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NOTHING ABOUT YOU. There is nothing related to your healthcare that I don’t want you to know. I want you to have high quality information, and take the time to discuss it with you, so that we can collaboratively make good decisions about your needs and your treatment. I want you to have the best possible care, even if it’s not from me.EVERYTHING ABOUT ME. I try not to let you see how tired or hungry I am, that I’ve been working since yesterday morning, and that my body hurts. I stifle those yawns, even though I’m sure the uncombed hair and smudgy eyes are obvious clues. When you’re annoyed at me for running 15 minutes late, I smile and say, “sorry about that - thanks for your patience - I’m trying my best.” I TELL YOU NOTHING ABOUT MY OTHER PATIENTS. I don’t tell you that I worked through lunch because one of my teenage patients attempted suicide, or that I spent the last 45 minutes (of a 30 minute appointment) trying to get a patient a bed in rehab, because his wife says that otherwise she’s leaving him and taking the kids. You don’t need to know those things. Those are my burdens. I don’t tell you that when you spend the whole appointment making small talk and denying any concerns, then wait until your hand is on the doorknob to tell me why you’re really here, a part of me screams inside, because I know the whole day will be spent catching up, with a dozen people who are annoyed with me. That I will again (eternally) miss lunch. Or that if it’s the end of the day, I will stay an hour late and either have to choose between going to the gym or having dinner with my family. Instead, I plaster my best smile on my face, take a deep breath, and ask “Oh? What’s going on?” with as much empathy and curiousity as I can muster.I also cannot tell you about the successes, the wins, the profound joy that comes from seeing other people recover. I hope that you see that I am willing to stay with you, to give you the best possible care, and that you can remember that, when I am running late with the appointment before you. I hope that you feel welcomed, at ease, and protected. I am often humbled by how kind my patients are with me, how they often tolerate me running a little late, how they express concern if they see me sneezing, how they don’t mind if I drink coffee while we talk. It is a colossal duty and also privilege to practice medicine.Thanks for listening.

Short answer: In a medical unit and in a combat zone, it's actually not that far off. Some of the pranks, disrespect to rank, and general jackassery go a little far, but not by much.Long answer:As a general rule, certain things (like shaving, uniform appearance, and addressing by rank) tend to slide slightly on deployments. Here are some examples: My NCOs did not care if I didn't bother to shave for a day or 2 since we were running 18 hour missions, 5-7 days consecutively. It was more important that I spend that 5-10 minutes doing weapons/kit maintenance, downing chow, or sleeping. Similarly, it was sometimes better to refer to my LT or squad leader by call sign, first name, or “boss" because rank can get them shot.Overall, enforcement of discipline depends entirely on the unit. My old man was the commander of a med unit (it was actually a MASH unit before the Army changed them all to Combat Surgical Hospitals). His enlisted and officers were all professionals (from combat medics, to nurses, to doctors). They were exceptionally skilled and saved hundreds of lives while in Iraq. However, professionalism is relative. In a medical unit, actual experience and expertise don't correlate to rank as much as they do in combat units (you might have a doctor with 5 years practice who joined late in life outranked by a nurse who went green-to-gold and just finished his clinicals). Rank also doesn't matter as much as patient care.Compared to my Infantry unit, they were not as publicly disciplined, physically fit, or professional (from a “soldiering” perspective). There were considerably more first name and lack of rank addresses than are common in combat arms units. They were, however, fucking exceptional at their jobs.You've also got to take into account how different MOSs/units deal with trauma and blow off steam. If one of our guys gets hit, we can kill the asshole that shot him. If we have a shitty day, we can get some ammo and take the squad to the range. Med units don't have that. They are constantly seeing the absolute worst the battlefield has to offer. Grown baddasses bleeding out and crying for their mother or their wife. Little kids caught up in a roadside bomb and missing pieces. We grunts see it, but we have the heat of the moment, the adrenaline, and the outrage to temper it. Medical personnel don't. They have to SEE it. They have to inspect it, diagnose it, and cure it.There are other factors too. Doctors and nurses tend to be older and more mature than your average 18-20 grunt, so they don't need the rank structure as much to enforce discipline. Medical professionals and similar aren't mentally wired the same as the guys who voluntarily choose to be the pointy end of the stick.So yeah, it's really not that far off. If those folks had to see the things they do and run the tight kind of discipline that an infantry unit does, they'd go crazy. Our (infantry) discipline keeps us razor sharp and combat effective. Their “relaxed" attitude and jackassery keeps them the same (and sane).

“I do not recall having seen more abject pain manifested in any other medical or surgical condition.”That was the professional opinion of a physician who witnessed another physician deliberately inflict a black widow spider bite on himself.That was Dr. Allan Walker Blair of the University of Alabama, Tuscaloosa, in 1933. He was able to take good scientific notes on his own condition for about two hours until he was suffering too horribly and had to leave the documentation to other observers. The ordeal lasted three days.There were some legitimate scientific controversies about black widow spider venom in 1933 that Dr. Blair felt obliged to address.“…the patient stated that he became so upset mentally that he was afraid that if firm control was not exercised he would go insane.”How a UA doctor allowed a black widow spider to bite his finger for science