http://www.studentdoctor.net/pandabearmd Navigating Medical School, Residency, and the Goat Rodeo that is American Medicine Thu, 17 Dec 2009 03:22:08 +0000 http://backend.userland.com/rss092 en Empty Suit How's that Hope and Change working for you?  Had enough?  Still grimly resisting that urge to scrape off the bumper sticker?  It's all right.  Nobody likes to admit they were fooled even though it's now painfully obvious that, like many of us warned you, The Sun King Ra-Obama is ... http://www.studentdoctor.net/pandabearmd/2009/12/17/prince-of-denmark/ Jumping the Shark "My arm was numb after I slept on it funny and my mom says I'm having a stroke," says my essentially healthy 34-year-old patient to the nodding approval of his indulgent mother sitting by the bed. "How long did the numbness last?" "A couple of minutes...it went away after I ... http://www.studentdoctor.net/pandabearmd/2009/11/21/money-for-nothing-healthcare-for-free/ Struggling for Rationality "This patient," I said to myself, "is going home."  I know.  She's 85 with the dreaded complaint of "Altered Mental Status" described by the family as a brief period of "staring."  No generalized seizure activity, you understand, and no syncope (fainting), slurring of speech, facial droop, drooling, weakness, confusion, ... http://www.studentdoctor.net/pandabearmd/2009/10/12/state-of-fear/ (More questions from real readers. -PB) What's the Emergency Department Really Like? The American College of Emergency Physicians and their bogus statistics notwithstanding, the majority of cases we see are not emergencies.   As I have mentioned before, most of the cases we see probably don't need to be seen at all by anybody in ... http://www.studentdoctor.net/pandabearmd/2009/09/05/yer-stinking-tax-dollars-at-work/ (Just a few random questions from real readers-PB) What is your job really like? As you know, I am an Emergency Physician working in a medium-sized community Emergency Department in a medium-sized hospital in a medium-sized city in a medium-sized state.   A "community" Emergency Department is not a major trauma center and ... http://www.studentdoctor.net/pandabearmd/2009/08/30/life-or-something-sorta-like-it/ Quick Learner So I had a drug seeker come in the other day with her usual back pain.  Lately I have been very stingy with narcotics and after refusing to give her a shot of anything stronger than Toradol I explained that I only give narcotics for patients with fractures or obvious acute injuries ... http://www.studentdoctor.net/pandabearmd/2009/08/15/pandamorama/ Michael Jackson is Dead and I Don't Care Michael Jackson is dead and, God forgive me, I don't care. I wasn't a fan and I didn't like his music. Sure, I listened to it; it would have been impossible not to but I never bought an album, stopped turning ... http://www.studentdoctor.net/pandabearmd/2009/07/13/poker-and-other-things/ 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/