A high school student has questions about a medical career and pathology vs surgery

A female high school student asks about pathology, surgery, and medicine in general. [Email edited for length.] See if you agree with my answers.

The field I am most interested in is pathology. I have a very logical mind and would enjoy being able to solve the complex puzzle of disease. I would also like the somewhat flexible hours compared to other more intensive specialties. However, I do have some qualms.

Im also interested in general surgery. I would love to learn how to perform all the different types of surgeries that surgeons perform. If I were to be a pathologist, would it be "knife-free"? Pathology really intrigues me, but participating in the occasional surgery sounds like it would be extremely interesting and full of learning opportunities.

There is some knife wielding in pathology. Specimens must be properly cut, and there is the occasional autopsy. However, its definitely not surgery.

What does a pathologist really do? Ive looked at various descriptions online, and none of them seem to be very specific. What would a typical day look like for a pathology resident? I was also wondering what types of skills pathologists are taught?

Pathologists spend most of their days looking at specimens, mostly microscopic slides. Here is what pathology residents at Johns Hopkins learn.

I know that medicine is constantly evolving. With new medical technology, certain fields will soon become obsolete. Do you think this will happen to pathology?

I suppose there will be some technical advances that might involve automated digital reading of pathology slides, but I believe there always will be a need for pathologists. A residency position in pathology is much easier to obtain than one in general surgery.

Since Im interested in both pathology and general surgery, I was wondering if there was a way I could do them both (in a combined program or something like that). I know this is highly unlikely.

It cant be done.

I am a very anxious person. Specifically, I have health anxiety. (Im all too aware of the irony). Do you think that the amount and intensity of the material covered during med school and residency could take a severe toll on a persons mental health?

I think every medical student at some point worries she might have a disease she just read about. Im not sure what to tell you because I am not a psychiatrist, but studying diseases for four years and having a health anxiety might be a problem.

I would also like to know whether being involved in medicine could dramatically alter a persons personality by magnifying their negative characteristics. I am very driven, hard-working, ambitious, logical, easily annoyed/frustrated, and sometimes easily distracted. Im quite anal-retentive and OCD. Some of my friends and family have described me as an emotional robot. How do you think these characteristics would be affected by a journey through medicine?

Many medical students and residents become less empathetic and more jaded as they go through medical school and residency. Except for being easily distracted, many of your traits are common in med students. Heres more about empathy and medical students.

Do you know how difficult it is for Canadian students to get into American med schools? Or do you know any medical schools abroad in English speaking countries (e.g. Scotland, England) that would be willing to admit international students? Also, would it be more difficult for a woman?

Its not easy. Here is a link to a website that has some data on Canadian applicants to US schools. I dont know much about UK schools. Ive written about Caribbean schools. Type "Caribbean" in the search field of my blog. Being a woman wont matter.

How would medicine affect interpersonal relationships? Im really close with my immediate family, and it would be difficult not being able to see them all the time, let alone during holidays or breaks. How can a person manage a serious relationship and medicine at the same time?

It can be done, but it takes some effort. I have written a few posts about so-called work-life balance.

Choosing a specialty is difficult
More about choosing a specialty
Anguish about choosing a specialty
Surgery and work/home conflict

I hope this helps. Good luck.

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Questions about antibiotics vs surgery for acute appendicitis

A study from Finland suggesting that antibiotics may be a viable alternative to surgery for acute appendicitis has created a stir. As you might have expected, I had some concerns about the paper which you can read in my blog post here.

On Twitter, many surgeons have commented on both the paper and my post. Several interesting questions come to mind.

Based on this and other similar studies, is the treatment of acute appendicitis with antibiotics now a mainstream alternative to surgery?

Should surgeons now mention the Finnish study results during their informed consent discussions with patients?

Is CT scanning accurate enough to differentiate a reasonable percentage of uncomplicated appendicitis from more complex cases? Previous papers have reported conflicting data on this topic. Will this lead to more CT scanning (if that is even possible)?

What do patients want? In an effort to avoid surgery, are they willing to take a 25-30% chance of a recurrence of appendicitis?

Will patients be able to understand the distinction between complicated and uncomplicated appendicitis?

