Sunday, July 13, 2008

Reflections on Medical Specialties

Reflections on third-year clerkships
Current mood: content

OB-GYN: OB was routinely 14 hours of waiting in pregnant-lady hell for something to happen. Attendings and residents in OB tend to have the most malignant personalities I've ever encountered, and let me tell you what - women in the throes of labor are no bowl of ice-cream either. It was cool for about two days, but there is only so long that you can spend 5 hours at a time staring at dirty floor tiles only to have the monotony broken by the thrill of a sterile vaginal exam. And when something actually happens, it WILL adversely affect your pearly-gray tympanic membranes. What got me were the grand-multiparous women who were screaming like they were extras in some D-list horror flick. Half of the time, I wanted to look at the woman and say, "B%*!@, puh-lease. Can ya knock off the screaming? This is baby 9- like you didn't know this experience was not exactly a full-day spa treatment." And overnight call? At 2 am, I'd rather be eating lima beans in a prison camp than watching a yelling, sweaty lady push a watermelon out of unmentionable areas of the body. Oh yeah -the "miracle" of birth? It's just plain gross, folks.

PSYCHIATRY: Aside from the fact that the patients really ARE stark raving lunatics, it wasn't so bad. It's also really hard to apply the idealistic garbage they force-fed you through the basic science years. You know? The stuff in Understanding Your Patient and Psychpathology about how mental illness strikes at the very heart of a person?'s sad and worth remembering, true, but also very hard to remember when your patient has informed you that they'd like to eat your face for breakfast because the tap-dancing aliens in their fingernails told them you'd be tasty.

SURGERY: Could have been better,could have been worse. Unfortunately, because of overnight call on surgery, I still have nights where I wake up and scramble blindly for my pager,only to find that the phantom-pager demon has struck again and there is, in fact, no sadistic resident that wishes to wake me up at 3 am so that I can attempt to drive the laproscopic camera. Upon having that experience on one overnight call, the attending asked me if I even knew what the appendix is and if I knew up from down - words cannot describe how much I yearned to tell him "It's 3 am and I've had 1 hour of sleep because you just HAD to fix an inguinal hernia that could have waited until tomorrow. Drive your own damn camera, amigo."

FAMILY MEDICINE: I was placed with a 9-ft tall, orange-haired Amazonian who received her medical degree from a university deep in the heart of Mexico. That statement right there just about sums up my experience on family medicine perfectly. I'm not sure exactly how Amazon-woman contributed to my medical education - she prescribed Robitussin for a teenage girl with severe right lower-quadrant abdominal pain that turned out to be appendicitis. Who knew? Not her, apparently.

PEDIATRICS: Peds was the most miserable time of my medical career. The residents are incredibly strange people who are worthy of being subjects in some sort of clinical trial on how mentally screwed up residency can make you. Or mayhap they've dealt with small, screaming germ-bags for so long that they forget how to be normal and speak in sentences that don't include insipid words such as "tum-tum" and "poopy". In addition, during the course of my rotation, I mananged to get a bacterial pink eye in BOTH eyes, two viral colds, and one particularly nasty case of pneumonia - all inspite of having meticulous hand-hygiene and submersing my stethoscope in Chlorox after every patient encounter. Syonara, peds. See you again never.

INTERNAL MEDICINE: Riverside County Regional Medical Center sucks. Really, really sucks. I'm still trying to figure out who I pissed off in a former life to deserve going to RCRMC. Don't get me started on the anal-retentive, micro-managing, tree-wasting Attendance Nazi of the clerkship. By the way, _____, the world will NOT, contrary to your opinion, end if my weekly patient log is missing the useless purple cover sheets you incessantly jam down the throats of clerkship students. Also, I would like to inform everyone who reads this that the Attendance Wizard is full of beans - the Simulated H&P is not at all useful unless you delight in having a new anal orificine unkindly manifested on your backside in a short, 30 minute time span. I'd also like to ask the powers that be why the VA insists on those annoying, computerized health reminders for DM, HTN, high cholesterol, coronary artery disease, etc - when they also insist on feeding their veterans fried chicken and deep fried hamburgers for lunch. Anyone else see the weird dichotomy there?