tuesday

i couldn't think of a clever title...

thanks for all of the wonderful comments on my last post... esp jer

my internal medicine excitement has been tempered a bit. last week's sweet old lady was replaced by man with rather unpleasant stank. here i am trying to do an abdominal exam and half the time i'm straining my neck to keep my tie from hanging over and interacting with said patient's crotch and its rather pungent musk. why do they make us wear those things anyway?? actually i rather like wearing ties. i really just wish i didn't have to touch anyone.

still going through the motions, palpating and prodding and percussing and auscultating like I know what I'm doing. I don't. Really I'm just focusing on just getting the nodding part down so it looks like I know what I'm doing.

oh yeah, note to self: next week throw in a cheesy 'do you concur?' joke to my partner. that will so own.

I was pretty happy because we were listening to dude's heart for like 10 minutes and although honestly we were pretty lost I vaguely maybe kind of thought i heard a holosystolic murmur and after our attending came down to listen he confirmed a "very faint" mitral regurgitation... score!!!

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i'm like in a weird stage of medschool limbo/hell right now. i hate learning but i don't quite want to be done with school. i'm having fun studying for boards but i'm not ready for it to be upon me just yet. And I am deathly afraid of 3rd year. As much as I hate 2nd year, I am good at 2nd year. After 2 years I should be. If there wasn't the uneasy stress of the impending boards, I would be having a lot of fun. My ping pong is just at another level right now. I even got a compliment on my improvement today from the 1st year jedi pingpong grandmaster in the lounge.

But maybe 3rd year won't be so bad after all. Getting pimped is actually kind of fun. I know it's unrealistic to expect all attendings to be so cool, but it's sweet when you're getting pimped by someone because they like to teach versus demean (I strive to one day be a cruel attending who does the latter).

It's kind of like jeopardy, only you're not getting quizzed on 15th century literature and other crap you've never studied before. You don't even have to know all of the answers... just more than the guy next to you. My biggest fear is that i'm going to be rounding next year and like in poker, i won't be able to figure out who the sucker in the group is... in poker i've learned, it's usually me.

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what i really want to do is get a cane. so i can be like House MD and shit. Or perhaps more like costanza and people will think i'm handicapped. I just get so tired standing around all of the time. It's like being in line at disneyland, without fastpass. and if there's only one chair available in the patient's room, you can't be the loser calling attention to yourself by sitting. so it usually remains empty... what a waste.

i really need to find some good dress shoes that feel like sneakers...

Song of the Week - Usher ft. Young Jeezy - Make Love in this Club.mp3

What to do???????

We've picked out our 'tracks' for clincals and i'm sad that almost all of my friends or even just people that i like are in the opposite track as me. which means i won't hardly see them again. :( i'm stuck in the track with more hard core gunners (in quantity and quality- we actually counted).

I'm trying to figure out WTF it is I want to do for the rest of my life. Because I honestly don't have a freaking clue. I like everything. I can see myself hating everything. So i figure i might as well just free write for a bit on the pros and cons of the different options so i have something of a reference to look at.

General surg

um, fuck no. i came into med school sure i wanted to do something surgery, but then i took a laparoscopy elective and i realized there is no way in hell i want to work with these kinds of personalities. i mean come on people, didn't we all learn to share in the 3rd grade?

it used to be that surgeons were universally top-dog smart but now unless you're the exception or in a subspecialty you're more than likely just an overworked grump who likes to work with your hands. I refuse to suffer and be stepped on through 5 years of residency only to be left with the most boring body parts to operate on.

Internal Medicine

the more i think about it the more this makes more and more sense. I started to seriously consider IM after taking our renal class which I love love loved (not coincidentally our professor was awesome). I love physiology and almost every other specialty except maybe path or EM just seems like a collossal waste of 2 years of grueling preclinical education. I can't stand the thought of having all of this bullshit I memorize on a daily basis going to waste. One of the biggest reasons I went into medicine was so that I'd be able to take care of my family if any health problems ever came up and this is probably the most useful specialty for that sort of thing.

You get to use your brain (it's kind of like on House) and you also get to talk to people. The other day we spent a couple of hours talking to and physicalling an uneducated but totally sweetheart old lady. I actually stopped and told myself, if all i did all day was talk to and help out sweet and grateful old ladies I could totally be happy. We'll see how I feel after a year of dealing with druggies and such. But my family's had enough experience with grumpy/jerk docs and I'd like to prove that I can be different.

Cons: prestige, $, general healthcare industry bs, having to compete for fellowships

Emergency Medicine

Less pay but less work. <40 hour weeks sounds damn damn good. Skiing on weekends. Shiftwork. And I have to admit I'm big on the hero factor. I'd like to think that if the situation arose I'd be the best person to deal with an emergency, whether it's someone having a heart attack or sticking a pen through someone's throat. You know a lot about everything. And did I mention 36 hour work weeks?

Cons: disrespected by other physicians, working with homeless, druggies, thugs and the like.

