MS-III
Sunday, October 31, 2004
Surgery...
I guess I'm the first to go through a surgery rotation. And you were wondering where I was the past 2 weeks, right? Let me explain -
First, I had the family medicine departmental exam and the NBME Family Medicine shelf a week past. I'd heard the Family Medicine shelf is the hardest of the shelves, so I took some time to study because I wanted to do well. That took a few days of hard-core studying, then 2 days of exams. The really sorry thing about it is after the departmental exam, we had to go back to the clinic. It isn't a bad idea, just not the best setup for studying for the shelf. I was worried, but I think I did fairly well on the shelf. I'll see in 4-6 weeks, I guess.
The weekend was a glorious time off. I didn't do a damn thing, except rest and relaxation. It was beautiful. I wish every day could be like those 2 days.
Surgery began last monday, 10/25/04. It began with an orientation (like every rotation). I thought it was particularly humorous when the head of the department of surgery told us we were to work no longer than 80 hours per week - including study and academic time. We are to divide our 80 hr/wk into thirds and divide it between hospital, academic (meaning lectures, etc), and reading.
Obviously, he has never been over to the hospital where I am assigned. It is a VERY busy county hospital where noone EVER gets out on time. Let me break down the past week for you - keep in mind, call is every 4 days...
Monday: 0700 (orientation) - 1400 = 7 hours
Tuesday (Call): 0600 - 2400 = 18 hours (call not finished)
Wednesday (Post-call): 0000 - 1600 = 16 hours
Thursday (clinic): 0530 - 1800 = 12.5 hours
Friday (Precall): 0600 - 2000 = 14 hours
Saturday (Call): 0630 - 2400 = 17.5 hours (call not finished)
Sunday (Post-call): 0000 - 1300 = 13 hours
Grand total for week 1: 98 hours
And remember, that's supposed to be 1/3 of my total time spent per week. I still have to read and go to academics for a total of 294 hours per week. The only problem with that is there are only 189 hours per week actually available.
I think it is important to spend time in the hospital in order to learn, but 1/2 the total time in a week is a little insane. The only good think about it is that we have had some really cool traumas this week. Sounds pretty morbid, huh? The thing about medicine, especially Emergency Medicine or Trauma, is that you become cynical and begin to view the morbid as exciting.
For instance, my first night on call (Tuesday) we had a patient with a GSW (gunshot wound) to the left anterior chest. He was shot by a police officer after he'd first tried to break into an apartment, flee the police, then shot at the cops. He was down for 15 minutes in the field without a pulse and an idioventricular rhythm on the monitor (per EMS). When he arrived in the ED, he was in about the same condition - no pulse, no pressure, no spontaneous respirations. He was intubated and manually ventilated. CPR was in progress and there were 2 large bore IVs draining wide open for volume support. His GSW was just below his left nipple; there was no immediately obvious exit wound. Given the location of the entry, we were concerned for cardiac and pulmonary damage. As a result, the chief resident performed an emergency thoracotomy. It was F-ING AWESOME!! I was performing CPR on the patient's right as he was opening up the left. He spread the ribs and about 2 liters of blood and fluid poured out all over the place. I could see the heart and lungs plain as day.
They delivered the heart from the pericardium and examined it. They found a large laceration in the posterior portion of the left ventricle - no wonder he didn't have a pulse or blood pressure, right?
They repaired the defect and everything was re-started. We were giving intracardiac epinephrine, direct cardiac massage, open defibrillation - the whole works. It rocked... in a sick and twisted sort of way.
The patient died - as most people in that situation do, but it still got all our blood pumping.
Ok.. I'll write more later. I've been up since 0530 yesterday - I'm really freaking tired.
