Anonymous Asked
Questionwhat is meant by the term "sucking chest wound"? Answer

Oh, this will be a fun question to answer.

Okay, so:

(Also someone please correct me if I’m wrong)

To understand what a sucking chest wound is, we first sort of need to understand the concept of a pneumothorax, a “collapsed lung”. Basically, under normal circumstances, your lungs operate under what’s called a negative pressure system. This negative pressure system means that the pressure in the “lungs” is more negative than the outside environment, which allows the air we breathe to flow into our lungs as we inhale. As we inhale, our chest wall expands, allowing the lungs to expand and decrease the air pressure, allowing air to flow from high to low pressure.  Our lungs also have what’s called pleura, a membrane around each lung with two layers called the parietal pleura and visceral pleura. The parietal pleura is attached to the chest wall while the visceral pleura is attached to the lung itself. This membrane is very important in helping to establish the negative pressure system mentioned earlier. Importantly, the pleura have what’s called the pleural cavity, which  is a potential space. What this means is that under normal physiological conditions, there is no actual space between the pleura other than the small amount of pleural fluid between them. But there is the potential for their to be space under abnormal conditions.

So, because the lungs operate under negative pressure, this means that air will flow from high pressure to low pressure under almost all circumstances. This is how pneumothoraces are created. A pneumothorax is caused when air enters the pleural cavity, turning the potential space between the pleura into an actual space. This is usually due to trauma (gun shot wounds, stabbings, rib fractures) but can sometimes be due to things like COPD, cancer, and interstitial lung disease. The creation of the actual pleural space is bad because air will travel from the path of lease resistance, and oftentimes create a large pleural space when one shouldn’t exist. This now existing pleural space separates the lung from the chest wall, preventing it from being able to expand and placing pressure on the lung. This is why we use chest tubes to correct a pneumothorax. The tube is inserted into the pleural cavity, and connected to a vacuum pump to remove the air/fluid in the pleural cavity and restore the negative pressure environment and making a potential space rather than an actual space. 

So, to answer your original question, a sucking chest wound is a very very serious type of traumatic pneumothorax. A sucking chest wound occurs when there is an open wound through the chest wall and into the pleural space, creating a one way route for air to enter the space. Air, like many other things, follows the path of least resistance. With every breath someone with an open pneumothorax takes, more air will enter the pleural space, making the situation worse. These sucking chest wounds get their name because you can sometimes literally hear a sucking sound coming from the wound as air enters into the chest wound during inspiration, and you will also see blood bubbling during inspiration and expiration.

I hope this answers your question and wasn’t too long of an answer!


PCAT tomorrow guys!image

YOU CAN DO IT!!!!!!!

This is going to be you destroying the PCAT tomorrow!


Anonymous Asked
QuestionI know a lot of people that have gotten sick from flu shots. I have never had the flu and stop getting vaccines years ago. You're the ignorant fuck if you think people "need" vaccines. It is a persons right to deny them and given a hell of a lot of proof people are justified to deny them as well Answer


Ignorant fuck must be some new compliment because all these anti-vaxxers keep calling me that. You angels. I think I’ll hang it next to my BFA and my not giving a fuck lifetime achievement award, but still leaving room on the wall for my MD, which is currently in progress and halfway completed.

Spoiler alert #1: you can’t get the flu from the flu vaccine, which covers some strains of influenza. It’s literally impossible. You can, however, get a flu-like illness from over a dozen other viruses, some of which have the same seasonal prevalence as influenza.

Spoiler alert #2: Your personal experience as a single unvaccinated person does not have any statistical significance. I’m really stoked you, a presumably healthy younger type of person with a functioning immune system and halfway decent nutrition, have not gotten the flu. I am. The flu sucks. However, babies, pregnant people, people with compromised immune systems or even chronic medical conditions such as asthma, and elderly, are very much at risk. When you, healthy person, get vaccinated, you do a little part to maybe prevent one of them from getting the flu and developing nasty complications such as deadly pneumonia.

Spoiler alert #3:









I’ll tell you who needs vaccines:  this baby, who I saw last night on my overnight shift in the pediatric ER. And here is a post where I admittedly was real snarky BECAUSE THIS SHIT IS GETTING REAL OLD OK GUYS and it has some really good graphs from an excellent lecture I went to about the public health impact of vaccines (in case the crapton of links above isn’t enough to make you reconsider your stance maybe some graphs will, I dunno how your brains work).


What EKG changes are classically seen with a pulmonary embolism?

