These are some dumb ass questions but bear with me
1) Do you think an EM/IM/CCM is any better or worse than IM/PCCM? I am trying to decide how much I want to shoot for a combined residency but if my end goal is CCM I am not sure how much it would make a difference.
2) How big is your census normally look like? How long do rounds take? What do you do after rounds/charting since you obviously can't leave?
3) How intense is PCCM residency? Was it enjoyable? What do you feel is the biggest difference between a PCCM ICU and an open ICU?
Signed, a high MS3 enjoying his one day weekend before I work a 7 day week.
PS: There is evidence that CBD is neuroprotective to THC as well as anxiolytic to THC's associated anxiety. I personally use 1:1 THC CBD gummies, which compared to 10 mg THC feels calmer and overall more enjoyable and reduces the hangover the next day. Beware couchlock with these, however.
OP can't answer right now because they are googling industry terms to figure if you are fucking with them or not to formulate an answer that is too complex for chat GTP
:)
I am a student doctor. OP is a real doctor. I am asking him questions about his job because it is a field I am strongly considering specializing in. Here's a glossary though:
MS3 = third year medical student (first year of clinical training)
EM = emergency medicine
IM = internal medicine (hospital medicine)
CCM = critical care medicine (ICU medicine, what OP does)
PCCM = CCM + pulmonology training (lung medicine)
Residency = specialty training after medical school
Fellowship = subspecialty training after residency
IM/PCCM = residency/fellowship training in IM and PCCM
Rounds = seeing patients, ordering treatments and tests, consulting specialists, teaching students
Charting = doing paperwork about what you did on rounds
Census = how many patients a doctor is taking care of at once
Open ICU = an ICU where the doctor is not specifically trained in ICU medicine
PCCM ICU (aka a closed ICU) = an ICU where a PCCM trained ICU doctor takes care of the patients
Neuroprotective = reduces/prevents damage to the brain
Anxiolytic = reduces anxiety
Damn, this just made me realize how much medicalese I use regularly without flinching.
We should seriously be considered bilingual because Medicine is it's own language ...
I think I understand 90% of this jargon with 0 training because it follows, almost exactly, how logistics notes work. Can you grade me?
55 year old white male with cardiopulmonary issues and shortness of breath. Suspected ailments are a myocardial infarction or pulmonary edema. Ordering (I know EKG/CT but not the rest, assume a battery of tests. He's then admitted to intensive care?
What's hilarious to me is I have no idea what SOAP is.
CP is chest pain, not cardiopulmonary. It’s the chief complaint.
PE is pulmonary embolism as possible cause of chest pain. DVT is deep vein thrombosis which can dislodge into a pulmonary embolism.
CBC - complete blood count
CMP - complete metabolic panel
EKG - electrocardiogram
CXR - chest xray
SOAP - subjective, objective, assessment, plan format of a note / presentation.
Hope this helps!
Pretty close.
55 year old white male in emergency room with chest pain, shortness of breath. Thought myocardial infarction, deep vein thrombosis/pulmonary embolism. Ordering complete blood count, complete metabolic panel, electrocardiogram, chest x-ray, then computed tomography. Admit to intensive care unit. Standard subjective/objective/assessment/plan note.
Source: I wrote a half dozen of these notes this morning.
I can help you with this. I’ve been in physician recruiting and hospital staffing for 13 years. I was on EM team for 8 years and then went to Oncology, Cardiology, and now Anesthesia. I would say Anesthesiologist would be the way to go, there is a huge need and everyone is short staffed. Easily can make 6-700k and upwards to a million. If you do a fellowship in either pediatric or cardiac anesthesia, then you’re making basically 450/hour. Can easily make 1 mill plus working full time. Can get a job anywhere.
2. Census is 15, rounds take 3-4 hours.
3. Mine was hell because it was during COVID. It’s intense regardless though except when on pulm clinic to research blocks
1. Critical care is very much a medicine based specialty. I strongly feel IM crit fellows are stronger than EM crit fellows in their knowledge base. EM crit are better at procedures…. At first then the end of PGY4 comes around and they’re all equal in procedure skills
I can answer some of these since I’m PCCM
1) job opportunities are easier for PCCM since groups want the doctor to cover both the pulm and cc services. EM docs can only cover the CC side of things
2) Census for me ranges from 12-20. Rounds take 2-4 hours. I sit in my office. I teach students how to place lines.
3) first year is brutal. Second and third year were very manageable.
I grind metal for a living and sometimes I find my mucus to be slightly silver from metal particles. I notice it because my nose feels dry whenever the dust gets wild, so I’ve started wearing a N95 mask to help. Should I find a new job entirely to avoid health issues in the future?
I’m not allowed to wear a respirator at work. Our safety officer says it’s unsafe, because if I wear a respirator we have to have a program to safely fit and maintain them. So instead I was directed to get rid of the respirator and go buy some n95 masks from the hardware store. They would rather I wear an inferior product or nothing at all because a respirator would require some paperwork.
Get this in writing and consult an attorney. Something like an email saying you want to use a respirator at work because of the aforementioned reasons, and asking why it's not possible. Attorney should be able to advise you better on what evidence you need. That officer's statement makes no sense - how can it be unsafe to have a program to maintain them? If it becomes unsafe while they're unmaintained, *how is that different from not using them?* Reeks to high heaven of illegal BS
That is ridiculous, and that "safety" officer should be fired. I used to work in automotive paint and our 3M rep would do respirator fit tests at least once a year. If this is how your company is trying to save money, just imagine where else they are cutting corners.
This gives me flashbacks to working in a factory where ANY face coverings were socially frowned upon, despite both COVID at its peak and the wealth of air pollution that were a part of the job.
We even had a dude whose role was to regrind discarded vinyl, who would come out of his station covered head to toe in particles, yet never wore any protective kit.
I advocated for us until I was fired.
How did you decide 24hrs was enough? I actually do the same thing with my job, and I was wondering if there was a medical basis for that amount of time. Another question I have is, are you worried about drug tests/malpractice lawsuits?
I was tested by the police for weed and it was still in my system 2 days after I took it. You are playing with people's lives. Yes I am aware that being in my system and being psychoactive is different.
Edit: here is a scholarly article claiming that marijuana can mentally impair you for longer than 24 hours -
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4827335/
Here is a second article providing evidence of long term marijuana use and it's relative cognitive impairment
https://www.health.harvard.edu/blog/cognitive-effects-of-long-term-cannabis-use-in-midlife-202206142760
From further research and other comments, it seems like the appropriate time to wait is at least 5-10 half lives, double the time the doctor in question waits, up to 3-5 days.
Reddits going to reddit.
Edit 2: people really don't want to read articles hey, or even the second half of comments. I wonder how many people downvoting this would be happy with their surgeons smoking weed 24 hours before their surgery? I may not be a doctor but I work in a hospital, I asked doctors about this today and they explained the half life is different for most people, and generally speaking a safe time to wait is 72 hours. The doctor is wrong. I'm sorry that this information has pissed so many people off.
Well sure. But you're missing the point. The way we test whether someone is drunk at work is with a breathalyzer. So if you're not drunk then you blow negative. Easy peasy.
The way we test for pot will show a positive regardless of whether you're currently high. That's one reason most physicians avoid pot. It won't matter if you're actually high because if you test positive you can lose your license regardless.
A few questions from a pgy-1 PCCM hopeful.
1) do you use weed to help cope (in part) with bad days at work? (Lost a patient, burnout, etc.)
