MCW Class of 2010, Part 3

[Gimlet]

and now it's off to peds. I actually thought I'd slept in when I woke up and there was sunlight in my room. I'm so used to getting up at 4:30 when it's pitch black.

What team are you on for inpatient?

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[45408]

What team are you on for inpatient?

Blue team - center 4 (used to be 4 west) - step-down from NICU and PICU, I think. We start tomorrow.

 

[Gimlet]

Blue team - center 4 (used to be 4 west) - step-down from NICU and PICU, I think. We start tomorrow.

Nice! Funk and I have both been on the Blue team. Make sure to wear your comfty shoes...rounds go for about four hours most days.

You'll have to let us know who your attendings are as you find out this month. They usually go on service for a week at a time.

 

[indo]

hah, hypoglycemia rounds. nice.

 

[Ashers]

hah, hypoglycemia rounds. nice.

I carried snack bars around for Red team rounds. not only were they long (depending on how many pts we had), we had to walk all over the hospital.

Red team was fun. And, you don't have to track down attendings like on some other teams.

 

[Agent Splat]

Nice! Funk and I have both been on the Blue team. Make sure to wear your comfty shoes...rounds go for about four hours most days.

You'll have to let us know who your attendings are as you find out this month. They usually go on service for a week at a time.

Ha! Four hours! That's nothing! Back in Joo-Ly o'eight, I rounded some days from 8am till 4pm! Puts hair on your chest.

 

[Agent Splat]

Red team was fun. And, you don't have to track down attendings like on some other teams.

The curse of St. Joe's. Thank God the worst of them is leaving.

 

[samenewme]

Ha! Four hours! That's nothing! Back in Joo-Ly o'eight, I rounded some days from 8am till 4pm! Puts hair on your chest.

I do not so much want to have hair on my chest, thank you very much.

 

[yeasterbunny]

The curse of St. Joe's. Thank God the worst of them is leaving.

I talked to one of the high-ups today about the faculty member you are alluding to. He had no idea we had a problem but said he will advocate for the residents and our interest in sleeping at 3 am rather than listen to aimless blather.

 

[indo]

You all don't like impromptu lectures at 7pm on a friday while everyone is trying to round?

 

[akpete]

Nice! Funk and I have both been on the Blue team. Make sure to wear your comfty shoes...rounds go for about four hours most days.

You'll have to let us know who your attendings are as you find out this month. They usually go on service for a week at a time.

I was also Blue team and LOVED it. We usually managed to keep rounds to more like 3 hours though. Well, with some attendings. We'd give up on cards a lot and just do work until they showed up and round individually with them.

 

[45408]

Good Lord, I've never had to look up so many terms in a patient's chart. My patient has a double outlet right ventricle, mitral valve atresia, total anomalous pulmonary venous return, and heterotaxy. Because of the heterotaxy, the pt is asplenic and underwent a Ladd procedure for a midgut volvulus with paraesophageal midline hernia (all small bowel on one side, all large on the other side, and an appendectomy. And a Roux-en-Y with a jejunostomy).

Jeebus. The good news is that I don't see anything that precludes a reasonably normal adult life so far....


go blue?

 

[Agent Splat]

Good Lord, I've never had to look up so many terms in a patient's chart. My patient has a double outlet right ventricle, mitral valve atresia, total anomalous pulmonary venous return, and heterotaxy. Because of the heterotaxy, the pt is asplenic and underwent a Ladd procedure for a midgut volvulus with paraesophageal midline hernia (all small bowel on one side, all large on the other side, and an appendectomy. And a Roux-en-Y with a jejunostomy).

Jeebus. The good news is that I don't see anything that precludes a reasonably normal adult life so far....


go blue?

Ah yes. That kid. Big faker. Just discharge to home with a little kiddy percocet.

 

[yeasterbunny]

You all don't like impromptu lectures at 7pm on a friday while everyone is trying to round?

7 pm? Really I was not exaggerating. This attending will give his hour-long impromptu lectures/pimpings at 3 am after we have taken our final admission and he is the last thing standing between us and a couple hours of sleep. And not about things that necessarily have anything to do with our patient. Completely inappropriate.

