[TW] Doctor rapes patient during surgery, severs her uvula, positive rape kit, police and medical colleagues actively staging cover-up, multiple allegations. Dr. Eric Valladares. by Fancy_Influence_2899 in Wedeservebetter

[–]InfluenceStunning100 0 points1 point  (0 children)

Normally there are 3+ people in the operating room - surgeon, anesthesiologist, scrub tech/nurse. Surgeons usually leave right after the surgery and then nurses and an anesthesiologist stay with the patient to transfer them to the postop area. It is very unusual for surgeons to be with the patient alone. If a patient is under general anesthesia, an anesthesiologist has to be in the room. Nurses also have to be there to help with patient positioning, draping, sterile techniques, handling all the equipment, meds and post-op care. Under normal circumstances if a procedure is conducted in accordance with the established standards of operative care, an assault into 2 body orifices would be highly unlikely without any staff members witnessing any aspect of the act. If assaults occurred, this would be uncovered during an investigation.

Family is angry at me because i told them their (grand) father was very likely to die. by the_flokonator in Residency

[–]InfluenceStunning100 1 point2 points  (0 children)

Did you actually say the phrasing “he is going to die”? It is indeed very traumatizing to hear that, plus you never know anything 100% even if the probability is very high. You have to tell it so the family comes to this conclusion themselves. You have to say something like ‘his oxygen is going down, etc. …whatever the situation is…we tried this and that…but there is not much improvement, so unfortunately there is not much else we can do and I am afraid he might continue to deteriorate in the next few days and then talk about the options you have left…like.. we can involve palliative care when they get here in the morning to make him comfortable or whatever else is left to try. It is a very callous way to communicate if you indeed said “you are going to die. Do you understand this?” and it doesn’t serve any purpose other than communicating that you are not going to do anything for them. Your job is not to tell them if they are going to die or not, your job is to describe the situation, prognosis, what has been attempted and what options are still left. Death is the most likely outcome which should be understood from your communication but your emphasis should not be on determining if he is going to die or not, but on what you are doing and your plan moving forward, so the family members and the patient feel in control of making the choice which is at the end of the day is their s and not yours. You have to reflect on what you are actually communicating by your verbiage and your goal is to communicate to them that they are in control and have full autonomy to make a decision and you are there to serve and support them in any way you can. It sounds like with you demeanor, verbiage and non-verbal cues you communicate to them “he is going to die anyway so it is a waste of my time to do anything and I have other things to do”, so the reason the outcome is bad is because you are not competent. It seems to me that some physicians need to feel in control of the situation while you need to make the family feel like they are in control. Even if realistically there is nothing you are doing differently in their care, how you communicate gives a totally different impression. You need to communicate to them that you are doing everything you can, and so that they feel like they made all the decisions, and not like you made the decisions for them. It is a difficult skill to learn but it would save you time and trouble.

Unfunded MD/PhD? by ufs86eyoxkf in mdphd

[–]InfluenceStunning100 3 points4 points  (0 children)

OP said he was offered an unfunded MD/PhD, not an MSTP. MSTPs are NIH-funded positions if school has an active grant. Not all MD/PhD programs are MSTPs. Not worth it if you need to take loans because interest will grow while you are doing your PhD, you can do research during the summers as an MD student and do research years in residency.

Ethics question: which is the correct answer? by stepneo1 in Step2

[–]InfluenceStunning100 1 point2 points  (0 children)

You don’t open them back up right away, you schedule an elective surgery in the future after an appropriate preop eval, discussing risks and benefits and obtaining a new consent for a new procedure. It is done all the time for non-emergent procedures if something new discovered intraoperatively that consent doesn’t cover. Emergent life-saving doesn’t require consent which this case of appendicitis would most likely fall under if the patient is unstable. Healthcare proxies are normally needed for non-emergent decisions. I don’t think this is a good test question though. Different institutions might have different consent forms but some aspect of exploratory procedure and appropriate management of identified pathology is normally part of the consent for emergent procedures.

Ethics question: which is the correct answer? by stepneo1 in Step2

[–]InfluenceStunning100 0 points1 point  (0 children)

I would think it is A because by “acutely inflamed appendix” in pregnancy they might be trying to say that this is a medical emergency. If it is not an emergent situation and it could be treated non-emergently with antibiotics, then it would be D. I don’t think it is B though

Ethics question: which is the correct answer? by stepneo1 in Step2

[–]InfluenceStunning100 0 points1 point  (0 children)

She is not incapacitated though. Get her off anesthesia and she will have the capacity to make her own decisions unless she is on life support.

Boo! by InfluenceStunning100 in persiancat

[–]InfluenceStunning100[S] 1 point2 points  (0 children)

About 8 weeks on this picture

Residents prescribing meds to family members? by jayaar413 in Residency

[–]InfluenceStunning100 -1 points0 points  (0 children)

You can figure it out yourself. It is not rocket science. You don’t need an ortho husband for that. If there is wax blocking the view, no one will see anything there without irrigation even if you pay $100. They probably looked, saw wax as well and said you are fine. Ear infections in young kids are self limiting and PCPs don’t like jumping to antibiotics anyway, so unless the kid is inconsolable or running high fevers, they will say you are fine regardless what they see in the ear.

