April 16, 2014

Anonymous asked: Hi! I'm so happy I stumbled upon this blog. Can you please tell me if choosing a different major other than a life sciences undergrad is really important? I mean do med schools really care about that? Do they like English majors? If you don't mind, where are you going for med school, what do you want to be, and what did you choose as your under grad major? Thank you!

Hi back at ya! I’m glad so glad you stumbled upon this blog too ;) Hope you enjoy it!

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Med schools like well-rounded applicants - so basically what’s important is choosing a major that you’re interested in. You can be an English major and still be on the pre-med track. I’ve answered most of these questions in this previous post.

I’m currently attending the University of Medicine and Health Sciences in St Kitts. The same school compoundfractur attends. I’d like to be a pediatrician and a writer of sorts. My undergrad major was Biology, and I did a minor in English. I also went to grad school for English Lit.

aspiringdoctors majored in the arts in undergrad. And if I remember correctly, I think baffledinbrooklyn had majored in something music related?

So go ahead, and pursue what you love! You can have your cake and eat it too the best of both worlds!

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April 14, 2014
"We choose to go to the moon. We choose to go to the moon in this decade and do the other things, not because they are easy, but because they are hard, because that goal will serve to organize and measure the best of our energies and skills, because that challenge is one that we are willing to accept, one we are unwilling to postpone, and one which we intend to win, and the others, too."

— John F Kennedy - Moon Speech at Rice Stadium, 1962

March 30, 2014
Stream of Consciousness

The following is a teaser, perhaps from the 'I See How Your World Shakes' series, which is a continuous work in progress…

Problems of being an introvert. Eating cookies and stressing away. Retrospect. Introspect. Don’t be shy, speak up. No Professor Arrogant, Pinenut did not do the dissection. It was me, can’t you see? Can’t you see? She tore away my ascending cervical. Said she was “cleaning it up.” Pinenut, you just ripped our ascending. Who me? No, she says. Sigh. Our dissection does not need cleaning. Clean your side, not mine. Look at the superior cervical ganglion I found, she says. But no it wasn’t you. It was my group that cut yesterday. Very nice, says the professor. I stare down. Pinenut points to me for a split second. Yes it was me. Can’t you see? Can’t you see? No, of course not. I’m not working hard enough. Drink more coffee. Doesn’t matter. More coffee. Another cookie. I had studied for that last exam. But nothing to show for it. Take a break. Internet not working. Can’t watch, can’t Google. Where’s my Kindle? Crumbs in my book, crumbs on my lap. Can’t take a break, can’t take a break. Nothing works. Nothing’s right. Island life. Med life. If only. You could have done better. The past. Stop sleeping. Speak up. Chocolate chip cookie. Everything’s crumbling. Matches the coffee stain on the page. Look there’s the tear drop that smudged the letters of those antibiotics. Yes, my lacrimal glands are working. So many words. Too many words. Blurred vision. What future. Always working. No shortcuts. But never any credit. No credit. Doesn’t matter. No, I’m not working hard enough. Read, study, memorize. Understand. More pictures, more slides. No Professor, nothing’s ailing me. I just don’t know what’s wrong with my brain. Histology. Pathology. More “-ology”. Don’t panic, the good professor says. But I used to be top of the class. I won’t panic. You can do it. Speak up. Don’t be shy. Think of all the patients you can treat. Think of all those smiles. Everyone looking up to you. Big sister. Retrospect. Introspect. Meibomian glands. The ascending cervical is gone. Because that’s the way the cookie crumbles.

March 15, 2014
Malcolm Gladwell: Tell People What It's Really Like To Be A Doctor

wayfaringmd:

Pre-meds and med students, take notice. This is 100% real life. 

The only statement I can disagree with in this article is “Most nights, physicians go to sleep fulfilled and grateful for the honor of becoming a part of their patients’ lives.”

Most nights, I go to sleep tired. Real tired.  

Truth.

March 12, 2014
Do they teach fear in medical school?: Clinical anecdotes

mdorbust:

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"Self portrait with Dr. Arrieta," Francisco Goya, 1820.

