I was now feeling very fucking good about myself.

A short while later, I go to a different table. About twenty minutes into it, I have proceeded to win about $150. I'm also working on my 4th Long Island of the night. Relative to your average Vegas money-loser, I was feeling VERY FUCKING GOOD about myself compared to your average Vegas money-loser. So naturally, you know where this is going...

By this point, another friend arrived, and we decided we had to just go balls out and make a big wager (for us) - $100 on red or black. Last year when we did something like this and got destroyed, so naturally we decided we had to do it again. After all, my gambling momentum could not be stopped, right? Right. We find a table that feels right (whatever the hell that means), put our $100 chips on the table, and hold our breaths. The ball is rolling...rolling...and...well...it hits black. In the words of one of my favorite classmates, "Awwww HELLLLLL NAWWWW!". Relative to your average Vegas money-loser, I was feeling like shit. Not your average shit. I'm talking the fiber-induced smushy kind.

Nerves rattled, still a little shocked, we stay at the table and I cash in a lot of money for chips to start trying to make a little money back. I lose betting on colors, and then, as I put twenty bucks on red (as an aside...seriously why the fuck do I bet on red? I'm such a fucking moron. What's that you say? It doesn't matter because the odds are the same? Fuck you. I love it how all logic goes down the toilet in Vegas.), the lady spins the ball and my roommate comes by, saying "Fake Doctor, what are you doing?!? You should put this on 22. You've already hit it twice! C'mon. It's your lucky numb-".

Well. I imagine you can guess what happened next. The ball dropped, hit 22, and I lost all will to live. In case you're curious, the payout is 35:1 and I would have walked away with $700. Which comes out to 140 Baja Fresh Bean and Cheese burritos with black beans, pico de gallo, enchilado style, in case you are curious (which is the only way I can quantify anything). Relative to your average Vegas money-loser, I felt like the roulette lady just chopped off my penis. Except about a million times worse. On the bright side, which there really isn't any, my $200 Long Island finally arrived. Three Long Islands later (for a total of 7, I think, for the night), I returned to our condo, a poorer but wiser man.

Wiser, you ask? What lessons can you take from this? Well, for one thing, Vegas happiness is all relative - I was feeling great, but I realized that this was mostly because I knew that on average just about everyone around me was losing, because the actual amount of money I was winning was pretty small change in the grand scheme of things. Then I was feeling awful, because I knew that no one in my income demographic (i.e. negative income) had lost that catastrophically not betting on a number I should have been betting the whole time that I had won on twice before. And I had never blown that much money in a span of about ten minutes without at least getting some totally useless set of medical school textbooks in return.

But there's a lot more. I think of how this weekend compared relative to what my life would have been like in the alternative universe where I had I gone to that medical school in Boston. If you know me at all, you know I have agonized about this decision on an hourly basis. I realized that I would have never had a chance to do this - spontaneously go to Vegas with all of my college buddies and have great times (gambling tragedies aside) if I was the only one that was on the other side of the country. Sure, I might have avoided the freakshows I comment on here and there (and here...and there, here, and here), but they would have probably been replaced with even bigger freakshows, because lets face it, who goes to the Big H anyways? Freakshows. So relative to that alter-Fake Doctor, I have to be really grateful for being close enough to all of my college friends that I can actually see them in person and hang out on a regular basis, and that's the kind of stuff that really matters. Not to mention the great people, however small the number, I've gotten the chance to know in medschool here.

And just in case you think I've gone soft (notwithstanding the idea that depending on who you ask, which is almost everyone, I'm already a big pussy), there are always other great ways to apply this philosophical doctrine to Vegas to make me feel better about myself. Sure, I may have lost a shitload of money in a catastrophic manner, but relative to the slime in Vegas, I'm doing very well for myself. How do I know this? Well let me share with you the conversation I overheard at a food court restroom adjacent to the MGM Grand at 3AM:

Sketchy MIddle-Aged Hispanic Dude: Man, seems like you and that girl were hitting it off.
Sketchy Middle-Aged White Dude: Ya man, it's pretty sweet.
Sketchy MIddle-Aged Hispanic Dude: She's got no titties though.
Sketchy MIddle-Aged White Dude: Doesn't matter. When we were on the dance floor, I finger-banged her in her ass!