And by the way, never ever EVER EVER EVER be on call when the time change goes back.. that extra hour really sucks. ¶ 8:54 AM 0 comments
First, I had the family medicine departmental exam and the NBME Family Medicine shelf a week past. I'd heard the Family Medicine shelf is the hardest of the shelves, so I took some time to study because I wanted to do well. That took a few days of hard-core studying, then 2 days of exams. The really sorry thing about it is after the departmental exam, we had to go back to the clinic. It isn't a bad idea, just not the best setup for studying for the shelf. I was worried, but I think I did fairly well on the shelf. I'll see in 4-6 weeks, I guess.
The weekend was a glorious time off. I didn't do a damn thing, except rest and relaxation. It was beautiful. I wish every day could be like those 2 days.
Surgery began last monday, 10/25/04. It began with an orientation (like every rotation). I thought it was particularly humorous when the head of the department of surgery told us we were to work no longer than 80 hours per week - including study and academic time. We are to divide our 80 hr/wk into thirds and divide it between hospital, academic (meaning lectures, etc), and reading.
Obviously, he has never been over to the hospital where I am assigned. It is a VERY busy county hospital where noone EVER gets out on time. Let me break down the past week for you - keep in mind, call is every 4 days...
Monday: 0700 (orientation) - 1400 = 7 hours
Tuesday (Call): 0600 - 2400 = 18 hours (call not finished)
Wednesday (Post-call): 0000 - 1600 = 16 hours
Thursday (clinic): 0530 - 1800 = 12.5 hours
Friday (Precall): 0600 - 2000 = 14 hours
Saturday (Call): 0630 - 2400 = 17.5 hours (call not finished)
Sunday (Post-call): 0000 - 1300 = 13 hours
Grand total for week 1: 98 hours
And remember, that's supposed to be 1/3 of my total time spent per week. I still have to read and go to academics for a total of 294 hours per week. The only problem with that is there are only 189 hours per week actually available.
I think it is important to spend time in the hospital in order to learn, but 1/2 the total time in a week is a little insane. The only good think about it is that we have had some really cool traumas this week. Sounds pretty morbid, huh? The thing about medicine, especially Emergency Medicine or Trauma, is that you become cynical and begin to view the morbid as exciting.
For instance, my first night on call (Tuesday) we had a patient with a GSW (gunshot wound) to the left anterior chest. He was shot by a police officer after he'd first tried to break into an apartment, flee the police, then shot at the cops. He was down for 15 minutes in the field without a pulse and an idioventricular rhythm on the monitor (per EMS). When he arrived in the ED, he was in about the same condition - no pulse, no pressure, no spontaneous respirations. He was intubated and manually ventilated. CPR was in progress and there were 2 large bore IVs draining wide open for volume support. His GSW was just below his left nipple; there was no immediately obvious exit wound. Given the location of the entry, we were concerned for cardiac and pulmonary damage. As a result, the chief resident performed an emergency thoracotomy. It was F-ING AWESOME!! I was performing CPR on the patient's right as he was opening up the left. He spread the ribs and about 2 liters of blood and fluid poured out all over the place. I could see the heart and lungs plain as day.
They delivered the heart from the pericardium and examined it. They found a large laceration in the posterior portion of the left ventricle - no wonder he didn't have a pulse or blood pressure, right?
They repaired the defect and everything was re-started. We were giving intracardiac epinephrine, direct cardiac massage, open defibrillation - the whole works. It rocked... in a sick and twisted sort of way.
The patient died - as most people in that situation do, but it still got all our blood pumping.
Ok.. I'll write more later. I've been up since 0530 yesterday - I'm really freaking tired.
And by the way, never ever EVER EVER EVER be on call when the time change goes back.. that extra hour really sucks. ¶ 8:54 AM 0 comments
Wednesday, October 13, 2004
Medical Records Implant: Good or Evil?
Do I think the idea is good? Yes. Do I think it will ever actually happen? No. The ACLU would have a freaking field day with this one, as would every human rights group saying we would be tracked, we would be reduced to nothing more than numbers, etc, etc, etc.
While I appreciate their concerns, they have obviously never seen a John Doe in the Emergency Department at 0200, not known anything about them or their past history and had to make decisions about their care. Maybe then these groups wouldn't throw such a huge freaking fit!
