ndab Ah Yes, Medical School: Spiraling Out Of Control

Monday, October 09, 2006

Spiraling Out Of Control

Some time ago, I made a decision that went catastrophically bad. Those of you who know me on a personal level might be thinking that the decision I am referring to involves going to Supercuts today, having subsequently seen me sporting my new look that not only allows me to fulfill my dream of using my forehead as advertising space, but also allows me to look like a complete and utter douche bag for the next month. Assholes. However, the decision I am actually referring to is one slightly grander, one that most of you might predict. If you guessed “Go to medical school”, then congratulations, you can read. Given how this has turned out (see Ah Yes, Medical School, Years 1-4), you might imagine that I have approached my decision to choose a specialty with more than a little trepidation. After all, if I can mess up a life choice this badly once, there really isn’t all that much to stop me from doing so again. (Just in case you haven’t figured this out for yourself yet, I should remind you that optimism does not exactly go hand-in-hand with Jewish guilt.)

Fortunately, the one difference between the circumstances surrounding that last decision and this one is that I now have you, my loyal band of trusted readers, to help guide me in my decision making process. Sifting through my fan mail from time to time (OK, OK, fine. I sit here and hit refresh every two minutes waiting for something - naked pictures - to keep me entertained.), I have received a plethora of useful and useless bits of wisdom geared towards helping me with my decision. One tool that I have received multiple times is this moderately humorous and moderately truthful flowchart. After thorough examination of this chart, I can’t help but feel frustrated by its lack of utility. There are multiple things wrong with this chart, such as the lack of a broader range of specialties covered or the spelling of "pediatrics" (damn British), but the one thing that stuck out in my mind was that this flowchart presented things in a two-dimensional space but did not indicate whether there was any directional component as one traversed the chart. In other words, I didn’t feel like I was going anywhere in this chart, but I knew damn well where I was going in real life - towards that charming, beautiful locale known as the shit house. Then, suddenly, it hit me like the hand of a congressman on a 16 year old boy’s bare buttocks (sorry, too easy). Why make a simple flow-chart when, in fact, a shame spiral would work much nicer? With that in mind, I have created the Medical Specialty Shame Spiral, and I hope you take a ride down with me…

Medical Specialty Shame Spiral

Much like the original flowchart, this shame spiral assumes you begin as a medical student, depicted by the skillfully drawn figure created by none other than yours truly. You hop on the shame spiral and spin around, still idealistic about your career choice, but are almost immediately confronted by the first branch point.

Branch Point 1: Crazy or Really Fucking Crazy
One subtle error in the original flow chart is that it makes this ridiculous assumption that a medical student can, in fact, be sane. Wrong. The separating factor is actually whether one is simply crazy, with quirks, tendencies towards masochism, and a sprinkle of OCD, or whether one is out of one’s fucking mind. The 25 hour studiers in a 24 hour day. The “I scrub in on every single case in this entire hospital at the same time” pricks. The people who ask me about my stance about whether it is socially acceptable to serve drinks at a dinner party (Don’t ask. Actually, let me ask you all. Is there a debate? How could anyone debate this? What the fuck is wrong with these people? Have a drink for Christ’s sake. Lord knows I needed one after talking to this nut.). These people aren’t just crazy, they’re crazy motherfuckers. Thus they are likely to become the future neurosurgeons, plastic surgeons, cardiothoracic surgeons, and even orthopedic surgeons (notice a trend here?) of the future, as well as becoming the first group to bypass the rest of the shame spiral and go directly to taking it from The Man. Oh, and don’t think I forgot about the psychiatrists. They are so fucking crazy they don’t even fit in the shame spiral.

Only crazy, you find yourself still spinning around this spiral of shame, having likely discovered the merits of drinking alcohol by yourself, and you now make your way to the shame spiral branch point 2.

Branch Point 2: Fascinated By Genitalia or Disturbingly Fascinated By Genitalia
Everyone is fascinated by genitalia. Right? It’s not just me? Right? Hello? Hi mom! But the real nuts are just a little too fascinated by it (Get it? Nuts? How am I not getting paid for this?), so much so that they would devote their professional careers, likely spanning 40 years and thousands of hours of their lives, knee deep in whichever set of genitalia they prefer. Why do I feel like I should have saved my Mark Foley jokes for this section? Oh well. Welcome, Ob/Gyn and Urology, you have just taken a dive off the shame spiral and can now go directly to taking it from The Man. And no, I’m not putting Adolescent Medicine here. Pervert.

