I'm an Intern Now
Blog Address: http://blogs.medscape.com/brianfishman
March 25, 2013

"I Don't Believe You -- I Don't Have Diabetes."

I've always found it amazing that people can be in such denial about their health. Just this past week alone, I've seen three patients who put off getting a colonoscopy into their 70s and 80s who presented with recurrent rectal bleeding that turned out to be cancer. I know a pulmonologist who takes cigarette breaks. Even my own father, an oncologist who should know better, had chest pain radiating down his arm, knew he had had an MI, and only told someone three days later when a nurse asked him why he looked so terrible. 

A few days ago, I saw a patient who was admitted for recurrent bilateral lower extremity cellulitis. She had multiple chronic non-healing ulcers on the dorsal surface of her feet, neuropathy, DVTs, and MRSA infections. She had a 40-pack-year history of smo...

Posted By: Brian Fishman  

March 13, 2013

Good Patient, Bad Outcome

I debated writing this entry for some time before finally deciding to share it here. It's a sad story about a poor outcome for a patient I got to know well over the course of her stay in the hospital. I hesitated to talk about it, but if the purpose of this blog is to share the important experiences from my intern year and talk about the effects those experiences had, then I would be remiss not...

Posted By: Brian Fishman  

February 28, 2013


Usually, apathy and lack of motivation happen to people who are about to finish whatever level of education they're working on. Seniors in high school and college, fourth year medical students, third year residents. I'm a few months away from finishing my intern year, with a full three-year residency ahead of me, and for the life of me, I can't bring myself to care about going in to work in the...

Posted By: Brian Fishman  

February 13, 2013

Match Day Relief

Match Day has come and gone for all of the 4th year osteopathic med students. Today, you're either breathing a sigh of relief or freaking out over having to scramble for your spot. I've gotten a few emails over the past couple of days asking for advice on what to do in the latter case. I'm happy to answer any questions that I can and help out, but honestly, I don't have much expert advice. I've...

Posted By: Brian Fishman  

January 29, 2013

Giving Up On A Patient

I've spent the past few weeks in the Intensive Care Unit. We've had plenty of patients come and go in that time. Most have gotten better and were transferred to step down units before going home. Some were just passing through for a day or two after a complicated surgery. Others came up from the emergency room and never made it out of their ICU bed. One patient has been in the unit since I arri...

Posted By: Brian Fishman  

January 12, 2013

Why Are We So Afraid of Death?

When I was in grade school, I remember having to write a persuasive essay on the topic of euthanasia. Thinking back on it, it was probably an inappropriate topic for someone my age to tackle. I don't remember the specifics of my argument, but they essentially amounted to "euthanasia is always wrong because god says you should always make every attempt to prolong life as much as possible." I was...

Posted By: Brian Fishman  

January 3, 2013

New Years Resolution: Less Cynicism

Despite a few professional setbacks, 2012 was a pretty good year for me. I graduated medical school and finally started doing what I've dreamt of doing ever since I was old enough to play with a toy stethoscope. My wife and I adopted a puppy, a first for both of us, and we couldn't be happier about it. But, most importantly, I've got a fairly good shot at matching into a residency in the same c...

Posted By: Brian Fishman  

December 21, 2012

Annoying Hospital Politics

A couple of weeks ago, I saw a young girl in the ER who came in with her husband to be evaluated for postpartum psychosis. We tend to get a lot of psychiatric patients coming through our emergency department because we have an entire floor (roughly half of our hospital) devoted to inpatient psychiatric care. This girl had a history of bipolar disorder and was 9 weeks postpartum. She was extreme...

Posted By: Brian Fishman  

December 10, 2012

The Best Interview I've Ever Had

I've been having a rough go of it for a little while. My internship year is going well, and I'm enjoying what I'm doing now that I'm back on emergency medicine, but I don't know that I've ever been as depressed as I was last month on orthopedics. My last hope for an emergency medicine residency in the same city where my wife is doing her fellowship was shattered with the

Posted By: Brian Fishman  

December 1, 2012

The D.O. Difference

Last week, I posted a story about the worst residency interview I've ever had. It garnered quite a bit of positive discussion, but it also made me realize that a lot of the folks who read this blog are doing so from countries outside of the United States. Osteopathic medicine, in its current form, is relatively exclusi...

Posted By: Brian Fishman  

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About This Blog

Dr. Brian Fishman shares his experiences as a new physician during a traditional intern year at his local community hospital. All identifying patient information is removed or altered to protect patient privacy.

  • Brian Fishman

    Brian Fishman, DO, MS, is a traditional rotating intern in Cleveland, Ohio. He obtained bachelors' degrees in biology and psychology from Johns Hopkins University in Baltimore, Maryland, and a master's in evolutionary developmental biology from Case Western Reserve University in Cleveland, Ohio. He earned his medical degree at Lake Erie College of Osteopathic Medicine in Erie, Pennsylvania. His primary interests include emergency medicine and pediatrics. He was a regular contributor to The Match Game, Medscape's student blog about the match process and finding a residency. He maintains his own blog, Doctor Fishypants, and is active on Twitter as @DrFishypants


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