*I should add that my recollections of this theory are incredibly vague and most likely incorrect, so please don't think what I am saying is at all reflective of what Relativism is all about. I would like to thank my undergraduate education for making the previous sentence possible.

Monday, February 14, 2005

Finally, A Valentine To Call My Own

As a result of today being Valentine’s Day and numerous reports about a so-called “Broken Heart Syndrome”, which demonstrated that sudden changes in mood as a result of being dumped by your significant other can actually kill you, I thought I’d write a Valentine’s Day love note to that special person in my life and avoid the chance of giving her broken heart syndrome. I think over the last year or so I’ve been just a wee bit harsh to this special someone sometimes. I mock her, I laugh at her. Most of the time I wish she would just crawl in a hole and die a miserable and painful death. Who is this mystery woman I speak of? No, not a real lovely lady to call my own (sigh…ok stop feeling sorry for myself…now!). No, not the plastic Natalie Portman Queen Amidala doll my college roommate got for me (Best. Hanukah gift. Ever.) that has taken enough loving for a lifetime. Today, Valentine’s Day, I would write a letter of love to the tasty bitch that has been with me for the last year and a half, otherwise known as Medical School:

Medical School

Hey baby. Can I call you Med School? I hope you’re down with that…

Look, I just want to say a few things, and I understand if you never speak to me again after the way I’ve been treating you. I know I’ve been harsh. Sometimes the words I say must hurt. Like the time you just had to show off your French speaking ability on our first date and it made me feel like an idiot (which admittedly is not that hard to do). Or the four hundred times you wouldn’t stop asking pointless and off-topic questions that totally ruined the flow of lecture. Or even that time you showed up to one of our dates drenched in sweat and still in your gym clothes, having just run what must have been a marathon, and you not only did not even have the decency to take a fucking shower but you also decided it’d be alright to snuggle up next to me and drip your sweat all over my notes and smell so awf - oh, there I go again. Sorry beautiful.

See, it’s not that I don’t love you. I really do. I love the way you give me something to do between the hours of 10 AM – 3PM besides sitting on my ass watching reruns of Saved By The Bell. I love the way you let me get away with half-assing just about anything and everything and still let me pass. I love the way you introduced me to some of my medschool friends – well, actually baby, I’m pretty sure they hate you as much (if not more) than I do – but that’s beside the point. I love the way you provide me with enough unintentional comedy to last a lifetime, all at your expense, of course. I even love the way you annoy the living shit out of me, because after all, without that, what the hell would I be writing about all the time?

Maybe a poem expressing my love will work better…

A Love Poem To Medschool

Oh, medschool, how I love thee.
Let me count the ways:
One, for the one time in about 300 lectures nobody asked a question for a solid two hours.
Two, for the two ridiculously amazing legs on a certain cardiologist.
Three, for the three fingers you taught me were necessary to do “The Shocker”.
Four, for the total slooter in charge of block 4 and her totally inappropriate attire.
Five, for the five…umm…fuck, I can’t think of anything. Couldn’t even get to five. Damn you.

Well anyways, baby, maybe you and me can work it out. Be together again. Live a long life of love and happiness. I hope so, because without you…well…I just don’t know what the hell I’d do with myself.



P.S. Christ you smell, take a fucking shower already.

Friday, February 04, 2005

My Preceptor & Me

Upon entering medical school, many people offered advice. The money is in dermatology. Try your best to stop your incompetence from getting in the way of not killing people. Keep on being the devilishly perfect handsome future doctor that Jewish mothers around the world hope will marry one of their daughters. But the most resounding piece of advice I’ve received thus far has been something along the lines of: find a mentor.

