Ask The Fake Doctor 3
1) I'd like to formally thank the kind folks at www.blogger.com for bestowing upon my blog the honor of "Blog of Note", which has given me a much wider audience and allowed me to more thoroughly gross out, disturb, and at least mildly entertain a whole host of people I don't know. Although I’m sure right now the blogger people are all sitting around their board room, shaking their heads in disgust at noting a blog that went on a vagina rant for the next three or four posts straight. Sorry everyone.
2) I have been inundated (well, at least for me) with emails and comments since this newfound notoriety began a week or two ago, including various questions, requests for links, and so on. I have tried to respond to everything I can in this and future Ask The Fake Doctors or with direct emails when appropriate, but it has been hard to find enough free time to do all this and, well, you know...save lives as the dashing third year medical student that I am. Also, I tried to add a bunch of links to my site to reflect the broader medical and blog community indicated by your various comments, but when I tried to do that I almost deleted my entire site by accident and decided to end that experiment then and there. I promise I'll try again if/when I grow larger testicles, but I appreciate the links to this site that have popped up nonetheless.
3) Mixed in with the various questions I would be able to answer (you know, about balls, vaginas, etc.) have been a few questions sent my way that involve actual (potentially serious) medical concerns. Christ guys, go to a doctor if you have a real medical question! I can't even tie my shoelaces half the time, so I'm really not qualified to give real medical advice. OK, just had to get that in print for future ass-covering medico-legal concerns. I can’t believe I just wrote “medico-legal”. It’s official, I just sold out. That didn’t take long at all.
4) I really appreciate all the feedback I have received, both positive and negative. Regarding any concerns that I simply delete comments that are not favorable, I would like to assure you all that a) the only comments I have ever intentionally deleted were obviously spam, b) I welcome negative feedback, because I am learning a lot about how my humor is (or, as is most often the case with negative feedback, is not) being interpreted by different people, and, most importantly, c) as those who know me personally can attest to, I am, in all aspects of my life, harder on myself and more self-deprecating than anyone I have ever met, and any negative feedback is probably a sampling of something I've already pointed out to myself in the past...so, in other words, feel free to tell me I'm an insensitive prick with an ego bigger than Ron Jeremy's penis who wouldn't know a vagina if it slapped me in the face (that last part, of course, may or may not actually be true).
5) Regarding the gross-out nature of the most recent post...don't say I didn't warn you! No seriously, don’t say it. Sometimes I forget that most people don't spend there days knee deep in human feces and bowel, and they are often phased by things that I have come to embrace…like feces and bowel. And since I got a bunch of questions about this, let me just clear things up by saying that sorry, it was amniotic fluid and not urine (although technically…ah screw it), the vaginal tear that woman experienced was very rare, it is (and was in that case) surgically correctable, her and her baby are doing fine, the residents did everything correctly and exactly in line with what they were supposed to do (the tear occurred when the baby burst it's big head through the woman's pelvic canal, which brings up the question of why was the baby so big in the first place? Feel free to read up on gestational diabetes and decide who, if anyone, is really at "fault".), and, as was pointed out by a commenter, that tear does not always lead to bowel incontinence. So please, ladies, keep getting pregnant, because what I described was a total freak occurrence and not the norm (which, having seen a few normal deliveries myself, is simply ghetto fabulous). Maybe you would want my help with this whole getting pregnant thing? Just thought I'd offer.
Now that all of that's out of the way, let's see what you all are made of:
a preamble: I am profoundly depressed and I have no idea what the hell I am doing in this life. content: I stumbled upon your blog randomly. So randomly, in fact, that it can not possibly be random. Dig?...so, should I try school again and become a doctor?
Unfortunately I am not a Jewish female or a female at all, however I do have a question since I am aspiring to go to med school in the far future. What advice can you give me to ward me off of this complex decision while I still have a fleeting chance?
