News and Gagdets

Progress Notes

Wednesday, October 08, 2008

  • Breast Cancer Awareness-The Non-controversial post.

    Why do i say non-controversial-do i dare? I say it because we can all agree that breast cancer is bad. I mean worse than black licorice bad. Worse even than kicking puppies bad. And that is why I am writing this post as an almost doctor on the breast cancer thing going on (aka xxxanga)

    So for those of you not following the latest xanga drama, some folks have been posting NSFW pics of themselves covered with the xanga logo in order to promotes awareness of breast cancer/and testicular cancer for cancer awareness month. Other people feel that this is an inappropriate way to bring attention to a serious issue.

    My thoughts: Lets face it people, nudity can sell just about anything. Yes, you can show photos of mastectomies, and maybe some people will say ZOMG what a horrible thing to have to go through and get up and contribute to breast cancer research or even go read up on it. But allow me to show you the average internet user

    http://img.photobucket.com/albums/v455/HeartView/People/boobies.jpg

    There you have it. I am now aware of breast cancer because it has given me the opportunity to leer at boobies. I would argue that while posting these softcore photos does nothing to address the issue of breast cancer in and of itself, it does in fact raise awareness by driving traffic to such sites. Once there, if the authors have at least mentioned the risks of breast cancer (#1 cause of cancer in women followed by lung and colon, whereas lung has highest mortality-so stop smoking!) or indicated things that young women can do to help prevent breast cancer (yearly breast exams, self examination-although studies show it is not as effective, mammography yearly for women over 30) then they have been at least semi effective in their goal of raising awareness

    By contrast, those who are offended or at the least disinterested and think the proper way is to post mastectomy after-pictures; well that is a pretty effective tactic too, provided the same information is provided. Then again, it is a tactic most likely aimed at an entirely different demographic. Not that the two dont overlap, but realistically speaking, the reason there is a month designated to raise awareness for these causes is because the great majority of people will think about it, wear whatever color ribbon has been chosen for that month, and then never go beyond that. Too many individuals (myself included) simply lack the dedication to join a race for the cure, or involve ourselves in painstaking research-so our solution is to read a few articles here or there, jokingly offer free breast exams to our female friends if we are male, or maybe just remind our friends to self exam if they are female, and then get on with our lives.

    So whichever way you choose to raise awareness, I commend you for it. But please remember, whether you use the enticement or the scare tactic, please PLEASE impart true and helpful information. Statistics arent looked at by people as anything more than a high/lo ball-so remind people that if they have a family history of ANY kind of cancer, if they feel a lump or notice a discharge from one nipple, or skin changes/retractions that they should definitely go get checked out.

    As for the testicular cancer- well, lets face it, most men find an excuse to adjust their testicles at least once a day, so self screening isnt a problem. Beyond that guys, if something feels different-a firm lump, or one testicle seems to be much larger than the other, or doesnt transilluminate (go ahead stick a flashlight behind your testicle and shine it through watch your balls light up! its a good party trick) then go get yourself checked out. That turn your head and cough thing is for hernias, not cancer, so that wont cut it. Just like with the women, family history is a danger, as is a history of your testicles not descending from your abdomen when you were young (and i mean like 2 years not puberty) While testicular cancer is by no means as common as breast cancer, its still no walk in the park.

    So there is my two cents. Promote awareness however you like, as those of us here in our lofty ivory towers enjoy the view. Just make sure that you give out true and accurate information and remind people to go to their doctor with any questions. Becuase the internet is only as reliable as wikipedia, and if you folks keep getting all your medical information from there, I will soon be out of a job

    If there is any more info anyone would like included in this post, or questions you want addressed, just leave em in the comments box. It will make me feel important and more likely to answer you.

    -Almost Dr J

Saturday, October 04, 2008

Thursday, October 02, 2008

  • Moral Turpitude

    Listening to the debate tonight, I really enjoyed the phrase moral turpitude. What is it?

    Moral turpitude is a legal concept in the United States that refers to "conduct that is considered contrary to community standards of justice, honesty, or good morals". It is of great importance for immigration purposes, as only those offenses which are defined as involving moral turpitude are considered bars to immigration into the U.S

    Okay, you say to yourself, but what exactly is an act of moral turpitude?
    Crimes of Fraud and evil intent: arson, blackmail bribery counterfeiting, forgery, child abandonment, and lewdness, and the like.

