Tag Archives: stupidity

really?

“Until I get there,” the urology resident instructed me, “you must apply direct manual compression to mechanically disperse the penile and preputial edema.  This will hopefully minimize the swelling and allow for manual retraction by the time I get there.”

So in other words, as my attending so eloquently directed me “grab that thing and hold on tight.”

There are a lot of awkward moments in the emergency department.  Many of them have to do with interactions with nurses (I am really sorry my patient threw up on your leg AGAIN yes he can have some Zofran), paramedics (last time I saw you, I am pretty sure you were making out with one of my co-residents in the middle of a bar), and even correction officers (um, please, just un-handcuff him for the lung exam. Fine, you can keep his feet chained to the bed).

My most awkward moment of late, however, had to do with one particular patient with one particular penis problem.

Paraphimosis is when, in an uncircumcised or partially circumcised male, the foreskin gets retracted behind the glans penis, starts to swell, and gets stuck in that position.  The reason this is an emergency is that this swelling then cuts off blood flow to the head of the penis.  The head will start to turn dark and eventually may become necrotic.  It’s usually iatrogenic in nature, meaning, we cause it.  In this case the patient has a foley catheter in his urethra (secondary to a recent surgery).  He resides at one of the homeless shelters that also provides some medical care, and the nursing staff inadvertently forgot to replace the patient’s foreskin after the most recent foley catheter change. This is actually a great case for me, it’s one of the few urologic emergencies and a case up until now I had only read about.

As great of a case as it may be, the treatment is nothing short of mortifying. Very reluctantly I pulled a chair into the room, and for the next fifteen minutes I sat by my 65 year old patient’s side and “mechanical dispersed the penile and preputial edema,” AKA, I very firmly held his penis in my hand.  For fifteen freakin’ minutes.

Really? I am really doing this right now? Please, just for a moment, put yourself in my shoes.  What are you going to talk about to make this less awkward… football? The weather?

I am a doctor, and this is what I do at work.  Really.

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Filed under emergency medicine, intern year

a joke

Yesterday a patient told me a joke:

What’s the difference between a surgeon and God?

God knows he is not a surgeon.

Funny only because it is so true.

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Filed under clerkships, jokes, medical school, medical student, Medicine

blunder

Today in the sports medicine clinic we had a dancer-patient.  As the resident was presenting the case to the attending, the attending interrupted, “YES, but I’d really like to know, what KIND of dance does she do?” The resident had a brain fart and looked at me for some help.  

Finally! A question I can answer! “Bazz and Jallet,” I blurted.

Without skipping a beat the resident continued, “Right, she’s been doing Bazz and Jallet for four years now.  She practices two hours a day, six days a week…”

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Filed under med school, medical school, medical student, Medicine

from the depths

1. I would like to anterogradely andTB Granuloma retrogradely [in the ways of kinesin and dynein, if you will] apologize for a) not answering my phone, b) not listening to my voicemail, c) not reading emails, d) not writing emails, e) spilling honey nut cheerios all over the kitchen because instead of paying attention to how full my bowl was I was thinking about type IV hypersensitivity, epithelioid cells, and granulomas.

2. I clearly am in no state of mind to write, so instead I will direct you to a relevant post from one of my favorite blogs: USMLE Step 1: The Tale of the Tape

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Filed under med school, medical school, medical student, the boards

update

No need to worry, I’m alive and well.  Med school is still a kick in the pants and as you will see, I’ve spent the last month and a half being incredibly busy:

