http://www.studentdoctor.net/pandabearmd Navigating Medical School, Residency, and the Goat Rodeo that is American Medicine Mon, 15 Jun 2009 07:04:52 +0000 http://backend.userland.com/rss092 en Customer Disservice There are days when I explain to the family of a 98-year-old customer, in terror of the the inevitable end, that today is not that day and while the odds of their mother living another month are close to zero, she's alert, reasonably comfortable, and they have some time ... http://www.studentdoctor.net/pandabearmd/2009/06/14/bread-and-circuses-water-and-sewage/ Marching Up Country (With Apologies to Xenophon) The campaign draws to a close and will end like many such expeditions do; in a victory of sorts for I have certainly marched into and through the Empire of Medicine with my fellow mercenaries, outwitting the enemy on many occasions, laying waste to his ... http://www.studentdoctor.net/pandabearmd/2009/06/02/anabasis/ Perspective While driving through the downtown of our small but not insignificant Midwestern city (there are corn fields five miles from the city center but we do have the state capital and a handful of miniature skyscrapers) I noticed a fat brown squirrel scampering down a tree and bounding across the street in ... http://www.studentdoctor.net/pandabearmd/2009/05/22/edumucation-and-other-things/ "I got the Swine" I'm hoarse from explaining influenza to my patients, the numbers of whom showed a small but significant increase over the last two weeks as Swine Flu hysteria grew, peaked, and then receded.  Everybody wanted a pill for "The Swine" for which, unfortunately, there is none except an ... http://www.studentdoctor.net/pandabearmd/2009/05/09/panda-emic/ Actual Patient Conversation: "Man, that Dilaudid didn't even touch my pain." "Uh, Okay.  Your CT was negative so you're fine to go home.  I'll ask your nurse to come discharge you.  Come back if you get light headed or start to vomit but otherwise, just take Motrin for your headache and you ... http://www.studentdoctor.net/pandabearmd/2009/04/23/cant-touch-this/ (Actual questions from actual readers. -PB) I know you don't like chiropractors but what are we supposed to do for chronic back pain? For chronic back pain I recommend back strengthening exercises, instruction in correct lifting and posture, weight loss, physical activity, judicious use of NSAIDs, and occasionally just sucking it up.  ... http://www.studentdoctor.net/pandabearmd/2009/04/16/more-random-reader-questions-and-in-which-i-give-some-real-medical-advice-without-fear-of-being-sued/ A short post today, my apologies, but I want everybody who can to attend their local "Tea Party" on April 15th.  As you may recall from American history, back in 1773 American colonists irate over increasingly oppressive duties and tariffs imposed by the British disguised themselves as indians, boarded British ... http://www.studentdoctor.net/pandabearmd/2009/04/13/dont-forget/ (With apologies to Deborah Peel -PB) So I had this uninsured patient with a chronic medical problem that was being addressed at The Big Academic Medical Center Sixty Miles Away who came to the department with worsening symptoms from her chronic medical problem, a problem that was competing, I might add, ... http://www.studentdoctor.net/pandabearmd/2009/04/11/47-million-uninsured-my-ass/ (In which I answer several random questions submitted to me by readers. -PB) Hey, Panda, I'm not sure what specialty I would like to do and am considering going to PA school because Physician Assistants can easily move between specialties.  Your thoughts? I often hear the ease of movement between specialties touted ... http://www.studentdoctor.net/pandabearmd/2009/04/05/ask-yer-uncle-panda-more-on-mid-level-providers-and-other-topics/ 1001 Ways to Die There has got to be a better way to die and surely the patient at the center of our frantic activity couldn't have wanted this one.  I arrived at his room with a code in progress although, as the patient was still alert, most of the activity ... http://www.studentdoctor.net/pandabearmd/2009/04/01/1001-ways-to-die/