Having survived the next stop, you are creeping further down in shame and are now taking shots of Popov and chugging Natty Light, you haven’t shaved in a week, and you look ready to start calling former girlfriends or boyfriends. Not looking good, but we’ve arrived at our next stop.

Branch Point 3: People or No People
Some people are people persons but other people are personally putrid at purporting to interact with, palpate, percuss, and personify people. Just in case you’re keeping score, The Fake Doctor Is A Big Loser is in the lead with 23094823098. Simply put, there are people that somehow manage to make it through a medical school interview process without having the slightest ability to communicate with your average Joe, or even your average Xiao, Neeraj, or Yitzhak. I’m still not entirely sure how that happens, but fortunately there is a place for these people in the medical profession. It’s called the basement. Yes, where better to hide the freaks and spazzes in your medical school class than in the one place where they will never see another living soul? I see no other reason why Pathology and Radiology are always in the dungeons of every hospital I’ve been to thus far. Oh, and you might as well throw in Anesthesia, and give them extra points for actually taking pleasure in making people incommunicable.

You’re still spinning down this spiral of shame, having graduated from liquors to painkillers. It’s getting ugly here, folks. Britney Spears ugly. And speaking of ugly, we’re at our next branch point.

Branch Point 4: Gross or No Gross
Much like staring at any recent photograph of Nicole Ritchie, some people are just better at dealing with gross and scary things than others. I am not one of those people. Call me a pussy if you’d like (and believe me, you wouldn’t be the first), but I can think of a lot of things I’d rather be touching and smelling than someone’s bowels, skin crusts, or diabetic foot ulcers (for a list of such things, please see Branch Point 2 – like you didn’t see that one coming). So that means no general surgery, no dermatology, no vascular surgery. Ah, hell. No ophthalmology (eyes are gross to poke), head and neck surgery (except for this), or colorectal surgery either. Sorry, but that’s just not how I roll, although that’s how these people roll…right off the shame spiral and directly into The Man’s fortress of doom.

Heavily sedated on painkillers, still binging on alcohol, you are sinking further down the shame spiral and have now resorted to watching the VH1 Flavor of Love marathon for the last 3 days straight on repeat courtesy of TiVo. Flava Flaaaaaaaaaaaaaav!

Branch Point 5: Baggage or No Baggage
It’s bad enough having to deal with the patient. But when the patient comes with excess baggage in the form of obnoxious, irritating, sometimes homicidally painful parents, then that pain becomes sheer agony. Don’t get me wrong, I love kids. Anyone who knows me personally knows of the things I’ve done on behalf of children (apologies for how horribly sketch that sounds). But I’d rather be the meat in a Hastert-Foley sandwich than deal with their freaking parents all day long, whining about little Johnny’s runny nose at 3 A.M. Also, last time I checked, it’s not fun making kids cry. Peace out, pediatrics and family medicine. I thought we had something together, but then again, Krazy thought the same thing about Flava Flav, too. I hope someone besides me finds that obscure reference amusing.

You have reached the bottom of the shame spiral, done every narcotic known to mankind and Paris Hilton, and are passed out on the floor of the bathroom, covered in your own filth. Not that that’s a bad thing. Why isn’t this on the cover of your medical school’s brochure, you ask? I do not have the answer.

Branch Point 6: OK Fine, It’s Not Technically A Branch
Well, there’s one thing left*. The one thing so generic, so bland, that just about anyone could pick it, shrug one’s shoulders, and just continue on this same shame spiral for at least a few more years before actually committing to anything: Internal Medicine. Ta da! Why choose a specialty now when you can put it off another 3 years? At least that’s what I figured as I clicked Internal Medicine on my application (That, and something along the lines of "Please let someone offer me big bucks to write my memoirs" ...Desperatelosersayswhat? What?) .

