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Motherly Instincts in Overdrive

Tue, 01 May 2012 15:02:05 -0400

Phillip: That was good bacon
Mother: Thank you.
Mother: Time to start making lunch! Do you want chicken or fish?
Phillip: I just finished eating breakfast 5 minutes ago.

Realization

Mon, 02 Apr 2012 09:51:16 -0400

Minso: I just realized that I have a really Korean face.
Minso: Like really really Korean.
Phillip: Well you are Korean.

Intolerance

Mon, 12 Mar 2012 10:22:20 -0400

John: What is Catholic mass like anyway?
Phillip: We stand, kneel, sit, and think about the things we did for fun during the week.
Phillip: And then we ask for forgiveness, because you're not allowed to have fun when you're Catholic.

"Really, what kind of doctor you want to be comes down to one simple question: do you want to be a..."

Sat, 13 Aug 2011 09:55:00 -0400

“Really, what kind of doctor you want to be comes down to one simple question: do you want to be a masturbator or an active participant?”

- An attending during rounds

This is helping me choose what field I want to go into.

Sun, 23 Jan 2011 11:08:00 -0500

This is helping me choose what field I want to go into.

Ask-Tell-Ask

Wed, 05 Jan 2011 12:20:03 -0500

I had my pediatrics clerkship for the last two months:

“You made my baby cry!”
“I’m sorry. I just looked at her.”

“Is this your first time giving a vaccine?”
“Yes.”
“Great. My kid is going to cry all night now.”

“Which ear hurts?”

The little girl points to her left ear.

“This ear hurts?”

“No, this one,” she says, pointing to her right ear.

“This ear hurts?” I ask again.

“No, this one,” she says pointing to her left ear.

We repeat this dance for the next ten minutes.

“Hi, I’m Phillip, one of the medical students. Do you mind if I ask you a couple of questions about your son?”
“No, I only want to speak to the attending. Go away.”

“What do you think is wrong with her?”

“I’m not sure. I’ll speak to my attending and we can move from there.”

“Do you have any ideas at least?”

“Well it could be…”

“Do you know anything?” she interrupts.

“Not really. One of the hazards of being a student.”

“Are you sexually active?”
“No.”
“Do you have a boyfriend or girlfriend?”
“Yeah, I have a girlfriend.”
“What do you guys do together? Make-out…?”
“We do it in the butt. It’s not sex if I’m not using her pussy.”
“Oh.”

“How long has his knee been swollen and red like this?”
“A week now. I was putting some oil and vinegar on it everyday. That usually works.”

“I always look at tall women and think they’re models, that’s how beautiful they are,” the doctor told her patient. The patient was on track to be six feet.
“OK.”
“Just remember, don’t feel that you need to limit yourself to tall guys. There are plenty of short men who you can date. Don’t rule out short men,” she said, pointing at me.

“Any nausea, vomiting, diarrhea, constipation, chest pain, or shortness of breath overnight?”
“No.”

“Is my son going to die?”
“I’m sorry?”
“Is my son going to die? Please tell me he’s not going to die.”

"You know, your nose doesn’t have to be in there."

Tue, 04 Jan 2011 19:40:21 -0500

“You know, your nose doesn’t have to be in there.”

- A resident to me as I performed my first pelvic exam on a woman. I have a bad habit of staring very closely at something when I’m really concentrating.

WTF Has Obama Done So Far?

Wed, 03 Nov 2010 19:20:29 -0400

WTF Has Obama Done So Far?

It's the first week of my pediatrics rotation

Thu, 28 Oct 2010 17:23:51 -0400

Patient's Mother: Do all kids immediately cry when they see you?
Phillip: Yeah, it's the face. I'm working on it.

Your stories are really well-written and funny! Do you plan on posting more parts of that story? I'd really love to read the rest of it :D

Sun, 17 Oct 2010 11:29:11 -0400

Thank you! I’m 4 months into my third year of medical school, so I don’t have as much time to write, but I’ll have more time soon once my easier rotations start.

