How to Speak Internal Medicine

[@TaiChiKnees]

During my residency I once said, "...the patient suffered a stroke..." and my attending said, "Isn't saying he 'suffered' a little subjective?" ...so I said, "Okay, the patient enjoyed a stroke..." Luckily, my attending laughed...

[@xyzct]

Woah, woah, woah ... _laughed?_ Aren't we Little Miss Confident. Are you sure it wasn't a chortle? Boff? Giggle? Snicker? Twitter? Cachinnation? ;-)

[@BeatriceSoucy]

HAHAHA love this!!

[@sophiathore3538]

That was the best comeback I have ever heard XD

[@bengeurden1272]

I assume that with "laughing" you meant "panting vocalizations". How could one dare to use the term "laughing"... 🧐

[@pessy4858]

I will be a resident forever if I do this.

[@osmosisjones1001]

Internal medicine doc here. This couldn't be more accurate. Just today I read in a colleague's note: alcoholic cirrhosis most likely secondary to alcohol use 😂😂😂😂

[@daucuscarotasativus]

Lmao

[@fumeeadonis4894]

I can’t! 🤣🤣🤣🤣

[@frankG335]

Hahahaha! Most likely.

[@Frommerman]

Woah, that's a little premature don't you think? How did they determine if the cirrhosis is alcoholic in eitiology?

[@bryanjacobs9680]

Lol but HOW DO WE KNOW!

[@adrianmole90]

Bill would make an excellent intensive care doctor. Straight to the point, ready to act, no time for bullshit, infinite amount of stress tolerance.

[@rexx3546]

bill better add internal medicine to the 'considered' fight list

[@BearcatEm]

My husband did his residency in internal medicine but is now critical care/pulmonary. I asked him if he could relate to this and he said it's definitely accurate but he's more like Bill because he just makes a decision and says "this is what we're going to do". Then I saw this comment, so can confirm that you are spot on lol

[@ParagMathurmd]

Or even further. Anesthesiology!

[@markgodish1347]

As a critical care doctor, amen. Good ICU doctors are poker players-I know I have to make decisions despite incomplete knowledge. Some people can't handle that.

[@kpliu2948]

All of us critical care physicians with internal medicine background were Bills back in our residency :D.

[@voidjockey82]

The three wonders of medicine: An Anestheseist at work. Two Internal Medicine Doctors agreeing. A Surgeon in the library.

[@hobbitomm]

A pod reading an ECG

[@dena3107]

those are signs of the apocalypse

[@mbeally]

I’ll add-an Ob/Gyn running a code 😂

[@fil4648]

I don't know where you get the surgeon stereotype from, we need to study just as much as internists, we just have to fit it into less time because we actually do something other than rounding in the hospital.

[@voidjockey82]

@@fil4648 I'm not the creator of this joke, just a reteller. Apparently the stereotype is not that surgeons don't study but that they are very self-assured, at times even cocky, to the point that they don't go through some things again because they're sure they still know it all. Whether that actually applies to a majority of them, I have no knowledge about.

[@DrGeneralkumar82]

And 3 hours later they ended up starting the patient on 20 mg of lasix.

[@heatherakers5453]

Nurse here... After they dc the foley. 😢

[@christinajames1210]

True🤣🤣🤣🤣🤣🙏🏽

[@davidh9844]

Unlikely. You drown in about 5-10 minutes.

[@anonydun82fgoog35]

And mechanical ventilation with PEEP because of the pulmonary edema...

[@Paul-mx8sf]

Id rather have surgery without anesthesia than have to relive Internal Medicine teaching rounds. Only thing worse is MICU teaching rounds.

[@RJSearson12345]

1:21 "You can *consider* diuresis" I love this because I'm in paramedic school and when we do our practical assessments somebody always ends up saying something like "i'm going to consider calling for additional resources" or "I'm going to consider taking c-spine precautions" and the proctor always has to be like "You can consider whatever you want but you should probably actually DO something"

[@staceyk2274]

Sounds like my preceptor on my ED rotation!

[@Abcdefghijklmnopqrstuvwxyz1024]

We need more people like that Proctor in the world

[@dabiga2315]

I think you may have missed your calling in internal medicine

[@richyhu2042]

I am not in medicine but I feel this. Recently I got a job and had to make a presentation on what I think we should do to build brand awareness. At the end my boss told me "this sounds good, how can you execute the ideas" and I realized that Im not just putting hypothetical solutions and theortical solutions in for a grade to look nice anymore lol.

[@RLKmedic0315]

The number of times I heard that in paramedic school.

[@cwtrain]

These videos are getting stressful and traumatic as they align more and more with my actual daily life. It's kind of like how you get older and you realize the movie Office Space is not actually a comedy.

[@nancylindsay4255]

I come here for the movie recommendations.

[@yonpark6245]

Yes, I could feel my BP rising with each passing second, which is why I went into a surgical specialty, but then whoops, now I encourage this hedging, obfuscating language as a rad. I apologize, oh wait, I mean, these words have the appearance compatible with an apology.

[@a.humanbeing8171]

@@yonpark6245 these word may have the appearance, you mean 😉

[@aslansown]

Working a corporate job for decades Office Space is accurate.

[@theman11999900]

Or idiocracy....

[@PrincessLelouch]

In veterinary medicine, we like to say you could ask 5 internists a question and get 6 answers, because by the time you get to the last one the first one will have changed their mind.

[@marthawall3318]

😅😅😅😅😅😅

[@kelseywalker7586]

As a internal medicine veterinarian... you're not wrong

[@davidh9844]

Especially true among Jewish physicians, I might add. This Internist salutes you - we can get patient histories. How you guys do it is beyond me.