Of course, that still doesn’t stop you (or me) from sliding directly into The Man’s filthy lair, but by now you’ve probably figured out that The Man is nothing more than your own future medical self, proving once and for all that if you do decide to go to medical school, you’re really only screwing yourself.


*There’s actually more than one thing left. Like Nuclear Medicine. Or Radiation Oncology. That doesn’t change the fact that you’re a total asshole for wanting to point that out.

126 Comments:

Blogger Dr. Wannabe said...

Internal Medicine!!!

Yeah, I've come to the conclusion that I'm going to end up there too. Although, I still haven't gotten into medschool yet. But since I'm still dumb enough to want to go to it after reading this blog then I suppose I'm stupid enough to want go into IM.

11:53 PM  
Anonymous Anonymous said...

hilarious!

1:23 AM  
Blogger Joy said...

Omaine to the analysis of surgeons in general. Ortho and neuro are particularly psycho specialties in my experience as a consumer of medicine (only in peds though -- I'm one of those hopefully-not-too-neurotic parents who drove you from all forms of peds).

Internal medicine seems a good choice for a guy who enjoys and hates such a broad spectrum of ills. The only caveat is that you've condemned yourself to seeing the unsick and the mildly-sick-but-could-treat-over-the-counter 90% of the time. Pick a narrow speciality and you increase your odds of seeing more of the Truly Ill.

6:38 AM  
Anonymous Alex Beard said...

BOO-yah to you, Fake Doctor. Internal Medicine? Kind of out of left field. I look forward to seeing how this works out in the future.

7:39 AM  
Blogger ABBEY said...

good luck with ur decison...I've heard mixed reviews about Internal medicine..some say its boring others love it. I guess u'll find out soon enough!

btw...two posts in one month? u are too nice.

9:20 AM  
Anonymous Anonymous said...

dude, if you're so bummed out about all of this, why don't you change careers? take a year off? find something else to do in life? yes, you've done the pre-med thing and the med school thing, but if you're as miserable with your decisions as you claim to be, you really should change tracks.

9:40 AM  
Anonymous Anonymous said...

Internal medicine. The bread and butter of medicine. Good for people who like the complexity and nuances of pathophysiology. Good for people who like continuity of patient care. Many options for specialization so you can see only the patients you want to see. At least that's what they tell me. Hopefully you can find a niche that doesn't make you miserable. Good luck!

9:55 AM  
Blogger CrankyProf said...

I'd like to point ou that your shame spiral looks suspiciously close to the diagram of Hell from Dante's Inferno.

I suppose medical school and Hell have quite a bit in common.

10:38 AM  
Anonymous some girl said...

anynymous-the one who said leave if you're misearable:

i am a second year med student. we're all miserable, and often yell "KILL ME NOW". that doesn't mean we actually want to die, or leave medicine.

acually, we put up with all the crap and pain and unfair tricky bastard exams (can you tell i just had an exam?) because we have an extrodinary commitement to it. also, we love to complain bitterly because it makes us feel special, like martyrs, sacrificing our health, sanity and sometimes morals for the good of humankind. not like that's really true, but we like to think of it that way.
we also like to think that we're in a special elite club, and that you can't "get it" unless your "in it".

Fake MD: i wish i had discovered this site earlier, i hope the you keep it up during residency!

11:15 AM  
Anonymous Anonymous said...

what does it mean that I am going into Radiation Oncology????

11:45 AM  
Blogger JesusFreak84 said...

Wow....just.....wow.....

12:00 PM  
Blogger MamaChristy said...

I think you missed a few levels of Dante's hell...

12:08 PM  
Anonymous Celeste said...

Internal Medicine + Endocrinology

You'll be a detective extraordinaire and it's pretty much hands off.

I'd like a finder's fee, please.

12:17 PM  
Anonymous Anonymous said...

omg, thank God I'm not in medicine, thank you Fake Doctor! =) once again you bring a smile and a chuckle to my every day activity..sigh the office is so boring but your blog makes me feel better once again.. ooh guess what so the other day i went for teeth whitening and i think i saw a huge scam - u know how offices can inflate prices if a dentist is involved in the process? ok so the dentist comes in for less than 1 min, shakes my hand "hi i'm.." and looks at my teeth (not very closely) and says "ok" and bam - thats well..hundreds of dollars for something the assistant is actually doing LoL - snoopy girl

1:38 PM  
Anonymous Anonymous said...

whats internal medicine? like - do u just psychically predict what they need internally? or do u take x-rays?

