medical school

Actually my institution puts out a higher percentage of orthos than any other med school year after year, so we are kind of indulged. Although there are many dudes who are more typically ortho-y than me (i.e. very tall dudes who played sports at a high level and call each other "bro"), which makes me slightly nervous. Most of my interest was built up over years of athletic training and physical therapy work going way back to high school, where I got to watch all kinds of horrible knee trauma. But then this summer I was at Children's Hospital LA working on an ortho research project and oh man kids with congenital defects <3 <3 <3 so rad Best Ever. Plus hanging with orthos (and PTs) all day was way less about "I am IMPORTANT listen to ME I am an IMPORTANT DOCTOR" than working with/shadowing the avg surgeon in my experience. Maybe it is just a West Coast vs. East Coast thing, though.

I have not been to a Shriner's hospital. There seemed to be some interaction between the Shriner's in LA and CHLA that I didn't get to be a part of, but it looks like the closest one to DC is in Philly. We do not even get to rotate at Children's National Medical Center in DC because that is apparently GWU's (and maybe Howard's) hospital. We get to go to Walter Reed, and they don't, so there is that.

Yeah it is kind of odd to be super-concerned about the fact that there really ought to be some gigantic expansion of primary care and yet at the same time be like "I want to go into a sub-subspecialty, why because it look interesting". I am part of the problem! Although it could be worse, I could be gunning for that #1 Derm spot.

Yeah it is kind of odd to be super-concerned about the fact that there really ought to be some gigantic expansion of primary care and yet at the same time be like "I want to go into a sub-subspecialty, why because it look interesting". I am part of the problem! Although it could be worse, I could be gunning for that #1 Derm spot.

― C-L, Monday, November 23, 2009 6:14 PM (2 seconds ago) Bookmark Suggest Ban Permalink

this is like the central tension, for me. the us and the world just needs more ppl doing general practice and yet surgery/radiology/etc are just so dang intriguing. like i actually worry that i'd go into GP and feel like i'm working a 'desk job', even though i routinely grouse about the how what the world needs is more GPs and less academics/specialists

obv the best choice is to do the thing to which you are most inclined (for whatever reason), but sometimes i think it'd just be crass and selfish if i was like 'fuck it, ophthalmology is my SHIT'. but then you know i think about how the eye is pretty dope and i can understand why someone might want to spend a lot of time dealing with it

Yeah the guys who can come in and give a lecture of like "Look at all this crazy shit that can happen you guys!" are almost always more fun than "Here is why it is bad that people are so fat now", even though obesity and hypertension and all that are way more of an issue than the crazy stuff that people usually only get on House. And then the specialist guys come in and be all "We can do medicine with positrons and lasers and SCIENCE!" and then an old guy tells you what a 3rd heart sound kind of sounds like usually.

The exception for me is with pharm since it is kind of awesome every time I watch ads for boner pills because now when they say "Do not take Viagra if you are taking Nitrates for chest pain, as it may cause an unsafe drop in blood pressure" I can nod my head knowingly.

http://www.hopkinsmedicine.org/geneticmedicine/

max - not sure how widely your defining "innovation" but these dudes (including most recent nobel laureate) are doing some pretty interesting research in medical genetics. i cant think of one specific breakthrough that might be worth writing about but i bet the have a press office that can put u in touch with someone

thanks lamp thats exactly what im looking for

haha, neurology is hilarious, though, esp since it seems like a great deal of it is pointing to the precise location of the lesion, detailing how exactly it is the pathways are disrupted, and then crossing your arms and looking like a kid who built a model. "see, there it is? pretty sweet, huh!" "so now what? does it work?" "...wait, waht"

i have been very persuaded by the neurologists, if only because i tend to be a person who likes to solve a puzzle and then do ~nothing~ about it.

