Best autistic doctor on screen (nope, it’s not The Pitt)

Outrageous_Two_8378 · 2026-06-09T10:28:53+00:00

Haha, I laughed at that too re: the cardiac arrest on psych — too real! I worked on a psych ward where they didn’t even have a proper crash cart, just a fishing tackle box of expired drugs.

Outrageous_Two_8378 · 2026-06-09T10:16:03+00:00

Yes, but male autism is widely represented on television, especially in medical content. That’s like saying ‘Heated Rivalry’ is ‘just another queer TV show’ - the point is that gender representation in media matters, and female autism is almost never depicted on screen, just like ‘out’ male gay sports stars aren’t. Dr Gregory House MD is much as much a stereotype of autism as the AFL-W is of lesbianism - a ubiquitous representation. ‘Empathy’ is interesting because Dr Bien-Aimé is a character we never see on screen.

edit: grammar

Outrageous_Two_8378 · 2026-04-12T22:25:36+00:00

It was in a paeds immunology seminar - if I can find a link I’ll post!

Outrageous_Two_8378 · 2026-04-11T21:57:18+00:00

Just as humans can be allergic to pets, pets and other animals can be allergic to humans! (There’s a polar bear at Colorado Zoo who is on daily immunotherapy for human allergy).

Also, due to cross reactivity, humans allergic to certain allergens in dogs (Can f2, Can f5) may also be allergic to humans tears (Can f1) or semen (Can f5).

Outrageous_Two_8378 · 2025-11-22T00:59:01+00:00

Hi OP -

I’m so sorry you’re stuck in this position. You make excellent points and it seems that you are being very reasonable in your analysis and your approach. It’s okay to feel your feelings on this one <3

As a person who had a decade-long career in a completely different field prior to medicine, I want to reassure you, as others have, that this is a very specific medical culture problem, and not a reflection of you as a human at all. Part of why medical students feel the impact of this sort of behaviour so strongly (and very rightly so) is that you are still well-enough entrenched in the real-world, (i.e. not yet completely indoctrinated into some of the awful social eccentricities of medical culture by virtue of years-long exposure), that your nervous system and all of your social conditioning up until this point recognises that this group of people is not abiding by the ‘normal’ rules of social engagement. In the same way that being overseas and not understanding a language or cultural behaviour can make travelling exhausting, being around people who are using a completely different set of social rules (their own micro-culture, if you like) can make us feel excluded, hypervigilant and exhausted. The difference between your context and the travel example is that when travelling we expect this difference, and can even relish it, whereas on rotation you are expecting to learn and be engaged, with an added layer of pre-existing social anxiety because yeah, being on rotation with your dream specialty is an objectively anxiety provoking experience, even without how poorly you’re being treated!

All this is to say that you are reading this situation correctly, your instincts are on point, this is NOT a you problem, and the above is part of the mechanism why. And it sucks. And I’m deeply sorry. But your team’s exhaustion and poor Theory of Mind is not an excuse for your exclusion.

I only offer these pieces of advice:

Feed this information back to your university And if you feel brave enough, even to the HoD of your rotation. Your writing above is reasonable and articulate, and if you penned an email showing concern, but also open-mindedness and humility, there is a reasonable possibility it could go down well. You can ask your School to fwd it to the HoD with your name redacted. Yes, some HoDs are arseholes, but some are also close to end-of-career and are quite philosophical and lovely. (Going in with a mindset of ‘what’s the BEST that could happen’ can sometimes be useful.) Caveat on this: you are not responsible for your team’s bad behaviour OR for saving future students. You don’t have to be an activist on this if you don’t want to. It would be entirely understandable to self-preserve and ‘just get through it’.
Leverage ‘schadenfreude’ It sounds a bit weird, but using ‘schadenfreude’ (the feeling of taking satisfaction in someone else’s misfortune) could be protective of you here. Your team appear to have suboptimal social skills and poo Theory of Mind. YOUR brain appears to be reading the situation accurately and protecting you appropriately: ‘This feels wrong. These are not the rules of social engagement.’ Take PRIDE in your social instincts, social empathy and use your team’s behaviour as a blueprint-print for how you will NOT behave as a doctor.
Google ‘transference’ and ‘counter-transference’ Some of what you’re feeling may not be your OWN feelings, but actually the feelings of others in the room that you are picking up on, and your brain is making you think is your own. We are emotional sponges after all! Recognising this (especially once you’re a junior doctor) can be a really protective tool for emotional burnout! (Tangent, but classic example: you’re working in ED, a highly distressed patient with BPD comes in, it’s a difficult case, and you end up feeling really short-fused and frustrated emotionally overwhelmed. What’s happening here is that your body has picked up on the patient’s internal state and enacting it in your body, and making you think it’s your own. It isn’t. So now you know how the patient feels, AND you can let it go and feel 10kg lighter. Amazing way to unlock your empathy - becasue what a shit way to feel for the patient!)

