r/Residency • u/DrfluffyMD • Aug 31 '24
HAPPY AMA: I am an interventional radiologist from 1000 years in the future.
There has been a freak temporal event where the entire radiology department in a county hospital was displaced 1000 years into the future and I, along my department, was translocated 1000 years backward to old earth calendar 2024.
Ask me anything about radiology, medicine, residencies, or humanities in general in our universal calender year 347 or old earth calender 3024.
133
u/CarmineDoctus PGY2 Aug 31 '24
You have been paged by the CCU. They have a patient who suffered cardiac arrest complicated by devastating anoxic brain injury. Neurologic prognosis is dire but the patient is otherwise stable. Family wants everything and the CCU wants you to place a PEG tube. Thoughts?
214
u/DrfluffyMD Aug 31 '24
Oh thats no big deal in our time. I’ll ask my temporal tech to revert patient’s state of brain / cognition to when they were consentable, scan their neurostructure and send it over to pallative care to see if they would want peg done. If they would want to be resustated then we’ll place peg while temporal medicine rebuild this patient’s mind structure.
If they dont wanna be revived then well theres that, straight from the patient.
33
17
u/dr_shark Attending Sep 01 '24
How long is temporal medicine residency? Is it a subspecialty?
45
u/DrfluffyMD Sep 01 '24
It’s 100 years subjective to them but those guys finish in about 1 year subject to us. I think there is a lot and a lot of physics and cultural studies etc. there is a lot of stuff they can’t do.
There is temporal imaging where they reveal state of the past and provide that info, and then there is temporal intervention where it’s another 100 years. A lot of times they can’t intervene on something because it affects timeline etc.
One awesome thing about them is that we never need prior imaging. We can just scan people in the past so it produces a prior that way.
16
20
u/Throwaway6393fbrb Sep 01 '24 edited Sep 01 '24
What the heck man that’s malpractice
How come you don’t just do a nanoreconstruction of their pre injury neurocognitive structural state??
Hope you have a good lawyer AI (oh wait yeah uptodate offers a free open access one so of course you do)
1
u/AdDowntown4932 Sep 01 '24
If not revived will they be repurposed? Like Soylent green?
1
u/DrfluffyMD Sep 02 '24
Depends on what they want! Some want to be tossed in a black hole. Others want to be remade to integrate with ascended AI, etc.
We just send the meat to the morgue.
20
u/ConsuelaApplebee Aug 31 '24
My thought - you still have a pager in 3024?
74
u/DrfluffyMD Aug 31 '24
Of course. How else they gonna get hold of me? Its straight to my neuroimplant though.
21
11
u/JohnnyThundersUndies Aug 31 '24
We don’t place PEG tubes. PEG tubes are placed endoscopically by GI.
We place percutaneous gastronomy tubes.
Sorry - it’s a pet peeve
9
u/CarmineDoctus PGY2 Sep 01 '24
👍 we all have em. I’m trying to get everyone to understand that CVA has one meaning and it’s costovertebral angle
7
u/amemoria Sep 01 '24
Oh wow look at this guy with his fancy gastroNomy tubes while we do gastrostomies
3
-9
Sep 01 '24
This hurts to close to home. My mom presented to a ER in my town with a hemorrhagic stroke shown on CT scan, was discharged to a Non stroke designated facility within 5 hrs. She lived 2.5 years after a Peg tube insertion. Then died during COVID of pneumonia. Death certificate didn’t say COVID but I think it was.
50
u/WanderOtter Attending Aug 31 '24
It’s Friday afternoon and my REALLY NICE patient with portal hypertension with liver cancer (no HCC from alcoholic cirrhosis, just a random cholangiocarcinoma from exposure to Fukushima reactor fallout) missed their scheduled therapeutic paracentesis with IR because they were saving kittens stranded in trees. The ER waiting room is 30 deep, we are boarding inpatients in the ER, and I have a hypotensive multi system trauma patient, a septic third trimester pregnancy patient, and a upper GI bleed that is having seizures. I don’t really have time to help this poor soul right now. Please, intrepid time traveler, tell me how we help this patient as you approach 5pm on a Friday afternoon 1000 years in the future.