We all agreed that ertapenem is not a first-choice antibiotic in the United States. In fact, the real questions may be is a three-day hospitalization for intravenous antibiotics really necessary, or as is the case with acute sigmoid diverticulitis, would a course of oral antibiotics as an outpatient be sufficient to deal with an attack of uncomplicated appendicitis?

How will it work if antibiotics and surgery are considered equivalent treatments? Although I am retired, I think I am qualified to say that I would not have enjoyed going to an emergency department at 10 o’clock at night to see a patient with acute appendicitis who after a discussion, chooses to be treated with antibiotics. Should these medically-treated patients be admitted to surgery or another service? Should the emergency physician have the discussion with the patient and only call the surgeon if the patient elects to have an operation?

Is it appropriate for an anonymous blogger to be questioning the methods and results of a paper published in a top-tier journal such as JAMA?

What do you think about all of these questions?

Many thanks to the following for their input. If I omitted someone, I apologize. @jdimick1, @NirajGusani, @TomVargheseJr, @ChrisFriese_RN, @LVSelbs, @NatalieBlencowe, @JBMatthews, @ehldallas, @zuckerbraun, @SarahB_MD, @docaggarwal, @aneelbhangu, @smootholdfart, @DRSoup34, @hswapnil, @qdtrinh, @TimLaheyMD, @jonessurgery, @RogueRad, @DrKathyHughes, @putrescine, @krchhabra, @Apathetic_Cynic, @SimonRBarron

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Why Charity Work Matters to Me

Charity Work is something that I have been interested in for quite some time. My interest reached a new level after discovering that many people I knew were in the Heroes Alliance. The Heroes Alliance is a nationwide non-profit organization of  volunteers who give back to the community by making super hero appearances at child-related charities and events. I had seen many wonderful photos and spoke to the charity workers about their mission and how they used their skills in costuming to brighten a childs day. They became real life heroes to children (and their families) who desperately needed hope and I wanted to become a part of it.



I wanted to get involved for many reasons. First and foremost, I know what its like for your life to suddenly change. In 1999 I went from able -bodied teenager to being in a wheelchair in a blink of an eye. One moment I was carefree and the next, I was bleeding and broken, trapped in a car. Words cannot describe how shattering it is for your life to suddenly change. You experience shock, depression, anger, exhaustion, hopelessness and a whole other truck load of emotions. And then theres your family and what they are experiencing. It is not easy. The world goes dark and during these times it is so important to let any amount of love and light in. It does make a difference. It can help you heal. I was so happy after months of being in the hospital, when I was finally taken to the art room to do a craft project. That memory stands out. That happy moment. If Superman or Wonder Woman came to visit me, I can tell you right now that would have made all the difference in the world.

When I got the process moving on creating and running a Heroes Alliance branch in Pennsylvania, the unthinkable happened. My grandmother had fallen ill. My beautiful green-eyed grandmother was always there for her family. If someone needed a place to sleep, she offered her couch. If they needed a meal, she cooked for them. She swept the sidewalk of her neighborhood and always loved telling people that God loved them. She was a good, loving woman and sadly in late 2013, I had to gather up the strength to say good-bye to her on her deathbed. That was the hardest thing I have ever done. Emotionally and mentally I was a mess and then my body shut down. I broke out in hives that spread throughout my body and came down with a cold. I was in bed and on medication for days and yet, I did not want to stop the process on creating a Heroes Alliance branch. Although I was terribly sick, I felt my grandmothers strength with me and knew proceeding with this would be the best way to honor her memory.

My grandmother and my accident is why charity work matters to me. I know what its like for your life to change and I know what its like to lose someone you love. My grandmothers kindness and generosity inspired me to help others like she once did.


I cant speak highly enough about the Heroes Alliance organization. It truly is a beautiful concept to give back and an added bonus that we are dressed as super heroes. Everyone has a big heart and they are just as passionate as you are to make the world a better place. We are making a difference and spreading love, support and positivity.  And everyone within the organization supports one another in their mission 110% all throughout the United States. We all have a story on why super hero charity work means so much to us. Now you know mine.