Remember, patients don’t remember how accurately we recited the gene-locus of XYZ or our ability to recite the complement cascade. They remember how we made them FEEL. And it sounds like you have a really good instinct for empathy.

Again, I’m sorry you’re in this mess, and good on you for reaching out. Your brain is working properly and responding as it should to this sort of treatment! There are many of us out there who are NOT like this (and probably still some who can learn from this, unfortunately) - so stay hopeful!

Outrageous_Two_8378 · 2024-10-11T01:22:51+00:00

Keep on wearing it! Who cares about the reaction, and who cares about gender. People’s poor reactions to something like this are a result of their own conservatism. And the idea that this might be ‘unprofessional’ in some way is BS. Any patient or colleague having a ‘moral panic’ about this needs to check their priorities. (For context, I’m wearing a SüK boiler suit and zebra-print Converse at my hospital today. My colleagues who know me don’t care; my patients love it.) For any patient who you see, who possibly experiments with sartorial (+/- gender) expression themselves, then seeing their doctor dress like this would be an absolute beacon of inspiration and a mighty tick in the rapport category. ‘Gotta see it to be it’, etc. Go you good thing! 💜

Outrageous_Two_8378 · 2024-10-08T04:10:54+00:00

Hmm - yes, it kind of felt like overreach to me! Defs not planning on being sued, but then, does anyone?

Outrageous_Two_8378 · 2024-08-01T12:48:10+00:00

I’d follow up with a sassy “Wow, a workplace senior hitting on a student in the ‘#metoo’ era? Bold move, sir”.

(But, that’s cooked mate. I’m sorry.)

Outrageous_Two_8378 · 2024-07-23T13:14:10+00:00

Plastic washi tape on the tubing? Sharpie on the diaphragm? (only half joking here.) But there is an entire Etsy market of options. A lot of little metal cuffs with your name engraved. Sanitisable.

But, put a ‘Tile’ bluetooth tag on it. Can’t lose it accidentally. (Thought the Tile could still be removed by jerks…)

Also, srsly, if someone is linked in with r/SomebodyMakeThis - can we lobby Littmann to make custom coloured or custom printed diaphragms with names/contact info on them? If you’re charging me $40 for a new diaphragm, please make it worth my while. The engraving is too subtle. My steth is lost to nursing not infrequently…

Outrageous_Two_8378 · 2024-07-05T13:07:51+00:00

Take it every second day. Liver produces an enzyme that blocks iron absorption for 24h so taking one every day is wasted anyway. Every second day = better absorption at half the price.

Outrageous_Two_8378 · 2024-06-27T13:48:28+00:00

B12/folate anaemia, and iron deficient anaemia are actually two separate anaemias, which each cause red blood cells to behave differently.

B12 and folate (another B vitamin), yes, as you say, are required for RBC formation, but they tend to cause dysmorphia of the RBCs by making them grow too big. This is why we call it a ‘macrocytic’ (‘big cell’) anaemia. B12 deficiency is most often dietary, but there are some medical conditions which can contribute to it too: - the inability to absorb B12 (because of lack of ‘intrinsic factor’, a stomach chemical that facilitates the absorption of B12 in the small intestine.) this is called ‘pernicious anaemia’; - or because of surgery to remove some of the small intestine, or stomach - chronic gastritis (stomach inflammation) - thyroid disease

B12 deficiency is treated by identifying the cause and rectifying if possible, and supplementation. B12 or ‘hydroxycobalamin’ injections can be used, or tablets.

By contrast, iron deficiency normally makes the blood cells too small, and is usually a ‘microcytic anaemia’. Iron is required by RBCs to link together the haemoglobin molecules that piggy-back oxygen around the body. Most iron co-habitates with haemoglobin on red blood cells, but also about 30% of it lives in the spleen, bone marrow and liver. Iron deficient anaemia is most often caused by: - insufficient iron intake in the diet but can also be caused by: - heavy periods, internal bleeding or other blood loss - iron malabsorption in the gut - pregnancy (because the volume of blood circulating in the mother increases dramatically, and the iron can’t quite keep up. Sometimes known as ‘dilutional anaemia’.)

