After finishing my first elective in a medicine subspecialty, I'm pretty sure I never want to specialize in any one organ. Doing just lungs or just anything everyday seems really monotonous to me.
My other takeaway is that, while surgeons often ignore patients on purpose, medical doctors can still ignore patients accidentally. One of my attendings this week had a habit of thinking out loud to the rest of the team while standing over the patient - not a bad thing necessarily. But then he would occasionally keep thinking out loud and just wander out of the room without ever summarizing or saying goodbye to the patient. I started to lag behind to quickly translate to the patient what I thought was going on. To my classmates: please don't pick up this habit. It makes otherwise kind and considerate doctors seem like assholes.
MIL: Sickle cell disease can increase reticulocyte (immature red blood cell) levels which can be mistaken for white blood cells (WBCs). Leukocytosis (high levels of WBCs) indicates inflammation, usually caused by infection, so these patients can be needlessly worked-up or treated for an infection they don't have, if you don't think about this common lab test error.
TuIL: A cheap treatment for sleep apnea is having the patient wear a shirt with a breast pocket backwards and put a tennis ball in the pocket. This way, the patient can't lie flat on their back, which is one of the ways to stop the airway from collapsing in sleep apnea.
WIL: The PaO2/FiO2 ratio is the ratio of the pressure pf oxygen in the arteries to the oxygen content of the inspired air. It is a simple way to estimate lung function and used to categorize the level of adult respiratory distress syndrome (ARDS).
ThIL: Telephone standardized patient encounters are weird but not as scary as people tend to think. Most of our practice patient encounters are in person, talking to and examining an actor. But part of our board exam that I take this summer includes telephone interactions, where you enter an examination room and call an actor in another room. Usually this is one of the ways that they test students' proficiency in patient care related to pediatrics, as having child actors would be problematic.
FIL: Extracorporeal membrane oxygenation (ECMO) is an attempt to make for the lungs what dialysis is for the kidneys. It is essentially a less-than-fantastic artificial lung that is sometimes used in ICUs when a patient's heart and lungs aren't doing a good enough job at oxygenating blood.
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