Tuesday, March 29, 2011
Monday, March 28, 2011
just had an amazing weekend with my classmates and had a good get-away from studying. i cant remember the last time i went more than 3 or 4 days without studying...obviously taking long breaks away from my computer is not very common in my life. so while on the plane coming back from a Georgian wedding i wanted to catch up on the last month of school. Lots of exciting ‘first times’ occurred and of course the most crazy of those events was doing my first Breast exam, female pelvic exam and male prostate exam [all in the span of 30mins]
i guess i can say i wasnt really nervous because it was in the middle of my Friday afternoon with my GI final coming up on that Monday and I was much more nervous about failing that exam then doing something wrong during the PBRs. thats probably because we had 6 large group sessions on that test making it one of the longest tests we have had and add on that i was barely studying GI during the weeks prior as I was focusing on my board exam studying...oh, and then add on that our professor gave a ‘pep talk’ on Friday morning telling us to not expect lots of As and Bs...that we should just be happy/satisfied with passing. yeah, all that kinda trumped the fact that i was about to stick my fingers into places that are not easily accessible... so that kinda shows ya how scared we all were for the GI final. Well, they must have scared the shit out of everyone because we all studied like soldiers preparing for battle and the class average ended up being around what it normally is and most of us did just fine. but really, did they need to add in that additional stress to the weekend? Another reason why i cannot wait to be done with lectures, classes and exams. Starting in June I will be working like a normal adult [though not getting paid...but im not gonna worry about that right now] and i wont have to stare at a computer screen for 12 hours a day and although i will be still taking plenty of tests to demonstrate my competence..it wont be nearly as frequent in the past 2 years.
but back to the PBR; the general class consensus was that they weren't too bad. We were scheduled for a certain time to show up to the standardized patient department [where we have our ‘learning to play doctor’ sessions] and we were escorted to a room. It was a total of 3 different rooms with 3 different people so i first did a breast exam on a lady then went to a different room and did a pelvic exam on another lady, and so on. Sure it was awkward not knowing what to do but there was an instructor right there next to us taking us through it and answering any questions that we had. After the procedure, the ‘patient’ gave us feedback to build our confidence by telling us ‘it didnt hurt’ [even though they might have been lying]. To note, these were people paid by the school to allow us to practice on them before we go out into hospitals and do it on innocent people who are paying us to do it...smart move to have us run through it once. I am sure you are curious as to the people that use this as income [as was i] but unfortunately no one knows for sure how much they get paid...i only heard a couple rumors but dont know if they were true. But, our instructor said that they will get about 10-12 students to practice on them in an afternoon...yes, 10-12 pelvic exams or fingers in the butt.... they better be paid well.
The next day i got to use my new skills by volunterring with 6 other students at a Womens health clinic. I ended up seeing 2 women--one was a 45 year old lady who was exctremely nervous and the other was a 60+ year old female who couldnt speak english so i needed a translator. For both patients I took their vitals then escorted them to their exam room where I did an initial history and short physical exam [listened to their heart, lungs, palpated their abdomen, etc] and then explained to them that i would leave the room and would come back with a doctor. Then after allowing them some time to change into a gown, i went in with a doctor and we did a pelvic exam. The doctor i was with did the first pelvic because the lady was a more complicated case and she was pretty nervous but then i did the exam on the second female. It is such an invasive and private exam and I was very honored that these women trusted me to be taking care of them. A little pick me up before a long couple days of studying for our GI final.
so anywho, those are the most notable things that happened recently. This Thursday will be my last shift at the Montclair clinic because the first year class will be taking it over so us second years can spend any and all time studying for boards. Sadly, the month of April is still jam packed with responsibilities, tests, mandatory lectures and attendance quizzes. Even though we have this HUGE exam looming in June our school doesnt really seem to care...so they went right ahead and decreased our life expectancy by adding massive amounts of cortisol [stress hormone] into our bloodstreams for a continuos 2.5 months. that sounds bad.. but i think it is probably true.
