wondering why i’ve got this urgency,
all that i yearn to be is right in front of me,
i’ve maintained courtesy to nth degree,
and now it’s my turn to go out and get it,
so i run full speed like towards the 45 kipling bus
when we were seventeen, and we saw it rolling up,
yeah i’ve got issues with trust,
yeah i’ve got issues with lust,
spontaneously combust, need no lighter
for this fire, we aim higher
than thought possible,
white coats, donned in hospitals,
expectations, we’ve got lots to fill,
we get lost at will, i’ve seen lots of real
turn fake, pile too much onto plates,
too much emphasis on fate,
this is our place, this our time,
this is our shine, and it’s not
dependent on jewelery or sunlight,
this is within, this is from soul,
this is from cell, this is nucleus,
this is realness, i can’t appeal to this
demographic, i used to think i couldn’t hack it,
but the fact is we’re all actin,
they’re all actors, where we act sure,
when we lack cures, where we act like
we all rap tight, when we lack right,
this aint black and white, this is real life,
this is the discarded blue boxes
of blockbuster videos, this is
thrown out mixtapes containing
high school flows, this is home phones,
this is loonies spent on speakers corner segment,
this is respite, these are my confessions
there are still lessons to learn,
used to burn all my mistakes,
but the only way to elevate
is to criticize, so now i analyze,
realize that our demise
is ongoing, foreclosing, impending,
but the ending is still under revision,
make each decision, with finality
don’t underestimate gravity,
levity and brevity are dead to me,
we grew up on mase and diddy,
so forgive me if i act hypocritically,
you’ve yet to see, the best of me,
this isn’t just a test to me,
this is everything, this is all of me,
all i want to be, is satisfied,
keep these struggles in perspective
with the end in mind.
Here’s the news I’ve been aching to tell you all about.
I teamed up with ObizMedia to create this infographic about physician salaries and costs of education (financial and time related). It’s been under wraps for a few months now and is finally ready for release!
Head over to my blog, MD Salaries for more information.
update: reposting this as a photo post for easier viewing for my tumblr readers.
Great infographic is great. In summary: don’t go into medicine if you wanna get rich.
Seriously. If you don’t believe doctors and med students who tell you that they do it for the love, not the money, listen to the numbers. We do this for us and for others, not the dollar. And I’m damn proud to say that!
How can residency programs help trainees address conflicting emotions about their professional roles and cultivate a curiosity about their patients’ lives beyond their diseases? We drew on the medical humanities to address these challenges by creating an intensive writing workshop for internal medicine residents.
To help participants become better physicians by reflecting on their experiences and on what gives meaning to work and life. This paper describes the workshop and how residents were affected by the focus on the craft of writing.
A group of 15 residents from 3 training programs affiliated with 1 institution.
We engaged the expertise of physician-writer Abraham Verghese in planning and facilitating the 2 and one-half day workshop. Residents’ submissions were discussed with a focus on the effectiveness of the writing. We also conducted a focus group with participants to evaluate the workshop.
Themes in the writing included dysphoria, impotence of the physician, and the healing power of compassion. Our focus group data suggested that this workshop served as a creative outlet from the rigors of medicine, created a sense of community among participants, enhanced both self-awareness and awareness of their patients’ lives, and increased intra-institutional and extra-institutional interest in writing and the residency program.
Teaching creative writing to residents in an intensive workshop may deepen interactions with peers and patients, improve writing skills, and increase interest in writing and the residency program.
July is coming, and in the US that means a new batch of nervous and inexperienced interns handling a large proportion of medical care for hospitalized patients… which likely contributes to the July Effect: a “10% spike in fatalities in teaching hospitals in July.” So don’t get sick enough to be admitted in July… if you can help it!
But regardless of when you are in the hospital, there are things you can do to proactively avoid common medical mistakes. Here’s a summary list (read the linked MSNBC article for the full details).
- Ask about your hospital’s infection rates.
- Check your doctor’s experience.
- Avoid elective admissions/operations on nights, weekends and holidays.
- Ask about the hospital’s use of electronic medical records to avoid errors.
- Bring your own pill bottles (not just a written list of drug names).
- Request blood-clot prevention (and screening, if you’re high-risk for clots!)
- Involve your family/friends as advocates for your care.
- Have your surgeon review the surgery with you just before the procedure.
- Help the nursing staff keep track of your important details that could be overlooked during shift changes.
- Demand (politely!) that people wash their hands before touching you.
- Ask for your room to be regularly disinfected if you’re staying for more than a couple days.
