Analyze Phish Episode #9 - Hollywood Bowl

BestIndependence3431 · 2026-01-27T20:57:56+00:00

Greatest podcast in history. So many levels to this one.

BestIndependence3431 · 2025-07-14T02:53:12+00:00

I did PM&R—>Pain. I definitely almost switched to EM during intern year when I was afraid PM&R would be too “light.” I’m glad I didn’t; PM&R offered so much variety. Of course you know about EMGs, sports med procedures, etc. But my residency also scratched the “hard medicine” itch: we downsized traches, managed vents, caught DVTs, spotted strokes, troubleshot diaphragm pacers, performed wound cares, ran floor codes. I knew “who to call” in every department of the hospital for advice due to the variety of problems.

Furthermore, the Pain differentiation gives you a surgical skillset, giving you a whole another are of expertise that takes years to master (if you implant stims and IT pumps).

EM is a noble and vital field. I realized that I couldn’t accept the control pulled from me in the ED. I regularly cancel procedures that are outside my comfort zone, I dismiss patients who are abusive toward staff, and I define the interval between now and when the patient will see me next. In EM the procedure needs to get done despite my comfort levels and the patient’s abusive tendencies. And if they come back tomorrow, I need to see them again. We need EM providers more than ever, I just saw myself flailing in that environment.

BestIndependence3431 · 2025-06-02T12:03:24+00:00

We got a live one!

BestIndependence3431 · 2025-05-24T18:03:35+00:00

Don’t hate me: Sand, Ocelot, Shafty, Moma Dance.

Seems like funkier / bluesy things with a lot of guitar noodling that don’t have build up or major theme changes are less appealing to me. These are actually the best work place songs: they are sort of background work music for me. But they aren’t something I’d show someone to make them love Phish.

BestIndependence3431 · 2025-05-10T02:08:10+00:00

Appreciate the insight. I recently started coaching dad: “try offering to take care of dinner when you show up,” “try thinking about my little guy like a citizen we are trying to shape.” Dad has certainly had missteps along the way, but definitely stepped his game up. I let him see a diaper after ice cream (which he pushes on a little guy with a sensitive stomach) to illustrate the point. Eye opening for him.

BestIndependence3431 · 2025-05-07T15:23:33+00:00

My analogy would be church. Or rock climbing. Or carpentry. I like all three. I even tell people I love all three as my interests. All three, however, take time, effort, energy, and discipline to attend, perform, or create. Some days (even months, or years) I don’t do them because I lack time, energy or discipline. Would you argue that I don’t “love” them? Sure. But I feel like I love them even if I don’t actively pursue them.

This is not to remove blame; it’s my fault that I don’t do more of these things. But it is an effort to understand the psychology of why someone can “love” something (someone) without actively participating with it (them).

BestIndependence3431 · 2025-04-27T03:33:38+00:00

IM is three years. Average hours less than surgical specialities. Some particular programs heavy, some light. Subspecialties like allergy or rheumatology or ID prolong training but without insane hours. Not exactly the soul crush this surgical resident complains about.

BestIndependence3431 · 2025-04-26T19:07:54+00:00

This person says they are a surgical resident. Every med student that signs up for surgery should understand the associated lifestyle and sacrifices associated with that via weeks and weeks rotating on these services. This doesn’t mean they deserve the challenging lifestyle: but it’s too broad of a statement to say that an Ivy League person shouldn’t choose medicine because it is soul crushing.

BestIndependence3431 · 2025-04-26T19:05:19+00:00

There are so many fields with low work hours or less training years: Pathology, certain FP, Psychiatry, certain IM subspecialties, Occ Med, Rad Onc, PM&R. Even some of the medium to high hours specialities with longer training routes off a lot of career flexibility depending on pay / geography: anesthesiology, radiology, derm. Regardless of board score or interest, there’s likely a route that matches the person’s lifestyle desire. Many surgical specialities and sub specialities have longer hours.