One

Wendy Smith* had thinning hair, penciled in eye-brows, and a frame so thin that you could see, in painstaking detail, the bluish-grey veins underneath her pale skin. Cancer had taken so much from her that she almost didn’t look human.

But the feeling in the room was extremely human. Fear. Palpable fear. Fear made all the more palpable because this was an aggressive, rare form of cancer. Fear made all the more palpable because she was only in her early 30s. Fear made all the more palpable because the cancer had been discovered during postnatal care following the birth of her first child.

Motherhood…and chemotherapy.

It was hard not to detect a little desperation in her husband’s voice as he kept asking about new, experimental treatments he had read about in his own research. It chills my blood to think that the notion of single fatherhood has probably crossed his mind.

Two

Susan James* was older and had already experienced breast cancer, which had reoccurred several times after several lumpectomies. The cancer has now reoccurred. This was not the reason for today’s visit.

Today’s visit was to tell her about the tumor in her bladder.

Her visage was blank, almost hollow. The word “surgery” snapped her out of her shock. Waving her hands, tears welling in her eyes, she said she didn’t want to hear about surgery; she didn’t even want to think about it. She had been under the knife already, a half-a-dozen times, endured radiation, chemotherapy, and now she had to consider surgery to remove her bladder—it was just too much. Too much, at least for today. The doctor, wisely, pulled back, consoled Susan, and urged her to go home, be with family for the holidays, and maybe even take a vacation. Decide in the new year. No rush.

Three

John Peters* was different. A veteran of cancer fights, with the scars to prove it, John was nonchalant about his medical condition, nodding along to some of the doctor’s medical jargon (which I should note she only used due to her relationship with the patient, and her recognition of his acquired expertise), and tossing out some of his own. As we left the exam room, he casually asked for a syringe with some saline solution, so that he could flush out his own nephrostomy tube, which, he noted in a matter-of-fact way, had become clogged after bleeding from his kidney.

The distance between Susan and John is remarkable. I cannot imagine myself ever advancing past denial and disbelief if and when I am diagnosed with cancer. Given its prevalence, and my own family history, I can’t help seeing this as an inevitability later in life. But I’m going to be a doctor so nothing bad can ever happen to me.

Hmmm…

Soapbox

There is a tendency, on the part of some, to dismiss patient-centered care—being “extra-nice” to patients is itself a nice concept, but ultimately irrelevant, and even naïve. I’ve sensed this attitude not only from practicing physicians, but also from fellow students. Intellectually, I know I should respect this view, just as I expect my more humanistic take on medicine to be given credence…

March 1, 2014
It's that time again! MedWAR!

lifealamed:

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***REGISTRATION IS OPEN!*** & ends March 15th!

MedWAR, also known as the Medical Wilderness Adventure Race, is a competition that combines wilderness medicine and racing. Teams of four compete to see who can finish first. The teams will have put their minds together and
find solutions to the many medical scenarios constructed throughout a course, which involves running, hiking, biking, and canoeing. MedWAR is an annual event created and coordinated by Medical College of Georgia students and emergency medicine physicians. Now in its fourteenth (or fifteenth? something like that) year, it has expanded to a series of races in the US and Canada.

I was one of the administrative directors for the race last year, in charge of advertising & helping plan the medical scenarios (which are always Awesome by the way), & I’m helping out again this year! Pass this along to anyone who is interested or let me know if you are!! 

Special note to the anon docs/med students I follow: You guys are amazing and I respect your anonymity. Feel free to sign up / e-mail me and let me know you are interested. No need to let me know how you heard about it or let me know your alias, I just want you to enjoy the race!! 
Contact me @ lmalone@gru.edu if you’re interested!! OR just go ahead and sign up ;)
A note: Anyone can participate :) So bring it on.

You can also go to the website (http://www.medwar.org/southeast/) or facebook page (https://www.facebook.com/medwar.southeast) to see more about the event. OR if you’re in a different region, check out the website for the race near you!


More info below the cut:

Read More

As I said last year when signal-boosting this event — I would totally do this if I had the time…

OR MAYBE I’LL ACTUALLY BE THERE THIS YEAR, UNDER MY REAL IDENTITY, AND NOBODY WILL EVER KNOW.

