Monday, October 27, 2008

Pick Your Battles, Moron

It isn't that often that I call people names, but in a class of medical students I am not surprised that many of us have somewhat off-kilter social compasses.  You know, making jokes bout being a 'floppy baby' for halloween (a buzz word in pathology) loud enough for others to hear, talking out loud in the library, repeating 'fecal-oral' every chance you get, being a democrat (I only kid, don't taze me bro).  It is a surprise that they allow some of us to be around naked dead people as much as we are.  Seems like 268 walking liabilities with probes and scalpels to me.  But, I let that all slide.  I am cool like that.  

What I do not understand is how some of my classmates do not know when to keep their mouth shut.  Word around school is that some brilliant one went and complained to a pathology professor.  I could stop there.  Many of you know that you do not voluntarily go and seek out a pathologist to converse.  Like going to rehab to pick up on chicks, you're just asking for trouble.  I mean, pathologists are usually odd, let's be honest.  This one in particular swears he has an extra Y chromosome or something.  So rule number two of med school was breached.  Now I will tell you that this little genius went  to him to complain about how he mentions religion a lot and how offended she was that he mentioned that Muslim women that cover all their skin except their eyes are looking at potential bone disease from lack of Vitamin D from lack of sunlight.  Really?  What offends you?  FACTS?  Or because he said 'Muslim'?  Learn to pick your battles genius.  You want to go petition to change the color of stop signs because RED is offensive and brings negativity also?  Good luck with that.  So now good old path professor pulled his intended test for us and is replacing it with a much harder test for our benefit.  Guaranteed that guy could make a test out where we would all get none right because contrary to what some of my classmates think, we know nothing about diagnosis, recognizing, or treatment of disease.  Rule number one of med school is you don't know crap.  Rule number two is you don't talk to pathologists unless spoken to.  We are first years with undergrad degrees.  Pick your battles.  Go ahead and put the phrase "that offends me" away for a little bit, or at least until I won't be directly affected by your hairpin trigger reactions.  You can't bark up every offensive tree, because if you do, it will be a loooooooong rotation and residency and life.  Path and anatomy practicals thursday.  Pretty sure I now create mnemonics for my grocery lists. 

Sunday, October 26, 2008

Study Break

This next week is finals week.  Short post as my time is limited right now.  Somehow the administration has let one of our four finals slip to next tuesday which means the ONE weekend we get in between sections will be consumed with studying for another final.  Awesome.  Hey, one day do you want to tell my children there is no santa too, buzzkill?  I am really tired of anatomy as I have now spent more time around dead people then OJ Simpson.  I have been trying to learn as much as I can for our practical on Thursday, which has forced me to neglect a lot of other material.  I think we are all ready to be done with Musculoskeletal so we can move on.  I think this will be the trend for the rest of med school....always looking forward to the next fix.  

Speaking of the next fix,  special thanks to Frank Drackman MD for his spotlight on The Week.  It can be read here.  The Hideout is a daily read for me between classes and it keeps me laughing when I am not laughing at the gunners.

I now leave you with a great editorial piece:

October 2008
By David F. Baehren, MD

The United States has enjoyed the most successful and enduring form of elected government in the history of mankind. In spite of our political class being populated by some of the most unworthy scoundrels ever to run for office, our system of checks and balances has served our nation well, and we have prospered.

The genius of our founding fathers is evident in their deliberations over the writing of our Declaration of Independence and the Articles of the Constitution.

The signers of the Declaration were accomplished and serious men. Almost all were wealthy, and each had much to lose by signing his name. At the end of the document, they wrote, "We mutually pledge to each other our lives, our fortunes, and our sacred honor." They knew the dangers they faced. Many were hounded by the British and eventually lost family, fortune, and their lives. They died, however, with the thing they cherished most still intact: their sacred honor.

Fast forward to present day, when our politicians and candidates spend more time trying to get and stay elected than they do thinking about the preservation of the republic--a republic for which so many have risked and given their lives. Our current crop of public servants couldn't shine the boots of the likes of John Adams, Samuel Adams, Thomas Jefferson, and Ben Franklin.

An election year seems to bring out the worst in them. The dishonorable pandering that goes on is most vexing. There seems to be little talk about what's best for the country as a whole, and lots of talk about what can be done to please this or that interest group. The latest redistribution-of-wealth scheme disguised as a stimulus package is a very good example of this kind of nonsense.