Dedicated to Virginia
I love you

                                                             

                 
                                                   

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Ask Victoria Part 5

So for the fifth round of "Ask Victoria" I had my fans ask whatever they wanted on my Facebook fan page (www.facebook.com/VictoriaCosplay). The original plan was whoever asked the best question would get to interview me for my Blog but there was such a huge response and so many great questions, I decided to pick the ten best for this article.
My apologies that I could not get everyones questions in. There were far too many and some of them were questions I have all ready answered in other interviews across the web. Thanks again to my fans. Read on and enjoy!

Emily Ruth asks: What has the process been like going from a low-key cosplayer to the Queen of Cosplay? Your great greatest challenge and hardships that you had to overcome as each new con approached? How as those challenges shaped you as a person and where can you see yourself growing from there?

Victoria: I never thought I would receive any kind of title in the cosplay world especially being named the Queen of Cosplay. Its a bit mind boggling. I was just a shy little nerd girl who wanted to give cosplay a try and really enjoyed it so I continued with no specific goal in mind other than to have fun and pay tribute to my favorite characters. In the beginning I actually dealt with a lot of racism with my first cosplay (Aerith from Final Fantasy VII) and I would consider that the biggest hardship. I also have individuals whom I refer to as my "sheep" who literally would shop at the same local stores I would or apply to the same shows or websites, contact people I have worked with, imitate my modeling photos, even cosplay the same characters that I do. Sometimes they are former friends, sometimes they are plain ole stalkers.  But these women arent considered hardships in the least, they are just people I laugh at when our paths cross. I think any obstacle in life helps you become who you are and I have faced everything from being in a wheel chair, to murder in my family, divorce, abusive relationships and even alcoholism. I always found the light however thanks to my family, friends and God. I do not exaggerate when I say I have very thick skin. I have even taken up the practice of meditation and feel I am constantly evolving.

Russell asks: How has cosplaying changed your life? Pros and Cons of cosplaying for you?

Victoria: Gosh, its changed in so many ways. First and foremost, its crazy that I dont have to worry about a ticket anymore. Im getting invited to these shows or am granted access because of my work and the name Ive made for myself and thats incredible. My first trip to the San Diego Comic Con was in 2010 and I had people come up to me who knew who I was. It wasnt just fans either; I met a Fox San Diego camera man and he said he followed my work online. I couldnt believe I was all the way across the country and people knew who I was and it really showed that all my networking has really paid off. I would say the annoying thing about being an internet celebrity is the idioticy I have to deal with; people who just act stupid. But thats easily taken care of with the click of the "block" button. Sometimes I will spit their stupidity right back at them, other times I dont bother and just block them.

David asks: What is your opinion of the latest Superman costume from Superman: The Man of Steel?

Victoria:  I actually really like it! Its different from any Superman costume weve seen onscreen. I think it was time to step away from the traditional outfit (just a bit) and give us something new. Its not too different though so its still safe. I also think its sexy. Ive been in love with Superman since I was a little girl and am very much looking forward to this film.

WeAre NerdCaliber asks: What was the last thing you read that made a huge impact in your life or thinking? Why?

Victoria: I dont know if this counts but I have a Dream Interpretation book that I use to decipher dreams and visions I have while I meditate. I record everything down in a journal and its amazing once you decode the hidden meanings behind dreams and visions.

 Brian asks: I sort of know the answers to any question that could be asked but I feel like one question in particular would have an interesting answer and I wonder if its changed over time: How do you go about "retiring" a cosplay? I know youve had quite a few that have been shelved for good (Aerith for example), but I would like to hear in your own words what goes through your head when you decided that a cosplay has run its course ...

Victoria: If I feel like I have done all I can creatively for a character whether it be costume upgrades or photography wise, I will retire it. With Aerith I was very satisfied with the pictures that were taken (http://cosplaygirl.webs.com/aerithfinalfantasyvii.htm) and had no desire to cosplay her variant dresses. I also dont attend many video game shows so I had no where to really wear the outfit to.

Dave asks: Do you regret cutting your hair?

Victoria: Not at all! It has to be cut after I put my hair through hell one week. I went from dark to highlights to back to dark. It got fried so I cut only two inches off. As you can see in the Alice picture above, its not too short. It looks shorter though when I wear it curly.

Humphrey asks: With all the hype of the new 52 how do you feel about the new costume designs. Do you see yourself cosplaying any of them in the near future. If so which would be the first. Ohh yeah will you marry me.

