Germy

I never gave much thought to the root of the term "stroke" but a recent lecture given by a neurologist enlightened me. It stems from the 1500's when "The stroke of God's hand" referred to what we now call just "stroke." I’ll also refer to it as a CVA, short for "CerebroVascular Accident,” in this article. With continued workup of a stroke, we will then diagnosis either a hemorrhage or infarction. Infarction refers to the process which begins when a blockage in blood flow occurs. The tissue that is fed by the blood will die, provided there are no other routes for the blood -- no other corollaries. Sometimes, like in the heart we can have new blood vessels grow over time in response to decreased rate of flow, due to the growing partial blockage. More specifics diagnosis are made based on the what the blockage is made of; we'll get into that, too. At most 18% of strokes are hemorrhagic. A blood vessel, often an artery in the Circle of...

Welcome to the first edition of an ongoing series built to break down common medical conditions and emergencies so all of us can have a better understanding of just why doctors do what they do. One of the most enjoyable parts of my day to day is explaining physiology and pathology to my patients. I've made it a habit to go over every test sitting side-by-side with the patient. I tell them what every element means; very briefly if normal and with a little more in depth explanation if abnormal. I break down the fancy schmancy radiology jargon and explanations, telling them what the reading means in plain language and what it means for them. Most people appreciate it, I think. Diabetes. So prevalent. So destructive. Many times preventable. Once in a while patients present to the clinic with complaints related directly to a new onset diabetes. The ones that do are often type I, or in the olden days, juvenile diabetes. This is a very different process than type II. In brief, type ...

Had more OSCEs today. Thought that was over with, actually. What does OSCE stand for, you may wonder? OsteopragmatipathSomethingClinicalExamination. Sounds about right. Had these on a regular a basis in medical school. Standardized patients, who are trained to act in a certain way and function as if they were a living "Choose Your Own Adventure" book, in that what I do or don't ask them determines how the visit goes. We're videotaped. We're given feedback from the standardized patients about every little thing we did. Of course, the more dramatic the more tempting the scenario is to set-up. I had to deal with an actress sitting in front of me reacting to the news that her pregnancy was culminating in a baby who would have no brain -- anencephaly -- and she had no idea before I sat down. The SP is able to cry on demand; it was impressive and believable. Another young lady had a history of trauma, was seeing me for a sprained wrist and would not make eye contact and...

Your first interview is coming up. Your mom said to 'just be yourself.'  This may be good advice.  Nevertheless. Take a moment and reflect on those you have been with along this academic journey. Perhaps some of them should not 'just be themselves' during the interview process.  Assuredly none of the readers of this particular corner of the internet would find themselves in the position to go against their own mother's advice, but if only for our own edification let us forge ahead and review the world renowned  Germy's Annual Guide to Answering Residency Interview Questions So You Match Good . This year's installment is provided in a convenient multiple choice format.  1. Which of the following is the most appropriate response to the following: "Why are you interested in coming to our program?" A. Best results when I place my location here on Tinder B. Best food delivery options C. Best overhead page voice D. High...

Nearly a year ago I wrote this  after watching the return of Twin Peaks   and in that post I admitted to my David Lynch fandom dwarfing my knowledge of the Lynchian Universe . I bring this up because I find myself hesitant to write about David Lynch because I am not an expert concerning his work; I am not and never have been interested in going to art school. I am accustomed to being regarded as the "expert" on a daily basis, and while my depth of knowledge is not always up to "expert" standing -- perception supersedes reality much of the time. I'm not one to back down from feeling uncomfortable so I'll forge ahead and put my thoughts out into the universe. I came across this today  and as a person who feels like existential crises spring eternal, of course I went down the rabbit hole (pun intended) of this piece of Lynch work that I had yet to realize was it's own thing. Regarding the article (I hardly ever click on links when I'm reading and...

Top ten things I'm into this week: Golden weekends -- easy to take for granted!  Planning for Oregon deep sea fishing trip. Last year a big storm cut us short. Scary Caramelized onions with bacon Cooler nights. So tired of running the AC unit Air fryer. Seriously, get one of these Bamboo cutting boards Kamado Red Egg for grilling -- that thing gets sooooooo hot!  Mango La Croix Voltaren gel. Topical NSAID that kinda actually works. OTC in Canada; super expensive and Rx only in US 2nd year of residency Top ten things that I eschew this week: Hot days. I'm over it LA Traffic Continuing to wait for medical license to arrive Toes. My toes hurt Elevators that frequently break down Costco crowds Debt Not into Jack Ryan. I tried Having more time to pay attention to politics and such. So depressing Low thresholds for hangovers

For a number of years, when I was much younger, I would refer to 1993 as my favorite year. I realize that many of you reading this were not born at that time. And the fact that I was old enough to regard such a year as 'my favorite' just accentuates this fact. 1993. I was fourteen for much of the year. I had been skateboarding with a great amount of motivation and drive for a couple of years at that point. I thought of little else. Too young to have a job but old enough to explore the urban landscape by bus and friend's cars. Looking back I can identify a flavor of societal optimism that has been absent since September 11th, 2001. I remember watching, on a small television in my parent's basement, the Berlin Wall fall -- I remember sitting on the brown plastic couches watching President Reagan tell Gorbechev to "tear down this wall." At some point a pop song by Jesus Jones called "Right Here Right Now" was published and back when I would actu...