ndab Ah Yes, Medical School: August 2005

Sunday, August 28, 2005

Ask The Fake Doctor

Just to prove that I actually will respond to these things, and also to squeeze in one last morsel of catharsis before I enter yet another week of surgery at the shiningly beautiful hour of 4 AM, I thought I'd open up the mailbag I just recently formed and try to answer your questions. In spite of the (cough) overwhelming volume of emails, I regret that due to time constraints I can only choose one question to reply to at this time. (I also regret that I have yet to receive any solicitations/pictures from any females out there, so ladies, don't be shy!)

Dear The Fake Doctor,

...now that you are in it, what advice would you give to someone who is just starting to take the prereq's to apply to medical school?


Someone Who Didn't Send Me A Naked Picture Of Him Or Herself


That felt good. Obviously, none of my subtle attempts to persuade you all to consider other careers is working, so while I will try to answer this question wholeheartedly, I would strongly recommend that you all still take a moment to check out that lovely link to business school I have conveniently placed at the side of this blog. And here's one about law school. I bet culinary school is interesting. OK sorry...

First, a little background in my experiences with medical school admissions. While I in no way intend or want to show off (I grew up with a strong appreciation of the evil eye and am firmly convinced of its existence), I should state that I did pretty damn well in the admissions process, proving, among other things, that this system is obviously flawed. Seriously though, while I'm not going to go down the list of the schools I got into, lets just say that even though I chose not to matriculate at one of these schools for reasons beyond the scope of this post, I still get "Wait, you turned down _____ to come here?!?" and, more frequently, "You can't possibly have been smart enough to get into _____. I mean you're a freaking jackass. C'mon, stop bullshitting me." Furthermore, I spent a year on the admissions committee at the school I chose to go to, reviewing applications and interviewing prospective applicants, so I actually know what goes on behind the scenes (hint: while it's not actually a massive orgy, you still leave these meetings feeling tired, confused, and dirty). Given this background, I feel especially well qualified to advise you in this manner. OK, I'm done showing off.

So, where to begin...well, for starters, let me suggest that while you will never know what it's like to be a doctor, resident, intern, or medical student until it's three in the morning and you're being vomited on by any number of Hepatitis C infected patients, you should really, really, really get as much exposure to medicine in a hospital as you can, so you at least have some clue what you're getting yourself into, and, perhaps more importantly, so you can prove to the admissions committee that you have some clue what you're getting yourself into. Even more so, if you pass this step, you won't find yourself in the position of a certain someone (who may or may not be me) wandering the halls of a county hospital one day during your third year rotations, looking back on your life choices and wondering what the hell you've gotten yourself into.

Assuming you've been through all that, the next step is actually taking all those awful prerequisites that medical schools have decided are important for your future as a physician. First, let me clear something up for you all, something that just about everyone in your shoes is curious about but never knows for sure: You will never, ever, EVER need to know, use, or apply anything you learned in any of your physics, general chemistry, or organic chemistry classes throughout your career as a medical student, resident, or doctor. There, I said it. Unfortunately, The Man, taking the form of admissions committees across the country, has decided that proficiency in these topics (among others) is a necessity for becoming a physician. While there is no way around all of these classes, and you will need to know some of this stuff to take the MCAT, I can share one dirty little secret with you that no school advertises but all adhere to: these admissions requirements are not actually requirements, but merely suggestions. This means that you can take classes that are in the same department as "Organic Chem 120: What The Fuck Are We Talking About?" but not nearly as painful from an anal penetration point of view. This also means that if you're like me (which, coincidentally, sucks for you), and you realize that you are about to graduate and would rather be the meat in a Rush Limbaugh/Michael Moore sandwich than take that last biology lab class you never got around to signing up for, you can actually call up the admissions offices of the schools you got accepted to and inform them that you are not planning on taking that class - it turns out that they've already invested so much time and money to select you, they're not going to care that you haven't finished your requirements. So, yes, I still have yet to finish my pre-med requirements, and I never will. Suck on that, AMCAS!

