The Differential
Blog Address: http://blogs.medscape.com/thedifferential
February 9, 2011

Do you really want that DNR?

"Do Not Resuscitate." After nearly a year in the hospital, I've seen those words in more charts than I can count. We assume they tell a pretty clear story: The patient, or their proxy, having understood the process and consequences of CPR, has decided that should things take a turn for the worse while in hospital, they prefer that we let well enough alone, and allow them to die in peace.

That's what we assume, but I don't think it's as simple as that, and after considerable reflection I have to say that I'm rather disturbed by the whole process of deciding DNR status. Consider all that's implicit in the DNR order:

First, that the patient or their proxy...

Posted By: Alex Folkl  

February 7, 2011

Don't Discount Sexism in the Physician Gender Pay Gap

The story that made headlines last week was that the pay gap between male and female physicians is widening.  Even when specialty and work hours are accounted for, an unexplained $16,819 gap exists betwe...

Posted By: Shara Yurkiewicz  

February 6, 2011

How do you escape the grind?

Perhaps the information overload of school has caused the fantasy world to play tricks with my mind. I often think, when I have a salary, I am going to do this or go there on vacation. My daydreaming gets the better of me when I should really be focused on the ta...

Posted By: Joshua Batt  

February 5, 2011

Snow day!

Yesterday we had a snow day in San Antonio. A whopping one inch of snow, and all the highways were shut down, schools were closed, offices were closed, even clinics were closed. Unbelievable, right? I waited four years at Northwestern for a snow day, but instead managed to trek th...

Posted By: Arti Allam  

February 5, 2011

There's a World of People Out There....or so I'm told.

Solitude vivifies; isolation kills. -- Joseph Roux

Medical school is a wonderful place to make friends and meet your future colleagues (and perhaps find love). The adversity and joys of the medical curriculum can make a cohesive band out of a rag tag bunch of stud...

Posted By: Carl Streed Jr  

January 30, 2011

Changing the Way I Think

Way back in first year, in a class called "Doctoring Skills," one of our attendings described his method of extracting meaningful information from a patient's story. He'd let that person talk, and while they were talking, his brain would be putting specific bits of information in ...

Posted By: Alex Folkl  

January 30, 2011

Third Year: DIY Medical School

How does a medical student spend two free hours between M&M and grand rounds? 

A few months ago I bit the bullet and paid for a NEJM subscription. The event reminds me of my decision to subscribe to the New Yorker after I graduated college. Without classes, I reas...

Posted By: Rosalyn Plotzker  

January 30, 2011

Lessons From Death

I remember sitting in the workroom. I was pre-rounding and pulling up lab results for my patients. My resident came in and told me that Mrs. X had passed away. I knew she was not going to live long, but I was completely not expecting her to die so soon. No one did. Even my attendi...

Posted By: Jeffrey Wonoprabowo  

January 30, 2011

The Privilege of Treating Patients

While rounding on my patients in the early hours of the morning, I was finding myself getting into a routine of looking up lab results, filing through charts and questioning patients. One morning I stopped in to visit a very frail appearing patient suffering from respiratory distr...

Posted By: Joshua Batt  

January 29, 2011

A Team Effort

I had never seen this kind of daily huddle at a doctor's office... [T]here was the particular mixture of people who squeezed around the conference table. As in many primary-care offices, the staff had two physicians and two nurse practitioners. But a full-time social worker an...

Posted By: Carl Streed Jr  

 
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Medical school and residency can be a stressful, demanding time. These medical students share their insights and experiences, good and bad, in order to create a community of support and understanding for medical students everywhere.

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