medical

What Skinny Doctors Don’t Get About Their Obese Patients

by

Let’s just keep talking about treating obesity

Fifi Trixiebell (not her real name) wrote to [email protected] asking us to discuss what medical students learn about nutrition, and whether they think the keto diet is just another fad. Luckily, Madeline Slater, Emma Barr, Kyle Kinder, and newbie Sam Palmer–M1s all–just had a unit on nutrition so that’s an easy one. But Fifi Trixiebell had written in before, a message which–despite his policy of answering every listener question–Dave had passed over. Why did he ignore it? He’s not sure; it was a while back, but it may have triggered him (though, to be clear, it wasn’t Fifi’s fault). We also discuss an article from HuffPo about the “unique and persistent trauma” doctors visit upon their obese patients.

Read more

Play

Podcast: Play in new window | Download

Are physicians hopeless in the face of the obesity epidemic?

by

Obesity may not be hopeless, but it is very difficult for physicians and sufferers

Listener Hannah wrote in after shadowing physicians, noting that many of the morbidly obese patients she observed resisted their doctors’ advice to lose weight. Is there any hope that doctors can treat this intractable illness when patients don’t “want” to do the work? Aline Sandouk, Claire Casteneda, Kylie Miller, and newbie Ali Hassan offer their views and what they’ve learned so far about treating this difficult disease.

Read more

Play

Podcast: Play in new window | Download

How would you manage this acute abdominal pain?

by

A 24-year-old sexually active female presents with a three-day history of severe right upper quadrant pain that worsens on inhalation. She has a history of multiple sexual partners and does not use contraception. Examination reveals marked tenderness in the right upper quadrant and laparoscopy demonstrates the findings seen here. Based on this patient’s diagnosis, what treatment would address the most likely underlying infection?

Read more

Handling Sexual Harassment as a Medical Student

by
sexual harassment as a medical student

Changing dressings on diabetic ulcers is not particularly pleasant. The oozing, the meticulousness of laying down protective layers, and the smell make the task less than ideal for even the strongest stomach. There I was as a 3rd year medical student, working with the resident team for well over an hour assembling the dressings on the patient’s legs to apply a wound vac. To make matters even worse and more uncomfortable, the patient continued to make sexual remarks about me. I kept quiet and finished the job with the rest of the team. In fact, even when we were done, no one mentioned the inappropriateness of the patient. It just went unsaid that this is something that is encountered frequently, and I continued to see the same patient on daily rounds.

Read more

Why is this urine bag purple?

by

An 80-year-old female with a history of diabetes and chronic constipation presents to the emergency department with a purple urine bag. She is currently bedridden and uses an indwelling catheter. On examination, she is hypotensive and confused. Blood cultures are positive for Proteus vulgaris. Based on this patient’s presentation, which of the following antibiotics should be commenced?

Read more