OK, so now lets assume you've actually taken all/some of the requirements needed for matriculation. The next step is the dreaded MCAT. In retrospect, I regret having expended as much energy as I did on this exam, because what I learned from my time on the admissions committee is that your score on this exam doesn't really mean shit. Well, you have to do at least marginally well to make the initial screening process, but not getting that 45-T on the exam will not make any difference whatsoever in your final results as an applicant. Actually, I tended to be harsher on the applicants that got these astronomical scores because it was more often an indicator of how big a freak and how socially retarded these people were than how smart or well-qualified they were for medical school...and if I learned anything over the first two years of medical school (and from what I'm gathering, I didn't learn much), it's that the last thing this profession needs is another socially retarded freak. Anyways, I don't really know what to tell you about how to actually study for the MCAT, other than that if you can get by on the Kaplan or Princeton Review stuff, you'll find that the actual test is much easier and the passages in the real exam give away a TON of information/answers. I do wholeheartedly recommend getting completely and utterly wasted after the exam, however. And if you're female, drunk-walk your way over to my apartment afterwards.

OK, so lets see where we're at: Prereqs? Check. MCAT? Check. Actually applying? Crap. Now, I can go on and on about what to do and what not do to for your application essays, secondaries, and interview, but I'll just shorten it to three relatively brief things for now, and elaborate significantly on this later if anyone actually cares (and, as an aside, if anyone is still awake reading this megillah of a post, I'll give you a big hug if we ever meet). One, get your application in as soon as humanly possible. I'm not joking. You would not believe what a difference this makes, because you could be Ghandi (or even me) and still be waitlisted if the admissions committee doesn't get to your application until March and the class is already full. Two, the admissions process is undoubtedly the most arbitrary process ever, and you may think you had the best (or worst) interview of your life, but what you think and what actually happened are almost never in line. Seriously. You could have developed the cure for cancer, but if the interviewer thinks you farted in the middle of the interview (whether you actually did or not is not important), you're not getting in. Conversely, you may be completely unqualified to go to medical school and may be stumbling at your every word, but if you went to the same alma mater as your interviewer and can successfully name the four bars adjacent to the campus, which to your interviewer is a sign of your coolness (or lack thereof), and hence your qualifications as a pre-med student, you're in. (No, I never did that to anyone I interviewed, but yes, that was asked of me at one school that I ultimately got into).

Three, the most important point (see, it gets its own paragraph!), be genuine at every step of your application (and through this whole process, actually), especially when you show up for your interview. I cannot say how much it annoyed me to see an applicant try to bullshit me (the king of bullshitting, no less) about their activities, experiences, or desire to be a doctor ("I knew from the moment I was born that I was destined to become a radiation oncologist." Prick.), making up answers over and over again in a feeble attempt to impress me, when I would have been a lot more impressed if they'd just told the truth. This means majoring in a Biology because you actually like biology, and having a damn good explanation for why you majored in Economics but are still pre-med (hint: that explanation better not be "I wanted to look unique on my application"). This means proving in some way that you only worked on activities or research you were genuinely interested in pursuing, and not because you wanted to fill another box on the application (yes, we can tell). Looking back on my experiences as an interviewee, I think that's why I did so well. I'm currently completely confused and lost, trying to find my place in this chaos of medicine, but I still cling to what I talked about in my interviews regarding why I wanted to be a doctor in the first place, I am still involved in those activities that got me down this path, and I know that there was not one ounce of bullshit, regular shit, or any other shit-like material in my answers I gave on my application or to my interviewers. I was being genuine about who I was, and that was conveyed to my interviewers.

Finally, to the person who submitted this original question (which came in a longer email than what I pasted above), I hope this overview has been helpful, and everyone please feel free to ask me more specific questions in the future. More importantly, based on what you wrote in your email, I have no doubts about your sincerity in pursuing medicine, and I am sure you will be wholly successful in this regard.

Christ, I'm such a softie. Or maybe the better description is a big pussy. Either way, I hope you have enjoyed (or at least grudgingly tolerated) these rather long-winded posts I've managed to churn out the last two days.