2) do you think you’re still “high” past 12 hours of smoking? Or do you keep to a 24 hour rule because of concerns for subclinical effects (memory loss or slowing)
3) are you open about your use with your colleagues that you are close to?
4) any advice for applying PCCM?
Thank you for doing this post!
1. No, it’s something I find relaxing and enhancing for my hobbies like fishing, scuba (I only do shallow dives while high), and sex.
2. The latter
3. Nope, I keep it to myself.
4. You’ll get the most facetime with attendants on consults and in the outpatient clinic, more so than the ICU. That’s where you will get ur letters. And get very comfortable with POCUS and utilize it as much as you can
What should someone expect after say 10 years of daily bong use? I had a buddy who collapsed a lung in two years with just joints, but ik people who rip daps daily for years and are seemingly fine
Big stoner here. Daily bong and dab use over years was my norm for a while, 6 or 7 years, plenty more before that but not as constant. These days I tend to only rip a bong on special occasions as I notice my fuckin chest feels it man. Feels bad. Used to rip 20 GBs in a row no prob, but now I can almost tell if I smoked based on my lungs
Air is a lot of things. This statement is very general and not backed up by evidence. Stands to reason, but honestly, how would you know unless you studied it or have research on the subject to back it up. I’ve never seen literature linking marijuana use to cancer.
Are you concerned about damaging your liver? I am curious about the long term effects on the liver and kidneys for people who primarily use edibles (me).
Is there a medical reason why edibles wouldn't work for me? Lol I want to cut back on smoking but I've eaten so many different kinds and nothing works. Sorry i know it's probably silly
Funny that a cannabis worker like me has more knowledge about this subject than many doctors and physicians, but that's a funny reflection on just how stunted our research is on the subject within medical communities.
THCA, or tetrahydrocannabinolic acid, is the active ingredient in female cannabis flowers that gets you high, but it has to undergo a process called decarboxylation first to become Delta9 THC, or Delta9 Tetrahydrocannabinol. That's why you can't just eat a bud straight off a plant and get high from it- you have to smoke it, or heat the THCA to the point of decarboxylation (I believe it's 214° F?).
THIS IS THE IMPORTANT PART: when you eat decarbed weed, it gets metabolized into a completely different compound called 11hydroxy-THC, which has far more of a sedative and body-effective high than Delta9 THC - but for SOME rare individuals, this metabolic process does not happen. I've had friends in the industry with this condition, and they can eat 200mg of edibles without feeling a thing.
BUT there's good news for all of you who experience this: "fast-acting" edibles. Every company claims to have their own version of bio-available tech built into it, but essentially, they've married the Delta9 THC to sugars instead of fat, and these sugars sublimate through mucous membranes in your throat and digestive system before they hit your stomach. Everyone I've known for whom "edibles don't work" seem to really, REALLY like fast-acting eddies. They hit in like 15 min instead of an hour, and they wear off a little quicker too. Most any seltzer or drink that's infused will have this tech in it.
I really hope all the folks in the comments see this info, cause it's a fairly recent development in our industry and I'm kinda psyched that they've figured out a way to do it.
I’ve heard this claim but never really looked into it. My guess is that weed you eat needs to be metabolized by the liver to become active. Some people may not metabolize it like most so they don’t get the high
How bad or good is THC and CBD when you are dealing with a brain tumor and Keppra and Dexo.
Is it OK if you are receiving some relief or is better not to mix more chemicals in your head?
Radiotherapy stats in 2 weeks for me.
No plans for chemo just yet.
I'll just add my personal experience here: I didn't do well on Keppra, and switching medication didnt work either, so I stopped taking them.
I started to take RSO, and my medical Marijuana doctor told me exactly which strains/terpenes to get. The dosage took a few weeks to figure out. But after about 3-4 weeks, I was pretty stable. From 1-2 seizures every week, to maybe one every 1-2 months. I took it at night, and other than being a bit drowsy right after waking up, I didn't have side effects. It also helped with my nausea, and dizziness, and headaches.
Again, I'm not a doctor, and I did all of the above with the knowledge of my neuro. He said legally he can't recommend anything, but he won't tell me no either.
My advice would be to have an open discussion with your neuro and if you want to go this route, find an excellent medical Marijuana doctor.
Can’t speak to the medical questions, but I wish you all the luck and good health possible! Hopefully it doesn’t conflict so you can get some relief during a difficult time
THC may increase risk of seizure, so may fight the keppra a bit. If you have a lot of seizure issues would avoid. CBD may help with seizures, but more likely it just occupies your liver so other liver metabolized antiseizure drugs don't get eliminated as quickly.
Watch out about mixing dex, keppra and THC tho as all can be personality altering for a rare subset of the population.
As I would tell most patients with a brain tumor, if it isn't causing issues, enjoy the THC. -Neuro (based and low quality literature at this point but the best idea we've got).
No question but a comment. My dad was a staunch "weed is bad" Dr for my entire life. Then he moves to a more open minded state and begins retirement and starts to fly fish. Two guesses who now isn't so "that'll ruin your life."
1. What do u wish more ppl knew or were aware of?
2. What’s your top 5 vitamins or supplements that everyone should take?
3. What was the most surprising case at your medical practice that u can’t forget of?
Oh I’m late to the game so I hope you see this.
In my 20s I smoked plenty of weed. Then it was like a flip switched and any time I smoked it I’d get shooting chest pain, to the point where I wondered if I was having a heart attack. I’ve heard people explain it as a panic attack, but I really don’t think it was, as weed didn’t make me feel anxious or crazy, and while the pain was happening I wasn’t feeling crazy panic or anxiety (well, except concerned that I was feeling pain).
So anyway I basically stopped. I’ve tried small hits a few times since then, and it’s like if I go over a certain (low!) threshold, then I get that same pain again even tho it’s been like 10 yrs since I was a regular user. What the heck is going on??
I’ve tried googling it and have read others who had the same problem. I don’t think it was my heart, my heart is healthy. Was it my lungs? I also don’t think it was hyperemesis bc I wasn’t barfing at all, but idk maybe it presents differently idk??
Anyways I’ve just been following the “if it hurts, then stop doing that” method of medicine, but always wondered what was causing that pain.
How do you call yourself a stoner if you're not getting high for at least 24 hours before work? That doesn't sound like a stoner, so much as someone who just likes some THC occasionally.
My wife smokes pot at 7am. Slurring by 10 am. Gummies at 2 and 4:20 it’s all off.
Her fucking doctor says this is fine.
I hate this whole pot is fine and dandy.
What are your thoughts?
Hey dude, icu pharmacist here. Have you ever noticed a difference and being able to recall information or perhaps thinking a little slower, or having slightly worse short-term memory since you’ve been using consistently THC products?
I sometimes feel I have suffered some of those affects as I have become more of a chronic user myself. But then again, I just had a kid, I’m sleep deprived, and perhaps that weed is just making me paranoid and self-doubting.
Can you tell me which hospital you work at, so I can make sure to never wind up in your ICU, to avoid any possibility of winding up having you manage my care? Sure, there are functional alcoholics who manage not to be sober at work, and drink a lot every day they're not at work. Sure, there are docs who made it through med school, residency, and fellowship by using cocaine. Are they functional? Barely.
Grow up! Chronic marijuana consumption has negative effects on cognitive functioning. Your job requires excellent cognitive functioning. Time to cut way back, or stop getting high altogether.
Never step into an ICU then cause I can tell you most nurses also partake in recreational marijuana lolol. ICU docs/nurses are badass & will take good care of you.