Until then, enjoy the read!
===========================================================
FDA: Chip Implant Can Be Used to Get Health Records
WASHINGTON (Reuters) Oct 13 - A computer chip that is implanted under the skin won U.S. approval on Wednesday for use in helping doctors quickly access a patient's medical history.
The VeriChip, sold by Applied Digital Solutions Inc., is placed in the upper arm in a painless procedure that takes minutes, the company said.
About the size of a grain of rice, the chip contains a patient's identification number that corresponds to health information in a computer database. A handheld scanner can retrieve the patient's number from the chip, which emits radio waves when activated.
Proponents hope doctors will use the technology to find vital information about someone who is unconscious or having trouble communicating. The database could include details such as medication use, allergies and major health problems.
The chip implants have been used for years for various purposes such as identifying lost pets. But Applied Digital was not allowed to market the chips for medical use in the United States until the company received clearance from the Food and Drug Administration on Wednesday.
The FDA ruled in 2002 that it would not regulate financial, security or other uses of the chips.
Privacy advocates have voiced worry about the speedy transfer of sensitive medical information via computer. Applied Digital said the data would be kept secure. ¶ 8:56 PM 0 comments
While I appreciate their concerns, they have obviously never seen a John Doe in the Emergency Department at 0200, not known anything about them or their past history and had to make decisions about their care. Maybe then these groups wouldn't throw such a huge freaking fit!
Until then, enjoy the read!
===========================================================
FDA: Chip Implant Can Be Used to Get Health Records
WASHINGTON (Reuters) Oct 13 - A computer chip that is implanted under the skin won U.S. approval on Wednesday for use in helping doctors quickly access a patient's medical history.
The VeriChip, sold by Applied Digital Solutions Inc., is placed in the upper arm in a painless procedure that takes minutes, the company said.
About the size of a grain of rice, the chip contains a patient's identification number that corresponds to health information in a computer database. A handheld scanner can retrieve the patient's number from the chip, which emits radio waves when activated.
Proponents hope doctors will use the technology to find vital information about someone who is unconscious or having trouble communicating. The database could include details such as medication use, allergies and major health problems.
The chip implants have been used for years for various purposes such as identifying lost pets. But Applied Digital was not allowed to market the chips for medical use in the United States until the company received clearance from the Food and Drug Administration on Wednesday.
The FDA ruled in 2002 that it would not regulate financial, security or other uses of the chips.
Privacy advocates have voiced worry about the speedy transfer of sensitive medical information via computer. Applied Digital said the data would be kept secure. ¶ 8:56 PM 0 comments
Saturday, October 09, 2004
Friday Night Lights!?!?!?
Well, I just returned from the movie theatre with my girlfriend. We went to see Friday Night Lights. Awesome movie. It really took me back to the good old days of High School football...
If you remember from my "bio," I'm originally from a small town in West Texas. Yes, both words should be capitalized because West Texas isn't really part of Texas - hell, it's just barely a part of the United States. If you're from West Texas, you know what I mean. Everything is different out there. There are no towns of 1/2 million; 100k is about as big as you get until you reach El Paso (which, disputably, is part of Mexico). From the day young boys enter kindergarten they are indoctrinated into the ways of West Texas Football. There is no sportsmanship, there is no U.I.L. rules, there is only winning. At any price.
I remember 2-a-days. What I remember most was dreading it for the 2 weeks prior to August, hating it while enduring it and being so very relieved when it was over. I really don't know how we survived those all-day practices in the 100+ degree West Texas heat, but we did. I compare it to the brainwashing a group of recruits endures during basic training - isolated from humanity, your family, humiliated, broken down, and finally rebuilt as a single fighting machine - your troop, your team. That is the only way I can describe the punishment, the pain, and the suffering we went through. By the time 2-a-days was over, we were ready to eat the other teams alive if we had to.