[@seeyouchump]

After one year of internal medicine in the uni, I learned more about how to be humble than how to actually treat the patient

[@godspeedsumitbiswas]

We all missed the part where and that is our problem. 😂

[@faizanquraishi4126]

Im proud that bully maguire is a doctor.

[@hinnah5954]

I'm going to put some dirt in your eyes

[@Scholupine]

I'm glad that you're not an ophthalmologist

[@seeyouchump]

@@godspeedsumitbiswas Call an ophthalmologist already....my dirt is ready for combat

[@rockyvolcano4]

This reminds me of the time I was in a room full of law students trying to figure out how to word, “The muffin tastes good,” in an objective way. (it was a practice question for part of their class) “The sensations caused by eating this confectionery are usually perceived as pleasant by most individuals whom consume them.” Was the closest we got. The reason I was in a room full of law students is because we had booked the same study room at the same time and I was really just there to use the Wi-Fi (which was only available for people using the rooms) to download some games, so joined the conversation while I waited.

[@ovni2295]

I would have just gone "Of X number of individuals who tasted the muffin, Y number said they enjoyed it." No wriggle room there and doesn't discount that other people who did not taste the muffin wouldn't like it.

[@rachels.8051]

@@ovni2295 ‘four out of *only* five dentists agree…’

[@TheQuark6789]

@@ovni2295 But that requires that you actually go around and survey X people to taste the muffin

[@eekcm23]

As a doctor of philosophy, despite what people may expect, people in my field find conversations like this insufferable. The muffin tasted delicious to me. Done: objective, for some sense of the word.

[@xxBreakxxAwayxx3]

This baked good stimulates certain parts of the brain and body when consumed by certain individuals that is often considered pleasant or filling, particularly when in combination with other food groups such as fruit or even coffee. Enjoyment seems highly likely but not guaranteed, such as in the case of dietary restrictions like celiac or lactose intolerance.

[@giraffegiraffe3]

Thanks Dr G - definitely going to use "a likely non-zero probability of it being not unreasonable to consider a possible diagnosis of..." in clinic tomorrow 🤣🤣🤣

[@MM-pt9oz]

Same!

[@shaliniverma7020]

🤣🤣

[@sauercrowder]

WHOA Whoa whoa, likely??

[@2Bad4YOUuu]

So "aggressive"

[@XanderL]

Definitely? Don't you mean you're most likely going to use?

[@Michelle-mn5zz]

As a lawyer, I feel like the internal medicine doctors are my kind of people lol

[@boopsce]

Mathematician: ditto.

[@AstroZombie1]

Slightly smarter than average nursing student agrees.

[@NiteSaiya]

I was going to say this is where a philosophy major might go if they went into medicine. The painstakingly precise language and robust use of qualifiers is fundamental to a certain type of philosopher.

[@hathor9777]

I'm in Corporate Compliance, and I concur! haha

[@darkawakening01]

As a German lawyer I confidently can say that 'it depends...'

[@abuazizm]

*I SWEAR THIS IS EXACTLY HOW THE INTERNAL MEDICINE ROTATION ROUNDS.*

[@ShamrockBanksObservatory]

"EXACTLY"?????? As an internist myself, I find your assertion of precision 'troubling'. It is, however, highly suggestive of every set of rounds in my 30 years in practice. Clinical correlation is recommended.

[@agent0422]

Almost exactly*

[@derekantoku6431]

I love how confident Bill has become! He is growing as a doctor.

[@amandalynn7063]

The multiple same-sounding voices arguing with one another ❤️ It sounds like an achievement unlocked.

[@frankG335]

I was really impressed by that argument!

[@sunshinegirl1967]

This reminded me of dear old Dr Miller, internal medicine rounds took hours as his 3 partners discussed, argued, digressed, pontificated, and all that while he hardly said 2 words. I was a unit secretary back then (the 80's) and filled the doctors charts and nurses charts every day. I found these words on one of Dr Miller's progress notes (just started/never finished) "80 year old woman". That was all he wrote before he fell asleep. Dear old man, Catholic, 12 kids, never a day off, very humble and overworked. He never complained or even got angry, ever.

[@andreapradella9011]

You're great! It's not just the fact you're producing funny, truthful and informative videos... It's that I'm enjoying every single one of them, no exceptions! Please keep it going!

[@eraytunali998]

Woah woah there, thats a little agressive. I would say it is reasonable to think that his videos are funny. And I do not disagree that they are informative.

[@BeefyZie]

@@eraytunali998 please take into account all possibilities of what is considered informative in these settings

[@eraytunali998]

@@BeefyZie Correct. When the settings are considered along with the history and examination, the videos are most consistent with being informative.

[@aj-dg1lj]

@@eraytunali998 🤣🤣🤣🤣🤣

[@aj-dg1lj]

@@BeefyZie 🤣🤣🤣

[@ashutoshsharmash]

Internal Medicine resident out here... This is so accurate... Even if I think it's heart failure or Iron deficiency anemia, I can't just come out and say that. I need to say that it is my impression and not even provisional diagnosis, and that I advise these medications, order these tests and consults to determine the problem. But really true... Like even in, let's say, an acute decompensated heart failure, before I order Lasix for the patient, I need to take a history, check the patient's BP and other vitals, their baseline electrolytes on admission, most recent electrolytes, present mental status or any alterations in it, my examination findings, counsel the patient and their family, transmit my decision up the chain of command for approval, order a bunch of tests to determine the cause, then give this to the patient, order a Serum electrolytes panel the coming morning to establish a new baseline, and then finally after all this, chart this down. Piece of cake. If you love being meticulous and approach a problem in a step wise manner, then Internal Medicine is a perfect fit for you. Because, as an internist, you're taking care of the sickest patients in the hospital. So even the smallest decision you take, can have a huge impact on the course of disease.