here’s to the end of spring break and the beginning of spring HELL
i guess i can say i wasnt really nervous because it was in the middle of my Friday afternoon with my GI final coming up on that Monday and I was much more nervous about failing that exam then doing something wrong during the PBRs. thats probably because we had 6 large group sessions on that test making it one of the longest tests we have had and add on that i was barely studying GI during the weeks prior as I was focusing on my board exam studying...oh, and then add on that our professor gave a ‘pep talk’ on Friday morning telling us to not expect lots of As and Bs...that we should just be happy/satisfied with passing. yeah, all that kinda trumped the fact that i was about to stick my fingers into places that are not easily accessible... so that kinda shows ya how scared we all were for the GI final. Well, they must have scared the shit out of everyone because we all studied like soldiers preparing for battle and the class average ended up being around what it normally is and most of us did just fine. but really, did they need to add in that additional stress to the weekend? Another reason why i cannot wait to be done with lectures, classes and exams. Starting in June I will be working like a normal adult [though not getting paid...but im not gonna worry about that right now] and i wont have to stare at a computer screen for 12 hours a day and although i will be still taking plenty of tests to demonstrate my competence..it wont be nearly as frequent in the past 2 years.
but back to the PBR; the general class consensus was that they weren't too bad. We were scheduled for a certain time to show up to the standardized patient department [where we have our ‘learning to play doctor’ sessions] and we were escorted to a room. It was a total of 3 different rooms with 3 different people so i first did a breast exam on a lady then went to a different room and did a pelvic exam on another lady, and so on. Sure it was awkward not knowing what to do but there was an instructor right there next to us taking us through it and answering any questions that we had. After the procedure, the ‘patient’ gave us feedback to build our confidence by telling us ‘it didnt hurt’ [even though they might have been lying]. To note, these were people paid by the school to allow us to practice on them before we go out into hospitals and do it on innocent people who are paying us to do it...smart move to have us run through it once. I am sure you are curious as to the people that use this as income [as was i] but unfortunately no one knows for sure how much they get paid...i only heard a couple rumors but dont know if they were true. But, our instructor said that they will get about 10-12 students to practice on them in an afternoon...yes, 10-12 pelvic exams or fingers in the butt.... they better be paid well.
The next day i got to use my new skills by volunterring with 6 other students at a Womens health clinic. I ended up seeing 2 women--one was a 45 year old lady who was exctremely nervous and the other was a 60+ year old female who couldnt speak english so i needed a translator. For both patients I took their vitals then escorted them to their exam room where I did an initial history and short physical exam [listened to their heart, lungs, palpated their abdomen, etc] and then explained to them that i would leave the room and would come back with a doctor. Then after allowing them some time to change into a gown, i went in with a doctor and we did a pelvic exam. The doctor i was with did the first pelvic because the lady was a more complicated case and she was pretty nervous but then i did the exam on the second female. It is such an invasive and private exam and I was very honored that these women trusted me to be taking care of them. A little pick me up before a long couple days of studying for our GI final.
so anywho, those are the most notable things that happened recently. This Thursday will be my last shift at the Montclair clinic because the first year class will be taking it over so us second years can spend any and all time studying for boards. Sadly, the month of April is still jam packed with responsibilities, tests, mandatory lectures and attendance quizzes. Even though we have this HUGE exam looming in June our school doesnt really seem to care...so they went right ahead and decreased our life expectancy by adding massive amounts of cortisol [stress hormone] into our bloodstreams for a continuos 2.5 months. that sounds bad.. but i think it is probably true.
here’s to the end of spring break and the beginning of spring HELL
Wednesday, March 23, 2011
Wednesday, March 16, 2011
"med school is like running a marathon with no feet or legs so you have to army crawl along the hot asphalt, and then you take a wrong turn and you can't find your way back to the race course, and at this point you're exhausted and lost and have road rash all over and you just want to quit but then you realize there is a wolf with rabies behind you, and if you stop it will eat you. so you have to keep going and hope that you survive till the end when someone will whisk you away in a stretcher and feed you vodka sodas with a straw."