Victoria: Im digging the designs so far although I am still getting use to Supermans collar. I may try Wonder Womans new outfit but I have no love for Supergirls new uniform. I think  its horrendous. As for marrying you, if Im still single in five years lets do it!

Michael asks: You have been featured lately on several big cosplay websites, and even most recently on EW.com. Do you hope to become a model outside of the cosplay world, and if so, what would you model?

Victoria: Ive been doing three things like a mad woman; teaching, cosplaying and modeling. I feel I am ready to be more active in the modeling world so cosplay may be pushed to the side for a little bit now that I am in negotiations with a modeling agency. Ive actually held off on signing with an agency because teaching and cosplaying came first but even with doing that, Ive proved I can make it into national publications. As for what would I model, that would depend on what assignments I would get but I am open for pretty much anything.

Mind Trickdmedia asks: Best Pick up line when youre dressed as Slave Leia?

 

Victoria: I love it when females ask me to marry them at conventions or when they say "I love you Princess Leia!". Conventions are suppose to be fun and with all the online Slave Leia bashing going on, its always nice to meet a confident, strong, female fan who appreciates Leia.

Phil asks: Thoughts on being the subject of so much fan art? I could probably have an entire art related conversation.

Victoria: Its awesome! I appreciate everyones efforts and for incorporating me into their art! Ive seen some incredible work and try to post as much as I can on my website: http://cosplaygirl.webs.com/fanart.htm

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Earn Money By Answering Questions

Answering questions may not seem to be an obvious way to make money online, but it can be. You may be familiar with Yahoo Answers where you can pose a question and invite others to answer you. Its a bit like that, but if you are the person who supplies the answers, you will get paid. 

Unlike Yahoo Answers, the sites that answer questions and pays those who supply the answers screen their experts a lot more closely. Anyone can supply an answer to any question on Yahoo Answers, but only those approved to do so will find themselves answering questions for pay. 

Some of the sites that pay you to answer questions are general and cover most subjects. Some of them are more specific and target a particular niche only. There are a growing number of these kinds of sites and some pay quite well too. 

However, it is quite intensive work as you will have to be present at your computer and online waiting in real time for people to pose a question that you are qualified to answer. You may also have to do some initial research to come up with the answer. While you are likely to know most things in your chosen field of expertise, you cannot reasonably be expected to have everything right at your fingertips every time. 

One popular question and answer site is Just Answer . They have over 100 categories with experts to answer questions in every one and more. For example, while researching their site they claimed they had 159 experts on hand, ready and waiting for questions to be posed to them. This number will likely vary at different times, but this is an indication of their popularity. 

The experts on these sites are often subject to a feedback system. This means that customers rate them according to how well their questions were answered. A feedback rating of 100%, for example, would mean that the expert concerned would have fully satisfied every customer with the answers they provided. In this way customers can choose the expert they feel is most likely to provide the best answer.

To earn money answering questions you will have to undergo an expert screening process. You will be expected to be an expert in your chosen field, and you will be tested on this. You may also be scrutinized by customers as well as by other experts as this is the real test of your skill. 

If your knowledge is in a subject that is taught at college or even in school, then you may be interested in Student Questions . This site is geared towards students who need the answers to questions concerning their homework. There are certain ethical questions in this regard, but you will have to answer those for yourself. 

If your expertise is in small business, then Small Biz Advice could be ideal for you. This is a site where people pay to receive business advice and answers to their perplexing business questions. 

One site that is slightly different from most of the others is ChaCha . They accept questions from people using cell phones. This means that people may ask questions that are area specific, such as, "Where is the nearest gas station?" They would of course have to also provide their geographical location and you would then have to provide them with an accurate answer.

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The Surgeon Scorecard My analysis

Ive got nothing against ProPublica. If a valid way to rate surgeons is ever discovered, I would support it completely. However, ProPublicas Surgeon Scorecard is not the answer.

I keep hearing its defenders say, "Some data is better than no data at all." I disagree strongly with that. To me, bad data is worse than no data at all. People with much more statistical sophistication than I have pointed out the flaws in the scorecard.