[@christinae30]

And if the patient wasn't in worse condition after all that waiting, maybe he/she didn't need the medication after all🤔 (just joking!)

[@ashutoshsharmash]

@@christinae30 😆😆.. No issues... Well this is where an Internal Medicine Residency is a coming of age training... You get faster and more efficient with practice. All of this, which takes you 30 minutes at the start of residency training, takes you less than 5 minutes by the end of it. As you go from Year 1 to Year 3 to finally becoming an attending, you ascend that chain of command, till you finally are in command.

[@achillesglacia7700]

Actually the joke is obviously a little exaggerated and very funny. but if you think about it, that is really the only way to treat a patient medically, it's the only way, you can't just go in, you have to look up left right, back take one step and check for sink holes, ofcourse while being chased by a hungry bear behind you.

[@davidh9844]

If you think it's failure, and it is, you have to move your butt and jump! Iron deficiency anemia allows you to take your time. And it is YOUR responsibility to recognize the differences between cardiac insufficiency based on both subjective and objective findings, and failure brought on by iron deficiency. (Look at the patient's palms and listen to the bases of his lungs...) And trust your gut when the time comes, you will be right 9 times out of 10.

[@AndreaJag1]

I think I need to know more Internal Medicine practitioners. It appears I might like that way of thinking. Does curiosity outweigh ego in these people?

[@mohrle1100]

As an intern in internal medicine I can say that this video is as comical as it is true. There is nothing more funny and frustrating to see five to six doctors needing about three hours to round 25 patients while making the "internal medicine arguing noises".

[@AlexandreRodrigues-mv5cl]

I'm an internal medicine specialist and I take offense. We would never take 3 hours for 25 patients! Wouldn't want to rush any decisions without proper back and forth, would we ? :)

[@mohrle1100]

@@AlexandreRodrigues-mv5cl My apologies, of course not. Where would we even end up if not for the completely necessary and absolutely not annoying to the nurses back and forths?😂

[@Pronnt]

My current attending takes 4.5 hours to round 12 patients. Usually the outcome is some wacky dosage of something, or lansoprazole 30 mg in the morning and famotidine 40 mg in the evening, torasemide 5 mg on even numbered days, things like that. I would pay in gold for him to take even three hours

[@chiarakoch6034]

ONLY THREE HOURS?!?!? we need 7 hours for 15 patients.

[@johannageisel5390]

As a mechatronics technician: What exactly are they arguing about? What could happen in those arguments did not take place? Can somebody please explain it to me like I was a PLC with only 1 input channel?

[@merryb6646]

As a patient, thank you internal medicine docs for considering things from many angles and being thoughtful about meds. We appreciate it. And thanks Dr. Glaucomflecken for always entertaining content.

[@NEPtune-fy1ug]

awww

[@prognosis2019]

This is just so accurate 🤣 One time we consulted nephrology and we specifically stated we thought the patient needed a renal biopsy and the consultant wrote, "It would not unreasonable to consider renal biopsy" and I died 🤣 I responded, "We did consider renal biopsy which is why we asked you." 😂

[@faarsight]

And he said you weren't being unreasonable in doing so, what more do you want?

[@joestevenson5568]

@@faarsight For him to get one

[@roetemeteor]

@@joestevenson5568 WHOA, HOLD ON THERE SPEEDY GONZALES .

[@grandma460]

Too funny ;)

[@elizabethm3310]

Coming home from my internal medicine rotation to watch these🤣🤣🤣 It is not unlikely that these videos are almost 100% correct

[@nrmbnt]

GREAT, GREAT, GREAT!!!! As an internist I "significantly" concur that this stereotype of "us" is spot-on! Then again, that is true for all of Dr. Glaucomflecken's characterizations. For a surgeon (well, barely a surgeon since it's ophthalmology) you are a very smart and capable physician and human being. Now you will please excuse me as I have to go take a medication (to be decided upon after a prolonged internal debate) since I used the term "smart" and "surgeon" in the same sentence and that has given me both a headache and nausea.

[@afrozeahmed6515]

How can u say he is barely a surgeon?When u have an eye problem I wonder where you will go

[@nrmbnt]

@Afroze Ahmed I will first meet with the ophthalmologist's scribe, and then I will say complimentary things about ophthalmologists...of course!

[@patti6194]

@@afrozeahmed6515 general surgeons and specialty corporeal surgeons present as significantly more egotistical with a higher probability of a God Complex than Ophthalmic Surgeons, in my experience. For instance, my sister had sudden onset lower quadrant abdominal pain, with negative tests for appendicitis. Probably an ovarian cyst, right? A very common thing. They were going to do exploratory surgery in case of ovarian tortion, (talk about hearing hoofbeats and looking for a Zebra!) and had her sign a release for removal of everything from one ovary and one fallopian tube to a complete hysterectomy (in case of cancer.) She was in her mid 20's and single, no kids. Suffice it to say, she was freaking out. Shift change comes, another surgeon takes over the queue, comes by to introduce himself and looks at the release. "Why in the world did he have you sign a release for a total hysterectomy?" "In case of cancer?" The guy looked at us and said, "I'm an Obstetrical Surgeon. If I find cancer, I'm going to close you right up and send you to Oncology as soon as you wake up. I'm certainly not doing a hysterectomy." This was in the 80's at a well known HMO that has a significantly better reputation now than it did then. When my older sister had the same symptoms at the same HMO, they made her think she had cancer. I had a private doctor with BC/BS insurance. When I had one, they shrugged nonchalantly and said, "It's probably an ovarian cyst, they're very common. We're going to send you for an ultrasound to make sure it's not too big. It will probably burst and resolve on its own, just take Tylenol." So, instead of having a huge stressful health scare and surgery, I had a common, boring, everyday ailment that, while painful, sure wasn't even close to the Big C. When we were comparing notes one day, we found that all three of us had a benign functional heart murmur as well as the ovarian cysts. When I had cataract surgery on both eyes simultaneously, the surgeon told me her percentage of unfavorable outcomes, which was something like .002 or .0002%, and added, "... and I've never blinded anyone." Ok, good to know, but not sure I wanted to hear it out loud, lol.