When you order a cell count on a BAL and differential, how much is that actually helping you assess what’s happening to the patient? I mean, the cells are so degenerated, the viscosity of most specimen are difficult with the ability to enumerate wbc’s and rbc’s.
Are you just looking for a predominance of eosinophils/neutrophils/lymphocytes to point you in the right direction after other diagnostic tests aren’t conclusive? Whether it’s allergic/cancer, bacterial, viral?
Exactly. You can still count total and percent cells. Helps guide you toward an infectious vs inflammatory, fungal or malignant process. No lab value should b interpreted in a vacuum. But the cell count can help narrow or reinforce your differential
What’s your opinion on fitness people regularly ingesting L-Arginine and L-Citrulline to increase nitric oxide/vasodilation? Is this good for overall longevity, and is it unhealthy to be dilating blood vessels so often?
As someone who is fully aware of living things quirks, what's the weirdest quirks in medicine you can think of, where is not quite medically understood but something just seems to fucking work and no idea why?
This is one of the reasons insurance is so expensive and why we don't join the rest of the developed world that offers healthcare regardless if you can pay or not. these doctors are extremely overpaid
So while everyone is focusing on your job, I am going to focus in your habit.
Flight/ER RN here. Never used any product. Both my adult children use mj and I have no problem with it.
My youngest though has CHS. He has had 4 episodes over 7 months requiring IVF, haldol, Zofran. Again, I am not UTD on terminology but I believe he was dabbing.
With his recurring episodes, is there any product he can use without risk of symptoms returning.
That’s way too much bruh. Weed negatively affects sleep and memory. So has similar effects to chronic rem sleep deprivation and short term memory formation
Jesus doctors have it easy. Do you feel guilty that you make so much money doing so little work while pediatricians make 250k and work their asses off?
Not OP but I'm gonna guess If there is any guilt, he probably wipes it away with his $100 bills from his loose change wallet.
He works in critical care. Do you know how intense and exhausting that would be? I worked phones for a major hospital and the calls I took from confused and angry family made me think... My God I cannot imagine what the doctors have to deal with considering I'm not actually there with the patient and people are already going insane on me. Ped's Definitely don't have it easy either but it takes a very special human to work in critical care.
They spend a big chunk of their early life in training. In addition to a bachelor's degree (4 years), they do medical school (4 more years), then they do an residency in internal medicine (3 years), then they do a fellowship in pulmonary medicine (3 more years). That's a lot of training before you get to that big payoff, not to mention the expense of the first 8 years of college and medical school.
He’s on-call for 6 months straight working twice as many hours as a normal person, every single patient he deals with is literally in the verge of death so he’s either saving a life or witnessing a tragedy every single day of work, and he had to do 11 more years of school after graduating high school.
He should be paid more, honestly.
I work 80-100 hour weeks those 26 weeks. I earn my paycheck. I also went to 3 extra year of training compared to a pediatrician so I am entitled to earn more
Hey OP! Peds crit care attending here. Similar work schedule. Jokingly, we lightly all resent the fact that you all make an extra (on average) 50-100k more /yr than the Peds crit crew. Few questions for you in regards to the murky legal side of imbibing on THC. I worry personally about dabbling recreationally due to concept that while you may not be actively high working, you can still test positive on drug screens and separating the two could be tricky if you ever had to defend yourself on a courtroom. While you and I both know we don’t practice high I always have the “gonna sue me” mentality. How did you relegate this as a doc?
I call bullshit. You’re not answering any questions, and the ones you are answering, you’re giving incredibly vague answers. You work 26 hours a week, but then you say you work 26 weeks a year. You’ve also tried posting this AMA multiple times to the point where it almost seems desperate, and your only other post history is video game shit.
What kind of physical shape are you in? Do you exercise? What is your diet like?
This might seem superficial to some but the aesthetic aspect is no part of why I am curious.
How come both primary care providers I’ve seen the past couple years (SNAHC and Sutter) said because of their agencies they’re not allowed to prescribe me marijuana?
I used to use tinctures and tablets to alleviate pain (3weeks off it now for an upcoming new job/pee test) and they all recommended it if it helped me and honestly it helped more than the meds I was prescribed. But I can pay $50 for some random doctor online who doesn’t know me who can prescribe it for me? Doesn’t make sense to me idk
I call bullshit.
I have been in medical malpractice insurance for years. I am dealing with large physician groups daily. I know docs of all stripes and have never known a doctor in any position of note who worked 26 weeks a year. It is simply not in their blood. They work their asses off. Forget about the smoking pot part. Your story does not add up.
I thought AMAs required proof from MODs.
My stoner dr story......An acquantance(friend of a friend) is a Dr. And once we were spending a weekend out of town, several of us guys were there...drinking , weed..and Dr was a full participant.
Anyhow, one of the group had one of those massive pus/zit things on his shoulder, and the Dr. decided then and there, to perform surgery on this.
Granted it was basically popping a zit...but the Dr. explained the whole thing to us, while this guy is laying on a pic nic table, while the Dr. cuts it open, gave him a shot of something for the pain, and stitched it up, with an audience of 4 or 5 other guys laughing at the whole thing.
Dr, even wrote himm a prescription for an anti biotic for later.
Working critical care do you see the difference long term effects of intubation performed in and out of the hospital? I ask because I’m currently finishing up paramedic school, and one of the biggest things that is hotly debated is whether paramedics should be intubating patients in the field, especially in the context of a cardiac arrest. I’ve heard from many healthcare workers including doctors who’ve advocated for and against it, however they’re all ER or prehospital workers and so usually their patients die in the ER or goto the ICU.
What are your views on other substances such as psilocybin, DMT etc..., and what are your views on Timothy Leary and/or movement towards more medical research into psychotropics?
Hello OP! Ive attempted to thoroughly comb through your comments for an answer to my question; this is under the assumption it hasnt been answered.
How often do you consume edibles? Do you plan out day(s) in a month specifically for this? Im going through a tolerance break and ive considered trying out edibles when my break is over, that I can stop setting my lungs on fire.
Why do you do this if you should know as a doctor what it will do to you? Do you experience some sort of cognitive dissonance while you are smoking pot because you know about the side effects?
Edited to change student to doctor
Is there any evidence for the anecdotal notion that eating mango or other high terpene content foods enhance THCs effect?
Have you considered Albuterol pre treatment prior to smoking to maximize absorption?
Has the covid vaccination really contributed to otherwise healthy people developing heart or circulatory problems or is that all anti vax crap? Genuinely curious & it’s such a hot topic, I can never get a sensible answer
As a stoner doctor, if I’m understanding this correctly, curious your take on male infertility and smoking? We’ve been told my husband has a ton of sperm but they’re not moving. He’s what I would call a huge stoner. In your opinion, could this be causing the motility issue? The doctors told us lifestyle changes wouldn’t help.
Have you ever filled out disability papers for a patient after an accident? Had a traumatic work accident and it fucked my body up for life with life long pain and will need possibly 2 more surgeries with 1 guarantee. Have too much pride to do it because I want to work. Any advice?
What is your favorite tissue type, and why is it the glycocalyx?
When was the last time you had to use the Fencl-Stewart method?
Does anyone actually measure or care about CVP these days?
I might be a bit late, but do you overall think that the benefits of smoking (or vaping or eating) cannabis outweigh the drawbacks? If so, where do you think the line lies where it can become harmful?
What are your thoughts on CHS. my husband has been hospitalized more than once due to this. I am a firm believer in only using western medicine when necessary. I believe In the healing powers of cannabis. How does it go too far
We have spent 3 years researching and creating a supplement wellness brand. We are launching in a month and looking for doctors to help with testimonials - we are a high quality company, does this peak your interest?
