Wayfaring MD

I am a family medicine resident who likes to highlight the hilarious in medicine as I write about patients, medical school, residency, medical missions, and whatever else strikes my fancy.



Disclaimer:
HIPAA is for reals, folks. All of my "patient stories" have been changed to protect patient privacy. I will change any or all identifiers, including age, location, race/ethnicity, sex, medical history, and quotes. Also, I am an anonymous internet person. Why should you trust an anonymous internet person to give you medical advice? Don't ask me, ask your doctor!
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cranquis:

princeton-medbloro:

Due to a recent influx of not-the-greatest publicity (PMTH is still seeking a new PR representative, by the way), the Executive Board of PMTH has found it necessary to rebrand the hospital. 

Since we are a hospital that values community input and togetherness, we would like to give the community the opportunity to take part in our makeover.

PMTH seeks both a new logo and a new hospital motto for our website. Keep in mind that the new hospital motto should encompass the spirit of PMTH: Education, Donuts, Scut Work, and Pure Incompetence. 

We will be accepting submissions from now until November 10th, 2014. The submissions for logo and motto will be voted on by the PMTH community as well, and the winner will get….um…. a prize of some sort (TBD). 

So get crackin!

(Or Cranq-in’ (tm). Either one.)

What’s Latin for “Donuts”?

There is no such thing as a readable EMR note. Your position is false. Your very existence is a lie. :)

Oh dear Cranquis, I think you know better than anyone that my existence is very real…

Bad handwriting should be regarded as a sign of an imperfect education.

Mahatma Gandhi

But readable notes are a sign of a good EMR. - WayfaringMD

Intern in rounds: This is a 63 year old lady who presents with chest pain and shortness of breath that started at Wal-mart…

Attending: That’s the second one this week! What is there, a hypoxia section at Wal-mart? 

plannedparenthood:

image

Someone asked us:

Hi, I’m just curious about pregnancy tests. Are there test that shouldn’t be used or tests that are better? When should you take a test?

When it comes to pregnancy tests, brands don’t matter, because all at-home pregnancy tests work the…

Cranquis dear, you’re totally ruining our business plan to market TheSuperAccurateTestYourDoctorUses (TM)! We could be squillionaires!

Ophtho: Today we’re going to go over some common disorders of the eyelids and eye musculature. I expect you guys to answer out loud. These things are pretty straightforward. 

*First slide*

Resident: Strabismus!

Ophtho: This is an example of myasthenia gravis.

*Second Slide*

Resident: Strabismus!

Ophtho: No, this is dermatochalasis.

Residents whispering amongst themselves: What? What is that word?

*Third Slide*

Resident: um, wonky eye

Ophtho: This is blepharospasm.

Residents whispering: geez, we’re supposed to know these? 

*Fourth Slide*

Resident: uh…well…the eyelid is droopy

Ophtho: This is called ectropion.

Resident: sure, okay.  

*Fifth Slide*

Resident: It looks like all the others. What’s the big made up word name for this one?

Ophtho: This is actually called droopy eyelid syndrome.

Resident: Of course it is. 

Every day you get to sleep, study, or have a social life, but you can never do more than one thing per day.

Words of warning from a local surgeon to med students RE: surgery residency. 

watching a group of internists from places including Syria, Afghanistan, India, Egypt, Pakistan, and Ghana…

learning cuss words in each others’ languages and dialects. 

  • Family member: HIIII DOCTOR!!!
  • Me: .........
  • Family member: HOW ARE YOU DOING DOCTOR??
  • Me: ..........
  • Family member: I HOPE ALL IS WELL WITH YOU DOCTOR!!!
  • Me: ...............
  • I'm not a doctor yet I swear THIS IS TOO MUCH FOR ME STAHPPPP THE PRESSURE STAHAAAAP
  • Edit from Wayfaring: and then when you graduate and enter a room wearing a long white coat, the family will ask, "are you his nurse today?"

Attending: Which one is Mr. B again?

Wayfaring: The one who’s using the dead neighbor’s oxygen. 

