via Medical students request, participate in legislative course.

More self-adulation information on my class.  I’m in the second photograph, and we CLEARLY are NOT POSING.  Bah, hum-bug.

Since I’m the VP of MCG’s Southwest Campus, I was briefly interviewed for this story.  I hear that I was on local TV…I apologize if I looked tired and sounded sorta out of it.  I don’t do well in front of cameras (yet). But I guess we’re working on that, right?

I’m quoted in the news story, but there’s a spelling error.  I must not have spelled my name distinctly enough.  Oh well.

So, I’ll blog about other random things, still weighing in on some medical issues.  I’ll just not be summarizing my experiences, especially the bad ones.  Hence, I’ve started the new mini-series on music and musicians.  I hope I’ll have time to continue that one.

Thanks for understanding.

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I was introduced to this song by a friend of mine that I worked with on my OB-GYN rotation here in Albany.  A great song with great words.  I’m not a huge fan of Tenth Avenue North, but the lyrics of this song are quite powerful.  My favorite part?  “Sparks will fly as grace collides with the dark inside of us, So please don’t fight this coming Light, let this blood come cover us. His Blood can cover us.”

Not bad music either, actually.

Just the song, with the lyrics.

And the story behind the song. Never heard the story until today, but he has alot of good things to say in these 3:42.

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Edited to add:  Sorry that these videos cannot be played here on my site. You have to go to YouTube to see them, but it’s worth it, in my opinion.  Feel free to return to comment (but these aren’t my videos).

What do you think?  Become a commenter!

It’s one more reason, seen personally by Yours Truly, that I cannot in any way agree with elective deliveries away from a recognized health-care institution.   (Now don’t you”natural people” go get all upset at me.)   Simply put, a shoulder dystocia is defined by the anterior shoulder of an infant becoming entrapped behind the pubic symphysis, thereby disallowing a normal delivery.  So there you are: baby is not moving anywhere, its head is saying “hello world” (fetal distress is, needless to say, strongly present) but shoulder is stuck securely behind the maternal pelvis.  So, third-year-medical-student, what do you do?  A simple easier-said-than-done process:

1. DO NOT TRY THIS AT HOME, OR ALONE, OR HOME ALONE. BADBADBADBAD!!!!
2. Pray. Seriously.
3. Check your pulse. The first pulse to check in any emergency is your own.
4. McRobert’s Maneuver.
5. Suprapubic pressure. That’s PRESSURE, not a light touch.

Yup, glad I read about that before it jumped me all-of-a-sudden yesterday.  Scared me to pieces,but I’m SO GLAD there was someone with more training than I in the room, quarterbacking the situation.

It gave me time to check my pulse.

No grins.

Resolution: Baby lived, but took a few minutes several seconds to show any signs of life.  I’m getting practice at swallowing my heart.

Relieved smile.

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NEWSFLASH #1.  Obstetrics has a litany of things involved in it that aren’t pretty, or fun to deal with.  It has its exhilarating moments, sure, but it’s not all fun and games.

NEWSFLASH #2.  Gynecology is not entirely an enjoyable field either.  There’s…never mind, I won’t go there.  Just believe me.

NEWSFLASH #3.  I’m enjoying OB-GYN more than I thought I would, but not enough to do it for the rest of my life.

Ok guy, so I know you are tired of waiting for your significant other to finish with her doctor visit.  I also know that your fingernails might be needing trimmed.  But do you REALLY have to trim your (very think) fingernails in our waiting room while waiting, as a way of expressing your displeasure of waiting? Seriously, who carries fingernail clippers around “just because”? Like, nobody?!  Your deliberately soiling our carpet with your fingernails, and brushing the ones that fell into your lap onto our floor (just for good measure) really didn’t please our staff.

Next time, clip your nails while waiting for your buddy to tee off. I’m sure he’ll appreciate it.

Thanks,

I. B. Whiny, JMS

*Dedicated to Doctor Grumpy**, who occasionally gives us “Things that make me Grumpy.”

**Does not always use “polite” language.

So I finished the second year of medical school the second week of May by taking several NBME exams. NBME = National Board of Medical Examiners. These exams were to serve as a benchmark so that I could evaluate my base of knowledge and better prepare for the upcoming USMLE Step 1 exam. Then came 6 weeks of intense studying for said exam. My resources were as follows: First Aid for USMLE Step 1, 2010 edition; USMLEWorld Qbank; DoctorsInTraining.com Step 1 review course; and a few chosen classmates as study partners. I took the exam on June 17, breathed a quick sigh of relief and thanked God for getting me through it, and undertook the exciting task of moving to our current location in Southwest Georgia. We then settled in to our new house, and began the process of waiting for the arrival of our lovely little boy, Ravi.

Yup, he’s cute!

He finally arrived in the wee hours of July 22, and we were thrilled to have the waiting game over with.  He currently gets lots of attention from his sisters, mom, and occasionally, me.

