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It’s almost November 15th and not only am I woefully behind on my studying for my quals, but I also have only one submission for the upcoming edition of the Carnival of GRADual Progress on you-guessed-it: November 15th. So please send your submissions to me at grad dot carnival at gmail dot com or through the other two methods mentioned on the Carnival of GRADual Progress website by 11:59pm EST November 13th.

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Well, because I can do completely unethical things like fall in love with a patient and then proceed to cause him harm (ultimately resulting in his death) with no consideration at all for all of the colleagues that I selfishly dragged into the mess in the process and still be a doctor, of course!

Did that sound just a bit wacky there? Well, it is exactly what Grey's Anatomy is telling us. And, yes, of course, I know…it’s TV—they’re supposed to stretch things a bit. But when such a show is causing our young impressionable youth to consider medical careers, I would hope that they would be a little more careful. But then of course, being careful never did bring in the ratings, right?

For the two of you out there who do not watch this show, here’s a little recap of what’s happened: Denny is a patient who needs a heart transplant because of a cardiomyopathy. Izzie (one of the interns) is assigned to his case and proceeds to fall in love with him. After coming thisclose to getting a heart, he disappeared for awhile only to return in slightly worse shape, requiring the use of a left ventricular assist device (LVAD) as a bridge to transplant. Conveniently enough, once the device is implanted, Denny has to stay in the hospital until he gets his transplant, which leads Izzie to fall further in love with him, so much so that when a heart does become available but is assigned to someone else who beat Denny onto the transplant list by only a second or so, Izzie purposely cuts Denny’s LVAD wire so that his condition would deteriorate and therefore take priority over the other person. In the mess that ensues, all of the other interns and even the attending cardiothoracic surgeon become involved and Denny gets his new heart only to die from a stroke caused by a clot that broke off from his sutures. Oh yeah, right after he wakes up from his transplant and before he dies, Denny proposes to Izzie and she accepts. Izzie cannot deal with his death and quits the program after admitting to the Chief that she was the one who cut his LVAD wire.

And really, it should have ended there because what Izzie did was so horribly unethical that there was no way she should have been allowed to continue had she even wanted to. I literally squirmed during the episodes where they showed her falling more and more in love with Denny and jumped off the couch and shrieked in disbelief when she cut his LVAD wire and when everyone on the team proceeded to help her cover it up after they found out. I was glad she quit. But this is TV, so it was inevitable that they would bring her back somehow. And that they did, by spending several episodes focusing on her moping around being an attention whore because her fiancé died because she cut his LVAD wire. Then her resident convinces the Chief to let her come back by effectively taking a good share of the blame for what happened, but she still dilly dallies for more dramatic effect until the Chief himself has a talk with her, telling her that he also made a mistake as an intern that resulted in his patient’s death. Uh, hello! Cutting an LVAD wire is NOT a mistake! So, Izzie finally rejoins the program and her punishment includes counseling as well as community service and not being allowed to have anything to do with patients until she can prove that she won’t get too involved with her patients again (now that’s an understatement). It also includes shadowing a different colleague each day. Last week’s episode had her shadowing super-bubbly-annoying resident who took over when her resident went on maternity leave. When the resident tried to get her to talk about Denny as part of her counseling, Izzie blew up at her and ran off. Instead of realizing how wrong she was to do such a thing when she doesn’t even deserve to be there in the first place, she just sulks until the super-bubbly-annoying resident sought her out and confided that she lost a pediatric patient as an intern too.

What bothers me besides the fact that Izzie should have never been allowed back into the program (or any other program for that matter) is the fact that everyone keeps comparing what she did to some mistake or other they made during their training. It’s NOT the same. Doctors make mistakes and those mistakes sometimes harm patients. But purposely cutting someone’s LVAD wire is NOT a mistake—it was a selfish act that was done because she fell in love with her patient and wanted him to be better because of her personal feelings for him. And then after they let her back into the program, she acts like a complete snob, avoiding counseling and breaking rules when she should be groveling to prove that she deserves this extraordinary second chance that she’s been given. Is this what we want our future doctors to believe? That it’s okay to fall in love with patients and do actual physical harm to them without much punishment at all? Then why do medical schools put us through the torture of ethics classes? I know that modern medical TV shows portray more of the flawed human side of doctors, but do they really have to perpetuate the idea that grossly unethical actions go essentially unpunished? I already found some of the ethics of my classmates to be lacking, but how much more will the ethics of our future students be eroded because they have been exposed to TV shows that make them think that it’s okay to be unethical?

And yes, I know, perhaps I take it all too seriously, but I can’t help it because I’ve had way too many cousins-in-law, brothers-in-law, and other high school (their parents let them watch such things?!) and college kids telling me that these TV shows make them want to be doctors to ignore the grossly inaccurate aspects of the career that these shows perpetuate.

