Med School/resident/attending thread

Discussion in 'The Mainboard' started by skeezy, Apr 27, 2015.

  1. lunchbox

    lunchbox ...
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    Had someone from my class commit suicide as well. I wasn’t super close with him, but as much as it is a difficult thing to say/articulate why, I wasn’t surprised it was him. Even knew him from undergrad a bit, he was good friends with a girl I was hooking up with for awhile. I thought he was getting better, he even graduated despite having to drop back, got into residency (psychiatry). But had baseline psych and chronic pain issues from a car crash.

    I remember thinking oddly, well good thing he’s at a psych program, surely they will pick up on signs…

    weird day when that broke.

    burnout is too real and recognizing in oneself is important. can’t take good care of patients if you’re suffering too much. life’s better post residency but still… I’m a hospitalist in Covid, this is fucking ridiculous. and I typically see 20-23 pts.

    and now I’m studying for boards after work because I missed last year after getting Covid six days prior… and I’m on the Covid unit this week… if I get delta and miss another board exam imma flip shit
     
  2. lunchbox

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    Had a renal transplant patient, obvi on immunosuppressive meds, positive for both Covid and Flu B lol. AKI cause of diarrhea. walked in that morning got this patient handed to me and felt palpitations.

    but guess what she’s vaccinated, and doing the best of all my patients, chilling out on 2L NC.

    burnout in noticing in my colleagues and nurses. they have zero sympathy for those here without the vac, and you can hear their disgust with these families and patients. It’s hard to maintain professionalism and sympathy sometimes when you deal with complete assholes or dumbasses who spread this disease. One patient was still going out to bars with a fever, dumb cunt.
     
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  3. Leeroy Jenkins!

    Leeroy Jenkins! Big Ivermectin Energy
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    Its bad here, ICU is full of unvaccinated 20-40 yos. There were 2 30ish yos prone/intubated/ecmo last week, one was thinking about getting the vaccine but worried about "conspiracy theories" but too late now.

    We just shut down elective surgeries here starting tomorrow.
     
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  4. clemsonvianj

    clemsonvianj Well-Known Member
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    yeah it sucks for transplant patients (or anyone on immune suppresion). we've had seen the "transplant + vaccinated" combo and the slightly scarier "transplant + had COVID prior to vaccine availability + vaccinated + came back with COVID months after vaccine."
     
  5. lunchbox

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    do they even have alveoli
     
  6. Tiny Tom

    Tiny Tom I used to be with it then they changed what it was
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    Got an email for locums with the header "elective cases shut down?" It must be bad for some of you.
     
  7. MrOutlaw

    MrOutlaw Director corp medical
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    where are you if you don’t mind sharing?
     
  8. Leeroy Jenkins!

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    ATX

    There's 7 ICU beds available for 2.3 million people but that's only 20% covid occupancy. Just busy season right now and then staffing issues like crazy because everyone is quitting.
     
  9. pnk$krtcrÿnästÿ

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    Yeah labor shortages are kinda killing everybody right now. That's been the major hurdle to our organization mandating vaccines, because we really can't afford anymore loss of nursing staff. Even if they're butthurt anti-vaccers
     
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  10. RonBurgundy

    RonBurgundy Well-Known Member

    We’re fine on nurses but our front desk staff and schedulers turn over like crazy.
     
  11. lunchbox

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    oh hi
     
  12. Cousin Eddie

    Cousin Eddie Lookin for the place called Lee Ho Fook's
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    Question for yall, how are your hospitals screening for Delta variant patients? I know at my hospital the test is just positive/negative and we send out samples to the CDC if we have suspicion for a variant. Are other hospitals doing genome analysis of each positive result? I don't fully understand how hospitals and public health agencies are getting their data on percentage of cases caused by specific variants.
     
  13. pnk$krtcrÿnästÿ

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    Guess I'm not really sure how to have clinical suspicion for a variant.

    I have no idea what our process is. Happens from the lab scientist end of things
     
  14. Cousin Eddie

    Cousin Eddie Lookin for the place called Lee Ho Fook's
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    I don’t understand either to be honest. Just what my attending told me. I just have no idea how people are getting figures like “45% of cases in the last week are delta variant” when neither my hospital nor those some of my friends work at test all patients for specific variants.
     
  15. RonBurgundy

    RonBurgundy Well-Known Member

    Physicians/hospitals are not looking at the variants AFIAK. Maybe Mayo is, but no one else.

    At least in my state, the state epidemiologist office is randomly sampling the positives for what strain they are. That random sampling then gets applied to the population. So they take random 100 positives per X time (assuming monthly but idk details), then report that info to the CDC.
     
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  16. Cousin Eddie

    Cousin Eddie Lookin for the place called Lee Ho Fook's
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    makes sense. I’m not sure if GA is doing the same but hopefully we are.
     
  17. pnk$krtcrÿnästÿ

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    Yeah I think state health depts are largely the ones doing the sampling/sequencing
     
  18. Mr Mortisay

    Mr Mortisay Well-Known Member
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    As a radiologist the sheer amount of new Covid pneumonia radiographs every day in the 20-40 year old population is staggering. This thing is still ramping up. Had a 2 month old with Covid yesterday
     
  19. IV

    IV Freedom is the right of all sentient beings
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    Is the vaxx protecting from Pneumonia
     
  20. Cousin Eddie

    Cousin Eddie Lookin for the place called Lee Ho Fook's
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    We have several people in their 30s on icu. One had a stroke on a vent. One was doing fine in his respiratory function and then had arterial emboli and nearly lost his foot.
     