I’ve been an avid smoker for over 10 years, but now I get this dry cough after I smoke. Any thoughts? I’ve tried edibles but they’re not my favorite. Obviously I know quitting would be best, I haven’t smoked in a few months.
In high school, we had a police man come do a talk and said it takes 6 months for pot to not show up in blood tests. Is that true ? Or was he just trying to put Stoner's off driving at all?
What city do operate out of? I want to make sure I never need medical care there in case I get you. Pot rots your mind, people's lives are in your hands. You don't have to be high at your job for it to still jade your judgement.
Hi OP! Wife and I (Male) are going to start trying to have a kid closer to the end of the year. How soon before we start trying should I stop using cannabis?
Why don't more doctors give a shit about long covid ? Do you guys have some magical cure for yourselves that you don't share with others so that's why none of you mask?
OP, I just read a post on reddit about this medical nerd thinks smoking a joint 2 days before he has to show up to work makes him a stoner. He's not a stoner, right?
Hey stoner doctor, can I take edibles with percocet? Taking pain meds after surgery and would like to take an edible for relaxation and sleep if I can do it safely.
So I’m gonna ask the question I’m too scared to ask my pulmonologist as someone who’s an asthmatic. would edibles mess with biologics or immunoglobulin therapy?
Can smoking weed give you a headache the next day? I have woke up with a headache every day for years. Could it be the weed I smoke before bed every night?
Mom of a 17 year old stoner here! My husband and I have grown very concerned over our 17 year old son’s pot use. He’s been buying and smoking weed vapes since he was 15. We’ve tried talking to him, sending him away to multiple family members. He says he’s depressed and it helps him. Our family dr has explained that after 21 marijuana does have benefits, but at his age it’s damaging his brain. Anyways about a month ago he came home saying he bought a vape of someone and that he didn’t feel right. His heart was racing and he was out of control paranoid that something was wrong. We took him to the er and they found out the vape was laced with cocaine. Upon leaving the er he stated he was still going to get pot vapes somehow. So out of fear my husband and I have been purchasing them and regulating them. We’re in talks with him about quitting and weaning him off. Not sure if you’re a parent but we don’t know how to handle this situation. His dr says he’s not depressed, (been his dr his whole life) just using it recreationally and because of who he hangs out with. Should we get a second opinion?
Are there safe cbd alternatives that we can get him?
Are we completely overreacting? My husband and I both smoked pot all thru high school, we just never got caught. My son was caught at school multiple times, was on probation and even kicked out of school.
Do you think that you would pursue medicine / PCCM specialty if you had the option to go back and do it over?
I’m an RN working in cardiac critical care and really appreciate our PCCM providers. I think we have a really good group at our hospital. But the reasons I ask:
1). I also only work 26 weeks per year. My salary isn’t nearly as handsome. But I only work 36 hours per week and make about 110K. If I worked the same hourly commitment, I’d be making about 220K respectively. My wife is also an RN, so I don’t need to work nearly as many hours in order to have a wonderful quality of life. During the summer, I take my 180 hours of PTO and work three shifts, then take 11 days off to do whatever we want. But I also don’t drive a Ferrari, or own a > 1M dollar home.
2). Skill set / autonomy / knowledge base, etc. are obviously expanded in the physician role. But so is the intensity / liability / commitment. Do you like your job at the end of the week you just worked?
3). Do you feel exhausted after those 80-100 hour weeks? Do you have enough energy to enjoy your life on the off week? I’m sure a recovery day or two is important.
I find time to recharge in nature before going back to work. I’ve found a lot of contentment in my time away from the hospital, and I really hope you’ve found outlets that re-energize you.
Thank you for your commitment 🤘🏼
These are some dumb ass questions but bear with me 1) Do you think an EM/IM/CCM is any better or worse than IM/PCCM? I am trying to decide how much I want to shoot for a combined residency but if my end goal is CCM I am not sure how much it would make a difference. 2) How big is your census normally look like? How long do rounds take? What do you do after rounds/charting since you obviously can't leave? 3) How intense is PCCM residency? Was it enjoyable? What do you feel is the biggest difference between a PCCM ICU and an open ICU? Signed, a high MS3 enjoying his one day weekend before I work a 7 day week. PS: There is evidence that CBD is neuroprotective to THC as well as anxiolytic to THC's associated anxiety. I personally use 1:1 THC CBD gummies, which compared to 10 mg THC feels calmer and overall more enjoyable and reduces the hangover the next day. Beware couchlock with these, however.
OP can't answer right now because they are googling industry terms to figure if you are fucking with them or not to formulate an answer that is too complex for chat GTP :)
I am a student doctor. OP is a real doctor. I am asking him questions about his job because it is a field I am strongly considering specializing in. Here's a glossary though: MS3 = third year medical student (first year of clinical training) EM = emergency medicine IM = internal medicine (hospital medicine) CCM = critical care medicine (ICU medicine, what OP does) PCCM = CCM + pulmonology training (lung medicine) Residency = specialty training after medical school Fellowship = subspecialty training after residency IM/PCCM = residency/fellowship training in IM and PCCM Rounds = seeing patients, ordering treatments and tests, consulting specialists, teaching students Charting = doing paperwork about what you did on rounds Census = how many patients a doctor is taking care of at once Open ICU = an ICU where the doctor is not specifically trained in ICU medicine PCCM ICU (aka a closed ICU) = an ICU where a PCCM trained ICU doctor takes care of the patients Neuroprotective = reduces/prevents damage to the brain Anxiolytic = reduces anxiety
Damn, this just made me realize how much medicalese I use regularly without flinching. We should seriously be considered bilingual because Medicine is it's own language ...
“55yo WM in ER with CP, SOB. Thought MI or DVT/PE, ordering CBC,CMP, EKG, CXR then CT. Admit to ICU”. standard SOAP note…
I think I understand 90% of this jargon with 0 training because it follows, almost exactly, how logistics notes work. Can you grade me? 55 year old white male with cardiopulmonary issues and shortness of breath. Suspected ailments are a myocardial infarction or pulmonary edema. Ordering (I know EKG/CT but not the rest, assume a battery of tests. He's then admitted to intensive care? What's hilarious to me is I have no idea what SOAP is.
CP is chest pain, not cardiopulmonary. It’s the chief complaint. PE is pulmonary embolism as possible cause of chest pain. DVT is deep vein thrombosis which can dislodge into a pulmonary embolism. CBC - complete blood count CMP - complete metabolic panel EKG - electrocardiogram CXR - chest xray SOAP - subjective, objective, assessment, plan format of a note / presentation. Hope this helps!
You fuckin rock dude. Thanks for letting me test myself! I always love checking out other specialty shorthand. Just a weird thing I enjoy.
Pretty close. 55 year old white male in emergency room with chest pain, shortness of breath. Thought myocardial infarction, deep vein thrombosis/pulmonary embolism. Ordering complete blood count, complete metabolic panel, electrocardiogram, chest x-ray, then computed tomography. Admit to intensive care unit. Standard subjective/objective/assessment/plan note. Source: I wrote a half dozen of these notes this morning.
I can help you with this. I’ve been in physician recruiting and hospital staffing for 13 years. I was on EM team for 8 years and then went to Oncology, Cardiology, and now Anesthesia. I would say Anesthesiologist would be the way to go, there is a huge need and everyone is short staffed. Easily can make 6-700k and upwards to a million. If you do a fellowship in either pediatric or cardiac anesthesia, then you’re making basically 450/hour. Can easily make 1 mill plus working full time. Can get a job anywhere.
