Wayfaring MD

• Even residents who were gunners hate other gunners. So just don’t be one. If the resident tells you to go home at 4:30, for heaven’s sake, go home. They probably have run out of things to teach you for the day, and they have work they need to get done with peace and quiet. If they tell you to leave, they’re not going to rat you out for leaving early. 
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• Get to know your resident as much as you can. Don’t take up work time, but when there’s downtime, don’t disappear immediately. Have a conversation. 
• Stay out of the way. This will be hard to do because you will always feel like you’re in the way. I still feel like I’m in the way as a resident.
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• If there are no chairs available and a nurse, attending, or resident needs one, you are expected to give yours up. This is something I still practice, and it weirds me out when nurses offer me their chairs. 
• Don’t steal the resident or attending’s computer. And don’t log them out. 
• Don’t misrepresent yourself to your patients. They should understand that you are not a doctor yet. 
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• Be a team player. Don’t fight other students for procedures or throw them under the bus. If we perceive that you are trying to tear down your fellow students, our opinion of you will automatically fall. Help other students when they’re slammed. Remember, attendings are looking for good things to say about you in a letter of rec, and programs love residents who are easy to work with.
• Don’t try to teach your resident. We already know you’re smarter than we are. You’re closer to step 1 than we are. But we have plenty to teach you. 
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• Ask your residents for advice about residency applications, clerkships, whatever. It’s flattering to us. 

When your dentist takes one look in your mouth and then asks, “are you diabetic?”

Clinic cancelled tomorrow AM.

Was super excited about sleeping in till like 8 or 9. 

Till, like an idiot, I called for a dentist appointment. 

And they were all “we have a cancellation at 8:00 tomorrow. Be there by 7:45.”

Darn you, dentist. If it hadn’t already been over a year since I’ve had a cleaning, I’d totally no-show tomorrow. 

1. cranquis said: Ooh you’re expecting med students! Have fun! Almost feels like someone should throw you a med-student-shower or something.

A shower sounds great. I will get started on my registries at Target and Etsy.

Since a lot of you are about to start the clinical part of your training, and I’m about to get med students for the first time, I figured I’d put together a little how-to (in 3 episodes) with the help of my fellow residents.

• Take initiative with your patients. Know all their info: what meds they’re on, their labs, their histories, etc.
• Check back on your patients in the afternoon. Follow their labs or tests done during the day and think about what needs to be done about them. Otherwise you’ll find that a ton of stuff has happened the next day and you’ll be out of the loop. 
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• Have your notes written before the resident rounds so they can read them and hopefully give you feedback on them.
• Always attempt to write an assessment and plan on your notes, no matter how simple it is. “Continue current management” is usually not an acceptable plan. What needs to be done before this patient can go home? 
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• In surgery, always ask permission (preferably from the attending) to scrub in. I do this still as a resident. If they say yes, get your gloves and gown for the scrub tech because they’re probably not prepared for you. 
• Ask to do procedures, but don’t expect to get them. The residents are always first in line. If it’s a procedure they’re confident doing and they have time to teach you, they’ll probably let you do it. 
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• If we ask if you want to do a procedure, always say yes. Even if you don’t want to. 
• In the outpatient setting, always offer to help write the note. Rarely will a resident turn you down, and you will really help them out. They will still review and change it, but it will definitely help.
• Be available. You don’t have to be a shadow, but don’t expect your resident to call you for admissions/procedures/check out, because she will forget. If you haven’t heard from the resident in a while, check back in with them. She may have forgotten you were around and might send you home early!
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Attending giving a talk on eastern medicine: Has anyone here ever had moxibustion?

**Everyone looks to J, the only Asian in the room at that time**

J:  

Um, I think I’ve had moxifloxacin once.

Any advice for when they hit you with the big ones like “I’m going to die”, “I don’t want to die”, “I’m in pain”, etc? A lot of my residents are pre-hospice or should be there already. Thanks for your time! -kiashinigami

I think people worry about these questions way too much. I very rarely get questions like this. People in hospice or in nursing homes generally know that they don’t have decades of life left. 

When people let on that they are afraid of death (which is a pretty normal feeling), try to offer them some understanding and whatever hope you can. Ask them what exactly they fear and why. Do they fear pain? The unknown? The afterlife? Help them work through their fear. You may not be able to offer them solid answers, but you can offer them a listening ear. 

As for the pain question, if patients are in pain, try to figure out why and relieve it in whatever way you can. Pain may not always be completely relieved, but we can always try to offer some comfort and improvement in symptoms. 

Resident: Mr. H complained that his “bag” hurt. After a lot of questioning, I figured out that he meant his testicles. 

Attending: Did you examine him?

Resident: Yeah, I couldn’t find anything wrong. Other than he had been sitting on his balls.

Attending: So what did you do about it? 

Resident: I thought about writing an order for nursing to remind him q2 hours to not sit on his balls. 

Any advice/tips on being introverted and working with patients in a volunteer setting? -anon

Hi! Do you have any good advice or sources for learning how to interact with patients better? I’ve been volunteering at a nursing home assisting with the residents there, which I very much enjoy, but I can be pretty introverted, and I want to improve on my ‘bedside manner’. -kiashinigami

In my previous post about Introverts in Medicine, I talked about how there’s always a place for introverts in the medical field.

Let me clarify one thing: introversion is not the same as shyness. I think what both of these questions are really getting at is shyness. Introverts enjoy being alone and regain their energy from alone time. Shy people may want to be around people, but often have a hard time tolerating the anxiety that comes along with human interaction for them.

The thing about shyness is that you can overcome it or at least manage it with practice. During the course of medical studies, you will be forced to interact with many different types of people. Initially these encounters will seem painfully awkward. They will not just magically get easier on their own. You will have to make a concerted effort to manage your own thoughts and emotions. 

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Me (before delivery): so have y’all decided on the baby’s name?

Patient: we’re still trying to pick between a few different Bible names. We’ll see what he looks like when he’s born.

***

Delivery: FLUID EVERYWHERE. FLUID IN MY PANTS. FLUID IN MY SHOES. SMALL LAKE ON THE FLOOR. 

***

Patient (after delivery): Sorry I flooded the floor. 

Me: It’s ok. But have you thought about the name Noah?

Me (thinking to myself): Geez, this girl is a terrible pusher. But we’re finally getting close. After this push I’m going to put my gown on, and then in a few more pushes we’ll have a baby. 

Me (out loud): …5…6…7…OH NO GET ME A GLOVE NOW. STOP PUSHING! 

Me (to myself again): You stupid idiot. Why you gotta think stuff like that?! Now you’re covered in baby juices!