Internal Medicine – Day 14

I finally got to see a paracentesis. It’s one of those procedures that makes you think of old crude, medieval medicine. There’s fluid in a place where it shouldn’t be. How are we going to treat it? We’re gonna suck that shit out with a big ass needle and drain it into a giant milk bottle. Simple, yet effective (of course this doesn’t address the underlying issue, but we’ll put that aside for now). As much as we like to think of medicine as a strict science, a lot of it is intuitive/ common sense, as long as you know the science.

How do you treat an infection likely cause by this organism? Put something in the body that kills via a mechanism specific to that organism.

At the end of the day, doctors are just people who are out here making decisions based on the evidence available to them, especially with inpatient medicine. In outpatient the script is flipped. Patient’s have more say if the direction of their care, which on one hand is a good thing and navigating that is an art of its own, I’m not sure which I prefer. Inpatient feels more like science which I think is really fun. Outpatient feels more like life coaching and habit-shaping, which I think is also fun in its own way, but not in a science way, but it also aligns better with my philosophically. aowegawehgawiaejgoaehgueah

(1) People who are willing to be vulnerable, (2) stranger smiles, (3) made up phrases.


Iced vs Hot

I recently came across this “life hack,” or rather this (quite elegant) rant from a disgruntled individual who took to the internet to promulgate about why he thinks iced coffee is a scam. He makes several well-reasoned arguments as to why, including value (with iced coffee you are getting less coffee volume per unit money because of the ice), science (some research found that ingesting hot beverages actually makes you cool down more under certain conditions), and respect for the art of coffee making (you “taste the qualities of the coffee” better when it’s hot). My initial instinct was to agree with him because from an objective standpoint, yes you are getting less volume of the thing your are “paying for” for just as much if not more than you would be getting sans ice; I like science and primary literature-based arguments (even though technically he cited a secondary source and not the journal article itself); and I myself can be a bit snobbish when it comes to wanting to enjoy things in their more “pure” form.

The more I thought about it though the sillier it seemed to me that this man was so fired up about this. Despite his good arguments, the one thing he doesn’t satisfactorily address is that some people may just enjoy iced coffee more. He uses the aforementioned study to argue against the point that people find ice coffee “refreshing” and “helps regulate body temperature.” But even if objectively it may not do that (though also it’s just a single study from 2012), if people believe it does and if they feel good drinking it who are we to deny them that. If people are willing to pay for something they enjoy they should have that right, even if it’s not good deal from a good-per-money standpoint, because the value is in more than the good itself. Also, something tells me not all baristas are toiling over the idea that customers aren’t savoring the hidden notes to be found in the giant vat of coffee they brewed in bulk at the start of their shift in anticipation of the morning rush (though of course those that do should be respected if it means that much to them).

And yes I am also being a bit dramatic, he is not advocating for denying anyone their right to iced coffee. I’m just saying that sometimes I think it’s ok to let people make their own potentially questionable decisions in life if it makes them even just a little bit happier for a trivial personal cost.

Mad at the Drive-Thru

I had a craving for McDonald’s today. Apparently a lot of other people in Camarillo did too. The line was kinda long, but that’s how it be sometimes. I made my order; 2-for-3.99, a McDouble, a spicy McChicken, and a large fry (or large fries?). Looks like there was trouble up ahead and so took 5-10 mins for me to get up to the window, and when I did the cashier read back to me my order before charging my card. After I confirmed, he said, “Yea cause I don’t want to get it wrong because the last was really upset when I said the wrong order.” I expressed my sympathy to him and thanked him for his diligence.

Sometimes it blows my mind when people get upset at little things. Some guy was literally sitting is his car, gave orders out the window of said car, and just had to sit there until it was time to pay and get his food. But he decided to get worked up because the cashier made a mistake and maybe because the food was taking a little longer than usual. Sure maybe that customer was having a rough day, and I think it is reasonable to have a standards and expectation when being provided a service, but I my mind getting upset is never the productive option.

What does it accomplish? Ok maybe it made the cashier start to pay a bit more attention, but perhaps there is a way that the same thing could be accomplished without the same emotional toll on the cashier and on the customer.

In the earlier days of this blog I challenged myself to come up with three things I’m thankful for (3TITF [maybe I should just write it out]) with every post. It’s been a while, but I think I’ll try starting that up again:

Full, lush trees rustling in the wind, mangos, custom stickers