Last post and more

June 5, 2009 at 8:55 pm (Uncategorized)

white_coat

Dear readers,

I have decided to stop blogging. I created this website a little over two years ago with the hopes that I can share with the world my experiences in medical school. I think that I have accomplished that goal. At one point, I was writing one of the most popular student-run blogs on the Internet. However, as I am about to begin residency, I must focus all of my time and effort into pursuing my specialty. Moreover, I have simply run out of things to write about. If I ever get an idea in the future, I will submit it to Kevin, MD.

I am regularly asked if I could go back in time, would I make the same decisions. Four years ago I wanted nothing more than to become a doctor; now that I’ve finished medical school, I know that was the right decision. While many people have become jaded by medicine and want to leave, I enjoy nothing more than practicing this field. While there are certainly lots of negatives—and I have written about many of them—I will still take medicine over any other occupation. If I could change one thing, however, I would never have joined the Air Force. Taking the HPSP scholarship was the single biggest mistake of my life. It is a financial setback. It is an educational setback. And it will wreak havoc on my personal life. If you gain nothing more from this website, please reconsider any decisions on joining the military.

I will continue to read the comments and emails that people submit me. I may even reply. But for right now, this is the end of HalfMD.com.

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Graduation speech

May 23, 2009 at 4:00 am (Uncategorized)

The following is the graduation speech I wrote for my university:

Dear fellow students, parents, brothers and sisters, children, faculty and staff: welcome to the graduation ceremony for the class of 2009. It is one of the four great days of medical school and I am honored to be given the chance to speak with you about the achievements of the 152 people who are graduating today. As a group we have published papers, presented at conferences, nailed a one-in-a-million diagnosis, gotten married, had children, and won the coed intramural volleyball championship.

These past four years will certainly be memorable to me for a very long time. Although it has taken us only four years to complete medical school, some of us have aged much more than that. Whenever I am at a bar and ordering a drink, I pull out my driver’s license to show my age only to have the bartender say, “Don’t bother.”

People talk about medicine as if it’s a calling. I don’t know if that’s true, but I do know that this is the field for me. Nothing else gets me up in the morning so early and so eager as medicine does. Every day is a chance to learn something new.

With all that learning and training comes an awesome responsibility. As doctors we will have great authority and power in which we can literally decide the fate of other people. With this role comes respect, prestige, and yes, even money. We have made many sacrifices to get to this point. We have given up the best years of our lives to sit in classrooms learning the nuances of the human body. Some of us have given up on relationships. We’ve held off on having children. We’ve suspended other careers. And yet the greatest example of self-sacrifice as a physician is to give away all of that talent for free.

A month ago I took my fourth trip overseas as part of a medical mission. Some of you here have gone on international trips as well. You’ve seen the worst hand that humanity can deal. You’ve gone to an impoverished region where poor people who cannot speak English receive your services at no cost to them. You then returned to this city where you worked with poor people who cannot speak English and received your services at no cost to them. And yet, somehow that trip was more meaningful. And you’ve realized that’s what gets you up in the morning. You can have an impact on the lives of others. Whether you decide to ultimately practice here, elsewhere in the country, or abroad, your decision to become a physician should be one of your guiding purposes in life.

Unfortunately, not everyone feels the same. So many of my classmates have gotten this far only to realize that they have made a very expensive mistake. They entered medical school in search of prestige, money, or the approving of their parents. Nothing is worse than a person who says, “My mother’s son is a doctor.”

I know of several people who now openly admit that they dislike medicine. Unfortunately, they are now more than $200,000 in debt and cannot leave the profession. They are now stuck in this job field for no other reason than economics. I think that many physicians are similarly trapped because so few other careers have a high enough payout to clear the necessary debt that comes with this training. So to all of our younger brothers and sisters who are here tonight and thinking of becoming doctors: know what you’re getting into. This is an 80-hour-a-week job that comes with high emotional strain, abuse from those higher up, abuse from patients, threats of litigation, inability to predict whether or not you will be paid, and a constant worry that maybe you didn’t make the right decision with that last patient. But if you like science, are good with people, and enjoy solving puzzles, then maybe you should consider a career in medicine.

I’ve brought something today. Here is my old white coat. I’ve worn this jacket almost every day over the past year. It is covered with stains from various bodily fluids, food from the cafeteria, and a mysterious orange color that I have yet to identify. Although I wash it regularly it will continue to be synonymous in my mind with transference of infections from one patient to another. It’s a reminder of the power and trust that physicians instantly hold with all patients. It’s the universal symbol of healing and knowledge. And yet when it comes right down to it, it is barely more than a glorified bed sheet with buttons and pockets.

