medical school

also should I be a transplant social worker, word on the street is that this is a sweet gig.

should I check into an inpatient psych ward if all I really want is to have people pay attention to me and make sure I eat for a couple days?

NOOOOOOOOO

at least not the psych ward at my hosptial

protip if you decide to go that way: plan to spend 20+ hours in the ER and then you'd better have a convincing story of suicidal or homicidal ideation and/or delusions that interfere with your activities of daily living. Otherwise you'll be sent back home. If you have no home, you will be sent back to the streets with a suggestion to check in on shelters tomorrow before they get full.

You may get a shitty boxed lunch after 8+ hours in the ER. Guy I saw in the ER and then the next day on the psych unit remembered me as the person who brought him a sandwich but could only offer diet ginger ale because we only had regular coke, not diet.

I spent this week on the inpatient psych ward!

As a social work intern, not a patient.

Also shadowed the ED psych social work

my 2 cents of observation/lyfe experience is that psychiatrists are either totes cool dudes/chicks or ppl who have er challenging personalities that some might suggest are Axis II ish

this seems about right

I have finished my internship in hospital social work (primarily ICU, some med/surg floor experience, some ED and inpatient psych).

I will not do hospital social work ever again.

I will not willingly be hospitalized.

I think our (U.S.) hospital system is irreparably fucked.

I start as a home hospice social worker next month.

Surely this will be better.

Favorite quote from an Esteemed Psych Attending: "these people don't need our compassion, they need our intellect."

Fuck. You.

Anyhow good luck to docs of ILX. I do believe that you are all actual *helping* people in a profession that is all "oh I want to help people" but c'mon, let's not equate docs with nurses, teachers, social workers, EMTs, etc.

hi ilx medical ppl

I have completed 480+ hours in the ICU of a large teaching hospital in a major U.S. city.

After this experience, I have zero intention of becoming a hospital social worker.

Tomorrow I start 720 hours as a home hospice social worker.

I hope I like it. I like long term care, so that will be my back up.

"Being Mortal" may be an obvious "must read" for medical ppl, but I think it is so worthwhile. It is for me.

gbx how do you do IP psych. It is the saddest most unfulfilling thing I experience at the hospital.

All of the hospital stuff, actually.

Hospital: avoid. AVOID.

i've only done six months of inpt psych, all last year. i just now (like, hours ago) finished six months of the inpt psych consult service. the former was definitely more frustrating, but a lot of that was buried under the workload that comes with being an intern -- you spend more time writing notes and making phone calls and such and very little time with patients.

i enjoy my outpatient clinic (which is at the VA), in part because the VA (at least our VA) actually has those social services that are more likely to improve a patient's quality of life than my tender ministrations. like if someone is depressed or w/e because they've been out of work or don't have transportation, there's fat lot of good that a script for zoloft is gonna do. but then again i can send them down the hall to any number of offices that will get them connected with ppl that can help them with employment or a ride or something, which is so, so, so much more difficult at a private hospital

also the inpatient social worker at our VA (CHAD WE LOVE YOU CHAD WHY ARE YOU LEAVING) is a fucking miracle-worker, and has shored up my belief that, in mental health at least, the SWs are almost certainly doing more for our shared patients than the actual docs

but my god on our consult service we had a patient on medicine, a 62yo man with the most profound dementia i have ever encountered, who has been medically stable for literally ONE HUNDRED DAYS and cannot find a place to live because, outside of the hospital, he would require p much 24/7 attention because he is still so very physically fit and active and prone to wandering. in the hospital he spends 75% of his time in a g-d net bed (which, if you haven't encountered one, is the saddest thing ever). it is completely messed up, and the SWs on medicine have been working very hard for months to find somewhere, anywhere, that can care for him appropriately

Ugh, what a sucky situation! I am not familiar with a net bed. Sounds awful. 100 days, dear god.

hi dere I am taking an adult psychopathology class

I have *feelings* about the DSM

What are YOUR *feelings,* docs of ILX?

where's the thread for mental health consumers to share their feelings about the DSM

but I'm also curious about doctors b/c my sense is that in general the feeling is "yeah those symptoms are accurate for, like, maybe half of patients"

it's mostly heuristic, and for billing tbh

so this is happening

have gotten two offers so far, about which i am ecstatic, tho they are probably toward the bottom of my wishlist** given what is still possible. am very much hoping i hear some good news from vermont (where i live and which i love), where i was wait listed :/

am currently at the mouth of dart (hi gbx), everyone wish me luck tomorrow on my interview

