Working for a better me @needabetterme - Tumblr Blog

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raddestbabe

everyone’s having their mid-life crises at like 19

olivertrees

wordsnquotes

None of us understand what we’re doing but we do beautiful things anyway.

Allen Ginsberg, The Letters of Allen Ginsberg (via wordsnquotes)

rainbow-on-my-parade-deactivate

“You know so little of war. Battles may be fought from the outside in, but wars are won from the inside out.”

the-bookshop

Source.

nevver

das Bibliothek, Olivier Martel Savoie

studymedically

50 Reasons Why You Should Study

Need motivation?

To get an education.

To earn a degree. There are barely any jobs that offer positions to people without a degree, or are on the path of obtaining one.

To prove people wrong. That science teacher that said you’ll never make it in the medical field? Make him eat his words.

To prove yourself wrong. Every student has doubts on whether or not they can be good enough in the classroom. Prove yourself wrong, and always be better than you were yesterday.

This is a privilege. Regardless of how much you believe that you HAVE to do this, to some extend you don’t. Realize that you have the privilege of an education even being an option for you.

Take advantage of what you’re capable of. Don’t waste a perfectly intelligent mind.

More money. That degree can do wonderful things to your bank account in the future.

It’s interesting. Studying can get pretty boring, but there are always those topics that spark your curiosity and motivate you to learn more.

It’s attractive. Not everyone cares for someone who is academically gifted, but a partner who is eager to learn makes me eager to take my pants off.

It’s useful. That random fact that you read in a random textbook can stick with you and really end up helping you out one day.

It’s fun to know useless shit sometimes.

To make your parents proud. This is one of the main reasons I study. My parents have always been aware of my capabilities and have pushed me to be academically better every year. They know I have big dreams, and I just want to achieve them so they can know that their child made it.

To make myself proud. This goes along with number four. Knowing that you accomplished something, however small or big the thing may be, is a huge self-esteem booster.

To be independent. There’s nothing quite like knowing that you don’t need someone else’s job, degree, intelligence, or presence to make you successful.

To pursue your passion.

To gain knowledge. Whether its in your field, or a completely different one, being knowledgeable is just downright fun.

People will look up to you. Your siblings, your best friends, and your classmates may see you consistently studying, and it could motivate them to do the same.

To make a name for yourself. “Oh yeah, (insert name here), I know them. Aren’t they like really successful now?”

To become your own role model.

To be able to pay off your student loans.

Because the long nights and excessive coffee will all be worth it. Even if it doesn’t seem like it now.

To exercise your brain. Your brain is just like a muscle, and like the body it needs to be exercised.

To improve your hippocampus. Your hippocamus is responsible for memory, and if you study your memorization will become significantly better.

To not waste time doing useless stuff.

Because stationary is amazing. I could spend a whole paycheck on just pens.

Because notes are actually all so pretty.

To be productive. I used to spend a lot of time on social media, and although I still do, the amount of time I spend studying and getting stuff done has definitely increased.

So classes will be easier.

So tests will be easier.

To impress your professors. Get those letters of recommendation!

So the anxiety of getting a bad grade is sufficiently decreased. I constantly worry about my grades, but studying has helped me not worry so much.

Because coffee exists.

There is no other atmosphere quite like the inside of a library.

So you won’t have to retake a class. Failing a prerequisite for your major really sucks, so maybe try not failing the first time around. This also saves you a lot of money because you won’t have to pay for the class again.

Finals week won’t suck as bad. You’ll be used to studying so when finals week comes around it wont nearly be as stressful as for those students who are now opening a textbook.

You won’t go to as many college parties. Don’t get me wrong, I am all for socializing and having fun, but a lot can go wrong at a college party very quickly. And there’s no better way to prevent that, than just not going to the party cause you’re reading your economics textbook.

You’ll get used to FOMO. Fear of Missing Out. Every teenagers nightmare. Eventually, you’ll get used to the feeling.

You’ll be getting the most out of your college experience. You’re paying for these classes. Might as well try your best to pass.

You’ll get used to not getting enough sleep. So, if you decide to go to grad school you’ll have that department covered.

There’s really good study music out there.

I guarantee there will be at least 5 places on campus, or around you that are perfect for studying, and you’ll want to go there everyday.