My mother wants to make sure I get the full meaning of her statements

Sat, 16 Oct 2010 13:11:14 -0400

Mother: Your cousin is having twins!
Phillip: Wow! Congratulations to her.
Mother: Yes.
Mother: And she's pregnant!
Phillip: I assumed as much.

Depressed Bowels

Mon, 20 Sep 2010 06:00:47 -0400

“When was your last bowel movement?” I asked.

“Two weeks ago,” the patient said. I glanced at the initial history and physical that my intern had given me, stating that the patient had diarrhea one day prior to admission.

“I thought you had diarrhea two days ago,” I said.

“Oh yes, it was very watery. I had to run to the bathroom six or seven times that day. Explosions every time.” He clapped his hands together, demonstrating the force at which his GI detonations took place.

“So have you had a bowel movement since that day?”

“No, not for two weeks. I already told you that.”

Thirty minutes of interviewing later, I finally discovered that Mr. M did not consider diarrhea to be a bowel movement, but rather “peeing from the buttocks.” My team had already rounded on him earlier that day; his diagnosis of dizziness due to diarrhea-induced hyponatremia did not foster interest from most of the team, but I had still volunteered to follow the case.

“Did you drink anything that day?” I asked.

“Yes, water.”

“How many glasses?”

“Fifteen. I drink fifteen glasses of water every day. Ever since I came to America,” he said. Mr. M had emigrated from Bangladesh eight years ago, was unemployed, and lived at the men’s shelter next to Bellevue. The history I extracted from him was no different than the history the intern from the previous night had taken, but needing the practice, I decided to perform a full medical student history, one that would take up the next two hours.

“Any history of depression?” I was near the end of my review of systems.

“I’ve always been depressed. Ever since I came here.”

“Ever since you came to the hospital?”

“America.” The glazed look in his eye was difficult to interpret. I thought I sensed sadness. My intern said it was retinopathy due to uncontrolled diabetes. “I came to America and was such a failure.”

Using a Bengali interpreter, I questioned Mr. M with a PHQ-9 scale. After enduring long,
foreign conversations that resulted in short yes and no answers and an episode where I was put on hold for ten minutes after the interpreter’s dog started barking, I finished assessing the patient’s depression. Mr. M scored an eighteen, giving him the oxymoron of moderately severe depression. “This is the first time I have ever talked about my pain.” He smiled for the first time.

“Thank you, my son,” he told me at the conclusion of my interview. “I always wanted a Hindu son, to show that Muslims and Hindus could get along.” I told him I was Christian and left. We started him on an antidepressant, called a psychiatry consult, and planned to discharge him the following afternoon.

The next day, Mr. M looked even worse. “Do you still feel dizzy?” I asked, immediately assuming that his initial chief complaint was his primary ailment.

“No, my son.” He had started to call “son” after our bonding session the previous day.

“What’s wrong?”

“I haven’t gone to the bathroom in two weeks.”

“But you had a bowel movement three days ago.”

“No, I haven’t done anything in two weeks.”

I decided against arguing with him about the definition of constipation, instead focusing on documenting what medications he was currently taking from the bag of pills his friend had brought in. Among the blood pressure and diabetic medications, I discovered two bottles of duloxetine vs. placebo from a clinical trial located in Staten Island. “Why do you have these?” I asked.

“I’ve never taken them. My friend just gave them to me.”

“But why?”

“I don’t know. He said they would make me feel better.” He hesitated. “Do you think these will make me go to the bathroom?” he whispered.

“No,” I said, confiscating the bottles without any complaints.

On work rounds, I told the team about the bottles of clinical trial drugs. In summing up Mr. M’s case, I stated that psychiatry should be called again to see him. “And maybe we can give him a suppository,” I suggested. My resident shrugged me off, put in an order for bisacodyl per rectum, and hurried off to see the next patient.

When I saw Mr. M later that day, he was beaming status post bowel movement. “I feel so happy. You cured me. I’ve gone to the bathroom so much!” he exclaimed.