Saturday, August 27, 2005

Eagle Eyes

The origin of my real last name (versus the one that I actually use...a long story for another time) comes from a European language and means "eagle" in English. In the spirit of this namesake, I have always prided myself on my eagle eyes when it comes to everything from observing the human condition to hitting a baseball (as long as the baseball was thrown by a puny Jewish kid – I should mention that I batted 1.000 in Jewish baseball leagues as a child, utterly dominating the Jew leagues and staking my claim as arguably the greatest baseball player in the history of organized Jewish youth baseball, which I'm sure has an illustrious history…but I digress). I knew that this skill would pay off well as a budding physician, since so much of medicine involves making careful observations about patients and looking for subtle signs and symptoms of disease.

For the first few days of inpatient surgery, I felt like things were moving along nicely and I was using these skills with relative ease on my only patient, a congenial, elderly Hispanic female who had a leg amputated as a result of uncontrolled diabetes. She was very nice to me and incredibly tolerant of both my sheer incompetence and horrific gringo Spanish speaking skills, and her recovery from surgery was going nicely. My eagle eyes, which I should add come in a dreamy shade of blue, weren’t even needed because things were going so great.

Well, since it has been confirmed that smoothness plays no part of my life, whether it comes to my life as a medical student or my feeble attempts to pick up women, it came as no surprise to me that this past Thursday, the day before she was going to be discharged, my patient’s recovery hit a road block. During my afternoon rounds, I stopped by her room and found her not in her bed, but instead on a chair, with a strained facial expression and noticeably squinting her right eye. She then told me that she was having decreased vision. This got me really nervous, because one thing you worry about for a post-op patient is that patient suffering a stroke, and sudden vision loss is a textbook sign of stroke. In other words, I was in full “Fuck, I’m going to be that guy who killed his first real patient” mode.

I raced down to present this information to my chief resident, who ordered me to go back to her room and perform a series of tests. I returned to her room, out of breath because I literally ran up a flight of stairs (yes, I am that out of shape), and sat back down beside her to begin examining her more carefully. In between breaths, I asked her for more information, noting her even further strained facial expression, patting myself on the back for interpreting her actions as her newfound severe pain. While my patient may have been decompensating, there was no doubt that my observational skills were second to none.

Then, a funny thing happened. I started to notice a smell, a markedly unpleasant smell. It began permeating the room, but I was determined to complete the tests to get the information I needed. I asked her if there was any change in her vision from the morning, and then asked her about her squinting eye. Suddenly, her story, like her now more serene facial expression, changed. Her vision wasn’t actually any worse now than before, she explained, and she was surprised I hadn’t noticed her squinting before. Ignoring the fact that the smell was getting stronger, I approached her chair and looked into her eyes, discovering for the first time that the reason why she was squinting in her right eye was because…well…she didn’t actually have an eye there in the first place. In my four days as her fake doctor I hadn’t even noticed that she did not have a right eye. My powers of observation were perhaps not quite as grand as I had supposed.

But that wasn’t all. Even though I was more at ease about her vision problems, assured that they were not a result of a sudden stroke but in actuality due to the fact that she was down one eye, I was still concerned about her previous pained facial expressions. I asked her about the pain, but she responded that she was feeling much better. It turns out that my so-called powerful skills of observation, which I had relied upon for so long, which had helped me succeed so well up to this point, had failed to pick up one itty bitty little detail:

For the entire time I was sitting next to my patient that fateful afternoon, she was in fact sitting on top of a portable toilet, straining her sphincter away and trying to push out every last morsel of poo that had accumulated in her bowels over the last five days.

While I should have felt honored that my patient felt so comfortable around me that she had no qualms about taking a crap in front of me while I was trying to help her out, I couldn’t help but feel discouraged that I hadn’t even noticed that was happening until it was too late. I learned a valuable lesson in all this: I may not be as observationally skilled as I thought I was. I don’t pick up on patients who are missing eyes. I apparently can’t even figure out when someone is taking a shit right in front of my face. But it is still early, and I will have many chances to redeem myself, develop these eyes and become that great doctor I know I can be. (In case you’re wondering, I’m not even going to pretend that I typed the previous sentence with a straight face.)