-anonymous first year medical student
reply by another first year:
"I'd say it's more like prison...You get half an hour a day of yard time, the occasional conjugal visit...and get raped on a daily basis."
to bad they have NO IDEA how much worse it gets. HAHA
-anonymous first year medical student
reply by another first year:
"I'd say it's more like prison...You get half an hour a day of yard time, the occasional conjugal visit...and get raped on a daily basis."
to bad they have NO IDEA how much worse it gets. HAHA
Sunday, March 13, 2011
Saturday, March 12, 2011
everything you wanted to know about poop...and more. GI system quotes
“We are following where the food goes. It starts in the mouth and it goes out the..... tooshie...” - Pummy
“We promise none of these tapes will be shown to your future patients.” - Pummy
“Good morning everybody, I am sorry you have to see me again... I know most of you thought you were done with me after head and neck.” -Chew
“There’s two parts to the tongue, the oral part, which is moving around right now like crazy for me.... and the root of the tongue.” -Chew
“[The teeth] are lined by gingival mucosa... gingival mucosa is commonly known on the streets as...gums.” -May
“Generally when the dentist pulls the tooth, what they basically due is rip the PDL, of course at the same time you hear a pop, which is very reminiscent of opening a champagne bottle. If you like champagne you will like having your teeth extracted.” -May
“This is why individuals giving speeches may suffer from dry mouth... much as I am now...” -Wagner on sympathetic oral nerves causing secretion of mucinous saliva
“How many of you have had a tooth cleaning?” – Boehm
::One student raises their hand::
“Well I hope it is more than that” – Boehm
Poor Dr. Boehm… none of us could understand you =(
“Why would you give 2x daily PPI instead of 1x? Well it is very simple, because 1x daily isn’t working.” - Bahlodia on GERD treatment
“Well the parietal cells, their nucleus is located on the side... you see it looks like a pac-man. I used to play that game...” Al-tikriti finally let his true nerd shine through.
“I have to retract some thing I have said about the GI system being a dumb kidney.. because now I am working in the GI system...” -Barnes
“And in this way we can get more bang for our bile salt dollar.” Wagner on Enterohepatic circulation of bile and how much of the secretions are reabsorped.
“Aren’t you glad we don’t do surgery this way anymore. You can imagine being that patient.... all these people staring at you, no anesthesia, the nurse sort of holding your head... I was going to put a bottle of jack daniels in the patients hand, but I thought that might not be appropriate for class.” Barnes
“Mr. Belly Pain (spelled Belli Paine) came in for nausea and vomiting, hah ha ha.” Barnes
“Joseph why don’t you whip Ashlynn on the table and show us how to do the psoas sign... okay nevermind, we will have this naked lady show us how instead.” -Barnes
“He says he can feel the appendix on the rectal exam. He has long arms I guess...” -Barnes in response to a student describing what they would like to order next for our patient.
“Often times you find that the student goes in and gets a history and they get one story. You send your intern in and they come out with a different story, you send your resident in and they get a third story, then you go in and get a completely different story...” -Davis
“It’s called historical alternans.” -Barnes along with Davis on the difficulties on making a diagnosis in real life.
“What is concerning about this patient? Did someone say because she is a woman?” -Barnes
“No, I said its because she’s an old woman.” Emory
“I wouldn’t want to be you right now Emory...” -Barnes
“Anatomically the liver is probably one of the most boring organs you will find.” -Kheun
“I have never heard the liver called boring, maybe it is boring at the gross anatomy level, but I will try and make it interesting for you at the histological level… I think…” -May
“If I take a cut through here, and put it under the microscope… you are going to look at that and say boring! A new buzzword from Dr. Keuhn.” -May
“Hopefully you can appreciate the liver, it is not boring, it has got structure. It is boring until you get to the microscopic level.” -May
“What do you know about RNA viruses with respect to antigenicity? ::silence:: Anything?” -Thrush
“And sometimes Dr. May is like that…. You will have to contact him directly since he is loathe to put up his powerpoints on blackboard…” -Kheun
“And Dr. Kheun should know what Dr. May is like…” -Pummy
“It either cold in here, or I have a 24hr hepatitis that is going around…” Pummy
“Oh, only a few of you haven’t seen this interesting…’yeah I have them at home’ “-Pummy
“Are you guys just looking this up? Because I can also just read a list... It’s like kissing your sister.” - Pummy
“Let’s take a look at Dr. Khuen’s [quiz] question... he is no longer here to get any tomatoes thrown at him.” - Pummy
“Remember all bleeding stops.... eventually.... so let’s try and do that before the heart stops as well.” Pummy on how to manage esophogeal varices
“Where is the problem and why are we using spirinolactone? God that goes back to the fall
… that sucks...” - Pummy on treatment of cirrhosis with diuretics and a drug we learned about during endocrine.
