Doctor Fishypants

I’m an Intern Now!

brianfishman — Fri, 31 Aug 2012 01:18:00 +0000

Now that I’m a few months into my intern year, things are starting to settle into a rhythm. I’ve been in the emergency room, on a rural medicine rotation about an hour from home, and now on OB/Gyn. From here, I move on to orthopedics, internal medicine, and anesthesia. I’ve gotten into a semi-regular exercise routine, and I’m hoping to stick to it for the foreseeable future. I’ve been able to visit Emily three times since starting my internship. Some weeks go by quicker than others, but it’s still rough. I’m working on getting in touch with residency directors out in St. Louis to increase my chances of matching there next year.

In other news, I’ve begun writing for Medscape again! With Match Game wrapped up, I was asked to keep my own blog on the site. I’m an Intern Now operates similarly to Match Game, but I’ll have weekly posts (rather than biweekly) about anything and everything related to a traditional internship year at my local community hospital. I’m hoping to keep it fun, helpful, and lighthearted. The first post went up a few days ago, and I’ve got a few more waiting in the wings for the coming weeks. Please keep an eye on it and send any feedback you have my way.

Match Game Archive

brianfishman — Fri, 31 Aug 2012 00:28:34 +0000

Medscape’s Match Game Blog
January 2011 – June 2012

When I Grow Up (1.19.11)
An introduction to the Match Game blog

Surviving the Match with Your Relationship Intact (2.1.11)
A personal story about surviving the match with a significant other

Doing Well on Rotations, Step 1: Stay Conscious (2.15.11)
A humorous anecdote about my first day of third year

The Atypical Medical Student (2.21.11)
A quick summary of my path to medical school

What If I Don’t Match? (2.28.11)
Preemptive Consolation for the Worst-Case Scenario

Misconceptions About Family Medicine (3.9.11)

Rotation Selection Desperation (3.16.11)
Be proactive with your electives!

Studying for 3rd Year Shelf Exams (3.30.11)
Advice for Shelf Studying

Attending to Your Attendings (4.13.11)
Quick tips on interacting with attending physicians

Attending Do’s and Don’ts (5.3.11)
Pet peeves from 3rd year

Clinical Skills 101: Building Rapport (5.18.11)
Relating to patients and their families

Step 2 PE Review and a Brief ERAS Introduction (6.1.11)

How I Chose Pediatrics (6.14.11)

Dealing with Dropped Rotations (6.29.11)

Sacrifices for a Medical Career (7.19.11)

COMLEX Step 2: Done! (8.10.11)

(Trying To) Write My Personal Statement (8.24.11)

Confession Time: Deciding to Change Residencies (9.4.11)
Why I switched from pediatrics to emergency medicine

Finding the Right Internship (9.19.11)
Considering an extra year of training

Trying to Plan for the Unexpected (10.3.11)
Reactions to my wife’s fellowship match

Being Honest With Residency Directors (10.18.11)

Submitting My Dean’s Letter Request (11.7.11)

With A Few Interviews Under My Belt (11.29.11)

Match Panic Sets In (1.5.12)

Taking the COMLEX Level 2 PE Exam (1.19.12)

Rank List Submitted and Certified! (2.2.12)

Good Luck in Tomorrow’s Osteopathic Match! (2.12.12)

And Now We Wait (2.23.12)

Patient Perspective (3.3.12)
My Personal Experience with a Laparoscopic Cholecystectomy

Congratulations, New Residents! (3.16.12)

Preparing for Graduation (3.25.12)

Following Your Own Medical Advice (4.1.12)

Avoiding Cynicism in the ER (4.19.12)

Graduation Cold Feet (5.4.12)

Realizing How Lucky I Am (5.24.12)

It’s Been a Good Run, Match Gamers (6.9.12)

The Next Chapter

brianfishman — Wed, 20 Jun 2012 22:04:02 +0000

I realize that it’s been a while since I’ve posted anything of worth here. It’s been a hectic time for me. Medical school graduation has come and gone, and while I’m thrilled to be done with that chapter of my life, the commencement ceremony was fairly anticlimactic. My traditional intern year begins soon, and I’ve got orientation activities for the next couple of weeks. Maybe once that’s over and I start seeing patients again, it won’t feel as weird introducing myself as Dr. Fishman.

