An outsider's take on Duke-UNC rivalry...

In talking to a classmate today about the Duke-UNC rivalry, I think I've finally figured it out...

1. Nobody likes Duke fans. Academically, Duke is the best school in the ACC and one of the best schools in the country, and their fans make sure you know it. Watch a Duke-UNC or Duke-NC State game and you always hear "First place, safety school!" chants and see signs that say "You'll be serving us fries one day!". I went to Georgetown, and Duke fans held up signs saying how our players couldn't read when we played in Cameron. I'm not saying that this isn't an effective psych-out strategy, but it sure does make everybody hate you. Another reason fans of other teams in the conference hate them so much is that the ACC is made up of predominately southern schools attended by people from the surrounding area (obviously this is less so after BC, Miami, etc. joined in early 2000's). When a bunch of dudes from rural NC that cheer for State look at Duke fans, they see a bunch of future-lawyers from NJ/NY/FL/etc. cheering against them. Making it worse, Duke grads have high level jobs in just about every industry all over the country, which means that when Duke comes to your hometown to play your school, there will always be a bunch of Duke fans there cheering loudly in seats that are better than yours. How could you not hate them? At the end of the day though, Duke fans are extremely passionate about their teams and really no different from any other fans...

2. UNC fans hate everybody. In my opinion, UNC fans think that Chapel Hill is the center of the universe and that UNC is best at everything. This doesn't surprise me - Chapel Hill is a great town, UNC has had success in MANY sports, and the school is probably one of the top 5-10 best state schools academically. Carolina fans hate every other team in the ACC, every conference that's not the ACC, and any other university that is good at anything, period. When half of the Big East teams lost in the first round of the tournament this year, UNC fans were overjoyed. "GO ACC! Screw the Big East!" When half the ACC teams lost in the first round the year before, Big East fans were like, "Huh? ACC teams lost? Who cares... screw _insert rival Big East school here___!" If you say to a UNC fan, "Man, Stanford's women's volleyball team is unstoppable", a UNC fan would probably be like "SCREW STANFORD!" They really just don't like anybody but UNC having success at anything.

3. Southern schools care a lot more about college sports than everybody else (although the Midwest is probably a close second; also, I'm counting Texas and OU as southern schools). Fans in places like Philadelphia definitely love college basketball, but if Temple or Villanova lost in a huge basketball game, it would hurt, but it wouldn't be the end of the world (not true for the Eagles or Phillies, though). It's totally different with SEC and ACC fans though - if you talk trash to one of their fans about their team/school, you have to be willing to fight them. No, they probably won't throw punches, but they might. These fans take their sports more seriously, get more excited when they win, and are more distraught when they lose. If Duke and UNC ever faced each other in the tournament finals, there would probably be riots in the Triangle, no matter the outcome. If Georgetown ever lost to Syracuse in the tournament, we'd be upset, we'd shed some tears, and we'd go home pretty bummed out. If UNC ever lost to Duke in the finals, people would probably flip over cars, light them on fire, and then drive to Durham with baseball bats looking to rip some throats out. You gotta respect that level of fandom.

I stabbed myself.

Uh oh, the cat's out of the bag, My neighbors have figured out that I'm in medical school, which wouldn't normally be an issue if I wasn't convinced that the house next to mine was a brothel/dance club/coffee shop hybrid (and I don't mean 'coffee shop' like Starbucks, I mean 'coffee shop' as in, "We went to the coffee shops in Amsterdam and bought/smoked a ton of pot") . Seriously, the three 50 year old guys that live next door work the night shift and spend all day long partying with a wide array of characters that obviously share a similar fondness for fermented beverages (and God knows what else). Anyway, now that they've figured out that I may be able to dish out medical advice, they don't feel the need to go to a real doctor, which is bad news for many reasons (especially since there's probably a 30% chance that one of these people will accidentally light themselves on fire during their lifetime). On Friday, a woman with a hand wrapped in gauze stopped me while I was walking the beast and said that she heard I was in medical school. I don't know how she found out, but it's not much of a secret when you have a School of Medicine sticker on the back of your car...

"I'm glad I ran into you, could you look at my hand?"

"Um, sure, what's up?"

"I stabbed myself."

Right. You stabbed yourself. Totally normal. I've stabbed myself tons of times. Anyway, this woman's hand was infected, and she wanted to know if she needed to go back to the emergency room or could wait until next week when she had a follow up. The entire time I gave advice, my dog was feverishly trying to get at her discharge covered bandages like they were pork chops. She actually got one of them too, and I had to dive down and scoop them up before she gobbled down this woman's pus. Gross. 

Either way, I don't think she listened to my opinion ("you should probably go back to the doctor"), because she promptly thanked me and declared that she wouldn't be going back to the doctor. Fantastic. At least she didn't come over to my house with a piece of beer bottle halfway through her palm and ask me to stitch her up (which hasn't happened yet... YET). 

Note: I don't feel this way about all my neighbors. The family that lives on the other side of my house are my favorite people ever. The husband drives a cab, details cars, and (for some reason) loves us. Not only do our cars mysteriously get washed while sitting in our shared driveway, but we have a go-to ride home from the bars (which we almost never go to now that we've become completely and totally lame). Sweeeet.

Rent A Wife!

Just saw a flyer in the lobby in the building where our lectures are held that was titled "Rent a Wife!" - it advertised cleaning services.