**man, my list of schools to apply to would look so much different if i could do it all over, i really had no idea what i was doing

oh snap, good luck man

Great news and good luck!

how'd it go

i thought it went well! i felt like the only one in the room who didn't go to harvard tho, lol. i would be beyond thrilled to go there, man is that campus beautiful

interviewed with r1ch@rd m0rse (ped neuro) and w1lli@m r0sen (optho surg), both of whom seemed v interested in me and were super friendly

well best of luck dude, you should be hearing soon yeah?

k3vin k pls go into palliative care, we need u

also other doctors of ilx, make sure u have some terminal pt skillz because oh my god, the stories. . . like, I don't know what they do to you in med school but UGH

one of my interests is onc and i did talk a lot about end-of-life discussions at some of my interviews (including dartmouth) but i'm not sure i can see myself doing palliative as a career. palliativists are heroes tho for sure

I totally get attracting to onc but ime onc docs can suck the very very worst in terms of holistic pt care, i.e. I will offer anything no matter what, even with zero evidence base (or more likely evidence base of NOT GONNA WORK but you go for it anyway). Then super late referral to hospice AND SOMETIMES ONLY IF PT ASKS FOR IT then write them off and they feel totally abandoned.

I expect you'd do better! 'Cause hopefully not institutionalized by Big Med at early age? Or whatevs.

Palliatives are clearly considered bottom of the med totem pole. Not sure how I can change this because the ppl who learn otherwise die/mourn/grieve/move on before they can enact change.

I mean let's be real most docs are "oh yeah palliative v. important yay" but so much BS in practice. IME most docs think pall is for shit and once pts go that way, primary doc SO DONE. So I challenge u ilx meds to tell me what you are doing to help our (N. American) pitiful end of life care sitch.

I mean real talk and srs q: what falls below palliative/hospice in terms of respect/prestige in med specialty land? I can only gauge from my time in an acute care hospital and particularly ICU/critical care. And as a grad student in grad bio/med school. But for real, let's list:

My outsider experience goes:

surgery/radiology/lolderm/. . . . uh opth. . . . other stuff. . . uh IM and specialties thereof. . . uh psych (no offense gbx proud of u). . . OB/GYN. . . family/primary care. . . blah blah blah palliative why is that even a specialty etc

onc docs are the fucking worst as far as terminal stuff. neuro better yay plasmon! Also how to get better end o life options for all of us halp.

tbf psych usually sits lowest on the totem pole, quince, i'm cool with it

most palliative docs i've worked with (and most of them at my institution) double-time as something else. we've got internists, family docs, and at least one surgeon

onc docs are the fucking worst as far as terminal stuff.

this is so fucking otm. onc docs especially seems to think they're winning as long as a patient is drawing breath, quality of life be damned.

dunno if i've mentioned this before, but one of the most horrifying experiences i had as a student was coding a cancer patient who then ended up in the ICU. we (the ICU team) consulted palliative, and they said that the onc docs at this particular institution were especially bad about avoiding the DNR/DNI talk, they didn't want them to give up hope

oh shit it's ~Match Day~ oh shiiiit

there are so many proteins. sooooo many proteins

why can't one protein do everything

Hey gbx remember back when you were a first year and you posted abt that woman in your class who was obsessed with going derm? What did she end up with?

Also Kevin k I am the world's expert on one protein from a tamarin virus, happy to share this valuable knowledge with u

Hey gbx remember back when you were a first year and you posted abt that woman in your class who was obsessed with going derm? What did she end up with?

derm!!!

kk I have a jacket made by Rab and when I wore it to school people just would not shut up about it

haha you should have written SNARE on each sleeve

quincie tell me about this virus protein, i want to know all the proteins

why can't one protein do everything

― usic ally (k3vin k.), Friday, August 28, 2015 2:20 PM (5 hours ago) Bookmark Flag Post Permalink

i think this every day

Well I had a lead that this protein may have lead to chronic vs acute liver infection. Virus is closest relative to HCV in a small mammal. Protein (GVB-V 5A) I am world expert about; no one cares including me.

world expert is pretty cool

i mean i'm fairly knowledgeable about 'journeymen who once played for pittsburgh sports teams' but i wouldn't call myself a world expert

this protein binds to everything! http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3987992/

kevin, trust me, there are approximately six quadrillion proteins that you should be more interested in than GBV-B NS5A.

back when I was in grad school Take One everthing was all about transcription and I was SO LONELY as a translation person. Now everyone is all proteomics this, proteomics that, and I'm all oh please, I was doing proteomics (back before THAT WAS EVEN A WORD) back in the mid 90s OK?

good idea for a med school band name: blood islands