ndab Ah Yes, Medical School: October 2003

Monday, October 27, 2003

Big Pimpin

So I learned a new word in medical school today: pimping. Now I'm sure you must be thinking, "But Fake Doctor, if anyone should know about pimping, being a pimp, or encapsulating all that is pimpdom, it's you!" Alas, I don't mean that kind of pimping. For you see, pimping in the medical sphere refers to the process of having your superior publicly embarrass you in front of your peers by demonstrating that you don't really know jack shit. My first encounter with this pimping came today, in my hemotology/oncology bone marrow transplant selective. Last week our head doc gave us assignments on stuff to research regarding acute myelogenous leukemia (oooo big words!), and I had to look up information on how a patient presents with AML along with one other guy in our five-person class. I casually looked things up and figured I'd be able to bullshit enough to get by, but I didn't get the memo that you can't just bullshit your way through medical school like you did in every other phase of your educational life.

The doc was his usual self at first (mid-30s hem/onc doctor who's really damn smart), asking me and the other classmate to tell us what we knew regarding how a patient presents. So I started saying things about how the patient might have intermittent fever, be pale, anemic, stuff like that. However, I was less than prepared for his set of questions, all of which began with "OK so tell me the mechanism behind how _____ is a symptom of AML." I managed to answer some of it, but i believe he mentioned something about how i scored a 50%, and that this 'pimping' (i.e. Socratic method) should increase my anxiety level so I'd work more. Umm. Yeah. Fuck.

After noticing how he didn't pull this shit with anyone else in the class, I immediately assumed he was an anti-semite out to get another defenseless Jew. Of course, I later found out he too is Jewish, so that argument didn't hold. After interviewing one of his AML patients and reconvening with the rest of the group who did the same, he nicely said he hoped he wasn't being too harsh, and that he's just sarcastic. I said no problem - being the middle child of two domineering sisters has taught me a lot about verbal abuse. I laughed it off, and he then proceeded to pick on just about everyone else also (although definitely not to the same degree, says me). He was making fun of appearances and stuff, no big deal. Class over, I survived, no problem.

I learned two things from this:
1) Do not be intimidated by these people - even if they try their best to embarrass you, they are really just checking to see if you have any balls.
2) If you sense the guy is a wiseass in the first place, be sure to get in the last word - going down the elevator after class, I was talking college football with the doc, whos a huge fan of a school that was a rival to my clearly superior undergraduate institution. I mentioned that I followed my team but they've been losing a lot lately. Doc mentioned that he was at the last time my school's football team was at the Rose Bowl. Conversation went something like this:
"Yea I was there the last time your school was at the Rose Bowl."
"Oh ya? That was my freshman year, about 5 years ago."
"Oh no, the one before that."
"That was at least 50 years ago though..."

(OK so it's not that great an insult, and I didn't even realize it could be interpreted as an insult until after I said it - the guys in his 30s, not his 70s - because I really thought the last time my school was in the Rose Bowl was that long ago. But fuck it. I'm pimping now.)

Wednesday, October 15, 2003

Seeing Gross Shit, II

Yesterday I got my first exposure to true anatomy. A few weeks ago they had us poke at the cadaver and learn various surface landmarks, but this time we actually got down to business and, for lack of better way to put it, took this poor former guy apart. We dug through his skin and fatty layers, broke open his ribs, and removed his lungs. Holy crap. The first thing I realized is that I absolutely have to work out more, because now I really have an understanding of how gross fat is and how it deposits everywhere in the body. Since our guy was large, his fat was spraying all over the place as we tried to cut him open...it was freaking melting over everything. Sick.

At first, we were all a bit tentative and tried to be as humane and careful as possible in cutting Jim-Bob open. However, one of the anatomy profs walked by our table and decided to show us how it was really done. The guy just mowed his way through everything, showing no regard for all the fat and skin and muscle that was in his way. That was just fucking gross. Do you know what blunt dissection means? It means "take your hands and just jam them into this guys pecs as hard as you fucking can until the pec major opens up and the pec minor is revealed". It takes a seriously sick fuck to want to do this holy body dissection thing as a living.

Later, we had to remove his lungs. By this point I thought I'd seen and smelled just about every gross thing possible. However, I was not prepared for the wheezing noise that the lungs were making as I tried to wiggle his lungs out of his thoracic cavity. It's like they were pleading for me to stop messing around with them. Maybe that's because at this point I was hallucinating because I hadn't eaten all day and smelled anatomy lab for about four hours straight. Luckily, I totally fucked up one part of it and had to start cutting away rather than just pulling the thing out, so I shut that thing up quick.


Wednesday, October 01, 2003

Seeing Gross Shit

I wish I had a better way to put that, but that's about the only way I can describe my first venture into the real medical community. As part of our Doctoring class, once a month we go to a preceptor who is a family practice doc and get to practice our skills (uh huh) on real unsuspecting patients. Lucky for me, I got to shlep out to a Kaiser way out in bumblefuck Yay bumblefuck! Yay traffic! Assholes.

Anyways, my preceptor is actually a really cool - he is of the "throw them in the fire" camp, and after shadowing him for one patient just started handing me charts and having me taking patient histories to present back to him. Most of it was relatively benign and I learned a lot the entire day, but it wasn't all like that or else I'd have nothing entertaining to say. About halfway through my day there, the doc hands me a chart that says "{unreadable words} inflammation" and, with an evil smile, says "Be sure to report back to me a description of what the nodule looks like." I'm assuming that somewhere in medical school they teach you how to read these people's handwriting, and that's how he was able to decipher some message about there being a nodule.

I saunter over to the patient's room and open the door, politely asking the person's permission to let me take a history of him (some people are averse to dealing with med students and don't want to have anything to do with them- what they don't realize is that 10 years from now I might actually be their doctor so it's better I learn now before I accidentally cause them severe pain later in a more serious case). He is a middle-aged guy (52 y.o. - and as an aside, turns out he's married to a girl in her low twenties...grrr baby ya!) who seems pretty affable. I talk to him about his problems and he says something about a fever and that he has pain in his...penis! And guess where that inflammation is? His penis! And guess what I got to look at? (after asking his permission - "Can I please look at your penis?" ...given that I'm heterosexual, I never thought I'd have to say that in my lifetime, but hey go nuts) His penis! And guess what had a disturbingly large red bulge growing on the side of his penis? His penis! And guess who worked out a bit to hard on the stationary bike, leading to severe chaffing? His penis! (OK not really, but you know what I mean). Note to self: Never work out ever again.

What I wanted to tell my preceptor was "HOLY SHIT HE'S GOT THIS RED THING GROWING ON THE SIDE OF HIS DICK! AHHHH THE HORROR AHHHH!", but somehow I managed to elicit a semi-logical presentation and the doc took over from there. Yay medical school!