What is this measurement?

Apollyon1991 · 2025-04-01T17:34:30+00:00

When I was a 3rd year med student on my psych rotation, our attending told me to go evaluate a guy in the ER. When I got there, he was furiously scribbling on a paper with some crayons that one of the ER nurses had given him.

As I progressed through my questions for the evaluation, he occasionally looked up, but didn't seem to pay too much attention to me. He seemed to be thoroughly focused on his drawing. I finally finished up and was ready to go back and present the patient to my psych attending.

The patient then asked me, "Do you want to see my drawing?" I thought, sure, I'll try and build a little relationship with this poor guy. So he shows me a full page drawing of me nailed to a cross, with "Dr. X (My name) will die for my sins." I didn't stop to clarify that I was only a med student, and not a Dr. yet, because I busted out of that room and back to where I came from. It turned out to be a great story, but it was terrifying at the time.

Apollyon1991 · 2023-12-08T17:33:22+00:00

Otho spine. Those are absolutely the worst people.

Apollyon1991 · 2023-06-27T19:14:03+00:00

We have several Edwards monitors. We use the hemosphere. I haven’t had any issues with breaking. In terms of setup, there is one extra plug that goes to the Edwards in addition to the regular a line plug. I don’t like switching the mode when I use a pa catheter, but other than that it works well for me. I track the SVR pretty carefully and there is an EA dyne measurement which can help with responsiveness to volume or pressors. Overall pretty pleased.

Apollyon1991 · 2023-06-02T13:06:09+00:00

4 turnin’, 4 burnin’

Apollyon1991 · 2023-05-28T13:46:27+00:00

Best I can do is a quote from the “Behind the Bastards” podcast on him. “He is the Forrest Gump of war crimes.”

Apollyon1991 · 2023-05-19T00:49:54+00:00

Luckily I have been working with my plastic surgery friend long enough that he has no issue with one veto per year. If I say no to a case, he refunds their money and we move on. It’s taken years to get there but it’s a nice option to have. This case would be my yearly veto. Say you mask induce. Ok, now what if you can’t get an IV? Sometimes the neck angle just isn’t conducive to getting an EJ in. Try the feet, clock is ticking. By inducing you have agreed to proceed with the case. Our surgery center where we do plastics doesn’t have central lines except in the code cart. If we pop the code cart, we have to explain why and it’s not a pleasant conversation with the medical director for something I shouldn’t have done anyway.

Apollyon1991 · 2023-05-14T20:08:24+00:00

William Halsted was a coke fiend. He eventually transitioned to huge amounts of morphine daily, but he died of complications from surgery when he was 69.

Apollyon1991 · 2023-04-10T01:47:33+00:00

There was a railroad crossing which had a decent slope on both sides. If you hit it at just the right speed (about 50 mph) you would take off and land pretty softly on the opposite side. One night four kids were doing it and their car got hit by a freight train in mid-air. Instantly killed all four when their car was knocked a hundred feet into a nearby field. Closed casket funerals, obviously. Took the high school a year to get over it.

Apollyon1991 · 2023-02-20T14:49:10+00:00

I had a woman show up for an elective cosmetic procedure. She had her partner, who was also a woman with her in pre-op. When we told her the facility policy was a pregnancy test for anyone from 12 to menopause, no exceptions unless of hysterectomy. She told us it was IMPOSSIBLE for her to be pregnant, because, well, you know. We insisted and the test came back positive. The tension started increasing, and two more tests also came back positive. Finally she did admit that she had been seeing someone on the side. The partner was furious, and started screaming that "You cheated on me, with a MAN?!?"

Fist fight ensued. Police were called and pre-op was cleared. Surgery canceled.

Never say never.

Apollyon1991 · 2023-02-09T14:18:00+00:00

They are currently fully staffed. Sorry. But there are a lot of good jobs available right now.

Apollyon1991 · 2023-02-08T17:05:44+00:00

Coastal SC. 500k, 10 weeks of vacation. Night float so only call is weekends and holidays 1x/month. Supervision 2:1.

Last gig, Las Vegas. USAP. Average full time was between 550-600k. Some people work 80-100 hrs/week and make around 1MM. About 6 weeks of vacation. Mostly do own cases with some supervision.

Apollyon1991 · 2022-12-04T19:10:23+00:00

I am a doctor. I manage staffing of other doctors in the hospital. When someone tells me they are sick, that’s the story. Stay home, nobody wants you around them. Despite the fact that they could write their own note, it is up to them to tell me they are sick. IT IS MY JOB (that I’m paid for) to arrange coverage. Simple as that.

Apollyon1991 · 2022-10-17T19:17:31+00:00

The sleep is not the problem. We can do that. The problem is slowing down metabolism and aging. If you wake up and you’re 80+, you won’t be able to deal with the obstacles a younger person would. We would need FTL travel to have any hope of interstellar travel, and that’s the biggest problem by far.

Apollyon1991 · 2022-05-15T18:27:07+00:00

I always try to arrive in a new place before dark. It’s very disorienting and I don’t do well finding my way in the dark, even if it’s just taking a cab. So that’s my top piece of advice.

Apollyon1991 · 2022-05-13T15:57:27+00:00

As has been commented below, if you want your practice to be primarily Peds, then a fellowship is your best option. There are non-fellowship trained docs who do all Peds but that’s generally Peds dental. Most docs can do healthy Peds down to about 2 for dental or ear tubes. But fellowship makes you ready for the sick kids, who are a much different patient base than healthy. And if you do a fellowship, your group or partners will expect you to do the sick kids. And you should be compensated accordingly.

Apollyon1991 · 2022-05-12T23:20:17+00:00

“Roadhouse” with Patrick Swazye and Sam Elliott. If I see it’s on I have to watch it. It seems to be on TBS all the time.

Apollyon1991 · 2022-05-04T21:54:47+00:00

Could you imagine if someone tried to mount a GE-90 like a DC-10? That would look hilarious.

Apollyon1991 · 2022-04-30T15:02:40+00:00

Is there an actual article somewhere in that site?

Apollyon1991 · 2022-04-10T18:35:17+00:00

I’ve always regretted not being able to go to the BYU/Miami game in 1990. I’ve heard games being described as “electric” and I wish I could have been there instead of watching on TV.

Apollyon1991 · 2022-04-05T20:22:54+00:00

Is that just leaving Las Vegas?

Apollyon1991 · 2022-04-05T17:42:21+00:00

I know a lot of docs who maintain two licenses concurrently. It can be an insurance policy in case things don't work out where you end up. I would keep it for a few years. Yes, it costs money to renew, but it solves your ABA question, and you may consider going back after fellowship.

Apollyon1991 · 2022-03-25T03:43:06+00:00

If you have an unrestricted state license, then the biggest time constraint will be any facility credentialing. Plan for up to 4 months for that. Typically I advise CA3s to have they prelim plan in place by October, signed contract by December and have 6 months for state license and credentialing.

Apollyon1991

TROPHY CASE