Now if you’ll excuse me, I have to go to bed so I can get up at 5 AM on a Sunday to pre-round on my new patients. Five more weeks of inpatient surgery to go…


I would like to formally introduce the…uhh…introduction of my very own Ah Yes, Medical School email address, thefakedoctor@gmail.com. Feel free to ask me questions about medical school, medicine, why you shouldn’t be a pre-med anymore, and why medical school is what it is. Feel free to offer to pay me exorbitant amounts of money for the rights to publish my blog. Feel free to share pictures of your hot, sexy, Jewish female self. All mail will be responded to in some way shape or form, if and when I have the time (how’s that for commitment?), possibly in the form of a mailbag post on this very site, with my witty and remarkably incoherent answers to your logical questions, in as long of a run-on sentence as possible. (Naked pictures of hot, sexy, Jewish females will, of course, remain for my eyes only. So feel free to send them. Please.)

Friday, August 26, 2005

Call Me

I really can't think of any clean way to say it, so I'm just going to say it: My dreams for a peaceful and uneventful first call night ("taking call" refers to an overnight shift at the hospital, beginning at approximately 7 PM in the evening and ending at noon the next day) went quite literally down the toilet when I was overwhelmed by and eventually succumbed to an acute case of explosive diarrhea at around 7 PM last night. This was followed about seven hours later by my privilege in sharing an unventilated call room with quite possibly the most horrifically odor-ridden human being of all time. Perhaps the only surprising thing about this whole evening was that nothing really dramatic happened in the actual ER or OR, save one elderly head trauma case that I couldn't get anywhere near anyways because there were so many people around watching the proceedings.

I regret that my willingness to share the previous information (specifically my own personal "code brown") is likely a secondary effect of having rather frantically worked approximately 49 of the last 56 hours. I will have something more entertaining and perhaps less personally embarrassing to share with you all sometime soon, but right now I think I'm just going to go to bed.

Sunday, August 21, 2005

Putting the "Scared Shitless" in "Inpatient Surgery"

Tomorrow morning I begin the legendary six week rotation entitled Inpatient Surgery. This rotation separates the men from the boys, the strong from the weak, the circumscised from their foreskin-retaining but equally equipped bretheren. This is where the 4 AM - 11 PM day is standard, where taking call means actually staying functional for 36 hours straight, and where my (admittedly pathetic excuse for a) life ends for a while, as I am sucked into that chaotic mess I shall always fondly remember as Generic Big City County Hospital. The home of the most intense pimping, the most malignant personalities, the most hideously unattractive residents, the most bizarre patients, the most...ah fuck it, you get where I'm going with this. Needless to say, I'm thrilled. And by thilled I mean scared shitless...and anyone who says otherwise is just not comfortable enough with their insecurities to admit it (so there!).

While I am sure to collect a vast array of absolutely ridiculous stories over the next six weeks, I regretfully will not likely have much time to share many of them here (or anywhere, for that matter). To be honest, I am starting to wonder if I'll be given enough time to take a crap on a regular basis*. I will try to update this website as much as possible, as I've found this to be an invaluable method of catharsis in getting me through medical school, as well as a way to educate others about what being a medical student is all about (and not to mention being a hell of a lot cheaper than paying for a therapist). However, I apologize in advance to my loyal readers (Hi Mom!) if I cannot post with the regularity I had recently achieved, a regularity only matched by the recent addition of Fiber One to my diet (that's two poo jokes in one post, in case you're keeping track).

With that in mind, I'll leave you with one lasting image before I go: When you are on the verge of descending into sweet sleep and taking a moment to appreciate the infinite darkness of the night, with it's glimmering moon, shooting stars, and deep serenity...pause for an instant and consider that somewhere, out in the distant fog, there is some poor schmuck medical student struggling to stay awake for yet another night, running around a hospital somewhere, trying to survive. Please do that fine young individual a favor and pray for his or her soul before shutting your eyes and enveloping yourself in a magical dream world. Amen.