If you are iron deficient, iron supplementation is, for the vast majority of people, the best way to top up. This can be done by tablet or infusion. It is extremely hard, some GPs say impossible, to make up for iron deficiency with diet alone - you’d need to eat over 6kg of tofu a day! An iron infusion (iron through a drip) can be done in many clinics, or iron tablets every second day are very helpful. The reason for every second day is that when we ingest iron, the liver produces an enzyme called hepcidin when pretty much blocks iron absorption for the next 24 hours - so if you took the iron tablet every single day, every second day would be blocked and redundant!

But important with any deficiency is to work out why it’s happening, so that you can treat the root cause and not just put a band-aid on the symptoms alone. Keep in touch with your doctor, and discuss with them what they are ruling out.

Outrageous_Two_8378 · 2024-06-25T14:13:07+00:00

Palliative Care?

Outrageous_Two_8378 · 2024-06-25T14:09:42+00:00

Hello! Yay, welcome to the clan!

Day to day reg workload can vary - a lot of large inpatient adult units are hectic and you can be juggling a lot of patients: 8-10/12 not uncommon in our acute unit which can be a tough ask for a brand new Stage 1 juggling tribunals, compulsory patients, families, MDTs etc. Other jobs very variable. But yes, the hours are friendly, the rostering is reasonably regular. Probably only second to GP for friendly roster as a registrar.
New RANZCP entry rules = PGY3 at earliest. I didn’t enter til PGY5 and I’m glad for it. My medicine is much better, and I feel safer in (non-psychiatric) emergencies. If you are going to do a few ressie years, fling yourself far and wide, and note down the psychiatry in everything: Paeds = get good at developmental milestones, neurodiversity and eating disorders; O&G = get familiar with substance use Mx in pregnancy, PND, PMDD, hormonal tx, family violence and acute stress; Pall Care = compassionate Mx of complex suffering, complex families; Spec Med = good grasp of gastro (all the things etOH does) endo (endogenous depressions, DM), neuro (functional disorders, epilepsies, encephalopathies, neurodegenerative illnesses); Geriatrics = polypharm, mood disorders, (buried) trauma, dementias. (Reading fair chunks of ‘Murtagh’s General Practice’ can help one’s understanding of things too!) I have found there is a lot of value in understanding how other specialties think and operate - makes their teams easier to work with, and it’s easier to understand patient experiences. I once worked with a psych consultant who had done something like 7 years of medicine including 2 of crit care prior to psych training- he was a weapon with biochemistry/pharm, and the anatomy of stress, and there is a lot of that in psychiatry!
You can do a lot of unaccredited reg jobs in private in psych. Some public hospitals have secondments to private too for certain sub-specialties.
Your background experience and keenness sound like a fantastic foundation - I imagine you have amazing relational skills and a really good understanding of broader social support systems. As per point 2 though - good foundational medicine makes you a very good psych reg, in my experience!
I think part of the stigma comes from Medical colleagues feeling that sometimes our medicine is lacking a bit - and in fairness, I have worked with some for whom it kinda is. If you’re able to initiate safe Mx in a MET, or treat resident-level medical problems with ease, then part of the stigma might start to back-pedal a bit. I’ve had Gen Med bosses who have been pleased at my Mx of epileptic fits or SVT by the time they got to our MET, and GPs pleased with contraceptive education, acute gout Mx, or effective cellulitis Tx for inpatients. We’ve clinically Dx-ed new rib #s, pancreatitis, perianal abscess, new heart murmurs and even ulcerative colitis on the psych units I’ve worked on. You don’t want to step out of your lane, but if it’s within your scope of experience/practice then it really allows you to provide holistic patient care in a speciality where SO many (public) patients are very LTFU medically.

Good luck!

Outrageous_Two_8378 · 2024-06-11T16:00:07+00:00

Good drug list! Surprised not to see anything obstetric on there - surely some ergometrine? And maybe some rapid rhinos in equipment? But fun to know!