  21. Mr Mortisay

    Mr Mortisay Well-Known Member
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    I do various thrombectomy procedures so there’s been a decent amount of that over the past year and a half as you’d imagine. Seen multiple instances of arterial thrombus flapping in the wind in the aorta, horrible prognostic sign, they usually die not long after.

    The vax does seem to be protecting from pneumonia as far as I can tell. We don’t always get the best indications though (classic radiologist complaint, I know), so there’s no way to tell who has a breakthrough infection.
     
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  22. RonBurgundy

    RonBurgundy Well-Known Member

    Physician suicide rate is twice the general population fwiw
     
  23. pnk$krtcrÿnästÿ

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    That seems more reasonable
     
  24. skeezy

    skeezy what is this? meowschwitz
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    interviewing for acs/crit care fellowships. forgot how much this process sucks
     
  25. Cousin Eddie

    Cousin Eddie Lookin for the place called Lee Ho Fook's
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    The past month on icu has been wild. Went from maybe 4/24 beds in a med surg icu being covid a month ago to 22/24 today. Cardiac icu is full of covid as well.

    We’ve had multiple sets of patients that have the following timeline: husband admitted, 5 or 6 days later husband gets intubated and wife admitted, 5 or 6 days later wife intubated. Some time later one or both die. Just depressing as fuck.
     
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  26. lunchbox

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    I’m used to it now. Covid is like easy breezy at this point. You know what to do. Get palliative on board. Hope for the best.
     
  27. IV

    IV Freedom is the right of all sentient beings
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    be a doctor they said, help people they said

    never told your white ass you’d be running a suicide recovery ward
     
  28. Cousin Eddie

    Cousin Eddie Lookin for the place called Lee Ho Fook's
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    my self proning motivational speech has gotten really good.
     
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  29. lunchbox

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    Wow that’s a bit too much work for me. At this point the nurses run that show lol. They got routine down
     
  30. lunchbox

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    I sound a bit callous today but I see too many patients so in a way when you haha a few Covid patients it’s like, I can breathe not think as much for a second ya know?
     
  31. Mr Mortisay

    Mr Mortisay Well-Known Member
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    Reading daily covid chest radiographs is the easiest thing I’ve ever done in radiology. They hardly ever change!
     
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  32. Cousin Eddie

    Cousin Eddie Lookin for the place called Lee Ho Fook's
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    I swear the radiologists at my hospital are flipping a coin to decide whether to read them as slight interval improvement or worsening
     
  33. Leeroy Jenkins!

    Leeroy Jenkins! Big Ivermectin Energy
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    I'm glad we're all on the same page here.

    #feeltheburn(out)
     
  34. Mr Mortisay

    Mr Mortisay Well-Known Member
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    My favorite on the initial radiograph is to say covid vs mild pulmonary interstitial edema, correlate for fever. Something about saying correlate just makes a radiologist feel all fuzzy inside
     
  35. skeezy

    skeezy what is this? meowschwitz
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    finally done with interviews. rank list is due wednesday. ive already changed it 16 times
     
  36. Cousin Eddie

    Cousin Eddie Lookin for the place called Lee Ho Fook's
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    What fellowship are you doing?
     
  37. skeezy

    skeezy what is this? meowschwitz
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    Trauma Surgical crit care
     
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  38. Leeroy Jenkins!

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    Lol I remembered mine was just like whatever. I interviewed at 17 programs and disliked most of them. I ranked 3 programs above my home program and matched at my third.
     
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  39. skeezy

    skeezy what is this? meowschwitz
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    im happy with my top 5. they just keep shuffling. im at a community program so we dont have advanced training sadly. think ill end up ranking 12 total
     
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  40. RonBurgundy

    RonBurgundy Well-Known Member

    Ranked 3, got my first. #primarycare
     
  41. RSK

    RSK Well-Known Member
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    Hi all I will be joining this thread. I'm a bit older than most starting this journey but I decided on a career change so I am a late nontradtional applicant. Just got my mcat score back and got a 518! Ready for the grind!
     
  42. Leeroy Jenkins!

    Leeroy Jenkins! Big Ivermectin Energy
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    We all old up in this bitch
     
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  43. MrOutlaw

    MrOutlaw Director corp medical
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    im so old I cant understand an mcat score that high
     
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  44. RSK

    RSK Well-Known Member
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    Haha I hear ya. 518 is 96-97th percentile similar to a 36 on the old scale. I thought I bombed it leaving so pretty stoked about the score
     
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  45. lunchbox

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    Oh wow mr 36 mcat here. Fucking gunners
     
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  46. lunchbox

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    Congrats though. welcome to your descent into a life of cynicism
     
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  47. pnk$krtcrÿnästÿ

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    We have fun here
     
  48. pnk$krtcrÿnästÿ

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    My favorite is ordering a cxr with reason "cough, fever, LLB rales" and getting "correlate clinically" on the report
     
  49. skeezy

    skeezy what is this? meowschwitz
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    Tmb is SDN lite
     
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