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28 May 2012

Medical Horoscopes

A aptitude test is floating around among my Facebook medical buddies, with 130 questions which will help slot you into the specialty where you think like the average consultant of that ilk. My top 10 were definitely not what I was expecting:



The test is mostly mostly horsefeathers, in my opinion.  Children are probably my least favourite patients. Bears are more predictable.  And population health (needed to do preventative med) makes me want to gouge my eyes out with a pickle fork.  OK, if you can't stand interruptions in your schedule, emergency medicine may feel a bit grating. Or if you can't abide with the thought of your patients dying regularly, oncology and palliative care are probably not for you.  Or you'll get used to it.  It's amazing the things we learn to accept and work with as we are transformed from lay people into doctors:
  High caffeine levels and minimal sleep.
 Asking awkward questions non-awkwardly, and keeping a poker face regardless of the answer. 
Living under bureaucracy that tells us when and where to show up (if we're lucky), but demands we be flexible lest they change it all at the last minute.
Consuming and regurgitating stacks of information and theory, and learning how to synthesize it together to make decisions on the spot.
And then have patients not fit the textbook. Ever.

So in the end, we need to find out what we want to be when we grow up by experience, not tendency. It would be sad if all oncologists thought the same. Or every surgeon fit the stereotype. Thanks goodness we are all different.

13 May 2012

How to give your smallest muscle a workout.

Can you name the smallest muscle in your body?  It's the stapedius, and it's actually in your head.  Thus you can go around knowing you are a musclehead, regardless of your level of fitness.  You are also a fathead and a bonehead at the same time, but those are different stories.  The stapedius works together with the tensor tympani muscle to dampen sudden loud noises, dropping the intensity by 20Db! This protective mechanism is called the acoustic reflex.

On Thursday night, we gave those muscles a mighty workout by going to a concert at The Zoo (Fortitude Valley) with Mutemath.  The band is a new favourite of ours, and when they came to town, we saw them live in their first Australian concert of their Odd Soul tour.  They put on a fantastic show, and despite being severely jetlagged were enthusiastically thrashing and jumping all over the place.  The drummer actually taped his earphones to his head as he was so exuberant!
Rob had an app that measured sound amplitude on his phone, so we checked- the average was around 82Db. That is actually enough to cause gradual hearing loss after prolonged exposure- which probably explained why all the staff there were wearing earplugs!

We enjoyed the concert immensely.  My current favourite is "Blood Pressure" (yah, I know- no surprise there.)  It is a brilliant video:



And one of the more interesting videos around:


This segment makes the drums and bass players some of my musical heros:

30 April 2012

Geek pics

Our "official' portraits from the Calgary Expo.  The first is Tavia and I with Wil Wheaton (Wesley Crusher).  The second is Jonathan Frakes (Will Riker), Marina Sirtis (Deanna Troi) and Micheal Dorn (Worf)


A Little Rant from the Bottom of the Totem Pole

Some people you will succeed because of, and other people in spite of.
I have had yet another encounter with a consultant who sees students a bothersome and burdensome or bug-like, not worthy of talking to. I started by introducing myself, and she stared coldly and snipped "we're not starting yet."  OOoookay. So the other student and I sat and waited half an hour until she called me in and assigned the other student to another Dr. She then proceeded to see several patients, not once explaining to me or the patient what she was doing, or why. No teaching moments happened in an hour and a half.  Since I have much more interesting ways of wasting my time, I left halfway through clinic.
This is not an isolated incident. Last year in Internal Med, I was assigned to a consultant for 8 weeks. After 3 weeks of daily scribing and ward jobs, he looked up and said, "Yes, can I help you?" with no remembrance of me. Way to make me feel like part of the team.  This same guy then YELLED at a patient for not knowing she had the atrial fibrillation which caused her stroke. The poor woman was aphasic from the stroke (lost her ability to speak), and could do nothing but shake her head as tears rolled down her cheeks. I spent most of the morning after rounds comforting her and explaining what was going on with her treatment.  I have seen registrars just not show up with no explanation, or not prepare anything to teach for sessions because they "don't like students" (yes, she said this. At least she's honest.) I have seen more senior staff rip strips off junior staff, or like my experience today, just ignore them.  Just about everyone I know has been reduced to tears at one point or another in their training.

Why does everyone think this acceptable behaviour??? I think there is no level of education at which being a jerk of a human is OK.  I understand that the consultants are not paid to take us on at teaching hospitals (Even though the school of med still thinks it's OK to charge us full tuition for the free service they're getting). I also realize that not everyone is Chatty Cathy or uber-teacher.  But why can't there be competence AND kindness, or at least civility? ARRRRRRGH!
OKAY, getting off the soapbox. I have to say in all honesty that I have had more GOOD teachers than bad ones. I just had to get the grump off my chest.

