Revolution fever

A lot of people are excited about the overthrowing of dictators in the middle east. Tunisia did it and Egypt is in the process. Some (idiots) are crediting the U.S.'s policy of trying to "spread democracy" in the middle east (starting with Iraq). A called on NPR wanted to credit Bush for Tunisia's revolution, but luckily, the guest shot him down quickly. The guest said that it actually proves the opposite of what Bush was trying to do. You get effective regime change when you don't interfere (Tunisia) and you get failed regime change when an outside force is interfering (Iraq). Whatever the cause, these revolutions are exciting. Although, I fear that something very similar to Iran in the late 1970's will happen. A popular, largely secular uprising will pave the way for an Islamic Theocracy. Let's hope it doesn't.

Not another "miracle"!

Crazy interview season has kept this blog quiet. Well, I'm done with radiology interviews and only one more intern year interview left. I'll have an update soon. I'm sure no one is left to read the blog, but whatever... I'll vent about the latest "miracle" I heard about. This is from NPR:

BRADY: At times during today's briefing, Drs. Rhee and Lemole were almost giddy. And in undoctor-like fashion, Lemole said Giffords' progress may be partially attributable to outside forces.

Dr. LEMOLE: Miracles happen every day. And in medicine, we like to very much attribute them to either what we do or others do around us. But a lot of medicine is outside of our control, and we're wise to acknowledge miracles.

Dr. Lemole, sir, you are an idiot. A lot of medicine may be outside our control (especially when it comes to recovery from brain injury), but there is no such thing as a miracle. Just because you don't know how something works, doesn't make it a miracle. This is an even less appropriate thing to say when you have no idea what her long-term condition will be. I move that any doctor who attributes the recovery of any of their patients to a "miracle" should not receive any monetary compensation for taking care of that patient. Clearly, they admitted that they didn't do anything.

It's bad enough that an imaginary deity gets all the credit when the hard work of a physician saves someone's life, but it really upsets me when physicians go around accepting that.

(A real miracle would be if the right wing nuts who have been spitting out violent rhetoric for the last few years actually admitted that what they say can affect what another nut does.)

TSA all over T&A

With all the traveling for residency interviews, the ever-increasing invasion of privacy that is the TSA is starting to become more than just an annoyance. They either get to get to look at you naked (via a body scan) or perform a "heavy" pat down (i.e. grope your genitals... or in some cases, cause your urostomy bag to spill urine all over you). A lot of people are afraid of radiation exposure with the body scans, but (based on how little radiation is emitted by X-rays that can actually see your bones) I'm not so worried about that (though I wouldn't go through them if I were pregnant or had any chance of being pregnant). It's more the invasion of privacy. The government has no right looking under everyone's clothes. It's humiliating and unnecessary. The other option (being groped) is no better. But, if someone is going to take away my dignity, I may as well make them do some work. I'm a little disappointed that the planned pre-thanksgiving protest of refusing to be scanned (and thus, backing up the security line) didn't pan out, but I plan on getting to the airport early just so I could make those useless TSA agents get off their asses and work. Also, I plan on getting them to change to new gloves (who knows how many other people's genitals they've groped with the same glove?).
This is even more upsetting because it really doesn't do much to prevent a terrorist. It's all a show that isn't impressing anyone. It's much easier to do all the work behind the scenes from the moment a passenger books a ticket, but I'm sure the government is afraid that people will think that they aren't doing anything to keep them safe. I'm glad that people are finally starting to protest, but, like with all other steps TSA has introduced, (take your shoes off, no water, etc.), I have a feeling people will fall in line, because it's just easier to.