Pathology

I think they're all creepy bastards. Cruel bridge trolls who make us memorize microscopic minutiae that we will never ever see or need to know about. If I had it my way 75% of pathology for med students would be limited to conceptual cartoon drawings. Actually most of our pathologists are super nice but the whole field still creeps me out.

Opthamology

Supposedly very happy and the jesus factor is definitely there. I totally dig the idea of restoring ppl's sight... that's the kind of thing people name their kids after you for. But goddamn what a waste of med school. We've had maybe 10-20 hours total of eye/eye-related lectures in 2 years. Renal, gi, resp, etc... all down the toilet. I'm also deathly afraid of fucking up someone's eyes. Not to mention it's super competitive.

Anesthesiology

I feel like a bitch to even mention this, but I won't lie and say I'm not seriously thinking about it. You get to sit there and read... books, comics, porn whatever. Imagine that!... reading... for pleasure! on the job. sure it occasionally is stressful or whatever, but comeon how smart is the average anesthesiologist. i'm sure i could learn to deal. They have like a 100% match rate for people with passing board scores. Sure you aren't the brains of the operation and you don't get any respect but you get to go home at the reasonable hour while the surgeon keeps toiling. I just don't get why it isn't more competitive. GREAT money, great hours, great lifestyle, all shiftwork. Seems too good to be true. I could open up a pain clinic with some other greedy bastards and rake in 1 million/year. I wish they made all anesthesiologists take huge paycuts so I wouldn't have to consider this.

Orthopedics

Seems kind of cool. Also seems like a lot of work. Very competitive. Need more data.

Urology

Another one of the big 4 ultracompetitive surg subspecialities (ent, ortho, urology, optho). Seems pretty damn cool. Except for the whole working with penises part. I flinch (and cry) everytime a big 8-foot chancred penis is projected onscreen during reproductive lectures. Not for me.

Obgyn

Fear of densitization. When I see a vagina, I want to want to have sex with it.

Neurology

Neuroanatomy was probably my favorite class this year, but i really can't see myself dealing with crazies and people going into freaking seizures right in front of me. I dug the whole mental gymnastics with lesion diagnosis but in the end how much can you really help those people. It's like, hey guess what dude, I just deduced you have korsakoff's psychosis! You won't even remember this conversation. booyah.

For me the biggest perk would be getting mistaken by laypeople as a neurosurgeon. Maybe if someone promised me a future million/year position in their sleep clinic...

Neurosurg

Seems like the coolest job ever. But why put myself through that kind of fatigue? THe whole "it's not brain surgery" joke will probably get old after 10 years or so. Which is about how long training lasts.

Dermatology

I've been thinking about this lately. Why? Because we're getting derm lectures this week and 3/4 have been pretty darn hot looking (med school goggles notwithstanding). Nothing sexier than a girl in high heels who can run circles around you intellectually. The only problem here is that derm lectures are boring as fuck and the whole field seems superficial and lacking in substance. Pimple poppers, indeed. Outside of your melanomas and what not, you treat everything (with marginal success) with steroids, creams, antibiotics, vitamin A and constant prayer. Then there's the whole issue of me not being smart enough... damn!

ENT

I guess if I had to pick right now this would probably be it. You get medicine and surgery. You work with people and cool toys. And if you believe the party line, it's supposedly hard not to like an otolaryngologist. They're all happy and hold hands and what not apparently. Not bitter and resentful like general surgeons. You get to operate on the coolest body parts outside of the 2 CNS specialties, and compared to neurosurgery, the lifestyle is "Every Night Tennis". Downside here is the competitiveness and my fear of being the village idiot. I also have no idea if I will even like surgery. There's also way too much material to learn in the head and neck.

Radiology

Seriously, seriously seriously tempthing the shit out of me. My friend's sister is a PGY2. Supposedly year 1 residency was 7-5. Year II 8-5. IN FREAKING RESIDENCY. If I sell out, i might as well sell out all the way and do something like this and make more money vs anesthesiology. With my software background I'm pretty good thinking in 3d and always got the highest or one of the highest scores on the anatomy slide exams. The hours are supposedly good, the pay is ridiculous, and I could probably do some computer science hobby stuff on the side. Sure there's no patient interaction... but I can get probably get good people satisfaction when I give them rides in my M3 and pay for their dinners and such. Helping people? I can roll up on a bum and afford to give him a benjamin.

Peds / Family Medicine

I'm in a lot of debt. End of story. Pride factor comes into play here too.

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I probably missed a couple and forgot some big points but I have to go to bed soon and fix my retarded sleep schedule. So far it looks like:

ENT
Internal Medicine
Emergency Medince
Radiology

with maybes for
Ortho
Anesthesiology

Sunshine

I changed the wallpaper on my iphone yesterday and now I get a big smile on my face everytime I click my phone on or am greeted with a phone call from someone. Kind of like how I can't stop grinning each time after watching nick robinson's shot:



Hands down the cutest, baby... ever.

Well, ever since, 1980-83ish when I was a baby. But she had a much better personality than I did and she was by family concensus the cutest baby my mom ever took care of.