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(Kind of a reverse April Fool’s prank?)

February 27, 2014
Medical school gig a healthy challenge for actors

February 21, 2014
I am just a medical student.

docedace:

She’s 58, but appears maybe three days older than 42. Her eyes are sunken, tearful, worried, anxious.  She tells me about her two grandchildren, and how she just visited them in Michigan.  She came to the hospital, straight from the airport.  She’s worried.  

She’s worried because her shortness of breath hasn’t gone away for over a month now.  She has had breast cancer, and opted for a more conservative approach - a lumpectomy with axillary node biopsy without radiation.  She’s admitted, and gets a chest x-ray and a CT scan, which show a pleural effusion with what looks like nodules in both lungs.  ’Likely represents metastatic disease,’ reads the official radiology report. She knows, so I don’t bring it up again.

'I am just a medical student,' I think. 

On the second day, she undergoes surgery to evacuate the effusion, and her lung is biopsied.  Now, we wait for the pathology report.  I visit her everyday as we wait, sometimes two or three times. I’ve met her husband, and we know each other by first names.  Her daughter and son are also beautiful people, just like her.  They ask me questions, and I keep my answers limited to what I’ve read in the chart. They never ask me about the cancer. They know what the radiology report said, so I don’t bring it up again.

'I am just a medical student,' I think.

She never complains. Not from post-operative pain, not from shortness of breath, not from coughing, not from anything.  I take my time with my physical exam, ensuring that I don’t miss any tenderness.  I don’t want her to suffer unnecessarily.  ”Surgery is painful,” I tell her, “make sure you let us know if you are in pain.”  She agrees, but never complains.  

The nurse corners me one afternoon, and asks me, “Is there any way to put in an order for morphine PRN for her?” 

'I am just a medical student,' I think.

"Why?", I ask.  

"Because when her family isn’t here, when she’s alone, she cries.  She’s in pain, she’s scared, but she’s a silent sufferer."

Oh.

I am the first person she sees every morning, and I try to make sure she’s comfortable.  I offer extra blankets, water, anything I can do just to make sure she is as happy as she can be.  She appears more and more cheerful, and I spend what seems like hours holding her hand and chatting about life, the weather, her family, my family, my future goals, my girlfriend.  I show her pictures.  We laugh. We smile. But her eyes remain anxious and worried. 

She says she likes my bowties, so I make sure to wear one everyday for her.  And I tell her, “I thought of you when I put this one on this morning.”  She smiles through those tearful, anxious, worried eyes.  I smile back. And that is enough to make my day.

I walk in with my bowtie and smile around 6:30pm. She just got back from the CT scanner, and her family is around her bed, as per usual.  I visited, just to say good-bye for the day.  The sun dips a few degrees further West, just enough to peak through the curtains, and her husband turns to me and says, “Edwin, thanks for bringing the sunshine.”

I stand there, in a loss for words, armed with little more than a bowtie and a smile.

'I am just a medical student,' I think.

"There’s something of yourself that you leave with every meeting with another person…" — Fred Rogers

January 23, 2014

Anonymous asked: Today I got the results of my exams to get into med school and I totally failed, I feel helpless, I can't stop crying and I don't know what to do. I just want to end everything, Im not srong enough to get up

Dear Anon,

Cry it out and let all those negative emotions go away.

Now, stand up and know that you are strong. I’m not sure if you’re talking about the MCAT, or maybe you’re in another country, but there is definitely no need to end everything. Think about all the hard work you’ve done to get where you are - you should be proud. Now just think about why you failed - evaluate the exam, how you studied, your exam taking skills, etc. You can definitely take the MCAT over again - talk to a professor and/or your pre-med adviser to get more help and advice on how you can improve.

Trust me, it’s not the end of everything - you just need to be confident and stay positive. There are plenty of people who have failed, and tried again, and succeeded into getting accepted into med school. Where there’s a will, there’s a way - if medicine is your passion, you’ll find it in you to get the strength. You can do it!