I think of those times with fondness. It really sucked while I was living it, but, in retrospect, they really were some of the best times in my life. There's just something about laying a good hit on a running back or quarterback that you never forget. It's a craving - once you've had it, you want more. And you can't rest until you get it again.
Damn, I miss football.
We had a different kind of "Friday Night Lights" the other night. My girlfriend and I had gone out for a friday night on the town. We spent about 5 hours at Dave & Busters - it was my first time there, so I had to explore everything. We played games until my eyes, my arms and my wallet hurt from buying so many damn tokens. Afterwards, we contemplated going to a movie, but declined since it was after 1030pm and we had about an hour drive back to our home-town.
As we were driving home, my GF snoozing lightly in the front passenger seat, I cruising easily along with traffic, I noticed a pair of headlights weaving erratically in and out of traffic behind us. They were travelling at least 95mph down the highway, cutting in and out between cars - often barely avoiding hitting other vehicles in the process. As the headlights came closer and closer to my tail-end, I looked for a place to bail out of the lane, but there was nowhere to go. I had a small car on my right rear-quarter-panel, an SUV about 1/2 car lengths in front of me on the right, and a cement barrier on my left. Instead, I held my course, woke my GF, and hoped we didn't die when I got rear-ended.
What happened instead was like a medical student's dream (especially one interested in Emergency Medicine).
As the headlights flew up behind us, I saw them lurch to the right and a grey Jeep Grand Cherokee (JGC) flew by me, almost clipping my rear end. How it didn't hit the car at my rear quarter-panel, I don't know. Maybe there was a bit more space there than I thought - I'd lost track of that car by now. As the JGC went to the right and by me, he overcorrected back to the left, causing his car to careen out of control. The vehicle ended up perpendicular to the flow of traffic, sliding down the highway and still coming to the left (i.e., toward my car). I had already slammed on my brakes and hit the horn by this time. The JGC continued in its leftward/forward direction, going up on 2 wheels and slamming into the cement barrier.
As if that weren't enough, the JGC then went into a 1-1/2 rollover, ending up on its top and spewing sparks as it slid forward and to the right, back into traffic. How this JGC didn't hit a ton of cars, I seriously don't know. Fortunately, the JGC was the only vehicle involved in the wreck.
Anyways, I had stopped by this time, killed my car, turned on the emergency flashers and began running toward the overturned vehicle thinking (somewhat morbidly), "Oh let there be blood, let there be blood." Does this make me a bad person? Am I something of a monster if I crave blood and maiming like I crave a crushing blindsided blow to a quarterback? Perhaps, but it's what keeps me ticking.
When I got up to the car, my GF was already there (she didn't have to mess with the ignition or the emergency flashers, so she got a headstart). There were beer bottles everywhere and the whole scene smelled like alcohol. The driver (the only passenger in the JGC) had already crawled out the passenger side window, since the driver-side window and the windshield were completely crushed. We ran over to the other side of the JGC and found the driver very drunk, and mostly unscathed (dammit). He was very nonchalantly explaining to us (and everyone else that had stopped) that he was not drunk and that he, in fact, was "awwright." He repeatedly refused to sit down on the side of the road and even let us look him over. Instead, he was hell-bent on staggering back out into traffic to look at his precious pile of scrap metal that was taking up 3 lanes of traffic. BTW, it also happened to be blaring Beastie-Boys "You Gotta Fight!" How apropos when the police, fire, and ambulance crews arrived a few minutes later.
After a few more minutes, we were all cleared to leave, awed not only by the fact that this guy hadn't killed himself, but that somehow, despite the fact that traffic was pretty heavy at the time, he had managed not to take anyone else with him (or send anyone else in his stead, if you want to look at it that way). The truly scary thing is, my GF and I would have probably been the first to go, since he was less than 10 feet from the front of my car when all this happened.
Thank God for small miracles, huh?
Ok, enough for now. I hope you all make your own Friday Night Lights, keep the faith, go after your dreams, and believe in yourselves.