I miss our kids. Abigail, Sally, Natty, Chris, CJ, Jordan, Devin, Monica, James, Binky, Marissa, Michael, Graham (may your soul rest in peace), Gheanna, Alia, Webbo, and the one super chubby little girl whose name I forget (all of the stupid shit i have in my head these days) who had the sweetest sweetest personality ever and I always felt bad she was so chub and is probably getting teased to death in school now. Probably half a dozen more I'm forgetting. Except for maybe those 2 devil kids, who shall go unnamed and whom I don't particularly miss at all. Well, maybe a little. But they were pretty evil.

I wish I had more pictures of them all. They were all like my little brothers and sisters. I loved those kids. Even the evil two. Hard to believe some of these kids are now graduating high school and going on to college now. A couple of them I know can definitely beat me up. And sad to know they don't remember me at all. Damn I'm getting old.

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I ran today for the first time since October... of 2006. Probably ran almost 3 miles... albeit very verrry slowly. It was actually pretty refreshing. We'll see if I can keep it up.

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i doubt it

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trying to figure out what rotations to schedule for 3rd year, but goddamn i seriously have no freakin clue what the hell it is i want to do.

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i'm getting sleepy so i will continue this train of thought later...

test week again so i'll probably be blogging pretty frequently.

damn my legs are already sore.

Respect

People give me way too much respect just because I am in medical school. All of these old filipinos that my parents only sort of know are always trying to talk to me after church is over. Which would be cool if they had hot young daughters which they never seem to have. Or if they wanted to ask me for medical advice which would be cool... at this point in my medical education I think I can generally fake like I know what I'm talking about with laypersons.

But instead they usually want to talk to me about their daughter's friend's friend who used to go to medical school or something completely unrelated to... anything, really. Not that I necessarily mind listening to boring ramblings from which I can't escape. But where were these people 3 years ago, when I was 'just' a software engineer but probably a nicer person. Is my head-nodding now that much more appealing to others, because I'm heading into a 'noble' profession?

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Everyone wants to marry a doctor, but What's so great about doctors anyways? They're way too busy, for one. And it's no secret that I don't think the average physician is all that smart. I'd wager the average computer science grad student at a good school like stanford is much smarter. I go to an average school with very above average board scores so I think I can tell.

But my friend and I were talking about this a few weeks ago, thinking through our class of 170 people with nearly 100 guys, and we could not come up with little more than a handful of dudes who weren't so flawed in some way or another from a superficial distance that we'd be comfortable with them dating a theoretical younger, eligible sister. That's 7 or 8 people, including, perhaps out of courtesy on his part, each other.

That is, to say, not much better or worse than the general worthless population, 90% of which is, according to the wise Jerry Seinfeld, "UNDATEABLE!"

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In general, I think I probably make for a poor admissions committee member. To steal a line from the departed, I don't trust people with an immaculate record. Or maybe I'm too forgiving of people with flawed records. Take the kid with A's/A-'s in lecture ourses but C's in labs. Explanation? Just wasn't interested. At this point most people begin to shake their heads, wonder "what happens if they come across a class in medical school they don't like?" etc. My take? That is EXACTLY my kind of dude. Labs are seriously stupid. Especially premed labs, my god...

The dude with the shitty grades but the awesome MCAT? Could be a mad genius, let's take him! Mediocre grades and MCAT, interesting hardship/background? Take him. Completely mediocre applicant who sounds just like I did? Let's give him a shot!

I guess it's a good thing I'm not in charge of this sort of thing. I mean you gotta have some standards. There's probably no better way. I just find it disgusting how coachable the whole thing is. And despite the numerous qualified decent people you get through, you also select for quite a few of the arrogant paper-resume'd ass-kissers that i completely despise. The kind that tend to get selected for committees and such.

One thing about medicine is that few people quit once you're sucked in. You're just too far invested. Time, money, etc. So the person with 5 shadowing experiences doesn't know any better or worse that they want to do medicine than the person with only 1. They're just as likely to be a bitter person who wants a return on their suffering. So why make the good people suffer jumping through hoops in order to weed out a few bad apples? They're going to suffer enough once they get in. We're just putting lipstick on pigs.

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i wrote all of that on the plane 2 weeks ago and then forgot to post it. i realize i am quite the cynical bastard hahaha.

amusing how homogenous our flight got after our stopover in LA. It was like going from a quilt of different cultures to then being a plane full of whites, a few blacks, me and a couple of others.

LA from the sky is a concrete freaking jungle.

must get back... to california.

Song of the Week - Leona Lewis - Bleeding Love.mp3 From the british 'x-factor' winner. She's pretty hot too. More here (angel and better in time are very good)

Ughh youtube won't let me embed so - http://www.youtube.com/watch?v=sF84pIhP5UM

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edit: ohyah i forgot to add, congrats to my protege julius aka strong-side for being done with his mcat! Over-bitching about school is a stupid little hobby of mine but in all honestly despite my constant whining I actually like it quite a bit and i'm very happy I made the big leap.