Pressure ulcer.

As the Spring turns warm -- it is an excellent reason for medical students to get increasingly stressed out. The entire admissions process is bred to burst brain aneurysms. It turns a four-year undergraduate degree into an arduous screening program. Pre-meds are salmon swimming upstream, loaded with eggs and hope, and only a few make it.

Med school proper feigns support for the first two years, and then we are doomed to repeat our futile stressful lifestyle. So now as we are supposed to figure out what we want to do with our lives -- eg -- what type of doc -- it begins anew. I was asking a seasoned veteran for advice, what kinds of questions to anticipate when interviewing for residency, and she said the only question that took her by surprise was this:

"What is one time you had a conflict with your attending, and how did you resolve it?"

For those not in the system, an attending is our boss, the top of the foodchain, and we learn from an early age to do everything possible to avoid a conflict with an attending. If what the attending says is incorrect, we can at most helpfully suggest alternatives in the form of a question when no one else is watching, and more likely, modify the orders to the actual helpful therapy when the attending has left the room.

But the veteran said -- simply avoiding conflicts is not enough, they pushed for more dirt -- they wanted answers.

And I have one -- however -- most conflicts with attendings seem to boil down to pure craziness, as an actual real conflict is extremely easy to avoid as a good med student knows to live in fear of his (or her!) attending.

I had finished sewing a scalp laceration that was an excellent argument for wearing a bike helmet in itself. I had put on a bunch of bacitracin and was going to send my patient on her way, when my attending came by.

"Clay -- bring me a roll of gauze, a piece of tape and two cotton balls -- I'm going to show you how to do a correct head dressing."

The implication being here that antibiotic goo and hair was incorrect. Cotton balls are rarely needed as there are literally thousands of other dressings, swabs, bandages and wispy things that have capably taken their place. I went on my mission, gauze and tape in hand -- I asked one of the MAs (medical assistants -- overworked, amazing and underappreciated. Also a lot of them are cute) for cotton balls, and was given a handful.

"Clay -- I only need two cotton balls, bring the rest back to where you found them."

I obliged, dumping a wad of cotton balls in my lunch bag.

Back in action, my attending had succeeded in making my patient a mummy from the top of her head to her eyebrows. My suturing made the statement,

"Hey -- there's nothing wrong with this 24-year-old women, because the stitches are hidden by hair."

His dressing said:

"Please make sure this women does not have a seizure, and please don't date her."

Nonetheless, it was time to place the cotton balls. One behind each ear for comfort. The attending dropped one.

"Clay -- bring me more cotton balls."

I obliged. The scene had also attracted a small crowd of nurses, residents and MAs stifling laughter. I swallowed my own, placed the last cotton ball, and voilaá!

"Now that's a head dressing, Clay," the attending said.

My patient looked at me, and when the attending left the room, told me that the stitches kicked ass, and asked if she was OK to go out drinking tonight.