Sociologists tell us that whenever there is a life-altering event, a ceremony is used to celebrate that change. Whether it be the birth of a child, a wedding, or a funeral, we use ceremonies to signify that something important has just happened. In a few moments we’re about to have a ceremony to signify our graduation. But it should be something much more than a party. Once we walk across this stage our lives will be forever changed, for better for worse, with all the rights and responsibilities of someone with the title M.D.

There will deservedly be fear as we enter the next phase of our training. We will constantly question ourselves: did I study this disease enough? Did I get all the information that I needed from the patient? Am I the right person for the job? Am I doing the right thing? As Dr. B______ once told us, every time you start to write a prescription, your hand should tremble.

Fear does not need to be limiting. A mystic once told the story of a group of lions who decided to attack a herd of zebras. The older, weaker lions went to the far side of the zebras and began roaring. The zebras, upon hearing the roars, became frightened and ran away from the sounds—right into an ambush of the younger, stronger lions. The moral of the story is that whenever you become scared, run towards the roars.

We can use that fear for good. We can say: I did study this disease enough. I am confident I got enough information from the patient. I am indeed the right person for the job. I know that I am doing the right thing. Medicine then becomes a focus on lifelong learning and purpose rears its head once again. And once we realize that what we do has a greater effect on our patients then on ourselves, I think we have learned the greatest lesson that medical school can teach. Kicking and screaming along the way, the University has taught us how to be doctors.

I look at this old white coat and realize that I have finished some of the hardest years of my life. I can smile knowing that I don’t have to take a shelf exam ever again. I also frown knowing that one day my signature will be on the prescription pad or the order form and that I’ll be the one who’s held accountable. I look at it and wonder where the last few years have gone.

I look at this old white coat knowing that one stage of my training is almost finished and know that I am about to embark upon the next journey. And whether medicine is a calling or simply an interesting job, I look at this old white coat knowing that soon we’re all going to be doctors.

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What the hell?

May 18, 2009 at 4:00 am (Uncategorized)

As I’m coming up on the end of medical school, I started reading old comments on this blog. Some people generate discussion, others criticize, someone else might say something funny, and then there are those times when I read a comment and think to myself, what the hell was he thinking? So now, I present my weirdest comments from the past two years.

By far my most popular post has been about the difficulty in getting into medical school . Despite my constant pleas in which I beg people not to ask me about their individual circumstances-such as “what are my chances of getting into medical school”—I am regularly hit by high school students who clearly know nothing about what doctors do. Calah writes:

So, is it better for a girl to be a doctor or nurse? Nurses make less, for doing the same thing. But, doctors have to go to school for soooo long. Is it worth it? What if u want a family? After you graduate, are doctor and nurses working hours that different, especially if u want a family?

What the hell are you talking about? Doctors and nurses have very different jobs and work different hours. I don’t watch many medical TV shows, but does ER tell us that doctors and nurses do the same thing?

Phuong follows up with,

I think that if you truly wanted to be in the medical field, gender doesn’t matter. I rather be a doctor, because they make more, and it seems more fun anyways (BTW I’m a girl). I also thought that being in school to be a doc, you’ll get out at 30 years old or something. and that sucks….but i think that most doctors, have families, and most of them meet their loved ones while in school or something. That’s what i want to do, i would find a guy i like while in school. And don’t give up your dreams, cause my LATIN teacher wanted to be a doctor, but she didn’t want all the work cause she was already in a relationship, so she became a teacher instead. NOW, she said she wished she could turn back the clock, and become a doctor, cause it’s her dream. She told me “don’t get married a/f high school, cause it will hinder your chances.”

What the hell are you talking about? Just who told you all this? Your Latin teacher? What the hell does your high school foreign language teacher know about being a doctor? And don’t give me this, “I was supposed to have been a doctor instead.” You just can’t up and decide to go to medical school.

Occasionally, I get real firecrackers such as Landon, a high school sophomore who writes,

I am young,but I am very interested in being a Interventional Cardiologist.I am a 16 yrs old 10th grader… I have the money and grades to be one.

Where the hell did you get that idea? I didn’t even know what an interventional cardiologist was until I was a medical student. And you certainly don’t need money to become a doctor. You just need to make money after you finish medical school to pay back all of those loans.

Another very popular post has been on finding the best college for pre-med studies. Brittany writes in to say,

Medical school is such a challenge. I feel like it is so difficult, and people make it out being such a scary process. I am just a junior in high school, but I feel like I have been stressing out about this every day lately.

