Saturday, August 11, 2007


Not much new here. I am currently procrastinating studying and residency-applicationing by internet surfing. I came across a real gem: a fish empathy quilt. It looks like something I would make as a joke, but these people are actually serious. I was cracking up looking at it--I found the square that used "WWJD" to imply that Jesus would not "torture" fish to be especially intriguing, particularly considering the fact that Jesus' best friends were fishermen. Idiots. If you're going to argue a ridiculous position, at least use arguments that support your position rather than destroy it. While I found the whole thing amusing, it also really ticks me off that there is so much human suffering and immorality in the world, but rather than address that, these buffoons spend there time making "empathy quilts" for fish! Get a life!

To further procrastinate, last Tuesday while I was in radiology, staring at mammograms for hours on end, with nothing more than a far-too-small-cup of coffee to sustain me through the crushing dullness, I thought to myself: "At least this is better than rounding." A small comfort, but a comfort nonetheless until I remembered that I will be on nephrology next month and have been warned that the nephrologists here love rounding like most people love hot fudge sundaes. Brought down by thoughts of portending doom, I decided to express my feelings in a poem--a poem of the modern variety since I do not like modern poems thus feel a modern poem will express my disgust with rounding more effectively than a rhyming poem with syntax and meter. I'm actually making it up as I type, so I'm not sure how it will turn out--I just know that I will die at the end with a small hint of irony.

Death by Rounding:
Rounding, rounding. Pre-rounding, team rounding, attending rounding.
I think I will die.
I have been in the patient's room for fifteen minutes that seem like an eternity
Nothing is being done
I have long since ceased to hear words and now only hear a humming sound
From the attending's perpetually moving lips
Annoying, yet strangely sleep-inducing
I am drifting off the hospital whirls around me
I think I will die.
Left the room the attending turns to me
His lips move but I can't make out the words
It is a question but I don't know what
I don't know I say in a false cheerful voice but I'll look it up and get back to you tomorrow
Knowing full well that tomorrow I'll be dead. Dead from rounding.
We move on to the next room five hours down and still ten rooms to go
I muse to myself and wish Dante were alive now
The Inferno would have turned out differently
A new circle of hell probably between the sixth and seventh maybe six and three quarters
Would be rounding always rounding
I think I will die.
Ten fifteen forty-three minutes we start to leave the room and the patient asks a question
The same she has asked for three days in a row and gotten the same twenty minute answer
Every Time
I feel it now
Like a dark black cloud settling over my brain
My vision dims
The outline of white coated residents darkens
They become a row of shadowy specters watching me silently
They see death and respect it
The window is the only light object left and I feel myself moving towards it
As my body collapses to the floor like a scarecrow knocked off its pole
By the wind
With my last breath I hear the team and strangely the patient debating
Is the proper terminology
Death by roundosis or hyperroundosis?


Anonymous Alice said...

That is good, Chris. Funny, and a carrying rhythm to it as well. Hyperroundosis, lol!

5:07 PM  
Anonymous Anonymous said...

It doesn't sound like IM or radiology will be your ultimate destination. Do you have a specialty that does cause your heart to beat a little faster? I see you are applying for residencies, so you must have decided something.

Medicine services in teaching hospitals round. That's what they do. On a non-teaching service, a private practice service, rounding is quite different. The problems encountered are generally repetitive and predictable and not too dificult, since you deal with them every day. Rounds go much more quickly.

So take heart. Medicine in the real world is rewarding!


PS Why did you take nephrology if you don't like rounding?

9:12 PM  
Blogger Chris Emlyn said...


I'll be applying (hopefully accepted!) to general surgery with the eventual goal of going into private practice. Now that 70% of surgery graduates are going on to fellowships, I imagine that I will specialize in something--maybe colorectal or laparoscopic, but I haven't had nearly enough experience yet to know where my interests lie.

I worked with some private practice med/peds doctors last year, and was happy to find that their rounds were as you said much more efficient that those of academic doctors! My advisor, a trauma surgeon, recommended taking nephrology to get a good grasp of acid/base status--and despite my dislike of rounding, I can't deny that I do learn a lot, and since that is the purpose of my being in school, I put up with it:).

7:26 AM  
Anonymous Anonymous said...


General surgery is exciting. It is a mix of mostly GI/abdominal surgery with breast surgery being a big part of it. Many older general surgeons also do thyroid, gynecology (including vaginal hysterectomies and AP repairs), lung, some orthopedic and some GU. You sleep more at night than an OB doc. You live off referrals and do not do continuing care, such as annual exams, peds, IM things. If you eventually settle in a smaller community, having a wide range of operations you can accomplish will serve you well.

I have heard that some surgery residencies are competitive and difficult, although that may no longer be the case.

In my experience, general surgery attracts more than its share of ego-maniac primadonnas. It's easy to immitate them when you work with them every day, but don't. I expect you are mature enough to know kind behavior is always in order and there is never an excuse for sarcastic behavior which would belittle or demean any member of the health care team. Having been through a residency, I am now quite disappointed at my own behavior when I finished the program. How I referred to patients, my workload, the hospital and staff was often less than positive or kind, to my shame.

Got to go. I enjoy your blog.

Matt Anderson

10:50 AM  

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