Good night. ¶ 9:18 PM 0 comments
If you remember from my "bio," I'm originally from a small town in West Texas. Yes, both words should be capitalized because West Texas isn't really part of Texas - hell, it's just barely a part of the United States. If you're from West Texas, you know what I mean. Everything is different out there. There are no towns of 1/2 million; 100k is about as big as you get until you reach El Paso (which, disputably, is part of Mexico). From the day young boys enter kindergarten they are indoctrinated into the ways of West Texas Football. There is no sportsmanship, there is no U.I.L. rules, there is only winning. At any price.
I remember 2-a-days. What I remember most was dreading it for the 2 weeks prior to August, hating it while enduring it and being so very relieved when it was over. I really don't know how we survived those all-day practices in the 100+ degree West Texas heat, but we did. I compare it to the brainwashing a group of recruits endures during basic training - isolated from humanity, your family, humiliated, broken down, and finally rebuilt as a single fighting machine - your troop, your team. That is the only way I can describe the punishment, the pain, and the suffering we went through. By the time 2-a-days was over, we were ready to eat the other teams alive if we had to.
I think of those times with fondness. It really sucked while I was living it, but, in retrospect, they really were some of the best times in my life. There's just something about laying a good hit on a running back or quarterback that you never forget. It's a craving - once you've had it, you want more. And you can't rest until you get it again.
Damn, I miss football.
We had a different kind of "Friday Night Lights" the other night. My girlfriend and I had gone out for a friday night on the town. We spent about 5 hours at Dave & Busters - it was my first time there, so I had to explore everything. We played games until my eyes, my arms and my wallet hurt from buying so many damn tokens. Afterwards, we contemplated going to a movie, but declined since it was after 1030pm and we had about an hour drive back to our home-town.
As we were driving home, my GF snoozing lightly in the front passenger seat, I cruising easily along with traffic, I noticed a pair of headlights weaving erratically in and out of traffic behind us. They were travelling at least 95mph down the highway, cutting in and out between cars - often barely avoiding hitting other vehicles in the process. As the headlights came closer and closer to my tail-end, I looked for a place to bail out of the lane, but there was nowhere to go. I had a small car on my right rear-quarter-panel, an SUV about 1/2 car lengths in front of me on the right, and a cement barrier on my left. Instead, I held my course, woke my GF, and hoped we didn't die when I got rear-ended.
What happened instead was like a medical student's dream (especially one interested in Emergency Medicine).
As the headlights flew up behind us, I saw them lurch to the right and a grey Jeep Grand Cherokee (JGC) flew by me, almost clipping my rear end. How it didn't hit the car at my rear quarter-panel, I don't know. Maybe there was a bit more space there than I thought - I'd lost track of that car by now. As the JGC went to the right and by me, he overcorrected back to the left, causing his car to careen out of control. The vehicle ended up perpendicular to the flow of traffic, sliding down the highway and still coming to the left (i.e., toward my car). I had already slammed on my brakes and hit the horn by this time. The JGC continued in its leftward/forward direction, going up on 2 wheels and slamming into the cement barrier.
As if that weren't enough, the JGC then went into a 1-1/2 rollover, ending up on its top and spewing sparks as it slid forward and to the right, back into traffic. How this JGC didn't hit a ton of cars, I seriously don't know. Fortunately, the JGC was the only vehicle involved in the wreck.
Anyways, I had stopped by this time, killed my car, turned on the emergency flashers and began running toward the overturned vehicle thinking (somewhat morbidly), "Oh let there be blood, let there be blood." Does this make me a bad person? Am I something of a monster if I crave blood and maiming like I crave a crushing blindsided blow to a quarterback? Perhaps, but it's what keeps me ticking.
