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Things I've noticed while visiting the ICU

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Re: Things I've noticed while visiting the ICU

#171

Post by tomcam »

parker_mountain wrote: post #3
tomcam wrote: post #2

Very well thought out article, but I promise your life will improve if all you do is read the caption on the first image.

This is not a picture of a real hospital. This is a picture of Mystic Falls hospital, from the CW show “The Vampire Diaries”. If I remember correctly, the guy on the left is an evil vampire hunter (the vampires in the show are mostly heroes, except when they’re evil and trying to take over the world), and the doctor on the right is maybe a vampire? Or she might just be friends with a vampire but not realize it. Or sh…

Thank you

Re: Things I've noticed while visiting the ICU

#172

Post by dogmatism »

lofatdairy wrote: post #147
j-bos wrote: post #113

Earlier quoted context omitted.

I personally want my doctors to be amazing and very good. For now tests are a fair proxy, it's the 8 years that seem ridiculous, esp when looking at non US countries.

I would argue that having onerous tests are not a great proxy. Not only do they not necessarily measure how good a physician a student would be, but it also encourages undergraduates to intentionally enter easier/less rigorous coursework to focus more on the exam aspect (though GPA plays a large role as well). I'm sure a psych major may make a fine physician, but I don't want doctors to only be educated in a rather d…

Nah, doesn't matter. There are still the pre-med requirements (organic chem etc -- recall recent bruhaha about that at ?NYU) that can't be sidestepped for easier courses

Re: Things I've noticed while visiting the ICU

#173

Post by prenevikdale »

jlarocco wrote: post #148

> The ICU is filled with old people. What else would you expect? Health deteriorates as people age, so old people, having deteriorated for a longer amount of time, will generally need more health care. Good insights overall, though.

I actually thought the article was narcissistic and shallow, and I didn't find the author to have anywhere near the experiences or qualifications to make the judgments in his article. The contributions in this thread have been orders of magnitude more interesting than the OP.

Re: Things I've noticed while visiting the ICU

#174

Post by oaktrout »

kudu wrote: post #128
maxerickson wrote: post #13

The solution to difficulty booking doctors isn't to pontificate on how to allocate their time, the solution to difficulty booking doctors is to make more doctors. There's lots of levers that could be pulled in the US. Cut down on undergraduate requirements, incentivize large health systems to fund more training (people like to complain that the federal government only funds a fixed number of residency slots, as if a…

> people like to complain that the federal government only funds a fixed number of residency slots, as if a trillion dollar industry is just absolutely helpless to do anything Agreed, but I would go further and say that if demand by students for the training provided by residency exceeds the demand by hospitals for the work provided by residents, I don't see why residents couldn't pay for their training just as they…

If you've spent on average ~200K for medical school, how willing will you be to pay to work for 3 to 8 more years before you get a paycheck? Resident doctors already make less than nurses with 4 year undergraduate degrees.

Re: Things I've noticed while visiting the ICU

#175

Post by intelVISA »

chromatin wrote: post #154
maxerickson wrote: post #13

The solution to difficulty booking doctors isn't to pontificate on how to allocate their time, the solution to difficulty booking doctors is to make more doctors. There's lots of levers that could be pulled in the US. Cut down on undergraduate requirements, incentivize large health systems to fund more training (people like to complain that the federal government only funds a fixed number of residency slots, as if a…

Although I agree with you on a distaste for the foolishness of central planning, lLet me provide an alternative perspective. A huge proportion of US physicians are already mediocre; a shocking number are bad. (Source: I am a physician.) Given this, I am concerned that further relaxation of standards in an effort to train more doctors won't lead to better outcomes.

"But I want my doc to have a degree from medical school not some 3 month anatomy bootcamp..."

Re: Things I've noticed while visiting the ICU

#176

Post by jmcgough »

lofatdairy wrote: post #147
j-bos wrote: post #113

Earlier quoted context omitted.

I personally want my doctors to be amazing and very good. For now tests are a fair proxy, it's the 8 years that seem ridiculous, esp when looking at non US countries.

I would argue that having onerous tests are not a great proxy. Not only do they not necessarily measure how good a physician a student would be, but it also encourages undergraduates to intentionally enter easier/less rigorous coursework to focus more on the exam aspect (though GPA plays a large role as well). I'm sure a psych major may make a fine physician, but I don't want doctors to only be educated in a rather d…

Everyone takes the same premed courses though, and you need to be able to teach yourself any MCAT content that wasn't covered by coursework. Sure people will game it, but it's your science GPA that counts, and having people from a diversity of backgrounds is a good thing.

Re: Things I've noticed while visiting the ICU

#177

Post by jmcgough »

Fatnino wrote: post #15
georgeg23 wrote: post #9

The hallucinations sound like a side effect from lorazepam (Ativan) -- something hospitals give almost everyone but is a hardcore drug. Consider asking nurses to stop administering it after you do your own research. https://www.webmd.com/drugs/2/drug-6685/ativan-oral/details#... ).

I went to the hospital for debilitating shoulder pain. Came out 3 hours later with an xray that showed nothing wrong and a bottle of Ativan. Still no idea why they gave that to me. I didn't take any of the pills. And the bill came out to over 7 thousand dollars.

Probably assumed it was somatoform

Re: Things I've noticed while visiting the ICU

#178

Post by pgrote »

I spent 2 weeks in an ICU due to an appendectomy gone wrong followed by growing open wound and infection. Horrible time from a mental health perspective with visual and auditory hallucinations, feeling of paranoia concerning the medical team and nightmares. Hallucinations and paranoia stopped before I was discharged, but it took a couple of years for the nightmares to subside.

Post-intensive care syndrome is something that happens that hardly anyone who hasn't been in an ICU knows about. Even when I was in the ICU the medical team never discussed it with me. My running joke to deal with what happened is that I aged 10 years the 2 weeks I spent there.

Re: Things I've noticed while visiting the ICU

#179

Post by Fomite »

coryrc wrote: post #160
croes wrote: post #53

Earlier quoted context omitted.

Where do you draw the line? At what age, what illness do you refuse to treat a patient even though he may not want to die? You could give a lot of people medical treatment with a proper healthcare and tax system. Why don't we try that first?

At some QALY/$.

QALYs are hardly non-controversial.

Re: Things I've noticed while visiting the ICU

#180

Post by Fomite »

jlarocco wrote: post #148

> The ICU is filled with old people. What else would you expect? Health deteriorates as people age, so old people, having deteriorated for a longer amount of time, will generally need more health care. Good insights overall, though.

A lot of medical dramas and things that shape people's perceptions portray ICUs are filled with exciting and puzzling cases that need to be solved.
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