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!
Wayfaring MD followers
Recent Tweets @WayfaringMD
Asker Anonymous Asks:
I'm an incoming ms2 and I was wondering how you learned to accept things as they come and not fret about it. There's not a day/moment that passes by over the past year that I haven't incessantly thought about my residency prospects, and the thing is, I'm doing pretty well in school---I just feel burdened by this pressure that I feel my peers don't have as bad. I think the prospect of not meeting my expectations/becoming the doctor I envisioned myself as worries me most. Does it ever get better?
wayfaringmd wayfaringmd Said:

Hmm, that’s tough. 

I’m generally a very laid back, go with the flow kinda gal. I never had much confidence in myself, but I always believed that if God got me in medical school / residency, He would also get me through. It’s a lot easier to not stress when you’re trusting in someone else’s capabilities and not your own. My abilities are pretty mediocre, but I believe that if I’m doing what God wants for my life, He’s going to provide what I need to get through (here I am preaching this to myself on a daily basis as I start to look for post-residency jobs now). 

Sure, I still worry. Ask cranquis. He has had to talk me down quite a few times as I was blubbering on about trying to figure out what my next step after residency is. I still stress over these things occasionally. We all have days when we think we’re not smart enough or confident enough or compassionate enough or whatever, but you’ll have good days too. Your peers probably feel the pressure just as heavily as you do, and they’re bottling it up just like you are. 

My mantra has always been “do my best, do what God wants, and what happens happens.” If I truly do the best I’m capable of and am in God’s will for me, then I can’t really worry about the outcome. If the outcome sucks, it’s out of my hands. There must have been a plan besides mine in the works. If the outcome is awesome, well hey, yay me. 

It is completely okay to have these worries. Use them to motivate you to learn more and be the best student or doctor you can possibly be. You should always be striving to be better at what you do. But if your worries are consuming you or interfering with your work or are your main focus, you gotta do something to release them. You need an outlet. Blogging is great. Quiet nights in with a friend are great. I’m a big fan of coloring books and tea myself. Heeding the counsel of someone who has been through it or is wiser than you is always a good plan too. 

Asker Anonymous Asks:
To the year 11 Aussie anon about maths: I'm an Australian medical student now and maths isn't that important if you do well in everything else and get a high enough mark to actually enter med school. I haven't done serious maths since I started uni - except those times I forgot to bring a calculator to prac and decided to average numbers in my head - you pretty much need to know basic arithmetic. So don't worry about it - just do well in high school. Best of luck!
wayfaringmd wayfaringmd Said:

sounds good to me!

Asker Anonymous Asks:
Hello! First of all, I'm very very very, deeply sorry if this question has been asked before. I'm only asking you because you are experienced. Is math really that important? I'm in 11th grade (from Australia) and my teacher is like, the spawn of the devil. I don't understand her teaching style and my grades aren't good (D+). This makes me very depressed because I'm very interested in studying Medicine. Is there such a job that does not require high math grades? Thank you so much in advance!
wayfaringmd wayfaringmd Said:

It’s important to do well in high school so you can get into a good college, and to do well in college math so that your GPA stays good, but we actually don’t use much math as doctors. Just some occasional basic algebra. 

Patient: So are you just doing family medicine or are you going to do something special?

Wayfaring

Well I think Family Medicine IS pretty special, so I’m sticking with it!

Rheumatologist (in patient’s room): Solid answer! 

Rheumatologist (out of patient’s room): Ugh, I can’t stand those comments. Little does she know that you family medicine residents know WAY more medicine than I ever will. All I have to know is one tiny corner of the world. How do you guys do it?

I was wondering if you have much experience with mental health patients, and if you do, what was it like? (:
wayfaringmd wayfaringmd Said:

Oh yeah. I did a psych rotation in med school (all inpatient psych) and will do another one this year in residency (all outpatient). Plus I see patients with psychiatric conditions on a daily basis in the family medicine office. Whether you’re treating psychiatric disorders or not, you will deal with psych issues and patients with mental health problems all the time. Remember the old saying “crazy people get sick too”. 