Brittany, go into your mother’s medical cabinet and find the bottle labeled either Xanax or alprazolam. Take one of those pills and then go outside and play. Another young reader, Kathleen, shows off her optimistic side:

Maybe then I would be able to set aside money saved from attending the public university honors program in order to help pay for the best medical school that I could be admitted to

Just how expensive do you think college is compared to medical school?

As a follow-up to the “best pre-med school” article, I wrote a piece explaining that there’s no such thing as a “best medical school.” However, that doesn’t stop some people. ATWIINE writes,

PLIZ RANK THE MEDICAL SCHOOLS AROUND THE WORLD FROM THE BEST TO THE WORST. IF I MUST JOIN ANY OF THEM, WHAT ARE THE CONDITIONS I SHOULD FOLLOW.

Arrrggghhhhh… my eyes! What the hell do you think I do all day? This is a personal blog. It’s not some kind of Internet charity.

Sometimes, I get readers who like to dispense advice on subjects they know nothing about, similar to the Latin teacher above. Two years ago I wrote a financial analysis of the military’s health professions scholarship program. While the information there is outdated because of a substantial boost that the program has received, that didn’t stop one dejected father from writing in. Silvanus had to tell me,

my son is a recent undergrad, i was recommending the HPSP to him.

Why the hell would you go and do something like that? Were you in the HPSP program? No? Then don’t recommend something if you’re not familiar with it.

The primary way that I deal with the stresses of medical school is to inject humor whenever I can. I’ve written quite a few fake posts over the past two years. However, not everyone gets that I am writing a parody.

I’ve been asked,

Is this for real?

I provided my e-mail address, would you please sent me information you used to create such a bogus pie graph.

Somebody actually got paid to write this crap?

No, I do it for free. And then there are those who just want to bitch. I’ve written quite a few rants against psychiatrists. Carrie Nation writes,

Your entire blog is confirmation for me that medical doctors, and the pond scum who hope to be one, are no more valuable to our society than personal injury lawyers and auto insurance brokers.

But my favorite coment came from Danielle, a reader who gave a very long objection to my portrayal of psychiatrists, then admitted that shrinks have personality disorders, and finally preceded to talk about her own bipolar condition.

Finally, a recurring theme on this blog has been the suggestion

I strongly suggest skipping residency and getting an MBA.

But there is that rare occasion where one reader writes and says

nice article… thanks

and it really brightens my day.

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Why your apartment is still on the market

April 22, 2009 at 11:19 am (Uncategorized)

Given that I’m about to move in a month, I started looking for apartments in my new home city. One of the difficulties of moving to an area that I’m not familiar with is trying to find a new place to live using only the descriptions that I find on Craigslist. I’m becoming increasingly frustrated by the description is that people give of their apartments. As a public service to my readers, if any of you own property and are looking for new tenants, here are some pointers:

1. Include a picture. I know this sounds like a no brainer to most people, but having a picture of the facility is a good way to get perspective tenants to read your ad. If all I see is an outside shot taken from the street, I assume that there’s nothing on the inside worth looking at. And if all I see are bars on the windows, I don’t want to keep my stuff inside. I certainly don’t feel like getting robbed at 4:00 AM when I’m going to the hospital.

2. Give a description. Now that we’ve got the picture out of the way, I then want to know more about the apartment. Is the neighborhood quiet? How close are the neighbors? Are they quiet? Were the previous tenants smokers? Did the previous tenants own pets? Is this apartment pet-friendly? What is the crime rate in this neighborhood? When will the apartment become available? If the only thing that you can tell me is that this is a “hipster” pad, then I’ll assume that you’re an idiot.

3. List the amenities. Is there a washer/dryer included in the unit? Is there dedicated parking? Is there a pool? “Interesting kitchen cabinetry” is not an amenity if I can’t cook my food and later wash my dishes.

4. What is the true cost? I expect you to tell me what the monthly rent will be, as well as the expected utilities, deposit, and additional costs such as parking. Don’t try to sell me on an $800 apartment and then have additional stipulations in the contract such as homeowner association fees.

5. Give the correct number of bedrooms. I’m astounded by the number of people who list the den as a second bedroom, particularly when this second room does not have a closet and access to it requires walking through the first bedroom.

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Counting down the days

April 16, 2009 at 11:24 am (Uncategorized)

Posting from the road:
Fourth year is about to end.
Only one month to go.