    I was doing well up until lewdness and pandering.

    See politics can be fun! So remember remember the 4th of november, and then...don't vote. unless you care about...


  • Recounting Patients

    The last couple weeks of Sub-I have gone much more smoothly than the first few. Although that first sink or swim call definitely contributed to that-if you can learn to admit and manage 5 patients in one day, then an occasional admit every other day doesnt have quite the same terror inducing power.

    And I realized I have neglected to tell you any patient stories from SubI...now this is again because of the aforementioned busyness and studying, not because I havent had any interesting patients. Here are a few brief summaries of the folks I have had the *dubious* pleasure of treating during the last month

    1)A 50 yr old man who was brought to the paramedics following a grand mal seizure. He had a history of seizures 10 years previous for which he took dilantin, but had since become noncompliant with meds. His history was additionally signficant for Crohns disease and a blood clot in the brain necessitating a right craniotomy. What is a craniotomy?
    Awake craniotomy

    That's right, it's zombie bait surgery...your skull is cut open and the most delicious parts of the brain (or the one causing the problem, whatever) are removed. As you can imagine, this can occasionally lead to an indented sort of look for the patient. Luckily (or not) for our patient, he had no knowledge his sull looked caved in, or even that he had undergone a craniotomy, as the piece of brain removed from him had something to do with his short term memory, as per the family's description. Oh and btw, he was postictal (the state of confusion following a seizure) and wandering naked about the ER when I first went down to attempt an interview him.

    We loaded him with dilantin, an anti-seizure medication for while he was in the hospital, but he refused to take it saying he hadnt had a seizure in 10 years and didnt need it, nevermind the one he was brought in for. Until, that is, his mother came him and told him he was taking it because her and the doctor said so. To which he immediately agreed. I guess no one ever gets over being scared of their parents

    Assesment/Plan: EEG negative for current seizure activity, MRI declined, pt sent home with dilantin and a stern lecture from his mother.

    2) A 56 year old cocaine abuser in for chest pain radiating to the shoulder. That's right its everyones favorite rule out ACS (acute coronary syndrome). His history was significant for hypertension and heart failure, not to mention the cocaine abuse which can precipitate heart attacks through vasospasms. His social history revealed that patient abused cocaine while his girlfriend used heroin. How long do you suppose they've been together? 17 years. Wow perhaps the marriage counselors are missing a key therapy here.

    Assesment/Plan: Three sets of cardiac enzymes negative, no EKG changes, a beta blocker to decrease afterload on the heart and a negative stress test showed our gentleman was not in fact having a heart attack, just the standard cocaine buzz. Discharged home with the admonition that coke is for drinking not snorting. Wonder how long til we see the girlfriend

    3) a 29 year old mixed martial arts fighter with multiple MRSA abcesses including a rectal one. While his choice of career could lead to abscess potential, the sheer number and the fact that they were all colonized with MRSA (a drug resistant bacteria usually only accquired in the hospital) he was a rather interesting case whose etiology we never quite figured out. But the real kicker is that I am a pretty big fan of UFC and all those fighting leagues...so while this fine fellow was not technically one of MY patient, but rather on my team, I would just pop in and chat over his fight record and techniques with him. He's still a small time fighter and not one I have followed, but it was still the closest I have come to meeting a sports star I actually gave half a damn about.

    Assessment/Plan: You really think I am going to tell a man who beats people up for a living to do anything? We pumped him full of antibiotics and set him loose on particularly difficult staff members

    Of course there were a whole grab-bag of other ill folks, with seizures, diabetes, abuse, and the usual hospital culprits, but like any good med student I know that both audiences and attendings tend to stop listening after the 3rd patient, so I will leave you with that thought.

Wednesday, October 01, 2008

  • Tagged


    Tagged by MadisonLinh. I will leave to those of you who know me to determine how accurate you think this is

    Your view on yourself:

    You are down-to-earth and people like you because you are so straightforward. You are an efficient problem solver because you will listen to both sides of an argument before making a decision that usually appeals to both parties.

