Friday, April 27, 2007

I am DO, hear me roar!

Michelle fights the good fight for OMM in her newest post over at Michelle vs the Med Student
*Despite what the picture suggests, no MDs are harrassed in this post. We love MDs!
(I just can't eat a whole one)

Mr. Falls Asleep During Everything Guy

Thursday, April 26, 2007

Type B-ness in the Clinical Setting

Poster: Jesse


So my HPS with Stan the human patient stimulator…fuck, no, simulator… encounter was so good today that I thought it deserved a posting.

We always have no idea what we’re doing in these things. Standing around outside, waiting for them to take us back, one guy, let’s call him Todd for now, Todd starts talking about how awesome it is that we never have an OTM lab again, and now he can rejoice in the fact that OTM doesn’t matter anyway. I tell him I’m going to report him to the OTM police. Female student number 2 shows up, we’ll call her, um, Lucy. Todd pounces on her, because she has brought her reflex hammer to the HPS encounter. And while Stan has a lot of things, he doesn’t have reflexes.

I chime in about how I brought my Bakerman’s, the little blue book with all the lab values in it, because I’m sick and tired of them giving us a patient’s chart and it meaning absolutely nothing to me because I haven’t memorized a million different normals. David, the course coordinator, and an awesome person, coughs under his breath “BS”. He clarifies that whenever a student goes in a starts racking off what they interpret normals as, more likely than not, it’s BS. This makes me in my type-B-ness feel a little better, because I just thought I was the only stupid one not to know the values, turns out I’m just the only one with balls enough to admit I don’t know the values.

Then Todd starts calling Stan a robot, which is a major no-no (They’re patients, not mannequins). First year it would have gotten you asked to leave. But I guess Todd is man enough now and is so ridiculously cocky that they put up with it and ignore it. He then asks David if we get to kill the robot today. David says no, but he’s now questioning Todd’s career choice.

Anyway, they get ready for us to all go in to the room. I’m thinking “fuck, somehow I was the first one to walk in to the room, now I’m going to have to act like I know what I’m doing.” I’m going to spare you the details of the exact case, no one who isn’t a med student really cares and I probably don’t remember enough of it to write it all down. But it is at this point that our true med student-ness starts coming out.

The doctor running the case is a hypertension-nephrologist specialist. Kind of like a person who specializes in using a salad fork, but only when its warm outside, a little too specific. He starts asking a bunch of questions, and everyone’s trying as hard as they can to get a word in, so they won’t have to answer something we have no idea about. Todd tries to answer everything, he eventually ends up being told to be quiet, some of the other students might actually have a clue too. I get excited when I get one (”What’s the best way to evaluate his renal functioning?” “BUN/Cr”), but like most of these labs are, I get pissed off because I know the answers to far more of them than I answer, I just don’t trust myself enough to say it quickly enough.

Dr. asks a question about what would cause a 20 year old to have elevated upper extremity pulses, but normal to low lower extremity. At this point, random Indian boy chimes in. Random because I have been in class with him for almost 2 years and have no idea what his name is. And have probably never heard him talk before this either. “Renal artery stenosis?” random Indian boy says. Major mistake, never answer a question with a question mark at the end of your statement. Dr gives him a slightly weird look. “No” Oh well, good try random Indian boy. The correct answer was aortic coarctation, which I of course thought of but wasn’t brave enough to say out loud.

Dr goes on to ask what would cause the same symptoms, but in a 70 year old. Random Indian boy uses a classic med student strategy, that his answer has to be right sooner or later, and this doctor is a nephrologist after all. “Renal stenosis.” Dr gives him a total wtf-who-are-you look. “No….why would you think that? Anyone else?” Random Indian boy says nothing else for the rest of the 45 minute lab. Todd gets the answer, aortic dissection. I almost start laughing because I think of Michelle saying “aortic dick-suction.”

Todd recommends we do an opthalmic exam, and of course that is exactly the correct answer. They put up a picture of what it would look like, and I want to punch Todd because he shouts out “papilledema” before I get a chance to. But then, Dr asks why papilledema, and I am the quickest to say “because the margins of the optic disc are blurred,” trying as hard as I can to sound confident and like that is the most obvious answer in the world. I get a very approving nod and repeat of my answer by the Dr. Take that Todd.

A little later on, we start talking drugs. I am a drug retard. I’m offering absolutely nothing to this conversation, except repeating other people’s answers and trying to act like I knew if to begin with. “Oh yeah, alpha 1 antagonist” etc. I’m almost afraid that I’ll look like the worst person in our group, but then I remember random Indian boy, who is now basically hiding in a corner behind me.

We leave the room and Todd complains about how we didn’t get to kill the patient.

Day in the Life of a Type B Med Student

From: Michelle vs the Med Student, entry: Type B Med Students...they do exist.

