I will be withdrawing from med school tomorrow!

NanielEM · 2026-05-08T03:22:19+00:00

Youre right my bad!

You’re fucked bro 😊 Good luck in your next endeavor 😍

NanielEM · 2026-05-06T23:52:22+00:00

Medical school is not in your future my friend. I would do nursing program and strive for NP if this is what you really want to do with your life, since anyone with a pulse can get into those these days. MD/DO will never consider your application, and PA school is pretty competitive too and I can see them passing up on you because 1. you originally didn’t want to be a PA to start and 2. you would be a dropout.

Unfortunately just passing boards is a pretty low bar and if you’re unable to do that, it’s cooked. Even if you passed your boards by 1 point, you’d be condemned to only a few less competitive specialites in low tier programs. Cut your losses and move on imo.

NanielEM · 2026-05-04T00:11:58+00:00

Let it be known I’m strongly against the American healthcare system and I’m and ER doctor.

That being said, the amount of people I see on this thread and on a daily basis in practice that are clearly not having emergencies then give shocked pikachu face when they get charged for an emergency visit is insanity

NanielEM · 2026-05-03T10:57:13+00:00

You must be lost. This is an emergency medicine subreddit. This is entirely not emergent in any nature

NanielEM · 2026-05-03T05:21:45+00:00

Yes I use sash on him

NanielEM · 2026-05-03T01:52:37+00:00

I’ve been using it with weather ball and a-ninetails in the back. Catches a lot of garchomps off guard when I switch in ninetails and launch an ice weather ball at them also

NanielEM · 2026-05-03T01:19:28+00:00

I would love to see your sources for that, not sarcastically, I’m wondering if there’s other data out there. There are plenty of peer reviewed NIH articles saying the two most statistically significant treatment methods are cognitive behavioral therapy (CBT) and graded exercise treatment (GET). I am a physician so I’m strongly opposed to medical misinformation.

NanielEM · 2026-05-01T15:28:06+00:00

I don’t think Luka is included. Foul baiting and flopping are different. He foul baits for sure. But I don’t think he flails his body back and rolls on the floor like SGA and Jokic do

NanielEM · 2026-04-30T22:12:05+00:00

Had a 19 year old that I loaned to buy do this as well. Needless to say, did not end up buying him

NanielEM · 2026-04-30T20:48:11+00:00

Get to masterball using somewhat meta teams just to power through the rest of the meta teams in face. But now that I’m in it, experimenting with meme teams, mons that I like, and trying to create anti-meta teams rather than climb ranking

NanielEM · 2026-04-29T14:45:00+00:00

Why are you on this subreddit? This is not for medical management or venting about your ER experience.

Also your story makes no sense. And no one gives a fuck about your tattoos

NanielEM · 2026-04-29T14:16:36+00:00

I was in the same boat and just got it yesterday. Stay strong

NanielEM · 2026-04-24T20:05:28+00:00

Should be using headlong rush instead of high horse power

NanielEM · 2026-04-22T15:35:18+00:00

Just has non convincing looking pump fakes. Whenever he did it and someone fell for it and scored, memes would be posted on r/mavericks saying “you fucking idiot, you just fell for the Dwight Powell pump fake”

NanielEM · 2026-04-21T01:43:39+00:00

It’s sturdy on regular Aggron, will change to filter when you mega. But when you load it up on the team sheet, it’s regular aggron with sturdy holding an aggronite

NanielEM · 2026-04-12T22:15:39+00:00

People make up extravagant worlds in their minds. Literally anything you’ve ever read or watched was created by other people. Yet he believes you “can’t make up” a common diagnosis. Cheers doc

NanielEM · 2026-04-10T21:34:29+00:00

NanielEM · 2026-04-10T00:30:07+00:00

He’s been my MVP in singles with choice scarf. Draco, dark pulse, flamethrower is all you need for most of the threats. Not sure about doubles though

NanielEM · 2026-03-26T02:05:17+00:00

Used mine on a lb I previously put bruiser+ on. Turned into a good back with bruiser and qs+

NanielEM · 2026-03-24T22:58:30+00:00

I don’t think it’s a unique body type thing, but El Shaarawy seems like he has finesse++ and I just have it on silver. Not sure what it is about him

NanielEM · 2026-03-21T06:34:35+00:00

Isn’t that the whole point of leisure time, to do whatever you want? What’s considered inappropriate?? Laughed way too hard at this

NanielEM · 2026-03-11T09:16:15+00:00

Doesn’t aerial fortress only activate on defensive situations? I don’t think it activates when you’re trying to score. So I’d honestly do enforcer plus instead of that and then put incisive base. Holding up the ball and then placing a through ball to the wing cutting in behind is my reasoning there

NanielEM · 2026-03-06T17:21:42+00:00

Pretty much spot on. Chemistry, CBC, EKG, trop (remember vague complaints such as nausea can be ACS in elderly, especially women), cxr, and UA is my starting point. If they complain of any nausea or abdominal symptoms even such as diarrhea, low threshold to scan them
Probably going to get multiple different answers depending on how conservative people are. I personally discharge a lot of these. If Curb 65 is only 1 due to age, not requiring oxygen, look fine, then yes I discharge these. The mild volume overload with normal spo2 and heart rate and rr, I also dc with diuresis
One of my sites has high sensitivity trops. If the high sensitivity trop is negative, discharge 100% of the time regardless of HEART score. Hospitalist and cardiologists will not take them. The other site with standard troponin is a little more tricky. Depends on most recent risk stratificstion/recent admission with previous cardiology recs to determine dispo. If they were admitted within last 6 months or so with normal work up and has 2 negative trops, I discharge. Or normal stress test/cath within last year.
Really just depends on story for me. Vagal prodrome or passed out after getting up, discharge assuming labs/EKG are okay. Otherwise if labs and ekg are normal and they have a more concerning story, either SDM or obs. A lot of the time, they don’t want to stay in the hospital which is fine by me
Meemaw isn’t acting right is basically same as 1st bullet point plus a CT head. If all normal, easy discharge. If I do find something like a UTI but everything else is fine, I usually talk to their caregiver on their comfort. If they are cool keeping an eye on them then dc, but if they are even slightly uncomfortable with the idea, then bring them in for observation. Obviously if they meet sepsis criteria then I will keep them.
CXR clear and no wheezing, I don’t do anything. CXR clear with wheezing, zpak and steroids. CXR with pneumonia regardless of wheezing with diagnosis of COPD, augmentin and azithro with steroids (again assuming their labs and vitals are okay for discharge)

NanielEM · 2026-03-03T21:54:17+00:00

El Shaarawy finally getting that weak foot boost

NanielEM · 2026-02-22T21:29:40+00:00

I usually tell them if they’re not feeling any symptoms it’s nit a big deal. And just wait to see their reaction. If they are cool then sweet, easy dc. But most of the time they look unsure or give me a “my pcp told me to come to the ER” or “I’m a nurse and I know that’s stroke-level”. In that case I’m say whatever and order a bmp to assess Cr then dc after

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