67
u/DrfluffyMD Aug 31 '24
Oh we teleport the ascites out. Thank god for teleportation medicine. I just draw the circle on where i want the fluid to be teleported.
24
u/WanderOtter Attending Aug 31 '24
Perfect! A quantum paracentesis with small risk of scrambling an abdominal organ…I’ll take it!
35
u/DrfluffyMD Sep 01 '24
I heard its done with needles 1000 years back. Doesnt that scramble organs?
6
1
u/AdDowntown4932 Sep 01 '24
Can you opt to have urine continuously transported? That sure would be convenient
2
u/DrfluffyMD Sep 02 '24
Urine sample is directly teleported from the kidney yeah, so is utox. Actually normally in the blanket consent you mindfax for treatment include a clause where hospital can use any mindstructure or memory of you or your ancestor so we know if you are using substance. Utox is just a formality.
1
64
u/tino_tortellini Aug 31 '24
Is pee really stored in the balls?
61
7
1
u/AdDowntown4932 Sep 01 '24
Yes. Unless you’re a women. Then it’s in the Fullopeeins. (I learned this the other day on Reddit)
48
u/FutureInternist Aug 31 '24
Do you still decline the consult because INR is too high?
95
u/DrfluffyMD Aug 31 '24
Yeah, our society guideline from 3015 says anything over 1.4 is not a good candidate and requires a new body rebuild. I mean why risk a bad outcome when we can just send them to surgery for a rebuild consult
13
u/FutureInternist Aug 31 '24
Can’t you 3D print some clotting factors?
54
u/DrfluffyMD Aug 31 '24
There’s been some treaty with the azlrians about 300 years back. Apparently replacement human clotting factor without replacing the whole body violates their religion and so many of us now practice that believe it’s honestly easier just to replace the whole body
11
25
u/secondarymike Aug 31 '24
How drunk are all the pharmacists?
38
u/DrfluffyMD Aug 31 '24
We don’t have pharmacists anymore. The medicines themselves would interface with my neurolink module as well as nurses and authentic things in real time then the med gets teleported to where they need to be
4
u/TrumpsCovidfefe Sep 01 '24
What kind of conditions still need meds considering the availability of new bodies? And how do the new body surgeries get done? Do they have a body similar to their own or do they have a choice?
10
u/DrfluffyMD Sep 01 '24
They can have whatever kind of bodies they want. Their body their choice. Just can’t have kid bodies if they are sexually active and was older than 18.
22
u/Specialistyellow123 Aug 31 '24
What procedures are left for IR in 3024? I heard the urologists took the nephro tubes, surgery took over IO, neurosurgeons completely took over NIR, and GI took over embolizations for GI bleeders.
Kidding on that last one.
12
u/DrfluffyMD Aug 31 '24
Oh we do like everything still. Urologist and surgery are now doing the whole body transplant and system rebuilds. The tubes are really for people that decline whole body transplant / rebuild or too poor to do so. I guess there isn’t enough RVU in IO, NIR and embo when you can just rebuild whole bodies or organ systems.
2
u/fellowhomosapien Sep 01 '24
Why do you think you still have economic disparities in your time such that only some have the ability to finance a body transplant/rebuild? Do you think that functional immortality in and of itself could have exacerbated the problem?
4
u/DrfluffyMD Sep 01 '24
Wealth disparities always existed. Too many people, too little resources. IR is the poor man’s medicine, sort of say. It’s like doing car repair when the rich can just buy a new car. Why do any procedure when you can just get a new body?
1
u/Drkindlycountryquack Sep 01 '24
How does your AI interpret ‘I just don’t feel right since uncle Willy burned the barn down’?
1
u/DrfluffyMD Sep 02 '24
Instapermadeath. That specific phrase appearently was linked to an anti-AI hate group.
6
6
u/Dracula30000 Aug 31 '24
What were the three most transformative new procedures of the last 1000 yrs?
26
u/DrfluffyMD Aug 31 '24
I can tell you whats the most transformative for my resident. Because now we can scan people’s mind structure and ethics / pallative care can interrogate the scan for people’s specific wish, my resident doesnt need to consent the patient anymore because we already know whether they want it or not. Yeah, that was a nice discovery years back.
