Posts tagged conversation

Cultural References

  • Doctor: You see this wiggly thing? That's a camera. It lets me look inside your nose!
  • Child: Ew! That's yucky!
  • Doctor: Do you remember that episode in Magic School Bus? When Ms. Frizzle's bus gets all teeny tiny and goes exploring Ralphie's nose?
  • Child: What's the Magic School Bus?
  • Doctor: The...it was this awesome show on television...hmm...(to the mother) you know what I'm talking about, right?
  • Mother: Haha, yes. I used to watch that a lot when I was babysitting my neighbour's kids.
  • Doctor: ...(to me) you watched Magic School Bus, right?
  • Me: I did.
  • Doctor: Phew...thought I was ancient for a moment there...ahem. Anyways, this is going to be like that.

Pay Grade Zero

  • New Fellow: I need to see someone in the ER, can you see this patient and scope them?
  • Me: You want ME to scope them?
  • Fellow: Yeah, it's a pretty straight forward scope. It's a follow up. I'm pretty sure the scope will be normal. Piece of cake.
  • Me: That might still be a little bit above my pay grade...
  • Fellow: But you said you were a resident right?
  • Me: No, I'm the medical student.
  • Fellow: Oh...

For Your Consideration

  • Attending: I think you are doing great. Keep it up.
  • Me: Thanks for the feedback.
  • Attending: I think you would have done well in the specialty.
  • Me: Well...
  • Attending: Ever give us any thought?
  • Me: There was a time, but CaRMS is now over.
  • Attending: There is always the future. Just something to consider if you have a change of heart down the line.

Recorded

  • Me: Is there anything else that is bothering you?
  • Patient: I have been recording some conversations.
  • Me: ...And you understand that that is not legal?
  • Patient: ...Yes.
  • Me: ...Alright.

Death is a Continuum

  • Palliative Team: Do you know anything about or have ever considered hospice?
  • Patient: I know what it is but I am not interested.
  • Palliative Team: May we ask why that is or what you understand about hospice care?
  • Patient: Once you are in hospice, you are dying.
  • Distinction: Being in hospice does not initiate the process of dying. Death is being driven by the underlying disease. This is a common misconception and the role of hospice in the care of dying is an arbitrary distinction. The care of the dying can happen in hospice, in hospital, or at home.

90 plays

I Feel That Too by Jessie Baylin.

Today, I received a call from a close friend and classmate on rotation across the province. It was a unexpected but pleasant surprise. We took a moment to catch up with how our respective electives were going thus far. Of course, the conversation eventually turned to CaRMS and we shared a collective groan.

"This is like applying to medical school all over again…but ten times over."

"Yeah, I feel that way too."

With Absolute Certainty

  • Attending: So what do you think is the cause of his symptoms? Does his blood gases help you?
  • Resident: My working theory is that the causative agents of his condition are obesity hypoventilation and obstructive sleep apnea, less so heart failure given his exam findings.
  • Attending: Are you sure he has sleep apnea? It has never been diagnosed before.
  • Resident: With his body habitus and the size of his neck, if he does not have sleep apnea I will buy everyone on the team a Porsche.

We could use you here

  • On my last day on the internal medicine service, I spoke privately with my attending, who is a highly respected member of the residency program.
  • Me: Dr. Appleseed, I was wondering if I could ask you a quick..
  • Doctor: Yes, you may. Fire when ready.
  • Me: I am considering applying towards internal medicine...
  • Doctor: As you should.
  • Me: ...And I was wondering if you would be willing...
  • Doctor: Yes, I would.
  • Me: ...to write me a strong reference letter?
  • Doctor: Of course. You are good, Tom. We could use you here. You would be a great addition to the program.

I Think I know Why...

  • A patient sits uncomfortably short of breath with new onset of atrial fibrillation.
  • Patient: I don't understand how this happened.
  • Doctor: Have you been on any stimulants? Drugs?
  • Patient: Not that I know of.
  • Doctor: Do you drink coffee regularly?
  • Patient: Yes.
  • Doctor: How much?
  • Patient: A dozen.
  • Doctor: A dozen cups per day?
  • Patient: No, a dozen pots.
  • Doctor: ...I think I know why you are in atrial fibrillation.

The Situation Sucks

  • Internist: So let me get this right. This elderly patient has cancer...
  • ER Physician: Mmhmm.
  • Internist: COPD on home oxygen...
  • ER Physician: Mmhmm.
  • Internist: CHF with an ejection fraction of 20%...
  • ER Physician: Mmhmm.
  • Internist: And acute on chronic kidney disease with GFR 20...
  • ER Physician: Mmhmm.
  • Internist: With full code...
  • ER Physician: Mmhmm.
  • Internist: And you want us to see what we can do?
  • ER Physician: Yes. It sucks...Good luck!