BOOMER DEFENDS HER MEDICAL EDUCATION

Was penicillin even a thing back in your day?

Like, do you guys think I was born in, like, the 1700s? I mean.

Hi, everybody, and welcome to the podcast. This is Generations md. My name is Stephanie and I'm joined here by my colleague, Dr. Sarah Davis, who's also my mother. Sorry, I was running a little bit behind today. I had to finish the second season of Bridgerton.

Oh, you're only on the second season. Aren't they on the third season now? Yeah, well, get with the program. Yeah, I mean, I've seen both those. I saw this first two seasons. I haven't started.

You did watch the first two seasons? Yes, yes, of course I did. Not like how season two ended.

I don't know. I don't really. A lot of that's. Yeah, it's fine. There's some good stuff in there. But, like, I don't know, it's. I don't love it. Yeah.

I can kind of understand how people get into, like, a rabbit hole on certain things when they're not around people and they're kind of just consuming content. Because I have been radicalized with my views on this show.

Radicalized on your views on Bridgerton?

Well, it's just I'm with my own thoughts. I have no one to talk to about it. Well, I guess I could go and talk to people about it, but I'm just not doing anything. I'm just binge watching tv, which I don't typically do. You kind of do that a lot?

I don't do it that much. I don't know.

But do you know what, like, a pick me is?

Oh, I do. I looked this. I've been. Okay. I have been watching some TikTok lately and I had to. I looked up what a pick me girl is. Yeah.

How. How would you describe what's pick me in the terms of boomer terms?

And tell me if I have this right, because I'm not totally. Totally sure, but it seems to me it's this girl. And is part of the definition the fact that she's kind of friends with this guy?

It's not like a certain person.

Well, okay. But it seems to me, at least the tiktoks that I watched, that it seems like it. Part of it is her, like. And I guess maybe it's the. Anyway, she says stuff like. Like, there's the. There's a guy and there's his girlfriend, and then there's the pick me girl. And the pick me girl is talking to his girlfriend and she just does all of These things to be just like, I don't know, just basically kind of putting down the girlfriend in different ways. But I. But I think she tries. The pick me girl tries to act like she's one of the guys.

Yeah.

And she's just like the buddy and she's the friend, but she likes whatever it is that he likes.

Yeah.

Yeah.

And it's not necessarily in the. I mean, the term is thrown around a little bit. It's kind of like the, like 2019 gaslighting. Like people would just throw that term around and now people throwing around pick me a lot. But it's not necessarily like, it doesn't have to be situational. It's just like personality traits of a certain person who. Yeah. Always goes with what the guys want. I think that Kate is such a pick me. And it drove me crazy. Like, she was off, like, going hunting with the guys and she could ride horses and she's not like other girls. People who put girls down and try to present themselves in a way that is like, hi, pick me to the guys.

Right. Right. Because they are so cool. And they always act like they have all of these interests, but you just know that those aren't really her real interests. She's just acting like she's interested in those things because. Because that's what the boys like.

Yeah.

And she's just trying to be cool.

Not a girl's girl, like a guy's girl. Right. Like, oh, like I'm not really. Like, I have all my friends are guys. Like that sort of thing.

Yeah. I was watching reruns of How I Met yout Mother and Robin's a total pick me girl. She's like. She's really into her guns and sports and she doesn't have any other girlfriends except for Lily. And. Yeah, she's. And all the boys go for it.

Too, though, is the thing. Yeah. Exactly.

In there is also that, like, oh, well, you're like one of the guys, so you're low maintenance. Right. Yeah. Yeah. You're cool. It doesn't take you two hours to get ready and blah, blah. You just wake up looking beautiful. Yeah. Yeah.

So, yeah, it's just like, yeah, the pick me.

Okay.

But I just think that Kate is a pick me. And the whole thing, they were both just. They were the villains of the whole show. And then her and the Lord Bridgerton Anthony ended up getting together and I don't know, it was just really. The whole thing just made me really mad.

Yeah. I can't. I honestly can't remember anything about It. But I do remember, like, there were just some things, some themes in there that I didn't like all that much. I remember that. So I was going to boycott the third season, apparently.