Ignoring the broader question of fate versus free will and randomness indicated by that first email, if only because I’m not stoned and therefore not adequately prepared to discuss such matters, I will instead humbly suggest that you read through this and perhaps less cynical accounts of medical school and decide for yourself. If you are specifically interested in the application process as a microcosm for whether you should really be putting yourself through all this, as that process really feeds (or it should, in theory) on people with a genuine desire to pursue medicine, read my first Ask The Fake Doctor post, since that might help.
Dear Fake Doctor, what do you recommend for a patient who is losing his mind?
Go out, meet some girls (or guys…or both!), and get some action. Do I have a serious answer to this question? No, because I have been losing my mind for the last 2.5 years now. Actually, here’s an idea: start a blog and begin ranting about what troubles you, and someday you’ll start to feel better. At least that’s the faint slice of hope I am currently clinging to.
Have you noticed that, during the past several years of blogging, your writing, grammar, punctuation, use of initial caps, and awareness of "its" vs "it's" for "it is" has improved? Do you credit med school, the amount of time writing/blogging as increasing your awareness of how to articulate thoughts, or something else? Sad to see this talent disappear once you begin to write prescriptions.
I think it’s more that when I first started this, my mom kept telling me a) she couldn’t understand what I was writing, b) that I needed to write in something that vaguely resembled complete sentences, and c) that I needed to stop cursing so much. If you think I’m joking then you don’t have any friends with Jewish parents. My mom still tells me I curse too much. In all seriousness, I have only noticed this trend you mentioned after I went back recently to look at some of the older posts newfound readers started commenting on. I’m not sure I have any explanation for it, other than that the neurotic Jew in me wouldn’t be able to rest knowing that there were hordes of errors in stuff I had written that was being read by other people, whereas early on I was writing for an audience of three (me, my mom, and Natalie Portman).
I'm not Jewish, but I have a question: Why (and I'll restate that in big letters just to get across my confusion), oh WHY do all doctors think that drugs should be the first solution to everything? Well, except German doctors who can prescribe herbal rememdies. Why do they think it's acceptable to give you a pointless prescription full of some crappy artificial substance that will screw around with your body probably doing as much harm as good?
I have two responses this very valid question:
1) Much of the satisfaction gained from practicing medicine is in actively witnessing a positive change in a patient, and even more so knowing that you were the person at least partially responsible for that change (“I filled out the form that let the senior resident perform the surgery that saved that man’s life today mom!”). However, many medical problems these days center around chronic disease management for which there is no clear cure, so in an effort to feel like we are still helping you, we prescribe pills that often can help and hopefully at the minimum do no harm to you while possibly controlling your chronic disease. Of course, we do realize that there are side effects with medicines (as with herbal remedies, it should be noted), but there are risks inherent in any proposed method of cure. So, in summary, we dish meds out because, if nothing else, it makes us feel like we are doing something for patients even if it is not really helping all that much, because if we didn’t have that option there would really be no hope and we’d all just get depressed and quit. That, and don’t we just look so cool writing out those prescriptions?
2) Perhaps the bigger reason why we dole out all those meds is not for any fault of our own, but it’s actually all of you, the patients, that force us down this path – we dish out the drugs because the patients demand them. Oh he did not just go there! But I did, and please hear me out before clicking submit on that nasty comment (of course, feel free afterwards). Let’s take as an example what I like to call The Big Three that envelope the vast majority of medicine these days: Diabetes Mellitus Type 2, Hypertension, and Heart Disease. Yes, there are plenty of medications we give out to control these health problems, and yes, they have risks of messing with your liver, kidneys, heart, and so on. But here’s the catch: if instead of writing out a prescription for some drugs we only told you to get off your ass, exercise, and eat right, you (the royal “you”) will more often than not do some combination of a) try that plan for 2 weeks and quit, b) ignore us completely and show up three years later about to die, and c) get mad at us for not giving you some medications, where you just have to pop a few pills a day to control your blood pressure, cholesterol, etc., so that you walk out the door and complain to your friends that your doctor didn't do anything for you (of course, then there’s all of you who are given the drugs, have the means to pay for them, and still don’t take your meds, showing up at an ER years later clutching your heart in agony and demanding to know how you got to this point). Can you imagine what kind of patient revolt would occur if doctors actually stuck by the “Try diet and exercise for a year and get back to me if that doesn’t help” route, even though diet and exercise are the only things that will always work at no increased risk to the patient? I’ve seen patients literally sit there and insist on the latest drugs right after their primary care doctor I worked with spent a whole session trying to counsel them on the importance of diet and exercise. Do you see where I’m going with this? Doctor’s have an immense responsibility to provide you with healthcare and do so with the tools we’ve been given, whether they be diet management or pills, but you have just as large of a responsibility for looking after your own health as well, which isn’t always equivalent to demanding the latest and greatest new drug. I have no idea if what I just wrote made any sense whatsoever.
