Welcome newcomers. The tradition of Festivus begins with the airing of grievances. I got a lot of problems with you people! And now you’re gonna hear about it.
-Frank Costanza (Seinfeld)
Hi everyone,
Tomorrow is Festivus, and it’s about time! Not inclined to whine, I bottle up my grievances for months, until the cork pops. So listen up, people! Here are my top 10 grievances for 2024.
- Stethoscope over the gown: Spare me! That’s crinkling cloth you hear, not pneumonia, heart failure, or atelectasis! Lift the gown, place your stethoscope on the skin, and hear the lungs.
- Objective data: Why do we call lab results “objective?” As opposed to what? Aren’t the history and physical objective too?
- Past has passed: Don’t copy forward old news! The line was placed yesterday, and ID already saw Mr. Johnson. Ms. Baker doesn't need another SBT; she’s leaving the unit!
- But know your history: To quote the sages:
- “History repeats itself, first as a tragedy, second as a farce.” (Karl Marx)
- “Those who cannot remember the past are condemned to repeat it.” (George Santayana)
- “Those that fail to learn from history are doomed to repeat it.” (Winston Churchill)
- “There is no present or future - only the past, happening over and over again - now.”(Eugene O’Neill)
- “History merely repeats itself. It has all been done before.” (Ecclesiastes)
- “PE was ruled out last time, the time before that, and the time before that. She doesn’t need another CT.” (Me)
- What do you want to order?: Wait! Stop! Whoa! Can’t we discuss the differential before we order tests?
- Jargon: Instead of “You’ve responded favorably to diuresis and achieved negative fluid balance,” how about “Yay! You peed! Go Bumex!”
- Nothing!: Sorry to bear bad news, but we can all improve, so when asked for constructive feedback, don’t say “nothing!,” “N/A!,” or keep up the good work!” Unless your intern is Osler reincarnated, say something constructive.
- MedHub: As some of you know…every week I check the MedHub procrastinator list- and then nudge the top 5 to complete their evaluations. Feedback is essential. Submit your evaluations right away, and stay off the Dishonor Roll!
- Just Covering: Don’t underestimate yourself! When you’re pulled for jeopardy, do a night shift, or cross-cover, those patients become yours. Take a fresh look. You may crack the case!
- Table Rounds: You’re missing out if you round in the conference room. One of our alumni, Justin Choi, recently highlighted the value of bedside rounds: you’ll make new diagnoses, improve communication, engage your patients, and learn.
Now that I’ve aired my grievances, I want to thank you for a great year. For reasons unrelated to the residency, 2024 was hard, but let’s embrace the good we’ve done, with more to come in 2025. It’s an honor to be your program director, watch you grow, and revel in your dedication, skills, and kindness.
Thank you to everyone working this holiday week. Your patients are lucky to have you. Heide, the girls, and I are headed to Quebec on Thursday for a mini break. Happy Hanukkah, Merry Christmas, and Happy Festivus to all who celebrate.
Mark
P.S. Program Director’s Notes will return on New Year’s Day.
P.P.S. What I’m reading and listening to:
- The Productivity Paradox: Why Less Is More With Oliver Burkeman on Plain English with Derek Thompson
- Four Thousand Weeks: Time Management for Mortals By Oliver Burkeman
- The God Squad: Chanukah and Christmas share a healing message By Rabbi Marc Gellman
- We’ve Been Getting Human Nature Wrong for 100 Years By Kurt Gray
- Like Kennedy, I Recovered From Heroin Addiction. I Don’t Agree With His Approach. By Maia Szalavitz
- A Christmas Carol By Charles Dickens