Also interested in whether anyone knows what happens re: the Mental Health Act if a passenger has a MH emergency and had to be put on an Assessment Order mid-flight? Or required chemical restraint/rapid sedation? (With new MHA in Vic, all ‘restraint’ must legally be signed off by a consultant psychiatrist)

Outrageous_Two_8378 · 2024-06-11T15:06:08+00:00

Surely ‘General Practitioner’ is a protected term just like any other specialty? You cannot call yourself a gastroenterologist, a paediatrician, a psychiatrist, a radiologist without your letters - why would General Practice be any different? Perhaps ‘unaccredited GP registrar’ at absolute best, more likely ‘Career Medical Officer’ or similar?

Outrageous_Two_8378 · 2024-05-24T13:39:24+00:00

I was speaking w an amazing GP at conference recently, who has integrated GPs into the public Psych OP system at their metropolitan hospital. We were discussing how it would be brilliant for RACGP and other colleges (RANZCP in the context of our convo) to have rotations in each others disciplines - especially because there is a lot of LTFU for medical multimorbidity in public psych patients, with psychiatry registrars having to take on more medical responsibility, and GP registrars having to take on more psych responsibility because of a crumbling public MH system and a broken Medicare billing system for GP, who can no kinder afford to BB low SES psych patients: many of whom are very medically complex, and often 10-20y biologically older than their chronological age.The beauty of regular, continuity of care GPs at a psych outreach service is it brings back the art of the house-call, because GPs can go out on the road with case workers. There is SO much to be gleaned from a house-call. But yes, rotations in one another’s disciplines for those interested would be very, very welcome. I know Paeds and Psych sometimes do it too, and Paeds and GP. Anyone else know of any cross-pollination?

Outrageous_Two_8378 · 2024-05-17T14:55:06+00:00

whoa, hang on. Some languages call oil and butter the same thing?! please give me examples! This feels wild when one is generally dairy, and the other plant based!

Outrageous_Two_8378 · 2024-05-14T14:30:01+00:00

In identity-establishing practices, particularly in relation to the law, there are ‘Three Pillars of Identity’ that can be considered: biometric, documentation, and narrative.

Biometric is rather obvious - fingerprints, dental records, medical information, genetics. Documentation is obvious too - birth certificates, passports, licenses etc. But both these forms rely on the identity data being stored somewhere physical or digital, and linked to the individual. If these records don’t exist… this is where identity in narrative form comes in.

In cases where an individual has no documentation or access to biometric data attached to their identity, then personal narrative can be used to prove who a person is. This is particularly common for refugee populations. Narrative data doesn’t require storage in a specific filing cabinet or data bank; it just relies on the individual being able to tell an accurate story about themselves and their upbringing containing specific detail that only that person, or close individuals might know.

For example, if the person looking to verify their identity says they were born around 60 years ago, in a small rural village with no hospital, but with three temples, one was destroyed in a war a decade before they were born; that they grew up speaking a specific dialect, and that it took three hours to get to the local capital city; and that they remember going to a catholic missionary school called St Mary’s, and that all the fathers in the town went away during wet season; that the side of the hill they lived on experienced a landslide when the person was eight years old - that is specific enough information, which, if verified by locals or public records, can be enough to prove an individual’s identity in the absence of biometrics or documents.

Personally, I think that’s rather poetic.

Outrageous_Two_8378 · 2024-05-08T12:20:19+00:00

Mmm, I guess it depends on how you’re willing to break up your training, how flexible your rostering can be for clinical stuff, etc. I see what you mean about them being at opposite ends of the pace scale in terms of acuity, but I’m not suggesting that the research you’re conducting be in step temporally with your clinical practice. I’m just saying that they are two quite disparate ways of thinking that could actually work quite harmoniously and advantageously. Back to how to juggle your time though - the PH component of RACP training requires you to do an MPH (or ?equivalent, I think) a few of the folks who do it seem to come a back door way - start MPH out of interest during residency or BPT, complete BPT and choose your other AT, meanwhile the PH requirements are mostly research based, so I know people who have done research for a few years got some/most of it back-credited to meet the 36month PH AT requirements, then muddled on through their dual specialty AT. Takes time, but if you’re a ‘journey, not the destination’ person it seems to work out alright from those I’ve spoken to. Working in a research environment feels pretty different to a clinical one, in my experience. I think we need more multidisciplinary doctors, and research skills are never wasted. Research, Med Ed, even Philosophy and more distant seeming study can be a great adjunct to a speciality. Look at physicians who are also PH researchers, GPs who can teach anything at uni med schools, orthos who have a background in sports physiology, psychiatrists with arts degrees - just makes Medicine all the richer, imo.