I think the third season's supposed to be better and more. I don't know, just better. Cause the whole. I like the first season better. The second season, they just locked eyes and they're like, oh, I'm in love. Like, all this stuff. It's like, I don't think they know the difference between lust and love.

Yeah, well, that's a common theme in lots of TV shows, too. I kind of hate that whole thing of, like, they were in love and I like. What does that even mean? Hot take. Okay. Right. What does it mean in love?

That's valid. That's valid.

Well, speaking of those other terms, the one I had to look up because it came in the comments of our last TikTok was gatekeeping.

Good transition, but, yeah, you don't know what gatekeeping means?

Not the way this was. Like, they used to say primary care, that we were the gatekeepers and that we would, you know, and that's how people got funneled to different specialists and stuff. So I knew that definition of gatekeeping, but. So in our last TikTok, that got, like a little over 30,000 views, which, you know, we've had bigger ones than that before, but. And, you know, that was pretty decent. But I was looking through the comments, which I have said that I wouldn't do because it just. It makes you feel weird. I don't know why. Like, it's just. It's just a strange thing to look at the comments, But I did look at these comments, but. So that. That one came up, two different people said, she's gatekeeping.

So do you understand what that means?

Well, I looked it up just like I did with the Pick Me Girl.

Urban Dictionary.

Yeah, Urban Dictionary. And it sounds like the definition is that you're not giving the information that somebody asks you a question and you're not really giving them that information.

Yeah. Because you want to keep it to yourself or your group.

Yeah. Okay. Okay.

So it's like, if you. If there's some, like, niche artist that I really liked, but I don't want, like, other people to know about it for whatever reason, then I would be like, then I wouldn't. And some. I played a song, and then someone was like, oh, who's. Who sings this song? Then I wouldn't tell them who sings that song because I wanted to keep that artist to myself.

Okay.

I guess it doesn't have to be that extreme. I'm trying to think of other examples, but yeah, withholding information for your own benefit.

Well, then it was kind of a dumb example because the TikTok is about me, her asking me how I used to study back in the 90s for medical school. And I'm. I'm not really, I guess, forthcoming with telling that.

Exactly.

Although I do eventually get to it later in the people. That wasn't in the clip. But I'm like, why would I be gatekeeping that information? Nobody cares how I studied 30 years ago.

Well, I think both, like, I think the people who commented was kind of a joke because that is like you ask somebody a question and then they kind of like parlay it to do something to say something else.

Like tune into the podcast.

Yeah.

You'll find out.

Yes, that would be gatekeeping. Yeah, exactly. Exactly.

Well, then that's valid. Yeah. Because you were asking me questions and I was like, nope, nope, nope, nope.

Yeah, exactly.

So, well, okay, but back to this last Tick Tock and the comments. Okay, wait, so first I have to say, like I said, I don't like to look at the comments because this is so ridiculous. I am 56 years old and I still get like kind of upset when some troll on Tick Tock says something about me. It's about, hey, you didn't get.

Someone told you were. Somebody commented that you look like Celine Dion.

Oh, they. A lot of people. Well, one person commented, but let me just check. At last saw, I got 29 likes on that comment. There you go. Okay. I was like, okay, Celine Dion.

Yeah, but for one good comment and then for like, then you get one bad comment and then it's just.

That just stays in your head. Well, you're.

You're experiencing what I've grown up with.

I know, it's terrible. I mean, I don't know. I wonder if you are more resilient to that because you have seen it all the time or not.

I don't know. Maybe.

Yeah.

But at the same time, what I will say about reading comments is that I don't because sometimes some like social media personnel people, one of the reasons why they're so good at what they do is because they just never respond to anything and they just like, keep making their content and like, just never acknowledge any of the hate. I am a yapper at heart and I will always, like, I can't stop myself. I feel like I have to defend yourself. I have to defend and do all that when like, that's not normally the best thing to do because then you just bring more attention to it and all of that. So I don't know. But yeah, I would say I guess I probably am a little more resilient to it.