I began the third year of medical school in July, technically speaking, but deferred my elective to fourth year so that I could help get settled in after the move, help with the new baby, etc.  It was good to have this time off for both familial reasons as well as school reasons.  As Vice-President of this Southwest Campus of MCG, I was able to use some of my time off to talk with my colleagues to make sure things were going smoothly with their rotations, and bring these things to the attention of the leadership if they were not.  They were, at least mostly, but there were a few small issues to help colleagues work through.

My first rotation (of sorts) was two weeks of Hospice and Palliative Medicine (HPM), and I spent a fair amount of time talking with patients about facing the rest of one’s life with a terminal illness.  It was a sobering experience, but enjoyable.

I am currently in my second rotation, but since it is the first rotation to actually give me hands-on experience working with and treating patients, I refer to it as my first rotation.  I hope the HPM people, and the Intersession (that’s what that rotation was called) people will forgive me, if this is a transgression; I do not intend it to be so.  This current rotation is 6 weeks of Family Medicine. I am actually in my last week of this rotation, and will shortly give an overview of this rotation and my impressions of it as a specialty.  I intend to do this with all rotations, but will endeavor to update you during the rotations as well.  For safety reasons (if there are any lurkers, I mean you) I will not give details of where I spend my time until I am done with my time there: this will be more relevant some months than others, but I take few chances.

So now you are caught up, albeit briefly, with my life.  As I just said, I plan to post at least every other week, schedule permitting; I may even post in successive weeks, but that’s a little much to hold myself to.  Additionally, at the end of each rotation, I’ll give a little more info on where I’ve been, and what my opinion (brief) is of the rotation.  Any case studies that I may or may not include are changed enough that they must be considered fictitious; if it sounds like you, then either you or I have a most wonderful imagination, because I’m definitely NOT talking about you. Period.  Additionally, do not consider my stories/discussions to be medical advice; for all you know, I’m just another Mongolian yak-herder, the next hill over from Dr. Grumpy. So there.

Until next time…

The vocation of medicine, especially the counseling side of medicine, is unarguably the field in which one deals the most with people in need.  There are many occupations in which one deals with other people on a regular basis, but few (I didn’t say “none”!) have the potential for impact that the couseling doctor does.  Often, the physician sees a health problem with his patient, and recommends lifestyle changes/medications/other interventions for the patient; it is up to the patient to accept that these interventions need to happen, and to subsequently implement these interventions. This is where cynicism enters the picture.

• The 85-year-old patient refuses to use the walker that you prescribe and Medicare provides, and ends up falling and breaking bones.
• The 25-year-old patient refuses to stop smoking, and 20 years later has COPD and can barely maintain a conversation.
• The 55-year-old man with a family history of colon cancer refuses to have a colonoscopy because “it costs too much,” and is devastated when 8 years later bowel movement changes tell you he has cancer.
• The 60-year-old woman doesn’t get her mammogram done because “it’s a little uncomfortable and it costs too much,” and 8 years later dies of metastatic breast cancer.
• The 30-year-old patient doesn’t think that being 5’6″ and 425 lbs. with a daily intake of 5,000 Calories is problematic, and refuses lifestyle changes. Oh yeah, at 55 he’s lost both legs from venous insufficiency, and has the use of only one eye (it has a cataract).
• The 35-year-old mom who’s been experiencing palpitations doesn’t want to see a cardiologist because “it’s probably nothing,” and falls over 6 weeks later of sudden complete heart block due to her hypertrophic cardiomyopathy.
• The 15-year-old thinks that promiscuity among his classmates has no repercussions, but can’t figure out why he has ” ‘roids”. Or maybe she just doesn’t get that PID is terrible, and AIDS and herpes are for life.
• Possibly even worse is any personal friend or family member who asks you for your opinion on any given health matter, then continues on doing whatever they have already made up their mind to do.
• I could go on.

No, none of these instances are true cases, at least to my knowledge. But I can guarantee you that there are doctors, most likely in your hometown, that would say, “Yup, that’s my patients, exactly.”  Doctors see patients that need help, are making unsound or even dangerous life choices, and come to the doctor because their health is failing them and they can barely get around.  Problem is, it’s not their health that is failing them: they failed their health a long time ago. Your doctor knows that you haven’t been keeping your diet under control: your A1c tells him that. She can see that you are not taking your blood pressure medication. Really. You think 180/115 is lower than 165/100 normal?!  Seriously, it’s not difficult to see the non-compliant non-adherent patient.  But you come see the doctor, she’ll tell you what you need to do for your chronic health problem, and she’s pretty certain that you’ll be back, with no improvement because you refuse to do what you need to do.  Contrary to popular belief, those tests he orders and those medicines he prescribes for you do not make him more money; they are for your benefit, to help you get better (which is what you are there for, right?)  But we know that you won’t listen, but you still want us to be on a first-name, good-friend relationship. And we roll our eyes (inwardly), and we add one more block to the cynicism wall.

Of course, this can apply to other areas as well (finances, spiritual life), so apply it as you will.  Most health issues have a moral aspect as well, and are addressed in The Ultimate Life Guide, the Bible. But for those who won’t listen, all the persuasion in the world won’t change their actions.

Now, back to studying pulmonology and Step 1 material…