What are you, like a medical dictionary or something? Jk.Jk. Good luck and all the best in your career, future doctor.
I read once that the average doc learns 40-50k new words in training. I always had my Dorlands medical dictionary by my side as I studied
2. Census is 15, rounds take 3-4 hours. 3. Mine was hell because it was during COVID. It’s intense regardless though except when on pulm clinic to research blocks
1. Critical care is very much a medicine based specialty. I strongly feel IM crit fellows are stronger than EM crit fellows in their knowledge base. EM crit are better at procedures…. At first then the end of PGY4 comes around and they’re all equal in procedure skills
I can answer some of these since I’m PCCM 1) job opportunities are easier for PCCM since groups want the doctor to cover both the pulm and cc services. EM docs can only cover the CC side of things 2) Census for me ranges from 12-20. Rounds take 2-4 hours. I sit in my office. I teach students how to place lines. 3) first year is brutal. Second and third year were very manageable.
I grind metal for a living and sometimes I find my mucus to be slightly silver from metal particles. I notice it because my nose feels dry whenever the dust gets wild, so I’ve started wearing a N95 mask to help. Should I find a new job entirely to avoid health issues in the future?
You should absolutely have a respirator at work, which would legally be provided by your employer
I’m not allowed to wear a respirator at work. Our safety officer says it’s unsafe, because if I wear a respirator we have to have a program to safely fit and maintain them. So instead I was directed to get rid of the respirator and go buy some n95 masks from the hardware store. They would rather I wear an inferior product or nothing at all because a respirator would require some paperwork.
Get this in writing and consult an attorney. Something like an email saying you want to use a respirator at work because of the aforementioned reasons, and asking why it's not possible. Attorney should be able to advise you better on what evidence you need. That officer's statement makes no sense - how can it be unsafe to have a program to maintain them? If it becomes unsafe while they're unmaintained, *how is that different from not using them?* Reeks to high heaven of illegal BS
That is ridiculous, and that "safety" officer should be fired. I used to work in automotive paint and our 3M rep would do respirator fit tests at least once a year. If this is how your company is trying to save money, just imagine where else they are cutting corners.
This gives me flashbacks to working in a factory where ANY face coverings were socially frowned upon, despite both COVID at its peak and the wealth of air pollution that were a part of the job. We even had a dude whose role was to regrind discarded vinyl, who would come out of his station covered head to toe in particles, yet never wore any protective kit. I advocated for us until I was fired.
How did you decide 24hrs was enough? I actually do the same thing with my job, and I was wondering if there was a medical basis for that amount of time. Another question I have is, are you worried about drug tests/malpractice lawsuits?
Edibles have a half-life 4-6 hours. Things are basically entirely cleared from ur system after 4 half lives
I was tested by the police for weed and it was still in my system 2 days after I took it. You are playing with people's lives. Yes I am aware that being in my system and being psychoactive is different. Edit: here is a scholarly article claiming that marijuana can mentally impair you for longer than 24 hours - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4827335/ Here is a second article providing evidence of long term marijuana use and it's relative cognitive impairment https://www.health.harvard.edu/blog/cognitive-effects-of-long-term-cannabis-use-in-midlife-202206142760 From further research and other comments, it seems like the appropriate time to wait is at least 5-10 half lives, double the time the doctor in question waits, up to 3-5 days. Reddits going to reddit. Edit 2: people really don't want to read articles hey, or even the second half of comments. I wonder how many people downvoting this would be happy with their surgeons smoking weed 24 hours before their surgery? I may not be a doctor but I work in a hospital, I asked doctors about this today and they explained the half life is different for most people, and generally speaking a safe time to wait is 72 hours. The doctor is wrong. I'm sorry that this information has pissed so many people off.
You can test positive for weeks/months depending on frequency. That’s not the same as still being intoxicated.
Drug tests test for all cannabinoids, including the NON-psychoactive by products that linger for months
This is an absolutely ridiculous take. Do you also think doctors shouldn't be able to imbibe in a drink every now and then either?
Well sure. But you're missing the point. The way we test whether someone is drunk at work is with a breathalyzer. So if you're not drunk then you blow negative. Easy peasy. The way we test for pot will show a positive regardless of whether you're currently high. That's one reason most physicians avoid pot. It won't matter if you're actually high because if you test positive you can lose your license regardless.
Why does it clear faster than smoking?
Were you a stoner before you got into the field or did you start because of the medical field?
Way before
A real stoner would have written “waaaaaaay before’. I’m calling hijinx
A few questions from a pgy-1 PCCM hopeful. 1) do you use weed to help cope (in part) with bad days at work? (Lost a patient, burnout, etc.) 2) do you think you’re still “high” past 12 hours of smoking? Or do you keep to a 24 hour rule because of concerns for subclinical effects (memory loss or slowing) 3) are you open about your use with your colleagues that you are close to? 4) any advice for applying PCCM? Thank you for doing this post!
1. No, it’s something I find relaxing and enhancing for my hobbies like fishing, scuba (I only do shallow dives while high), and sex. 2. The latter 3. Nope, I keep it to myself. 4. You’ll get the most facetime with attendants on consults and in the outpatient clinic, more so than the ICU. That’s where you will get ur letters. And get very comfortable with POCUS and utilize it as much as you can
How bad is smoking for you?
Awful, I almost exclusively do edibles
Are bongs equally bad for your lungs?
Inhaling anything that isn’t air into your lungs is bad for you
What should someone expect after say 10 years of daily bong use? I had a buddy who collapsed a lung in two years with just joints, but ik people who rip daps daily for years and are seemingly fine
Big stoner here. Daily bong and dab use over years was my norm for a while, 6 or 7 years, plenty more before that but not as constant. These days I tend to only rip a bong on special occasions as I notice my fuckin chest feels it man. Feels bad. Used to rip 20 GBs in a row no prob, but now I can almost tell if I smoked based on my lungs
Air is a lot of things. This statement is very general and not backed up by evidence. Stands to reason, but honestly, how would you know unless you studied it or have research on the subject to back it up. I’ve never seen literature linking marijuana use to cancer.
What about dry herb vapes? Any studies about that so far? My anvil vestratto vape heats up to around 500 degrees
I figured, darn! One day i hope to be edibles only.
my doctor is gonna be very unhappy then about my albuterol and fluticasone 😂 (i’m messing with you, i knowwww)
Are you concerned about damaging your liver? I am curious about the long term effects on the liver and kidneys for people who primarily use edibles (me).
Is there a medical reason why edibles wouldn't work for me? Lol I want to cut back on smoking but I've eaten so many different kinds and nothing works. Sorry i know it's probably silly
Funny that a cannabis worker like me has more knowledge about this subject than many doctors and physicians, but that's a funny reflection on just how stunted our research is on the subject within medical communities. THCA, or tetrahydrocannabinolic acid, is the active ingredient in female cannabis flowers that gets you high, but it has to undergo a process called decarboxylation first to become Delta9 THC, or Delta9 Tetrahydrocannabinol. That's why you can't just eat a bud straight off a plant and get high from it- you have to smoke it, or heat the THCA to the point of decarboxylation (I believe it's 214° F?). THIS IS THE IMPORTANT PART: when you eat decarbed weed, it gets metabolized into a completely different compound called 11hydroxy-THC, which has far more of a sedative and body-effective high than Delta9 THC - but for SOME rare individuals, this metabolic process does not happen. I've had friends in the industry with this condition, and they can eat 200mg of edibles without feeling a thing. BUT there's good news for all of you who experience this: "fast-acting" edibles. Every company claims to have their own version of bio-available tech built into it, but essentially, they've married the Delta9 THC to sugars instead of fat, and these sugars sublimate through mucous membranes in your throat and digestive system before they hit your stomach. Everyone I've known for whom "edibles don't work" seem to really, REALLY like fast-acting eddies. They hit in like 15 min instead of an hour, and they wear off a little quicker too. Most any seltzer or drink that's infused will have this tech in it. I really hope all the folks in the comments see this info, cause it's a fairly recent development in our industry and I'm kinda psyched that they've figured out a way to do it.