1:41 PM  
Anonymous Anonymous said...

u need a super long vacation maybe u can take half a year off after u graduate..

1:46 PM  
Anonymous Anonymous said...

you should try jdate..

1:47 PM  
Blogger Sarah said...

BUZZ! WRONG ANSWER! It's so obvious u should have chosen ob/gyn....i remember ur rotation there....reread what u wrote in that post ;)

3:17 PM  
Anonymous your favorite person ever said...

I love the "what's internal medicine?" comment.

3:36 PM  
Anonymous enrico said...

Crankyprof:
That, and it's Virgil at the bottom waiting with the chili lube.

Fake Doctor: Internal medicine? I am shocked. Seriously. I thought for sure it would be Ob/Gyn or Urology. Because 1) I know how much you love being made to be the bitch in the OR, and 2) you DO have a fascination with genitalia, admit it. That life-long possibility of adding to the mental database must have been tempting. It's not going to be as fun blogging about someone's hyperlipidemia than their swollen 'nads in the future, but oh well.

Congratulations. :)

3:45 PM  
Anonymous enrico said...

By the way, I totally get the Krazy reference. I really dug her.

I walk around the house randomly and tell my wife, "You know what time it is baby; come over here and get your clock!"

It doesn't seem to work like I intended. I think the gold teef are the ticket--I'll try that next.

BTW, with your new specialty, you can correct all sorts of metabolic imbalances in the likes of Nicole Ritchie and Lindsay Hohan. Yes, I think I see a nice practice for you in Beverly Hills...

3:50 PM  
Anonymous Anonymous said...

Sam Shem would be proud...

5:36 PM  
Blogger Suchie said...

I'm glad you chose internal medicine! There are tons of fellowship options available afterwards. Gastroenterology, Rheumatology (my preference right now), Cardiology, etc... Granted, my dad was planning on doing a fellowship after he finished emergency and then internal medicine, but then he had kids and got stuck in a crap town. And he's been working continously since and then he had a heart attack a month ago from all the stress (he's alive). So all I am saying is don't get stuck.There's a reason people insist on specializing (other than money).

5:55 PM  
Anonymous darling said...

your spiral looks like a toilet flushing....

where do you wanna do your residency?

9:06 PM  
Anonymous Anonymous said...

get an mba and do something medically-business related! you'll love it!

10:30 PM  
Blogger Meh said...

I dunno what you should do, but my doctor specialized in internal medicine, and he is FREAKING ridiculously hot, he gets girls all overhim all the time. That has nothing to do with your shame cycle, but perhaps it will help the specialization go by quicker.

Excellent Read.

10:47 PM  
Anonymous Anonymous said...

Really fairly funny. I would really recommend removing your picture from this, as this was posted as one of the best medical school blogs on medscape.com's recent article on medical students blogging. You might get a ton of hits and maybe someone you don't want finding this finds it. Good luck.

11:01 PM  
Anonymous Anonymous said...

It is so obvious that "some girl" is a student, even without her admitting it. She still fantasizes about "being in it" and even more laughable, doing good for "humankind."

The truth about healthcare, which is impossible to fully realize as a student, is that it makes you bitter. And jaded. And it makes you hate humankind a little bit. I used to be a genuinely nice, compassionate person. Now that I've worked in healthcare for 2+ years, I hate people. Go figure.

As for IM, I say good choice. But then, I supsect you chose it because it allows you to keep your options open. I know this because I too am paralyzed at the thought of making life decisions, and that's why I would choose IM in your situation, too.

Sorry for the depressing comment. I'm feeling bitter about my career choice today, what can I say?

11:15 PM  
Blogger Me said...

Love your blog and your sense of humor. Really great fun to read. Congrats on deciding to wait several more years on that decision. ;)

8:07 AM  
Anonymous Anonymous said...