Thanks, Dr. Douche, for at least teaching me how I don't want to practice (WHICH INCLUDES TEACHING). I'll remember it. And thanks, Drs. Decent and Still-Cares: I'll remember your lessons too.

"Dr. D" at Ask An MD addresses the Jerk Factor:

Why are so many doctors jerks?
Excellent question! As any nurse will tell you, doctors are notoriously difficult to work with. We doctors have a much higher percentage of jerks among us than the general population. Even Doctor D (on very rare occasions) has been known to be downright ornery towards patients. There is a epidemic of condescending, difficult, foul-tempered doctors, and you the patient are the one who suffers!

Some doctors have been jerks their whole lives. Maybe they weren't hugged enough as babies. These docs just love having a position of power so they can make others feel small. Such natural-born jerks can be found in any profession, and just one of them (especially as a customer service representative) can make anyone's day miserable. Such doctors will never change. It is best to avoid them whenever possible (unless you need surgery).

But the relatively few natural-born jerks in the world just aren't enough to explain the over-abundance of jerk doctors. This only leaves one explanation: many doctors become jerks by becoming doctors.

The number one reason everyone says they want to go to medical school is "to help people." Believe it or not, we were all once innocent wide-eyed young medical students who really cared about you.

Then they fed us through the decade long meat-grinder of training involving sleep deprivation, endless memorization, calling patients by their diseases, and getting yelled at regularly by our jerk-doctor teachers. At first we hated those other jerk-doctors, then we felt sorry for them. We worked till we were dead tired, and then got told heathcare is cutting back so we had to do the same work twice as fast next time. Patients expect us to work miracles after watching too much TV, and don't see any reason for dieting or quitting smoking since our purpose in life is to cure everything. Despite our good intentions people keep destroying themselves with bad habits, and nice people keep dying, and everyone is angry we can't turn them back into twenty-year-olds. Add to that lawyers promising irritated patients that they can hit the jackpot, if they just sue jerk doctors--It is enough to turn even the nicest medical students into misanthropic bastards.

As a patient that just wants to get your check-up none of this is your fault, but you are going to bear the brunt of this. Your best bet is to look at your doctor, and try to imagine him/her as the kindly, altruistic, and terrified student that showed up on that first day of medical school. Somewhere in your doctor lurks that annoying humanitarian impulse that doesn't die easy.

28 April 2012

Getting my geek on.

For the first time in several days I have a decent Internet connection. I can now tell all you fine folk what I have been up to.
  Today was the first day of the Calgary Comic & Entertainment Expo. This wasn't the only reason for my trip to Canada, but it was the reason I am doing it now.
  My friend Tavia and I where able to meet several of the Star Trek The Next Generation actors. First was Wil Wheaton. He was at a convention last weekend in Gold Coast, so we were able to chat about Australia.  He loved the Koala Sanctuary and Morton Island. He's not such a big fan of the Gold Coast, but neither am I.
  We were also able to meet Marina Sirtis, Jonathan Frakes and Brent Spinner. Brent was very chatting.  We also got a photo taken with Wil Wheaton.
  Tomorrow is our big photo op day.  Hopefully we will also get to see a bit more of the expo.
  Most of this week was in Deadwood. I spent some time with Mom and was able to fix up her computer.  I was also able to scan a pile of my baby pictures which I'll post later. Wednesday night I spent with my sister Barb visiting and sorting REA contracts by land location.  The rural electrification area was having a big meeting the next day and she had taken some work home.
  Also visited Tavia where I got to bottle  feed a lamb and haul firewood.  The lamb was more fun.
  Last weekend was spent visiting my inlaws.  I helped Susan buy an new computer and set it up for her. (I'm seeing a computing theme).
  The mid week was spent in Martensville, Saskatchewan.  I went to visit my adorable 3 year old niece Hunter. My brother Rick happened to be there too. ;-)  It was a good chance to see Rick, Tracey, Jackson and Hunter. While in the area I got to visit the Krahns; Aunt Carol, Uncle Neil plus Christopher and Daniel.  My Brahma hat barely escaped Neil's clutches.
  The first weekend in Canada was spent visiting old friends.  We even had a Skype party at Barbra's so Barb could get in on the action.
  So far everything is going so fast.  I haven't been able to see everyone that I wanted to see, but it has been great to see so many.
  We are planning to both be coming back to Canada next June for my nephew Trevor's wedding to Amanda.  Hopefully we can see you all then.

(Photos and videos to follow as soon as I can)