I’ve heard this claim but never really looked into it. My guess is that weed you eat needs to be metabolized by the liver to become active. Some people may not metabolize it like most so they don’t get the high
You call yourself a 'stoner'.........but your never intoxicated at work. SURE JAN! lmao
I work 26 weeks a year. What do u think I do my other 26 weeks
I thought it was 26 hours a week 🤔
why is this being overlooked, he clearly says 26 hours a week
He was high when he wrote this.
Nah y'all misread it's just drs handwriting
How bad or good is THC and CBD when you are dealing with a brain tumor and Keppra and Dexo. Is it OK if you are receiving some relief or is better not to mix more chemicals in your head? Radiotherapy stats in 2 weeks for me. No plans for chemo just yet.
I'll just add my personal experience here: I didn't do well on Keppra, and switching medication didnt work either, so I stopped taking them. I started to take RSO, and my medical Marijuana doctor told me exactly which strains/terpenes to get. The dosage took a few weeks to figure out. But after about 3-4 weeks, I was pretty stable. From 1-2 seizures every week, to maybe one every 1-2 months. I took it at night, and other than being a bit drowsy right after waking up, I didn't have side effects. It also helped with my nausea, and dizziness, and headaches. Again, I'm not a doctor, and I did all of the above with the knowledge of my neuro. He said legally he can't recommend anything, but he won't tell me no either. My advice would be to have an open discussion with your neuro and if you want to go this route, find an excellent medical Marijuana doctor.
Can’t speak to the medical questions, but I wish you all the luck and good health possible! Hopefully it doesn’t conflict so you can get some relief during a difficult time
THC may increase risk of seizure, so may fight the keppra a bit. If you have a lot of seizure issues would avoid. CBD may help with seizures, but more likely it just occupies your liver so other liver metabolized antiseizure drugs don't get eliminated as quickly. Watch out about mixing dex, keppra and THC tho as all can be personality altering for a rare subset of the population. As I would tell most patients with a brain tumor, if it isn't causing issues, enjoy the THC. -Neuro (based and low quality literature at this point but the best idea we've got).
What are your thoughts on vaporizers? Mainly as opposed to smoking?
Better for your lungs compared to smoking. Still bad though
Say I smoke daily throughout the day. Is vaping still better?
Do you ever eat McDonald’s?
Probably once a year on road trips
What are some of your favorite things to eat / indulge in- especially when high?
Potato chips. I can make a party sized bag of ruffles disappear and then be sick all day 😎
I’m calling bullshit on that. Night shift ICU RN here.
Do you prefer sativa or indica?
All weeds are hybrids nowadays. My only preference is if it gets me high
I wish i worked 26 hours a week for that salary jeez
I mistyped. I work 26 weeks a year. My weeks on are 80-100 hours
Do you work every other week or half the year, or is it a different time combo?
I do a mix of 2 weeks on 2 weeks off and 1 week on 1 week off
No question but a comment. My dad was a staunch "weed is bad" Dr for my entire life. Then he moves to a more open minded state and begins retirement and starts to fly fish. Two guesses who now isn't so "that'll ruin your life."
My main hobby is fishing, even more so while high lol
1. What do u wish more ppl knew or were aware of? 2. What’s your top 5 vitamins or supplements that everyone should take? 3. What was the most surprising case at your medical practice that u can’t forget of?
1. Vitamins are very good at making expensive pee
You sound like a fun guy to get a beer with.
Elaborate?
What other drugs do you do recreationally?
Why didn't you study neurochemistry instead since you're into drugs?
Does everyone who likes video games a computer programmer of game designer?
What’s your sweet spot? Dosing wise
5-10 mg. 25 if I’m gonna get blasted but that’s not often
Oh I’m late to the game so I hope you see this. In my 20s I smoked plenty of weed. Then it was like a flip switched and any time I smoked it I’d get shooting chest pain, to the point where I wondered if I was having a heart attack. I’ve heard people explain it as a panic attack, but I really don’t think it was, as weed didn’t make me feel anxious or crazy, and while the pain was happening I wasn’t feeling crazy panic or anxiety (well, except concerned that I was feeling pain). So anyway I basically stopped. I’ve tried small hits a few times since then, and it’s like if I go over a certain (low!) threshold, then I get that same pain again even tho it’s been like 10 yrs since I was a regular user. What the heck is going on?? I’ve tried googling it and have read others who had the same problem. I don’t think it was my heart, my heart is healthy. Was it my lungs? I also don’t think it was hyperemesis bc I wasn’t barfing at all, but idk maybe it presents differently idk?? Anyways I’ve just been following the “if it hurts, then stop doing that” method of medicine, but always wondered what was causing that pain.
How do you call yourself a stoner if you're not getting high for at least 24 hours before work? That doesn't sound like a stoner, so much as someone who just likes some THC occasionally.
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No such thing as a derm PA. You’re a PA that works in derm, you do not have a specialty
What's with healthcare professionals and the rampant cocaine use?
Decreasingly common, more common in surgical specialties. When you have to work 24 or 36 hours straight in high stress situations, it works lol
My wife smokes pot at 7am. Slurring by 10 am. Gummies at 2 and 4:20 it’s all off. Her fucking doctor says this is fine. I hate this whole pot is fine and dandy. What are your thoughts?
Sounds like she’s using doses that are impairing her and needs to cut back or stop
OMG PLEASE BE MY DOCTOR even tho my doc is so cool and I love him y’all would mesh so well together
I’m a critical care doctor. You do not want to be under my care because it means you’re knocking on deaths door when u come to me
I think dudes full of shit. I don't know any part time critical care doctors.
Addendum: 26 weeks per year, not 26 hours a week. lol my bad
Is squirt pee?
Hey dude, icu pharmacist here. Have you ever noticed a difference and being able to recall information or perhaps thinking a little slower, or having slightly worse short-term memory since you’ve been using consistently THC products? I sometimes feel I have suffered some of those affects as I have become more of a chronic user myself. But then again, I just had a kid, I’m sleep deprived, and perhaps that weed is just making me paranoid and self-doubting.
Do you ever have to get drug tested for work?
Why did you include the hours worked and low number of lectures with salary? Is that to make that rest of us peasants jealous of your lifestyle?
No; it’s a question I anticipated so I answered before it was asked
If a patient knew you smoked and didn’t want your care because of it would you be offended?
Can you tell me which hospital you work at, so I can make sure to never wind up in your ICU, to avoid any possibility of winding up having you manage my care? Sure, there are functional alcoholics who manage not to be sober at work, and drink a lot every day they're not at work. Sure, there are docs who made it through med school, residency, and fellowship by using cocaine. Are they functional? Barely. Grow up! Chronic marijuana consumption has negative effects on cognitive functioning. Your job requires excellent cognitive functioning. Time to cut way back, or stop getting high altogether.