[@frankG335]

@@afrozeahmed6515 pretty sure he's joking.

[@marysalmon2367]

@@afrozeahmed6515 its a joke

[@swood07413]

EM resident here. This is fantastic. I've watched pretty much all of your videos and can't thank you enough for bringing just the right amount of humor to an otherwise insanely stressful time ❤️🙏

[@peggyerickson2549]

Concur

[@SilentWayFarer1]

Cardiology fellow here. After watching this video, I now feel guilty for making a diagnosis of heart failure too quickly

[@cinimatics]

It's ok they're gonna consult you for an opinion anyway 😆

[@mannagarwal5390]

ProBNP 2D echo

[@mrwiggiewoo]

As someone with multiple chronic and serious health conditions, I love and appreciate the thoroughness of my physician of internal medicine. 😄👍

[@popenieafantome9527]

As someone who has sat in my mother’s doctor appointments, i also appreciate the thoroughness of it but it can be a little disheartening when i asked “how do we know it’s getting worse” and 90% of the time the symptoms is stuff that is already kind of “normal” for her. Such as some form body pain, tiredness, and lack of energy.

[@farah5189]

After watching Bill's session with Psychiatrist, I respect Bill more. I feel like Bill is the "normal" one except here he receives so many burdens and feel overwhelmed sometimes. We love you, Bill

[@yuki97kira]

I feel like only jonathan appreciates bill here

[@dena3107]

Im slightly confused about Bill's speciality because I see him with all the other characters, what exactly is his role ?

[@dianavaleriaandres4631]

I am a medical interpreter residing in Argentina, and even though I am not a doctor, I really enjoy your videos and with this one you really made my day!

[@mrfxhnd9680]

as a Hospitalist this is HILARIOUS! 😂 Internal Medicine… nothing certain, nothing definitive, keep all options open and everything vague …why? for liability of course

[@patti6194]

Yes, as with so many other things in American life, we gave so much to thank the lawyers for.

[@mandas677]

I’ve never met a nice hospitalist. Why are you guys so mean to patients? We can’t help the orders that were put in by our admitting doctors/surgeons. But we get yelled at by you for it. It’s not just been to me, but also to my roommates while hospitalized. And no matter how serious our conditions are, you always try to discharge us and yell at us about “taking one of my beds”. Even when specialty says it’s an inpatient issue, all you want to do is discharge. Never look at the chart to even know why we’re there, just start in on us trying to make up leave. Like I was admitted and waiting to get brain surgery and the hospitalist tried to discharge me. Wtf is wrong with you guys? I had a roommate in kidney failure and the hospitalist said “you love laying in that bed don’t you? I’m not going to just let you take up space here.” Like tf???

[@samfish5500]

@@patti6194 true.... I think lawyers really fucked it up.... but here in a different t place, IM is much more certain than the above. The problem is, certainty sometimes misguide..

[@gaycatboy69]

@@mandas677 I'll take "shit that didn't happen" for $500. Alternatively, "made up sob stories by people who have no idea what the inside of a hospital is like". A hospitalist is a general care doctor that does the same work as your PCP, but at the hospital. Theyre a temporary PCP for your hospital stay, essentially, and they aren't in charge of discharging patients. There is an entire team of people responsible for reviewing your options of care and keeping track of your health while youre in a hospital. Nobody would walk in and try and discharge a patient waiting for brain surgery or in kidney failure unless they made a grave administrative error. Hospitalists cannot and do not just override inpatient specialist care.... like an entire fucking brain surgery. More importantly, you probably won't even see a hospitalist while waiting for surgery, because you'd be under the care of the specialists who will be doing your surgery during that time. Most importantly: **any doctor that yells at a patient over something as inconsequential as preferring inpatient care or occupying a bed while waiting for care would have been fired.** that's not how that works. there are rude nurses and doctors, but you cannot expect a doctor to be able to go around kicking dying patients out of the hospital without that doctor losing his job in the process. There are entire legal teams that do nothing but review how a doctor handled a case and interacted with the patient on the off chance that that patient could sue for malpractice. A doctor kicking a patient in kidney failure out would be a hilariously easy target for anyone interested in making money from medical mismanagement. Have you tried actually getting a hobby that isn't making up garbage online? Therapy, perhaps?

