What have you done for me lately?

So what. Yes, it's been months and months since my last blog entry. Honestly, you should be used to that by now. I ask you, what have you done since my last entry? Did you diagnose a 4-year-old with Malaria? Didn't think so. Well I did, last Friday as a matter of fact. SUCK ON THAT!

Family Medicine: The most dangerous medical specialty

I am currently in the final week of my Family Medicine clerkship. This is where we learn how to be a good ol' country doctor, a general practitioner. Late last week my attending asked me to see this very kindly looking gentleman who looked to be around retirement age. He was tall with a shock of untamed white hair sticking out from his head. He was in for just a checkup, some blood work and a refill of a couple prescriptions; it was pretty standard stuff for a Family Doctor. As with every patient I had to do a quick physical exam just to make sure everything was normal on him. It was a routine exam, blood pressure was fine, heart and lungs sounded normal, and then I got to his abdominal exam. I had the gentleman lay down on the exam table and asked him to life up his shirt to expose his midsection. This is where things got a little weird.

I noticed a wooden handle sticking out of his trousers, just to the right of his naval. "That's funny", I thought. "Why does this old fellow have his cane shoved down his pants?" Not wanting to offend or appear alarmed, I continued my exam and as I was palpating the lower quadrants of his abdomen I realized that the man didn't use a cane. The wooden handle sticking out of his pants was actually the revolver he was carrying.

I paused for a moment and then continued as if nothing were amiss. I remember thinking to myself: "Well, I have my hands half-way down this man's pants, if he was going to shoot me, he'd have done it already."

"Driving in that condition was probably the stupidest thing I have ever done..."

I'm in my Family Medicine rotation right now. I work with this attending who is easily in his 80's. He took over the practice his father started in The Bronx in the 1930's. Today he told me this story:

"A few years back I had an MI*, a pretty big one too. I was in Central Park for that art exhibit 'The Gates' by Christo. When the pain started and I knew what it was I said to myself: 'Shit, I don't want to die here in Central Park looking at these stupid gates.' So I drove myself to the emergency room. Driving in that condition was probably the stupidest thing I have ever done, but I didn't want some cowboy ambulance driver taking me to Metropolitan Hospital or something. I think that if it had happened while I was at home in bed I probably would have just said 'Ehhh...fuck it'."

Priceless.

*MI = heart attack.

"Yeah I got lucky, I decided not to sleep with SA"

"You look"

Imagine this. Imagine you are an engineering student. You decide to learn all about aeronautical engineering. For two years you study lift, drag, wing aspect ratios, and stall speeds. You memorize the fuel storage and delivery systems for all the different planes made. You learn about air foils and the flash point of Jet A-1 fuel. By the end of the 2 years you could take apart and put back together any flying machine made by man. Then, you are sent to the airport to learn in "real life" all about flying planes.

On your first day, you buckle into a Boeing 777 next to the pilot. You greet all the passengers as they file into the cabins. You're feeling great as you get ready to be taught about flight first-hand. The pilot fires up the engine and taxis to the runway and executes a textbook take off. You easily describe to him all the physics behind the thrust and the differential pressure between fast and slow moving streams of air over the wings. Upon reaching cruising altitude, the pilot switches on autopilot and you enjoy the smooth flight. Right about the time for the descent into the destination airport, the captain switches off autopilot and casually tells you to "taker 'er in, buddy" and calmly walks out of the cockpit.

You don't even have time to process what just happened. Immediately, the navigator screams at you for an explanation as to why you haven't radioed ATC for an approach vector. The lead flight attendant barges into the cockpit demanding to know why you haven't given the alert for landing preparations. The Tower is suddenly in your ears barking that you are going way too fast and are way to low to even attempt setting the aircraft down on the runway. An alarm starts whooping in the cockpit and you swear that Stephan Hawking is demanding to know why the landing gear hasn't been deployed yet. Suddenly the pilot peeks his head back in and demands to know why you are taking so "fucking long landing a 10 million dollar airplane full of people". You hear in the background several passengers nervously asking each other "Is this the FIRST TIME he's doing this??!!" You begin to realize that the previous two years of classroom learning has taught you nothing about actually flying an airplane. You stare at all the people glaring at you, expecting someone to give you at least one instruction on what to do. The pilot just sighs deeply and shouts at you to "get the fuck out of my cockpit" and lands the plane himself.

As you exit the aircraft, the dude with the two flashlights shakes his head at you and says: "Motherfucker, did you even go any classes in the last two years?"

That is year three in medical school. Kind of makes sense now why most people die in hospitals.

Best "fuck you" quotes of my first month on the surgery rotation:

I was in a surgery with a very famous neurosurgeon last week. We were removing a lipoma from a 15-year-old girl's back that was on top of her spine.
Me: So Doctor, how can you tell where the tumor ends and the nonpathological tissue begins when you remove this mass?
Neurosurgeon: *sigh* You look.
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My chief resident told me to tie one of the sutures as we were closing after an operation.
Chief: *as he is cutting out the stitch* Yeah, that was a really good knot . That was your last chance at tying with me my friend.
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I was told to put a Foley catheter into the patient just after she was anesthetized and before the operation was to begin. I had a little trouble placing it, but managed to get it in. I think I worked at it for about 5 minutes.
Resident: Congratulations, it only took you a half an hour to put that Foley in.
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Vascular Surgeon: How long are you here until? Friday? Damn, it's only Tuesday and already I'm sick of you.
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Neurosurgeon: I'll let you in my OR today, but that's all, I don't like your face.
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Chief of Pediatric Surgery: Patient comes in complaining of rectal bleeding. Craig, what do you do?
Me: Do a rectal exam.
Chief of Pediatric Surgery: Shouldn't you talk to the patient first? My God, what are you like on dates?

24 hr on call and I'll kill patients

Wow. I have almost no recollection of posting that last night. I wasn't even drinking.

it's called sleep, ever heard of it?

I'd bitch about the hematology test I took this (yesterday, technically?) morning, but I'm just too F'ing tired.

When I came home tonight I took my books out of my backpack and put them in the laundry hamper.

Have you checked out Dr. Shock's blog yet? The link is right over there -->

I ate almost a pound of peanut M&Ms after dinner tonight.

I've been catching glimpses of ghost cats out of the corner of my eyes all night. I wish the ghost dogs would chase them away, I'm allergic to ghosts.

I recently bought a guitar and have been practicing every day at least 30 min, usually an hour. It's fortunate that I'm good at science. I'm pretty sure that in the history of the universe, no being has ever sucked so magnificently as I do at anything that has ever existed that can be sucked at.

I'm pretty sure this post shiofhjl lkjds;'/................................................................................................................................................................................................