Wednesday, February 28, 2007

Scrubs vs. Grey's Anatomy

Abortion. Euthanasia. Stem cells.

These are famous examples of some of medicine's oldest and greatest debates. There is no shortage of passionate people on each side arguing their position, and unfortunately there will likely never be a solution that satisfies both sides.

The times are changing, however, and a new debate is emerging, one that involves medical TV shows. Yes I'm speaking of Scrubs and Grey's Anatomy, both of which have huge and loyal followings. Is it Scrubs, the quirky single-camera show about the life of three residents and a nurse, or is it Grey's Anatomy, the new medical drama about a group of surgical interns?

Never fear, Axis is here to help settle this debate. I will attempt to evaluate this dilemma by using several objective criteria to answer modern medicine's ultimate question once and for all.

Medical Accuracy
Let's start with the easy one. The medicine that takes place on Scrubs is nearly dead-on. Internists diagnose and surgeons operate. Classic stereotypes are explained (e.g. surgeons as knife-wielding morons, ob/gyn's as sorority girls, etc.), inside secrets about medicine are revealed, and the emotional aspects of medicine are well conveyed . On the other hand, in Grey's Anatomy surgeons deliver babies and neurosurgeons do abdominal procedures. Most interestingly, the interns have hours of free time on their hands. Point goes to: Scrubs

The Girls
Elliot and Carla on Scrubs are both fairly attractive and well-fed. On Grey's, while Katherine Heigl is hot (albeit whiny), Ellen Pompeo is so skinny she looks like an ashen grey skeleton ... and Sandra Oh looks like a catcher's mitt with eyes. Point: Scrubs

You can't beat Dr. Cox: who else can turn a word with two syllables into six? Who can come up with a new girls name every 10 minutes? In fairness, Dr. McDreamy is unusually popular, both on- and off-screen. Point: tie

Chiefs of Service
This is a tough one. On Scrubs, Dr. Kelso is a scowling money-driven Chief of Medicine who makes everyone's life miserable (especially for Ted, that poor attorney). On Grey's, the chief is Dr. Webber, a big guy who simply plays a generic "stern black man". Point: tie

Scrubs is overflowing with quirky humor (my personal favorite) while Grey's has none (quirky or otherwise). Point: Scrubs

But what Grey's lacks in humor, it more than makes up in drama. Grey's Anatomy is not so much a medical TV show but rather a soap opera that happens to take place in a hospital. Medicine is occasionally practiced, but only if an intern can hook up with an attending in the process. The winner here is clear-cut. Point: Grey's Anatomy.

Characters in Scrubs progress nicely each year, from intern to junior resident to senior resident, etc. In Grey's, the characters apparently are so dumb that they are still interns after three years. Point: Scrubs

And the winner is: Scrubs.

There you have it peoples, objective proof that you may safely avoid watching TV on Wednesday nights. Anyway, it's time to watch Scrubs ... seeing how it's the better show.

Thursday, February 22, 2007

The Flu

I think I have the flu. I woke up three days ago unable to move a muscle and have since been clinging on to life by a delicate thread. I wish it was just a severe cold, but I guess I have the classic flu symptoms: fever, chills, muscle aches, cough, headache, and fatigue. I'm a mess. I also don't think I've ever slept as much as I have in the past few days, with that first day setting the record: only 3 hours of the day when I wasn't asleep!

I should just be thankful that I'm on a rotation where I can afford to take a few days off without serious repercussion. Speaking of this ID rotation, I should also be thankful that I only have the flu, and not one of the many nasty infections I've encountered the past few weeks. Would much rather have influenza than salmonella or cryptococcal meningitis. (But then again, with the way I easily scare, I keep fearing that I have the bird flu).

Anyway, back to the grind (meaning get out of bed, drink juice, take temperature, get back into bed.)

Thursday, February 15, 2007

1 Month Until Match Day

Title says it all. One month -- exactly 4 weeks -- till we find out where we go for residency. I am really looking forward to Match Day ... except that once the day arrives and it's time to open the envelope, I know that anxiety will overpower me, and I won't be able to do it.

Apparently there is also a big breakfast for us that morning (this is probably common to all schools). I don't know about other people, but I will likely be a little too nervous to keep any food down. We shall see.

Wednesday, February 14, 2007

Rank List

It's in. Today I submitted my rank order list, which is the next step of this residency application process. Even though the deadline to submit our finalized rank order list is February 21, it was recommended that we submit approximately one week early to avoid overloading the apparently frail servers that become unresponsive the night of the deadline.

