Anesthesiologists everywhere:
One Nice Bug Per Day
Cosmic Funnies
AnasAbdin
todays bird

if i look back, i am lost
tumblr dot com
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Lint Roller? I Barely Know Her

titsay
Sweet Seals For You, Always

JBB: An Artblog!

shark vs the universe
sheepfilms
TVSTRANGERTHINGS
Monterey Bay Aquarium
hello vonnie

Janaina Medeiros
Misplaced Lens Cap
we're not kids anymore.
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@md-icallyinclined
Anesthesiologists everywhere:

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I remember watching the behind the scenes on this show. The creator of the show said that they got so much fan mail saying this show was the most realistic hospital show.
My parents both worked in the medical profession my whole life, and when I was watching them come home, I could see echoes of what this show did. All other medical shows were so much about the drama. This one nailed it. It nailed the good, the bad, and everything in between.
Also, I read that Scrubs was more medically accurate than House, Greyâs Anatomy, and every other medical show on TV
The official Medblr response to non-healthcare people objecting to our online jokes and complaints.Â
I remember watching this scene as a baby medical student and thinking, âWow, this is soooo true, haha, Scrubs is so good! They sure do this whole doctor thing pretty well. :)â
I just happened to watch this scene years later as a resident, and it nearly brought me to tears because I saw myself in that scene. Iâd been that doctor to break the bad news to a family and then went on to work for another 8 hours. In my clinic, Iâd go from talking to a patient about severe depression to a patient happy about her new pregnancy to a patient struggling with 3 or 4 chronic medical conditions, and all in the span of an hour or two. Itâs emotional whiplash, and itâs HARD. And we do it every day.
Forgive us our jokes - theyâre one of the things that help.
One of my first hospital pharmacist mentors told me what to do in a situation like this: get out.
Get out, because nobody is going to turn to the pharmacist and rightfully so. The family needs time with the physician, and what you do, as the pharmacist, is your level best to buy time for the physician. You watch over his patients, go among the nurses, answer their questions so his pager doesnât go off. You keep an eye on all of the vital signs and labs and the piggyback administration times to make sure that the rest of the patients stay safe.
It was great advice thatâs served me well so far.
At a coffeeshop
Two hours ago I was in a trauma room doing compressions on a toddler. The motherâs screams mixing with the sounds nursesdoctorstechs calling out, the beeping monitors telling us what we already know. Now Iâm sipping a raspberry vanilla latte out of a mug with red birds riding snowflakes listening to some 80s music. The baby inside of me is kicking. My hands still smell like gloves and hand sanitizer.
This job is completely surreal.
Itâs hard to see what we see, and then go back to ânormalâ life, surrounded by people who will hopefully never have to witness what weâve seen, much less play an active part. Sometimes the ordinary is so jarring and suffocating that you almost canât stand it, at other times itâs like a warm blanket, insulating you from the hurt. I hope you can take time to process, and to make peace with what happened. And to rejoin the outside world.
The first time i read this i thought âthis must be such a contradictory feelingâ. But when you get to actually experience it you feel everything and nothing at the same time. No contradictions, it is a new thing that you couldnât imagine before. It is surreal in the shape of freakinâ clocks melting.
I got my first taste of this type of surreal during the start of my second semester as a first year (so. this year haha) and I was doing History and PE on a trauma patient in the ICU (electrical burns).
And while we were taking history, the patient beside ours (itâs a government hospital so the beds are literally right next to each other), was surrounded by family.
They were talking. I couldnt see them but judging by the sound of their voice, i was pretty sure they were holding back tears. A few minutes later, there was a long pause and a longer songular beeping sound. The patient had flatlined, as confirmed by the sudden wailing from maybe his wife? daughter? Anyway, all I could see through the little slit between the thin drapes that divide us was a lifeless body.