...pretty much. that's why i went into neurology, some combination of one-upnerdship and fatalism.

in real life, localization problems are mostly put into the cold hands of the MRI machine. not everything works out as cleanly as in brazis or blumenfeld. even aside from localization, neurologists have to face more vague, complex and/or unknowable clinical situations than other specialists except psychiatrists (unlike psychiatrists, we're expected to get the answer right). expertly-done clinical neurology takes more time and care than modern medicine usually allows: it's a bit of an anachronism. so it helps to have a self-concept that's heavily dependent on believing you're the only one who has the brains and willpower to sort through the morass of possibilities to find the shining nugget of clinical truth. self-satisfaction in problem-solving and patient care has to make up for the lack of some of the more tangible rewards that accrue to practice in, say, interventional radiology. therapeutic options in neurology are improving all the time, but i'm afraid we're a long way from the sort of revolution that would make treatment and cure the most rewarding part of the field.

old maxim that will tell you if neurology is right for you:

if you don't understand it, it's psychiatry;
once you can explain it, it's neurology;
once you can fix it, it's neurosurgery.

that's about right. neurology, day by day, isn't about the great unknowns (oliver sacks case studies aside). it's mostly about accurately explaining complex (and often obscure) problems we can do little about. and most of our promising/experimental therapies are really surgical and/or interventional (epilepsy surgery, DBS, endovascular procedures, m-a-y-b-e stem cells). someday neurologists as a tribe might show an interest in learning some of those techniques themselves, but for now we're generally happy to pass them off to NSx or Rad.

bottom line, if you like dealing with people and being the only person in the hospital who can figure out what's wrong with Mr X, you're going to have a lot of fun in neuro.

hello plasmon!

(unlike psychiatrists, we're expected to get the answer right)

I will be stealing that line, thankin' U Dr. Plasmon.

Plasmon, don't neurologists ever work closely with cognitive neuropsychologists on therapies, in or out of the hospital setting?

plasmon what are the answers to my neuropathophys exam tomorrow

hello med-ilx!

Plasmon, don't neurologists ever work closely with cognitive neuropsychologists on therapies, in or out of the hospital setting?

there aren't a lot of proven cognitive neuropsych therapies. neuropsychologists help diagnose some neurology patients (doing detailed cognitive testing) and help establish parameters for treatment of others (testing memory in epilepsy patients to see if their baseline level of cognitive function will be severely impaired after temporal lobe resection). cognitive/behavioral neurologists (read: dementia specialists) work the most closely with them. i'm sure there are some promising avenues for therapy, but they aren't established yet.

plasmon what are the answers to my neuropathophys exam tomorrow

path slides? gross or micro? cases and questions? MCQ? short answer?

pathophysiology, all cases and questions. basically: localize!

i just need to know the brainstem a little better

took gross/micro neuro path on monday, did ok :-/

lol exams lol posting 2 ilx :/

good luck bro

Good luck, do not let them catch you on a Central VII lesion that they want you to believe is Bell's Palsy.

i will allow no such thing to happen. if innervation to the forehead is preserved then u kno what THAT means

lol exams lol posting 2 ilx :/

good luck bro

― Lamp, Tuesday, November 24, 2009 5:47 PM (15 minutes ago) Bookmark Suggest Ban Permalink

study time out iirc

haha i was lol'n @ me really - gave up on drinks w/bros 2nite to stay in and "study" i.e. post to ilx

https://www.youtube.com/watch?v=WGgCy-hbp4Q

my downstairs neighbors must haaaaaaaaaate meeeeeeeee

all pacing back and forth to the kitchen, making 100000x cups of tea with a whistling kettle (pro-tip: white or green tea makes for a better caffeine titration than coffee imo)

aren't you guys about to figure out how to cancel sleep anyway

i think i did figure it out, and i think it was a mistake

literally seeing thru time right now

my test went well just fyi thinking good thoughts 4 u future gbx if u can still hear me~~

it is ~*all good*~

http://www.kevinmd.com/blog/2009/11/training-doctor-france-differs-united-states.html

How is everyone doing? hanging in there during exam week?

next week for me. should be pretty chill? our period was only 2.5 weeks

can i post here too? stressed about pharm finals tbh

also genuinely interested in fl3x md and their school of public health/int'l health opportunities

― gbx, Wednesday, December 26, 2007 5:35 PM (1 year ago)

you still heading this direction? public health was the coolest class i took this semester

We had two four-hour exams this week (Monday and then this morning), both of which were absolute monsters. There is one more shorter one on Monday and then winter break. I am so tired, and want 2nd year to be done so I never have to do 2nd year again, but other than that, you know no complaints. If I get a passing grade and it's not so bad that I have to kill myself next quarter to make sure I stay above the pass line, then I am all good.