Now, if you'll excuse me, I'm going to pay a triumphant visit to the restroom...one...last...time. Oy, I'm getting all fahklempt!

*Of course, that said, I'll always make time for any attractive, single, Jewish females out there. You didn't seriously think I was going to write all this and not put yet another shameless plug here, did you?

Saturday, August 20, 2005


(No Seriously, What The Hell Am I Going To Do With My Life-O-Meter)

Now that I've had a few (albeit brief) rotations under my belt, I thought it'd be fun to track my thought process and keep a ranking of the different types of doctors I might become, adding and subtracting things to the list as I am exposed to them or as I develop new epiphanies. To limit myself and keep this list contained, I'll make sure that fields I have not yet rotated through cannot be considered, and all inclinations to insert "Drop Out", "Drop Out Now", and "Jewish Sex God" will be (hopefully) rejected by me. However, if I develop a burning desire to include a viable career not directly related to medicine, I am reserving all rights to stick that in there (so "Screenwriter" and "Marry Rich" are still alive). Lastly, I'd like to create a final spot, entitled "Hell No", for a medical field I find so repugnant I can't imagine even the thought of pursuing it.

To kick things off, I'll try my best to explain my number 1 and my Hell No. So far, looking back on the last five weeks, we have a surprise winner for the first spot: Urology. You may be thinking to yourself, "Isn't this the same schmuck who went on and on whining about how gross it was to keep sticking his finger up so many people's asses?", and you'd be right. But you have failed to consider that, with urology, I have an endless source of material with which to make jokes about. And just imagine if I combined urology with my longterm interest in pediatrics? The thought of my mom having to tell her friends that her beloved son the doctor is a pediatric urologist alone is enough to make me laugh. While choosing a career for the jokes is probably not the best idea, I have absolutely no other criteria with which to pick a field at this point, so might as well go with what keeps me entertained.

Furthermore, I'd like to nominate anesthesiology as the current occupant of my Hell No spot. Tthis last week of anesthesia was by far the easiest week I've had, with me getting off the earliest and being able to joke around with a great group of wise-asses and otherwise laid-back residents while we did some intubations and got to sit around. So why is career this off? Well, rather than give technical details on the field of anesthesiology, let me give you an analogy that should explain why: Let's say you're trying to break into the porn industry. You're a strapping young lad packing a 12 inch penis, medicore acting abilities, and a perfect porn name, Rock Highlands. You are lucky enough to get a call-back from a movie crew, and when you arrive on the set, you find this gorgeous young woman with enormous breasts and a tiny waist, who, while perhaps not actually as hungry for cock as the title of the film you're about to shoot would suggest, will still be boning the lead of the film in about thirty minutes. However, after arriving on the set, you are told by the director that, rather than be the lead male in this scene, you are instead assigned to the role of the "auxiliary porn movie character who is there for no obvious reason but is still vital to every porn movie ever made". Now, you're role in this film is pivotal, you will get paid well, and you don't have to work hard at all. But you're not the one boning the chick, and you never will be. And that, ladies and gentlemen, is why I cannot become an anesthesiologist.

I hope you enjoy the progression of this chart, and I hope I figure out what the hell do to with my life. If you have any suggestions, please feel free to leave a comment.

Wednesday, August 17, 2005

A Special Guide To Laryngoscopy

The summer after my freshman year of college, I had the privilege of working for Hughes Space & Communications (which became Boeing Satelite Systems, which has now basically become an empty parking lot after all of the layoffs) as an operations engineering intern. I still have no idea what that means. Regardless, I vividly recall collecting a serious wad of cash and getting the company to pay for my "relocation fee" back to college (in other words, I got them to pay a shipping company to show up at my house, pack up all my shit, drive it up north, and unpack it in my dorm room). During that fateful (and miserably boring) summer, I was lucky enough to share a cubicle space with a few veterans of this company and learned many valuable lessons from them, such as how to leave early without anyone noticing and where the next (and first) rockin' CalTech party was happening (no joke). Beyond all of that, though, I was fortunate enough to be under the guidance of one special co-worker, who I noticed one day was playing Hollywood Stock Exchange, which, to my surprise, still exists. Before I could comment on what an utterly retarded waste of time that was, he caught my eye and started explaining:

"Look, the day's here are rough. My job is boring, my boss is a prick, the wife keeps calling and complaining, and, basically, I just have to do whatever it takes to make it through the day. If that means playing this stupid internet game and imagining I'm Michelle Pfieffer's agent and lover, then so be it. When you hit rock bottom like this, and I promise you, you will, let me know."

Fast forward five years (sigh), and I found myself yesterday reminded of these prescient words while on my anesthesia rotation. The trick to anesthesia is that the anesthesiologist does work in the beginning and end of a surgery, and spends the rest of the time reading a magazine while praying nothing bad happens. For any lowly third year medical students assigned to an anesthesia rotation, that means doing jack shit for as much as four hours at a time and resisting the urge to inject yourself with any variety of tempting narcotics when no one is looking. Granted, I've had the chance to intubate a few people just like they do on er (including one adorable seven year old - yes, they let me do that by myself, and yes, you should fear for your life if you ever go to a teaching hospital, because some schmuck medical student like me might be shoving a big metal tube down your throat while you are out cold). That's cool and all, but it doesn't make up for the massive bouts of boredom that follow.

So anyways, I was lounging in the OR during a direct laryngoscopy (a procedure where the surgeon uses a scope to visualize the larynx, vocal cords, and wind pipe, excising any suspicious tissue along the way), when the anesthesiologist recognized my boredom and suggested I walk over to the other side of the room where a television was displaying what the surgeon could visualize. What follows is a simplified description of the procedure, with visual aids. I hope you find it as entertaining as I did:

First, the surgeon sticks a scope down a person's mouth and visualizes the larynx and vocal cords (the two white bands, in case you're curious) with a camera attached to the scope, generating a picture that look like this:

Then, the surgeon wields a special laryngoscope, which may look like this:

Finally, the surgeon penetrates through the vocal cords with the scope like so:

The scope can penetrate past the cords into the trachea, often going in and out as the surgeon excises a mass or examines various parts of the trachea. Multiple times. Sometimes slowly. Sometimes faster. Slower. Faster. Faster! Fas-

Wait, what the hell are we talking about? Sorry. Anyways, at the end of the day, I couldn't help but be reminded of what that wise (and likely unemployed) coworker told me so long ago, because my mind wandered off somewhere and the last three hours of the day just miraculously flew by. What I learned is that you may not always be happy with what you are doing, but sometimes you just have to do whatever it takes to make it through the day. Now if you'll excuse me, I'm going to...umm...do some research on laryngoscopy.

Monday, August 08, 2005


The mood this morning was undeniably stressful. Blood flying through the air. Beads of sweat rolling down the cheeks of the surgeons that filled the OR. The tension emanating across the operating table had reached a pinnacle, with six doctors hovering over the dilapidated patient as she struggled mightily to stay alive. Halfway through a ten hour procedure to resect a tumor in this elderly woman's jaw, the doctors quickly realized that they were in dire straits, with the monitors beeping loudly and the patient's face literally splayed open. They had already removed part of the fibula (leg bone), with muscles attached, as well as half of the woman's jaw, with plans to replace the cancer-ridden jaw with reshaped bone from the leg. One-fourth of this woman's face was literally cut away, and the reconstruction process was about to begin. But just as this was about to start, after so much effort had already been expended by people skillfully trained to save lives, the doctors realized that they could not move forward. They were paralyzed, perhaps with fear, perhaps with the all-to-common reaction to the monster they had just created on the operating table, a woman so disfigured that even her own mother would not recognize her.