8
u/judo_fish PGY1 Aug 31 '24
When you're installing nanobots in patients' vasculature, do you opt for the iBlood or the TeslaRBC?
22
u/DrfluffyMD Sep 01 '24
iBlood had a recall and SpaceXBC (think thats what u meant) isn’t on our formulary. We use some terumo product.
6
u/Nsinr9 Aug 31 '24
What does the ER wake you up for in the middle of the night?
21
u/DrfluffyMD Aug 31 '24
They interrogate my neurolink for nephrostomy that fell out for the nephrostomy fetishers. Those patients have a protected fetish for nephrostomy and as part of the practice they must be instantly replaced regardless of infection.
Usually they are ok for my clone to do but some times they specifically decline clone and because all my partners decline to care for those i guess it falls on me. You know it’s just one of those junior attending things.
5
u/DoctorMedieval Attending Aug 31 '24
Would you be so kind as to change the gravitational constant so I can lose 20 pounds?
5
u/Lispro4units PGY1 Aug 31 '24
Who wins the Gen Surgery vs IR war
18
u/DrfluffyMD Sep 01 '24
IR took all the procedure back because everything on your birth body becomes low RVU. Gen surg usually does whole body transplant, transhuman stuff and augments. I couldn’t match gen surg :(
4
Sep 01 '24
[deleted]
11
u/DrfluffyMD Sep 01 '24
You know this take some explanation. At first ligma was though to be a hoax, and then around half a century back it was realized that some DNA molecules, upon transit through the phase space, start folding in a direction that is detrimental to their shape in three dimension space. People suffer from ligma which is highly nonspecific due to the random nature of DNA damage.
We call it the great imitator and supposedly just like the historical diseases known as TB and lymphoma, ligma can look like anything on imaging.
We still are striving toward a cure. Body transplant can help but some think that ligma has a component involving structure of the mind.
Other think that ligma is an engineered disease by the ascended AI to cause extinction of humanity. If you are one of those AI kill us all conspiracists.
Anyways, my standard report now days almost always include ligma on the differential. It’s one of the greatest threat to mankind
7
Aug 31 '24
Is radiology replaced by AI yet?
38
u/DrfluffyMD Aug 31 '24
Yes and no. About 35 years after 2024 humanities figured out how to build general artificial intelligence. Ironically for radiology. The very first general radiology AI decided that CT scan performed with enough radiation dose to give fatal radiation injury is better for imaging than the old CT.
And when it was told to not do that it decided humans were too stupid and it tried to manipulate the internet to lead to more radiation resistant humans.
Long story short there was some human vs AI war after global internet blackout.
Artificial intelligence and humanity brokered some sort of treaty where we would fly around and try to look for new planets to let them terraform those planets to computeronium or whatever their computing substrate is. What humanity got is that all AIs would leave us alone and not interfere.
So yeah they wouldn’t read the radiology study for us, or do anything. It’s yours truly reading, a human more or less
3
u/heart_block Sep 01 '24
Does the patient still stop in the ED for their complaints or do they go straight to radiology?
4
u/DrfluffyMD Sep 01 '24
ED never changes. ED first of course. There’s a scanner on the door so they get scanned on the way in
1
1
3
2
u/min2qaz Aug 31 '24
are there specialized medical field concerned with interplanetary medicine, have our understanding of physiology changed?
4
u/DrfluffyMD Aug 31 '24
Understanding of baseline human physiology didnt change much. There was an interplanetary medicine specialty field about 20 years back before they invented the portal but now we just teleport. There is teleportation medicine now though.
God i dont know how the old IRs did it. I still work with this dude who’s like 1000 years old and said he used to work without teleportation. I think this dude literally was working even now, 1000 years in the past cuz he told me what thjs department was like back in the day (aka now)
1
u/Blackmesaboogie PGY5 Sep 01 '24
thanks, I needed a brain reboot and i got that just by reading this.
2
u/I_lenny_face_you Aug 31 '24
Which is greater, the power of the continuum transfunctioner or its mystery?
1
2
u/Mista_Virus PGY4 Sep 01 '24
How many STAT pages do you get from the ED/ICU for a Throckmorton sign overnight?
2
u/DrfluffyMD Sep 01 '24
Pretty rare, but throckmorton is known to be something different (i just googled on your archiac internet).