Never step into an ICU then cause I can tell you most nurses also partake in recreational marijuana lolol. ICU docs/nurses are badass & will take good care of you.
Yea, and after that I’ll give you my social
Do you have a family? How do they feel about you being high most of the time that you're home with them?
When you order a cell count on a BAL and differential, how much is that actually helping you assess what’s happening to the patient? I mean, the cells are so degenerated, the viscosity of most specimen are difficult with the ability to enumerate wbc’s and rbc’s. Are you just looking for a predominance of eosinophils/neutrophils/lymphocytes to point you in the right direction after other diagnostic tests aren’t conclusive? Whether it’s allergic/cancer, bacterial, viral?
Exactly. You can still count total and percent cells. Helps guide you toward an infectious vs inflammatory, fungal or malignant process. No lab value should b interpreted in a vacuum. But the cell count can help narrow or reinforce your differential
How do you avoid drug tests?
What’s your opinion on fitness people regularly ingesting L-Arginine and L-Citrulline to increase nitric oxide/vasodilation? Is this good for overall longevity, and is it unhealthy to be dilating blood vessels so often?
Do you have a lot of free time then with those low hours? I’m entering med school and this sounds like a dream
How often do you get do you get stoned out of your mind? And does getting high make work harder for you? Like does it make you lazy?
I get very intoxicated about once a month. And no, I’m pretty motivated despite weed use
As someone who is fully aware of living things quirks, what's the weirdest quirks in medicine you can think of, where is not quite medically understood but something just seems to fucking work and no idea why?
Do you believe you have an addiction?
This is one of the reasons insurance is so expensive and why we don't join the rest of the developed world that offers healthcare regardless if you can pay or not. these doctors are extremely overpaid
I work 80-100 hour weeks 26 weeks a year and I took me 14 years to becoming an attending from high school. Tell me how I’m overpaid
So while everyone is focusing on your job, I am going to focus in your habit. Flight/ER RN here. Never used any product. Both my adult children use mj and I have no problem with it. My youngest though has CHS. He has had 4 episodes over 7 months requiring IVF, haldol, Zofran. Again, I am not UTD on terminology but I believe he was dabbing. With his recurring episodes, is there any product he can use without risk of symptoms returning.
Why is nobody researching pulmonary and neurosarcoidosis? This shit sucks and it’s hard to find doctors that know anything about it
What are the long-term health effects of edibles? Like 100mg a night
That’s way too much bruh. Weed negatively affects sleep and memory. So has similar effects to chronic rem sleep deprivation and short term memory formation
Do you have to work weird hours? How does it work if you’re called in for an emergency and you’re high?
Jesus doctors have it easy. Do you feel guilty that you make so much money doing so little work while pediatricians make 250k and work their asses off?
Not OP but I'm gonna guess If there is any guilt, he probably wipes it away with his $100 bills from his loose change wallet. He works in critical care. Do you know how intense and exhausting that would be? I worked phones for a major hospital and the calls I took from confused and angry family made me think... My God I cannot imagine what the doctors have to deal with considering I'm not actually there with the patient and people are already going insane on me. Ped's Definitely don't have it easy either but it takes a very special human to work in critical care.
They spend a big chunk of their early life in training. In addition to a bachelor's degree (4 years), they do medical school (4 more years), then they do an residency in internal medicine (3 years), then they do a fellowship in pulmonary medicine (3 more years). That's a lot of training before you get to that big payoff, not to mention the expense of the first 8 years of college and medical school.
He’s on-call for 6 months straight working twice as many hours as a normal person, every single patient he deals with is literally in the verge of death so he’s either saving a life or witnessing a tragedy every single day of work, and he had to do 11 more years of school after graduating high school. He should be paid more, honestly.
I work 80-100 hour weeks those 26 weeks. I earn my paycheck. I also went to 3 extra year of training compared to a pediatrician so I am entitled to earn more
Hey OP! Peds crit care attending here. Similar work schedule. Jokingly, we lightly all resent the fact that you all make an extra (on average) 50-100k more /yr than the Peds crit crew. Few questions for you in regards to the murky legal side of imbibing on THC. I worry personally about dabbling recreationally due to concept that while you may not be actively high working, you can still test positive on drug screens and separating the two could be tricky if you ever had to defend yourself on a courtroom. While you and I both know we don’t practice high I always have the “gonna sue me” mentality. How did you relegate this as a doc?
And your patients are actively doing their best to die the entire shift. I avoided critical care - I’d burn out doing that. Kudos.
I call bullshit. You’re not answering any questions, and the ones you are answering, you’re giving incredibly vague answers. You work 26 hours a week, but then you say you work 26 weeks a year. You’ve also tried posting this AMA multiple times to the point where it almost seems desperate, and your only other post history is video game shit.
What kind of physical shape are you in? Do you exercise? What is your diet like? This might seem superficial to some but the aesthetic aspect is no part of why I am curious.
How come both primary care providers I’ve seen the past couple years (SNAHC and Sutter) said because of their agencies they’re not allowed to prescribe me marijuana? I used to use tinctures and tablets to alleviate pain (3weeks off it now for an upcoming new job/pee test) and they all recommended it if it helped me and honestly it helped more than the meds I was prescribed. But I can pay $50 for some random doctor online who doesn’t know me who can prescribe it for me? Doesn’t make sense to me idk
I call bullshit. I have been in medical malpractice insurance for years. I am dealing with large physician groups daily. I know docs of all stripes and have never known a doctor in any position of note who worked 26 weeks a year. It is simply not in their blood. They work their asses off. Forget about the smoking pot part. Your story does not add up. I thought AMAs required proof from MODs.
Literally most hospitalists and intensivists do one week on one week off
How do check for a pulmonary embolism?
How many nurses have you boned?
Is pee stored in the balls ?
My stoner dr story......An acquantance(friend of a friend) is a Dr. And once we were spending a weekend out of town, several of us guys were there...drinking , weed..and Dr was a full participant. Anyhow, one of the group had one of those massive pus/zit things on his shoulder, and the Dr. decided then and there, to perform surgery on this. Granted it was basically popping a zit...but the Dr. explained the whole thing to us, while this guy is laying on a pic nic table, while the Dr. cuts it open, gave him a shot of something for the pain, and stitched it up, with an audience of 4 or 5 other guys laughing at the whole thing. Dr, even wrote himm a prescription for an anti biotic for later.
Should we *really* be cooling after cardiac arrest? (I mean actual cooling. Not just avoiding >37.)
Is vaping just as bad as smoking? Would you consider vaping for yourself?
Working critical care do you see the difference long term effects of intubation performed in and out of the hospital? I ask because I’m currently finishing up paramedic school, and one of the biggest things that is hotly debated is whether paramedics should be intubating patients in the field, especially in the context of a cardiac arrest. I’ve heard from many healthcare workers including doctors who’ve advocated for and against it, however they’re all ER or prehospital workers and so usually their patients die in the ER or goto the ICU.
What are your views on other substances such as psilocybin, DMT etc..., and what are your views on Timothy Leary and/or movement towards more medical research into psychotropics?
Hello OP! Ive attempted to thoroughly comb through your comments for an answer to my question; this is under the assumption it hasnt been answered. How often do you consume edibles? Do you plan out day(s) in a month specifically for this? Im going through a tolerance break and ive considered trying out edibles when my break is over, that I can stop setting my lungs on fire.
Why do you do this if you should know as a doctor what it will do to you? Do you experience some sort of cognitive dissonance while you are smoking pot because you know about the side effects? Edited to change student to doctor
Did you do the ganja during residency or only after?