 

[Agent Splat]

7 pm? Really I was not exaggerating. This attending will give his hour-long impromptu lectures/pimpings at 3 am after we have taken our final admission and he is the last thing standing between us and a couple hours of sleep. And not about things that necessarily have anything to do with our patient. Completely inappropriate.

he once tried to give an example of how there are different medications to approach a hypertensive emergency with, and somehow ended up giving a 5 minute lecture on which drugs to use in v-fib.

 

[indo]

this is the seizure-in-the-hallway = time-to-teach-about-seizures guy, right?

 

[45408]

I was at Joe's, but I can't figure out who you guys are talking about. Feel free to PM me.

 

[yeasterbunny]

this is the seizure-in-the-hallway = time-to-teach-about-seizures guy, right?

I haven't heard that story specifically, but I know of one resident whom he reprimanded for putting a teaching meeting on the back burner when he was helping a patient who was actively crashing, and was told that teaching comes before patient care.

 

[45408]

holy crap, these patients at CHW in the Special Needs ( >4 organ system issues) are unbelievably sick. Literally every body system in my incoming admission has an active issue. I'm thinking this won't be my full H&P write-up! This one would dwarf anything I did on medicine.

 

[45408]

okay, so my pt has ONE organ system without any problems - the heart. There's a severe vasculitis, so I can't even say cardiovascular is fine. geez.

 

[indo]

OSCEs are working me over this year. Crap.

 

[45408]

OSCEs are working me over this year. Crap.

I'm sure Ashers would agree.

on my surgery OSCE, I got comments from both patients that I wasn't personable enough. What are they expecting in 7 minutes?

 

[Agent Splat]

I'm sure Ashers would agree.

on my surgery OSCE, I got comments from both patients that I wasn't personable enough. What are they expecting in 7 minutes?

that you don't act like a dick? being personable isn't time dependent.

 

[samenewme]

Who needs books for OB/Gyn this block? I have stuff to lend!

 

[45408]

that you don't act like a dick? being personable isn't time dependent.

Just because I told them to shut up doesn't mean I'm not personable.

 

[Agent Splat]

Just because I told them to shut up doesn't mean I'm not personable.

I bet you didn't even start with an open-ended question and interrupted them within 12 seconds.

 

[45408]

I bet you didn't even start with an open-ended question and interrupted them within 12 seconds.

My review of systems is the most closed-ended series of questions you've ever heard. I don't really care if you had a cough for a few months when you were 12, and you're being evaluated for your gall bladder now at age 60.

 

[indo]

Hah...I was told today to never do a review of symptoms.

 

[Agent Splat]

Hah...I was told today to never do a review of symptoms.

I've been told that too. But honestly a few times it's gotten me some good information. Other times, usually with the old folk, it's just made me want to shoot myself.

 

[Ashers]

I've been told that too. But honestly a few times it's gotten me some good information. Other times, usually with the old folk, it's just made me want to shoot myself.

In real life or OSCEs? I a lot of times do it while going through the physical, if it's random stuff that's totally not related to anything other than the ROS, that way, I remember to ask the stupid questions.

 

[DoctorFunk]

Hah...I was told today to never do a review of symptoms.

I always do an abbreviated version covering the stuff that could kill you on my watch. Fevers/Chills, wt. loss, night sweats? You got cancer! Chest pain/SOB/PND/edema? Your heart and/or lungs be screwed! Melena, hematochezia, hematuria? You could be the proud owner of a new malignancy!

Then you add a few system-specific questions based on their chief complaint and you're good to go.

 

[45408]

Hah...I was told today to never do a review of symptoms.

symptoms or systems? I only used the whole nine yards when I was on medicine or doing a very formal H&P for surgery (only did like 3-4 of them). On trauma, I only did what I knew from memory, and usually only the stuff that was applicable. They're trauma patients - they don't have thyroid problems. I went almost the whole month without saying "diabetes."

 

[45408]

Darn. I did a lot better on the surgery shelf than on the departmental exam. Guess which one is worth more? Not the one I did better on!