Best of luck Anon! If you need to vent, talk, ask questions - feel free to use my askbox. But please, don’t do anything silly while you’re upset. A lot of times we wonder why things happen, and certain things seem like it’s the worst that can happen - but times always do look up - you just have to wait and work for it. And later, you might realize that something even better happened, that you never even thought of.

January 19, 2014
"Success is not final, failure is not fatal: it is the courage to continue that counts."

— Winston Churchill

January 18, 2014
The white coat ceremony: a contemporary medical ritual -- Huber 29 (6): 364 -- Journal of Medical Ethics

The white coat ceremony is a common practice at many American and European medical schools. Current justification for the ceremony is mainly based on the good will felt by participants and an assumed connection between the ceremony and encouraging humanistic values in medicine. Recent critiques of the ceremony faults its use of oaths, premature alignment of students and faculty, and the selective appropriation of meaning to the white coat itself. This paper responds to recent critiques by addressing their misconceptions and arguing that the white coat ceremony is a contemporary medical ritual with a key role for students and faculty in developing a professional identity.

Since its inception in 1993, the white coat ceremony (WCC) has become a national and international phenomenon. It is now practised at the beginning of the year at more than 100 American medical schools and is supported by foundation grants dedicated to endorsing and encouraging professional development and humanism in medicine.1 While some literature addresses the symbolism and history of the white coat itself, few sources consider the meaning of the ceremony.2–4 A common appeal is to the emotion and good will felt at the event.1,5 Although feelings are important, a deeper justification is called for.

Criticism of the WCC is more explicit, charging that the ceremony: (1) uses the Hippocratic Oath inappropriately or, at best, prematurely; (2) fosters improper student faculty relationships, and; (3) interprets the meaning of the white coat selectively.6,7 Critics suggest either that students not be asked to swear an oath together because it might conflict with personally held beliefs, or that students not be allowed to take the oath until they have demonstrated competence as physicians.6 Some also say that the WCC aligns students with faculty and against patients.6 The third category of criticism asserts that the historico-anthropological meaning of the white coat itself includes more than virtue and humanism and, in fact, represents an imbalance of power, separatism, entitlement, and paternalism in medicine.3,7 To address only the positive connotations of the white coat in a ceremony is deemed disingenuous.

Though critics have suggested that the WCC is misused, improper, an affront to professionalism, or even unethical, these objections have serious flaws of their own.6,7 I will examine three criticisms and, in response, offer an interpretation of the WCC as a contemporary medical ritual that holds a beneficial place in the professional development of a medical student.

January 18, 2014
White Coat Ceremony

Some quotes on the history of the White Coat Ceremony - it all started out to distill the values of compassion and ethics in medicine.

The involvement of The Arnold P. Gold Foundation in what we now call The White Coat Ceremony actually began at commencement exercises at Columbia University’s College of Physicians and Surgeons, where Dr. Arnold Gold has been a teacher and pediatric neurologist for more than forty years.

The Gold Foundation initiated commencement awards in 1991 for a faculty member and a student who best demonstrate both humanistic care and clinical excellence. In support of the awardees, Doctors Arnold and Sandra Gold regularly attended graduation exercises at Columbia where it is customary for medical students to recite the Hippocratic oath. This noble 2,500 year old tradition obligates new doctors to high professional standards for patient care and the practice of medicine.

Dr. Gold became aware, as he witnessed Columbia’s graduation ceremony each year, that the recitation of the Hippocratic Oath, when students accept the obligations of our profession comes four years too late. It is during medical school that students experience their initial contacts with patients and establish their professional orientation. The Foundation believes that medical students should be given well defined guidelines regarding the expectations and responsibilities appropriate for the medical profession prior to their first day of education and training. This is what inspired the Foundation to begin advocacy and sponsorship of what has become the “White Coat Ceremony.”

Providing a ritual to mark the passage of the student into our medical society is as old as the Hippocratic Oath itself. Hippocrates administered the oath to students before their medical studies began, not after they were completed.