K3vin I feel it is only appropriate to discuss Pharm here because I spent most of the past two weeks going insane trying to keep track of like, which antibiotics require dose-adjustment in renal insufficiency and which ones in hepatic insufficiency, and then today I got my ass handed to me by the cardiovascular drugs, esp the antiarrhythmics. Like the hypertensives and CHFs and anginas all make sense eventually, and the anticoagulants are comparatively a treat, but then all of a sudden we enter this hellish netherrealm where somehow Amiodarone is considered an agent that it is still OK to use, despite turning your skin kind of blue and having 1 million other toxicities.

Nursing school, not medical school, but whatever: One exam a week for the last month, two 50-75 page chapters a week to read. Two clinicals a week, both of which entails us having to get to the hospital at six in the morning. (It'll increase to three a week for a while after the first of the year.) And just about everyone else other than me works 30+ hours a week. True, it's not even close to what you future doctors have to put up with....

I'm glad I have all of this behind me!

re: Amiodarone, besides all of the potential serious (and potentially fatal) toxicities, I can tell you from personal experience (with an arrhythmia) that it's an extremely nasty drug. What they don't tell you is that it makes you feel like you're having to drag yourself through your life for every second of every day that you have to take it. I'm just glad that my trial with it didn't last very long.

C-L we must be on totally different schedules!

I think you started like a month after we did (we started like the second week of August, or whatever it was 20 weeks ago).

Am kind of envious of nursing school for letting students have some hospital time in the middle of the preclinical sciences. Maybe not so much for the 6 am part, but still. We get to do in-hospital Physical Diagnosis coursework in like March, I think. And then once July rolls around it is 3rd year~

and then once July rolls around it is 3rd year~
and then once July rolls around it is 3rd year~
and then once July rolls around it is 3rd year~
and then once July rolls around it is 3rd year~
and then once July rolls around it is 3rd year~

just saw a screening of Living In Emergency

did u???? i wanna talk about it

what is it abt? i am studying

https://www.youtube.com/watch?v=PMuLdA5AbXM

did u watch it for school gbx or on your own?

on my own

well, went to it w/dad and sis, actually. didn't even know it was showing here, but my dad got tickets. kinda wanted to talk with him about it afterwards, but it's late and i needed to get home.

(he is a libertarian surgeon, btw, and i think sometimes we have pretty different outlooks on healthcare, but he seem pretty affected by it, at least during)

haaa - i had heard abt it from my mom - think mb she knows some of the ppl involved - but havent seen it myself

looks like it was only screening today :/ - def something i want to see tho. did u ever end up reading strength in what remains?

not yet! haven't been reading much :-/

I passed cardio! I almost certainly passed pulmonary! I think I passed bacteriology!

Also I am drunk because I am celebrating being 37.5% of one doctor. EXCITEMENT

YES!!!!

congratulations!!

I actually did pass bacteriology! I am kind of hungover!

*Fist pump*

how political is medical school? asking because I was recently in touch with an old friend (with whom I have radically different political views, on some things anyway) whose medical career essentially tanked and went to hell for reasons that he viewed as political (although I'm pretty sure there was more to the story).

not very, ime! i mean ppl have their views, i guess, but save for the existence of some student groups that are inherently political (we've got universal healthcare groups, and both pro-life and pro-choice groups), politics isn't something most of my classmates keep up on.

that being said, the general climate could be regarded by a selective minority as stiflingly ~liberal~. social conservatism doesn't gain a lot of traction around here, nor should it (IMO---if what ppl do with their private lives is something you spend a lot of time getting aggravated about, you might want to avoid a job that places you squarely in other ppl's business).

or do you mean small-scale political, like "office politics" style?