Well, and that's why, you know, for the most part it's fine. But like. And I guess, and I do kind of. I think it's kind of ridiculous sometimes I'll see a TikTok video where they're responding to some comment and they're doing this whole long thing responding to some troll. And I'm just like, girl, why are you wasting your time on that thing? Like, nobody really cares. That's just some idiot. But yet I'm going to make some responses to some comments. Okay, so Dom 33242 had this to say, okay, because again, we're talking about me studying and I'm saying we didn't have these different resources and stuff. And this person says, we have way more resources now, but we also have way more info to know. I once saw a copy of first aid from the 90s and it was probs 1 4th to 1 5th the size of the book. Now that comment got 59 likes. I'm sorry, first aid has not changed since the 90s. That is ridiculous. Bleeding, you know, bandaging wounds. CPR has gone through some changes, but there's not more now. In fact, a lot of it is simpler than it used to be. I mean, maybe the book is longer than it used to be, but I'm sorry, there have been zero changes. It's not like there's been a whole bunch of new research in regards to first aid. That's.

That's fine. Valid for first aid, but like, I mean, someone commented there was like four antibiotics.

Now here's that, that comment. I'll go over that one. It says, bro, like only two antibiotics existed back then. What does she need Anki for? Okay, so I did look at this.

Was penicillin even a thing back in your day?

Do you guys think I was born in like the 1700s? I mean, I looked it up and since the year 2000, there have been 15 new antibiotics. So there are 15 more antibiotics that you're gonna have to know about.

Okay, antibiotics, but like medicines in general. There's so much more. You guys didn't even have like, like you just. What, just gave people lithium for every mental health disorder.

That is not true. All the SSRIs were invented.

Yeah, but you. Nah, I don't know. I think mental health in general too. That that was not a thing you guys even talked about at all.

Yeah, but the, but the point is, I mean, I mean, I would say most of the drugs that I use today, I, you know, I learned about in med school. Well, I mean, a lot of them were around. Wait a second, wait a second.

Yeah, because you learned about them then, that doesn't mean there's not more drugs now.

Okay, let's back up the. You know, yes, there are new ones, but also, I mean, when there's a whole bunch of different medicines for one disease, what that means is nothing works very well. And so sometimes you have to learn a whole bunch of different things to treat this one disease and then comes on the market something that actually is really, really good and works really well, and then you don't even have to worry about all the other things that don't work very well. So sometimes new inventions can actually make less work, at least for a clinician. Now, you probably still have to learn a lot of that stuff in medical school.

The boomer says more information equals less work.

Yeah, yeah, I'm going with that. But I mean, some of the other classes. I'm sorry, Biochemistry has not changed, Anatomy has not changed. It's all the same stuff. I mean, even things like pathology. I mean, I'm sure there's a few new diseases in there, but a lot of that stuff is just the same. We will be able to fact check this as Stephanie goes through medical school.

That's fine. But like, also, like, even in undergrad, in cell bio, we had to learn so many different, like, imaging techniques that they use now to, in order to like take pictures of cells and like all of that stuff and like different techniques that they use in the lab now to discover that stuff did not exist.

Okay, that's great.

Like all of that and also just imaging in general. Like what like imaging did you learn about when back in your day?

Well, there were microscopes. What kind of imaging are we doing?

Or just like you had X rays, CTs, MRIs.

Yeah, ultrasound.

But now even think about, go on to ultrasound. Like, that technology has improved so much more. And that's like another skill that we have to learn nowadays.

You have to learn how to do ultrasounds.

Oh, that's what med students do. Yeah, that's what they use to like diagnose now.

Ooh, wow, that's actually really exciting. Ultrasound was so bad when I was going through that. You basically had to be an expert in it and have a lot of imagination in order to really see the stuff on ultrasound. In fact, when I was pregnant with you, and the doctor's, like, looking at. On the ultrasound, we're seeing this little tiny heartbeat, and. And I was like, oh, yeah, yeah, I see that. I see that. And dad was like, yeah, I see it. And then we left, and he's like, I didn't see it.

So. So even.

Yeah, but I didn't know med students learned ultrasounds. That's. That's fabulous. Genetics.

Like, you didn't even have the Human Genome project happened in 2003.

Yeah, but we knew about genetics.

Yeah. Like CRISPR gene editing. That's like.

A CRISPR is cool. Yeah.

That's a big part of, like, what.

Even.

I learned about it in general class and college.