“What lactulose does is it lowers the nitrogenous waste that is going into the portal system... you shit it out. That is a technical term for that.” -Pummy on managing a patient post TIPS procedure.
“Dr. Mehta do you need to be excused?’ -Pummy on Mehta raising her hand to get his attention
“It’s a hormone” - Mehta
“Oh yeah... vasopressin it is the anti-diuretic hormone” - Pummy
“My question is who boo’d after the quiz? Were you booing me in general or was it all of us up here? What’s that? You want to know which question I wrote and you’ll get back to me? Well, you will see later... Don’t worry we won’t boo you back.” -Barnes after another disasterous quiz.
“Older people are at risk, because one of the genes poops out.” -Parsa describing the pathogenesis and risk factors for colorectal cancer.
“What do you want to do next for this patient? He is in the emergency room, he has bloody diarrhea... so calm him down... get him some diapers...” -Mehta on the workup for ulcerative colitis.
“What is it about this patient that concerns you? He’s crapping blood Byron says.. what else do you want to know about this crapping of the blood, since we are using this technical term.” -Barnes
“You want to ask these patients if they swallowed something, or if they put something? What do I mean by put something?” -Barnes on the differential for bloody diarrhea
“Are you guys going to share the joke?” Barnes
“Sorry I made a joke about pink eye” Student
“Wow, I am not going to touch that one. Alright well what would you be looking through the anoscope for, besides to develop pink eye.” Barnes
“This first lady comes to us all the way from the cardio system, she missed us so she is back in GI...” - Pummy
“Okay that one person, are you just trying to kid with us, you wanna make sure we go through this entire year without one 100%?” Pummy on the results of a class quiz question polling.
“What kind of situations outside of an outbreak would you expect to see viral enteritis?” - Pummy
“A carnival.” -Student
“Okay maybe if only one person went to it.” -Pummy
“That is why you always see me walking around with water bottles, because I am getting to be a granny.” Pummy on the complications of dehydration in the elderly.
“What are the other things we could do to slow this down?” Pummy
“A cork...” Student
“A cork? Well I wouldn’t go with that first...” Pummy
“You guys have your laptops... I am working off of my memory, which over 40 is plus or minus a few facts...” -pummy
“This case reminds me of the saying, that travel enriches the mind, and loosens the bowels.” -Pummy in regards to travelers diarrhea.
“Okay go for 100%...” -Pumy
::everyone clicks in on the question he has just given us an answer to, survery says 97% correct 3% incorrect::
“Okay who is the smart ass here that clicked false?” Pummy
“Now if you were a woman Casey... and I am not suggesting you are...what could antibiotics give you?” - Pummy answer = yeast infection and a baby...
“Now if you had a young patient, and that should cover almost everyone in this room except for Karoon....” - Pummy
“Salmonella... you gotta light some candles and give it some malox for it to come in and cause trouble. It has a relatively high infectious dose. Shigella.... it’s like rambo...” -Pummy on the virulence of different dysentary pathogens.