And it was weird to see someone die up close, right in front of you. I wasnât disturbed or anything. It was just⌠the first time I saw someone die. Iâve never even seen an old relative die. After that, I continued with our Hx and PE taking like I had not just witnessed death for the very first time. Like nothing happened. By the time we were finished with hx taking, the body had already been moved.
And until that moment, it never really registered to me how HEAVY the job that I signed up for was. Like the first few months of medschool were managable and I was excited because everything was new and fresh. But then you remember that you have. actual LIVES in your hands. And some days, I get anxious and I wonder if Iâll ever live up to the expectations of a docror. But most days, I feel numb idk. Maybe thatâs why I was able to move on quickly.Im scared. Am I gonna be this numb for the rest of my life? I dont really know. Iâll check back in two years after clerkship, I guess haha
Itâs weird and itâs hard, and non-healthcare people can only try to understand what itâs like to have these responsibilities and deal with these problems. Thereâs no right or wrong way to process the complex array of things we go through, but it helps to talk with friends and reach out if you are struggling to deal with it.
The first time I felt this feeling was when I walked out of my first cadaver lab. I stepped out onto this sunny college campus surrounded by young healthy people, and I smelled like death and formeldahyde because I had been cutting apart corpses for hours, and I felt like a member of a different species. Not a monster, exactly, but alien.
Hide the patagonias! Hide. The. Patagonias.
do i even really have imposter syndrome

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6 TED-Ed lessons to watch on International Womenâs Day
Happy International Womenâs Day! Hereâs a list of TED-Ed Lessons to watch as you celebrate all of the worldâs women, past and present.
The genius of Marie Curie: Marie SkĹodowska Curieâs revolutionary research laid the groundwork for our understanding of physics and chemistry, blazing trails in oncology, technology, medicine, and nuclear physics, to name a few. But what did she actually do? Shohini Ghose expounds on some of Marie SkĹodowska Curieâs most revolutionary discoveries.
The contributions of female explorers: During the Victorian Age, women were unlikely to become great explorers, but a few intelligent, gritty and brave women made major contributions to the study of previously little-understood territory. Courtney Stephens examines three women â Marianne North, Mary Kingsley and Alexandra David-NĂŠel â who wouldnât take no for an answer (and shows why we should be grateful that they didnât).
Equality, sports and Title IX: In 1972, U.S. Congress passed Title IX, a law which prohibited discrimination against women in schools, colleges, and universities â including school-sponsored sports. Before this law, female athletes were few and far between, and funding was even scarcer. Erin Buzuvis and Kristine Newhall explore the significance and complexity of Title IX.
The true story of Sacajawea: In the early 19th century, a young Agaidika teenager named Sacajawea was enlisted by explorers Meriwether Lewis and William Clark to aid her husband Toussaint Charbonneau as a guide to the Western United States. Karen Mensing debunks some of the myths that surround the familiar image of the heroic woman with a baby strapped to her back and a vast knowledge of the American wilderness.
Why should you read Virginia Woolf?: How best can we understand the internal experience of alienation? In both her essays and her fiction, Virginia Woolf shapes the slippery nature of subjective experience into words, while her characters frequently lead inner lives that are deeply at odds with their external existence. Iseult Gillespie helps make sense of these disparities to prepare you for the next time you read Virgina Woolf.
The pharaoh that wouldnât be forgotten: Hatshepsut was a female pharaoh during the New Kingdom in Egypt. Twenty years after her death, somebody smashed her statues, took a chisel and attempted to erase the pharaohâs name and image from history. But who did it? And why? Kate Green investigates Hatshepsutâs history for clues to this ancient puzzle.Â
And a couple more!
A day in the life of a Mongolian queen - Anne F. Broadbridge
The breathtaking courage of Harriet Tubman - Janell Hobson
The princess who rewrote history - Leonora Neville
Did the Amazons really exist? - Adrienne Mayor
How one scientist averted a national health crisis - Andrea Tone
The most successful pirate of all time - Dian Murray
More diversity is needed in every way, says general surgery registrar Daniella Donato-Brown
In 2016 58% of people applying to medicine and dentistry courses were women. However, according to the Royal College of Surgeons of England, only about 12% of consultant surgeons in 2018 were women. Why? A small survey in the BMJ medical journal points to the level of discrimination. As a general surgical trainee, I have been shocked by the experiences reported by some female colleagues. The discrepancy in the number of women applying to medicine and those going on to become consultant surgeons can partly be explained by the higher dropout rate. Could inherent gender discrimination within surgery itself play a part in that?