Poster: Michelle

All the med student bloggers eventually get a request to illustrate a typical day as a med student. They are all usually very scary, showing them engrossed in hours of classes and studying, capping the day off with a crying jag and a shot of jack daniels, pondering “Why God? Why am I doing this to myself?” Well, I’m not gonna say it isn’t really hard and the schedule can get crazy some weeks, but generally its doable. Here’s the day of a Type B personality in an ocean of Type A gunners-


12midnight- I am working on a quiz due tomorrow for Women’s Health. Its a bitch. If I knew it would take so long I would have started it before 10pm. But hey, I just literally spent the whole weekend studying for Boards (We had Kaplan Review for 18 hours). But ROXY IS HELPING us with the quiz.

1am- We call it a night. I set the alarm for 7am. Josh is already asleep. Tessy is at my feet. Roxy is snuggled up to my butt.

7am- Alarm goes off, I WAKE UP TO THIS. Roxy jumps on the bed and starts poking me. I lean over to turn off the alarm and just then she curls up on my pillow. This is a helpful trick of hers to make sure I get up to let her out. I throw on a robe and let the dogs out. I wash my face, gargle, and let the doggies back in. Fuck its cold!

7:15am- Heat up some coffee, pour a bowl of cereal, plop down in front of computer to check my e-mail. I read my Xanga subscriptions (Oh Ryan, you and your kooky birding stories) and read the latest blips of news (The dead duck came back to life!)

7:30am- Get dressed and make myself perrty (ok…presentable). Roxy always sticks her paws under the door. I slide my robe tie under the door and we play a little tug of war until I finally let go and I watch the tie disappear under the door.
7:40am- Start the car, I SEE THIS. Did I mention its fucking cold?

7:50am- Kiss the hubby, pet the dogs, head to class.

8am- DERM- I know, I know. Class at 8am? I say thats for chumps, or at least morning people, which I am neither, but we have a quiz at the end of lecture. At some point the Derm guys say “infucktion” instead of “infarction.” I nearly pee my pants. Not b/c I’m 5 years old, but b/c it reminded me of last night when I kept saying “aortic dicksuction” instead of “dissection” by accident.

9am-DERM again!- This time I know there is no quiz but the material might be on Thursday’s quiz so I halfheartedly listen while I write up some fake surgical orders. Anonymous mentioned his surgery professors might or might not be assholes…not sure :) … but mine has graciously decided to help people refine their order writing skills without us having to worry about points, so I’m trying to take advantage.

10am- There are two hours of Cardiology coming up and though this professor is quite foxy, she is also very easy to follow on Noteservice (a service we have here that records the lectures) and I am fading fast, so I head back home for a glorious 2 hour nap. Like I said, I’m not a morning person.

Noon- Wakeup, throw in a load of laundry and make myself a mac & cheese cup for lunch. Mmm triple cheese. I find this hilarious blog called Ah Yes, Medical School by Fake Doctor. I love his astute analysis of Gray’s Anatomy and description of the shame spiral that is medical school.

1pm- SURGERY- I love this guy. His lecture was called Wound Care but he ended up giving a whole lecture dispelling the myths of wound care techniques and the overprescription of antibiotics.

(1)Why do people use hydrogen peroxide instead of flushing it with saline? The only reason is b/c it burns & foams so people think it must work better!

(2) Do you order antibiotics when the wound is red, feels hot, has identifiable swelling, the patient reports pain in the area, the appropriate culture demonstrates a pathogen, the WBC is 13,000 w/ a left shift and the patient feels nauseated and weak w/ a 102 temp?Even after all this….NO! You must investigate all sources of infection other than wound, ie urosepsis.


1:50pm- We head to the OTM table at the front of the class and I crack Katie’s back. She returns the favor by popping a rib back into place. I hug her leg and bite her. Good OTM has that effect on me.

This is the only doctor I can think of that wears his scrubs to class. I notice this b/c not only is he a big guy talking about girl parts but they are colorful, patterned scrubs that he tucks in…barely. They almost don’t quite make it over the gut. Again, I normally don’t talk about people’s fashion sense or guts, (cuz of the landslide case of stone v. glass houses) but he occasionally will comment on how he understands the plight of pregnant women having the big abdomen in the way. I think more people would notice this kookiness about him if his voice wasn’t so rhythmic and monotone and utterly sleep indu…..zzz.

To wake up, I have Katie jump on me piggy back style and I run down the hallway with her on me. Effective as usual.

3pm- PHARM- I normally never EVER go to this class. Its all memorization and the slide packets are good enough, there’s no need to have them repeated verbatim to me. However, today we had a special guest speaker from St. Louis College of Pharmacy about anti-microbials. It was the same kind of lecture we normally get, but with a new, younger face and the slides were tinted periwinkle blue. You know. To liven things up. Woo. I half-heartedly listen as I nerd around on my pda.