Dude, why not emergency medicine? It's just as random as IM, but there's no rounding. At least not in the traditional sense. Nor are you on call. Ever. It would be nice to leave the hospital when you go home for the night, instead of taking it there with you. Seems like a good way to have a life outside of your work. Also, you've seen those studs like George Clooney. ED guys get all the booty!

9:23 AM  
Blogger B said...

Wow! The thinking process in words... I ended up in internal medicine, too. And I enjoy it a lot (right now I am discovering poisons)... Hope you'll like it, too.

9:23 AM  
Blogger The Angry Medic said...

great. just great. I'm still in university, and one of the world's (supposedly) best universities at that, and I've just come back from a pharmacology supervision realising how screwed I am, and then I read this. I feel so much more optimistic about my future and not at all suicidal now! thanks a lot, dude.

*goes to find a really tall building to jump off of*

11:50 AM  
Blogger O said...

Ha, agree on the crazy factor. I've found plastic surgery to be the department containing the most narcistic and generally weird persons (exceptions to the rule of course). Was a fun post to read. Glad you've got mentioned on the medscape site, otherwise would've missed out on your blog!

11:58 AM  
Anonymous Allison said...

haha i cant handle you! the shame spiral is AMAZING and when i mean amazing i mean pathetically true... ah med school.....

12:54 PM  
Anonymous canmedclerk said...

I chose General Surgery because I hate myself and I hate sleep and I like having a good cry in the OR change room every once in a while...haha. Good luck filling out those applications!

3:35 PM  
Anonymous Anonymous said...

as someone who is doing a preliminary year in internal medicine, i can tell you that you're in for some pain.

good luck though, i hope you enjoy it!

7:20 PM  
Anonymous Anonymous said...

i agree with the poster above..."some girl" certainly needs to get a clue. what's amusing to me is that she seems like the exact type of person that the fakedoctor would hate! he should go to coffee with her sometime, just so he can come home and write a hilarious blog about how annoying people like her are. make it happen fakedoctor.

7:55 PM  
Blogger Chole said...

Flava Flaaaaaaaaaaaaaav!!!! i hate new york... she sucks and her mama is a crazy biotch. ok now that i have that outta the way... another great post... good luck with the internal medicine... its weird to think that you've actually picked something...

8:22 PM  
Anonymous Kumar said...

Nice blog. Keep up the good work. I've added the rss feed from your blog at SocialMD (www.socialmd.com) a social network for physicians.

8:23 PM  
Anonymous LabMonster said...

Excellent post & excellent choice - definitely keep your blog up during residency - if you don't, you shall be sentenced to a lifetime of geriatric gynecology

8:33 PM  
Anonymous some girl said...

okay, so clearly the sarcasm was totally lost. also clearly lost was the part where i did say i was a second year med student. . .

i guess me=not so good at the sarcasm. i will now tell you when the sarcasm is coming.

not sarcastic: i like this website. the fake doctor is funny, and i like finding new ways to procrastinate.

sarcastic: i think i am a martyr for the betterment of humankind. no one in the world has a burden like ours, we are extra, extra-special, like paris hilton or superman.

not sarcastic (and random): professors that smile about weird things creep me out, and we seem to have a lot of those here.

okay, done with the procrastination, on to effing neuropath. (again, not sarcastic)

8:52 PM  
Anonymous Anonymous said...

I'm hurt that you dropped psych first thing!! As a future psychiatrist I must say I'll have the best job in medicine-interesting patients, great lifestyle. And remember the patient has the disease not you!

11:04 PM  
Anonymous Anonymous said...

Well, Fake Doc, here's my two cents:

Give it all up. Become a writer. You have a talent for it and you've already got the drinking alone thing down. You're golden. Sure, you've worked too hard and spent too much money to give it up now, but... isn't it tempting?

My two cents count for nothing of course, because I am an artist. My people don't do (much less understand) science.

Sorry about that haircut.

12:27 PM  
Blogger The MSILF said...

Oddly enough - that's pretty much the way I got to thinking of family practice - lazy, not too much genitals, no gross stuff...you should really send this to the BMJ's last issue of the year (where they put the original flowchart and all kinds of funny medical stories).

12:54 PM  
Anonymous Shari said...