Female colleagues with children have struggled to be accepted and are seen as less than full-time surgeons, despite working similar hours in hospital to those surgeons with part-time hospital and research commitments. A female surgeon returning from maternity leave didnât dare tell colleagues that she had a 10-month-old baby at home, fearing that she would be viewed as lacking âcommitment to specialityâ. Female surgeons are continually asked about their family plans. I was even asked at an international conference if colorectal surgery would be the correct career path if I plan to have children. These arenât challenges that are unique to surgery â or to women, with more men taking longer paternity leave â yet the stigma seems more entrenched in surgery than other specialities.
All I can say is, as a woman in medicine, I am not surprised. Surgery is renowned for being a boysâ club, and that is just not on.
I told y'all how I did my royal college OSCE and out of the 40ish examiners and 20 candidates a full zero (0) were women right?
Also surgery is the worst but itâs across the board. One of my classmates ditched Paeds after being asked in her interview if she was planning to have kids soon. It was the first question from her majority female interview panel.
I donât have the energy to add long personal stories right now, but this.
Iâve had the âyou shouldnât do this specialty if you are a woman and want to have kids/donât want to get divorcedâ talk from seniors on multiple occasions.
Me too. I donât know how many times Iâve received âadviceâ from seniors to choose a shorter specialty or one that has more regular hours because âthink of the children you will have to care forâ or like âwho is going to watch your children while you work those crazy hours?â. Or told that this or that specialty is not suitable for women.
Iâve had female colleagues who initially were really interested in surgical specialties or clinical specialties that require several years of training drop those dreams because they eventually would want to have a family and they couldnât do a career in âxâ specialty and raise their kids, because âwho would take care of their kids thenâ.
And donât get me started on the harassment one can experience in the surgical ward and overall condecendent attitude from some surgeons toward female trainees and med students.
When I shadowed as a premed, I was told to be careful about when I got pregnant so as not to inconvenience my male coworkers. Itâs ridiculous how (a) people assume all women must want children (b) treat it as a huge burden and somehow about them if a women does want children and Š assume women must be the primary caretakers of any children.
How dare people get pregnant and have kids, right? Maybe we should all be sending surveymonkeys out to colleagues asking their permission to start a family. Itâs interesting that people assume all women want kids, but people rarely place that expectation on their male counterparts. Itâs not that men donât want kids, itâs that it never factors in to how society treat men in the same way. In general, nobody feels they have to factor in a manâs family around their life because men arenât expected to factor their work around their family. Thereâs an unspoken expectation that someone else is doing that; their wife, perhaps a childminder or au pair. This is why my male colleagues rarely get the same âhey, if you wanna have a family, avoid these specialties; talks. Men arenât expected to limit their career based on whether they have a family. They arenât expected to sacrifice something to be happy. Itâs taken for granted, woven into the very fabric of society. Women shouldnât always be the ones looking after kids. But most people still end up assuming this is the only way it works. Not only that, but research shows that even women who work full time still take a disproportionately large share of childcare and housework duties. When we entered the workplace, things didnât entirely balance out to match. Itâs not that men arenât working hard or donât have it tough. Itâs that women are trying to balance out their old role and their new one, mostly on their own. Itâs not enough for society and womenâs partners to be OK with women working and balancing being a partner and a mother. Society, and womenâs partners, need to step up to doing their part. Men need to meet women halfway. As things stand, weâre not there yet.Â
I read the above and feel so sad for all of the children missing out on their fathers, and all of the fathers who donât question how medicine is asking them to sacrifice their children for the prestige of the career.
