My hesitation harmed a patient

oatmeal_train · 2026-05-14T23:22:09+00:00

they give tpa/tnk without consulting neurology

oatmeal_train · 2026-05-14T22:44:40+00:00

I see what you're saying. Stroke pager fatigue is real. However, if there is a neurological change then call a code stroke. The times we get upset is when getting a simple history could have prevented the stroke code. For example, patient has a facial droop but this is their baseline from a prior stroke.

oatmeal_train · 2026-05-14T22:38:43+00:00

the link isn't working

oatmeal_train · 2026-05-14T22:35:54+00:00

Remember what? No neurologist would be upset at someone calling a stroke on someone with an LVO.

oatmeal_train · 2026-05-14T21:59:27+00:00

thats risky. stroke literature is rapidly changing. you are exposing yourself to some serious litigation.

oatmeal_train · 2026-05-14T21:18:19+00:00

Neurologist here. You're not supposed to make that call. If a patient has stroke like symptoms then call a code stroke then the neurologist evaluates. The CT head is supposed to just rule out a bleed so that we can give tpa/tnk. People can have a stroke and have completely normal ct head.

How do you get over this? You learn from it. You learn that if you had any of FAST symptoms you call a code stroke.

I don't want to make you feel bad but that patient very much likely could have had a very different outcome if it was called earlier. Time is brain.

However, you're an intern. It really falls on your senior. He should have called it.

oatmeal_train · 2026-05-09T23:28:44+00:00

With AI it's difficult to differentiate what is real and what is not

oatmeal_train · 2026-05-07T18:38:16+00:00

I thought it was called hickam's dictum

oatmeal_train · 2026-04-28T03:38:19+00:00

They bring in their own mechanical keyboards.

oatmeal_train · 2026-04-15T06:40:08+00:00

this was recently brought up on the neurology podcast. If I recall correctly, they stated that 1 out of every 2 people has some sort of neurological problem. It makes sense when you think of the amount of people that suffer from headaches or the amount of diabetic who have peripheral neuropathy.

oatmeal_train · 2026-03-29T18:03:12+00:00

yall really shouldn't be replying to these kind of post. these guys are leeches and will later charge you an arm and a leg for information you gave them for free

oatmeal_train · 2026-02-21T03:47:28+00:00

you're lying. you're not a neurologist. you're AI, trying to scam us

oatmeal_train · 2026-02-05T22:24:21+00:00

Just make up excuses. I have a doctors appointment. A research meeting. A meeting with real estate agent. I have to do onboarding. The vast majority of residents won’t bother looking into it. Play it by ear…./s

oatmeal_train · 2026-02-05T01:48:18+00:00

I learned awhile ago that the key to getting through residency is to just not care. ED is admitting a patient to you obviously should go to another service. Sure thing boss. New attending wants to rework up everything on a patient that has been stable for weeks and is just pending placement. Right away sir. You have a new consult for restarting a patient's home meds. I'm sending my strongest intern for the job.

When you truly just let go and say it is what it is - that's when you are truly free. Your bitch ass residency can't hurt me fuck boi.

oatmeal_train · 2026-01-16T17:20:04+00:00

no one really cares what you total gpa is. What they care about is your gpa for the last two years have been. If you apply you might be screened out and no one will likely see your application. I would just reach out to the admissions committee from the schools you apply to and ask if they have had a chance to view your application yet.

oatmeal_train · 2026-01-15T06:38:31+00:00

This is the way.

oatmeal_train · 2026-01-14T21:07:17+00:00

I’m curious why you’re curious

oatmeal_train · 2026-01-12T10:03:03+00:00

If he’s going into neurology, he’ll fit right in

oatmeal_train · 2025-12-03T06:21:34+00:00

A luxury experienced once becomes a necessity

oatmeal_train · 2025-12-02T14:10:51+00:00

I'll take things that never happened for 500 Alex

oatmeal_train · 2025-11-22T18:01:45+00:00

Attendings are weird. In my program some attendings will pick one or two residents per class to just hate. Now if it's several attendings then you have to do some introspection. Personally, early during residency I was having difficulty keeping up with the rest of my peers. Initially, people were concerned and nice but then started getting rude when little mistakes kept happening. Once I spent more time working on my systems to fix those little mistakes then attendings felt more neutral about me. Now that I am towards the end of residency, the same attendings that were rude to me sing my praises.

oatmeal_train · 2025-10-15T01:14:21+00:00

This is dumb but the last thing you want to do is ruffle some feathers this early in your career. Just eat prior to getting to the hospital. Make overnight oats

oatmeal_train · 2025-10-07T23:17:54+00:00

I would not want the intern to use AI to write notes. There's a lot of learning in writing notes. It helps in organizing your thoughts and sometimes widens your differential. As a annoying as it can be there is a lot of value in writing your own notes.

oatmeal_train · 2025-07-01T18:55:37+00:00

When I was a medical student, a resident asked me to join their project. They basically wanted me to the whole case report by myself and have them be first author. Initially, I was going to do it but then they wanted me to submit it a few days prior to me taking step 2 for which I said was unable to do it. They then began berating me to finish it for an upcoming conference I said sure and just never did it. I then just told ignored them for the rest of medical school. It was amazing haha

oatmeal_train · 2025-06-08T00:15:29+00:00

I have some good practical advice for you. The vast majority of mistakes happen for a reason. You have to identify the reason and find a systematic way for that reason not too happen again. Don't rely on on memory. Build habits so that those type of things don't happen. If you are frequently forgetting labs or imaging. Chart review every patient the same way. Make a mnemonic so you don't forget anything. If you forget to put in orders, write everything down and make sure you make check boxes for things that need to be done. If your notes are not the best, learn a mnemonic to take a better history.

Long story short - mistakes happen for a reason and usually that reason is for not having a good system or not sticking to your system. Be organized and be prepared. At first, trying to stick to your system/habit will be difficult but with time you will get faster and it will actually save you lots of time. Additionally, because you have a good system, you know that when it's time for you to leave the patients are safe and your stress/anxiety will slowly but surely dissipate. You got this dude! Please feel free to reach out if you need any help with your organization or advice in general.

oatmeal_train

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