When I got up to the car, my GF was already there (she didn't have to mess with the ignition or the emergency flashers, so she got a headstart). There were beer bottles everywhere and the whole scene smelled like alcohol. The driver (the only passenger in the JGC) had already crawled out the passenger side window, since the driver-side window and the windshield were completely crushed. We ran over to the other side of the JGC and found the driver very drunk, and mostly unscathed (dammit). He was very nonchalantly explaining to us (and everyone else that had stopped) that he was not drunk and that he, in fact, was "awwright." He repeatedly refused to sit down on the side of the road and even let us look him over. Instead, he was hell-bent on staggering back out into traffic to look at his precious pile of scrap metal that was taking up 3 lanes of traffic. BTW, it also happened to be blaring Beastie-Boys "You Gotta Fight!" How apropos when the police, fire, and ambulance crews arrived a few minutes later.
After a few more minutes, we were all cleared to leave, awed not only by the fact that this guy hadn't killed himself, but that somehow, despite the fact that traffic was pretty heavy at the time, he had managed not to take anyone else with him (or send anyone else in his stead, if you want to look at it that way). The truly scary thing is, my GF and I would have probably been the first to go, since he was less than 10 feet from the front of my car when all this happened.
Thank God for small miracles, huh?
Ok, enough for now. I hope you all make your own Friday Night Lights, keep the faith, go after your dreams, and believe in yourselves.
Good night. ¶ 9:18 PM 0 comments
Tuesday, October 05, 2004
Studying
Before I entered medical school, my idea of a lot of studying was a few hours of looking over notes the night before a test. I refused to study any more than 3-4 hours for any test because I didn't think it was worth it (and frankly, even in nursing school anything more than that would have been a waste of my time. Don't always believe what you hear).
When I was applying to medical school, I knew things would have to change. What I didn't realize was the extent to which everything would change.
For the past 2 years, 3 months and 1 week I have been studying for no less than 2-3 hours EVERY DAY (not including christmas/summer holidays) - this is not counting the increased study time that goes in before tests/shelf exams/boards. Weekends, minor holidays - all have fallen prey to the evil study gods that demand obeisance. That's fine, no problem.
But hell. I need a break. The problem is, I'm afraid that if I take a break I'll get behind, I'll never be able to catch up, that my whole system will fall to pieces and all my dreams will go by the wayside. I have too much vested in my dreams for that to happen.
I realize this is all a bit of overkill, but you get the point. I don't want to have wasted 4 years and roughly 135K by the time all this is through - if you catch my drift...
I think anxiety is a part of the game. I don't know how many of my friends here in school have started taking anxiolytics or antidepressants since first year. More than I can count on both hands, I can assure you. Fortunately for me, I've withstood the onslaught of anxiety and depression better than some and have yet to succumb to medication to ease my pangs. Of course, I've always considered myself thick skinned. Which I guess is why I can give and take so much $h!t.
But back to the point - I need a break from the daily grind. I'm ready for fall break. When do we get that? Just a nice week with nothing to do, nothing to study, no patients to see and no shelf exams at the end... only a mirage in the deserted distance? I'm sure, but it sure is a tantalizing vision!
Christmas can't come soon enough.
Fortunately for me, the block in which I find myself is probably the most intense - Int Med, Family Med and Surgery. Next is Peds and OB/Gyn block, then OMT, PCP, and Psych. Round out the year with some cush... that's what I'm talking about!! I'm ready. ¶ 6:03 AM 0 comments
When I was applying to medical school, I knew things would have to change. What I didn't realize was the extent to which everything would change.
For the past 2 years, 3 months and 1 week I have been studying for no less than 2-3 hours EVERY DAY (not including christmas/summer holidays) - this is not counting the increased study time that goes in before tests/shelf exams/boards. Weekends, minor holidays - all have fallen prey to the evil study gods that demand obeisance. That's fine, no problem.
But hell. I need a break. The problem is, I'm afraid that if I take a break I'll get behind, I'll never be able to catch up, that my whole system will fall to pieces and all my dreams will go by the wayside. I have too much vested in my dreams for that to happen.