Iâve always experienced more discrimination after people find out that I have a child. Thereâs more stigma to âmotherâ than âwomanâ in my experience, which goes along with the evidence that the gender pay gap is mostly a pay gap that occurs for mothers. I hide my child from employers and colleagues for as long as possible.
Iâm in cardiothoracics. Again, too mentally drained ATM to relate stories. But yeah, constantly told how itâs not going to work out for me.
the talk
Iâm on nights in the ED, and last night was an intense shift.Â
My first patient of the evening was a woman who was sent to the ED by her PCP for an indicentally-discovered WBC count of over 200, with 8% blasts (immature cells). That, non-medblrs, is very high, and she came in the door already understanding that she almost certainly had leukemia. I sat down with her and explained the next steps, and gave her The Talk that I have started to routinely give to people with new, serious diagnoses. The Talk goes roughly like this:
âA lot of things are about to happen in a pretty short amount of time. There will be a lot of people helping to take care of you. It might feel invasive and overwhelming, but I want you to know that you are the driver. If you are confused, ask questions. If something is happening that you donât like, you can tell us to stop. This is your body and you always get to decide what happens to it. As doctors we sometimes get swept up in treating your disease, and I apologize in advance if you ever feel like weâve forgotten about the rest of you, but please feel free to remind us. We are experts in medicine, but you are the expert on you.â
I then placed her first IV. It felt like I was firing the starting pistol at a race that this woman really didnât want to have to run.Â
Unfortunately, she wasnât the last person to get The Talk last night. The second person came in with abdominal pain, something we see often in the ED. While this patient wasnât feeling all that sick, his story worried me, and on exam he had a large palpable mass in his abdomen. As soon as my hands touched the mass I could envision his CT scan in my mind. We ordered the test, and the actual scan looked worse than what I had imagined. There was really nothing that could look like this except for a widely metastatic cancer.Â
It was a very busy night, and my (awesome) attending was running all over the place. I offered to go tell the patient the bad news, imagining that she would probably want to be there for that conversation. But she just thanked me, and off I went.Â
Iâve had serious conversations with patients and families, sometimes unsupervised. I had not, however, actually delivered this kind of news before. Of course it was somewhat hedged; cancer is diagnosed by biopsy, not by imaging. But it would have been impossibly dishonest not to tell them that all of the testing we were about to recommend was a cancer workup.
They were fairly stoic about it, which probably made it easier on me, though it made me worry at first that I wasnât being clear. They asked good questions. They wanted to see the CT scan, so I went over it with them. I gave them The Talk, and they seemed to appreciate it. We wanted to admit him, but they decided to go home and plan further diagnostics as an outpatient, and I felt like The Talk had worked. He wanted to go home, so he did.Â
I spent the rest of the night sewing and splinting, which is the beauty of emergency medicine: the heavy shit is mixed in with easy, fun, satisfying fixes. But I honestly really love the hard stuff. I love the type of healing that starts â and often ends â with words.Â
Cardiac distress symptoms in women
In the wake of Carrie Fisherâs death four days after she suffered a massive heart attack, one thing that was reported by some news outlets was that she had been in âsignificant distressâ on the flight. We donât know the exact details of this, but in my experience as an EMT, it often means âhysterical woman having a panic attack and thinking sheâs dyingâŚ*woman dies* âŚoops, guess she really was dying.âÂ
It is SO IMPORTANT to remember that many women present in what medicine considers an âatypicalâ manner for heart attack, but it actually IS typicalâŚfor women. Women are more than twice as likely to die from cardiac emergencies, not because our physiology is that much different than men and thus gives us a worse chance at survival (itâs actually better if treated promptly and adequately), but because our symptoms are more likely to go unrecognized or to be dismissed entirely.
Thus, please take a moment to review and pass on this list of cardiac distress symptoms as seen in women:Â
Shortness of breath - This is the most common one. If a woman, especially one without prior history of respiratory issues or shortness of breath, seems to be having trouble catching her breath and/or complains of such, pay very close attention. If she continues to feel winded after sitting or laying down, itâs probably time to call for help.