Okay. I mean, I'm not disputing the fact that there probably is more now, but I am saying that as new things come out, the old stuff does drop off. You know, you're not learning about some things because nobody's using that anymore.

I think that's true. I disagree with that because, I mean, just in my experience in undergraduate. Undergraduate education, we still had to learn about, like. I'm just thinking of microbiology. We still had to learn about all of the different stuff up until, like, the main thing that you use and all of that to, like, look at small things. Like, we. We still had to learn about all that stuff.

History.

Yeah, that was. Yes, exactly.

Okay. Okay. Well, we'll see.

And I would. I would argue to say that's probably the case in regards to medicines you're talking about. Okay, well, now if you have this one new medicine that is used to treat this one thing, then you don't have to learn about all the other stuff anymore. But I bet they still have. They teach all that other. All that other stuff and so that people can understand why that doesn't work.

Yeah, I'm sure there's some of that. Yeah. Even though it's like, okay, this is really the main thing that people use, but they do teach you. Yeah. I mean, and some of that's just because the curriculum doesn't always get updated. You know, they just kind of add something onto it without taking something away. But I don't know. We'll see. We'll see. I still just. I still take issue with the fact that, like, people think, like, we just, you know, there wasn't much information 30 years ago. There was a lot of information.

People do think it's like the 1700s. You want, like, leeching.

Right, Right. And, you know, sometimes when you didn't know what caused Certain things. Then you had to learn. There were like, five theories about it, and so you had to learn all the theories. And then at some point you're like, okay, yeah, now those theories aren't true. Now we'll see if they still make you learn a bunch of those theories. I don't know. We'll see.

Yeah, I mean, I guess I can't really speak on behalf of this because I haven't started yet.

Yeah, well, we'll find out. Okay. But then the last comment that I have to. That I read, and again, this is like, okay, why am I 56 years old and I'm worried about some troll on TikTok? But this person said she might be the most annoying.

I didn't see that. Well, how do you know they were talking about you?

Well, I don't think they were talking about me.

They were talking about me.

That's what I assume. No, I'm just kidding. I don't know yet. Just says she might be the most annoying. It didn't say which one of us. So I'm just gonna kind of be in my head. Well, I guess they were talking about Stephanie.

That's fine. I'll take it. I really don't care if one random user 1-35789 10 was.

Yeah, that person had, like, no followers either.

You went to their page. You know, you can see when someone's viewed your profile.

Wait, what? Yeah, yeah.

Oh, no. I mean, what? It's not like it's coming from generations MD TikTok account. Because you have your own account.

Oh, yeah. I have my own account that I'm now shutting down.

Out of embarrassment.

Yeah. Yeah. Huh. I really.

You were really on a deep dive. Well, maybe you should just let me handle the social media aspect of things. Well, which I mostly do.

And I did not look much at that TikTok that we had that went really viral. Our very first one, I didn't look at. I mean, I looked at a few comments early on, and then I was just like, oh, no, this thing is just. It's too big. There's too many random people looking at it. And so I didn't look at the comments. But this one, I don't know. Well, it started off with the whole Celine Dion thing, and so I was.

They reeled you in?

They reeled me in until I got to. She most must be the. She might be the most annoying.

Mom, it's okay. These are really of the things that people could say, like, these are not that bad.

Could be a lot worse. Yeah.

100%.

Okay. Okay. Well, no, it didn't really hurt my feelings that much. It just seemed like. It just is so bizarre. Like, what makes somebody comment something like that? It's like, you know, or anything. Anytime you hear about these negative comments that people do, like, you know, you don't have to watch anybody's TikTok, just scroll on through.

Well, they don't have any repercussions for commenting, something like that. Like, you can just drop. Drop a comment and then you keep on scrolling. You don't think about it anymore.

Yeah. Yeah.

So, like, it doesn't even really matter.

Yeah.

Well, what about the. Like, the top comment on this is. We. Like, my attending told me, you know, 40 years ago, most of this stuff you're seeing didn't exist.

Yeah, I saw that when I didn't quite know what to cause. That was an interventional. They said. My interventional cardiologist attended. Right. And.

Yeah, I mean, that's totally true. Like interventional cardiology, like that.

I guess. I don't really. I'm not quite sure what they're. What they're seeing that didn't exist. I don't know.