[@mandas677]

@@gaycatboy69 I know what they are, I’ve been sick since I was a kid. They are the most ignorant doctors I’ve ever been around. They constantly try to discharge you and say that the specialties can handle your case in an outpatient setting. They have terrible bedside manner and will literally raise their voice at their patients. I’d honestly rather see an orthopedic surgeon and that’s saying something. They put their nose where is doesn’t belong when you’re admitted for a specialty reason. I had Idiopathic Intracranial Hypertension with severe papilledema, admitted through the ER, it was to the point that I was at risk of going blind. I needed to get a ventriculoperitoneal shunt, I was admitted but my hospital wanted to do testing on clotting and other factors before surgery so I didn’t get the surgery same day. I was in the step down ICU and the hospitalist kept asking why I was taking up his bed. My neurosurgeon wanted me there. Another time I had an impacted bowel and the hospitalist tried to discharge me, I had no bowel sounds and hadn’t had a bowel movement in over a month, no gas passing and throwing up every 2 minutes of just bile. Hospitalist said this was an outpatient issue. Gastroenterologist said no this could need emergency surgery you’re not leaving. Had my gallbladder out, hospitalist walks in asking why I’m there as I had been admitted after. I explain I had my gallbladder out, he interrupts me and says I know that why are you still in the hospital people get open heart surgery and leave next day. I had pancreatitis and was unable to drink water or eat any food, it was my surgeon who admitted me. I have a very complex case because of my disability, I can’t walk, have epilepsy, and have had to have 15 surgeries in my life. But hospitalists don’t give a shit. They just want you out of “their” beds. Multiple hospitals, multiple hospitalists. They’re all shit. They’re GPs that don’t have the bedside manner to be family medicine doctors/PCPs at a clinic. All they care about are numbers and getting patients discharged ASAP. And you’re right the one that yelled at my roommate was banned from our room, she had to fire him and it was a huge report. For me, I had my family deal with them and yell right back. Unfortunately they can’t be there 24/7 so it’s really quite scary to have then come in your room early to berate you. That girl had lupus and multiple cysts on her kidneys with very little function. She had been there for over a month already and he basically said she didn’t want to get better and that she could trick everyone else but not him. It was horrifying. Medical trauma is real whether you want to admit it or not, and is disabled people with severe chronic illnesses tend to experience it more than the average person.

[@Joozt112]

With both parents in internal medicine the (internal medicine arguing noises) part made me laugh so hard as it's trip down dinnertime memory lane lol.

[@Roccofan]

I agree with the other doctors, at least a weeks worth of research and meetings are required to decide a reasonable course of action. Anything less would be irresponsible. If he dies, he dies, but we need to check all the boxes.

[@muhammedmemduhoglu7854]

Hello internal medicine :)

[@muhsalihu]

That's why Surgeons can't stand medicine because we are trained to cut out the bull shit and treat the patient. 😁😁

[@patti6194]

@@muhsalihu as surgeons, aren't you trained to cut out the problem, period? Don't limit yourself to the bull shot! And is a bull shot like a prairie oyster??

[@Marmalard]

Notice how he didn’t even mention sodium, which is the most important element in the human body.

[@inmyopinion-]

🤣

[@mar10ssj1]

Defensive Medicine at it's finest 👌. Any hospital administrator would be proud of their work 👏.

[@maryragan6335]

I'm a nurse and whenever there's an internal medicine or ID consult I read those for the history because they dig up stuff from the patients entire life 😂

[@pauldegregorio6432]

To be complete, Palliative Care, ID and Hospice care consults must contain BOTH APGAR scores.

[@CataclysmicStar]

"Patient had a splinter in the left hand palm when they were four that required stitches... GUYS I THINK THIS IS THE KEY!"

[@Theoneandonlyenelie]

@@CataclysmicStar did you see in the chart that his step mom had a negative reaction to this medication when she was 5 years old?

[@wentaoli7611]

It’s scary af, they literally dig out your past relationships, I once saw a note containing pt cheating on the second husband and he ditched her because of that. Like, from that point, nobody on the unit wants to every be admitted in the hospital anymore.

[@nancylindsay4255]

@@CataclysmicStar Hmmm . . . Could that be the problem? They're all guys.

[@mipizarrop]

Internal medicine doctor here. Showed up this to my residency partners and we all was like "LMAO FUCKING ACCURATE!!!" so kudos for nailing the point hahaha. Anyways I'm all like bill: straight to the point but still the differential diagnostic pun hahaha lol always on the verge of ddx. Thanks for this Dr glaucomflecken, you make residency a lot more cheerful.

[@Florkl]

I was expecting them to be arguing over you can’t call a chest xray significant to be followed up by, “They’re significant because the patient has five broken ribs.”

[@frankG335]

I thought he was going to do something like, "The femur is jutting out of the skin" but he took it in a different, more subtle direction. Great video!

[@joestevenson5568]

Yep I was expecting massive pneumothorax or a whiteout

[@richardsparks9904]

Ortho!

[@patricewilson8924]

I work as a medical assistant for an Internal Medicine doctor and this is exactly how he works. He also refers for everything because he wants an expert opinion to consult with. My boss needs to see this so I can explain why you can't overbook his schedule, not unless they want me to have 5 hours overtime a week because of how far behind he got during the day. Amazing doctor though!

[@melissaparks6698]

I was a nurse at a university outpatient clinic and this takes me back to my fly on the wall days of afternoon internal medicine clinic! Absolutely spot on! Side note* morning clinic rotated between Rheumatology, ID, GI Hep C clinical trials (long ago when Interferon was coming on the scene), a nephrology HTN clinic and probably more....all Dr. G's videos are scarily accurate! Love them!!!

[@zachbrenner9959]

These sketches are actually helping me learn the difference between the different specialties. Not super important for me as an EMT since I only work with the emergency department. Before I would have figured everything except dermatology and maybe urology was internal medicine

That "I concur." whipped up the memory of "Catch me if you can" in my head. I had to rewatch the whole short because I missed the rest of it due to laughing.