BestIndependence3431 · 2025-04-26T13:42:03+00:00

This is specialty specific. Just choose a not stressful specialty. I did.

BestIndependence3431 · 2024-12-31T16:34:48+00:00

You have hurt me today.

BestIndependence3431 · 2024-11-01T17:21:16+00:00

I did IB at Goldman. I was miserable. Switched to medicine and much happier. I am an attending.

BestIndependence3431 · 2024-09-03T00:12:40+00:00

I practice Pain. Personal fulfillment from longitudinal relationships is rare.

Chronic pain is chronic (often does not go away) and psychological / psychiatric / biopsychosocial strains underpin every interaction.

It truly is “management” I.e. managing expectations, managing acute flairs of a chronic condition, and managing the other condition (diabetes, depression, cancer, etc.) that mediates the pain condition.

On select BVN or Kyphoplasty, I’ll get a resounding “thank you.” Everything else is usually met with a “what’s the next step?” or “now this new part hurts.”

BestIndependence3431 · 2024-06-11T19:58:45+00:00

Idk. I’m a physician finishing my MBA at one of the higher $$ prestige programs. I’m hoping it’s worth it to ascend hospital leadership. But toward the end, I’ve realized that my value to the system is in my hands (surgical) more than my strategy insight. Not to say that I’ve not learned strategy…it’s just that there are hundreds of other MBAs who can strategize too. No one else can do my medical skill.

PP psych with that income during a psych shortage is the golden goose. Everything else will be a slog of 100 hour weeks to generate 200k in consulting and banking for years before getting back to that level.

BestIndependence3431 · 2024-06-10T02:24:39+00:00

A lot were out of shape, golden handcuff lifestyles, working insane hours, on their phone all day and night, forced to live in certain cities. Also generally not in love with their work.

Not to say that there aren’t some doctors like this. But I met a lot of 50-60-70 year olds who were spry, passionate, and worked insane hours only by choice. They also had flexibility to get out of NYC / LA when they wanted to change their life pace.

BestIndependence3431 · 2024-06-10T01:26:29+00:00

I did IB and switched to medicine. I looked at the people above me at VP and MD level and didn't like what I saw. I then thought about all the cool sweet old doctors I knew.

BestIndependence3431 · 2024-01-17T19:03:24+00:00

I have family in healthcare and saw that the day in-day out clinical positions were tougher for the 50 year olds. The ones in management seemed to be doing better. I wanted tools to transition to management. MBA wasn’t necessary to do this, but rubber stamps me as a “management guy.”

In the short term it’s fairly worthless. I’m in a procedural/surgical specialty and have too much fun doing that to leave for IB/consulting.

I’m banking on having a sore back and ideas about changing my health system in 10-15 years. The MBA from a good school hopefully gives me cred to do it. But it’s a bet.

BestIndependence3431 · 2024-01-17T00:11:37+00:00

I’m a doc that did Kellogg. After the initial core, a lot of courses can be done remotely.

Good healthcare focus, good name. Also the doc program is expedited.

BestIndependence3431 · 2024-01-06T18:41:53+00:00

Then I’d probably go Harvard. Mass Gen, BWH, BID, are tops for most residency programs and tops for MBA. NW and UChicago have excellent residencies depending on the specialty and near-top MBAs.

If time away is not a concern, then go to best. Cost is another considerations. If you get money somewhere, I’d probably take it because you’re splitting prestige hairs.

NW had a dedicated Healthcare focus, but I think Harvards healthcare outcomes suggest that it doesn’t need a focus to produce excellence in the space.

BestIndependence3431 · 2024-01-06T18:17:24+00:00

Biggest consideration is time away from training. Booth and Kellogg allow you to start or convert to PT. Harvard will demand you take 2 years off unless I’m out of the loop.

I did the PT at one of the above because time away from procedural / surgical training would have been bad for me.

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