medical school

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

the valves of houston

another good band name idea: the somatic hypermutants

there are so many proteins. sooooo many proteins

― usic ally (k3vin k.), Friday, August 28, 2015 3:16 PM (one year ago) Bookmark Flag Post Permalink

why can't one protein do everything

― usic ally (k3vin k.), Friday, August 28, 2015 3:20 PM (one year ago)

i still maintain that this would be a better way of doing things

just went to the local med school's match day and good lord it was retraumatizing

may this spur your compassion for those less fortunate

if you find you are too frazzled and upset for compassion, meditate on New Mexican mountains to calm yourself

that's the plan alright

i was just about to bump this thread last night to mention how much i love med school and 2nd year especially. i could not be happier that i made this decision

btw speaking of match day my gf just matched at her first choice today (yale) so we are super happy

nice one!

i wasn't sure where you were in the process, glad to hear you're enjoying it!

http://imgur.com/a/xyX2O

lol