Noah Got Upset

As a reponse to my previous Comical post about how I joke with my interns and students. Noah wrote the following:

"Just jump on the orthopods. The IM docs are always claiming their intellectual superiority. Would love to compare the average board scores of medicine residents versus ortho residents. I'd bet we beat the meds by a standard deviation, honestly.And internal medicine is far more rote memorization than thinking. 90% of what you need to know you could look up in the Sabatine pocket medicine manual, and the other 10% you read before rounds on up-to-date. Evidence-based medicine nearly gets you off the decision-making hook in most circumstances. All you need to do is look it up.I guarantee that the orthopod's functional application of anatomy and biomechanics is on par with any internal medicine doc's application of physiology, immunology, or pharmacology to pathological situations.And kudos to ER docs, who can not only understand the important aspects of every field within medicine and surgery, but, unlike meds, don't shit themselves when a situation gets hairy".

Noah at vertical mattress

Rare as it is that I get a negative reaction like this, I took the oppurtunity to explain to Noah just what I meant:

"Oops I've managed to upset someone. We're all just joking around and this definitely shouldn't be taken too seriously Noah.I know that Ortho residents do better on their boards. I always feel bad because I feel that an ortho resident is like taking a new mercedes and driving it off-road. it doesn't make sense that they take the brightest minds for the job when I feel we can put their minds to better use. But I do believe you may have just taken me joking around with my interns a LITTLE TOO SERIOUSLY! I really don't think of Orthopods that badly"

On another note, evidence based medicine VERY RARELY gets us off the hook. There are studies to support maybe 40% of everything we do. The rest is all thinking and rationalization.

And, one more sidenote. I've been on the medicine floors for three years now, in the ICU for two, in the CCU for two and did four one month ER shifts. Not once "When the situation got hairy" (and it does often, believe me) did I pass any form of stool on myself. Like the post I wrote, this is also just hospital humor!