The biggest prize of all in the pandering game is health care. Some are ready to give it away to all at the expense of the taxpayers. Assuming one believes that expanding the federal health care system would actually help people, it's easy to appeal to voters based on stories of individual hardship. How could anyone deny health care insurance to a working mother of three?

When the poster child approach is used, it becomes difficult to make an argument against a national health plan without sounding heartless. And those who are pushing for national health care are counting on this. A rational person might first ask what kind of coverage would be provided. Would it be like Medicaid, where access to care (except emergency care, of course) is quite limited, and the only guarantee is that nobody will try to collect money after the government pays 30 cents on the dollar?

Would everyone have Medicare, where money gushes like Niagara Falls? (Some of that money actually splashes at the feet of doctors on occasion.) Medicare pays for people who don't recognize a soul or know the year to get dialysis. Ambulances shuttle patients all over creation at $500 a ride--but Medicare won't pay a doctor a reasonable fee to make a house call. Amplify this kind of waste five times, and the budget deficit will soar. The money will dry up quickly, and then the rationing will begin. At first, it will be relatively easy, and we won't dialyze people who don't know what planet they inhabit. Later, choices will become more difficult, and people will wait months for bypass surgery or will be disapproved for hip replacements.

Will we allow people to purchase supplemental insurance and maintain a two-tiered system, or will everyone be forced to live under the same cash-strapped federal system? That's the way it is in Canada. Those with means choose to come to the United States and pay out of pocket when they are put on the waiting list for surgery or chemotherapy, because they are prohibited from buying private insurance.

Americans will demand choice in their health care coverage. Just as people with money abandoned city schools 40 years ago, people will flee the federal health care system. Access to good care will be diminished for those who are stuck in the federal system and will improve for those who can afford the private system. Our elected officials may feel better for having done something to "help" people, but everyone else will be the worse for their efforts. And the very people they set out to help will suffer the most. Just look at the failed public school system of every large city in the country to get a look into the future of health care.

There is more to this than guaranteeing health insurance for a mother of three. The larger debate should surround what's best for the survival of our republic. This is what our founding fathers pledged their honor to. They put the good of the nation ahead of their parochial interests.This is a rare discussion in Washington anymore. Remember, it is our elected representatives who have created the Social Security system but failed to put money aside to pay the tens of millions of people who are about to start collecting from it. These are the numbskulls who gave us EMTALA and demand our servitude (under threat of stiff penalty) without any promise of compensation for our efforts. This is the fiscally irresponsible lot that spends money on useless earmarks while our collective debt soars. I don't have high hopes that any of our candidates or elected representatives will look at the big picture and realize that our Constitution does not guarantee happiness. We have no right to it. We are free only to pursue it. 

Our founding fathers did not believe that pursuing happiness involves sitting on the couch waiting for your federal insurance card. Thomas Jefferson said, "The democracy will cease to exist when you take away from those who are willing to work and give to those who would not." He would not be pleased with our current entitlement state and our punitive tax code. He might even look at our current government in the same way he saw his British oppressors and say that it is his right--it is his duty--to throw off such government, and to provide new guards for our future security. No doubt, today he would be branded as a crazy extremist. Every election provides our nation with a crossroads. For physicians, this is a particularly important one. I fear that the implementation of a national health care system will propel us further down the slippery slope we travel already. 

When the majority sees fit to tax the wealthy minority to pay for something not promised in the Constitution, our republic creeps closer to collapsing into socialism. And then we will be a mere shadow of the great republic forged over 2 centuries past.

Dr. Baehren lives in Ottawa Hills, Ohio. He practices emergency medicine and is an assistant professor at the University of Toledo Medical Center. Your feedback is welcomed at

Or you can share your thoughts here.

Saturday, October 18, 2008

Ahhh, yes the BCS

In honor of the BCS, I will soon be changing my specialty hierarchy to a complicated mathematical formula that will in no doubt make it clear which one is right for me.  I hired a math-a-lete to help me.  I will also be giving you a very random, somewhat incoherent post as I have another test tomorrow and this last week was out of control busy.  Felt like I was one the trading floor of wall street, sans the awesome backstreet boy head mic.  

Anatomy lab was filled with phrases like "I hope that wasn't important."  "That looked important."  "I think I found the great saphenous vein."  "No, you found fascia."  "My nose itches."  "You got some juice in my eye." and "maybe we weren't supposed to cut that."  I accidently cut something I shouldn't have (don't worry, even the fellows do that), and instead of alerting my tank mates, and risk getting voted off the island, I tucked it back in and waited for someone else to touch it and pull it out of its intended spot so I could pull the old tommy boy "what'd you do??" line.  Stellar.