My time writing for Medscape’s Match Game blog has also come to a close as well. It was an amazing privilege to work for such a great site and with such awesome fellow medical students. Hopefully, this won’t be the end of my writing there. Keep an eye out for more. In the meantime, I’m working on a full archive post of everything I’ve written for Match Game. I’ll try to get that up as soon as I can.

I’m hoping to keep DoctorFishypants better populated in the coming months. Since most of my day-to-day life in medicine is covered elsewhere online, I’m going to try to use this site for more essays or long-form writing about anything from medicine to my increasingly expensive love affair with video games. I’ll try to keep it interesting, even for those of you who don’t know anything about medicine or don’t obsess over the next Super Mario Bros. game.

Tuna Fishman

brianfishman — Sat, 17 Mar 2012 19:11:16 +0000

My wife and I have always wanted a puppy, but neither of us were allowed to when we were growing up. Our parents aren’t huge fans of pets. Now that we’re married and off on our own, we decided it was finally time to adopt. We drove to our local shelter and met a 3 month old terrier mix puppy in need of a home. The folks at the shelter named him Murphy, but we thought Tuna Fishman would be more fitting. He’s scrappy, and he can be a handful at times, but he’s a ton of fun.

Patient Perspective

brianfishman — Sun, 04 Mar 2012 23:13:12 +0000

I’ve spent a fair amount of time in the ER, and I’d like to think I haven’t already become jaded or cynical. But I’ll reluctantly admit that I’ve rolled my eyes once or twice when a young, healthy patient strolls into the ER at 4AM complaining of intense pain that couldn’t wait until morning for an office visit.

A few weeks ago, I reluctantly became that patient. At about 11PM, I started having gnawing abdominal cramps. By 3AM, the pain had moved to my right upper quadrant and I was writhing in bed, unable to find a comfortable position. Tylenol didn’t help. The pain was in the right spot to be my gallbladder, but I wasn’t nauseous and I don’t exactly fit the traditional patient profile of someone with cholecystitis. My wife called off of work for the next morning and took me to the emergency room. I didn’t know what else to do.

When you’ve spent the past four years thinking from the physician’s perspective, becoming the patient is an odd experience. You know what to expect, but you don’t know what’s going on from one minute to the next. You find yourself trying to help the nurses, but there really isn’t anything you can do besides give a thorough history and be a good pin cushion. Unfortunately, most hospitals don’t keep an ultrasound tech on hand past midnight these days. By the time I left the ER, I was given some Zofran and a recommendation to follow up as an outpatient. I’m not really sure I expected much more than that when I came in.

The next morning, I called the family physician that I was on rotation with. She thought I should get the ultrasound, and I agreed. At that point, I had an inkling that I’d be getting my gallbladder taken out the next day. The exam showed acute cholecystitis, and I went straight back to the emergency room. This time, I had to wait nearly 3 hours to be seen by a physician. When you’re working in the ER on a busy night, it’s not uncommon (or unreasonable) to see patients with non-life threatening conditions wait extended periods before being treated. When you’re a patient in that same ER who’s sitting in the waiting room with no medication for your pain, that’s another story.

Fortunately, the ER wait was the worst thing about my experience in the hospital. Once I got up to my room for the night, it was almost as if I were staying in a nice hotel for the weekend. The only thing I had to do was wake up in the morning, answer a few questions, take a nice medication-induced nap, rest again, and go home. Everyone in the hospital from the transport team to the nurses and physicians were incredibly friendly and helpful. Having attentive nurses made me feel so much better as a patient because it compensated for my feelings of helplessness (or rather, futility) lying in a hospital bed.

As I was wheeled into the operating room the next morning, my wife was more nervous than I was. We’d both scrubbed in on quite a few laparoscopic cholecystectomies, and we both knew what to expect, but I was actually excited to finally experience everything as a patient. I know it sounds weird, but I wanted to know what it felt like to be put under with anesthesia and to wake up groggy and loopy. I wanted to know what the different pain medications we hand out so freely to patients actually do to your body. And I wanted to know what sutures and dermabond feel like. Now that I’ve experienced all those things, I’ll know what to tell my future patients to expect. I’ve gained more respect for my future colleagues, more appreciation for everything that the nursing team does for their patients, and, perhaps most importantly, more empathy for my patients.