“This is the Bristol stool chart which was developed at the University of Bristol in the UK. You can use this chart to discuss this with your patients, [#2] looks like a challah.... Any questions about anything before we go into the cases?” - Pummy
“Which one is normal?” -Student
“Well we were going to have a live demonstration, but we decided not to... What is normal? It depends on what ones own body does” ::turns bright red:: -Pummy
“Many of you are probably at this point... you are feeling furious and vindictive, instead of just irritable...” -Pummy
“Another 70 year old patient.... you notice all of my patients are either 40 or 70.... I wonder what that means... probably nothing....” -Pummy speaking only to himself I can assume
“At this point I would like to propose the use of OMT in this patient according to the MOPSY study.” Casey Pyle begins to assert various proven benefits of OMT in this situation
::class erupts in applause::
“The what study??? oh yes the MOPSY study... and the control group was using peanut oil on the skin....What you don’t believe? Good point thank you for brining that up. Its always good to bring evidence based medicine into these sessions.” -Pummy
“Now the first problem here... is that this patient is using the ER as his primary care physician.” -Pummy
“Dr. Kuehn is going to do an anatomy review..nothing has changed unless you grew any new anatomical parts..”-Pummy
“Hey what can ya say, nothing has changed since the time of Galen.”-Kuehn
“Where’s Kiff Ewing? Dorothy? Chelsea Chung? Nolan? Bueler?” -Pummy attempting to call on anyone other than Casey Pyle
“What else is important?” -Pummy
“He’s got floaters?” -Student
“No that isn’t it, I mean he does have an oil spill in his toilet bowl...” -Pummy
“Did I hear Hep C? Okay... you can retract that if you want to...” -Pummy on an incorrect differential for giardia
“That’s very good and he did that without his laptop open.... What’s your name.... and are you a student here?” Pummy after Tommy’s awesome explanation of the Giardia life cycle.
“And Dr. Kathari is here right in time... she’s got a white shoe thing happening with a sweater....” -Pummy
“I got stuck in the traffic” - Dr. Kathari
“You know pathologists don’t get the appreciation for how they dress... because they are always down in the basement...” -Pummy
“It’s true!” Kathari
“This is like egophony, someone [in the audience] says no, and it comes over as yes.” -Pummy on how hard it is to hear us in the large group sessions. Don’t worry pummy, we feel the same way in a lot of those lectures...
“Okay lets say that the patient does not get better after treatment and they still have giardia... what happened?” -Pummy
“The patient is living with a beaver?” Student
“Ok, well anything is possible...” -Pummy
“Tenesmus... where is that occuring? The rectum... damn near killed em.” -Pummy
“We promise none of these tapes will be shown to your future patients.” - Pummy
“Good morning everybody, I am sorry you have to see me again... I know most of you thought you were done with me after head and neck.” -Chew
“There’s two parts to the tongue, the oral part, which is moving around right now like crazy for me.... and the root of the tongue.” -Chew
“[The teeth] are lined by gingival mucosa... gingival mucosa is commonly known on the streets as...gums.” -May
“Generally when the dentist pulls the tooth, what they basically due is rip the PDL, of course at the same time you hear a pop, which is very reminiscent of opening a champagne bottle. If you like champagne you will like having your teeth extracted.” -May
“This is why individuals giving speeches may suffer from dry mouth... much as I am now...” -Wagner on sympathetic oral nerves causing secretion of mucinous saliva
“How many of you have had a tooth cleaning?” – Boehm
::One student raises their hand::
“Well I hope it is more than that” – Boehm
Poor Dr. Boehm… none of us could understand you =(
“Why would you give 2x daily PPI instead of 1x? Well it is very simple, because 1x daily isn’t working.” - Bahlodia on GERD treatment
“Well the parietal cells, their nucleus is located on the side... you see it looks like a pac-man. I used to play that game...” Al-tikriti finally let his true nerd shine through.
“I have to retract some thing I have said about the GI system being a dumb kidney.. because now I am working in the GI system...” -Barnes
“And in this way we can get more bang for our bile salt dollar.” Wagner on Enterohepatic circulation of bile and how much of the secretions are reabsorped.
“Aren’t you glad we don’t do surgery this way anymore. You can imagine being that patient.... all these people staring at you, no anesthesia, the nurse sort of holding your head... I was going to put a bottle of jack daniels in the patients hand, but I thought that might not be appropriate for class.” Barnes
“Mr. Belly Pain (spelled Belli Paine) came in for nausea and vomiting, hah ha ha.” Barnes
“Joseph why don’t you whip Ashlynn on the table and show us how to do the psoas sign... okay nevermind, we will have this naked lady show us how instead.” -Barnes
“He says he can feel the appendix on the rectal exam. He has long arms I guess...” -Barnes in response to a student describing what they would like to order next for our patient.
