Embarking

If you follow this blog no doubt you’ve noticed a few changes: the name, color patterns, profile, … This is because a new journey has begun.

I recently graduated from medical school and am beginning my internship year.  I am interning in Internal Medicine and plan to pursue a GMO position with the navy next year & then return in the future to complete my residency training. (What’s a GMO?  http://militarymedicine.com/gmo – more or less accurate.)

With a new phase of life, a new journey, a new title: An Officer & A Nut.  On a previous rotation at a military hospital I was party to an attendings “scolding” of a new intern who had “turned over” a patient to a senior nurse rather than waiting on this other physician and being late to another engagement. The attending said emphatically something along these lines: “NO NO NO, Turn-overs must be doctor to doctor, nut to nut, NUT to NUT!” half the people in the reporting lecture hall just could not stifle the laugh that this wording elicited.  You see Navy nurses’ specialty insignia is an oak leaf while Navy physicians’ is an oak leaf with an acorn in the middle, affectionately termed here as a ‘nut’. (Take a look at the dentists’ insignia sometime.) http://www.navy.mil/navydata/ranks/officers/specialty-staff/spclstaff.html

Embarking …

If you follow this blog no doubt you’ve noticed a few changes: the name, color patterns, profile, …

This is because a new journey has begun.  I recently graduated from medical school and am beginning my internship year.  I am interning in Internal Medicine and plan to pursue a GMO position with the navy next year & then return in the future to complete my residency training. (What’s a GMO?  http://militarymedicine.com/gmo – except for the “gatekeeper” part I agree.)

With a new phase of life, a new journey, a new title: An Officer & A Nut.  On a previous rotation at a military hospital I was party to an attendings “scolding” of a new intern who had “turned over” a patient to a senior nurse rather than waiting on this other physician and being late to another engagement. The attending said emphatically something along these lines: “NO NO NO, Turn-overs must be doctor to doctor, nut to nut, NUT to NUT!” half the people in the reporting lecture hall just could not stifle the laugh that this wording elicited.  You see Navy nurses’ specialty insignia is an oak leaf while Navy physicians’ is an oak leaf with an acorn in the middle, affectionately termed here as a ‘nut’. (Take a look at the dentists’ insignia sometime.) http://www.navy.mil/navydata/ranks/officers/specialty-staff/spclstaff.html

Embarking …

If you follow this blog no doubt you’ve noticed a few changes: the name, color patterns, profile, …

This is because a new journey has begun.  I recently graduated from medical school and am beginning my internship year.  I am interning in Internal Medicine and plan to pursue a GMO position with the navy next year & then return in the future to complete my residency training. (What’s a GMO?  http://militarymedicine.com/gmo – except for the “gatekeeper” part I agree.)

With a new phase of life, a new journey, a new title: An Officer & A Nut.  On a previous rotation at a military hospital I was party to an attendings “scolding” of a new intern who had “turned over” a patient to a senior nurse rather than waiting on this other physician and being late to another engagement. The attending said emphatically something along these lines: “NO NO NO, Turn-overs must be doctor to doctor, nut to nut, NUT to NUT!” half the people in the reporting lecture hall just could not stifle the laugh that this wording elicited.  You see Navy nurses’ specialty insignia is an oak leaf while Navy physicians’ is an oak leaf with an acorn in the middle, affectionately termed here as a ‘nut’. (Take a look at the dentists’ insignia sometime.) http://www.navy.mil/navydata/ranks/officers/specialty-staff/spclstaff.html

Embarking …

If you follow this blog no doubt you’ve noticed a few changes: the name, color patterns, profile, …

This is because a new journey has begun.  I recently graduated from medical school and am beginning my internship year.  I am interning in Internal Medicine and plan to pursue a GMO position with the navy next year & then return in the future to complete my residency training. (What’s a GMO?  http://militarymedicine.com/gmo – except for the “gatekeeper” part I agree.)

With a new phase of life, a new journey, a new title: An Officer & A Nut.  On a previous rotation at a military hospital I was party to an attendings “scolding” of a new intern who had “turned over” a patient to a senior nurse rather than waiting on this other physician and being late to another engagement. The attending said emphatically something along these lines: “NO NO NO, Turn-overs must be doctor to doctor, nut to nut, NUT to NUT!” half the people in the reporting lecture hall just could not stifle the laugh that this wording elicited.  You see Navy nurses’ specialty insignia is an oak leaf while Navy physicians’ is an oak leaf with an acorn in the middle, affectionately termed here as a ‘nut’. (Take a look at the dentists’ insignia sometime.) http://www.navy.mil/navydata/ranks/officers/specialty-staff/spclstaff.html

THE ART OF DYING

THE ART OF DYING.

Oddly enough this is NOT an original title. In fact the title has been used in medical articles, hospice articles, scientific reviews & even as here in ART.  I can tell you this as someone who has spent much of my life around death & done a lot of work in palliative medicine (including hospice & geriatrics).  So perhaps a jaunt through the art of foreign cultures regarding this universal event in every human being’s life can be taken by clicking the above link.  (at the very least the pictures are cool). 

An example of Preventative Medicine

The Ultimate Example of Preventative Medicine.

Video link

Peaked my interest to see a nice personal story clip that really puts a face on, exactly what CompassQuill rightly named it PREVENTATIVE MEDICINE.

Preventative medicine allows you to improve both your quality & quantity of life (ideally).

But the real take home message is:

The old-fashioned yearly (or at least periodic) physical is STILL SO IMPORTANT!

Remember the line he says in the video – I don’t go get check-ups regularly, I don’t even have a doctor.   There was the problem right there.  He’s using his body well & it’s working for him so far as he can tel but he’s not keeping up with the maintenance. Any young adult who didn’t know how to take care of their first car will tell you – if you don’t check & change the oil and keep up the maintenance, it’ll work for a while but next thing you know it’s gonna croak on you, usually in the middle of no-where with no cell signal and no one to help too.

A history & physical alone can do much in the way of prevention.  In prevention, your doc is like you’re own personal guide. But he or she can’t do anything for you unless you show-up & participate.

One thing to warn from this video though:

Medicine loves it’s fancy new machines (imaging, testing & labs) as much as everyone else loves their fancy new gadgets, phones, etc. But we can’t & don’t rely on them as first line and neither should you.

Medicine is a scientific field remember. So we rely on Evidence, which we get from trials – but not just any trials (with little effort I can find you lots of bad trials) – reliable, repeatable & thoroughly vetted trialS (and I capitalize that cause it’s never just 1 either).

This evidence tells us why we don’t CT everyone who walks in the door. Its not all because of $ either for the cynics out ther. Other than the radiation load, Its because in just about everyone’s films, etc you’ll find incidental things that were never going to hurt the pt (and those films can also not show things that will hurt you too – ask a surgeon or a radiologist about abdominal dx & imaging sometime). Unfortunately who’s to say that those incidental findings are never going to hurt you? Well you do actually. Your body through your experience (hx), physical findings & selective testing,  points your doc towards problems or potential problems. But unless you have those pointers the evidence tells us that doctors chasing down findings from uneccessary tests/images end up hurting the patient more than if they had not done the test.