Saturday, October 31, 2009

Do I know you?

Well we meet again. It has been a long time, I have been busy, but I haven't forgotten you. I think about you often, every time I shake my head after a comment/action/experience one can only have in med school. For instance, just last week someone in a class said "Concierge medicine is unethical." I laugh, roll my eyes and shake it off. Is not cleaning up someone else's trash on the street unethical too? How about eating at a higher-end restaurant while people starve all over the world? Should I just roll over and give up on the hope that I can actually make a decent living in medicine and just go into primary care, lose money by taking only medicare and medicaid patients and feel good about myself because I am not being "unethical"? (I am not implying that you can't make a "decent" living in primary care, just saying it is much harder.) It's ok, because you are one of the youngest people in our class, have never had a job and probably have never payed taxes unless you claimed the birthday money from grandma. Oh, what's that, you didn't? Isn't that unethical?

Oh, and I have a new "guy" similar to this one and this one that I will share with you soon. Hope to see you again really soon. For now, chew on the rest of my list of things to know before med school:

1) Military med students are like Mormons. They are uniformed, polite, and can make a great case for their cause. Medical schools constantly warn you about your mounting debt and the military men and women can see the fear in your eyes. Like an injured succulent bison, you will be picked off from the herd. You will be invited to informational meetings, asked to attend jogs, and even offered to be put in touch with someone. Be careful though, because they know how to keep you interested for years and each carrot they dangle in front of you implores you to stay on the train another stop. You make one nibble on Uncle Sam's teet and pretty soon you are ironing your Temple Garments fatigues and you are monetarily debt free yet you owe Uncle Sam some serious time. It works for some people, but just understand what is going on and think through the temptation.

2) Be prepared for words and phrases to become so hackneyed that they will begin to make you ill. Phrases like "gunner", "boards", "patients don't come in with a multiple choice question", "patients don't come in with a power point", "you learn by doing", "high-yield", "I don't study much", "I am soooo worried about THIS test", the list goes on and on and on. Just know that people will use these phrases with smug superiority masquerading as professionalism in front of others to put you or others down. It is like the guy who waits all night for the perfect set-up to let loose the one-line zinger he learned that day. It is old material that keeps being regurgitated as if it is new material. Kind of like the whole "I'm Rick James!!" skit done by Dave Chappelle before he went crazy. I can't count the number of times I had to listen to someone go through the skit as if they were the writer behind it and I was the first person to hear it. Yeah, I got it, the fingers said slap, you're Rick James, and you need to watch something else.

3) Don't be afraid to defer your admissions another year to do something fun. Really, it's ok to get some life experience if you are fresh out of undergrad. I planned at least one year off of school. Trust me, it will help take the edge off a little bit. Plus it gives you a chance to earn some money and save some money for med school all while getting life experiences. I am amazed at the amount of people in my class who have never had a job. Must be nice.

4) Correlation does not = causation. If this hard to grasp, take this example. Suppose I told you that sleeping with shoes on is strongly correlated with waking up with a headache? It would be easy to say, "well then, sleeping with your shoes on causes you to wake up with a headache." Not so. There is a lurking factor in the form of body shots and Jager Bombs that cause one to wake up with a headache. The fact that they sleep with their shoes on is secondary to being intoxicated. One of my favorite things to do is find the hidden agenda in a speakers talk. Trust me, everyone has an opinion they want you to know in their presentation (especially when you are in medical school) and when you get facts like there are "40 million uninsured people in the U.S." are shoved down your throat, don't trust it just because someone said it. There are lies, damn lies and statistics. Stats thrown at you from some study do no good unless you know how the number was derived which, most of the time, is derived by someone wanting a certain outcome. Be careful. Very careful. If something said is going to make you change your views, do some of your own research. Nothing is worse than uneducated (in terms of life experiences) people forming opinions based on biased or false information who then become too close-minded to change their views when presented with facts. Don't swallow any pill that is handed to you in class. In fact, just the other day I had a speaker tell me that "a majority of doctors believe health care is a right." I have my doubts about whether that is true or not, but either way she was stating an opinion and trying to hide it behind something that slightly resembled a statistic. If you didn't know any better you might fall for it.

5) Do not have a anything on your stethoscope in class. Nothing says "I need attention" more than that. So you worked with children. Great. Take the pink Giraffe off your stethoscope before you shove it in my face. You aren't a children's photographer. It is annoying and awkward, plain and simple.

6) You remember back when you started undergrad? Not day one, but like month three when everyone went home for Thanksgiving, saw some old friends and realized they had gained 15 pounds and then you took a look at yourself and realized you too had gained 15 pounds from all the cafeteria food? If you thought that was bad just wait. Every club on my campus serves pizza for their meetings. Sweets become lunch and a nutritious meal is considered taco bell because they serve rice in their burritos. 8 hours of studying is accompanied by 8 hours of snacks, soda and pizza. The med school 30 beats the pants off of the freshman 15. Trust me, if there is anything you can take from this it needs to be this point. EXERCISE. REGULARLY. Stress relief is so important in med school as is staying healthy. Make a time each day to exercise. No matter what. Just an hour is fine. It is so easy to say "well finals are coming up, I can't spend one minute doing something else other than studying." Bad decision. Excuses are abundant in med school. One hour of exercising isn't going to fail you. Neither will not exercising for that matter. I know that control of my own time only gets worse as the years go by. Pretty soon I will be in rotations and residency and if I don't have the habit of exercising it will be nearly impossible to start. I try to remember that one day I may have to lecture a patient about losing weight. I know they wont think twice about judging me by my appearance and lifestyle. You don't have to be perfect, no one is, just make an effort. Walking up stairs to go to class isn't an effort.

Bonus: Do not take your books into the cadaver lab. Your classmates wont think twice before grabbing your book with their greasy hands. They don't care. Let someone else be the sucker.

Bonus number two: If you have a habit of chewing on your pens, you better stop it. Nothing will elicit a gag reflex faster than when your pen tastes funny, and you then realize it is the same one you had in anatomy lab....except maybe people who update their facebook every ten minutes. Status Update...that spells H-i-s-t-r-i-o-n-i-c P-e-r-s-o-n-a-l-i-t-y D-i-s-o-r-d-e-r. (Let it be known that I made this)

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