You’ll become a pro at writing essays, or lab reports.

You’ll learn fairly quickly that study groups rarely work.

You’ll make a lot of friends that are just as passionate about studying as you are. And you will cherish them.

Beauty and Brains. Don’t you want to fit that description?

Thousands of students before you have done it, so you can too.

You can run a studyblr. Aren’t they the cutest?

You get really good at time management.

Sleep becomes 5x more satisfactory after a night of studying.

Because you want to. There’s no better motivation for studying, than the motivation that comes from within.

aspiringdoctors-blog

Basics for the Wards: How to Read EKGs

I’m on cardiology right now, and yesterday the fellow taught us some basics for interpreting EKGs. The trick is the have a thorough algorithm and do it every time so you don’t miss anything.

Disclaimer: Obviously this is just a cursory intro so folks won’t look like complete fools like me- who, when asked to interpret an EKG, went into a cold sweat and said, “Well, it looks like the heart is beating.” Attendings do NOT like that.

INTRO

This is what a normal lead II EKG one beat reading should look like. TAKE NOTE LITERALLY EVERYONE STOP CALLING YOUR SQUIGGLY LINES HEARTBEATS IT IS WRONG GAAAHHHH.

Normal EKG.

What the various leads are monitoring.

1. Rhythm: Sinus or not- aka, is the SA node talking to the AV node correctly? Check in leads V1 and II- if there is a P wave before every QRS you have sinus rhythm. If this is not the case, you do not have sinus rhythm! A whole discussion on things messing up sinus rhythm will come when I have a better grip on it myself.

2. Rate: How fast is the heart beating- aka, how fast are the ventricles depolarizing? So EKGs are little tiny boxes in bigger boxes, right? There are several methods for calculating rate using the boxes, but the one that works for my brain is to count the big boxes between R’s and divide that by 300. So, 1 big box between R = 300/1 = 300 bpm. 2 big boxes between R= 300/2= 150 bpm. And so on.

In general, any heart rate above 100 is tachycardia, and any heart rate below 60 is bradycardia. These values may vary (ex: SIRS criteria counts heart rate above 90 as tachy). Normal heart rate is around 75 (exceptions include athletes- look up athletic heart syndrome)

3. QRS Complex: Wide or narrow- aka, is the Bundle of His bossing the ventricles around? Basically, a nice narrow QRS complex generally indicates the bundle of His is intact and operating how it is supposed to. A wide QRS complex indicates something is awry with the Bundle of His- could be an organic pathology, could be a medication side effect (ex: antiarrythmics, TCAs, quinidine, to name a few), could be an electrolyte imbalance (ex: hyperkalemia), could be other things.

4. Axis: Is the heart depolarizing the way it should- aka right shoulder to left nipple. I, personally, am still sorting out the axis system, and it’s hard to do in this format. The first, most basic place to start is checking if lead I and aVF are POSITIVE, meaning their QRS complexes go ABOVE the isoelectric line. If that is the case, you are probably ok axis-wise.

Essentially, lead I’s vector goes from left to right, and aVF’s vector goes from head to toe. So the average of those vectors is the general path of depolarization of the heart. You want the axis to be between -30 and +90. So, if aVF is positive, but lead I is negative (the QRS is below the isoelectric line) that means it is going from left to right instead and would be classified as a right shift. Likewise, if lead I is positive, but aVF is negative, that means it is going down to up and would be classified as a left shift. There is soooo much more to axis interpretation, this is just a starting point.

5. Intervals: Again with the conduction system, it’s, like, totally important that it obeys all the rules every time. PR= <.2 seconds, or one big box QRS= <.12 seconds, or 3 small boxes QT= < ½ the RR interval

6. ST segment changes: checking for CAD- aka, is the myocardium getting enough blood/oxygen? Since the folks in the South seem to consider butter a food group and know that if it can’t be fried it’s not worth eating, CAD is a huuuuuuuuge issue here. When blood supply to the myocardium is compromised, there will usually be characteristic EKG changes. Note- not every episode of angina/MI will have EKG changes though! - Inferior leads –> right coronary artery. - lateral leads –> circumflex artery - anteroseptal leads –> left anterior descending. Disclaimer: does not apply to everyone all the time, some folks have variant coronary anatomy.

