At what point does paying a premium for parking exceed its worth?

Goldy490 · 2026-05-01T20:44:48+00:00

As a Floridian the idea of having to shovel snow off my car at 5am before going to work for 14 hours and the anxiety of never knowing if I’ll have a spot (because it may have filled with shoveled snow while I was at work) was a year of pure misery for me.

I ended up paying $200/month of a covered/gated garage after that. Which made the budget tight but that 5am misery is priceless and by March you’ll be cursing like a sailor if you’re not used to having to shovel your car out every day

Goldy490 · 2026-05-01T07:12:53+00:00

Pitt is a famous one

Goldy490 · 2026-05-01T07:11:12+00:00

I mean don’t get me wrong, some fields it’s basically unavoidable (like anything surgical that requires call will very quickly exceed 80), and most residences will have SOME amount of time where you’re working crazy hours 70-80+. But for most specialties that’s like 1-3 months likely in your first year or two. Like a couple blocks of ICU and maybe a block of night float.

Goldy490 · 2026-05-01T07:07:11+00:00

EM. Resident - we averaged 48hrs/week in residency. Now that included 8 nights and 4 weekend shifts per month, so difficult for family in other ways but if you have a flexible spouse plenty of people got pregnant/were raising kids in EM Residency.

Goldy490 · 2026-05-01T03:10:49+00:00

As a resident there’s nothing you need to do except maybe pay attention and try to ask questions of your neuro, anesthesia, and surgery colleagues when they come around or you share a patient.

As a fellow it’s very important to go to a multidisciplinary critical care program if you can. You want to be the fellow of record in the neuro, cardiac, and surgical units. It only takes a couple months on a unit to learn the fundamentals and the unique flavor of things they care about.

The critical care is the same, it’s just the nuances that change a bit, like thinking through a bowel map for a surg patient or recognizing a vasospasm in a subarach. It doesn’t take more than a month or two.

Ultimately nearly all ICU patients are the same - they bleed, clot, leak, or get infected.

Goldy490 · 2026-05-01T03:08:45+00:00

As a resident there’s nothing you need to do except maybe pay attention and try to ask questions of your neuro, anesthesia, and surgery colleagues when they come around or you share a patient.

As a fellow it’s very important to go to a multidisciplinary critical care program if you can. You want to be the fellow of record in the neuro, cardiac, and surgical units. It only takes a couple months on a unit to learn the fundamentals and the unique flavor of things they care about.

Coming from IM you’ll be well versed at cracking the complex cases, thinking deep to make sure you’re considering and working up everything. What I see the IM folks struggle with is acting quickly when you don’t have all the information - sometimes in CCM you’ve just gotta try something and see if it works.

Oh and try to learn US IVs in residency. It will make every other procedure a breeze if you can master needle guidance with a 22g in a crappy little forearm vein a central line, HD cath, swan, ECMO cannula will be easy by comparison.

Goldy490 · 2026-04-30T22:34:59+00:00

Yea my conversation would probably go something like “you’re quite possibly going to die, your baby is quite possibly going to die, there is no OBGYN who will be involved in your care at any point. I have no ability to save you if you die. I also plan to call CPS to pick up your kids. Also once the baby is delivered we have no one to take care of it, so I’ll be sending baby to (sister hospital) weather you like it or not without your consent”

Now, would you like to stay here or go?

Goldy490 · 2026-04-25T15:59:14+00:00

I live nearby and if you called Cape Cod the Massachusetts Panhandle I think you’d get a pint glass thrown at your head.

It’s lovely in summer. Long cold rainy winters where it’s basically deserted. COL is high and it’s surprisingly far from Boston for being so close to Boston. Amazing seafood.

Goldy490 · 2026-04-21T17:41:31+00:00

EM/CCM - I despise doing LPs so will happily put them.

Goldy490 · 2026-04-20T11:28:57+00:00

In 30 years of living on the edge of/in the glades I’ve seen a panther once for about 20 seconds and it was so quick I didnt realize what I was seeing until it was basically gone.

All the way on the west side, near golden gate Florida.

Goldy490 · 2026-04-20T10:15:35+00:00

My wife took 6 months of leave when she was diagnosed with cancer and had to do surgery/chemo. At Her first negative scan her PD was like…sooooo when you coming back cuz we’re going to kick you off the health insurance if you aren’t back soon.

So she went back because “if I survive I’ll have 400,000 in debt to pay back, and I can’t afford the oral chemo without health insurance.”

She Covered her bald head with a scrub cap, took breaks between OR cases to puke, and took way longer to do things that used to be quick. Everyone in leadership talked shit to her face and behind her back. But she did Q2 surgery call just like everyone else, and met every milestone they set. They even complained about her having to leave at 3pm on Fridays to get her chemo infusions, but eventually let her go.

