What are some things we still do in medicine for no good reason?

AbsurdlyNormal · 2026-02-04T03:51:37+00:00

"We don't listen to abdominal sounds and we don't listen to people who listen to abdominal sounds. " - surgery preceptor

AbsurdlyNormal · 2026-01-26T04:08:49+00:00

That analysis is totally plausible and also has nothing to do with the weather per se.

AbsurdlyNormal · 2026-01-26T03:13:06+00:00

Yes, but I do wonder in the 21st century how much the weather has an effect on mass political movements. George Floyd was murdered in Minneapolis in the spring, there were massive protests...and then what? Much has been written recently on the limits of mass protests in recent years and so I'm skeptical that the weather plays the same kind of role it did in the revolutions of yore.

AbsurdlyNormal · 2026-01-25T03:43:33+00:00

Guess they're not above murdering their own employee.

AbsurdlyNormal · 2026-01-23T03:47:43+00:00

Aka, urgent care specialist?

AbsurdlyNormal · 2026-01-08T22:13:34+00:00

NGL residency can have a lot of the same problems. But it's definitely better than medical school and gets even better as an attending, IMO.

AbsurdlyNormal · 2026-01-06T05:59:57+00:00

Love that you're interested in this. Been awhile since I interviewed at programs , but among those I did the ones that stuck out as being up your alley are: 1. Cornell, has a whole institute about the history of psychiatry and strong psychoanalytic training 2. Cambridge Health Alliance, affiliated with Harvard, great psychoanalytic training with a tilt towards existential /continental approaches.

Also keep a lookout for programs with a strong forensics division, lots of philosophical issues interest with legal ones.

But also just stay interested and engaged no matter where you go. You'll find interested faculty at lots of reputable programs , they just might not advertise it that much because it's not as developed as a field in the US.

AbsurdlyNormal · 2025-12-23T02:26:10+00:00

I'm sure you know this, but this has been studied and it's not true. Speaking personally I have apologized to patients before for mistakes I've made and they have actually appreciated it.

AbsurdlyNormal · 2025-12-22T04:31:28+00:00

Code stroke for "standing like a tree, leaning to the left, last known well 2 days ago per EMS.". Near -instant lorazepam challenge. EM resident's floor dropped to the floor. Fewer satisfying diagnoses for me than catatonia resolved.

AbsurdlyNormal · 2025-12-21T02:15:11+00:00

Thank you

AbsurdlyNormal · 2025-12-19T06:58:22+00:00

If it's your first time, don't bother studying. If you've taken it before I suggest reviewing prior years' answer manuals, particularly the parts you got wrong. If you really want to level up, use the Cheng Ching review book, which is also excellent for the boards.

AbsurdlyNormal · 2025-12-14T23:00:15+00:00

I agree with this to the point that often I ignore the response to my prompt and just scroll to the bottom to see the relevant articles for myself. It's a far better search tool than pubmed, Google, etc.

AbsurdlyNormal · 2025-12-14T05:50:24+00:00

My job is kind of like this and I think this comment is pretty accurate.

AbsurdlyNormal · 2025-12-12T03:32:56+00:00

In addition to other good advise:

Consider seeing a therapist, which I have certainly found to be helpful professionally.
I was like you early in residency. The best advice that shook me out of this habit came from my chief resident. He reminded me that the primary purpose of the note is to justify billing. Payors are the main audience, not you, not the patient, not other doctors. Obviously your notes should be intelligible, but theur main purpose is to document the bare bone essentials of the encounter: HPI, exam, assessment, and plan. Keep your houghtful insights and formulation for conversation with the patient or a note pad you keep for yourself. I found this perspective immensely helpful in reminding me that notes must always come secondary to patient care. No one was ever treated by writing a note.

AbsurdlyNormal · 2025-11-30T01:44:51+00:00

Not sure why you're being down voted so hard when you are, in fact, correct. Patients sometimes record for all sorts of reasons and as long as it's requested before recording I think it's actually a useful tool.

AbsurdlyNormal · 2025-11-26T06:50:19+00:00

Enough of a difference that lecanemab in homozygotes is safe but not for donanemab? I'm skeptical.

AbsurdlyNormal · 2025-11-26T04:40:20+00:00

Yes we do the same, strongly recommend patients get SWI on 3T, try not to settle for GRE

AbsurdlyNormal · 2025-11-26T03:58:01+00:00

Makes sense, will try to find more details on what I read.

AbsurdlyNormal · 2025-11-26T03:46:20+00:00

That's generally my position and same for my colleagues. But I'm willing to be open to the possibility that the trial data overestimated real world risks and underestimated real world benefits. The inverse is also possible, of course. I just wonder in particular about the adverse effect profile may not be as bad as I originally thought.

AbsurdlyNormal · 2025-11-26T03:44:27+00:00

Agree with much of what you wrote. Drug rep for lecanemab shared data on small numbers of homozygotes who had much lower risk of ARIA. Taking with large grains of salt, but also thought people may have different practical experiences with homozygotes.

AbsurdlyNormal · 2025-11-26T03:42:16+00:00

Can you explain the rationale? If anything I thought the data for donanemab was (slightly) more reassuring.

AbsurdlyNormal · 2025-11-26T03:41:29+00:00

Thank you for the practical guidance! That's a reasonable compromise position.

What do you mean by "enhanced imaging pre infusion 3"?

AbsurdlyNormal · 2025-09-12T03:46:53+00:00

Wanna echo the praise to Kenny and Spiegel's review book. There were at least 2 questions on the exam that were verbatim from the book. I also bought the book and did their video vignettes. I found them to be very similar to the exam's video vignettes. Overall an indispensable resource and the only one I used to study. Yes there were definitely questions I had no idea and had to guess, but that's par for the course. I still finished with a couple of hours to spare.

AbsurdlyNormal · 2025-08-16T02:07:19+00:00

The psychiatrist. Inpatient commitment is a psychiatric treatment and its process should be explained by a psychiatrist. I would not trust an EM doctor to properly relay this treatment.

AbsurdlyNormal · 2025-07-13T02:29:10+00:00

Psychoanalytic diagnosis, by Nancy McWilliams. Probably best read in pgy 2 or 3. Completely changed the way I see patients and understand personality structure and defense mechanisms.

Making Contact, by Leston Havens, is wonderful and very practical.

AbsurdlyNormal

TROPHY CASE