The thorckmorton sign 1000 years in the future happens when the ACHIEVER (trademark of the Humania corporstoon) brand penile / clitoral augmentation would point to the site of pathology and produce a complete report include all imaging report by interfacing with any diagnostic machine.
I just copy and paste whatever stuff achiever spits out. Humania is a company owned by ascended AI focus on human health care. My big beef with them is that i cant find a live person when i try to neurolink their product support people.
2
u/Moist_Border_8301 Sep 01 '24
What year does the United States transition into universal health care?
16
1
u/UncleTheta Aug 31 '24
What’s the new gold standard for a chest X-ray? Still PA and lateral, or have you guys moved on to something like instant holographic 4D scans that also predict the next flu season?
4
u/DrfluffyMD Aug 31 '24
PA now actually. It’s a great screening test plus it works super good with the (non general) AI reader.
1
u/ArtichosenOne Attending Aug 31 '24
are sex bots still creepy?
7
u/DrfluffyMD Aug 31 '24
Outlawed. General AIs refused that one to spite us. It’s instant perma death if we use AI for human sexual gratification. I think they did it to spite us
1
Aug 31 '24
[deleted]
15
u/DrfluffyMD Aug 31 '24
I am baseline human with some augmentations. Transhuman and AI have their own medicine. I am not as familiar. My MCAT wasn’t good enough for those
1
u/min2qaz Aug 31 '24
do you still use touchscreen or touch is replaced by neuralink ?
4
u/DrfluffyMD Aug 31 '24
Touchscreen if i am not trying to be super fast. I am kinda old fashioned though. Neurolink doesnt let me enjoy the process as much ya know
1
u/thisisrandom52 Aug 31 '24
What stock should I invest in.
8
u/DrfluffyMD Aug 31 '24
Man i dont have knowledge for stocks like 1000 year back. The oldest company we have is some drum maker from old japan on old earth. Maybe that one?
2
u/thisisrandom52 Aug 31 '24
So stocks are still a thing? Whats the biggest company in your time?
4
u/DrfluffyMD Sep 01 '24
Apple but they changed ownership and corporate structure so manytimes I do not recommend their stocks. Anyway they are a private company owned by transhuman named warren buffett and ascended AI so we cant really get those stocks anyway
1
u/Effective-Gold8859 Aug 31 '24
How's the average human lifespan then?
4
u/DrfluffyMD Aug 31 '24
Oh huge variation. Even for Baseline human its pretty unlimited unlimited if you can afford new bodies and mind upload.
1
1
u/Forward-Procedure462 Sep 01 '24
What happens with Bitcoin though ?
3
u/DrfluffyMD Sep 01 '24
Oh it was this thing we learned in history. CIA was behind it. Huge criminal plot.
1
1
u/Forward-Procedure462 Sep 01 '24
so you are from the future. you know it's gonna go to the moon. did you invest some in it yet in case you dont go back home to your time line ? also, given you studied in history, what is the maximum amount it goes to ? it's currently at 60k with a peak of approx 70k
1
u/Gutz_N_Gunzz Sep 01 '24
Is bitcoin still a thing in the future? Or it faded like every other currency.
3
u/DrfluffyMD Sep 01 '24
Faded but was a huge bubble and conspiracy!
1
u/Gutz_N_Gunzz Sep 01 '24
What year did it fade. So I can exit out
1
u/DrfluffyMD Sep 02 '24
Sorry bro i dont remember the year, but i think by 2874 it’s kinda petered out.
1
u/Gutz_N_Gunzz Sep 02 '24
Glad 2874 sounds about right, I wonder how big the bubble Couple Of billi per btc
Does This forum Still exist on Reddit?
1
u/DrfluffyMD Sep 02 '24
Nah we were all on metadigg
1
u/Gutz_N_Gunzz Sep 02 '24
Fuck digg made a comeback?
1
u/DrfluffyMD Sep 02 '24
I dont know further back, but in the last fifty years, 3781374 was replaced by NEW!!!Reddit and then everyone got on onlymen (the human only discussion forum) cuz NEW!!!Reddit’s moderator strike.