Now if you will excuse me, I will carefully lower myself from off the high horse that I am currently sitting on (I call him Chubbs), and proceed. There, all done.
P.S. I love it how so many of you have qualified the beginning of your comments/emails with an “I’m not Jewish” statement – don’t worry, I forgive you.
During the course of your Medical training you learn to detach yourself from your patients yes? If that's so....how do you then switch that off when you leave the Hospital? I've often wondered about Gynecologists... do they go home to their wives and girlfriends and think ewww...?
You bring up a very interesting point regarding detachment from patients. Much of our time in the first two years of medical school is spent in classes that strongly urge and pressure us to be sensitive, take our time with patients, and truly get involved in their lives. After all, these ideals represent what just about everyone would want in a doctor, and they seem reasonable enough. Except then one day, during your general surgery rotation at a county hospital, you find yourself dropped into a service with only three residents, and this team is expected to round on 37 patients in one hour. Doing the math, that amounts to 1.62 minutes per patient. What point am I trying to make here? I firmly believe that all doctors-to-be go into medical school with a big heart and that “I want to help people” mentality, but then reality shoves her acne-riddled, bloated face in their way and they slowly shift from spending as much time as they can knowing their patients to making sure they have acquired the maximum amount of information in the smallest amount of time that will appease their superiors. Why? Because there are 60 patients in the waiting room demanding to be seen right now, and one of them may or may not be packing a rifle. Of course, every patient thinks he or she is the most important patient there, and who is anyone to say they are wrong…I guess what I’m trying to say is, I have yet to see a doctor not busting his or her ass day in and day out, but given the medical establishment as it currently stands, it is really difficult to make it through the day without detaching yourself from the patients and still having enough left over to come home and be at least moderately functional. Regarding gynecologists specifically, I am not entirely sure, but I do recall an episode of Friends that dealt with that issue head on (and no, I wasn’t the guy playing the ambiguously gay, sarcastic character on the show, damn it.)
Let me quote you: "I shit you not". Why does every physician say that phrase?
Demonstrated by my previous post (and now and then in the past as well), as one progresses through medical training, ones threshold for what really makes the eyes jump out, the mouth gape open, and the insides curl up in a fit of terror keeps getting higher and higher. And yet, just when you think you’ve seen, touched, or smelled the most awful thing you will ever see, touch, or smell, some new poor bastard waddles his or her way into the ER to prove you wrong. When this happens, and it keeps happening to me on a weekly basis, we find ourselves searching for the phrase that best encapsulates this newfound appreciation for the freakiness inherent in human beings…and it just so happens that “I shit you not” best encompasses these feelings. I mean, it’s not just that it happened, I am not even shitting you that it happened! That made no sense. If you have any better suggestions, feel free to submit them for general usage (perhaps “I pee you not!”, “I shit you sometimes!”, or perhaps a more simply stated “Inconceivable!” to commemorate the late, great Andre The Giant is in order. (I can’t believe I just worked in an Andre The Giant reference. Somewhere, up in freakshow heaven, he’s surely smiling and eating a peanut. If you get that last obscure movie line reference, you are my hero.)