[@HayseedHick]

Yeah…I love that people ‘do’ internal medicine….it wasn’t for me…after completing my IM residency, I started my anesthesia residency. During a case you usually only one person to dialogue with…yourself. If I decided a patient needed something I did ‘that thing’….BTW: 100% compliance. I loved it.

[@veverizza2016]

I am an internist and I had an attending like that in Residency, I felt horrible No matter what I used to say, it was really impossible to please him. I am so glad I am done and I do not have to impress anyone anymore now.

[@petersoa840]

Retired Internist. Internists don’t usually smile much, but reading this, I did. Entertaining and sounds authentic. I don’t condone unbridled, unseemly enthusiasm but I have to say this is just perfect!

[@velvetrose12]

Far too early to find memes and other people's hilarious stories in the comment section haha

[@erinhopkins4819]

I’m a Hospitalist and love your videos so much. I would love to see some of the Hospitalist vs the ER doc. Or the rural medicine doc working in a rural ED as all of the specialties and calling himself to accept a patient 😂 Thanks for all you do to make us laugh while educating on important healthcare matters while single handedly improving the major PR issue docs have as a whole. You make me want to go to an ophtho conference just for fun. If that’s where the Jonathon’s strike I’ll weep for you all 😉

[@adityajadhao7137]

I am an Internal Medicine doctor and I can say that this video shows our daily conversations😂😂

[@Whitecroc]

With a potentially reasonable level of accuracy?

[@redpilledbachelor7776]

I would not have the patience for that LOL.

[@bryanjacobs9680]

I used the word significant during rounds one time and my attending stopped me and went on a 30 minute talk about why or why not it should be considered significant, followed by him asking me to prepare a presentation on the condition for the following day.

[@Whitecroc]

@@paulbarclay4114 So one could, as it were, possibly infer that within this video there might exist a non-zero degree of specificity as to the alleged accuracy of the supposed behavior of what, under certain circumstances, *might* be called non-external, empirically indicated positive chemical interventionists?

[@Zometh]

I never knew that I could relate to a doctor video, yet here I am. Never being willing to confirm or deny anything is my most prominent personality trait.

[@lakibrain]

After almost ending up in internal medicine myself, I can conquer that this is strongly suggestive of comedy gold 😂 Keep it up doctor G!

[@WandererTheLost]

Conquer is a little strong. Don't you mean that it would not be unreasonable that you might agree with the video?

[@robertbodden8810]

Do you mean "concur"? Lmao

[@WandererTheLost]

@@robertbodden8810 I mean yes but also that isn't what he said :P

[@robertbodden8810]

@@WandererTheLost yeah I know. You're both wrong. Concur is the right word lmao

[@blennergomes]

Dude you make it seem like working in the medical field is pure comic insanity. I love it. Keep up the great work doc!

[@purkinje972]

Considering different options,different doses,what kidney funcns look like,my most likely comment is consistent with 'Love your videos ' Significantly

[@taykaram6020]

How incredible it is that you are truthful about an actual morning round and also funny at the same time .....plz dont stop making these videos....breath of fresh air in the mobotonous routine 👍👍👍

[@vanshooky3875]

no way internal medicine consults are the same as me trying to write my thesis,,,internal medicine truly is the academia of medicine

[@naweka4319]

when you have to fill the 2000 word limit you become an internal medicine doctor in deep from your heart

[@ItWillRainXO]

Shookyyyyy!!!!!!!!

[@ItWillRainXO]

Never thought I would find an army in these comments :)))

[@vanshooky3875]

@@ItWillRainXO jkdfngkjdfngjf hi fellow army!!!

[@eddiegreif2715]

Literally came to say this, this is exactly like the academics department component of my design degree !! It's astounding how many words you can knit together to say something like "in conclusion" or "this means" or "because" 😂

[@lauravalle3766]

The face you make convey SO much! You must have been practicing these for like 7 years or something! 😂❤️

[@Shinnizle]

I know nothing about medicine yet your videos are absolutely hilarious to me. Keep it up!

[@stevenlouton6381]

Dude, I love your videos! Some of the only times I ever get a smile or a laugh from seeing a medical professional. Thank you, so much.

[@msiddhartho]

Honestly I feel bad for non medicos for being unable to appreciate how accurate your videos actually are!

[@melaniesee8916]

If one has been a patient, particularly an “interesting patient”, one understands this, too.

[@SimpleReally]

0

[@swals05able]

It’s actually a smidge terrifying but I want to also say these are awesome and make me laugh so don’t stop making them please.

[@chethangv7974]

These days everyone watches grey's anatomy and good doctor so I think they can also understand!!

[@abdulsbadr]

Wow Doc....you took that tweet (someone talked about insignificant/not insignificant etc) and turned it into yet another masterpiece!! You, Sir, you are a legend

[@NishantGogna]

Just finished my internal medicine inpatient rotation last month. This is 100% the truth.

[@botedj9084]

Honestly amazing how he can make content which is relative to everyone but is focused on such a niche topic

[@featherfluent1109]

as someone who used to work in internal medicine, this is one of the greatest shorts Ive ever seen

[@msmeyersmd8]

This is genius medical truth. Presented in an incredibly funny manner. Thanks for doing it. The"Golden Weekend" was priceless.

[@echognomecal6742]

The most informative & accurate video I've seen on this channel yet. Priority one: Coverage of the Gluteus Maximus.

[@rebeccakoch9203]

😂😂I love your videos so much. They make me value my non-interpersonal job as a dog groomer that much more.