Attending: You know, I picture 2 shotgun houses about 10 feet apart with a really long tube running out the window from one to another so he can steal the O2. 

Wayfaring: I pictured more of a Misery type situation. You know, neighbor imprisoned in a small room in the house so they can collect the neighbor’s O2 and social security checks.

Or maybe the neighbor was already a few days dead and was on the floor starting to decompose and they went and pried the nasal cannula off his face and then stole it….

Attending: Wow Wayfaring, you have an unexpectedly dark mind. 

Wayfaring: 

Intern presenting new patient: Mr. B is on 2L of oxygen all the time at home.

Attending: I thought you said he didn’t have a doctor. Who got his O2 for him?

Intern: Oh he stole it from his dead neighbor. 

Wayfaring: Was the neighbor dead before or after he stole it?

  • Me (to patient in hospital): Hey, I thought you were supposed to go home yesterday!
  • Patient: (shoves a HANDFUL of Tums in his mouth) well my doctors said my calcium level was real high and they don't know why, so they're keeping me till they can figure it out
  • Me: Hmmm.... I have a pretty good idea why.

Hi, I was wondering about illegal drug use amongst med students, residents and doctors. How common is it? And are there any periodic screenings for medical professionals to make sure they aren’t on anything? — wanweird-of-an-argonaut

Drug screenings are school and residency program dependent. Both of mine required a UDS before we started, and many hospitals will require them of all employees (including doctors) before they start work. I believe there is language in our work contracts that allows the hospital to require drug screening at random if substance abuse is expected, too. 
As to how common illegal drug use is with students and doctors, I couldn’t say. There are new statistics suggesting that 15% of med students are taking stimulants, but of course many of them are actually prescribed these meds. 
There is a surprising lack of good quality, large studies on this subject. The most recent and most thorough data I can find is from the early 90s, so I’m sure things have changed, but it suggests that about 10% of US physicians use alcohol daily, and a total of almost 1% use other illicit drugs on a daily basis.  The numbers are a good bit higher for use in the past month, year, or lifetime, but are less indicative of abuse. The linked study also breaks the data down by age group and gender. Overall it estimates a 2.1% annual prevalence and 7.9% lifetime prevalence of substance abuse among physicians. Those are pretty low numbers, but the study also notes that it relied on self-report from physicians, so that’s a possible confounder. 

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With people pushing for the legalization of medical marijuana there’s a lot of propaganda for it everywhere online.  I’ve been seeing a lot of stuff that says things along the lines of “marijuana KILLS cancer cells.” Now I’m pretty sure this is wrong, b/c I feel like if this were true then cancer wouldn’t be an issue anymore. This would mean marijuana is the CURE for cancer. My question is, what effects, if any, does marijuana have on diseases like cancer? -sammbaamm

Umkay, let’s get one thing straight right off: Cancer is not one disease. Cancer is over a hundred diseases all lumped under one name. What kills one type of cancer does nothing for a different type. So anything you see or read about that claims to “cure cancer” is either completely bogus or is a watered down claim based on shaky research. 

I find it interesting that none of these internet claims cite any decent studies to back up their claims. Honestly, I don’t know what effect marijuana has on certain cancers (or if it has an effect at all) because there just aren’t tons of well-designed studies out there answering that question. Actually, when I did a quick search on marijuana use in cancer, the top 2 pages of results (besides those discussing MJ as a treatment for nausea and cancer anorexia, which actually does have good evidence behind it) were all on correlations between marijuana usage and developing cancers of various types.

You can find studies to say basically whatever you want them to say. But that doesn’t mean that they’re legitimate studies. Most of the ones I’ve seen are small and have gaping holes and huge flaws in their designs. If the study is flawed, guess what — the results might be too. 

Also, you hit on a very important point, sammbaamm— if we had definitive proof that marijuana cured cancer (of any type), drug companies would be ALL OVER IT trying to patent their own marijuana blend for chemotherapy use. 

plannedparenthood:

I can see the appointment slots filling up on my schedule already.