3:50-I’m FREE! I run to the post office and bank, then head home. ROXY IS WAITING. She has jumped up on the back of the couch to greet me at the window. I come inside, set down my shit and let the dogs outside. I grab a quick snack, change, and head out to meet Katie at the gym.

4:30- WORKOUT-
30 min on the crosstrainer, then 3 sets of legs alternating with abs, then 3 sets of arms alternating with back. Katie & I have been trying to work out everyday we can. This sedentary lifestyle threatens to jump me a pant size higher but being the poor med student I am, I can’t afford the new pants, so I’m trying to keep the bootie in check. Workout plans have never worked for me until I found a good buddy. Though I have to thank Sandra for getting me going. BTW, she’s back and doing pretty well considering.

Back home. Throw some chicken in the oven, corn on the stove and hop in the shower. By the time I get done, the meal’s ready. I plop down in front of the computer and watch last week’s Gray’s free off Did I mention the fact I don’t have TV? I’m poor and I don’t feel like paying to lower my grades, but I am more than happy to catch the occasional tivo’d House or American Idol at a friend’s house :) Speaking of which…

7pm- Head over to Peacock’s to study for the Ortho test tomorrow. We get through the practice tests and end up watching American Idol and Frisky Dingo. What? You’ve never heard of Frisky Dingo?!


Now watch part 2 of episode 1

Others:”Please don’t kill us?”
Killface: “Don’t make it so appealing!”

11pm- Peacock’s husband is back from work, and mine will be too pretty soon. I head back home, start studying some of the finer points of Ortho. The dogs are chilling out.

1am- Off to bed. I set the alarm for 7am. Got that test at 8am after all. I fall asleep to thoughts of ORIF. Tessy is at my feet. Roxy is snuggled up to my butt.

The post that started it all

From the blog, Michelle vs the Med Student, entry: A Convo with Another Type B

We're here with guest Type B Med Student...Katie!

Michelle: Katie, its 11:38, I gotta get in my post for the day...fuck it...I think you should guest post.

Katie: I don't have anything to say. What do you want? How about, I like twinkies. Oh, and Michelle gave me a bad breast exam today, but that was intentional. The bad part. Well I suppose the breast exam was intentional as well.

Michelle: I'm writing this down. And embelishing.

Katie:, Yes! For the record I like other things than twinkies. Like peanut butter. LOTS of things. And my dog Baxter here [actually my dog Roxy who is nibbling on Katie's knee]

Michelle: And bacon.

Katie: I do love bacon. I bought veggie bacon. Its flavored like bacon, it does not have bacon-y texture......Roxy has eyebrows kinda. Like if you combined eyebrows and're still writing? At some point this has to end.

Michelle: I'm not saying anything anymore, just typing.

Katie: Ya, you should tell them how med school is like that Mario video. Going along, going along, oh fuck! Invisible block! This is worse than an RL Stine book!

Michelle: Its worse than Ann Coulter.

Katie: Who builds a castle with an elevator to a fire stick!...Tessy is licking her paws. [she's not allowed to do that]

Michelle: She does that stealthily, like with a toy as a decoy...Katie, I told you if we ever record our conversations we'd sound high...well, we should mention Jesse in this. And also our master plan.

Katie: Ya Jesse, she has the bigger boobs but did not get a bad breast exam.

Michelle: I couldn't handle 'em.

Katie: I don't think you're ready for this jelly.

Michelle: Well anyway, master plan. A very cunning plan actually.

Katie: How cunning is it?

Michelle: Its so cunning you could put a tail on it and call it a weasel.

Katie: That is cunning...[giggles] I saw you type Kat-o.

Michelle: Yes, lets go with that.

Kat-o: I did that to myself.

Michelle: ANYhoo, cunning plan.

Kat-o: Yes, please enlighten me with your typing.

Michelle: You & Jesse said you should guest post sometime, so I was thinking
that at the end of boards, we could just a launch a site together. Call it Type B Med Students.

Kat-po: Yes we are....AH, my name is getting is worse.

Michelle: Aw Kat-po, we were able to document when we came up with your new name. Kat-po.

Kat-po: Oh god!

Michelle: Well Jesse's is Peacock, and Jesse's phone named me Micahihi.

Kat-po: And Big V

Michelle: I tried to get "V" on my UAAO convo name badge but they didn't do it. Some guy got "Iceman" though. Dammit.


Michelle: ....

Kat-po: [starts laughing again] I didn't even say anything, you just kept going so you could type kat-po again.

Michelle: It is pretty sweet. Wow, we've outdone ourselves for ridiculousness.

Kat-po: Truly.