Thread: who?

who is the restless eye?
is he in vinnies or in grenada?

Students/residents/doctors/patients ... I think that, over time, they lose perspecive. They forget how to put the philosophy of "It's the small things that count" into practice. At the end of the day, how many really want to identify with others? Seems to me that they just want to be acknowledged that they are great and all-powerful. When they see others' with more pwer and control, those other people become idols of sorts ... whose personalities are copied without much thought to context.


Also, it is mind boggling to me how FD is still a medical student. I'll be amused when he makes residency - if he does.

People like FD help me look better on rotations.

Originally Posted by MerlinDoc85

They forget how to put the philosophy of "It's the small things that count" into practice.

Last week I had my surgery OSCE exam. At the end of the standardized patient (SP) the evaluator, a surgery resident, came in and gave me feedback and asked a few questions. What do you think she has? Do you think she needs a colonoscopy? With time you'll learn to focus your questions a bit better. (In my defense I had plenty of time and while I don't think this 60 y/o lady has a raging case of PID/TOA causing her abdominal pain and PID is towards the bottom of the differential because of the patient and this isn't OB/GYN, I still went there and asked a few questions about her sexual history). You probably should have mentioned that you're going to start antibiotics. All very valuable feedback, and all very technical.

After the resident was done giving me feedback and asking questions, I turned to the SP and asked if she had any feedback. She said "Oh yes, I do!" I won't lie, I was a bit fearful in that second. She complimented me that I asked if she was warm enough (she was under a blanket when I entered the room), asked who was in the waiting room and if she wanted me to talk to them about what was going on (this was a visit to the ED), asked if there was any other family that should be contacted, warmed my stethoscope, told her upfront that I knew it was going to hurt before I palpated her abdomen but told her I'd be quick and apologized for the extreme discomfort, asked if I could call her primary care physician to get some background information (she admitted she'd never been asked that before ... and told me her actual PCP's name because she didn't know what else to say), and that I made a point at the end to tell her that I was going to get her some pain medication, anti-nausea medication, IV fluids to help her feel better. She said she felt taken care of.

For all of the praise I got from the SP I didn't really need to know a single thing about what was wrong with her. I could have thought she had a raging case of toe fungus and it wouldn't have really changed how she saw me.

Nice. All encounters should be that positive.

Originally Posted by TheFooBar

I'm going to assume here that you've never done server administration on a site with non-trivial volume. If I'm wrong in this assumption feel free to offer specific suggestions on how to improve things. Get a better layout and servers isn't terribly specific input.

Please hold on to this your indignation for the future. That way when your patients complain about how they don't understand how you can charge so much money for 10 minutes, charge them if they miss an appointment, run so late they miss 4 hours of their job which you don't pay them for, and be so disorganized and they've seen the vet's office run better with newer magazines in the waiting room you know where they are coming from.

Side rant: I'm always amazed at how physicians get all upset when they are treated with the same level of (dis)respect they give other people. We sometimes make patients wait for hours for us to catch up in clinic. Yet we go crazy about having waiting the 3 minutes for the skin prep to dry ... which is the only way it is effective.

We call people by the wrong name and make little effort to learn how to say their name correctly. Patients become room numbers or procedures (He's the colostomy reversal). Yet some physicians will chew out a nurse who doesn't know their name and especially that their first name is doctor. Don't get me started on the attending a few weeks ago really did pull the "I DIDN'T GO TO MED SCHOOL FOR 4 YEARS SO YOU COULD CALL ME BY MY FIRST NAME" to a nurse in the OR. (Attending wasn't responding to Dr. LastName and after trying to get his attention for a solid 30+ seconds she resorted to his first name. He responded alright)

We blow off patient's complaints. You shouldn't be having that pain. I think you're just here for more pain medication. It can't hurt that bad. It's just a little nausea. Oh, I'm not worried about that. Vague aches and pains, even if the chief complaint sometimes get ignored. I've had more than one physician make it clear that fibromyalgia is just a fancy name for a psych disorder. (Even if that's true and it's a form of conversion doesn't that mean they're still in pain?) That patient is just a whiner.

Yet when a patient blows off our therapies we are all upset. The patient is non-compliant. I told them to stop smoking. They are continuing to eat too much sugar and that's why their HbA1c is double digits. If they would only listen to me they'd be better off!

As students we complain about how the residents don't teach us, scut us to death, and any question we are asked is answered with "I think you should go look that up."

As residents we complain about the med students taking up our time, asking questions that can easily be looked up and no longer have to get our own lunch when we find the right gunner ready to do it for us. (All those unhelpful residents were med students in the not too distant past)

Think about what you hate when you go to the doctor's office. Do you do the same thing to your patients? Personally I HATE it when my doctor pulls his stethoscope out of the fridge and slaps it on my abdomen causing me to wince so bad he thinks I might have peritoneal signs. Hence I make a point to warm up my stethoscope before using it on patients. You wouldn't believe how often patients comment and thank me for doing this.

I've found over the years that when someone is unhappy with the way something is being run if you look for a moment you'll find something in your own life and be able to understand where they are coming from a lot better.

Whoa.... Someone took what I said in a different tone. It was a more of a offbeat, casual observational humor. Not a "ARGHHH SERVER AND SITE NO GOOD, CAT SITE BETTER; More like a "Haha..... it's pretty funny Lolcats - Funny Pictures of Cats - I Can Has Cheezburger? still working, but the subject matter is a lot lighter in tone. Minor social commentary joke about cats more important then medical school, which isn't true, but is more hyperbolic"

That type of tone. The tragic issue of the internet not carrying tone, and inflection of words compared to real life.

Originally Posted by swimchick

Instead of whining here...why don't you post something here: The Suggestion Box & Technical Support. The support team checks it frequently and can often resolve issues fast if users let them know via that forum.

Yeah, but that will actually get something done.

Originally Posted by thxleave

Whoa.... Someone took what I said in a different tone. It was a more of a offbeat, casual observational humor. Not a "ARGHHH SERVER AND SITE NO GOOD, CAT SITE BETTER; More like a "Haha..... it's pretty funny Lolcats - Funny Pictures of Cats - I Can Has Cheezburger? still working, but the subject matter is a lot lighter in tone. Minor social commentary joke about cats more important then medical school, which isn't true, but is more hyperbolic"

That type of tone. The tragic issue of the internet not carrying tone, and inflection of words compared to real life.

Heh. It was a side rant, not directed towards you.

It's also the tragic effect of only getting 16 oz of coffee this morning instead of my usual 20 oz. HOW CAN YOU BE OUT OF THE 20 oz CUPS?!

My apologies. We now return you to your regularly scheduled program, Future Dermatologist, already in progress.

*bssssht*

FD: We only have to go to conference tomorrow (meaning M&M) with the residents and then we're done with lectures! I never get anything out of them. They're just all so focused on surgery.
Other student: You are on a ... surgery ... rotation.
FD: (Doesn't look convinced)

(This was part of the same breakfast conversation this morning)

I wish my breakfast conversations were full of that much entertainment.

Originally Posted by Salama

I wish my breakfast conversations were full of that much entertainment.

If you hurry you can be here for breakfast tomorrow.

:S ok ERAS token is up for grabs.... kinda scared to purchase it.
[psychosis] That would make this too real.... no, no, this is not real... I'm just playing doctor, it cannot possible lead to responsibility.... (breaking down and tearing my hair out) .... noooooooooooooooo, it is all a dream, it must be...[tbc psychosis..../]