While I’ve only been in medical school for about a year and a half now, I can say that I have been exposed to doctors from just about every specialty and every walk of life. There’s the self-important stickuptheirass surgeons. The vacuums devoid of personality otherwise known as nephrologists. The completely psychotic psychiatrists. The neurotic and insecure pediatricians (pediatrics it is!). Often lost among this crowd of physician specialists are the family medicine doctors. These primary care “specialists” are often degraded by their colleagues and looked down upon as inferior, which is ironic given that these doctors are most likely to first see a patient who is actually ill and be most likely to help the patient over the course of the patient’s lifetime. Whatever the case may be, the wise folks at my medical school insist that by pairing each of us with a family medicine practitioner in the community (our so-called “preceptor”) and learning from them during our first two years, we would no doubt pick up general skills that will help us throughout the rest of our training. Some people got paired up with doctors who treat rich people and did not let the students do hands on stuff or really learn much of anything because, lets face it, rich people just don’t put up with morons like us. Some people got paired up with doctors who see 60+ patients per day in order to make ends meet and can’t spend more than 10 minutes with a patient, thus leaving no time for teaching.

Then there’s my guy. From day one, he threw me in the fire and had me touching swollen penises (calm down, I don’t play for that team) and giving cortisone injections by marking an X on some poor schmuck’s shoulder and handing me a needle when I didn’t have the slightest clue what I was doing. However, it wasn’t until today that I realized how lucky I was to be paired up with this guy.

First, I should say that he knows his shit. Like he seriously knows his shit. But the thing is, there are a whole lot of doctors who know their shit cold, so that alone isn’t what impresses me. (By the way, by “shit” I mean the voluminous body of clinical knowledge needed to effectively practice medicine. But you knew that.) No. The thing that catches my eye the most is his ability to completely and utterly mess with his patients and the medical establishment, and not only get away with it, but come out on top of it all.

What the hell is this fool talking about, you ask? (Which of course is better than, Why am I still reading this crap?) Well, let me give you an excerpt from a patient interaction from today. We were talking with an elderly patient who had recently undergone a valvular replacement surgery. Among his problems upon followup, he was experiencing a loss of appetite, and his family members in attendance were very concerned about this. Now, a big loss of weight and appetite after a monstrous operation is pretty common, and there’s really not anything the doctor could do other than give the patient this liquid crap that the patient had already been trying and doesn’t really work anyways. The doctor could have just said nothing could be done. Or, the doctor could have done what they’ve been trying to teach us in our doctoring course where we are learning how to talk to patients: bore the patient to death with counseling and delve into the utter minutiae of the patient’s lifestyle in order to make stupid suggestions on how to change eating habits that the patient will under no circumstances actually do anyways. Instead, the doctor followed with this statement:

“Well, maybe he could go roll up a joint and smoke out. That’ll give him the munchies.”

My jaw almost dropped, but the patient’s family members just laughed and understood the implication that there was nothing that the doctor could do. Worked like a charm.

And what of the medical establishment? Something that is valued among doctors today is doing research and/or getting published. But let’s say you don’t really want to do intense research? Well, my preceptor and I were chatting in his office and he mentioned he just got a review article published in the premier journal for his specialty. I was of course impressed. After all, any journal publication undoubtedly involves many hours of work, including doing intense literature searches, making concise and informative tables and graphs, and writing clear and concise articles. He had me get closer to his computer to show him his paper on the computer, and then pointed to the graphs and laughed:

“Hey check this out. See these graphs? I was just dicking around on that stupid graph thing on Microsoft Word and made these half-assed pictures. And they published them!”

Perhaps you cannot appreciate the comedy of that situation, but for those of you who have ever tried to do research and have tried to get something published, you might understand how ridiculous that statement was.

Anyways, I don’t think I want to be a family medicine doctor. But I have already learned so much from my preceptor about doctor-patient interaction, and I know I have only just cracked the surface. Now go smoke some weed damn it!