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“The world tells you many lies about who you are, and you simply have to be realistic enough to remind yourself of this. Every time you feel hurt, offended, or rejected, you have to dare to say to yourself: ‘These feelings, strong as they may be, are not telling me the truth about myself.”

— Henri Nouwen

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“There are things that need to be forgotten if you want to keep on living.”

— Jim Thompson

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“Know yourself and you will win all battles.”

— Sun Tzu (via quotemadness)

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Beverly Hills, California

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What I Learned in Medical School #46: Radiologists are like the art critics/museum docents of medicine. I don’t know what it is that they see, but I sure am glad to have their interpretation.

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https://iglovequotes.net/

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Behind the Medic: If it sounds dumb, speak up

Group of administrators: Our Urgent Cares must see patients with fever, but we can’t test them for coronavirus.

Cranquis: Ok.

Admins: Or influenza. Or strep.

Cranquis: Ok?

Admins: And you have to stay in full PPE at all times, both inside and outside of the exam rooms.

Cranquis: Good!

Admins: And that means never changing your isolation gown.

Cranquis: Huh? Not even between patients?

Admins: No objections! We’re just following the CDC guidelines, and this is the protocol the other system Urgent Cares are using, and infection control signed off on this, and we need to implement this ASAP, and we’re just trying to conserve PPE, and and and….

Cranquis: Oh really.

—-1 hour of fierce googling later—-

Cranquis: Yeah, so here’s every PPE-related document I could find by the CDC, OSHA and NIOSH on extended use of isolation gowns, and the only crisis situation where you can reuse a gown for multiple patients is if they all have the same known infection. And since we can’t test for any infections in Urgent Care now…

Admins: Oh.

—-24 hours later—-

Admins: Attention all Urgent Cares! Effective immediately, you must change your isolation gown between patients when the cause of their fever is still unknown.

Cranquis: 

The moral of the story is not “Cranquis is so smart, and also humble and sexy.” (That IS the overarching moral of my Tumblr, though.)

THE MORAL OF THE STORY IS: At all times, but especially during the madness of this COVID-19 pandemic sweeping through America’s massively underprepared/over-administrated healthcare system, it is crucial that every healthcare worker keep their brains turned on. All too often, administrators are more worried about “getting the newest protocol implemented” – rather than checking for errors or questioning suspicious elements. 

IT IS UP TO US TO ADVOCATE for the safety of our patients, our home contacts and ourselves. We must be willing to speak up when something doesn’t sound right. We must even help the desk-jockeys that (currently) run our healthcare systems to protect themselves from the inevitable wrath of the public, as their bumbling action plans and short-sighted emergency policies will eventually come to light… for then heads will begin to roll. (A powerful phrase to gently mention when confronting stubborn admins is “I worry how this decision will appear if the media finds out…”)

So meanwhile, document everything. Don’t accept verbal policy changes, make a paper trail. Provide references for your objections. Communicate with your colleagues, so they know they’re not alone in their concerns.

Mark my words: the humors of the US healthcare system are imbalanced, its organs are in dysfunction, its cell counts are dropping and the tumors are spreading. But the COVID-19 pandemic is the full-body CT that will expose the rot. And after this, the scalpel…

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Uggggh, who is thinking of these step exam questions?

*shows X-Ray of spondylolisthesis*

Question: Your patient is very sportive. Which sport does she do?

Now do I really have to debate which sport does the most hyperlordose trauma and CAN I NOT JUST ASK HER?

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CML Mnemonic

CML also known as Chronic Myelogenous Leukemia. 

What do you find in the blood?

Well it’s called myleogenous leukemia. So obviously the leukocytes will be increased. But, what are myelocytes? They’re baby granulocytic cells, granulocytic cells create basophils and eosinophils. So look for increased white blood cells, granulocytes, and basophils. 

Break it down and you can figure out what you’re looking for! 

Photo from: http://www.hematocytologie.eu/wordpress/?page_id=209

What age group is most commonly affected?

It’s called CML, M stands for Middle Aged usually ages 13-40. 

Translocation?

BCR-ABL (9;22) aka the Philadelphia Chromosome. Remember Middle Aged People are ABLE to work in Philadelphia. 

Treatment? 

Imatinib, which inhibits. the BRR-ABL kinase. “I’m nibbling on the kinase”  (I know this one is a bit odd, but if it works.)

You also have to beware of blast crisis with CML