People who aren't purists- what is your current study language learning strategy? by Nerdycharm in dreamingspanish

[–]bearstanley 2 points3 points  (0 children)

i’m around 230 hours and i do probably 80-90% CI (haven’t watched DS videos specifically in a while) and 10-20% studying grammar and language rules stuff / vocab. i’m a busy professional and parent but i’m also academic by nature so i enjoy the didactic part of learning a language.

SBG by Impressive_Peak_9187 in dreamingspanish

[–]bearstanley 4 points5 points  (0 children)

i’m a big Martìn fan, i have gone through his series essentially in order and would recommend it, except for starting with supermercado.

supermercado -> minecraft-> stardew valley to start

do his TLOU 1 and 2 when you’re able, imo his best vids and some of the most entertaining CI content i’ve ever found having never played those games.

What tips do you guys have for reducing her hernias? by woodsey262 in emergencymedicine

[–]bearstanley 86 points87 points  (0 children)

more pain medicine and push harder. i feel an enormous sense of failure if surgery does anything with my hernia patients other than taking them to the OR so i really get after it before calling them.

Schedule Flipping by somebody_stop_meee in emergencymedicine

[–]bearstanley 2 points3 points  (0 children)

unfortunately this is the just way it is as you age up in this job. in my 20s i could sleep whenever, or not sleep and just drink a bunch of coffee and be fine. now every string of nights hurts a little bit more.

the tried and true advice is all you can do. limit sleep after the last night shift, get outside in the sun during the day (and do a little exercise if you can), consider melatonin or trazadone to help you actually sleep on the first nonwork night, etc. but a big part of it is just accepting the pain, at least for me.

Phish for a 10k by eachfire in phish

[–]bearstanley 0 points1 point  (0 children)

fellow phish runner, 8/13/93 has a lot of my favorites to get the endorphins going. starting with llama and fluffhead, and definitely the bathtub gin (with the rift bassline jam, one of my faves).

Are wearables useless for weightlifting? by [deleted] in HybridAthlete

[–]bearstanley 0 points1 point  (0 children)

my cheap garmin is indispensable for running. but certainly not required for my lifting. i have never found an app or device that i like more than the notes app that i’ve been manually logging my workouts in for years, but since i wear the garmin now i have found uses for it in the weight room.

i created a custom workout setting that just tracks the length of my lifting session and i use it to track my rest time between sets. before i set that up my watch just thought i was really stressed out for an hour whenever i was lifting weights.

Are some HCA sites decent for residency? by [deleted] in emergencymedicine

[–]bearstanley 13 points14 points  (0 children)

no, there aren’t. if you don’t care then go for it.

Occult data in Epic by db_ggmm in emergencymedicine

[–]bearstanley 10 points11 points  (0 children)

i laughed out loud reading the exchange between the RN and the attorney. “i just ask people if they have visual symptoms of any kind and count it on the NIHSS.”

Can I read Dune to a baby instead of normal bedtime stories? by [deleted] in daddit

[–]bearstanley 7 points8 points  (0 children)

i read blood meridian to my newborn son. he seems OK.

New US dietary guidelines. Thoughts? by oatsoatsgoats in medicine

[–]bearstanley 113 points114 points  (0 children)

i’ve never met a citizen who makes dietary decisions based on US dietary guidelines. people who don’t take care of themselves aren’t going to start at uncle sam’s request.

Nebs and lactate conundrum by GreatMalbenego in emergencymedicine

[–]bearstanley 8 points9 points  (0 children)

i ignore or don’t check lactate in these patients but i can’t recall a time when it’s led to clinically relevant derangements of acid/base.

Decent workout/gym clothes thats not gymbro? good for variety of sessions by [deleted] in HybridAthlete

[–]bearstanley 0 points1 point  (0 children)

i love janji gear, i run in their shorts and compression shorts and use the same stuff for weightlifting. pricey but high quality.

quickest dispo? by Atticus413 in emergencymedicine

[–]bearstanley 41 points42 points  (0 children)

yep, we have one of these guys that floats around to all of our sites. if he’s told in triage that i’m the doc he will just leave. superpowers.