Oh, and since all the blame can’t be placed on Grey’s Anatomy, I cover the same sort of issue with the current House versus Cop storyline in this post.

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what is it with men?

They just don’t listen.  Actually, they get annoyed when we try to tell them that we’re only nagging them because they’re so grossly illogical. 

Like today, when my husband decided to start on dinner.

Him: Should I start dinner?
Me: Well, you can start the rice now.  But you don’t need to start preparing the food yet because the rice takes so long that the food will get cold by the time it’s done.
Him: But it takes awhile to cut up the veggies and stuff.
Me: Does it take an hour?

With that, he just stomps off and returns after starting the rice.  I swear that’s why I do everything myself: to avoid his grumbling when I’m clearly right anyway.

And now, we’ve been sitting in our Prius for a good 4 hours because he refused to listen to my warnings about being careful with a particularly difficult part of this EV mode modification that we’re installing and broke the pin of one of the wires inside the plug.  Yes, that’s right.  The pin won’t come out now.  But instead of calling it a night and waiting until morning when there’s more light (which, by the way, I had suggested to no avail when we started off with this whole mod in the first place) and the possibility of buying some sort of extraction tool, he just keeps at it.  What disaster must befall us before he stops?  Seriously, we’re talking about the Hybrid Electronic Control Unit here…it sounds important.  And yes, I’m writing this post from his laptop while sitting in the car watching his failed attempts to get the pin out.  Men. *sigh*

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who needs a doctor anymore…

…when all I have to do is use Google? I’m just waiting for my mother-in-law and/or sister-in-law to tell me that and insinuate that it means even less to them now that I’m going to be a doctor since Google can do my job. I can just see my sister-in-law sticking her nose up in the air at me now. My job’s better than yours because Google can’t do it for me (oh, but it can—Google can do everything). It’s already bad enough that patients like my mother-in-law don’t trust doctors—do we have to really make it worse by making it widely known that sometimes, we need to use Google? Really, I’m fine with using Google to look up stuff, even medical stuff, which I was guilty of from time to time during my first two years of med school. But does everyone have to know? I know, I know—patients these days are more informed than ever before. And I’m fine with that. Really, I am. That is, if these patients have enough sense to realize that their internet searches cannot replace all the years of medical training that doctors have received as well as all their years of experience. And my mother-in-law is not one of those people. People like her will turn this study into leverage against doctors when they don’t tell them what they want to hear and every argument otherwise (like the fact that Google wasn’t very good at getting the diagnoses if the symptoms were not very specific) will then fall upon deaf ears.

As a matter of fact, I had a falling out with my mother-in-law because of this very thing. She complained of constipation, thin thready stools, and blood in her stools and was upset that she couldn’t get a doctor to see her immediately. Of course not, because doctors are busy and it sounded like she just had constipation. After a lot of dramatics on her and my sister-in-law’s part, her symptoms were revised to also include loss of appetite, fatigue, and weight loss, making it sound much more like colon cancer. Now how did that happen? Maybe because someone googled her symptoms and colon cancer came up? And the instant colon cancer got tossed around (and it wasn’t by me—I know way better than to do that to myself), my mother-in-law freaked out and started with more crazy dramatics about how we all have to take care of her now because she was going to die. Uh, right. Which doctor diagnosed you? Dr. Google? Anyway, to make a long story short, she eventually got a colonoscopy after my sister-in-law bullied a gastroenterologist into bumping her up on his waiting list (I feel sorry for the people who really needed that colonoscopy) and guess what the diagnosis was—hemorrhoids! Even I was shocked at such a uh-DUH result. But my mother-in-law, well, she refuses to believe the diagnosis because Google told her she had colon cancer. Hence the falling out—since I’m going to be a doctor and since I am but a mere student and therefore support the real doctor’s diagnosis, she thinks I’m out to get her along with all of the other doctors out there. No amount of explaining has been able to convince her otherwise. All because someone taught her how to use Google.

And that’s why I think that allowing uninformed, illogical patients to know that doctors sometimes have to use Google to help them diagnose things is not a good idea. Because these patients are the ones usually causing us the most trouble in the first place and we have now just handed them proof that their Google searches just might be as valid as our own reasoning. Really now, why did I go to med school again?