So the EKG changes to look for must be seen in two contiguous leads, aka, two inferior leads or two lateral leads. - Ischemia (low oxygen) = ST depression or T wave inversion (EXCEPT T wave inversions are ok in leads V1 and aVR)

- Injury = ST elevation

- Old infarct/dead myocardium = pathologic Q waves. Basically that first negative vector (aka, the Q of the QRS complex) should never be bigger than one tiny box.

And, that, friends, is a basic algorithm for reading EKGs! There is a lot more, but if you follow these steps every time, you will look like a rock star on wards. Good luck!

80slesbiab

chiefcomplaint

lmao

aspiringdoctors-blog

😂😂😂

md-admissions

I’M SCREAMING

thedisagreeabledoctor

How To Be A Good Med Student In The Clinical Years

A doctor once told me that the best instrument we have is medicine is the retrospectoscope. Basically he was saying that often it is easier to make sense of things when looking back from the vantage point of the future. This is true of life too. After being an intern for two months I suddenly understand what things make for a strong med students, and what things do not. Unfortunately, I feel like I lacked many of the qualities that would have made me a helpful med student. Though I cannot rectify my own mistakes, perhaps I can pass my advice on to future generations of third and fourth year medical students. I now present, how to be a good clinical med student:

Show up. This seems obvious. When you are there to work, then be there to work. It is so frustrating when medical students are mysteriously absent all the time (only to be found later in the cafe or cafeteria) or when they are there but totally disinterested in what is going on. I understand that sometimes as a medical student things get slow - like when the interns are putting in orders and notes or when there is a slow call day. But at least bring something to read. Don’t play Pokemon Go. Don’t spend all day on Uworld. Make an effort to learn real clinical medicine.

Take initiative to learn. When I was a third year I would wander the hospital to find learning opportunities. I made friends with the telemetry nurses and they started a folder of good tele strips to give me each day. I would go to other teams and see if their patients had good exam findings. I found the cardiology fellows and asked if they had good patients with murmurs. There is so much learning that can happen if you are willing to experience it. Now, referring back to number 1, make sure you always let your residents know where you are. Personally, I would be ecstatic if my students went to hunt down murmurs rather than playing Pokemon Go.

Read your patient’s chart. This can be very helpful and will make you look like a star. Residents are busy taking admissions and sometimes don’t have the time to hunt down records that are three and four years old. You can stand out by doing that Look at a patient’s past hospital notes or their specialty clinic notes. For example, you might be able to alert the resident that an old echocardiogram demonstrated a below normal ejection fraction, which in turn might change how much fluid the patient is given. Or perhaps you found that during a hospitalization in the past the patient became delirious and needed a one-to-one sitter. Find ways to add information in a helpful, non-prescriptive, non-judgmental way. I guarantee your reviews will benefit.

Read about your patient’s condition. Even if you just browse Medscape, UpToDate, or some other curated source, make sure you understand the basics of your patient’s primary diagnosis. If they are there for heart failure, read over the basics of treatment. If they have autoimmune hepatitis look up some info on diagnosis and prognosis. These things will get noticed, especially when you ask intelligent questions on rounds. Do not be like a med student I had who, when asked, reported for 4 straight days that he had not read about his patient’s disease. He instead responded he was too busy with Uworld so he would get a good shelf score.

See your patients. I literally had students who, on rounds, tried to present without actually having seen the patient in the morning. This is a huge no-no. Get to work early enough to see your patients, review their labs, and their overnight events.

Practice your presentations. Even if it is on your own or with other medical students, spend time working on your presentation skills. Heck, even ask the residents to watch you. I would be happy to do that for any of my students. Unfortunately, none have taken me up on that offer and instead bumble through their presentation each day making the same mistakes. By the end of medical school you need to be able to make a good presentation.

Spend time working on note writing. Compare your notes to your residents’, your attendings’, and the specialists’. Everyone has a different style. Look at lots of notes to determine a style for yourself.

Forget all the step 1 stuff you learned. I find many students perseverate on the terrible stereotypes and patterns they see on step 1. Not all black people with cough have sarcoidosis. Not every patient with acute kidney injury needs urine eosinophils. These are good associations, but realize that step 1 has little overlap with real clinical medicine. Take those associations with a grain of salt.