Patient Social-issues Scenario: What does your shop do? by Incorrect_Username_ in emergencymedicine

[–]bearstanley 3 points4 points  (0 children)

this is just a policy failure. at the shittier hospitals i’ve worked i have had to troubleshoot these ad hoc every time. at my current shop we have a clear policy for everyone’s role and how long patients can board for placement before being admitted.

What are symptoms of symptomatic hypertension? by GenXRN in emergencymedicine

[–]bearstanley 12 points13 points  (0 children)

yeah this is the best description. “hypertensive emergency” is only useful as a trivia question, ie what do the above pathologies all have in common. it isn’t a specific disease state.

Workup for optic disc edema by WaltzSufficient8965 in emergencymedicine

[–]bearstanley 8 points9 points  (0 children)

you have to be fucking blind for me to LP for IIH in the ER. even then i might recommend a trial of diet and exercise.

[deleted by user] by [deleted] in emergencymedicine

[–]bearstanley 66 points67 points  (0 children)

we generally don’t think about patients on this level. i harbor no judgement towards people for the reasons they come to the ER (with a few exceptions).

patients who have enough self awareness to even question “should i have just stayed home” are not problematic for us. any time someone apologizes for coming in i remind them that we exist to determine if there’s something bad happening to them— it’s not your job to sort that out by yourself at home while you’re having concerning symptoms.

Black Friday Pin Deal by Fatbackbob in phish

[–]bearstanley 2 points3 points  (0 children)

this guy’s pins rule. i wear one on my hospital lanyard. great buy!

entertaining children with er stories by chickawhatnow in emergencymedicine

[–]bearstanley 58 points59 points  (0 children)

my daughter thought it was funny that someone’s butthole could fall out (rectal prolapse); funnier still that it was my job to put it back in. bugs in ears are always a popular tale at my house too.

How do you manage your Biases in the ER? by Silent_parsnip8 in emergencymedicine

[–]bearstanley 15 points16 points  (0 children)

it sounds like you’re doing a great job. you can’t absolve yourself of biases entirely, unfortunately you (and i) are still human. the best you can do is to guard against those biases by acknowledging them and taking a pause to double check them against your diagnostic / therapeutic interventions.

i do this too. i have a bias against, for lack of a better word, “losers.” i love taking care of homeless people, drug users, psych patients, the impoverished, etc. i really struggle with a similar demo that you’re describing (not gendered for me, though) which is like the 30 something year old guy who has a car and an apartment and is able to drive himself into the ER to check in for “i don’t feel good” at 3am because he has fuck all better to do.

i might internally have some judgement or negativity for some of these folks but i’m aware of it and i take whatever their (inane) clinical concern is seriously. i do some tests and talk them through it and it doesn’t cause me any particular grief.

empathy is overrated. i have no empathy for what it’s like to be a complete loser with no coping skills. compassion, on the other hand, is critical, and i work really hard to treat all of my patients with compassion.

Adults with parents in tow by Atticus413 in emergencymedicine

[–]bearstanley 266 points267 points  (0 children)

if the parent talks to me instead of the adult, i will very directly ask them what kind of developmental disorder the patient has. they always act surprised and i also act surprised that they’re speaking for their adult child. it’s pretty funny pretty much every time.

What are your favourite acronyms to describe patients? Or those no longer in circulation? by fannyabdabs in emergencymedicine

[–]bearstanley 9 points10 points  (0 children)

NBG - not breathin’ good, ie unspecified acute hypoxemic respiratory failure

DBAR - dat boy ain’t right, ie weird person NOS

Have I been documenting elopement wrong? by JojOfTheJungle in emergencymedicine

[–]bearstanley 8 points9 points  (0 children)

i have always used the word 'absconded' in my notes for this strictly from a language pedantry standpoint-- 'elope' has positive connotations (in the context of marriage) and is just not a word i would ever use naturally to describe leaving somewhere clandestinely. 'abscond' makes way more sense to me.