Why do you have to advertise to find a girlfriend?...I'm just curious as to where it says in your religion that pork isn't to be eaten. Are pigs (of ALL animals), supposed to be holy or something?
-J., Edmonton, Alberta, Canada
I advertise partially as a joke, partially because my friends insist on it as no other forms of meeting girls has worked, partially because I don’t have much free time to go out and meet girls anyways (and lets face it, even if I had time, I’m pretty bad at this), and partially because yes, ladies and gentlemen, I am that pathetic. Oh, and partially because one day Natalie Portman is going to come across this site and, well, you know…
Regarding your second question, I regret that my six years of Jewish elementary day school education only left me with a working knowledge of how to say “I need to go to the bathroom” in Hebrew, along with some other bits of wacky Jewish knowledge (like did you know that Ron Jeremy is Jewish, thereby contradicting the generally accepted notion that Jewish men have small penises but compensate by being voraciously good at love-making? That’s two Ron Jeremy references in one post, just in case you’re counting.), so I found this link that might help enlighten you on the intricacies of what it means to be kosher (which, in case you are curious, I am as well). And speaking of food…
What type of meal does one feel like tucking into after scraping cells out of a vag?
Personally, I’ve always preferred a simple bean and cheese burrito from Baja Fresh - black beans, extra crispy, with excessive pico de gallo placed inside and a mound of pico de gallo and the green sauce poured on top. I’m drooling just thinking about it. So either that…or…I don’t know…maybe a…fish taco! Sorry, the previous sentence had to happen or else I wouldn’t be able to sleep at night.
You're starting to resemble George on Grey's Anatomy. Are you sure you're not pulling a "single white female" thing on these hapless unsuspecting female residents? If not, let me say that I am duly impressed by any man that can, not only get in touch with his feminine side, but go public with it. Hoorah for you. Can you tell me...how many dates do you get with such newfound estrogen flowing through your veins?
Are shows like Greys Anatomy realistic?
After being pointed to a well-written rant on the serious reasons why Grey’s Anatomy is subpar, I felt it was time for me to contribute to this general ranting by providing my less than serious take on this show, which I admit to watching as I type this but also cannot stand. Here’s a few reasons why:
1) In one episode, the show opens up with our hero, Dr. Grey, jogging with her co-resident in broad daylight, all prior to showing up at the hospital. Maybe Seattle has its own special climate and light control system that the rest of the world is not privy too, because that is the only explanation I can come up with for how any surgical resident on the face of the Earth has time to get in a run in broad daylight before work. There is simply no way in hell this happens. Ever. If she’s not pre-rounding on her patients by 5 AM, then she’s going to get her ass kicked out of that program faster than you can say Doogie Howser. As someone who had to experience this morning routine for six weeks, only a fraction of what a true surgical resident has to endure, I was still fuming at the sight of this televised blasphemy, if only because my non-medschool friends start giving me crap about why I don’t have any free time because “the doctors on Grey’s Anatomy seem to have all the time in the world!”. Pricks.
2) I can almost guarantee that any medical student, intern, resident, or attending in America has been posed with a statement like this one: “Set me up with one of you co-workers…I mean all the doctors on Grey’s Anatomy are so hot!” Let’s think about this for a moment. On average, who becomes a doctor? Smart people who did well in good colleges. On average, who were these smart people who got into these good colleges? Smart people who did well in high school. On average, who were these smart people in high school? The ugly people who didn’t get laid! So post-puberty miracles aside, we are, on average, not even close to being as hot as the doctors on that show are. At least ‘er’ had a balding pasty white guy on the show for a while. I mean, c’mon.
3) The show is littered with medical inaccuracies that even the dumbest third year medical student can pick up (that’s my cue). It’s all over the place, from OR etiquette to patient management, so many things are depicted on the show would never occur in real life. Of course, that’s why it’s a fake TV show, and I really shouldn’t be judging this show in this way since I’m guilty of enjoying the first two seasons of The OC, knowing full well that OC reality isn’t nearly as hot as is displayed on TV. Still, at least you could stop having the attending surgeon wear that flower cap on his head…no real surgeon I’ve ever met would be caught dead in one of those things.