However, just as doom was about to eclipse the last rays of light and forever smite the forces of good in this otherwise barren landscape of horror, the head doctor had his epiphany from an unlikely source. He looked up from the table and, to his surprise, spotted a dashingly handsome young medical student, ardently observing the proceedings at hand and focusing his passionate, dreamy blue eyes on the large gaping wounds before him. This young, single, and disease-free man, built with the strong arms, sharp mind, and soothingly sexy voice reflective of his Ashkenazi Jewish heritage, was standing by the operating table, waiting hours and hours for a moment, this moment, when his greatness would be exposed and his path to medical immortality would be secured. The head surgeon quickly made eye contact, was momentarily paralyzed by the penetrating power of this medical student's eyes, and then uttered the words that would define the beginning of the patient's climb back to health. With a soft, feeble voice, he tried to get the medical student's attention:

“Hey, you.”

The medical student turned his attention away from the gory mess of vessels, nerves, muscles and skin, and turned his head all around, wondering if someone was talking to him. Surely the doctor knew his real name but wanted to use "you" so as not to make the four other medical students in the room feel left out.

“Ya, you.”

The medical student pointed to himself in a questioning matter, but before he could speak the doctor began his words that would begin the student’s week on otolaryngology (head and neck surgery), as well as begin his flight to the top of the greatest legends in the history of medicine:

“Could you turn up the volume on my iPod?”

The medical student briskly leaped over to the iPod/stereo combination the surgeon had brought with him, examined the complicated contraption, felt for the appropriate buttons, and deftly turned up the volume, exposing the from-the-streets beat developed by Eazy-E many years in the past and revealing the musical tastes of the attending physician for all to appreciate...

In a world so full of terror, disgrace, and the banality of mankind, one must try to pause and remind oneself of a truly important fact: there are still heroes in this world, people who rise above the status quo, the average, the mundane, to produce something so beautiful, so profound, as to make all that came before it obsolete, and all that was to come after it a byproduct of the original success. The medical student paused, listened to the rap (“Boyz N Tha Hood” by Eazy-E) that now loudly filled the OR, and knew that his work was done. For just as he pumped up the volume, the mood in the OR changed from dark to light, the attitudes shifted from despair to the utmost optimism, and in only five more hours, the woman’s jaw was reconstructed, her cancer removed, and her future ensured. All thanks to a young medical student and his swift action. In a profession where the goal of saving lives and patient care has often been replaced by the bottom line and a fear of lawsuits, rest assured that there are still people so pure and noble as to uphold these original ideals in all their medical works. As the late Eazy-E, whose life was so tragically cut short, once poignantly stated, "Yeah, I kicked a little ass, but that was a blast from the past muthafucka...get busy ya ya ya y'all"

Yes…get busy. Get busy, y'all.

Thursday, August 04, 2005

Holding Pattern

A while back, I touched on the idea of relativism and how this philosophy permeated my life, and a few weeks ago I touched on a different area of philosophy and how it permeated the rectum. Well, I'd like to return to this original idea of relativism and how it relates to my current state of mind, or should I call it state of soreness, as a third year medical student rotating through outpatient surgical services over the last month.

A few weeks ago, during my urology service rotation, I was observing a surgery in the penis-balls area when the attending doctor, wanting to get the hell out of there, suggested I scrub in and help the resident finish up the suturing which would allow her to go home. I happily accepted the offer and scrubbed in, being the eager beaver fresh third year student that I am, because I thought I'd get a chance to finally do something. After two years of sitting in a dreary lecture hall, wasting away in a fit of extreme boredom, I was finally getting to where the action really happened. I sat down next to the resident, ready to throw my first stitches as a third year. Ready to close a wound. Ready to be all that I could be.

So it came as no surprised to me that my resident subsequently instructed me to hold up the patient's testicles for thirty minutes while he did some suturing.

I must say, I came home pretty disappointed, sad that I was relegated to holding activities, and even worse, what I thought was the worst kind of holding activitites.

Yet, in one of life's many lessons that I'm learning these days, I was to discover that even when it comes to mundane holding activities expected of a third year medical student, what I thought was the worst thing on Earth was actually only relative to subsequent holding events, and that when compared to my next holding activity it didn't even come close.