I realize this is all a bit of overkill, but you get the point. I don't want to have wasted 4 years and roughly 135K by the time all this is through - if you catch my drift...
I think anxiety is a part of the game. I don't know how many of my friends here in school have started taking anxiolytics or antidepressants since first year. More than I can count on both hands, I can assure you. Fortunately for me, I've withstood the onslaught of anxiety and depression better than some and have yet to succumb to medication to ease my pangs. Of course, I've always considered myself thick skinned. Which I guess is why I can give and take so much $h!t.
But back to the point - I need a break from the daily grind. I'm ready for fall break. When do we get that? Just a nice week with nothing to do, nothing to study, no patients to see and no shelf exams at the end... only a mirage in the deserted distance? I'm sure, but it sure is a tantalizing vision!
Christmas can't come soon enough.
Fortunately for me, the block in which I find myself is probably the most intense - Int Med, Family Med and Surgery. Next is Peds and OB/Gyn block, then OMT, PCP, and Psych. Round out the year with some cush... that's what I'm talking about!! I'm ready. ¶ 6:03 AM 0 comments
Saturday, October 02, 2004
Blah
Lately, I've become stricken with what I can only describe as the "blahs."
I'm sure you've heard of them - when no matter how much (or how little) you sleep, you always feel completely worn down. When no matter how much you have to do, you never want to do any of it.
Yeah. That's me - for like the past 3 weeks.
I don't know what's up lately. I was sick as all hell last weekend. I didn't remember what dry heaves felt like until last saturday and sunday - it had been that long. But it all came back to me in a flash of bad memories.
I wonder if I have mono or something. The thing is, I don't really have any other symptoms - fatigue, malaise... nothing else. No fever, cough, sore throat, weight loss (I wish), chills, diarrhea, nausea or vomiting (except for last weekend), adenopathy, rash... nothing to suggest an organic cause.
And then I was reading about fatigue today in my Blueprints for Family Medicine book - it told me that the majority of fatigue is psychological and stressful situations make one much more prone to be fatigued than not. So, I guess I've diagnosed myself with 3rd year medical student syndrome (3MSS).
I think I might write an article for JAMA or something. Or maybe I'll try to find some tenderpoints and write the article for the JAOA instead - oh wait.. I want people to take it seriously. JAMA or NEJM it is. :)
Not that I have anything against the JAOA - it makes a really good liner for the recycling container. Really, now - if you're going to publish a magazine, at least make it useful.
Ok. I'm done. I'm not feeling too good and my cynicism is showing (stronger than usual). Good night all, have a great weekend. ¶ 1:36 PM 0 comments
I'm sure you've heard of them - when no matter how much (or how little) you sleep, you always feel completely worn down. When no matter how much you have to do, you never want to do any of it.
Yeah. That's me - for like the past 3 weeks.
I don't know what's up lately. I was sick as all hell last weekend. I didn't remember what dry heaves felt like until last saturday and sunday - it had been that long. But it all came back to me in a flash of bad memories.
I wonder if I have mono or something. The thing is, I don't really have any other symptoms - fatigue, malaise... nothing else. No fever, cough, sore throat, weight loss (I wish), chills, diarrhea, nausea or vomiting (except for last weekend), adenopathy, rash... nothing to suggest an organic cause.
And then I was reading about fatigue today in my Blueprints for Family Medicine book - it told me that the majority of fatigue is psychological and stressful situations make one much more prone to be fatigued than not. So, I guess I've diagnosed myself with 3rd year medical student syndrome (3MSS).
I think I might write an article for JAMA or something. Or maybe I'll try to find some tenderpoints and write the article for the JAOA instead - oh wait.. I want people to take it seriously. JAMA or NEJM it is. :)
Not that I have anything against the JAOA - it makes a really good liner for the recycling container. Really, now - if you're going to publish a magazine, at least make it useful.
Ok. I'm done. I'm not feeling too good and my cynicism is showing (stronger than usual). Good night all, have a great weekend. ¶ 1:36 PM 0 comments