Classically: S1Q3T3. And also tachycardia, rightward axis, and RV strain pattern. 




amolutrankar and kvnwng, my co-hosts at the H&P, got a chance to interview one of Tumblr’s favorite docs, cranquis! Check out this hilarious interview with the good doctor (his voice has been altered to protect his anonymity) and let us know how we’re doing with the podcast! Remember to give us 5 stars on iTunes so we can continue producing!

It was a lot of fun speaking with Dr Cranquis and his surprising knowledge of pillow fort engineering, coming to a hospital wing near you, princeton-medbloro. If you haven’t done it yet, Dr Cranquis did a great AMA on Medella News!

Oh dear, who gave me a microphone and permission to opine again?

(I was hoping the voice alteration would make me sound like Hugh Laurie… or perhaps Morgan Freeman? But I’m ok with “anonymous witness testifying against the Mafia”.) :)

Y’all, go listen. This interview is really good!

Anonymous Asked
QuestionWhat starbucks drink represents what type of doctor? Answer



Oh gosh I love this.

Latte—Internal Medicine—The latte is the backbone of any coffee shop—fail to make a good latte and you fail everywhere! IM docs are often times the center of patient care in the adult world. The perfect mix of strong medicine with just enough mellowed milk poured in, IM docs are hard-working sweethearts ready to go to bat for their patients. 

Red Eye—Rads—Mostly because you’d need that much caffeine to stay awake in the dark all the time!! It’s also essential that radiologists always keep their eyes open to pick up on the tiny details on those CTs. 

Chai—Family medicine—Chai is a little bit of everything! A little sweet, a little spicy, a little creamy, a little tea, a little caffeine. Family med docs seem to have a hand in every pot doing a little derm, a little OB, a little psych, and a little chronic disease management all in one day! Chai seems like the perfect drink for these guys. 

Straight espresso (ideally injected right into a vein)—ER—This one seems pretty obvious to me! ER docs work crazy night shifts, and are generally the kind of adrenaline junkies that would drink their espresso just straight up. 

White chocolate mocha—OB—One part hard core caffeine, one part the sweetest white chocolate you can find, the white chocolate mocha is just like the mix of really crazy procedures they do in OB with the sweet adorable baby moments. 

Black coffee—Neurology—Neuro seems pretty simple on the outside but once you dive into the complexity of it you find a dozen layers underneath that “black box” of a brain. A good strong cup of black coffee is just like this—seemingly simple on the outside, but full of a dozen different flavors you might not have thought of the first time. 

Caramel Frappuccino—Anesthesia—Anesthesiologists are the docs coming to “chill” you out—which is probably why they always seem so “chill”. Caramel Frappuccinos also do double duty hitting dessert and coffee fix in one go—the way anesthesiologists always seem to manage to have time to do medicine and research!

Starbucks Canned Double Shot—Pathology—Mostly because I feel like it was intended to wake the dead. Haha. But more accurately pathologists are often the “neglected” medical specialty with most people feeling like they don’t usually see live patients so they’re not the same as most doctors—BUT they’re a super important part of the team and can really save your butt when you need help fast! Someone get me a read me the biopsy! QUICK! 

Cappuccinos—Surgery—A little bit finicky, the perfect cappuccino can take a lifetime to master. Surgeons, like cappuccinos demand perfection! But, they’re classic, strong, get the job done, and all with a fluffy coat of foam! Besides—pouring the perfect cappuccino with those little designs on top requires quite a precise hand!

Pumpkin Spice Latte—Psych. I mean—come on. The people who are so addicted to this coffee should see psychiatrists for some addiction counseling! 

Skinny Vanilla Latte—Dermatology—While appearing “fluffy” at first glance, dermatologists do everything from cancer to procedural work. Don’t judge this drink from the outside! 

Americano—Ortho—Just like the ortho docs muscling a bone back into place, an americano is just strong enough to wake you up in the morning. (Side note: The drink was named after American GIs who didn’t like the strong French espresso—I’ll let you draw your own conclusion about what that means about ortho docs??)

Hot chocolate—Pediatrics—Warm, comforting, sweet, and adored by children everywhere. 

Disclaimer: this post is OBVIOUSLY a joke. I intend no disrespect to any specialty by it!! It is all intended just to make you laugh and any stereotypes represented here don’t represent my view point on the specialties. 


How to celebrate finishing the worst class in the entire world.

Orange juice + ‘murica flavored vodka

I cannot wait until this stupid math class is over and we actually start learning interesting things. 

One more day until I am done with this horrible class. One more day..