There Are Days…

My Good Friends and Patient Readers,

I’ve decide to stop blogging. Although I have enjoyed writing this blog and mightily appreciate all of you who have taken the time to read and comment upon my many articles, keeping the blog going has taken an appreciable toll on my sleep, studying, and even on my family time. As I am about to enter my last year of residency I will have many new responsibilities to my program competing for my time. Additionally, I have signed a contract for my first job and, as I need to devote my last year of training to ensure that I am completely ready to take care of you, your family, and your friends if you ever end up in a gurney in my trauma bay, I won’t have time to update this thing and I’d rather just end it than let it fade out.

I’m going to pull the plug in a few days. Feel free to copy any articles from my archives to read at your leisure. Remember, however, that all of this stuff is copyrighted. I plan to write a book and have given some thought to its layout and content which may include some of the material from the blog. As to when this book will be ready I don’t know. I like to write but I don’t like to do it under pressure so this might not be for several years. There’s a big difference between writing an article every now and then and carrying a theme across a hundred pages, something for which I may need a lot practice.

As for medical school and residency, there are days when I wonder if it’s been worth it. I look at the financial devastation of the last seven years with every asset we ever had, every dime of equity, and every drop of our savings poured into the bottomless void of medical education and wonder if we’re ever going to recover. As I said, I still have a year left of residency in what will have turned out to be an eight-year ordeal and we are going to arrive at that glorious June day a little more than a year from now with absolutely nothing in the way of wealth to show for it. Just a couple of old cars, some household effects, an empty bank account, and a quarter of million in debt. Comes that June day then one last push before the money starts rolling the other way…one last leap of faith and credit to scrape together the money to pull up stakes and get started in a new town. Just a few more months of distracting the wolves, I promise my lovely and long-suffering wife, of playing the financial shell-game, of sandbagging Peter to pay Paul, before we start to pull back, slowly, from economic catastrophe.

Then there are days, fewer now then previously, when I look up from the petty humilities of working in the academic medical environment with the stifling egos, the petulance, and the sheer bad manners that are a hallmark of this kind of thing and swear that, if I had known the level of disrespect with which medical students and residents are treated, I would have laughed and thrown my medical school application in the trash. Except that most of our attending in my program are easy-going and manage to work in a large amount of teaching despite the constant stampede of patients in our department, dealing with the surprising level of malignancy in this whole system has been almost unbearable. Certainly if I wasn’t trapped like most medical students and residents I would never have put up with it. But what choice do any of us have? By the time you find yourself in third year, where the abuse really begins, you are not only deep in debt but now thoroughly unqualified for any other kind of work. I doubt I am going to work at an academic medical center ever again, even as an attending. I have just had my fill.

And on some days I get the strange sensation that I haven’t really done anything but shuttle one hopeless patient after another into the hospital for one more round of expensive and only marginally effective therapy. Most things are either self-limiting or utterly hopeless and sometimes it seems that the millions of dollars which have poured through my hands have bought nothing real. Just a bunch of redundant tests to confirm that your aged mother (or grandfather, aunt, uncle, brother or sister) is pushing ninety and at this point almost everything we do is more harmful than just letting things run in their natural courses. Either that or the solution, the cure, lies with the patient who could do more for their own health by giving up the smokes and fatty food, not to mention the booze and the drugs, than a whole hospital full of doctors. We’re just putting expensive duct-tape on most of our patients it sometimes seems.

There are days, however, when somebody taps me on the shoulder in the grocery store and says, “You may not remember me, Doctor, but you took care of my mother in the Emergency Room last month. She’s doing great and I just wanted to thank you for everything you did.”

Up and down.

Up and down.

Up and down.

With my Deepest Respect and Gratitude,

Panda Bear, MD

144 thoughts on “There Are Days…

  1. Thank you. I don’t know if I will ever become a doctor (it would be a mid-life career change), but you have given me a clear picture of what to expect… what to really expect. You have also inspired me, and made me think hard about serious matters in the medical/political world.

    Thank you, and God bless.