  • This semester I’m doing outpatient work. Last week the doctor I usually follow, we’ll call him Dr. Z, was out.  We worked out ahead of time that I would follow Dr. Y instead.  When I knocked on Dr. Y’s door I said, “Hi, I’m Dr. Z’s patient here for a check up.” When I walked in with my white coat on Dr. Y started laughing, “Dr. Z’s patient??” I hadn’t even realized what I had said.
  • It was my turn to interview the standardized patient in front of my classmates.  I was paired with a friend who started the convo, “Hello Ms. So-and-so, what brings you here today?” The woman had abdominal pain or something. This prompted me to jump in, “Are you sexually active?  With men, women, or both?” In my defense, it was sex week. But obviously, asking about someone’s sex life isn’t usually the best way to begin an interview.
  • Yesterday in small group we were forced to listen to pathologic breath sounds over and over and over again.  When the wheezing breath sounds came up I said to the girl next to me, that’s what I used to sound like.  Probably because everyone was bored out of their mind, everyone heard me.  And then they all looked at me like they were waiting for me to continue.  My face was getting hot and red, and then my brain turned off.  Next thing I know I am telling them that I used to think my wheezes were George Washington talking to me.  It’s true.  Not something I ever thought I’d share with my class, but that’s what happens when your brain goes on vacation.
  • Again in front of the class, I was delivering bad news to a kermitstandardized patient.  I told the man we were waiting for the lab results to come back, but I wanted to let him know that his son most likely had Acute Lymphoblastic Leukemia.  I was thrown for a loop because this man was an awesome actor.  He was on the verge of tears, wanting to know if his son was going to die.  Initially I handled the situation very well, “statistics show that 90% of chidlren recover completely. ” But then things started to go wrong.  “I know this news must be very difficult for you to deal with at the moment, but your situation is not dire.  It’s not like…” oh no here I go “… it’s not like it’s the end… ” where are my words?  “It’s not like it’s the end of the world.” Cringe. When telling a man that his son has cancer do not tell him it’s not the end of the world.
  • I was interviewing a standardized patient but this time I was being video-taped and graded by a professor/physician/man watching me on TV on the other side of the curtain.  The patient was a 50ish year old female presenting with chest pain.  After taking her history I started the physical exam.  When I got to the cardio aspect of the physcial exam and lay my hand on her chest to feel for thrills, palpitations, etc.  Usually as I am doing an exam on a standardized patient who has no real positive findings, I let her know what I’m doing.  This kills the awkward silence and let’s the grader know what I’m doing since the camera doesn’t catch everything.   So as I laid my hand on her chest I said, “I’m am going to put my hand over your heart…” and then my nerves kicked in, “so I can…” um, how so I explain palpitations and thrills? “so I can…” BRAIN! WORK!, “… see if your heart is still beating.” The patient started to laugh, then the man on the other side of the curtain started to laugh, and then my bright red face started to laugh.  Killing the awkward silence is worthless if you manage to make the situation 59 times more awkard than it already was.

Yes, I’ve been incredibly busy being a jackass.  On the bright side, I’ve been recertified in CPR and have not yet failed out.

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Filed under med school, medical student, off-site visit, standardized patients

wipe out

After sleeping for 11 hours on Sunday night, taking an hour and a half nap on Monday, sleeping for 9 hours on Monday night, and another hour and a half nap this afternoon, I am FINALLY starting to see recovery on the horizon. Exams wiped me out.

Too crazed to post regularly, I decided to keep tabs on a handful of stupid things that happened during exam week.

1. I smashed into a parked car and broke the back passenger window. Yes, the car was parked illegally, but it was my fault. I was probably thinking about the clotting cascade instead of looking behind me.

2. I put my pen into my cup of tea. And noticed it there about a minute afterward. Not really sure how or why that happened.

3. One morning, when I got to the front of the line at Dunkin Donuts, the first words out of my mouth were, “Thank you!!” Uhhh, I mean, can I have a medium black coffee please?

4. On a different day, after paying the man at a different coffee shop, I said, “Thank you! Have a nice stay!” What?

5. Overhead a conversation in the library, Guy: Are you really not hungry? Girl: Well, I guess I could eat. Guy: Oh man, I’m ravishing! (Ravenous + famished = ravishing?)

6. When reviewing genetic diseases there was incessant giggling (by everyone) over macroorchidism. (Large Balls). In Fragile X this comes along with large ears and mental retardation. The topic would then inevitably turn to Michael Phelps. (Sorry Michael, we really do love you).

7. I tried to turn the page of my text book with the computer mouse. On more than one occasion. It’s been a long week.

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Filed under med school

danger! jay-walking med students!

The state of New Jersey is broke.

So what do they do about it? They position two undercover cops in the vicinity of each of the three cross-walks at my school and target jay-walkers. Really?

That is six (SIX) undercover cops handing out hefty tickets, on the second day of school, to students who already have no money, all because they chose to walk across the street in a spot that is convenient but lacks the appropriate painted white lines.

This is so ridiculous and stupid that I don’t know what to say.

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Filed under Uncategorized