“Did psychiatry see you?”

“They were waiting for me after I came out of the bathroom. Nice people.” He was gathering his belongings. “I was told I could go home today.”

“You look much better.” I smiled and started to leave, another patient discharged without me having to do anything.

“Doctor, wait. Do you think…do you think I could get a prescription for the rectal thing? It’s changed my world.”

“I’ll see what I can do. Take care,” I said, leaving him for the last time.

I went to a nearby computer to see what the psychiatrist had said. “Patient is oriented x3 and appears well. Does not report any depression. Would advise that patient discontinue antidepressant that medical team started. Patient can follow-up with outpatient psychiatry if desires.” Translation: the medical student does not know what he is talking about.

The case of Mr. M demonstrates that so much of medicine is subjective and based on the personal relationship that a physician builds with his or her patient. Psychiatry may have concluded that Mr. M was better after clearing his bowels, but I remain unconvinced that constipation is at the core of all his problems. Of course, it is entirely possible that I am wrong, as psychiatry’s note indirectly points out. I may have misinterpreted diabetic retinopathy as sadness, but I can always blame my Bengali interpreter if I was indeed incorrect.

Stereotypes Do Matter

Fri, 04 Jun 2010 09:36:28 -0400

I take my USMLE Step 1 Boards tomorrow, so I’ve spent the last six weeks studying almost non-stop. Some things I learned that I find important:

1. Black women = sarcoids and lupus.

2. Black men = sickle cell and G6PD deficiency.

3. HIV = gay men. They are most likely bottoms who might also have anal HPV.

4. When a child comes in who you suspect is a victim of child abuse, it is not correct to say “What made you behave inappropriately? Maybe if you stopped, you wouldn’t be hit.”

5. Rare diseases are not very rare when taking the most important test of your life.

6. I CANNOT STUDY ANYMORE!

Tan Hong Ming - “I don’t want the whole world to...

Sat, 01 May 2010 10:38:19 -0400

Tan Hong Ming - “I don’t want the whole world to know!”

Innocent love. The look on his face at the end is priceless.

Sex in Europe

Sat, 27 Feb 2010 16:39:09 -0500

Mother: Don't let your friends pressure you into having sex in Barcelona.
Phillip: I won't.
Mother: It's bad enough if you have sex in America, but those Europeans are just so sexual.
Phillip: Did you have an experience with a European man?
Mother: (Ignoring the previous comment) You might get rashes, or your back will get sore, or your teeth will fall out.
Phillip: Oh no.
Mother: Your penis will definitely fall off. I guarantee it.

"If Rudy were here, he would have plowed the streets, kicked the homeless out, shot some minority 41..."

Thu, 11 Feb 2010 11:43:47 -0500

“If Rudy were here, he would have plowed the streets, kicked the homeless out, shot some minority 41 times, and exacerbated racial tensions—all in one week.”

- Reese, telling me how Rudy Giuliani would have handled the snowstorm if he were mayor during the snowstorm that hit DC this past week.

Med Students are Inherently Socialist

Tue, 08 Sep 2009 16:06:19 -0400

I wish I could have watched President Obama’s speech to children so I could also be indoctrinated into the ways of socialism. Studying hard and staying in school are essential elements of the Communist Manifesto.

"If I ever have a daughter, I’d want to name her Condoleezza."

Wed, 15 Jul 2009 21:31:10 -0400

“If I ever have a daughter, I’d want to name her Condoleezza.”

- Reese.

"Obama has 30 czars. That’s more czars than Russia had."

Sat, 11 Jul 2009 10:40:27 -0400

“Obama has 30 czars. That’s more czars than Russia had.””

- Reese’s senile grandmother.

Why I Should Marry an Indian Woman

Tue, 31 Mar 2009 09:20:42 -0400

Dad: You need to marry an Indian girl.
Phillip: Why's that?
Dad: Because you're pure Indian. There aren't that many left.
Phillip: There are a billion of them.
Dad: Where?
Phillip: India.
Dad: Oh. There.