I mean, there's so much of that stuff I feel like. Is.

You mean the disease or the treatment?

Treatments.

Yeah, I guess so. I don't know. I don't. I don't know exactly what they're doing. I mean, coronary artery disease and stents are. I mean, those things have been around for quite a while. I know they're doing other stuff too, but. But again, I don't know. It still doesn't mean that, like, now you're learning about a hunch.

I don't know what I wanna. This one stuck out to me, the saying that 50% of what you learn is wrong.

Yeah. So I remember when they taught us in medical school that 50% of the stuff we tell you is gonna be wrong. We just don't know which 50%. Which is a really painful thing to hear. Yeah. Because you're thinking, I'm gonna learn all this and half of it's gonna be wrong. I think it's a huge exaggeration. I don't think that 50% of the stuff I learned in medical school was wrong. I do think some things end up being wrong.

Like what?

Well, that you can't get addicted to opioids if you're just using them to treat pain. Even though that was just one thing that did account for. I mean, that's pretty big. That was a pretty big miss.

Yeah.

Yeah, yeah. Seriously, I mean, that was. And so you can see how, you know, it's maybe just one thing. That's a small fact when you're memorizing thousands and thousands of facts. But the impact of it was you.

Were actually told, like, you can't get addicted.

Absolutely, we were told that. It was really. It really was strange, too, because, like, basically before. So I graduated from med school in 95, and kind of before our. Before us, they were told. Everybody kind of had this perception that people would. If you gave them opioids, that they would get addicted. But then. And of course, this goes to the whole, you know, big pharma thing and all those big problems with it. But what. What they started to say was, no, if you're actually treating pain, then patients won't get addicted. And this is really fantastic because you've got to treat pain. And then they started using, like, pain was the fifth vital sign. So every time they would go around, the nurses would go and, you know, take blood pressure, temperature, blah, blah, and then ask the patient if they were in pain and what was the pain scale. And the goal was for people to have, like, no pain. And so they started giving them all these opioids to treat pain. And this whole thing was like, oh, you know, if you just give them for pain, then they won't get addicted and they'll get off the things. And then of course, that ended up being just not true at all. Yeah, but they were like, we felt like we were empowering patients and that these poor patients who had been in pain all of this time weren't getting their pain adequately treated. And so we were really like, oh, we're pro patient. We're pro. Treating their pain and listening to these patients, and we've got to get their pain under control. We felt really good. Like, we were like patient advocates for listening to them and giving them the medicines that they really needed. And, you know, then of course, the consequence of that was horrific. Yeah. So that's an example of something that was wrong.

I remember in, like, elementary school being told that, like, all of this stuff that you were telling you is wrong because it's at such a, like, low level of learning.

Yeah.

And I remember being really frustrated about that because I was like, what? Like, why would you be telling me wrong information? Like, isn't the point. And I guess I wasn't really thinking about it in this way, but I. I think what I was thinking about, I was like, isn't the point. So then you can learn more things, like, isn't this the lowest level of learning so that you can like rake on more things. Like why, why are you teaching us wrong things? Yeah, if I have to unlearn things.

Yeah. I remember like, I think they guys, they taught you guys. Oh yeah. Christopher Columbus discovered America. And then it was like, no, Christopher Columbus did not discover America. Yeah.

Or even. But science stuff too. Like, I remember a science teacher telling me that.

Oh, wow.

So I was that, that. But. And is. Was it in the same context of that's what they were trying to tell you in medical school or they were just like, no, like this stuff is going to be wrong. I guess you get more information to prove stuff.