“Often times you find that the student goes in and gets a history and they get one story. You send your intern in and they come out with a different story, you send your resident in and they get a third story, then you go in and get a completely different story...” -Davis
“It’s called historical alternans.” -Barnes along with Davis on the difficulties on making a diagnosis in real life.
“What is concerning about this patient? Did someone say because she is a woman?” -Barnes
“No, I said its because she’s an old woman.” Emory
“I wouldn’t want to be you right now Emory...” -Barnes
“Anatomically the liver is probably one of the most boring organs you will find.” -Kheun
“I have never heard the liver called boring, maybe it is boring at the gross anatomy level, but I will try and make it interesting for you at the histological level… I think…” -May
“If I take a cut through here, and put it under the microscope… you are going to look at that and say boring! A new buzzword from Dr. Keuhn.” -May
“Hopefully you can appreciate the liver, it is not boring, it has got structure. It is boring until you get to the microscopic level.” -May
“What do you know about RNA viruses with respect to antigenicity? ::silence:: Anything?” -Thrush
“And sometimes Dr. May is like that…. You will have to contact him directly since he is loathe to put up his powerpoints on blackboard…” -Kheun
“And Dr. Kheun should know what Dr. May is like…” -Pummy
“It either cold in here, or I have a 24hr hepatitis that is going around…” Pummy
“Oh, only a few of you haven’t seen this interesting…’yeah I have them at home’ “-Pummy
“Are you guys just looking this up? Because I can also just read a list... It’s like kissing your sister.” - Pummy
“Let’s take a look at Dr. Khuen’s [quiz] question... he is no longer here to get any tomatoes thrown at him.” - Pummy
“Remember all bleeding stops.... eventually.... so let’s try and do that before the heart stops as well.” Pummy on how to manage esophogeal varices
“Where is the problem and why are we using spirinolactone? God that goes back to the fall
… that sucks...” - Pummy on treatment of cirrhosis with diuretics and a drug we learned about during endocrine.
“What lactulose does is it lowers the nitrogenous waste that is going into the portal system... you shit it out. That is a technical term for that.” -Pummy on managing a patient post TIPS procedure.
“Dr. Mehta do you need to be excused?’ -Pummy on Mehta raising her hand to get his attention
“It’s a hormone” - Mehta
“Oh yeah... vasopressin it is the anti-diuretic hormone” - Pummy
“My question is who boo’d after the quiz? Were you booing me in general or was it all of us up here? What’s that? You want to know which question I wrote and you’ll get back to me? Well, you will see later... Don’t worry we won’t boo you back.” -Barnes after another disasterous quiz.
“Older people are at risk, because one of the genes poops out.” -Parsa describing the pathogenesis and risk factors for colorectal cancer.
“What do you want to do next for this patient? He is in the emergency room, he has bloody diarrhea... so calm him down... get him some diapers...” -Mehta on the workup for ulcerative colitis.
“What is it about this patient that concerns you? He’s crapping blood Byron says.. what else do you want to know about this crapping of the blood, since we are using this technical term.” -Barnes
“You want to ask these patients if they swallowed something, or if they put something? What do I mean by put something?” -Barnes on the differential for bloody diarrhea
“Are you guys going to share the joke?” Barnes
“Sorry I made a joke about pink eye” Student
“Wow, I am not going to touch that one. Alright well what would you be looking through the anoscope for, besides to develop pink eye.” Barnes
“This first lady comes to us all the way from the cardio system, she missed us so she is back in GI...” - Pummy
“Okay that one person, are you just trying to kid with us, you wanna make sure we go through this entire year without one 100%?” Pummy on the results of a class quiz question polling.
“What kind of situations outside of an outbreak would you expect to see viral enteritis?” - Pummy
“A carnival.” -Student
“Okay maybe if only one person went to it.” -Pummy
“That is why you always see me walking around with water bottles, because I am getting to be a granny.” Pummy on the complications of dehydration in the elderly.