4) George is the most unbelievable character on television. Why? Because there is no way a pussy like that would ever, EVER, get accepted to a real surgical residency program acting the way he does. You’d have to experience the surgical culture in its entirety to truly understand this concept, but it’s a wonder one of the chiefs on that show hasn’t ripped his head open yet. Of course, the fact that I am apparently starting to resemble him is really boosting that much-needed self-esteem.
5) That's zero dates and counting!
Wow, I feel so much better now.
This is why I no longer get pelvic exams--and I'm only 39…The crap we women have to put up with to stay healthy…Try to remember that the "hole" belongs to a woman, a person. Maybe you should have a rectal exam every year by some butt-ugly doctor with big hands making idiotic remarks without thinking. Think of your mother, maybe that will help. Good grief.
I have two points to make regarding this comment:
I am currently learning how to be a doctor at a teaching hospital, which takes many forms (private, county, academic, etc.) and is where all medical students and residents learn. In this setting, we are here to practice the craft of medicine in a controlled and safe environment while attending physicians and trained residents, who all have years of experience, look over our shoulders and make sure we do things the right way and learn from our mistakes – you may have missed the part in the post you were referring to where my attending pointed out to me the utterly moronic sentence I had uttered, and I promise I’ll never say something like that again. I respect any person’s decision to choose to avoid teaching hospitals and avoid having to put up with morons like me fumbling on our words while taking a history or doing any part of the physical exam, as that is your right. However, I would not use my (and my predecessors) idiocy and knack for sticking my foot in my mouth at the most inopportune times as an excuse to stop getting pelvic exams or any other regular health checkup, as that is only putting you at risk for all sorts of otherwise wholly preventable diseases (like cervical cancer). I’m sorry that you’ve had to put up with what must have been plenty of awful experiences with the pelvic exam in the past, but I would encourage you to have your yearly exam for your own health. On the flip side, speaking for medical students everywhere, I really do appreciate patients who have no problem letting us learn with and from you, as that is really the only way this system of training future physicians will ever work. I think I just found myself on my high horse again. Really sorry about that, everyone.
Secondly, so let me get this straight: your suggestion for not making a fool out of myself in the future while doing the pelvic exam is, while I’m poking around in some woman’s vagina, to think of my mother? You’re kidding, right?
You gotta explain the clothes. White coats and green cotton pants have always been a mystery to me.
I’m going to let you all in on a little secret: For some reason, unbeknownst to even the wisest sage or queerest eye (Yes, I’ve watched that show. Yes, I’m straight.), women love the scrubs-white coat combination. I have no idea why, but who am I to suggest that this color combination is more fitting for the cover of Green Eggs and Ham than for a medical outfit? If someone has a better explanation for this (and I’m sure someone does), please feel free to share.
Yup, I know exactly how you feel. I gained a perverse respect for anal anatomy, and enjoyed trying out my knowledge on my female roomate (nursing student). When I showed up with the anoscope, she was pretty game to try it. I remember every single time I scope someone in the clinic today. BTW I have a pic of her with the scope but I don't know how to load it onto your blog, just for your own education of course.
I love my new readers.
P.S. I actually got a set of nude photos! Unbelievable. Seriously, I love all of you.
P.P.S. I am about to start my actual OB and Gyn in-service parts of the OB/Gyn rotation (versus the outpatient clinic weeks), and my free time is about to diminish rapidly. I’ll try my best to share the latest gross and/or personally embarrassing stories that I have been involved with as regularly as possible, but I admit that this will become more difficult in the short-term and I apologize in advance.
P.P.P.S. Longest. Post. Ever.
P.P.P.P.S. Have you ever seen a P.P.P.P.S. before?!? Kind of like that whole *** thing. I have no idea why I find this crap so fascinating.
P.P.P.P.P.S. Are you still reading this? Unbelievable.