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Guest post on KevinMD.com

April 5, 2009 at 2:23 pm (Uncategorized)

I wrote a gust post recently for KevinMD about the Scramble.

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Students storm surgery department, kill two professors

April 1, 2009 at 4:00 am (Uncategorized)

New York, NY—at 7:00 a.m. this morning 8 third-year medical students stormed the surgery department at Columbia University’s College of Physicians and Surgeons, killing two attendings and taking six more as hostages. Drs. Whittaker and Montgomery were executed by the disgruntled students who claim that they are seeking change. The names of the six hostages have not been released by police.

After a six-hour standoff, the group’s leader, Martin Rove, has agreed to speak with reporters. He stated that the hostages were being treated well and are currently eating, something that students aren’t allowed to do during their surgery clerkship. He also listed the group’s demands. “We want more teaching, less yelling, and no more black weekends.” A black weekend is where a student must come into the hospital both Saturday and Sunday, thereby ensuring his presence at work for 12 consecutive days. He has been the only identified hostage taker so far. The rest of the students have been covering their faces with surgical caps to prevent identification.

“John” is one of the third-year medical students involved in the siege. He asked that his real name not be given because he has not received permission to speak to the press. He paints a starker imaged than Martin. “The professors have been standing for hours at a time and are not allowed to go to the bathroom. We’ve been asking them embarrassing questions about relationships, sexuality, and if they think they will ever be granted tenure in the hopes that they will see how humiliating it can be in the OR.” John also went on to mention that some members of the group have been throwing surgical instruments on the floor and playing Cher at loud volume to simulate the sounds of an operating room.

Police hope to have the issue resolved shortly, but admitted that no one will miss these medical students or their professors should any of them be killed. Mr. Rove mentioned by phone that Dr. Whitaker was chosen for execution because, “He is simply the most unpopular teacher we’ve ever had.” Dr. Montgomery’s death was an accident and regrettable, says the group’s leader. “He was an 85-year-old dinosaur who merely could not take the stress of running upstairs and being corralled into a tiny office that was shared by others.”

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Happy birthday to Half M.D.

March 23, 2009 at 11:05 am (Uncategorized)

This blog is now two years old. As a quick summary, in the past year I’ve written almost 70 posts and had 122,000 visitors take a look at this website. The Match was this past week and by now, all fourth year medical students around the country have given up working on their clinical rotations. Any chance at teaching these people is now hopeless. As the chief resident on my current clerkship told me on Friday, “You don’t need to be here anymore. Enjoy your weekend.”

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A plug for the Lucidicus Project

January 5, 2009 at 5:54 pm (Uncategorized)

A few months ago I came in contact with the Lucidicus Project, a group that aims to provide philosophical training to medical students in capitalism and individual rights. Its director, Jared Rhoads, writes regular editorials aimed toward political issues facing physicians. In addition, it freely gives away The Medical Intellectual’s Self-Defense Kit, a collection of books and articles by Ayn Rand and others, to anyone who asks for it.

I got around to reading Atlas Shrugged over the course of my surgical sub-internship last year and now I can see why some of my readers have compared me to her. The book is set in a period of worsening economic conditions and missteps that the government takes in currently the problems. I caution you that reading Atlas Shrugged is not for the faint of heart. At more than 500,000 words in length, you’re going to have to be dedicated to finishing it. But for anyone looking for a new novel to work through this year, I highly recommend it.

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A call for questions

December 29, 2008 at 8:39 pm (Uncategorized)

Dear readers,

I’m reaching a point where I’m grasping for new material to write about. As a person once mentioned, I’ve ranted on everything that can be ranted on. I’m now asking for your help for ideas for new articles. You’ve probably noticed that I’ve been answering people’s questions recently. I feel that some of you have come up with some pretty good questions that others want to know the answer to. For example, my posts on the best stethoscope, the best pre-med program, and the Life Raft series have all come from emails that I have received from my readers. If you come up with an idea, send it to halfmd [at] yahoo [dot] com. Good questions are general enough to be researched and then written about in 500-1000 words. Anything too broad like “What’s med school like?” will go unanswered. Also, don’t make your question too specific. If you’ve got a 3.1 GPA and a 27 on your MCAT, don’t ask me what your chances are for getting into medical school. You can formulate your own answer to that question using already available resources. Moreover, other readers aren’t interested.

I’m also willing to answer “How Stuff Works” style questions. I’m thinking that I can re-use some of my old notes on the coagulation cascade and steps in stomach acid production for the benefit of current medical students. By writing these articles, I’ll be able to keep the information fresh for when I start residency.

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