(x)

The Arnold P. Gold Foundation designed the White Coat Ceremony to welcome entering medical students and help them to establish a psychological contract for the practice of medicine. The event emphasizes the importance of compassionate care for the patient as well as scientific proficiency and includes several elements:

  • Welcome to the profession of medicine by the Dean and Faculty
  • Recitation or discussion of an oath (such as the Hippocratic Oath or a student-written oath) which represents the public acknowledgment by the students of the responsibilities of the profession and their willingness to assume such obligations in the presence of family, friends, and faculty
  • Cloaking of students in their first white coats
  • An address by an eminent physician role model
  • Celebration at a reception with students’ invited guestsThe White Coat Ceremony was initiated on August 20, 1993 at the Columbia University College of Physicians & Surgeons. Grants from the Robert Wood Johnson Foundation in 1996 and 1997 made future and widespread advocacy of this celebratory and solemn event possible. Currently, a White Coat Ceremony or similar rite of passage takes place at more than 90% of schools of medicine and osteopathy in the United States, as well as at all four medical schools in Israel.

The White Coat Ceremony was initiated on August 20, 1993 at the Columbia University College of Physicians & Surgeons. In 1994, New Jersey Medical School held its first annual White Coat Ceremony, becoming the nation’s second medical school to do so. Grants from the Robert Wood Johnson Foundation in 1996 and 1997 made widespread advocacy of this celebratory and solemn event possible. Currently, a White Coat Ceremony or similar rite of passage takes place at 96% of AAMC-accredited  schools of medicine in the United States, as well as at osteopathic schools of medicine and at schools abroad in Antigua, Australia, Canada, The Dominican Republic, Grenada, Haiti, Israel, Japan, Lebanon, The Netherlands, Pakistan, Qatar, and South Korea.

At the ceremony, students are welcomed by their deans, the president of the hospital, or other respected leaders who represent the value system of the school and the new profession the students are about to enter. The cloaking with the white coat—the mantle of the medical profession—is a hands-on experience that underscores the bonding process. It is personally placed on each student’s shoulders by individuals who believe in the students’ ability to carry on the noble tradition of doctoring. It is a personally delivered gift of faith, confidence and compassion.

(x)

January 13, 2014
Too Cool for School. Just Kidding.

It’s back to med school,

This time I ain’t a fool.

No time to dream and drool.

Heck yea, all this is cruel,

But y’all know I’m cool.

December 10, 2013
Finals Week - Crush Those Exams

It’s finals week/hell week and everyone is stressing out about exams and papers. Word of advice: stay positive!

Looming exams are always frightening, but don’t let that get in the way of motivation. Braving it through thick and thin always makes the end so much sweeter. (Also, I suggest studying as if your exam will be essay only, not multiple choice - you learn better that way).

Go into the exam knowing you know what you know (does that even make sense?)

Don’t over think on questions. Your gut instinct, and your first choice, is almost always the correct answer (on multiple choice exams).

And when you’re done, you’re done!

There’s no need to brood over what could have been, and should have been. You tried your best and if it didn’t go so well, you can learn from your mistakes. Things can sometimes seem really bad at the moment, but it always gets better. And whatever happens, probably happens for a reason anyway. And now you can relax!

December 6, 2013
Cranquis Mail: All I Want for Christmas (Residency/Med School Edition)

Hello Dr.! As Christmas season is coming up, what sort of gifts would you recommend to help improve the well-being and life-enjoyment of a pediatric resident? She loves to read and enjoys beauty products, so I’ve considered a few books (I wouldn’t mind some more recommendations) and hand creams (to soothe that constantly sanitized skin), but I was wondering what other ways I could help make her life a little less stressful? Thanks so much!

What a terrific question! I’m gonna ask my medical Cranquistadors to please add their own suggestions to this post (since I usually just buy whatever was rated the highest on the other person’s Amazon wish list, BOOM finished, moving on).

