The Most Useful Things I Learned in the Peds ER

1. How to (usually) successfully look in a child's ears

2. What a wheeze sounds like

3. Where the apple juice and graham crackers are kept

Pediatrics - Nursery Week

HOW ARE BABIES SO LITTLE?!??!

Science!

I was in the medical ICU for my elective, and I really learned a lot there.  One neat fact I learned was a scientifically-sound, sure-fire way to tell someone's prognosis...

cartoon bronch

We had a patient who was showing symptoms of a very, very rare lung disease.  The prognosis for this disease is actually much better than any of the other diseases in the differential, meaning we were all hoping this rare disease was what the patient had not only so we could say we've seen it, but because the alternatives if it's NOT what he had were really not so great for the patient.

While the pulmonary fellow was convinced this rare disease was what the patient had, the attending did not really agree.  He gave two reasons for his reservations: one, what we saw in the bronchoscope was not actually suggestive of this rare disease, and two, the patient was a nice guy.


....What?

nice guys finish last

The attending called this "the nice guy prognosis," meaning that the nicer you are, the worse your prognosis is.  He said this with complete seriousness and confidence, as if he had just told us that beta-blockers lowered blood pressure or smoking can make asthma worse.

Sooo, lesson learned.  I'm going to start being meaner.  For my health.

Just Skim It

When I studied for a semester in Spain during undergrad, I took a class on Don Quixote.  The professor "understood" how hard it was for us non-native speakers to read it, so she tried to "make it easier" by telling us which were the important chapters and which chapters we could just skim.

Now, I don't know how many of you have attempted to read any book in a foreign language, much less Don Quixote in it's original Spanish.  It's pretty much exactly like reading Shakespeare... but not in English.  Now, I can't skim Shakespeare and still have a clue what's going on, and I also can't skim even young adult books in Spanish and have a clue what's going on.  I pretty much have to pore over every word to have even a faint idea about what's happening.  So I certainly couldn't just skim 50-100 pages of olde Spanish a night and be able to talk about it intelligently in class the next day. 



This relates to med school, I promise.  Stick with me...

me, reading

I'm working on a research paper that involves reading a billion other papers (more or less) on a rare disease and pulling out specific quotes from those papers.  My boss told me to just skim the papers for the quotes we need.  But since I don't know much about this disease, I feel like I need to read the papers in their entirety so I can actually understand what's going on.  Which is making it go much slower than it probably should. 

In the Don Quixote class, I survived by (DON'T TELL ANYONE EVER) occasionally reading the non-important chapters in English (or much much worse, I even read the spark notes for some chapters --- don't look at me, I'm so ashamed).  I'm still working on a solution for making the research paper go faster, but for now all I'm doing is hoping that the more papers I read, the more I'll understand about the disease, and the faster it will go.

Halfway Point

 As you may have guessed from the title of this post, Thanksgiving break marked the halfway point of third year.  Check to surgery, neurology/psychiatry, ob/gyn, and elective #1.  Still to come: elective #2, pediatrics, family medicine, and internal medicine.  I can't pretend that I'm not extremely happy to have (what I think are) the hardest rotations behind me.  If I've survived so far, I feel pretty confident that I'm going to make it through this year in one piece with my sanity and empathy mostly intact.

Vacation!

We may not get sick days, and we may not get Columbus day, but we get A WHOLE WEEK OFF FOR THANKSGIVING!  I didn't even get that in college!

Here is how I am spending it:

That's right.  As a big, useless pile of jelly.  Doing nothing.  Relaxing.  Sleeping.

(Also getting all my yearly doctors' appointments done, running all the errands I've been putting off for ages, seeing my out of town friends who are back home for the week, celebrating a birthday or two, maybe finally cleaning my apartment floors.  But mooostly as a big, useless pile of jelly doing nothing.)




Happy Turkey Day everyone!  Have a happy, healthy holiday! 

I'm sorry, I can't help myself, here's a fun holiday timeline:

• 1863: Abe Lincoln makes Thanksgiving a national holiday to be celebrated on the last Thursday of November to help unify the country (this is wiiiidely believed to be the primary event leading to the end of the Civil War).
• 1939: FDR changes it to the second-to-last Thursday to lengthen the Christmas shopping season to help spur the economy.  People flip out, and only half the country listens.  And then there's Texas, who celebrated on the second-to-last AND the last Thursday, because YOLO, right?
• 1942: Congress passes a law (well, in 1941, but it took effect in '42) officially making Thanksgiving the fourth Thursday of November, which is sometimes the last and sometimes the second-to-last Thursday.  This law is also remembered fondly as the last time Congress was ever able to broker a compromise.

The Best Way to Study

I wrote a post wayyyyy back when I was a wee bitty first year about the best way to study (or at least the best weather to study in), and what I came up with is that there is no best way to study.  BUT for those of you out there who look to this blog for study advice (if there is anyone who does this, I imagine you must be quite disillusioned by this point), RELAX - based on years of research and much trial and error, I have finally figured out the best way to study.

First I'll give you a hint about ways that are NOT efficient.  The best way to learn new info is not reading it in a textbook, it's not hearing it in a lecture, it's not copying it over and over a million times in pretty-colored pens, and it's not even seeing it on a patient and then reading about it later in a textbook (sorry, Student Affairs).

The absolute best way to learn new information in medical school is to be scared and/or humiliated into learning it.

"But how do I go about being scared into information?" you ask.  "Do I have my roommate jump out at me and scream 'boo!' while I'm reading, as if I have the hiccups?"  No.  That is stupid.



Here is a handy step by step guide to being scared into learning:

1. Don't know the information to start off with.
2. Get asked simple question by attending while in patient's room ("What are the plantar flexors of the ankle?").
3. Have your mind go completely blank and say, "Umm" stupidly a few times.
4. Get prodded by the attending ("Ok, just give me one of them").
5. Make sure mind remains completely blank.  Forget all muscles of the entire body.  Turn your face red, say, "Umm" again to make it look like you are thinking about muscles (but we all know you're really only thinking about how stupid you feel or just repeating 'think think think think' to yourself).
6. Begin humiliation ("You don't know a siiiiingle plantar flexor?  You did take anatomy didn't you?"  Cue everyone else in the room such as residents, patient, patient's family, and researchers getting extreeeemely awkward and avoiding eye contact with you at all costs).
7.  Be told the answer exasperatedly ("You really don't know? ((sigh)) It's the gastrocnemius, soleus, and tibialis posterior.")
8. For the rest of the day, wish that you are dead and feel woefully inadequate no matter how much else you may know.
9. NEVER EVER FORGET THE PLANTAR FLEXORS.
10. Be asked the next day jokingly by the attending what the plantar flexors are, have a brief panic attack, but then rattle them off like it's nothing.  Boo-yah.


And that, my friends, is the best way to learn information in medical school.