    The type of girlfriend/boyfriend you are looking for:

    You are not looking merely for a girl/boyfriend - you are looking for your life partner. Perhaps you should be more open-minded about who you spend time with. The person you are looking for might hide their charm under their exterior.

    Your readiness to commit to a relationship:

    You are ready to commit as soon as you meet the right person. And you believe you will pretty much know as soon as you might that person.

    The seriousness of your love:

    You like to flirt and behave seductively. The opposite sex finds this very attractive, and that's why you'll always have admirers hanging off your arms. But how serious are you about choosing someone to be in a relationship with?

    Your views on education

    Education is very important in life. You want to study hard and learn as much as you can.

    The right job for you:

    You're a practical person and will choose a secure job with a steady income. Knowing what you like to do is important. Find a regular job doing just that and you'll be set for life.

    How do you view success:

    You are afraid of failure and scared to have a go at the career you would like to have in case you don't succeed. Don't give up when you haven't yet even started! Be courageous.

    What are you most afraid of:

    You are afraid of things that you cannot control. Sometimes you show your anger to cover up how you feel.

    Who is your true self:

    You like privacy very much because you enjoy spending time with your own thoughts. You like to disappear when you cannot find solutions to your own problems, but you would feel better if you learned to share your thoughts with a person you trust.

Monday, September 29, 2008

  • The Financial Ka Boom De Adda

    All right, I have a confession to make: I don't understand economics at all.

    It's one of those gaping holes in my understanding, like the intricacies of sports or which kind of car is which.* I just don't quite grasp it. My mental image of the current crisis is a black hole suddenly blooming under Scrooge McDuck's money bin, with all the cash in it inexorably draining away.** If you press me I can understand some of the big details ("We're fucked"), but to me, some of the finer points of the analysis sound like so much glossolalia. ("Blah blah blah blah blah we're fucked.")

    **"Gee, Mr. McD, when I let Gyro build a Large Hadron Collider under your bin I never dreamed this would happen!"

  • So So true 2

  • Excuses

    Anyone still come here?

    Well for those of you who do and have noticed the rather drastic drop off in posting frequency, here is my lame attempt at excuses

    1) I have been essentially living at the hospital this past month during my subinternship, and am busy taking care of patients instead of blogging

    2) I am filling out residency applications in time for deadlines and thus still not blogging

    3) I take my licensing exams in one month, and free time spent in front of a computer is used for usmle world, and more not blogging

    4) Have been dating someone new (Hello Nurse) and thus not blogging

    5) I actually have a life outside the internet...hard to believe I know, but its true

    SO yeah, dont expect to hear too much from me if you dont know how to reach me personally until after halloween or so

Wednesday, September 24, 2008

  • Call on me





    You know, its pretty darn amazing what people can teach themselves to put up with. Another post call day, during which I admitted 5 patients overnight, one of who had the nerve to try and have a heart attack during the first and only time I got to go sit in the bed.

    Honestly the nerve of some people.

    Aside from that, it was not a bad call...everyone was admitted after midnight, so i didnt have to write any progress notes on them this morning, and i had copies of the history and physical ready for morning report and even managed to find time to read up on some of their conditions. All on less than 2 hours of sleep.

    The post call day, in fact the entire call process is one of the classic trial by fire/hazing rituals left of old school medicine. And as much as physicians like to complain about it, I think it makes us pretty darn proud of ourselves on some level too. After all, aside from medicine and the military, no other job has the expectation that you will be running on your reserves not just once, but rather on a repeated basis for an indefinite amount of time.

    Of course there is some serious REM debt to be repaid later. During a brief nap today, I dreamt that my team and I were in the hospital (i know another dream about working, its sickening)

    In my dream hospital, there was a cricket that could either cause or cure disease. A wooden cricket. And a government conspiracy was involved somehow. So our team had to find this cricket, but we had 12 patients and we didnt know which one it was in, and we only had 30 minutes to find it or something would happen.