Doctor Hat

You reach a point during your second year of medical school where every symptom catches your eye, big or small...

Your neighbor has a cough? "It's probably just GERD or allergies... maybe it's a URI - hopefully he won't get a bacterial superinfection. Maybe it's something worse... heart failure? pulmonary embolism?" Somebody has a stomach pain? "Does it radiate? Does food make it worse? Better? Hopefully it's indigestion or PUD, not pancreatitis or cancer." 

I guess this kind of stream of consciousness analysis is helpful when we're on the wards or in the clinic, but I often find myself unable to turn the it off. Recently I've been in situations where making a diagnosis was irrelevant or inappropriate - where the people around me only wanted to be listened to and given empathy - yet I struggled to suppress the urge to find out what happened, where they were hurt, why the person died. My wife often says to me, "I don't want a diagnosis, I just want to you feel sorry for me." Yet, at this point in my life, it seems like everything I encounter is subconsciously integrated into the pathophysiology of a disease or becomes a bit of evidence for an eventual diagnosis. Sometimes I get frustrated or mad and stop myself, "You're projecting X onto ____; you should take what's making you upset and sublimate it into something good." The doctor logic overrides my thoughts and takes over. F*ck that.

Sometimes I just want to be frustrated; sometimes I need to just say, "I'm sorry your grandmother died of cancer" without thinking "I wonder what kind of lung cancer it was... was it small cell? non-small cell?" Maybe learning how to be a physician is a 24 hour process; that you can't possibly learn everything there is to learn in such a short period of time without it consuming your life. Hopefully, someday, when I'm done with my residency/fellowship/post-doc/whatever, I'll be able to leave my 'doctor hat' at the office and just be a friend, husband, or father when I get home.

Random thoughts

1. Okay so John From Cincinatti was the worst show ever made, but it's theme song was awesome. 


"Johnny Appleseed" by Joe Strummer and the Mescaleros: http://www.youtube.com/watch?v=9pYwPc6UNmo


Note: If you're John G, you should stop reading here - the rest is probably only (mildly) interesting to medical students and will probably be 'very disappointing' to you...


2. Andrew B sent me this gem from the most recent JAMA that reported that "multiple randomized clinical trials (RCTs) have established that reduction of sodium intake sufficient to lower blood pressure also increases sympathetic nerve activity, decreases insulin sensitivity, activates the renin angiotensin system, and stimulates aldosterone secretion."


WHAT? Low sodium diet isn't actually good for you if you have hypertension? Mind = blown. Wait a second...


"Financial Disclosures: Dr Alderman reported that he has been a member of the Diet and Cardiovascular Risk Advisory Committee of the Salt Institute since 1996."


Salt Institute*? Really? 



*My response was, "Are you sure it didn't say the SALK Institute?" Nope. Salt Institute is a real entity: http://www.saltinstitute.org/

Duke vs. UNC = Glory Road?

I've been musing about this for a couple of days, but here it is in writing...

This is the Duke/UNC game from the other night:

http://www.youtube.com/watch?v=TBRNcyTRAlU

Guess which team is Duke? Could Coach K be any more like Adolph Rupp? Think about it... both prolific winners, both favored jump shots and passing to ally oops and high flying dunks, both ride the referees, and (here's the kicker) both only recruit white people. I would've posted the second half of the National Championship scene from the movie, but Texas Western wins in that one, and we all know that Duke won on Wednesday.

PS. Can't you just see Coach K telling his players, "You saw who they put on the floor; look's like they're going to try to run against us!" or screaming, "We don't teach scared at Duke University!"

My First Psychotic Patient

And when I say "patient", I really mean "random dude walking around my neighborhood that is scaring the sh*t out of my dog and screaming at nobody..."

I got home from school and the grocery store around 3pm and took the dog for a walk. Sometime between pee #1, talking to the neighbor about the apple I was eating, and pee #2, Rosie and I were startled by the muffled ramblings of a dirty guy stumbling down the street*. I turned around and saw a guy violently thrashing as he walked, screaming, "Get out of here, n---a! Get out of here! I'll kill you! Get away from me n---a!"

Rosie started barking like a maniac^, and I just stood there dumbfounded. The guy didn't pay either of us any attention and just kept stumbling along swatting at the voices in his head. As soon as I came to my senses, the medical student in me came on full force: "This guys is having a psychotic episode! He's obviously experiencing auditory hallucinations!"

A few seconds later, the medical student got particularly annoying: "I wonder if he's schizophrenic and off his meds... Maybe he's just high on drugs... [this is where it gets bad] A typical neuroleptic would probably be best for the positive symptoms; I'd probably go with haloperidol, although I'd titrate the dose because of the extrapyramid-"

At this point, the normal person in me broke in, "Wtf are you thinking!?! Haldol?!?!? This guy is obviously high on crack! He better get out of my neighborhood before I call the cops!"

I didn't call the cops, but I probably should've. I was pissed - there are lots of families with kids in our neighborhood - and this guy was walking right toward the community center where students go to play basketball after school and do their homework...

Take home point: So what if this guy has the ghost of Old Dirty Bastard living in his head? I have an annoying, yuppie medical student living in mine...

*He kind of looked like one of the people that live underground in Demolition Man - the ones that 'live freely' and eat rat hamburgers...
^In retrospect, this was the correct response...