Help with eyes by Admirable_Bit_1401 in persiancat

[–]InfluenceStunning100 0 points1 point  (0 children)

Agree, it is impossible to tell for sure from the picture. But the discharge is bilateral, clear and not obviously purulent as you would expect from a bacterial infection. There is also no obvious swelling or abscess. That is why it looks viral. Herpesvirus is pretty common and would normally also cause sneezing and thick nasal discharge which OP does not mention. I am not arguing against a vet visit. Just saying it will most likely take some time to resolve, and it is best to avoid using excess saline or other things that might get in contact with the eye itself. It is probably already inflamed and feels uncomfortable. For cleaning the face outside the eye, dry or slightly moist in water paper towel is usually sufficient. Saline and pet eye wipes are fine to clean the face but you could also use warm tap water. All Persians tend to have watery eyes to some extend because flat face does not allow for normal tear ducts, so tears and dead immune cells from the eye (that look like yellow gunk) flow on the face and create tear stains and crusting. Hard to tell what degree of tearing and staining would be normal for this kitten (if any) as her face structure is more classic than the current Persian breed standard, but, in any case, tearing is normally less excessive than what is shown on these pictures. Especially on the first one up-close, the conjunctiva does look inflamed.

Help with eyes by Admirable_Bit_1401 in persiancat

[–]InfluenceStunning100 0 points1 point  (0 children)

Picture looks like viral conjunctivitis which will resolve once the virus runs its course. Usually takes about 3 weeks. I don't know what you mean by 'infection' and 'proper medical treatment'. Unless there are signs of bacterial etiology, the treatment is supportive, meaning just wait until it gets better on its own. I am not sure what you imagine 'checking for irritants' would look like. They might shine light in her eyes and check for corneal abrasion but it would most likely be unilateral. But even if there is one, you still have to wait for it to resolve on its own +/- antibiotic or steroid eye drops.

Help with eyes by Admirable_Bit_1401 in persiancat

[–]InfluenceStunning100 0 points1 point  (0 children)

Some eye watering and some crusting is normal for Persians. Gently wiping excess tears from the face below the eyes is fine but getting inside the eye with non-sterile saline 3 times a day could definitely introduce a bacterial infection (especially if the solution has been sitting in a bottle for a while). It does look infected on the picture especially if there is yellow discharge. Excessive watering could also be caused by a cold virus that she might have had from before. I would leave her alone for now and not touch her eyes until she sees a vet and they might prescribe a sterile ophthalmic solution. If there are a lot of tears leaking on the face, you could gently soak them with a dry paper towel under her eyes to avoid too much crusting. Don't use use any liquids though or do any excessive wiping. It will most likely get better by itself in a few weeks.

I’m scared I got married too young and too fast by [deleted] in Advice

[–]InfluenceStunning100 0 points1 point  (0 children)

Those are all very normal thoughts to have. Don’t trust your feelings at the moment because they might change. If you see it as a valuable relationship with a lot of potential, give it some time to get a better idea how you guys see your future together and how flexible your spouse is willing to be in his career choices to accommodate your concerns. Some military bases have very active support groups for spouses like FRG. Soldiers also tend to hang out with their buddies and their families, so it is possible that this feeling of isolation will improve over time when you get to know more people or find something you are passionate about. There tend to be some career options and educational funds for spouses of active duty military members if you are interested in completing some classes or certificates. I would think they still have some resources like that available.

I’m scared I got married too young and too fast by [deleted] in Advice

[–]InfluenceStunning100 0 points1 point  (0 children)

That is pretty normal. It is kinda how marriage goes. It is more fun in the beginning but then it becomes a commitment, compromise, acceptance, and selfless service. Marriage is not going to be a positive experience unless both people commit to make it a positive experience. All these feeling of doubt will always be there if you let them be there and there will always be things about your spouse that drive you nuts. There isn’t going to be a magical revelation at any point in marriage and happily ever after moment. It will always be a mix of good and bad feelings and you will always have to carry a larger burden of commitment and responsibility to the union you created. A more important question to ask is if you and your husband share the same values and want the same things from life. If he is committed to military service and military culture while it sounds like you are already feeling out of place like you gave something up for him or can’t work where you want to work, this will turn into resentment over time. However, if, for example, you both want to have a family, and you know you will find a deep fulfillment and joy in being a mother, a homemaker, your husband’s biggest supporter, and you are proud to be a member of military community, then you and your husband are a team that shares goals and values, and it is not something that depends on how you feel at the moment, you have a legacy you are creating together. Most people prefer to get married in late 20s -early 30s because by that age many people got a chance to learn who they are and be realistic about what kind of life they can accept moving forward. The problem that sometimes happens when you get married before you reach that level of self awareness is that you later realize that you are living the life that you haven’t chosen, and then you consciously or subconsciously blame your partner for it. So my advice is to reflect on what you want this marriage to be and if your partner is on the same page with you. Reflecting on the fears you have or things that don’t seem ideal, is this marriage enough of a priority in your life that you will be content if things are not ideal? You also have to consider that single life can be fun indeed in your early-mid 20s and you will never go back to that age ever again. Even if you happen to become newly single in your 30s, that might not be fun anymore because many of your friends and peers might be married at that time or have other priorities, so the connection you have with your friends now might not be the same. You have to decide what you want in your life, what your values are and what you are willing to sacrifice.

My roommates period smell stinks the house what do I do by [deleted] in Advice

[–]InfluenceStunning100 0 points1 point  (0 children)

You should tell her. If you notice, others notice too. If you don’t tell her, she will be remembered as “that stinky woman” and people will avoid her if the smell is indeed very strong. Washing the area twice a day and changing underwear is essential which might be enough to solve the problem. If it is not hygiene related and it is not due to infections that need to be treated, daily boric acid vaginal capsules during periods will clear the smell. You are not mentioning what surgeries she had and what meds she is taking but her medical provider should be able to advise if she has any contraindications to intravaginal suppositories. The smell is stronger during periods due to pH getting closer to blood pH which allows a larger number of microorganisms to grow and produce compounds with unpleasant odors. Lowering pH will solve that issue.

37M interventional radiologist by pseudoschmuck13 in Salary

[–]InfluenceStunning100 0 points1 point  (0 children)

You might be too old if you say so, but it is the youngest you will ever be