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And this whole qualifying exam thing definitely qualifies as annoying. I have finally met with all of my committee (of doom) members and apparently I met with them in the wrong order. All the ones I met with before today’s final member were nice and made me feel like they weren’t going to eat me. But my last member, she tried to eat me today, damnit. She acted like my meeting with her was in fact my qualifying exam and picked apart the very basis of my thesis project, refusing to accept any of my explanations otherwise. I haven’t felt this close to having a nervous breakdown in front of my attacker since that time I got reamed by my warm-and-fuzzy doctoring class facilitators. Is this what it’s going to be like when I take my quals? I don’t remember signing up for this. If I had ever wanted to quit this whole PhD thing before, what transpired today just pushes me that much closer. Why bother torturing myself with this crazy studying when apparently no amount of studying can save me from out-to-get-me committee member? Maybe it’s just the study-overload and lack-of-life that’s talking, but I’m feeling pretty hopeless right now, which is not very conducive to my mastering of my leastest favorite topic in the whole world: Physiology and Electrophysiology of Membranes. Couple that topic with what happened today and you have the perfect recipe for grad student breakdown, which I’m trying very hard not to succumb to here. But enough whining and onto the music. The song that’s been running through my head ever since that meeting today is Jack’s Mannequin - Bruised. Because that’s definitely how I feel right now. And then some.

…Hours pass, and she still counts the minutes
That I am not there
I’ve wasted not studying, I swear I didn’t mean
For it to feel like this
Like every inch of me is bruised, bruised
Don’t fly fast. Oh, pilot can you help me?
Can you make this last? This plane
time is all I got [to study]
So keep it steady, now
Cause every inch you see is bruised, yeah…

As always, feel free to send (preferably happy) song suggestions my way through the contact form.

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Super Bored Stressed Grad Student has been trying really hard to maximize her time at lab by studying for her impending qualifying exam (instead of surfing her way to the end of the internet everyday, tempting as it is). Of course, Dr. Grumpy Old Major Professor isn’t making it easy for her. She happens to be on a page on EKGs. He waltzes into her office for no other reason than to bother her.

Dr. Grumpy Old Major Professor (rudely peers over her shoulder at her book and notices the EKG tracing): So, what does the QRS complex mean?
Super Bored Stressed Grad Student (who actually has not gotten to that section yet and sadly does not actually remember what it means from her med school days): It’s showing electrical activity in some part of the heart.
Dr. Grumpy Old Major Professor: Ha. Well, not that I would know since it’s been 20 years since I studied that stuff.

And then he walks away, leaving Super Bored Stressed Grad Student wondering what she has done to deserve this kind of treatment. But he doesn’t walk far enough away. He stands outside her office door and carries on a pointless conversation with New Lab Scut Monkey about how great he is because the residents supposedly love him in a too-loud-for-anyone-to-possibly-ignore-even-if-they-tried voice.

Dr. Grumpy Old Major Professor: The residents are very good. They should all get funded.
New Lab Scut Monkey: Uh-huh.
Dr. Grumpy Old Major Professor: Yeah, it’s all thanks to me. I’ve always been nice to them. That’s why they’re interested in research and academics, unlike other departments. I never yell at them and they appreciate that.
New Lab Scut Monkey: Uh-huh.

It takes all of Super Bored Stressed Grad Student’s willpower to not jump out of her office and scream at him that he’s full of s*** since he’s not an MD and certainly not an attending, so why would he yell at them?! And even so, what the hell do they care that he’s nice to them since he’s not their superior? How dare he take all the credit for something these residents decided all on their own or maybe with someone else’s guidance?!

And that is why it’s harder for Super Bored Stressed Grad Student to study at lab than at home. Sadly, lab is more distracting than home, even though home offers the comfort of snacks, TV, a funny dog, video games, and a sexy husband among other things.

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About

The patient is a 20-something-year-old MD/PhD student with a history of extensive schooling now presenting with frustration at her current lack of progress consistent with being stuck in a rut. Click on My H&P for more.

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» The 10 dirtiest jobs in science.  Hey, they forgot to include being your major professor’s bitch.  Okay, I guess that isn’t quite as literally dirty as those on the list, but it sure feels like it is. # 0

» Yum!  Now that’s something I can live with: eating curry to stave off cognitive decline and Alzheimer’s disease.  Researchers in Singapore found that people (aged 60-93) who ate curry even only occasionally scored higher on the Mini Mental Status Exam (MMSE) than those who never ate curry.  The curry spice, turmeric, contains curcumin, which has potent antioxidant and anti-inflammatory properties.  And the prevalence of Alzheimer’s disease in the elderly in India is fourfold less than that in the United States. # 0

» There’s a great article today about how the MIT Dean of Admissions wants to reduce admissions anxiety in teenagers.  How about parents getting off of their kids’ backs?  That would help.  But I do admire her for trying to create a friendlier system that might just ease the pressure enough to not give parents such reason to push their kids so hard.  Too bad it probably won’t happen any time soon.  And go ahead and try to tell Asian parents to stop pushing their kids to the point of insanity.  I dare you. # 0

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