Feeling of impending doom - This can range from a sense of general unease to a full-blown panic attack. This one is extremely important, and is the symptom most commonly disregarded by doctors and hospital staff. If a woman tells you that she feels ânot quite right,â or like something terrible is about to happen, or that sheâs about to die, LISTEN TO HER FFS.Â
Nausea and âindigestionâ - Also common. Heart attacks frequently present as a feeling of vague nausea or indigestion, but unlike typical heartburn, antacids and other OTC treatments will not alleviate the symptoms.
Hiccups - Unexplained hiccups, especially if seen with any of the other symptoms listed above, can be indicative of heart muscle that is being acutely or chronically starved of oxygen. Â The exact mechanism isnât known, but itâs thought that the enzymes released by the dying muscle irritate the pericardium and adjacent diaphragm, causing spasms in the healthy muscle.Â
Fatigue - This is another commonly seen symptom, and is often overlooked or ignored as just transient tiredness. Many women having a heart attack will complain of feeling âflu-likeâ symptoms of nausea, sweating, fatigue, and shortness of breath, and theyâll lie down for a nap and never wake up.Â
Lightheadedness - A feeling of being lightheaded or about to faint isnât terribly uncommon in many benign conditions, and many women experience it on a monthly basis. However - be aware when it appears unexpectedly or unexplainedly, and/or with one or more of the other symptoms on this list.Â
Sweating (diaphoresis) - Heart attack does funny things to the sympathetic nervous system, which is behind reflexes such as sweating and hiccups. If a lady is experiencing unexplained or excessive sweating, pay attention to anything else that might be going on with her.Â
Tingling or numb extremities - A feeling of numbness or âpins and needlesâ tingling in the extremities can be an important sign that cardiac function is being impaired and those body parts arenât receiving enough oxygen.Â
Peripheral and/or central cyanosis - Often accompanies tingling or numbness, and is considered a later-stage symptom of cardiac distress and heart failure. Finger and toe tips will turn pale or blue first, and lips and gums after that. Important to remember that darker-skinned women may present cyanosis as ashen, grey, or darker purple rather than pale or blue.Â
Back pain - Pain between the shoulder blades, in the cervical spine, or even further down in the torso or lumbar region can be a symptom of heart attack. Alone, it isnât that suspicious, but if itâs unrelenting and presents with any of the other symptoms above, keep a watchful eye on things.Â
Classic âcrushingâ or âtightâ chest pain or pressure - Women DO experience this classic pain, too, just not as frequently as men do. This may be due to our higher pain threshold, or differences in blood volume, or maybe weâre just not sure because nobodyâs bothered to really study it. Whatever the reason, some women do still experience the crushing or tightening pain, and others may experience less painful pressure or tightness that doesnât seem to be relieved by anything.
Arm and jaw pain - Another âclassicâ heart attack symptom, and a bit more common than central chest pain. Unexplained pain in the left arm or shoulder, and on the left side of the neck or jaw, should not be ignored by anyone.

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Currently on my Neuro clerkship and had a long talk with a patient today about how tough it is for her to button up her work shirt. She has to put time aside to do so each morning. This collection is just amazing. Thank you @tommyhilfiger.
"This could end up being one of those little oddities and mysteries of our careers that 40 years from now, weâll be retired and still questioning quite how this happened," one monk seal expert said.
This has nothing to do with anything but itâs the greatest headline Iâve ever seen
This article is amazing
Iâd put my favourite quotes from the article up, but itâs the whole dang article.
âItâs just so shocking,â Claire Simeone, a veterinarian and monk seal expert based in Hawaii, told The Washington Post on Thursday. âItâs an animal that has another animal stuck up its nose.â
The âmost plausibleâ theory, he said, is that monk seal teenagers arenât all that different from their human counterparts. Monk seals âseem naturally attracted to getting into troublesome situations,â Littnan said.
