Scutmonkey Chronicles

Commentary on healthcare in general, life as a medical student, and issues of concern thereof. Readers warmly encouraged to contribute their "best" and "worst" experiences with the healthcare system (who knows, some budding young doctor might learn something from your pain...?) Submit via comments section, or email me at if you'd like to become a regular contributor. Welcome, and don't forget to double-glove!

Monday, October 31, 2005

A Little Radiation is Good for the Soul

FIRST of all, really like the comments so far about healthcare experiences. Hope the discussion will continue.

Done with psych, on to radiology. Interesting so far, but perhaps I'm biased as Marie Curie is one of my big heroes. Downside is we're back at school for this, which may as well be seventh grade after six months of being out in the "real world."

Maybe it's the "little leaguer taking batting practice with the Yankees" phenomenon of steep learning curves being the only way to make real progress, but at this point I'm not sure a one millimeter blip on a twelve by fourteen inch chest x-ray will ever be meaningful to me. It will be interesting to see what the improvement in skills over the next two weeks will be...

Thursday, October 27, 2005

Disinfected? Disaffected? Good, Bad, Ugly?

Had a good, bad, interesting, disgusting, experience with the healthcare system lately? Inviting patients, students, practitioners, etc, to leave comments here. Maybe we can generate some ideas, spark some changes, or maybe just vent, but I'll bet if you've taken the time to hit this site, you've got SOMETHING to say...

Recommend you sign your comment with a nickname (i.e. not your real name) if you choose to discuss a particular hospital, doctor, etc. or one who could be easily identified by context.

Tuesday, October 25, 2005

Mixed Mercies.

An interesting but very draining week. On the up side, saw one very ill young man (paranoid schizophrenic, last week thought he was a biblical prophet) make a complete turnaround four days after starting on antipsychotic meds. On the down side, watched in horror as a borderline patient (a particularly frustrating pathology) pulled up her sleeves to show me the "tiger stripes" she had etched into her forearms with the end of a paperclip. Amazing what our brains will do to us, bathed in the wrong mix of neurotransmitters.

Wednesday, October 19, 2005

Every Rose Has Its Thorns

Ah, psych...a pretty intriguing and plush rotation when compared with the others I've done so far. For human interest and humane hours, it can't be beat. The residents and attendings I've interacted with thus far are smart and decent. Refugees from other specialties come every week to check out the program and consider switching over to the psych-side.

So of course, one is tempted to consider this as a chosen specialty. And yet...

For every positive outcome I've seen take place, there are six or seven or fifty patients hanging around the day room without a seeming hope of improvement. Some get worse and not better under our care. Not even the positive changes can be wholly attributed to the profession.

Then again, are positive changes in any specialty ever wholly under control of the medical staff? Isn't there always an element of spirit, fate, luck, or whatever you prefer to call it, to healing? And don't psychiatric patients, possessing of a positive prognosis or not, deserve our best attempt at care?

As far as I can tell, to be both a good and a fulfilled psychiatrist, you would have to be not only tolerant of ambiguity but be able to thrive in a sea of it. One online test I have taken designed to match future specialty to med student personalities told me that I might be such a person ( , I would recommend this whatever specialty you think you're destined for...)

Then again, after nearly a month of this, an argument against choosing psych has emerged, and it goes like this: Why not head toward something like family med, where you interact mainly with highly functional patients, problems like hypercholesterolemia can more or less be brought under control by the numbers, and the vast majority of patients get better?

We shall see...

Wednesday, October 12, 2005

Scutmonkey 101

What's it like to be a medical student? Interesting. Fatigue inducing. Exhilarating. Expensive....

Not sure how this experiment will work out, but hey, what harm can it do? At a minimum, it will be a place to record the highly strange and wonderful occurances of life on the wards. Maybe it will be of interest to somebody, or perhaps not. Whatever. Whether you are a fellow scutmonkey or an interested interloper, I would love to receive your feedback and comments.

I'll throw out one question here as a discussion starter, a question that I have been asking friends, family, and random strangers since I embarked on the mixed adventure of med school. That question is "What has been your best, and worst, experience with the healthcare system?" Maybe we can light a spark and solve some problems, maybe not.

Anyhow, right now it is October of 2005. I am in the middle of my third year of school, ten days into a psychiatry rotation at a well-regarded private hospital in an eastern metropolis. On the whole, I like third year a whole lot more than years one and two. That neccessary but stultifying break-in period required far too much of two things I am not very good at, which are (1) sitting still for hours at a time in a plastic seat inside a not-so-well-ventilated lecture hall, and (2) rote spitting back of information in multiple choice format.

Third year is actually more demanding in the respect that we are (somewhat) responsible for the welfare of real people, but a hell of a lot more interesting. Common sense and compassion have become at least as important, if not more so, than the third substrate of the Krebs Cycle. Thank God!

Anyhow, enough babble for today...