Digression: Having written many posts about statistics, I can tell you that the mere mention of the word drives readers away about as fast as if you were to yell "Fire" in a crowded theater.

I want to focus on a different area. The scorecard has created a lot of chatter on Twitter, and just about everyone I know has blogged about it.

This reminds me of a couple of posts I wrote back in 2011. [Links here and here.] I pointed out that Twitter might not be as important as those of us who use it think it is.

While we were busy arguing about the merits of the scorecard on Twitter, Im not so sure what the general public was doing.

For example, ProPublica says the Surgeon Scorecard has had over 1 million visitors since its launch. That sounds like a lot until you consider that the current population of the United States is estimated at 321 million. So 1 million people would be 0.3%. We do not know how many of those 1 million were unique visitors. It could be that many of them were doctors looking for their own statistics and bloggers looking for ideas.

That the public may not care was reinforced by a rather tepid response to the ProPublica AMA (Ask Me Anything) on Reddit today.

By 1:00 PM EDT, which was two hours into the AMA, there were 80 comments, 31 of which were by ProPublica staff or the spine surgeon who had consulted on the scorecards methods.

Just to give you some perspective, an AMA last year by a guy with two penises drew 17,134 comments.

Because the demographic is skewed toward younger people, perhaps Reddit may not have been the right venue. Although Reddit boasts 169 million unique visitors per month, the most recent figures show that 33% of the Reddit users are mostly men between 18 and 49 years old. Those under 18 are not counted but represent "a substantial percentage of Reddit users."

My two favorite questions asked of ProPublica were "How can I tell if my doctor is capable of making an error?" and "Do you fix the leg which is broken completely?" [Did the question refer to a leg that was completely broken, or did it mean should the leg be completely fixed?]

What have we learned here? Its hard to say.

If you want to read a measured critique of the scorecard, go to Dr. John Mandrolas piece on Medscape.

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The Worst Cosplay Questions I Have Been Asked

Over the course of 8 years I have been interviewed by many websites regarding costuming and other hobbies that I enjoy. During this time I have been asked the absolute worst questions that are rude, invasive to my privacy or flat out dumb. I dont understand how anyone (mostly men) think its appropriate to speak to a woman like this but then again, thats the problem isnt it? These guys forget that I am a woman. I am a person. Im someones daughter, sister, aunt and girlfriend. Would you ask your daughter these questions to post on the world wide web? Probably not particularly when most of these questions are resulting in information that will bring a crazed fan boy right to your front door step. Thanks for trying to risk my safety, pal. Below are examples of the worst questions I have ever been asked.

#1. My Phone Number: This is always a nice excuse "Can I have your phone number so I can do an over the phone interview with you? Its easier."  Actually, no its not. I use to write for a comic website and conducted two over the phone interviews with artists and trust me when I say, its a bitch playing back the audio and typing it up word for word. Why do these guys think its appropriate to ask for my number? Youre a stranger. Why the hell would I give you my number so you can abuse it later? Nice try. Just email me the damn questions.

#2. My weight: Its never okay to ask someone how much they weigh. Ever. And how is that relevant to cosplay?

#3. Photo of me without makeup: Why the hell do you want to see what I look like when I wake up in the morning? I get asking for a "normal" photo but without makeup? Really? For what?!

#4. Can I take you out for dinner sometime? Wait; what?!

#5. Family questions: What does my family have to do with cosplay? Why do you want to know how they reacted to me wanting to dress as a superhero? Perhaps you think theres a story there? Maybe you think they tried to ship me off to the Betty Ford Clinic cause they thought I had a "problem"?

#6. Can you give me your full name?: Obviously Sherlock, "Cosplay" isnt my last name but I think its also obvious that if Im using a stage name, its because I dont want my full legal name out there. No you may not have my full legal name. Its none of your business.

#7. Can you tell me your city and state?: This is usually the follow up to the "Can you give me your full name?" question and is a great stalker tactic. If they have your full legal name and city and state, all they have to do is jump on Goggle and BAM! They can find out where you live. And Im sure my boyfriend will be more than happy to make street meat out of you while I call the cops. Seriously, have a little respect. I always answer with "The Philadelphia area" which is true and vague enough because there are dozens of townships in the area but you dont need to know which one I live in.

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