Don’t just look for zebras. I cannot tell you how many times students opt not to follow a patient because the case “doesn’t seem that interesting.” The majority of medicine is made up of mundane and common diseases such as heart failure, pneumonia, COPD, cirrhosis, etc. It is pretty rare to get the exciting cases, like disseminated histoplasmosis or a crazy paraneoplastic syndrome. A lot of learning can happen on cases that are “bread and butter” medicine. Make sure you follow those cases too.

Be gentle to your interns/residents. The transition from 4th year to being a doctor is swift and brutal. It is easy to criticize when you aren’t the one taking 5 admits. Find ways to help your intern/resident, because in return they will help you. I learned this lesson the hard way my 4th year, when I unintentionally threw an intern under the bus while trying to look smart. Afterwards she took me aside and reminded me that she controlled much of my fate while I was a student under her. I learned my lesson and we went on to become very good friends.

The clinical years of medical school are daunting. You constantly feel like a tap dancing monkey, trying to impress people you barely have time to get to know. But personally, I am not looking for someone who knows everything about everything. That’s why you are in school. The best thing you can get out of third and fourth year is how to do a good history and physical, how to write good notes, and how to triage patients. The best students are interested, willing to learn, and know their patients well. If you keep that in mind, the clinical years are much simpler. I promise, if you follow your patients you will learn much more than just doing qbank questions.

Best of luck on your clinical rotations. Don’t make things too complicated. At the end of the day have fun, treat your patients right, and keep an open mind. The learning will happen whether you recognize it or not.

downtownn

sofuckingbeautifulbabyy

needabetterme

Jon Stewart, explaining to young people why books are awesome.

bruliony

sixteensmallstepstohappiness

push yourself to get up before the rest of the world - start with 7am, then 6am, then 5:30am. go to the nearest hill with a big coat and a scarf and watch the sun rise. 2. push yourself to fall asleep earlier - start with 11pm, then 10pm, then 9pm. wake up in the morning feeling re-energized and comfortable. 3. erase processed food from your diet. start with no lollies, chips, biscuits, then erase pasta, rice, cereal, then bread. use the rule that if a child couldn’t identify what was in it, you don’t eat it. 4. get into the habit of cooking yourself a beautiful breakfast. fry tomatoes and mushrooms in real butter and garlic, fry an egg, slice up a fresh avocado and squirt way too much lemon on it. sit and eat it and do nothing else. 5. stretch. start by reaching for the sky as hard as you can, then trying to touch your toes. roll your head. stretch your fingers. stretch everything. 6. buy a 1L water bottle. start with pushing yourself to drink the whole thing in a day, then try drinking it twice. 7. buy a beautiful diary and a beautiful black pen. write down everything you do, including dinner dates, appointments, assignments, coffees, what you need to do that day. no detail is too small. 8. strip your bed of your sheets and empty your underwear draw into the washing machine. put a massive scoop of scented fabric softener in there and wash. make your bed in full. 9. organise your room. fold all your clothes (and bag what you don’t want), clean your mirror, your laptop, vacuum the floor. light a beautiful candle. 10. have a luxurious shower with your favourite music playing. wash your hair, scrub your body, brush your teeth. lather your whole body in moisturiser, get familiar with the part between your toes, your inner thighs, the back of your neck. 11. push yourself to go for a walk. take your headphones, go to the beach and walk. smile at strangers walking the other way and be surprised how many smile back. bring your dog and observe the dog’s behaviour. realise you can learn from your dog. 12. message old friends with personal jokes. reminisce. suggest a catch up soon, even if you don’t follow through. push yourself to follow through. 14. think long and hard about what interests you. crime? sex? boarding school? long-forgotten romance etiquette? find a book about it and read it. there is a book about literally everything. 15. become the person you would ideally fall in love with. let cars merge into your lane when driving. pay double for parking tickets and leave a second one in the machine. stick your tongue out at babies. compliment people on their cute clothes. challenge yourself to not ridicule anyone for a whole day. then two. then a week. walk with a straight posture. look people in the eye. ask people about their story. talk to acquaintances so they become friends. 16. lie in the sunshine. daydream about the life you would lead if failure wasn’t a thing. open your eyes. take small steps to make it happen for you.

Sixteen Small Steps to Happiness (via cardioconfidence)