I agree about the Endicronology.
My Endicronologist is the smartest,
sanest doctor I know, and this is
including among my dearest friends.
Apparently its a satisfying
corner of the medicine-o-sphere

3:41 PM  
Blogger Daphnewood said...

a flea doc! You're going to be a flea doc! I would have never guessed. At least the residency is short. I liked your drawing. It was easy to understand ;)

Congrats on your choice!

3:52 PM  
Blogger MedStudentGod said...

it seems to me that a lot of IM is dealing with people's diabetic feet, skin ulcers and crusts, and acute abdomens. just thought that i'd point that out...and if someone already did, there's no way i'm reading 46 comments before i comment!

5:47 PM  
Anonymous Anonymous said...

http://www.nurse-ratcheds.blogspot.com/

because you must read it!

8:06 PM  
Blogger genderist said...

The spiral and Hitchcock's Vertigo have a lot in common. I especially liked how the illustration mirrored the energy of a tornado... ;)

9:00 PM  
Anonymous Anonymous said...

What was all the angst about? You seem just like every other medicine resident I know. And unless something changes in your future, I predict a Heme/Onc fellowship to follow.

10:31 PM  
Anonymous Jordan said...

From a nurses point of view, most doctors have trouble with communication in general or are not really "people" people. Whenever I talk to a doctor or see them interact with a patient, they don't really show concern for the patient (i.e. the pt. says something and the doctor keeps on physically assessing them pretending to listen), are more concerned about appearing intelligent to the other members of the health care team, and lastly, don't tell the patient about their plan of care, etc. I also think most people are too some extent crazy. However, I get the impression that you're very intelligent and belong in medicine, even if you feel it is a mistake (but I think you're just needing to vent and take a semi-humorous perspective to keep a semblance of sanity - I remember how little sleep I had in LPN school (1 yr nursing school) and could not imagine being on call, etc. and the load of work you guys have to do. So take heart (easy for me to say, right?) and keep with it! And I hope you're generous and share your sense of humor with your patients and co-workers.

9:57 AM  
Anonymous Anonymous said...

You should apply to surgery, you cocksucker. There's still plenty of time.

5:59 PM  
Anonymous Anonymous said...

One thing you neglected to mention is that all of the fields are not equal. The fact is that most medical students would not match in fields like integrated plastics, derm, ortho, etc. if they applied to them.

This fact does 2 things. This means that the non-superstar students can pretty much forget about these fields... while the superstars are tempted to consider them just because they CAN get in.

9:36 PM  
Anonymous Anonymous said...

Dignostic Medicine like House M.D. You can stare at that nice piece of ass allday.

4:52 AM  
Blogger Justin said...

Dude, I was sure your sense of humor would drive you into Urology.


















Penis. HAH

7:13 AM  
Anonymous Anonymous said...

IM is for fags. You should do Ortho. Peace.

8:20 PM  
Anonymous jols said...

on a completely unrelated note...or perhaps not so unrelated. I'm bringing Paxil back...

http://www.youtube.com/watch?v=vo7Sng5Jeb0

5:07 AM  
Blogger Dr. Blorthog said...

I knew it... my brother in law did the same thing... but he's 2 years in and now what??? You guessed it: infection dizzzzzzzzzzeases!

3:17 PM  
Blogger Finishing Law School said...

Just be glad that you have job options after medical school.
Unless you are in the top 10% of your graduating class and/or at a top 10% law school finding a job is hell. There are way too many attorneys.

9:07 PM  
Blogger s tsui said...

Fake Doc: Congrats! No matter what you choose, I'm just happy to know that someone as humane and humorous as you has entered the medical profession. I am no doctor, but from my experience as a consumer I'd have to say that the flowchart seems to be largely accurate.

To the person who said that being in healthcare makes one bitter and jaded: This is too common among people who have worked a few years in their chosen profession. I've been in finance (as a result of working hard through college) for some years and am sometimes bitter and jaded, too. However, the trick is, IMHO, choosing what to dwell on: the unpleasant aspect of your industry or the pleasant one? (You know in your heart that there is always a pleasant side; yes, even in medicine). It is easy to moan and complain (although it's difficult to be as funny as the Fake Doctor), but it is not easy to stay positive and do your best. Human kind would be more depressed if it doesn't have doctors. :)

9:42 AM  
Blogger FUNKYBROWNCHICK said...