 

[Agent Splat]

symptoms or systems? I only used the whole nine yards when I was on medicine or doing a very formal H&P for surgery (only did like 3-4 of them). On trauma, I only did what I knew from memory, and usually only the stuff that was applicable. They're trauma patients - they don't have thyroid problems. I went almost the whole month without saying "diabetes."

unless of course the MVC was caused by an arrhythmia secondary to thyroid disease, in which case you might want to know about it. I've seen some MVCs caused by hypoglycemia as well.

 

[DoctorFunk]

unless of course the MVC was caused by an arrhythmia secondary to thyroid disease, in which case you might want to know about it. I've seen some MVCs caused by hypoglycemia as well.

You are a brilliant man. This is the kind of deep insight that will serve you well on Step 2 CK.

 

[Agent Splat]

You are a brilliant man. This is the kind of deep insight that will serve you well on Step 2 CK.

The most appropriate response to the above statement in this situation would be:
A. Thank you. I know.
B. Thank you, but there is more to taking an exam than regurgitating simple pathological relationships.
C. Thank you. Wanna get a beer?
D. Up yours. I'm in love with your wife.

 

[45408]

unless of course the MVC was caused by an arrhythmia secondary to thyroid disease, in which case you might want to know about it. I've seen some MVCs caused by hypoglycemia as well.

In which case the story would include either "I blacked out and woke up upside down in the car," or "I have no idea how I got here." My MVCs came in with the story of "I was furious at my boyfriend, so I headbutted the windshield and then grabbed the steering wheel and swerved the car into the nearest tree." True story.

 

[indo]

symptoms or systems? I only used the whole nine yards when I was on medicine or doing a very formal H&P for surgery (only did like 3-4 of them). On trauma, I only did what I knew from memory, and usually only the stuff that was applicable. They're trauma patients - they don't have thyroid problems. I went almost the whole month without saying "diabetes."

well technically it is systems but since every question is answered with a "yes" it becomes review of symptoms.

 

[45408]

Argh, surgery grades are *almost* available. I really want to know how I did.

 

[indo]

8 degrees, feels like -1....that has to be a typo, right?

 

[Ashers]

8 degrees, feels like -1....that has to be a typo, right?

It'll warm up by Monday, right?

 

[Gimlet]

I've got 6 degrees with a windchill of -7 right now. And my wife wants me to go outside and put up our Christmas lights before we leave today.

 

[45408]

I've got 6 degrees with a windchill of -7 right now. And my wife wants me to go outside and put up our Christmas lights before we leave today.

insist that she put them up instead. Put your foot down, man.

 

[45408]

Oh, hey, surgery grades are in, but we had a slight problem with the paperwork, so you can come in tomorrow. Oh, wait, tomorrow is Saturday. You can get it on Monday. Ugh. No hurry

 

[DoctorFunk]

Argh, surgery grades are *almost* available. I really want to know how I did.

Should have just e-mailed Amy, the course coordinator. She gave almost all of us the grade hook-ups weeks before the official ones came through.

 

[indo]

haha....grades came out at 4:35 on friday.

 

[45408]

Should have just e-mailed Amy, the course coordinator. She gave almost all of us the grade hook-ups weeks before the official ones came through.

she told me my shelf grade and departmental grade

 

[45408]

haha....grades came out at 4:35 on friday.

for you? or for surgery? because I didn't get an e-mail

 

[Gimlet]

insist that she put them up instead. Put your foot down, man.

I already make her do the ones that require going up on a ladder. Especially after seeing all the TBIs from ladder falls when I was on Neurosurgery. She also does all the inside decorations, since I pretty much refuse to help.

 

[Agent Splat]

for you? or for surgery? because I didn't get an e-mail

It was quite plainly stated by the registrar, Ms. Lesley Mack, that although colleagues even on the same rotation as you may be getting their grades in, do not assume your grades are available until an email is issued to your Medical College of Wisconsin email (mcw.edu) account clearly stating so.

We expect no further questions on the matter.

The Overseers