    And thats actually a pretty good description of my mental state at 4in the morning. One that followed by the slightly less intelligent waking thought that the housekeeping rainbow dusters look a lot like those tricolor rocket pops from the 80's

    Alright, time to get some sleep before I wake up and return to the hospital (which I technically havent left yet) tomorrow

     

Saturday, September 20, 2008

  • No Reservations

    Okay now this is just getting ridiculous-I have sent in the majority of my applications, and a few of the optho programs want supplemental materials. For the most part this is easy, as they are merely requesting my CV and a photo, the photo presumably because nobody wants to be treated by an ugly doctor, and that will help me pass the first cut-off in interview selection.

    One school however, the university of Miami, an amazingly good optho program requires this:

    U miami Bascon Palmer: Additional materials required aside from CAS: a signed autobiographical sketch not to exceed 600 words

    Are you freaking kidding me? Could we make this any more vague? I mean, i already sent in my personal statement (thanks internet for proofing that which covers the whole why i want to be a doctor and now they are requesting ANOTHER personal statement and I honestly have no clue what they expect of me. Including my alternate statement for my backup specialty, this will make the third ps i have had to write in 2 months. I am just about drained of personality.

    In any event, like all my other statements, I am going to post it here on xanga. Not in the hopes that you, my ever so patient readership will assist in editing. No, I have asked that too much of you lately, and it is hard enough to get people to comment. I am posting it here because I have a functional writers block staring at a blank open office document, but I seem to be able to pound something out, no matter how inane or craptastic staring at this little text box here on xanga. So if you read this, thanks for your time, and if you dont...erm, thanks for nothing?

    ------------------

    Umiami Autobiographical Sketch: No Reservations

    Scorpion doesnt sting quite as much as you would think-at least on the tongue. I discovered this at the Night Market in Beijing, China. I visited China for one month in the summer between my first and second year of medical school to study traditional chinese medicine such as acupuncture, moxibustion, and cupping. Learning about eastern medicine however, was only a part of the reason behind the trip, the remainder being to explore a new culture, country, and continent.

    I have always loved traveling, and China was only my latest stop in a series of jaunts around the world. In each locale I always tried to find not only some activity unique to the country, but also to learn at least a few words in the language, and immerse myself in the regional cuisine. Considering myself a bit of a "foodie", I figure the best way to start learning about another culture is to eat it. Nothing starts a conversation like a shared meal.

    Which is how I found myself staring down the stinger of a deep fried scorpion. A group of us all in the acupuncture program has set out to complete an Iron Stomach Challenge, competing in a gustatory version of the game "chicken" to see who was most willing to fully embrace the full range of edible oddities available. We had already sampled the famous Peking duck complete with internal organs at a five star restaurant, rancid butter tea and yak genitals at a Tibetan restaurant, and "meat on stick" as the sign read at the stand adjoining our hotel. A travel guide listed Wangfujing street as the place to find exotic street food, so that was decided upon as our next stop.

    The stalls were lined with vendors selling cockroaches, starfish, crickets, snakes, everything I could imagine and a few things of which I had never thought. My digital camera at the ready as always, I snapped pictures of everything to ensure I wouldnt forget the experience; I needn't have worried.

    The first bite was a cross between shrimp and french fries, crunchy on the outside with a chewy salty center that was actually rather pleasant on the tongue. The stinger while intimidating at first, was actually the easiest part and only pricked my tongue slightly while being consumed. Thankfully, no acupuncture was needed to heal me afterwards, though I am sure any of my fellow classmates would have been more than happy to put our newly accquired knowledge to good use should my qi have needed correction.

    On my return to the states, I posted all the albums and journal entries on my blog where the friends I made on my travels could see the adventures we had shared like bento boxes at the summit of Mount Fuji, fresh caught seafood on the banks of the mekong river in Thailand, paella and rioja at a tapas bar in Madrid and many others. (do i come off as too pushy here?-if so, nix this paragraph)

    I view life as an adventure, and among my goals is to visit every continent at least once and learn about its people, places and cultures while I am there. I hope to one day be able to combine my love of traveling with the career I have chosen for myself, and participate in medical missions which will allow me to interact with a place's inhabitants as more than just a tourist, providing services in exchange for the opportunities I have been given to explore the world around me. At the very least, I can discover if everything really does taste like chicken.

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