Fast forward two weeks, and I've moved on to the orthopedics service. One day, the attending decided that I should go with a resident to put a cast on a woman. I thought to myself, "Alright, this will be a good learning experience". We approached the room when I quickly discovered that beyond swimming in her own pool of fat, this 350+ lb. woman must have been sweating out of every gland of her massive body. And she had a serious attitude to boot.

You can imagine what happened next. While my resident was calmly and slowly applying the cast to this woman's gargantuan leg, I had the pleasure of holding up this 115 lb. leg for about twenty minutes, with my face about an inch away from her fungus-infected sweaty foot the entire time (so as to get out of the way of the resident in charge). My arms were literally quivering by the end (before you call me a pussy, keep in mind that it's one thing to do curls for a few reps, but it's something entirely different to hold that curl for twenty minutes while the weight is giving you 'tude and killing your brain cells with its smell). However, I knew that if I dropped her leg this patient would a) eat me and b) demand a re-casting, which would then require me to pass through her digestive system, emerge shit-stained out of her rectum, and resume my position as leg holder (I should add that the odor in the room would not be affected by my intestinal travel, seeing as it already smelled like shit).

What did I learn from this? There are no absolute truths in medicine. Ball-holding being the worst kind of holding is quickly superseded by orka-leg holding, which no doubt will quickly be superseded by some other awful experience I have to look forward too. What is today the absolute worst thing is only relative to the worst things that came before it and the even...uhh...worst-er things that will follow (Do you have a problem with "worst-er"? I thought not.).

To any pre-meds out there who might be reading this, please feel free to explain to me how, after reading shit like this, you still want to go to medical school. I'd love to hear it.

Monday, August 01, 2005

Uhh...That's Not Cool, Right?

Much of the mystique that revolves around surgery, surgeons, and the OR involves the intricate and time-honored tradition of "scrubbing in", the process whereby a person who will be invovled in the surgical procedure (whether that be the attending surgeon who makes the incisions or the peon medical student who cuts the ends of the stitches if he's lucky) meticulously lathers and scrubs his or her finger tips, fingers, hands, and forearm in a very specific fashion for a while, all before entering the OR to be specially draped by the OR nurse in a body cover, multiple layers of gloves, and a face mask. Needless to say, the utmost level of cleanliness, of removing as much contamination as possible, is a virtue of the operating room and permeates the ideals of surgery.

I bring this up because today, on my first day of my next rotation (orthopedics), I had the chance to scrub in on a few cases with the residents and attending multiple times, allowing me to really appreciate the level of cleanliness that these people aspire to. Given this huge precedent for cleanliness, what followed after one surgery struck me as odd:

We finished up a case and everyone left the OR. I followed one of the senior residents to the doctors lounge. I then followed him to the bathroom, where we both proceeded to do our business. (I should add that much of my life these days is spent following people around because I don't have the slightest clue what the hell I should be doing most of the time, so if this guy thinks it's a good time to take a piss...well then it's a good time to take a piss! - seriously, why the hell don't they talk about this kind of crap in the medical school brochures?) Then, after pulling my scrubs back up (again, I should remind all the ladies how amazingly hot I look in scrubs), I walked over to the sink and began washing my hands in the sink, filling my hand with a blob of soap and scrubbing it over my hands under a stream of water. Meanwhile, the resident finished urinating, pulled up his scrubs...and walked out the door.

Now I know that he did not walk straight from the bathroom into the OR to cut someone open, but I still found that behavior odd. How could someone so devoted to maintaining the utmost level of cleanliness not wash his hands after taking a piss? After wiggling his penis in his hands a few times? After possibly experiencing some post-void splashback onto his hands (hey, it happens to the best of us)? Would you want someone like that cutting you open? Am I making a big deal out of nothing? Have I been up since 5 AM? Will I be getting up at 5 AM again tomorrow? Can I keep asking myself questions?

Anyways, just thought I'd throw that out there as something to think about.