âIt almost does feel like one of those teenage trends that happen,â he said. âOne juvenile seal did this very stupid thing and now the others are trying to mimic it.â
SEAL MEMES, ORÂ âSEMES,â
It is an unspoken rule that if a little kid is hiding under a blanket or couch cushions, you are required to comment on how lumpy the blanket is and pretend to sit on it to try and âsmooth it out.â
Also, if youâre playing hide-and-seek with them, it is critical that you search every other possible (and impossible) hiding spot, all the while wondering out loud how they managed to disappear just like magic, before walking right past their hiding spot.
And if a baby starts playing peekaboo you are required to act surprised when they show their face again
If a kid hands you a phone, you answer it
If a kid shoots you with a Nerf Gun you are supposed to Die a dramatic death and explain âugh you shot me blaahhâ
when you push a kid on the swings ya gotta do the woosh
My shift last night...
Me: *walks into patient room in emergency department* Hi, my name is--
Toddler patient: HEY! THE FLOOR IS LAVA YOU CAN'T JUST WALK IN HERE YOU'LL BE ON FIRE!
Me: *gasps and jumps onto nearest chair, then proceeds to use another chair to climb over to the patient's cot to sit next to him*
Toddler patient: *watches approvingly*
Me: Wow, thanks for saving me, buddy! *high-fives*
(Proceeds to get history, etc. Toddler patient attempts to climb onto the chair I used to get across the room)
Me: Hey, my friend! You have to sit on your bum to use the lava transporter.
Toddler patient: *sits as I use my legs to push the chair across the floor, then bring it back toward the cot*
Me: Okay buddy! Now we will use the lava transporter to get to the lava checker! *pushes chair toward the otoscope as I switch spots with his mom on the cot, then checks his ears*
Toddler patient: There's something in there! *gestures to left ear*
Me: Oh, well you're in luck! This lava checker can also suck the lava out of there. *imitates sucking noise while checking ear* All better?
Toddler patient: Yah!
Me: Okay, I'm going to talk to my boss doctor and come back, okay?
Toddler patient: STEP ON THE ROCKS, NOT THE LAVA!
Me: *mimes putting on boots* Don't worry little man, I have magic lava boots!
Toddler patient: *high-fives*
End of encounter
Me: See you later, buddy!
Toddler patient: *runs up to me, hugs my legs, then licks my hand*
Patient's mom: I'm sorry... that's how he shows affection.
ATTENTION INTERNS.
AS PROMISED, IT HAS ARRIVED.
What this is: ideas and tips from a soon-to-be R2 who has survived intern year to help you function as an effective intern so you can focus on the important things: caring for your patients, learning and growing as a physician
What this is not: an encyclopedia, a bible you follow to the letter. The Immutable Truth of Intern Year Reality. This is not going to teach you medicine. This is not geared toward a specific specialty; it is designed to be helpful to an intern starting in any specialty training program.
Where did the self-care part go? For every time I attempted to write it or sought folks to help me write it, I came to realize that everyoneâs idea of self-care is different. The basic tenet of self-care in intern year is: remember that if you donât care for yourself, who will care for your patients? So remember that you deserve and need time and attention for your sanity. And everyone gets by better when they help each other.Â
Please feel free to download and use. Please let me know too if Iâve made any errors or if there are things that require editing!! GIVE ME FEEDBACK SO THIS CAN GET BETTER WITH TIME.
PDF LINK HERE.
I still have a couple months to intern year, but this is the most beautiful thing Iâve seen ever and Iâm going to print it in color and keep it on my fridge and maybe in my white coat pocket Iove it thank youuuuu!!!

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âThese are the pills for my heebee jeebeeâsâ
â An adorable 90 year old woman describing her anxiety medication
*accurately describing
Patient counseled to come back and see us if she feels âweird and scary.â
â nurseâs note from phone call with patient on new BP med
âBe the reason someone believes in the goodness of people.â
-Unknown