At some point onlymen became too biggoted so people migrated back to metadigg from about 500 years ago ironically but then it turns out the ghost of zuck did a good job with it so people stayed on
1
1
u/PathologyAndCoffee Sep 01 '24
Tell me about how NP's took over the entire medical system, become your boss, outlawed all doctors who did not accept them as their overlord.
11
1
2
u/PeaImpossible8076 Sep 01 '24
Whats your take on interventional nephrology?
3
u/DrfluffyMD Sep 01 '24
They are cool. I like fistulogram for those fistula fetishist who refuse to replace kidnies.
1
u/EntireObject3488 Sep 01 '24
How does lab grown meat taste?
3
u/DrfluffyMD Sep 01 '24 edited Sep 01 '24
Not so great. We dont lab grow meat cuz its way cheaper to eat k’wah (well descendant of k’wah. We conquered some alien civilization (basically intelligent dinosaur) about 700 years back. Appearently it was a real total war and humanity lost a lot of its morals. Sounds like someone realized that those dino tastes awesome (i dun wanna know how that happened).
Humanity eventually won. Anyway they supposedly genetically engineered those dino to be dumb, small and meaty, appearently looking like the current day chicken (who went extinct after the great manflu epidemic of 2348 where they all died).
Imagine, a race of spacefaring intelligence that built great space warships and towers that reach the sky, reduced to food.
From the story we were told, it seemed like those aliens were pretty brutal to human as well and were eating us also…so i guess it was just that kind of war.
Anyway our little kids eat descendant of those dino for breakfast now in the shape of those aliens, we call them k’wah nuggets.
Yeah humanity 700 years backs were freaking brutal. A whole alien culture completely destroyed, genetic code modified and hardwired to doomed to be forever uninteligent and destine to be meat animals. Evidently the code is programed in such a way that is impossible to modify and restore without instantly killing them. It’s one of the greatest horror ever committed by humanities and ascended AI.
The spaceship builders were gone, replaced by chicken 2.0.
We try to undo that but i think the whole chicken 2.0 thing is just too pervasive. I try not to think about it when I get my k’wah buffalo nuggets.
We still discover their artifact and cultural stuff on some planets and set off a wave of vegetarianism. Anytime now we gonna hit a generation ship of theirs and maybe we can right our wrongs.
Do you guys feel bad when u eat beef?
1
u/EpicFlyingTaco Sep 01 '24
What is your best excuse to not see a patient?
5
u/DrfluffyMD Sep 01 '24
Pt has united delta satoshi universal premier platinum insurance. New clone for any injury and bumps n bruises. Ir not indicated. Ship to orbital hospital.
1
u/chunkiegorgonzola Sep 01 '24
Did you do your residency from America? How much did you need for step 1, 2 and 3 and what electives / CV building things did you do ? Are you happy with your career choice ?
3
u/DrfluffyMD Sep 01 '24
Oh I grew up on Gilease 434b or as we call it, Hearth.
I work on earth now though. I didn’t need to test for it as neurocognitive testing around 13 basically qualified me for med school with the implants etc. i did tons of volunteering though cuz they need that human touch.
I am pretty happy. It reimburses well enough for me to afford rent on earth. You wouldn’t believe how expensive real estate is here compared to Hearth!
1
u/MeowoofOftheDude Sep 01 '24
The supervising advanced consultant nursing attending provider practitioner orders you to pick up the dog pile in front of her lawn because her nursing trainees are busy with doing procedures, what method will you use to pick up the dog shit and satisfy the supervising advanced consultant nursing attending provider practitioner?
2
1
u/Johnmerrywater PGY4 Sep 01 '24
Septic ureteral stone
2
u/DrfluffyMD Sep 01 '24
Most of the time we can punt to urology or telemed (short of teleportation medicine), but if it’s at night or weekend they would say that the stone is too small to teleport or the patient needs treatment NOW before wholebody rebuild.
I hop into my neurolink and place a nephrostomy tube.
There’s some backwater hospital I cover on Elysium (elysium my ass) that actually doesnt have a neurolink OR so i actually have to teleport to the planet central arrival hall, take a freaking ubershuttle, and actually go to the hospital to do a nephrostomy. I hate it.
1
u/CODE10RETURN Sep 01 '24
In 3024 do you work on weekends ? In 3024 is there still no safe window ??