- Avoid “germ magnets” (elevator buttons and doctor’s ties/necklaces are often overlooked!).
- Avoid falls by asking for help and/or wearing skidproof socks.
Cranquis Big Apple Treasure Hunt: Track 4
Cranquis Big Apple Treasure Hunt: Track 3
Cranquis Big Apple Treasure Hunt: Track 2
When I was on my OB/GYN rotation 3rd year, I had a post partum patient who was in the ICU. She went nuts on some people, went in to early labor, and then went into a coma. No one really knew what was wrong with her. She had been tested for and had ruled out nearly everything, and her doctors were still stumped.
She had very little family and no one ever came to visit her. As a result of her frequent fevers, developing C/S wound infection, and profuse sweating, she smelled pretty sour. Her hair hadn’t been washed or combed in quite some time. Her smell plus her contact precautions status made it so that people only went in her room if they absolutely had to.
“Two gun shot wounds,” the emergency medical technician says, breathing fast, the summer night pouring down his face. “One in the right flank, one in the right thigh.”
“I don’t want to die, doc,” pleads the victim, whom I will call Mr. Smith. His vital signs are stable.
“This is the trauma team,” I say. “We’re going to take good care of you, but we need to ask lots of questions.” I press my stethoscope to his chest. “Can you take some deep breaths?” I listen for the airy hollow of a punctured lung but am calmed by the hum of normal respiration, even as his alcoholic breath warms my cheek — or so I believe. He denies drinking, but this is one of those overnight shifts when everyone — motor vehicle crashes, chest pains, depressions, confused grandmas, even rashes — has thrown back one or two.
Once inside, we palpate Mr. Smith’s neck, chest, back, abdomen, and muscular extremities. “Does it hurt here, and here, and here?”
He doesn’t answer us. Now he acts annoyed and bothered. “Call my cousin,” he says.
“Sure,” I say, “after we make certain you don’t have an injury that needs immediate attention.”
“And you are?” he says.
I’d already introduced myself, but I know what he means: Who am I in the hierarchy? “I’m the doctor in charge,” I tell him.
“Good,” he says. “Go call my cousin.”
“First things first,” I say.
“Hey, douchebag,” he says, his voice hardening. “Call my cousin.”
I pretend the comment was what he might, on reflection, consider a regrettable slip of the tongue. But his head arches off the stretcher and his eyes meet mine. “Now, douchebag.”
I feel the heat of the trauma team’s averted gazes. I say nothing, but inside, I grasp at explanations. He’s been popped with two bullets. Maybe he’s scared, anxious, emotionally shocked. Or he’s a thug, a power-fiend, and now he’s vulnerable. He distrusts authority. Perhaps he is drunk, his tongue greased.
He refuses intravenous fluids, blood draws, x-rays. “Let us take care of you,” I say, proffering shared control, thinking he’ll soften up and participate. “You don’t want to die, do you?”
“I’m not afraid of dying,” he says, despite his plea on arrival. “Listen up, douchebag. Are you calling my cousin or what?”
I swallow hard. The ache in my stomach will ease somewhat when I find time to eat my tuna sandwich. But the frustration feels bottomless — untouchable and undeniable. “What gives you the right to talk to us this way?” I finally say.
He stares me down. I tear the blood pressure cuff from his right bicep.
“I’m not fighting you. Many patients are waiting to be seen. You’re free to go if you want.”
He stares at me. “I’m calling my lawyer!”
“Good luck. We’ll dress those wounds before you leave.”
A simple technique dramatically improved the memory recall of Harvard Medical School students. Try it for yourself!
Turning a medical student into a doctor takes a whole lot of knowledge. B. Price Kerfoot, an associate professor of surgery at Harvard Medical School, was frustrated at how much knowledge his students seemed to forget over the course of their education. He suspected this was because they engaged in what he calls “binge and purge” learning: They stuffed themselves full of facts and then spewed them out at test time. Research in cognitive science shows that this is a very poor way to retain information, as Kerfoot discovered when he went looking in the academic literature for answers. But he also stumbled upon a method that really is effective, called spaced repetition. Kerfoot devised a simple digital tool to make engaging in spaced repetition almost effortless. In more than two dozen studies published over the past five years, he has demonstrated that spaced repetition works, increasing knowledge retention by up to 50 percent. And Kerfoot’s method is easily adapted by anyone who needs to learn and remember, not just those pursuing MDs.
Also just a bit of advice for exams - it always helps to study as if your exam is all essays, instead of multiple choice. Studies have shown that students who study for essay exams do much better, and remember more.