Working with mental health issues can be very rewarding when your patient makes progress, but can also be extremely frustrating when they don’t (check my “depression” and “psychiatry” tags for stories). The frustration is definitely compounded by the inefficient and insufficient state of our country’s mental health systems and by our shortage of psychiatrists.  Because of these deficiencies in our system, primary care docs end up managing a lot of mental illness (and not necessarily well). 

Asker mamabeezoe Asks:
Are you worried at all about the Ebola outbreak in Africa? What do you think about the American doctor who contracted it?
wayfaringmd wayfaringmd Said:

Well, considering that I’m not in Africa right now, I’m not super concerned for my own health. But it is pretty frightening. Ebola is the scariest virus I can think of, because the death rate is so high and it’s such a terrible way to die. What’s worse is that it affects people in developing countries, who are typically ignored by news outlets, drug researchers, and even health organizations.

There have actually been several missionary doctors who have contracted the virus now (I’ve gotten bulletins from various organizations I have connections with —not all of the cases have been confirmed yet). The scariest part for me is that one of the missionary docs is part of the post-residency program I recently applied for. To think that I could have been one of those docs in the danger zones is pretty scary, but it’s also really wonderful that these people are willing to risk their lives to help others. 

If you work overseas in tropical areas as a doctor, you have to be aware of the risks you take with your own health. You can be exposed to many diseases (geez, half of the staff I worked with on my last trip had had malaria in the last year) that can be potentially fatal. But you take precautions and just take comfort in the knowledge that your sacrifice and risk will help someone else.

Asker Anonymous Asks:
Your just another asian who is going to med school because mommy and daddy made you and you can't think for yourself.
wayfaringmd wayfaringmd Said:

aspiringdoctors:

pleasedotheneedful:

ascienceofuncertainty:

medschoolmanic:

First of all, that’s horribly offensive towards Asian Americans. I have multiple friends from different backgrounds (Korean, Vietnamese) who are not involved in medicine. I don’t even think that their parents ever insisted they go into medicine.

Secondly…

I’m not even Asian. Do I look Asian? I’ve been told that before, but I’ve always kind of thought it was a joke.

I mean, I don’t really think so. I’m Cherokee, which is completely different.

Furthermore, my parents didn’t even try to push me into medicine. I loved science from a very young age. My dad wanted me to go to engineering school, but I hated math, so that was never going to happen.

We need like, one awesome gif that can be used to respond to anon hate so that we can expose that shit to daylight without explaining or justifying ourselves. Because this is just getting ridiculous. medschoolmanic, props to you for calling out offensive behavior.

Have to admit, the bizarre targeting made me lol

image

This one works for me, ascienceofuncertainty!!

There’s also always…

image

These are getting so ridiculous, they’re almost funny. Except for the part when the greyface is really stupid and mean. 

Dr. O: Wayfaring, have you had your hemoglobin checked recently? 

Me: Umm…no, why? 

Dr. O: You are reaaally pale. Like paaaale. 

Me: Seriously, you’re just now noticing this?  This is just my baseline color, Dr. O. Check my conjunctiva. See? Nice and red. 

Dr. O: Oh good. That’s comforting. 

Me: Now my vitamin D levels on the other hand…

Do you think it would be a bad idea for someone with a history of hypochondria and anxiety to go into medicine? I'm worried all the information would trigger panic, but I've been mostly fine for a few years. I just don't want to get into it and break down.
wayfaringmd wayfaringmd Said:

Yes and no. 

For some people, knowledge is power. Knowing more may give you some confidence in knowing that your worries are not so scary. 

But for others, knowing more only intensifies the anxiety. Every med student gets a touch of med student syndrome during their training. For most, we just brush it off and tell ourselves we’re being silly. But I suppose if you have a history, it could make things worse for you.