[@loiscassels8966]

Hey! dogs are persons, too! ❤️🇨🇦🐾

[@ZijnShayatanica]

As someone w/ several chronic illnesses, I'm grateful for the overwhelming level of analysis & uncertainty Internists treat me with, lmao. I'd much rather be shunted to several specialists & be told "We can't say for sure if this treatment will help, but it's worth investigating" than be dismissed by a General Practitioner & feel like an inconvenience. 🙃

[@serandipati7333]

this is spot on for IM Docs! 😂 I’m a medical inpatient coder. Sometimes the ddx list is endless!

[@scottdogfl]

So true. I was diagnosed as having a major heart attack by the paramedical staff, and then i was air-lifted to the hospital, It WASN'T A HEART ATTACK, but that that I had a perforated colon - .Jackson South Miami Medical center saved my life. And the staff were super nice during my recovery during 3 weeks in the hospital! Their nurse's were very experienced and kind as were the emergency room Dr's attending to me. If it were not for them, I wouldn't be here!

[@dammit3048]

If i was insane. I would say your videos are inspiring me to become a doctor. But I am in fact not insane so they merely motivate to support and better appreciate all doctors. I wish all the best to our medical workers!!!

[@Idahoguy10157]

Most Internists don’t like simple diagnosis and treatments. The video made me smile

[@coolfool183]

He forgot about the exhaustive literature review

[@anthonyhewetson5086]

I teach anatomy at medical school (to first year medical students and to graduate students) but have very little understanding of what 'my kids' are headed for as professionals. A few of my former students who are now doctors recommended that I watch a few Dr. Glaucomflecken videos to get a humorous but valid take on things. I hope they were steering me the right direction:)

[@lionheartsda9999]

As a neurologist and internist, this is legitimately frustrating if it actually happened in real life for each patient.🤣 But I agree, when working as a team each member has their own opinion and if opinions clash, it is best to have the team leader or the specialist of the system involved decide the best course of action. This does not happen much overtly, but I think in the heads of each consultant, this is the exact scenario that they are imagining. 😂 Love your videos by the way. Stereotypically accurate and very funny and entertaining. 😂 I can really relate with the neurologist persona and the jokes are really funny. Please never stop your videos and stay healthy.

[@KiKiQuiQuiKiKi]

Absolutely, “stay healthy.” If you develop a/some chronic conditions (especially neurological), no doctor will even spend the few minutes it takes to watch your video to investigate your health problems.

[@dana102083]

@@KiKiQuiQuiKiKi i think om living with a chronic csf leak for 13 yrs. It took 12 yrs to get an ehlers danlos diagnosis and no one wpuld consider my hypermobility and a baseball to the head reasons to do a spinal scan. This is my 4th neuro and hard to keep going.:(

[@KiKiQuiQuiKiKi]

@@dana102083 My kids and I have EDS, too (+ a host of other comorbidities). So many times doctors have said to us some version of “Why do you want to have that [disease, syndrome, etc.]? It’s terrible and extremely RARE.” 🦓🦓🦓🦓🦓🦓🦓🦓🦓🦓🦓🦓

[@kristaturner6470]

As a surgeon, this gives me chest pain. With an extensive, nebulous differential diagnosis list, which is, of course, derived from my history, great aunt’s anesthesia history, my FeNa, and my cabrini score. All of which will be thoroughly investigated and discussed, prior to being consulted for myself, after the self-inflicted knife is finally noticed in my chest. Ugh. I need a nap. 🤪

[@firelordOzai3]

I'm a Neurosurgery registrar, I've listened in on an endocrinology consultant round for a pituitary patient in our ward and this is exactly how it played out. I think I would probably die

[@luisozuna6456]

I got chills remembering IM rounds in med school after watching this. So freaking accurate. Once had an attending that would grill anyone for saying “endorsed.” Like “the patient is endorsing chest pain” and he would go off on how the word was not appropriate. I mean, I believe it’s not either but this would last at least 20 minutes sometimes.

[@anukriteenegi5129]

Oh my god 😂 This is the best one I have seen so far doc 😃🤠 Love your skits and hope to see more of these. In fact, you are one of the reasons why I will major in biology

[@Newbobdole]

One of my Grandfathers was an anesthesiologist MD post-WWII, and the other was an IM & Geri MD post-Korea... this video actually helps me finally understand one of 'em differently; thanks!

[@evastickler3298]

Maybe I should consider trying internal medicine out if I get into med school. They sound as politely unsure as I do, and Bill has the EXACT look of disappointment that my lab investigator had when I suggested that I not be the *only* one to quantify the sperm found in the experiment because…y’know…to err is human. Instead of just trusting my own judgement call on the number.

[@kiilas]

Omg💙

[@Persephone-t5b]

Was it 8? It seems like the number was 8 for some reason.

[@malaciousmark3903]

Why would you not just use a machine to count them. They are relatively inexpensive

[@merlinious01]

@@malaciousmark3903 sperm or machines are inexpensive?

[@deepashriramesh51]

Omigod SAME. I was just relating to how there's so many possibilities every single time and being thorough is something I've stuck to. I'm in med school now and have been considering IM for long now

[@120gktgbox]

This should be one of the greatest vids, It has to be.

[@galatea742]

This is like writing my lab reports where everything has to be ‘possibly’ and ‘likely’. This is even after I carry out painful ANOVA, Peirson’s R, Chi Square tests and such to get the actual significance number. My calculations say significant but I am not allowed to definitively say significant.

[@ghoghzilla]

I am studying the basics of anova chi square tests today!

[@galatea742]

@@ghoghzilla good luck! I use SPSS and have more or less got the hang of it now but it can be tricky! I suggest finding workbooks on each procedure if you can!