“What are the other things we could do to slow this down?” Pummy
“A cork...” Student
“A cork? Well I wouldn’t go with that first...” Pummy
“You guys have your laptops... I am working off of my memory, which over 40 is plus or minus a few facts...” -pummy
“This case reminds me of the saying, that travel enriches the mind, and loosens the bowels.” -Pummy in regards to travelers diarrhea.
“Okay go for 100%...” -Pumy
::everyone clicks in on the question he has just given us an answer to, survery says 97% correct 3% incorrect::
“Okay who is the smart ass here that clicked false?” Pummy
“Now if you were a woman Casey... and I am not suggesting you are...what could antibiotics give you?” - Pummy answer = yeast infection and a baby...
“Now if you had a young patient, and that should cover almost everyone in this room except for Karoon....” - Pummy
“Salmonella... you gotta light some candles and give it some malox for it to come in and cause trouble. It has a relatively high infectious dose. Shigella.... it’s like rambo...” -Pummy on the virulence of different dysentary pathogens.
“This is the Bristol stool chart which was developed at the University of Bristol in the UK. You can use this chart to discuss this with your patients, [#2] looks like a challah.... Any questions about anything before we go into the cases?” - Pummy
“Which one is normal?” -Student
“Well we were going to have a live demonstration, but we decided not to... What is normal? It depends on what ones own body does” ::turns bright red:: -Pummy
“Many of you are probably at this point... you are feeling furious and vindictive, instead of just irritable...” -Pummy
“Another 70 year old patient.... you notice all of my patients are either 40 or 70.... I wonder what that means... probably nothing....” -Pummy speaking only to himself I can assume
“At this point I would like to propose the use of OMT in this patient according to the MOPSY study.” Casey Pyle begins to assert various proven benefits of OMT in this situation
::class erupts in applause::
“The what study??? oh yes the MOPSY study... and the control group was using peanut oil on the skin....What you don’t believe? Good point thank you for brining that up. Its always good to bring evidence based medicine into these sessions.” -Pummy
“Now the first problem here... is that this patient is using the ER as his primary care physician.” -Pummy
“Dr. Kuehn is going to do an anatomy review..nothing has changed unless you grew any new anatomical parts..”-Pummy
“Hey what can ya say, nothing has changed since the time of Galen.”-Kuehn
“Where’s Kiff Ewing? Dorothy? Chelsea Chung? Nolan? Bueler?” -Pummy attempting to call on anyone other than Casey Pyle
“What else is important?” -Pummy
“He’s got floaters?” -Student
“No that isn’t it, I mean he does have an oil spill in his toilet bowl...” -Pummy
“Did I hear Hep C? Okay... you can retract that if you want to...” -Pummy on an incorrect differential for giardia
“That’s very good and he did that without his laptop open.... What’s your name.... and are you a student here?” Pummy after Tommy’s awesome explanation of the Giardia life cycle.
“And Dr. Kathari is here right in time... she’s got a white shoe thing happening with a sweater....” -Pummy
“I got stuck in the traffic” - Dr. Kathari
“You know pathologists don’t get the appreciation for how they dress... because they are always down in the basement...” -Pummy
“It’s true!” Kathari
“This is like egophony, someone [in the audience] says no, and it comes over as yes.” -Pummy on how hard it is to hear us in the large group sessions. Don’t worry pummy, we feel the same way in a lot of those lectures...
“Okay lets say that the patient does not get better after treatment and they still have giardia... what happened?” -Pummy
“The patient is living with a beaver?” Student
“Ok, well anything is possible...” -Pummy
“Tenesmus... where is that occuring? The rectum... damn near killed em.” -Pummy
Friday, March 11, 2011
another test weekend looms ahead...
Via facebook:
Laura: oooweee here we go again..cram, crush, compact, repeat.
Kelsea: Til Monday high noon. Then hit the eject button.
Laura: oooweee here we go again..cram, crush, compact, repeat.
Kelsea: Til Monday high noon. Then hit the eject button.
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