My rank list consisted of very few programs and thus was fairly easy for me to create, in that it was easy for me to determine which program I liked best, second best, and so on. It did, however, get me thinking about the programs' end and how they need to rank a large number of applicants. The average internal medicine program interviews 200-300 applicants for about 30 available spots. Assuming they rank most of those applicants -- or even if you don't make that assumption -- that is a lot of people to rank.

Furthermore I cannot imagine how they differentiate their applicants, in particular the ones that are similar. I had minor difficulty deciding my #3 and #4 spots; now imagine a program trying to decide which of their 200 applicants gets what rank. Can they fairly or accurately tell the difference between their #56 applicant and their #57? Differentiating that many applicants seems nearly impossible. I haven't a clue how they do it, especially in internal medicine where the interview -- a seemingly important component of their evaluation of us -- is useless. No hard-hitting questions, no difficult questions, no nothing; just casual chatting. (I suppose this weeds out the social idiots, but really, how many people does that eliminate?)

Anyway, the process is now completely out of my hands and controlled only by the magic that is the matching algorithm. Nothing to do but wait.

For a reminder of how the residency application process works, re-read this post.

Happy Valentine's Day (every day is the 14th)!

Tuesday, February 13, 2007

First Time With a Foley

Read this post by keagirl on her blog, UroStream. It is a great and entertaining description of her first time placing a Foley catheter in a patient. The reason I link to it is because this was exactly what happened to me too the first time I tried placing a Foley. I was obviously very embarassed, and my resident who was with me at the time instructing me, was thankfully being very patient ... although I could tell she was feeling slightly sorry for my girlfriend.

Anyway, I was going to write about this experience myself at one point, but I procrastinated and keagirl unknowingly beat me to it. Maybe it's for the better, as she probably describes it better than I could.

Saturday, February 10, 2007

Ensuring Professional Behavior

It's late at night right now, and I just got home from hanging out all night with people from school. We were at a bar, and something on everyone's mind was DUI ... or more precisely how to avoid getting one.

See, today we had a (outrageously long and boring) session on medical licensure, and to make sure this topic was properly shoved down our throats, three middlemen representatives from the Medical Board of California made an appearance to talk to us. In addition to describing their mundane job in great detail (i.e. sifting through thousands of applications a year), they spent lots of explaining how we had to make absolutely sure we were being truthful when reporting any prior offenses ... including but not limited to reckless driving, DUI, and running red lights.

Needless to say many students were a little shocked that these offenses, no matter how distant, would have to be reported, lest their application for a license be denied.

So whereas before, people were not overly scared to get a DUI (they were, but everyone has had a friend at one point who got one), now everyone was just a little more careful with their drinking and driving ... to make sure their behavior now doesn't jeopardize their future career.

That was a lot of words. To sum up: now we're really afraid to get a DUI.

Tuesday, February 06, 2007

Working Too Hard

Shoot me now. I just can't do it. I am now back in the hospital for an infectious diseases (ID) rotation, and it is killing me alive. After 2 1/2 months of easy rotations where I never worked past 10am, I now have to work normal hours (aka, a full day). Since these past few rotations were all some version of radiology, I also never had to deal with patients ... it was just me, the radiologist, and a dark room. So not only do I have to work long hours but I have to see patients too. A shame, because I think I've forgotten most of my history-taking and physical exam skills. Luckily the first few patients assigned to me were all intubated, making things much easier.

Furthermore, this is a consult service ... meaning that we get our patients when other services/specialties consult us (i.e. ask for our assistance). This also means that we do not round on our patients until the afternoon -- as opposed to the morning -- which for some reason is the tradition with consultation services.

As a result I have to get to the hospital at 8am, catch up with my patient, which takes less than an hour, and then entertain myself until early afternoon. At that point we proceed to round for about 3-4 hours. Yes, hours. (Rounds could easily be shortened, but our attending is the type who responds to a question with a 10-minute story.) As 5pm approaches I really do want to shoot myself. It is precisely nonsense such as this -- endless rounding, endless talking -- that turns people away from internal medicine.

Relatedly, this is quite reminiscent of my dreadful Neurology days.

At times like this I really wish I were going into surgery, where rounds are brief and focused. Unfortunately I have to look forward to 3 more years of this.