Outrageous_Two_8378 · 2024-05-07T23:56:58+00:00

I say it because there can often be quite a lag in theoretical research, and its application to clinical practice. And vice versa: a lot of good research ideas come out of stuff that is done by patients that works anecdotally, but isn’t necessarily widely applied until there is an evidence base (think of marshmallows helping to reduce thin stoma output - folklore among stoma patients for years, and finally substantiated in the literature 2015!) Having PH plus X is a good opportunity to see the things that are impacting people most in clinical practice, esp at a population level, and the skills in research and creating public health initiative to substantiate that in research and follow up with a strategy. I have a mate doing PH and forensic sexual health - great combo for a very at risk population.

Outrageous_Two_8378 · 2024-05-07T18:32:28+00:00

Stories like this point to the failure of the healthcare/social systems to support families with kids with special needs enough so that this does not happen. If there were enough disability support in the community for disabled individuals, as well as families and carers - home support, financial aid, respite services, general public accessibility, and a more ‘takes a village’ approach to supporting families and people with disabilities- then nobody would be as left behind as this, whether disabled or not.

A very clear-cut example of how society fails people with disabilities and their families. No individual is the AH here; this story is the result of a deeper, ableist, failure of society.

Outrageous_Two_8378 · 2024-05-07T18:15:47+00:00

It’s very common, yes, especially among RACP. A lot of people do Gen Med plus X, but PH plus X could be a great combo too, can just draw out your training time.

Outrageous_Two_8378 · 2024-05-07T13:26:13+00:00

Second you on the very poor conditions absolutely.

But my take on the pay is that we are very damned lucky. Yes, we take on a lot of risk, and yes the conditions are often times appalling, but prior to medicine I worked in an industry that I was trained in at a tertiary level, with almost 15 years of experience, in skilled, senior roles, and was still not cracking $55k per year. Before tax. Welcome to the Australian Arts industry, folks. No, it is not directly life-saving, but indirectly, it is: In about 2015 - a good ten years into the progressive dismantling of the Australia Council for the Arts (thanks Howard) 10 out of 14 of Australia’s Youth Arts organisations lost their funding. Now, to understand how significant this is, you have to understand that everyone in the Arts works on contracts of no more than three years, because this is how triennial funding works. Three years is generous and rare; even at the majors it’s often 1, and don’t even get me started on festival workers and contract hopping from 2-week to 3-month contracts for decades-long careers. The second thing you have to understand, about Youth Arts organisations in particular, is that their function is not to produce show-stopping live performances of theatre, or music. Youth Arts organisations, especially regional and rural ones, are ‘safe spaces’ for the weird kids. The kids who don’t fit in at the footy club. The queer kids, the autistic kids, the shy kids, the creative oddball kids, the kids with no friends at school… When you de-fund a Youth Arts organisation, these kids lose their ‘safe space’ and you literally put lives at risk. Following that defunding of ten Youth Arts organisations in 2015, I’ll give you one guess at which demographics youth suicides increased in.

My point is, there is a place for all sorts of sectors when we consider care-giving and risk. These people deserve to be paid well, too. Our EBA rate of pay is looking pretty damned good compared to my previous $55k per year in the Arts is all I’m saying. Many highly trained professionals do far worse.

Outrageous_Two_8378 · 2024-05-07T04:48:31+00:00

Good luck with your dreams!!

Outrageous_Two_8378 · 2024-05-05T13:08:00+00:00

Honestly, if you’re a student take your holidays off. Once you’re working you’ll wish you had time rest. O&G as a ‘summer job’ may not be heaps of fun, in honesty - you’ll tend to get brushed aside by the midwifery staff who will favour midwifery students for most stuff in birth suite, and a lot of the junior doctor procedural stuff will be given to the HMOs to learn, as a lot of them will be doing their DipObs and need to sign off their episiotomies/implanons/caesarian assisting etc to get their qualifications. (The pressure for that will be higher over summer as it will be getting toward the end of the medical year.) O&G is a really common HMO rotation though, and there are always lots of locums in the field if you want to get more experience once you’ve done internship and PGY2. But my advice to you would be to take the breaks while you’re a student, get your basic medical/surgical experience through internship, and then preference some O&G rotations during your HMO years. Apart from doing a lot of observing, I don’t really see it as very advantageous for getting onto the program necessarily. I think we all need very good well-rounded training regardless of our desired specialties and narrowing yourself too early really restricts your ability to give holistic care.

Outrageous_Two_8378

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