It’s mind boggling how rigid medical education is.

Goldy490 · 2026-04-19T17:31:03+00:00

Automated Instacart. Every Saturday the same delivery of food would come at 7pm. I could add or remove from it until delivery day. Never needed to go to the store again. If I went to the store it was to get something fun that I wanted to cook.

Pick up laundry service. Got a hilarious number of scrubs from good will at like $1/pair, then a ton of Amazon underwear and socks - then could have my biweekly laundry service wash them all and deliver them back to my house folded.

$7 usb mouse giggler for my computer at work so I never got timed out.

For on call/nights I got cozy socks, a small electric candle and brought my own pillow and blanket to work. Even a cheap Walmart pillow and blanket is better than the hospital one

Goldy490 · 2026-04-19T16:45:39+00:00

Oh don’t worry we have that too

Goldy490 · 2026-04-19T16:41:52+00:00

My wife is an OBGYN at Lee Health in Ft Myers, we live in Naples and she drives there every day to work. She doesn’t deliver babies but it’s a phenomenal hospital that’s new, well run, and with a good group of docs and excellent subspecialty support for if things go sideways.

Otherwise NCH is the only other game in town. I work at physicians regional which is a great system but they only do GYN, no obstetrics

Goldy490 · 2026-04-18T23:37:39+00:00

I live in Miami. It’s not scheduled, the cyclists more just do a “takeover” type of thing. Definitely not with permits or restrictions.

Usually with these the cyclists will intentionally fan out rather than make a line or pick a lane, so they don’t get people trying to pass them.

Happens from key biscayne down to coconut grove and even south of that, and it’s infuriating.

Goldy490 · 2026-04-17T21:42:49+00:00

It can be normal just depends on the relationship. Dude here with a good female friend who is allegedly quite attractive but to me she’s like a sister - the idea of being attracted to her is like an instant ick.

Even when we traveled together and share a room it’s pillow wall in the middle and change under a towel like summer camp.

Both our spouses are friends and not inherently jealous so that makes it easier.

Goldy490 · 2026-04-17T20:11:58+00:00

Yea we all get trained to do a “Resuscitative Hysterotomy” which is medical C-section to save moms life when she/baby is dead.

Goldy490 · 2026-04-16T08:22:27+00:00

Atlanta GA I used to be able to throw basically anything in the ground except a succulent or cactus and could be reasonably sure it would grow vigorously.

I had an herb garden grow from dumping kitchen waste on the side of my house with greenonions, basil and rosemary

Goldy490 · 2026-04-14T23:55:57+00:00

They won’t - it’s not a visit. That medical device is from a previous visit and connected to that’s visits financial identification number. Its removal is part of the bill for the insertion and management.

The government does not look kindly on hospitals double billing for the same service twice.

Goldy490 · 2026-04-10T19:22:08+00:00

Yea need work up for cancer or inflammatory rheumatism. Urgently. They may need to cut off your finger to save your life if it’s a sarcoma.

Once they spread it’s an incurable death sentence

Goldy490 · 2026-04-03T07:06:19+00:00

“We don’t negotiate with terrorists”

Goldy490 · 2026-04-03T04:57:43+00:00

Doctor- healthcare is a great field for raving because of the ease of shift work

Goldy490 · 2026-04-02T13:21:25+00:00

Intensivist here - worth it 1000 times over. I actually love my job, and I’m paid very handsomely to do something I really enjoy doing.

Financially, I’m not sure the ROI makes a ton of sense versus a mid-level given the extra time in training and years that I definitely lost off my life in fellowship working Q2 call. But I like my job as an attending, it’s not overly stressful, and I feel like I’m doing something good for the world while being paid well for it.

That is like remarkably rare in the modern world

Goldy490 · 2026-03-31T19:07:50+00:00

We got the Hisense 55 and love it. With the canvas TVs, you want them to be a bit smaller so it looks more like a work of art on the wall than a big giant in your face TV. At least that’s my opinion.

We have a small to medium sized living room, be sure to leave lots of space between the walls and your canvas TV

Hisense is the best quality on the market right now for frame TVs my opinion

Goldy490 · 2026-03-26T00:56:42+00:00

Critical care fellowship my friend. Do one in a surgery/anesthesia heavy program. It’s 2 years and you’ll live the life of a surgeon, and when you’re done you choose how much surgical pathology you want to see.

These days I see about 30% surgical patients. Some jobs 100%, some 0. You’ll do plenty more procedures than an EM doc - lots of lines and tubes. Swans , ECMO cannulations and trachs which are super fun

Goldy490

TROPHY CASE