Apparently I have been 'tagged' by this woman.  It appears that my job is now to entertain you with 7 'wacky' or unknown facts about myself.

7.  I have owned and actively worn the shoes I am wearing for 5 years.  I hold onto shoes until the soles fall off or they look bad.  Notice I said "or look bad" because I can keep the shoes looking new until the sole comes off.  In fact, my last pair of work shoes I had were spray painted and sharpied to mask the severe discoloration.  It worked.  Wall paper over the hole, baby. (don't hate)
6.  I have had a gun pulled on me (don't ask)
5.  The phrase "I need a bellhop" still brings a sickness to my stomach.  While we are on the subject, so does "I will tip you later", and "Oh, sorry I need to go to the ATM."
4.  I have never done anything wrong/illegal/immoral without getting caught.  (Yep, I suck at crime)
3.  I have never been in a fist fight.  In fact I often think how things would have been different if I had thrown a punch the one chance I had that was warranted.
2.  I have had seven surgeries and I am still convinced that the Kerlan-Jobe doc let his first-day fellow cut on me, but one day that could be me so I won't complain.
1.  I was suspended from pre-school....thats right, pre-school.  (When you're street, you're street.)

Because I was so generous and told everyone who reads my blog to go to their web site, I now 'tag' Frank Drackman MD, the DOA, and Cold Girl Fever (Medicine Girl)    (If you guys do not do this, you will have bad luck for 50 years and John Rocker will become president.)

This week I had a talk from an ED physician, and by ED I mean emergency department.  I wasn't surprised, but I was upset at the fact that he said his group only gets paid 35% of what they bill for.  You can't get that good of a deal buying chiclets from a mexican child on the beaches of San Felipe.  He started to worry some people by saying that his group only gets back 35%, they get a large part of their income taxed, and they still have student loans.   Now, do not take me for a greedy person who has no compassion and does not have a heart, but I wonder how it would change the face of medicine if doctors had no income tax.  Add in teachers, bellmen (had to throw it in there), firemen and policemen to that group and I wonder what would happen.  Just a thought.  Hey, the lawyers will pick up the tab.  A physician I shadowed once told me "you know, a lawyer makes $100,000 a year and people say, 'he must be good and work hard.' but a doctor makes $100,000 a year and people say, 'ah those damn doctors charge too much.'"  Now I know I am not in medicine for the money, and I do believe that some less fortunate people deserve medical care, and I will absolutely be a physician who gives back, but there are a lot of people who take advantage of the system and just ride it out, leaching off of the tax payers.  I could go deeper onto this topic but I have a test tomorrow.  

We did have one person in our class stand up and tell us that she really wants to go work for an insurance company one day.  Kind of like standing up at your  nun orientation and saying you wish to be a stripper one day.  So much for that oath you took at the white coat ceremony about doing everything in your power to get patients better.  I mean you took the seat of someone who actually wanted to treat patients, not actuarial statistics.  I tried to get her kicked out of school, but I couldn't get her to take a swing at me.  They should have kicked her out on principle alone.  Kind of not what we stand for.  I hope this week is not as busy as the last one.  Out.

Friday, October 10, 2008

Safe Haven

First of all, I wanted to thank M.D.O.D. for adding one of my posts to their "Grand Rounds" this week.  I give them full credit for the sudden 300% increase in visitors to my site the past few days.  In a futile attempt at reciprocity I encourage you to head over there and check it out.  They don't hold any punches and I agree with a ton of stuff they talk about, especially when it comes to EMTALA and healthcare in general.  This brings me to the blogs list I have started.  There are a ton of medical blogs out there as well as non-medical blogs that provide me with guidance, support, life-skills, and comfort on a daily basis.  I have started a top list on the right side of the page that I am sure will grow.  Check them out.

For all you parents out there who have at one time or another felt like driving your children to a place far, far away, (pretty sure that gets all of you) there is hope.  You may be saying, "they are 14, too old to abandon," to which I say, "not so fast." GO TO NEBRASKA before it's too late.  Oh, I can just imagine the conversation to pass that law:

Lawmaker #1:  Well, how old is too old for this law?  Lets think about it?
Lawmaker #2:  hmmm...(looking at watch)...the cornhuskers game starts in 5 minutes...
Lawmaker #3:  I know, let's just put 'children' where the age will go, that way we won't have to worry about it.  It's not like some guy will show up with 9 kids and leave them all.
Lawmaker #1 and 2:  Genius!