Okay, have you REALLY decided on Internal Med or are you just trying to fool all of us? :)

4:06 PM  
Blogger dog food sugar said...

Am I wrong or the last time you had all these comments there was this excellent fight about female circumcision and nazis or something?!

IM should give you lots of blog material. Congrats!

5:24 PM  
Blogger Pranay said...

Damn funny man!! and very enlightening. I think I would have to choose Internal medicine as well ....or maybe radiology ....Kepp up the good work bro.

7:29 AM  
Blogger Couz said...

DON'T DO IT!

Do you really want to spend entire days rounding on a patient population whose average age is 96?

Do you enjoy listening to or participating in lengthy sessions of mental masturbation, as your fellow IM residents and staff play the 'who knows the most obscure and random diagnosis' game?

Do you enjoy spending ridiculous amounts of time keeping people alive who should have been discharged to heaven several years ago?

Do you enjoy filling out paperwork?

Unless your answer to these questions is a resounding YES, internal medicine is not for you.

Come over to the dark side. The emergency room awaits you, your dry sense of humour and your short attention span.

Besides, you can finally chuck your electronic leash (aka pager) off the top of the nearest bridge.

Sold yet?

3:12 PM  
Blogger Nykki said...

" thought we had something together, but then again, Krazy thought the same thing about Flava Flav, too. I hope someone besides me finds that obscure reference amusing."

You're not the only one who found that obscure comment amusing.

IM, good luck.

1:32 PM  
Blogger Boomer and his mom Carol said...

I was sure you were going to go into ob/gyn. You like the female parts so much!

4:28 PM  
Anonymous Calavera said...

I'm thinking of Accident and Emergency, the British equivalent of 'ER'!!

Where does that put me??

Nice entry, fake dr!

11:51 AM  
Blogger Febrifuge said...

I second both the EM and House-style 'Diagnostic Medicine' choices.

In favor of Diagnostic, House himself is an IM guy, being double-boarded in Infectious Disease and Nephrology.

In favor of EM, it actually exists as a specialty in the non-TV world.

Seriously, dude, consider EM. Having too much personality is okay, even desirable, in EM. In IM, you'll need to learn to love to twitter the day away talkng about Mrs. Klein's INR. You'll spend weeks adjusting people's meds until you get juuuust the right hematocrit. And unless you love to have endless, pointless discussions about every little thing... well, okay.

IM moves slowly, like a glacier shaped like a giant tortoise would be slow. Like a bucket full of snails dumped uphill. Like Paris Hilton's reactions at 8:30am.

For reals. We do more in the ER before 9am than most people do all day. It's all those annoying things you hate about every other specialty... but it's none of them for very long. And then, you go home. You. Never. Take. Call.

Huh? Haaaaah? c'Mon!

10:47 PM  
Anonymous Anonymous said...

Don't listen to that EM wannabee- everyone knows EM are all about "stabilize or street".
I totally agree with your choice of internal med- I'm applying for it this year too!

4:53 PM  
Blogger labs.onexamination.com said...

Dear blogger

I hope you don’t mind me emailing you – my name is Ben Fawkes from onexamination.com. Perhaps you have heard of us – we are an online learning company for medical exams. We are currently undergoing some big changes and as a regular blogger we would love to hear your opinion. Our IT team are working on a new version of onexamination.com and we were wondering if you could help!

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4:26 AM  
Blogger Michelle said...

... Are there any normal people in a hospital? Is it possible to even find friends in such a sea of insanity?

You make medical school sound like such a lonely place.

11:50 AM  
Anonymous w said...

www.observer.com/20061030/20061030_Lizzy_Ratner_pageone_featurebox.asp

hilariously sterotypical (I hope it was meant to be funny...) article about residency and the med students who pick them.

8:34 PM  
Anonymous Anonymous said...