Well, yeah. And I mean, it wasn't. They just know that sometimes you, sometimes there's a particular dogma of thinking and then it changes based on additional information. So another example of that was we were treating women who were post menopause with hormone replacement therapy. And that was definitely the dogma of the time that you really, you need to have estrogen for your bones. And that. That's really good. Well, then we had the Women's Health Initiative study that Heidi alluded to when she was on our podcast the kids, out in 2001. And that study said, oh no, hormones are not good. We need to get people off of their hormones. And now here it is more than 20 years later, and now we're going back to what we originally thought and more and more studies have come and said, no, actually for most people, hormones are not dangerous and they can be very beneficial. So I mean, that's an example of like kind of this flip flopping nature. And it depends sometimes on what studies you're looking at and then it depends on what the endpoints of the study are sometimes. So I mean, I could go into lots of detail, but sometimes the study is looking at one particular thing, like mortality, but it's not looking at, you know, how. Looking at people's mental health or looking at their satisfaction with lots of different things in their lives. You know, more of like quality of life indicators. And so that's. So sometimes when you look at all of these other things, then you say, okay, whatever these risks, you know, the, the benefits outweigh the risk. So that's just. So then we kind of like do a 180 again, be like, oh, yeah, well, I know I told you 10 years ago that you shouldn't take hormones, but now I'm saying you should take hormones, which is kind of. It's good to not be super dogmatic as a doctor. I Think in general, because when you say like this is the right answer and then you get proven wrong, then you feel a little foolish.

Yeah, that's true.

But I mean, so those are examples of things that we have changed, got our minds on, basically. But a lot of stuff hasn't changed. I mean, the hormonal pathways haven't changed. A lot of the, like basic science, literature, I mean, none of that stuff has changed.

So yeah, people are saying that like now it's that people don't think that that is true anymore.

I don't know. I think, I still think you're going to learn about. You're going to learn some stuff that ends up being wrong. I don't think it's going to.

But yeah, I don't think being half. And I feel like that, that saying 50% of this is wrong contributes to like people not believing in science, you know?

Yeah, yeah, that's.

I feel like that's not safe to say to the general population because then like, I'm like, okay, well if, if there's a 50, 50 chance that if I take this pill, it's not doing what it's supposed to, I might as.

Well just flip a coin. Yeah, exactly. Yeah. Yeah. I don't, Yeah, I don't know where that. It would be interesting to look back and try to figure out where that came from because I don't, you know, I just don't think that's true. Those were all of my things in there. Oh, well, now I can't really go back. I was just gonna talk about Celine Dion and stiff person syndrome.

What, what is that?

Okay, so the stiff person syndrome just.

On someone who had a lot of Botox.

It sounds so bogus, but it's the. So yeah, whenever, when I saw these comments that I look like Celine Dion, then I decided to look into more information about Celine Dion. And then I pulled up some pictures of her and I was like, okay, that's good. You know, she's. She's a good looking lady. And then there was one picture where she looked absolutely terrible. And I was like, okay, I really hope that that's.

Let's not come first.

Lean Dion. But, but she, but I had read that she had this stiff person syndrome which used to be called stiff. Stiff man syndrome. And I had never heard of that, but I looked it up and it's actually like really terrible. It's an autoimmune disorder that affects, it affects your muscles. Well, your nerves and your muscles. Basically it affects the inhibitory neurons. So, you know, like to move your muscles. Right. To contract this muscle, I've got to relax this muscle. And that's how this movement happens. Well, if you can't.

If you're not for the listeners, she's talking about moving her bicep or moving her forearm up towards her shoulder.

Yes, thanks. But if your inhibitory neurons or neurotransmitters or anything, those things are not working, then you can't move your arm because it's still like you're trying to contract your biceps, but your triceps are contracting as well. And so that's what happens in this stiff person syndrome is the inhibitory neurons are attacked by this, by your own body, by your autoimmune disease, and it doesn't work. And then you have all of this just all of these contractions happening and you get all these muscle spasms and you can't, like, you get all this pain. You can't walk, you can't move properly. And the incidence is like one in a million. And happened to Celine Dion.

Well, what's the treatment?

It's probably things that suppress your immune system. Things like stuff, steroids or a lot of these other medicines like they use for people with other autoimmune diseases like Crohn's disease and that type of stuff. I don't know a lot about the treatment and I'm no expert in stiff person syndrome. I just literally read like one article on it. But. But I felt so bad. Cause it like, the thing sounds so bogus. You're like, stiff person syndrome, what is that? But it's. It's a real deal. Porcelain.

Porcelain. Well, on that note. Well, thanks for listening this week, you guys. We have some fun guests coming up, so make sure you tune in next week. Follow us on Instagram @GenerationsMD@TikTok GenerationsMD and we will talk to you next week. Bye, guys.

Bye.