We had a lecture in pathology today, where we saw the following picture of a colon with familial polyposis.

I wish I could tell you what familial polyposis is, but I unfortunately couldn’t pay attention. Why not, you ask?

Because, much like many of you, I was immediately struck by how much the colon looked like TROGDOR!!! (By the way… if you don’t know who or what Trogdor is, please visit that link first. The following post won’t make sense otherwise).

Here we go! Lets see my skills of a med student!

To begin, lets get a nice sheet of paper.

Close it up real good at the top for his head, and then using consummate v’s give him teeth, spinities, and angry eyebrows.

then you can add smoke, some fire,

and maybe some wings… now he’s a wing-a-ling dragon…

lets put one of those beefy arms back on him.

yeah, that looks real good… coming out of the back of his neck there…

And now he needs a name. How about…. TROGDOR… the BURNINATOR!

So I was in the computer lounge during the break just now, and a chair was open next to a computer. Naturally, I sat down.

After a few seconds I noticed that I was sitting on a warm, wet spot on the chair. As I got up, my hand brushed the spot, only to realize that it was noticeably damp. Then I smelled my hand.

Pee. Someone peed on the chair, left the room, and I just sat on it.

I’d like to point out that we’re in medical school, ostensibly learning things like “sterility” and “washing your hands when you walk into a patient’s room”. Apparently we’re also taking “Public Urination 101: How To Pee On Chairs” . I must have forgotten to go to that class. We may be dealing with a serial pee-er, folks.

I am so wierded out right now I can’t even begin to describe how wierded out I am. What is with my bizarre luck with chairs lately? My life has gotten so surreal…

Word on the street is that one of the first years has had the license plate “Doc2B” ever since college premed.

Dude… not cool.

I saw a really, morbidly obese woman in the grocery store today buying whole milk for her extremely fat teenaged son and her soon-to-be-extremely-fat young daughter.

I almost told her that her kids should be drinking skim, not whole milk. Then she started to scream at her kids like a harpy and I figured it was best to stay out of it. I can just imagine the conversation…

Me: Ma’am, your children don’t need to be drinking whole milk. In fact, they should cut all liquid calories out of their diets, as they may soon be mistaken for land-faring manatees.
Her: BWAAAAAAAAAAAA!!!!! (I die a violent death as she rips off my head)

We had our Psych visit today. A group of 10 medical students watched a psych resident interview a woman who slit her wrists and popped several Xanax last night. Some thoughts:

• A psychiatric interview is much different from psychotherapy. Psychotherapy is what you always see on TV with the goofy knitted sweaters and the comfy couch. An interview is much more directed and is aimed at pinpointing exactly what psychiatric disorders may be present. It’s also much more interesting than what you see on TV.

• In our case, the woman was very cookie cutter. Strong family history of manic/depression with her own episodes of mania and depression. The depression was comorbid with mild anorexia to help regain her sense of self control. There was an episode of sexual abuse in her past to which she attributed a lot of her anxiety and depression. Pretty cut-and-dried, which is nice. I thought shrinks usually dealt in grey, murky areas.

• Nobody should ever walk into a patient room in the middle of an interview, especially when the patient has just admitted that she was abused. It really screws with the flow. Jeez.

I think what struck me the most, though, was the fact that she started going to counseling last week, because she was worried she would try to hurt herself. Which she then did. Unfortunately, the psychiatrist only saw her for 15 minutes, put her on a couple of pills (that she then OD’ed on) and shoved her out of his office. He didn’t even bother to schedule a followup.

The medical students were all up in arms about this terrible psychiatrist. But, what the resident then said really struck me. Managed care is hitting all areas of medicine, even psychiatry. It’s hard to do proper psychotherapy when HMOs only pay for 15 minutes worth of counseling time. The sessions go something like this…

Doc: “How are you doing?”
Patient: “I’m a little depressed.”
Doc: “Fine, then, we’ll up your dose.”

It’s hard to do anything more than simple pill pushing when you can’t spend the time to really talk to your patients.