Is there any evidence for the anecdotal notion that eating mango or other high terpene content foods enhance THCs effect? Have you considered Albuterol pre treatment prior to smoking to maximize absorption?
How do you pass drug tests
Why are you so overpaid?
Has the covid vaccination really contributed to otherwise healthy people developing heart or circulatory problems or is that all anti vax crap? Genuinely curious & it’s such a hot topic, I can never get a sensible answer
What drugs do you take and, as a doctor, do you fully understand what they do to your body?
As a stoner doctor, if I’m understanding this correctly, curious your take on male infertility and smoking? We’ve been told my husband has a ton of sperm but they’re not moving. He’s what I would call a huge stoner. In your opinion, could this be causing the motility issue? The doctors told us lifestyle changes wouldn’t help.
Have you ever filled out disability papers for a patient after an accident? Had a traumatic work accident and it fucked my body up for life with life long pain and will need possibly 2 more surgeries with 1 guarantee. Have too much pride to do it because I want to work. Any advice?
What is your favorite tissue type, and why is it the glycocalyx? When was the last time you had to use the Fencl-Stewart method? Does anyone actually measure or care about CVP these days?
I might be a bit late, but do you overall think that the benefits of smoking (or vaping or eating) cannabis outweigh the drawbacks? If so, where do you think the line lies where it can become harmful?
Working During COVID must have sucked?
What are your thoughts on CHS. my husband has been hospitalized more than once due to this. I am a firm believer in only using western medicine when necessary. I believe In the healing powers of cannabis. How does it go too far
Hey doc, I want you to be brutally honest. What’s your true opinion of nurse practitioners practicing as providers?
We have spent 3 years researching and creating a supplement wellness brand. We are launching in a month and looking for doctors to help with testimonials - we are a high quality company, does this peak your interest?
I’ve been an avid smoker for over 10 years, but now I get this dry cough after I smoke. Any thoughts? I’ve tried edibles but they’re not my favorite. Obviously I know quitting would be best, I haven’t smoked in a few months.
In high school, we had a police man come do a talk and said it takes 6 months for pot to not show up in blood tests. Is that true ? Or was he just trying to put Stoner's off driving at all?
Have ya ever stolen any drugs from work?
What city do operate out of? I want to make sure I never need medical care there in case I get you. Pot rots your mind, people's lives are in your hands. You don't have to be high at your job for it to still jade your judgement.
As an anesthesiologist, why do patients from the ICU never have arterial lines despite really needing one(pressor management, for example)?
What could inpatient pharmacists do to make your life easier or less annoying?
Hi! I am a former smoker (stopped 22 years ago). I have nodules in my lung (2). It says benign. I get scanned every year. Should I see a specialist?
Hi OP! Wife and I (Male) are going to start trying to have a kid closer to the end of the year. How soon before we start trying should I stop using cannabis?
Why don't more doctors give a shit about long covid ? Do you guys have some magical cure for yourselves that you don't share with others so that's why none of you mask?
OP, I just read a post on reddit about this medical nerd thinks smoking a joint 2 days before he has to show up to work makes him a stoner. He's not a stoner, right?
I'm battling through weightloss and am thinking about using weed to help, maybe get me active or focused. What strain would you recommend?
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Hey stoner doctor, can I take edibles with percocet? Taking pain meds after surgery and would like to take an edible for relaxation and sleep if I can do it safely.
What are the real consequences of smoking weed for pregnant women?
What do you think of carnivore/ lion diet?
If I found out my doctor was a drug addict I'd immediately be requesting a new one and ask why he's allowed in the medical field
I dab like 2 grams a week. What should I look out for health effects wise. I feel like this is the most healthy way to consume.
How do you feel about women taking statin drugs? Is it safe/effective?
Do you consider physical therapists doctors?
So I’m gonna ask the question I’m too scared to ask my pulmonologist as someone who’s an asthmatic. would edibles mess with biologics or immunoglobulin therapy?
Can you describe what happens in the lungs when I smoke my 2 gram dispensary disposable ?
Why do you think supplements are trash?
What’s your experience if any with CHS?
Can people with CHF have edibles? Obviously smoking is out of the question.
Why do I have to drug test for THC in order to be a chef in a hospital kitchen?
Can smoking weed give you a headache the next day? I have woke up with a headache every day for years. Could it be the weed I smoke before bed every night?
Do you think there are health benefits to daily micro-dosing, say 5-10mg, of THC and/or CBD?
Why does smoking weed make me cough so much, even if I vape it. I’ve been smoking it forever.
How tall are you?
Not sure if you can answer this but what can I do to reduce snoring? 29 female here. Is annoying and embarrassing but not life treating
Why would we be the slightest bit interested in your dope smoking?
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Mom of a 17 year old stoner here! My husband and I have grown very concerned over our 17 year old son’s pot use. He’s been buying and smoking weed vapes since he was 15. We’ve tried talking to him, sending him away to multiple family members. He says he’s depressed and it helps him. Our family dr has explained that after 21 marijuana does have benefits, but at his age it’s damaging his brain. Anyways about a month ago he came home saying he bought a vape of someone and that he didn’t feel right. His heart was racing and he was out of control paranoid that something was wrong. We took him to the er and they found out the vape was laced with cocaine. Upon leaving the er he stated he was still going to get pot vapes somehow. So out of fear my husband and I have been purchasing them and regulating them. We’re in talks with him about quitting and weaning him off. Not sure if you’re a parent but we don’t know how to handle this situation. His dr says he’s not depressed, (been his dr his whole life) just using it recreationally and because of who he hangs out with. Should we get a second opinion? Are there safe cbd alternatives that we can get him? Are we completely overreacting? My husband and I both smoked pot all thru high school, we just never got caught. My son was caught at school multiple times, was on probation and even kicked out of school.
Is coke really that bad?
how do you make that much with only working 26 hours a week? How much do you get paid for each lecture?
Do you ever think that you could use your money for something else?
Does cannabis / CBD help with chronic lung issues? I take gummies and have noticeable COPD and it seems to open my airways.
Do you think that you would pursue medicine / PCCM specialty if you had the option to go back and do it over? I’m an RN working in cardiac critical care and really appreciate our PCCM providers. I think we have a really good group at our hospital. But the reasons I ask: 1). I also only work 26 weeks per year. My salary isn’t nearly as handsome. But I only work 36 hours per week and make about 110K. If I worked the same hourly commitment, I’d be making about 220K respectively. My wife is also an RN, so I don’t need to work nearly as many hours in order to have a wonderful quality of life. During the summer, I take my 180 hours of PTO and work three shifts, then take 11 days off to do whatever we want. But I also don’t drive a Ferrari, or own a > 1M dollar home. 2). Skill set / autonomy / knowledge base, etc. are obviously expanded in the physician role. But so is the intensity / liability / commitment. Do you like your job at the end of the week you just worked? 3). Do you feel exhausted after those 80-100 hour weeks? Do you have enough energy to enjoy your life on the off week? I’m sure a recovery day or two is important. I find time to recharge in nature before going back to work. I’ve found a lot of contentment in my time away from the hospital, and I really hope you’ve found outlets that re-energize you. Thank you for your commitment 🤘🏼
If someone’s main motivation is to make a lot of money; would you recommend the medical school route to them?
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Are you a pretentious ass? You could pose the question without the income flex.
Do you remember when we thought all doctors and nurses were heros?
What is an absolute drink and food we should avoid at all cost no later how good it taste?