But for what it’s worth, Dr. Cranquis would consider these Potential Holiday Gifts for Residents (and Med Students too!):

  • Books: healthcare-related books (memoirs, fictionalized, history, political, etc.) are an obvious choice, and you’ll find quite a few recommendations from me (and from Cranquistadors!) in my #books tag. As for non-healthcare-books, that depends on your knowledge of your friend’s tastes — and whether you think that receiving a “just for fun” book will just rub salt in their wounds as they reminisce about the days when they actually had time to read something that didn’t have Latin anatomic terms in it. :)
  • Media (movies, music, Netflix subscriptions, etc.): Sometimes all your numbed post-call brain can handle is a few hours of Battlestar Galactica or Monty Python. (Or maybe they can watch ‘em while they’re ON call, if their call-karma is way better than mine ever was.)
  • Gift Cards/Cash: Most med students and residents live on a combo of loan money/paltry stipends + gifts from friends and family. Gift cards to coffee shops, bookstores, shoe stores, big-box stores, and good old Amazon are fantastic! Even a roll of small bills for vending machines will make a resident smile. Don’t worry about the “But giving money is so impersonal” argument — they will appreciate it and USE it.
  • On-Call Hygiene Products: Travel-size personal grooming-kit items (or an entire kit, if you want to go all out) are so handy when you’re doing all your grooming in the hospital! Sometimes, the only thing that keeps you going at 4 in the morning (the Dead Zone between admitting the last patient and starting pre-rounds on all the other patients) is two minutes in the bathroom to brush your teeth and apply another layer of deodorant.
  • Drugs: (No, not THAT kind of drugs). Despite working in a hospital, residents who need pain relievers/anti-histamines/gas-reducers/antacids for personal use are usually out of luck! Toss a few handy OTC meds into that grooming kit.
  • Mugs: You can never have enough (spill-proof, easy-to-carry/clean) containers for hot stimulating beverages.
  • Pens: Yeah, yeah, we’re all “paperless” and “electronic” in healthcare now. Whatever — our clinic printer goes through more paper now than it ever used to before EMR. So pens are ALWAYS needed by/being stolen away from students and residents. Find out if they prefer the “click” (YES!) or “uncap/twist” (BOOO!) style. Only buy black pens (medical records have to be in dark color ink, and some facilities don’t allow even blue). No felt-tips (can’t write through carbon-copy forms). No fancy/engraved/expensive/meaningful pens (didn’t I mention these things get stolen all the time?). But not super-cheap-crappy ones (it’s considered bad luck to have your pen die in the middle of a call-night) (not really) (well maybe NOW it is).
  • Phone plug-ins (micro USB or Apple whatevers) or emergency quick-chargers: Having your smart-phone die while on call is like getting a surprise lobotomy. Anything which can prevent/remedy that situation is priceless!
  • Subscriptions to medical reference websites/apps (maybe): Some residency/med-school programs provide these for free, so check with your recipient before dropping $100+ on a subscription to Epocrates, Up to Date, etc.
  • Diploma Frames: Help them look ahead to the glorious day when all that they’ll have to show for these years of toil and tears is a really nice piece of paper and a sizable financial debt (well, and a lot of knowledge/skills, of course.)
  • Plane Tickets: Just in case your gift-giving budget is REALLY loaded. But be sure to either discuss the travel dates WAY ahead of time, or buy tickets with simple no-fees exchange/refund policies.

Hope that helps. Oh, and just for kicks, a few things which the average resident/student (probably) does NOT need/want for Christmas:

  • Scrubs: Either they already own enough, the hospital provides them, or they won’t dare to wear that uber-nice set you gave them around actual patients.
  • Medical Equipment: Exceptions exist, but for the most part, they already have a couple of functional stetho/oto/ophtho-scopes, and more tuning forks than the New York Philarmonic. However, if they plan to work in mission fields/under-served areas, extra equipment is ALWAYS needed.
  • Textbooks/Reference Books: They need to pick what works for them, without feeling guilted into carrying around that deluxe copy of Gray’s Anatomy (the book) you gave ‘em. If you really want to contribute to their medical reference library, talk it over with them first (or go with a gift certificate to a bookstore).
  • Phone card with a passive-aggressive “Try calling me more often next year” note: Med school is hard. Residency is hard. Right now, they need your support and your permission to focus on surviving, not your demands.

Any other to-give (or to-avoid) ideas, Medblr folks?

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