At least throw in a mandatory vasectomy/hysterectomy if you are going to pass some legal abandonment law.  If a guy can't produce one 'keeper' out of 9 kids, should he be able to try again?  You know what you are getting when you take on the responsibility of children.  (I appreciate the law when it is laid out correctly as it is trying to stop people from leaving their babies in dumpsters to die, etc.)  And yeah, some are more difficult than others and we could try to figure out whose fault nasty children are (parents) by discussing nature vs. nurture until David Blaine stops pulling off "incredible stunts," but I plan on being done with this discussion before I am 40.  [Plus, David Blaine is a crappy tipper.  Dude can change $1 bills into $100's, levitate, resurrect bugs from the dead and pull strings out of his stomach, but the hornswaggler hands over a 3 wadded up $1 bills and expects me to be amazed and dazzled?  Bro, change them into hundies!  But I digress]  I can't go to the fair, pop some balloons, walk around with a giant pink ape all night (or for 14 years for that matter) and then return to the carney and tell him I don't want to carry it around anymore because it is too much of a burden and I didn't realize what I was getting into.  That doesn't fly.  Should have stopped when I won the glass photo of Elvis or after the first three balloons where the toy was small enough for my dog to chew.  Yeah it seems cool at the time and you can't question my dart throwing ability that night  when people would stare and say "wow, he must be good at throwing darts because of the large, stuffed animal on his shoulders!  Wow he is so cool."  And my totally hot girlfriend is naturally impressed, but as soon as I leave the fair, I am just a guy with a giant pink ape on my shoulders and that puts a hamper on my lifestyle.  I do feel badly for the children though, but maybe they called Dad's bluff when he told them they were driving them crazy and he would leave them at the hospital.  "Fine Dad, if I can't watch the Hills or date Mikey, what do I care!"  Maybe 'Dad' doesn't realize that once they get grateful again and realize how nice it is to be home, they can't go back home.

Friday, October 3, 2008

"My oh Myostatin"

For those of you not familiar with Myostatin, let me introduce you to what happens without it.

You can't deny that this mouse is jacked.  The other mice couldn't get that yolked even with the juice.  Myostatin enables fat production and muscle atrophy.  Now, imagine if you weren't able to produce it.  Just so happens that researchers did it in mice.  It also happens that the first recorded human without the gene expression for the hormone is in Germany (documented via scientific literature).  At the age of four, he was holding approx. 7 lbs. straight in front of him in horizontal suspension.  This guy could smack the smirk off of Richard Sandrak's face while curling 50s.  There is no doubt that this little tyke is going to have a great life.  If he ever gets picked on, he will set an example by bending the bully's bike frame into a pretzel.  He will never go to his dad for help with bullies, his dad will come to him.  Fathers, good luck stopping this guy from dating your daughter.  And if by some fluke you have a daughter that cannot produce Myostatin, I say a forced marriage is in order.  You better hope you got some serious bridewealth.  This kid will play every sport imaginable and dominate them all.  Imagine this kid in Pop Warner.  Guy will have college strength in 5th grade.  I would be worried if this child was born in another country, where he might be able to go through life without picking up a sport or 10, but not in Germany.  They are hardcore.  Thing is, even if the kid pigs out on McDonald's daily, he will still be ripped.  With a little education and fitness, he will be unstoppable.  The Germans are prideful and take success seriously.  Not anly that, I wouldn't be surprised to learn that they cloned him to make a whole Olympic squad. Good thing this isn't Berlin, circa 1962, where they might require that parents only produce children sans the Myostatin gene.  The dates above are a range because quite frankly, I wouldn't be surprised to see the Germans cheat a bit to get him there sooner.

Note to Drew Rosenhaus:  Dude, get on this guy before it is too late!

Speaking of football, I just was briefly watching the Kentucky/Alabama game and the announcer said "Looks like they are going to take the penalty and try the field goal from further back.  They say it improves the angle, but I don't see it."  Seriously?  You are a football announcer and you don't see how a field goal from the three yard line on the hash is not as easy as it is from the 8 yard line?  I hope someone was ripping him apart in that little ear thing he wears.  Even Hochuli can make that call. 

Thursday, October 2, 2008


I am not one to brag, but I just found a piece of preserved human flesh on my cell phone.  That's all I have to say about that...

More updates this weekend.