[@ghoghzilla]

@@galatea742 Hey! you seem like a student of research 🤗 I am actually a med student and I have to take an exam for getting into the specialty of my choice. So there's a subject called social and preventive medicine in which we have a topic of biostatistics And they ask us very simple questions, we are given a scenario and we have to choose which test of significance will be valid Good luck with your studies!

[@galatea742]

@@ghoghzilla I just had a stats test last week and it was pretty slow with having to do all the different tests but luckily I got pretty simple questions too. The sample data was a laugh though, nothing to do with my course, nothing to do with anyones course? Stats is my least favourite part of the whole thing but it’s got to be done if I ever want to write anything about anything I suppose. Good luck with your test!

[@ghoghzilla]

@@galatea742 thank you 😊

[@themissingsock2437]

This is why my heart failure was missed. "Findings indicate that patient is likely candidate for right-sided heart failure" an 8 years later after doctor is telling me I was not in heart failure even though I had that on a documentation, I finally got a cardiologist that listened to me and said Oh my God what the hell and now I have a new pulmonary valve thanks to him although I am feeling really awful and the medical gas lighting is insane let me tell you I appreciate the knowledgeable specialists out there, but there is a difference between being a specialist and being a good specialist so thank you to the good specialists that listen and carefully consider the patient.

[@wsljoan]

As a biostatistician/epidemiologist, we also get jumpy about the word "significant" XD

[@lawrencetchen]

That was my first thought, "what's the p-value on that?!?"

[@bootmii98]

@@lawrencetchen First tell me what your alpha-value is

[@is_this_name_taken]

Brings back detailed memories of my internal medicine intern year, when the chief would superciliously stop me every 2 to 3 words to correct the way I said things. I learned quickly to say things the way he instructed, and when I got to my specialty training I think it was considered both overkill and overly formal, although the training in clinical reasoning served my patients very well, as too many of them brought their life-threatening IM conditions to my specialty care domain.

[@dr.floridamanphd]

I have a feeling internal medicine was the debate nerd who wanted to define every term every time a new word was used in an argument and then debate the definition of that word.

[@CanadianCaymanRS]

IM and CCM doc here. I felt like I was in morning report watching this and my PTSD was triggered. Conversations like this are why I subspecialized in CCM.

[@galehusom7266]

This is so great! 😅 The scrutinization of every single word is exactly what I went through when I was writing my capstone for my master's degree. It was pretty intense.

[@alyssajoyblack5007]

I love Bill. This style of speech- like tiptoeing around actual expressing a concrete opinion on something- reminds me of writing essays as an undergrad and certainly writing my thesis. You can’t be too aggressive!

[@Ichibuns]

This is hilarious but at the same time I understand why internal medicine can be so hesitant on quick decisions. The patient's life can be ended so easily without all the information that may take time to get. Running across a situation where there isn't enough time to get all the information must be terrifying.

[@justinmylesstark]

IM here. “It would not be unreasonable to consider gentle diuresis as tolerated.” I love this. Thanks Dr. G. ❤ And now for the obligatory William Osler quote: “To study medicine without books is to sail an uncharted sea, while to study medicine only from books is not to go to sea at all.” 🤓👊🏼📚

[@vikingshark2634]

I'm not a medical professional, but as an intelligence analyst I felt this.

[@myonlineusername6015]

I love that they succesfuly verbalize their concerns as an Internal medicine physician verbalization and some Knowledge and experience will Save a lot of metal energy

[@PoisonWolf]

I was waiting for the xray to have shown a bullet wound and the internal medicine guys to have just been flat out wrong about it not being a significant finding. This was just as good.

[@jasmadams]

This is awesome. As a business development bro, I totally relate to this. "Is that annotation consistent with sections L, M, and C of the solicitation? Have you consulted with Capture and Contracts? Are you sure there are no 8a or 508 requirements?"

[@michaelamilova1600]

Internal medicine in Czech republic is like family medicine in US. I am glad we do not play words here.

[@brianharder7714]

I never tire of these. Sadly, the majority of KZbinrs have no idea why these are so funny. Only people who went through some sort of advanced medical training will get it.

[@pamelap.144]

That look on Bill's face hahaha thanks so much for the laughs, Doc!

[@ilavalolipop]

My favorite PCP of all time is in Internal Medicine, and after watching this I understand why, this matches my personality perfectly lol She is also extremely kind and genuinely caring, so that helps too.

[@Thaffin]

Man this hits close to home. We had a noro-virus outbreak at my ward. I found myself unironically ask almost as a philosofical quandry "Well, what really is diarrhea and what isn't?" Peak IM.

[@dannydoc1969]

These videos he makes are incredibly accurate and hysterical. I did 7 years of residency (Yes I know) in both Internal Medicine then switched to OB/GYN, so great for the overlap with Maternal Fetal Medicine. If a pregnant woman has ANY medical issue the Internists, cardiologists, etc. always defer to me. Dr. Glaucomflecken has yet to do an OB/GYN video, and I can’t wait 😅

[@RaGiNgBaNaNa101]

As a pharmacy student on his last rotation (which is internal medicine) prior to graduation in may…yeah that sounds about all of my experiences so far. Also the amount of doctors (including cardiologists) leaving omeprazole on the med list for NSTEMI patients who are getting discharged on clopidogrel is astronomical. I always think of your Tally system from the pharmacy video whenever I intervene and fix that

[@angiolamariafasanaro8856]

A perfect representation of real life versus the ideal world! Funny and perfect! Thanks and... continue please!!!

[@spandanmishra9813]

This doc himself is a Multispecialty Hospital, playing each and every speciality so accurately like seriously Great videos keep it up Doc 👍🏻