Anesthesia here. I do in fact talk to people. I say witty things like, "TAKE A BIG BREATH." Or sometimes I shake them AND say "TAKE A BIG BREATH". I'm pretty versatile.
Anesthesiologists also have to be able to deal with the inane comments of the surgeon. My personal favourite is, "he's waking up." Umm guess what, he's not. Let me give you that much narcotic and volatile and then I'll ask you if you're awake.
Have you given anesthesiology any more thought? There's nothing quite as amusing as the disinhibited ramblings of the freshly extubated patient.

9:28 AM  
Anonymous Anonymous said...

Never had much contact with doctors and hospitals till I spent the last year and a half of my dad's life living with him and my mom as he dealt with lung cancer. During his last few days, while he was finally hospitalized with collapsed lung that would not expand under any circumstances, my family and I came across the best and the worst of the medical profession. I choose the best to represent in my memory what y'all do. The lung cancer specialist who finally delivered the news that, no, there was no way my dad was going to come through this performed this task with such unrelenting directness sprinkled with grace, she somehow made that moment liveable to a family who had never before been dealt the tragedy card. You're in my prayers. What you do is so important.

8:05 PM  
Anonymous Anonymous said...

Well, I can relate to your misery. I left medicine--the first time--shortly after my internship. It felt incredible. Then a very, very rough ride. I just started a blog to talk about the craziness and wonders of leaving medicine.
http://travelingmedicineshow.wordpress.com/

I wish you the best of luck. It is really hard when you hate it. Best, Dr. Nostrum

1:58 AM  
Blogger THW said...

That was a pretty frickin funny (and quite true) post about choosing your medical career path. Enjoyed it immensely. The spiral of doom was great. Best of luck with internal med.

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11:23 AM  
Anonymous Anonymous said...

Beautifully written and an apt description of the personalities who chose each specialty. Welcome to Internal Medicine, with your gift for writing, getting authorizations for the myriad new meds will be a cakewalk.
Internal Medicine is actually quite interesting, and the patients are enjoyable. You get to sample the human condition with all its quirks, and it leaves you a lot less judgemental. Jeve

1:10 PM  
Anonymous Anonymous said...

Your post is hilarious.

I hate medical school. I really hate it.
I had no idea it would be so awful.
I had more workplace respect serving beers to leery cirrhotic old bastards at bar jobs i had in college. No joke.
I've been humiliated daily, been hit upon by all manner of male attendings, had meal breaks taken away (in case some egomaniac wants to track me down to educate me about some some bullshit research paper he read twenty years ago), worked more hours than a taiwan seamstress, and my sex life has completely evaporated. I'm waiting for the next third year resident I encounter to whip me with a drainage tube for needing a pee break on morning rounds.

This is utter BS. Why would anyone stick it out in medicine? I am in third year and have never encountered so many cantankerous, egomaniacal wierdos. Once you become a resident, it's all over for you as a human being.

Personally, i'm going into child psych. Yes, I'm fucked up, but at least I'm aware of it. Also, I can work 3 days a week wherever the hell I want, still have a sex life, and work far, far, far away from surgeons.

Good luck with internal med! Someone told me they have the highest resident suicide rate...sigh.

8:41 PM  
Anonymous Anonymous said...

thank you so much. makes me feel so much better on this shitty day.

2:29 PM  
Anonymous Anonymous said...

Euuu...foot ulcers. With your fascination of genitalia, you should specialize in penis ulcers. Pearly penile papules! OMG - I had a derm lecture I walked in late to, just as the prof flipped to a reallycloseup pic of those beauts that took up the entire screen. And they always do that shit at like 11:59 am before breaking for lunch. Chickpeas, anyone? I hate my life. I want to quit med school and strip - I'd probably make more money...unless they somehow group all the clubs together, charge the regulars a set premium, and set the reimbursement-per-lap-dance maximums. Damn.

10:44 AM  
Blogger sheltonfamily said...

I LOVE YOUR BLOG!! As a fellow medical student, I share your agony and often wonder much of the same things. At least I know I'm not alone on upward or downward spiral.

2:45 AM  
Blogger S said...

I've only been here 2 months and I think I hate it too.

I'm having this "flight or fight" dilemma. Do I run like hell for my life and sanity, or do I stay and defeat the beast, and come out of the other end a stronger person? (Or do I just come out with 10 years off my life span?)

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