First interview and rash of rejections

I recently had my first interview. I had a great time, residents and faculty were both very nice. The interview was pretty low stress. One thing, though, surprised me. The institution that I interviewed at is well known for its research, but I had no comments made about my research and when I asked about research opportunities, each faculty member replied with a quick "yeah, we've got research" and seemed to not be so interested. The tone of the response of one faculty member almost made me feel like I asked an inappropriate question. I understand that in residency it's fairly difficult to work on a real research project and I have no intentions of working on a PhD level project, but I expected at least some acknowledgment of their research strengths.
I feel that most residency programs want a token amount of research in your background, but would rather not have your clinical training soiled with research. As such, someone with a background like mine actually has a big disadvantage. With average grades and boards scores my strength is in my productive research (and recommendations). This leads to a strange situation in which some mid-/lower- tier programs decide not to offer me an interview (I assume because they think I will go to a research heavy institution) and many upper-tier programs decide not to offer me an interview (I assume because of less than stellar grades/boards score). I end up with a small number of fairly random interviews with some of the best and some mediocre programs. Of course, maybe I'm just trying to rationalize a (essentially) random process. Anyway, another week or two of potential interview invitations, but I'm feeling a bit more pessimistic now than I did a few months ago.

People are stupid

It amazes me how millions of people can be convinced to vote against their self interest. Healthcare? Who needs that? What America needs is a tax cut for the rich. Also, get rid of the estate tax (even though it only applies to people who make millions and I only make $20,000 a year). Oh, and extending unemployment benefits is unamerican (even though I'm unemployed and collecting unemployment right now).

Rural Hospitals

I recently did a surgery rotation at an outlying hospital. It was labeled a "rural" hospital, but in reality it is only a 30-minute drive from where I live. It was a great experience. Without residents, I actually felt that I was a useful member of the team and in the OR actually got to do more than hold something that I can't see. The hospital only had something like 30 beds and I expected that any patient requiring more than a minimally complicated procedure would make the 30-minute hop to the giant academic center nearby. To my surprise lots of patients there would rather have their complicated multi-organ bowel surgery at the small 30-bed hospital (with only 4 ICU beds). Their main reasoning was that they felt comfortable in a place with familiar faces, where they knew the staff as friends or families of friends, something that they preferred over a giant maze of a hospital where you're known as a diagnosis or a room number. Also, I quickly figured out that the quality of care was the same (if not better, in some respects) than the giant academic center. True, you couldn't get a transplant or brain surgery, but for most procedures that general surgeons (or orthopedic surgeons) do, they're just as good. What's more is that things happen amazingly fast at this small hospital. There were several patients that came in with suspicious breast lumps and within a week had a partial mastectomy with pathology results in and an oncology appointment made. Scheduling several procedures across four different specialties is pretty much not possible in a large hospital. So, even though there's a lot of "outside hospital" bashing in academic centers, for the most part, they're just as good.

Checking email

Still checking my email for possible residency interviews. It's a very anxiety-provoking process. I check my email something like 20 times a day (I thought having a smart phone would be great, but it turns out to distract me more than help me). It's getting to be a crazy obsession. The plus side is that I've gotten two radiology interviews and four intern year interviews. It's somewhat reassuring, but it hasn't stopped the anxiety (and I did get one rejection from an intern year program).

One thing I'm really glad I managed to do was to take a large chunk of time off in December and January (prime interview season). With the number of interviews I hope to get (and an equivalent number of intern year interviews since I want to be in the same city for both), I will be traveling all the time. Our school only lets us take off one day per week of class for interviews and (by my calculations) I would have to break that rule to fit in the number of interviews I hope to get. Some classmates who don't have the time off are wondering how to deal with this dilemma. Since the med school administration always strictly adheres to their rules (and no amount of logic will let them change it), the best option is to either call in sick or ask your resident/attending and not bother with the administration. Nonetheless, the administration may find out and you'd have to deal with their fury.

Tips to any future medical student:
1. It's best to plow through 3rd year and free up 4th year for easy rotations/research/time off so that you could focus more on residency applications and interviews.
2. When it comes to needing time off, follow the old adage: It's better to take the time off and apologize afterwords than to ask for permission and not get it (because you won't get it).