Thursday, June 26, 2008

Kevin witnesses a public shaming

It's been a few weeks since I started my job as a glorified secretary in a clinical research lab and I've finally settled into the daily ho-hum routine.  Every Monday we have a lab meeting where researchers go over their progress and a single research fellow presents his or her data to the group.  So I was in one of these meetings one day and the conversation came to the status of a certain patient info database that one lab tech was responsible for maintaining.  It became quickly apparent that the database was woefully underpopulated and outdated, much to the ire of my PI.  Before I give transcript of what followed, I need to tell everyone that my PI has a way of calling out every ouce of bullshit anyone ever says without a single smirk or grin.  Essentially, he's completely deadpan and unabashed in saying you suck.  Let's continue:

PI: So you haven't been updating the database is that correct?

LT: Well... no... I try to update the files of the patients already in there and I think that may be a lot of work, I go back and forth between two computers bla bla bla (at this point I tuned out).

PI: So you haven't been entering any new patients

LT: No

PI: So what exactly do you do...


LT: Well... I'm updating the people that are already (blablabla basically the same thing all over again)

PI: Ok ok, regardless of that.  By your estimate, how long would it take to fully populate the database with all the patient files

LT: *Long pensive silence* 2 weeks

PI: No, seriously.  How long

LT: *Looking even more awkward* If I just enter the most basic data... 3 weeks

PI: *Smirking slightly* Ok, if you say so.  But I think you're just telling me what I want to hear rather than what is realistic.


So basically I just saw the infamous scene of Office Space reinacted in real life without the employee blowup.  And now I live in fear of disappointing my boss.

Wednesday, June 25, 2008

David Gets Pimped

Our med school, like many others with a traditional curriculum, offers students a full three-month summer following the completion of their first year. This provides a valuable opportunity to gain more research or clinical exposure as well as a welcome reprieve from the constant flood of book larnin’ that demands almost all of the preceding nine months. I will be spending the time completing a research project in general surgery. One of the perks of my particular project is the chance to scrub in on a variety of cases with my PI, who is also a surgical attending. This is very cool. This also means I get pimped. This…not as cool.

For anyone familiar with medical school or residency training (or maybe even a medical TV show), the following will be no great revelation. Pimping occurs when junior trainees (med students, interns, residents) are asked questions of varying difficulty and/or obscurity by their superiors (typically more senior residents or the totem pole-topping attendings), often during rounds, patient presentations, or in the OR. As the pimpee, you’re put on the spot with a second or two to find the right answer and no other resources at your disposal. It is not unlike the common undergrad scenario in which the professor randomly calls on an often unsuspecting student to answer a question in front of the class.

Pimping comes in a variety of flavors. Older medical students have described its use as something of a punitive mechanism employed primarily against those who are unprepared, overconfident, or perhaps just annoying. For the most part, however, it functions as a valuable teaching tool; it takes a lot more study/review to be ready to answer a question you don’t know is coming. Further, the potential for shame is undeniably a major part of pimping’s effectiveness. Getting the answer right? Not particularly gratifying. Looking incompetent in front of an OR full of doctors and nurses? No thanks. After all, no one wants to look bad in front of his peers or, worse, the people who hand out the H’s. One’s only recourse is to prepare as thoroughly as possible for the case at hand and hope for a bit of good fortune in the question lottery.

So far, my experience as a medical working girl has been relatively painless. The attending isn’t grading me, so there’s no tangible punishment to be had for a series of incorrect answers. He’s also a cool guy, so he’s not interested in embarrassing me or fixating on minutiae. Basically, he or the senior resident assisting the procedure asks questions that someone with a year of med school – or at least a quarter of gross anatomy and some background prep – should be able to answer. Still, the exercise isn’t a walk in the park. Identifying real-life, bloody anatomy – especially if you’re looking inside-out from the view of a laparoscope – is a lot harder than picking out structures in Gray’s or Netter’s or the all-the-time-in-the-world-for-meticulous-dissection cadaver lab. And when the question is about anatomy, rather than the mechanism of some antibiotic/3 causes of X/common presentation of Y, it stings a bit more when you fail to hit the proverbial mark (“You don’t know what that is? It’s right there in front you…”).

All in all, getting pimped is sort of like med school in a nutshell – it’s not always fun, you periodically look stupid, and sometimes you have to walk the streets…er…

Sunday, June 15, 2008

David and Kevin are awesome at How Bad Can You Be At Knowing Who People Are™

After a long break due to final exams and rugged mountain vacations, I am proud to announce that we have successfully completed the first year of medical school. I apologize for the intolerable aching that has surely penetrated your soul, loyal reader, as you have struggled to maintain the will to live during this blog’s extended hiatus.

To celebrate our triumphant return to the golden pedestal in your online lives, I present yet another random musing of arguable worth.


Recently, during some downtime on a post-finals trip, Kevin and I played a popular game with a few med school buddies, Robby and John, that I will call How Bad Can You Be At Knowing Who People Are™. Kevin, Robby, and I are really, really good at this game. John is really, really old, so he gets to play the host to save his heart from the inevitable overexcitement that accompanies HBCYBAKWPA™. As host, John presented a picture of a classmate and asked if the three of us could pool our collective brainpower to identify him or her by name. Going through the class, the three of us, combined, could only pick out a first or last name for about two-thirds of the subjects. Keep in mind, this is after a year’s worth of classes.

I’m bad with names in general, and Kevin doesn’t speak the good English, so perhaps we lack the requisite skills to know who people are. However, a freak prosopagnosia outbreak notwithstanding, some responsibility belongs to the unique med school social dynamic. The shift from college to medical school is one of those lifestyle transitions that one is vaguely aware of during the admissions process, yet cannot truly be appreciate until being in the thick of the med school action. In many ways, at least for people coming straight from undergrad life, medical school is like College 2.0; we take more classes, sit for more exams, and waste a lot of time discussing what we’re going to be doing in a few years. We still have no money, and most of us are going further into the red. Yet people have far more independent lives and bring much more diverse backgrounds to each incoming class.

Beyond varied expertise in both baby-saving and non-baby-saving endeavors, students come from a broader spectrum of ages and life experiences than those one meets at earlier rungs of the academic ladder. During undergrad, if you live in a dorm, you see the same people daily; you share meals, do fun stuff together, and see the same friends before you go to sleep and as soon as you get up in the morning. In med school, many classmates have spouses and children and live far away. Classes last most of the day and studying demands much of the evening, so there’s a significant reduction in leisure time. Thus, despite having a class size of only 100-200 students, it’s often difficult to get to know each one of the people you see every day. Or, apparently, to even remember their names…

On the plus side, we now have our first elderly friend (Hi John!) and know what prosopagnosia means. On the down side, I have to live in fear of the moment when I ask a fellow classmate what year he or she is during a med school mixer next fall…