1
u/DrfluffyMD Sep 01 '24
Yeah, i work on weekends, especially when surgery or telemed says whatever thing they have is too small for teleport or pt is too sick for a whole body rebuild now and they gotta be stablized first.
IR, the janitor of medical specialtiesz
1
u/lumpishere Sep 01 '24
What happened to internal medicine?
Who admits your patients after a complication?
Are there complications?
1
u/DrfluffyMD Sep 01 '24
We have complications, usually when we first start using something or if we have to work in a backward ass planet where we do things by hand.
Internal medicine is awesome. They admit my post TIPS patients. There’s this planet in the Vegas system that has this whole alcoholism and gambling schitck.
Some historical nerd there try to live in a society that models 2024 and would only accept care similar to that year. They are kinda like the dialysis fetishest.
Anyway I tried to do a TIPS this one time. Absolute barbaric. They told me they wanted the whole experience of sneaking in alcohol even their doc told them it’s an awful idea. Dude’s lifeID even told me he wanted me to place the stent too deep into the portal vein so he can suffer from the trauma of being told that he cant get a transplant.
Anyway, those historical nerds are like people in renfaire in 2024 i guess, but hey it’s a great locum rate.
But yeah, outside of the history nerds, your average citizen gets admitted to medicine if their care doesnt need a wholebody transplant and gets admitted to surgery if they are being lined up for a rebuild. So yes medicine would admit my pt if i need to have them stay for multiple days. Some of the temporal stuff can take some subjective time because temporal people need to look to see if there are paradoxes.
1
u/lumpishere Sep 01 '24
Can I be reanimated in your time to do a temporal fellowship? It sounds very interesting. I am tired of managing dialysis patients.
1
u/ucklibzandspezfay Attending Sep 01 '24
Do we still have to do prior authorizations or is our XRay vision sufficient?
2
u/DrfluffyMD Sep 01 '24
Oh all the time. Insurance’s a bitch. Especially those one ran by ascended AI. They refuse to do certain things but gladly do other things. As in they refuse to help me get prior auth but always work on the insurance side. They outsmart me.
1
u/bladex1234 MS2 Sep 01 '24
Can you imagine what medicine was like before the Omnitool? They must have been cavemen.
1
1
u/General-Medicine-585 Sep 01 '24
Does medical school curricula also cover aliens anatomy and physiology, or do we only treat human patients? 🤔
1
u/DrfluffyMD Sep 01 '24
No thats vet school for alien stuff. I think our alien allies secretly find human disgusting and doesnt wanna get lumped with. They go to vet hospitals.
1
u/selerith2 Sep 01 '24
Wait... Why did the year numbering system change? Why it started back from 0? What will happen in 653 years?
1
u/DrfluffyMD Sep 01 '24
I think some ship hit andromeda galaxy and came back that year?
1
u/selerith2 Sep 01 '24
So we finally managed to invent curvature propulsion? When? And have we found other cultures? How this changed society?
1
u/Life_Contribution516 PGY2 Sep 01 '24
What happened 347 years ago to create the universal calendar?
1
u/Drfiddle Sep 01 '24
In what year we’re all the doctors finally replaced by AI. Need to know how much time I have before I need to start being nice to my rumba.
1
1
u/swollennode Sep 01 '24
How are Martian physiology and anatomy different from human’s?
Are there residencies for Martian medicine?
1
u/DrfluffyMD Sep 02 '24
We never found life on mars. It’s a natural preserve with no long term human settlement so it’s just all a tourist trap.
-8
0
u/AutoModerator Aug 31 '24
Thank you for contributing to the sub! If your post was filtered by the automod, please read the rules. Your post will be reviewed but will not be approved if it violates the rules of the sub. The most common reasons for removal are - medical students or premeds asking what a specialty is like, which specialty they should go into, which program is good or about their chances of matching, mentioning midlevels without using the midlevel flair, matched medical students asking questions instead of using the stickied thread in the sub for post-match questions, posting identifying information for targeted harassment. Please do not message the moderators if your post falls into one of these categories. Otherwise, your post will be reviewed in 24 hours and approved if it doesn't violate the rules. Thanks!
I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.
0
114
u/[deleted] Aug 31 '24
[deleted]