There’s really no way of knowing which way things will go for you. If medicine is really what you want to do, then give it a shot! If your anxiety worsens during your studies, I would highly recommend you get some counseling about it so that it doesn’t interfere with your studies. 

ilovecharts:

Applied Math: Medicine

Continue your education this week with, Applied Math: Comedy

Specialist attending: Ugh, I’m exhausted from yesterday. I saw a total of 14 patients! That’s the busiest day I’ve had in weeks.

Wayfaring: Really? image

I thought the morning was pretty slow. I saw 9 patients in just 3 hours yesterday afternoon and it wasn’t bad. 

Specialist: WHAT?! How many patients do you guys see in a half day?

Wayfaring: I think the limit for 3rd years is 12 or 15 in a half day. 

Specialist: Whoa! How do you guys do it?! I only have to deal with one problem and you guys have to deal with multiple problems in each visit! How can you see 20-30 patients a day? 

Wayfaring: image

Um, and out in practice it’s more like 30-40.

Specialist: When do you do your notes?!

Wayfaring: In between patients and at home and after work. 

Specialist: You guys amaze me. That’s too much work. I can barely manage work and a baby and I only work 4 days a week.

Wayfaring: Well that’s why they pay us…the little bucks. 

image

Asker Anonymous Asks:
Hi- the anon with BPD and depression here Our medschool makes us show all medical health records every year, and makes our GP sign off to say we haven't had any mental health issues - Is there anywhere to get anonymous mental health help without having to go private... Also (sorry so many questions) do you think BPD will have any impact on my medical career? The associated symptoms etc? Thankyou!!
wayfaringmd wayfaringmd Said:

Um, I’m not sure about anonymous mental health care. Normally, all of your medical records would be private, but if your medical school requires them, then it would be pretty shady to go behind their backs to get care. That sounds like that would be against their policy. And think about this: hiding a medical condition, mental or physical, could potentially put your future patients at risk. Right now, the docs at your school know more than you do. You sort of have to trust them that they know which conditions are worth knowing about. 

I’m not sure if “BPD” here refers to Borderline Personality Disorder or BiPolar Disorder. Either way, yes, they could have an impact on your medical career if you go without treatment.  Personality disorders are not really treatable by meds (though some docs try and also wrongly  label them as other disorders so they can use different meds), but tend to improve with intense cognitive behavioral therapy. BiPolar disorder, on the other hand, generally requires medication. People with bipolar disorder can become extremely unpredictable, take big risks, and exhibit very damaging behavior during mania episodes. Clearly, this isn’t a good state to take care of patients in. But with good treatment and good insight into the condition (and caution around your patients), you could still practice medicine. 

Asker queenstales Asks:
hi I am interested in FM with Ob any thoughts? also do you plan on doing a fellowship ?
wayfaringmd wayfaringmd Said:

If you’re interested in doing OB after residency, it would probably be best to go to an OB-heavy residency program (especially one that teaches C-sections, not one that promises that you can get the experience if you work for it —in my experience, that’s usually a lie). The delivery requirements for family med residents has been significantly reduced this year, so if you go to a program that doesn’t have an OB track or that isn’t very OB focused, then you probably won’t get adequate training to practice prenatal care once you graduate.

I’ve thought about doing an OB fellowship, but there aren’t very many in my area of the country, and I’m not super keen on the idea of moving across the country for a year. If I had gone to a program that offered a fellowship, I’d definitely be up for it. My program was trying to get one off the ground, but it got put on hold because they started a different fellowship. 

Setting: my grandfather’s room in a brand new, very nice, very advanced-for-its-size smalltown hospital that serves as a referral center for the region.

Uncle: well, I guess I better get back home to [big city]. I have a long drive ahead of me.

Hospitalist: I wish I could go to [big city] with you. I looked for jobs there but couldn’t find one. The only thing you can find is places like this.

Hospitalist leaves

Grandmother: Well we don’t much care for you here either, Mr. Hospitalist! For all I care they can BOTH go back to [big city]! Snobs.