  2. Sad to hear you are pulling the on your blog. Although I discovered your blog only a few months ago, i have enyoyed visiting it and reading your views.

    I wish you all the best in your final year of residency and hope that when all is said and done you would clear your debt very fast.

    One last question, any chance you will write on USMLE as earlier indicated?

  3. Good for you, Panda. You never get time back to spend with your family, and you never have enough in the first place. I have certainly enjoyed your blog and want to thank you for many entertaining hours of reading (and yes, I have read every article in your archive).

    I myself completed family medicine residency three years ago, and start a diagnostic radiology residency in six weeks. Hopefully I can still put up with the indignities of medical training without getting fired. I think that in DR, however, the crap is less than in other specialties.

    Take care of yourself, and may you reap a bountiful harvest for all of your hard work. I will be looking forward to your forthcoming book.

  4. Dr. Panda,

    Let me be the first to thank you for your incredible effort on our behalf. You are truly gifted as a writer, thinker, and blogger. I await your book.

    You have made these difficult topics more ‘bear’able for all of us.

    Thank you.

  5. You’ve actually made me cry (What a wus, I know). I understand every reason for you leaving, yet I still want to scream don’t go.

    I want to wish you the best of luck with you career. I look forward to that book as well, you have really touched me with your posts and I should have said a long time ago.

  6. Best of luck to you. Thanks for many laughs, groans, and moments of introspection.

  7. Dr. Panda,
    Your blog has been an enormous resource to me. Thank you for writing all your witty, entertaining and informative posts, and best of luck with your last year of residency.

    I really hope you do publish a book eventually.

  8. I think Horace said it best:

    “Exegi monumentum aere perennius”

    More lasting than bronze, Dr. Bear. Your devotion to blogging throughout your medical ordeal has been mightily impressive, almost as much as your devotion to work & family. The unbiased look you’ve given your readers is worth its weight in platinum- for your time and your insight, we thank you. Good luck!

  9. Your writing is excellent. Good luck with the book! I’ll miss the blog, but I like your reasons.

  10. Panda Bear MD,
    Although I only just discovered your blog, I wanted to thank you for the few months of enjoyment that I got out of it. Your posts exactly say what I try to say when I try to explain my opinions on what medical school is like. I don’t write well (as you can see from my previous sentence) and it is so great to see my own sentiments in writing where I can email them to my family and friends. I will miss reading this dearly but I fully understand your need to move on. Good luck in your future career and I hope, for both our sakes, that life outside of the academic medicine setting is more tolerable and rewarding.

  11. Damn Panda, sorry to see you go, but I totally understand.

    Good luck with your final year of indentured servitude and with your future job.

    I too have gone through all the emotions you talk about in this post and have also wondered if I had it to do all over again whether or not I would again go through the crap that is medical school and residency.

    You’re a great blogger and I look forward to the book. I only hope that my own feeble newbie blog will someday come close to the success you have enjoyed.

    As I read this, your final post, I swear I could hear chiropractors across the country breathing a collective sigh of relief.



  12. thank you panda. my husband starts 3rd year rotations in six weeks. it’s his 2nd career…we have a lot in common with you and your wife. because of that, i’ve greatly enjoyed your blog and insights. we’ve been subscribers for a few years now, and you’ve definitely been a source of entertainment, information and reality-checking for me. i wish you all the best for your last year, and hope you do put that book out some day. just be sure to publish it as “Dr. Panda” so we all know who to look for 🙂


  13. This is a huge surprise. I have greatly enjoyed reading your blog over the years and I appreciate all the advice you’ve provided. I’ll be happy to support any book you produce, as your writing style and insight are both captivating. Best of luck to you!

  14. I too would like to add my well wishing to those that have posted. I want you to know that your blog helped me make a big decision in my life. I decided that for me medical school wasn’t worth it. I decided that I didn’t want to endure what you have. I want to thank you for your time and dedication to this blog. You will be missed and I have thoroughly enjoyed every one of your articles. I am very much looking forward to the book. Is there a way we can keep in touch with you so we will know when the book will be out? Thank you again for your time and effort.


    Taylor Darcy

  15. Tango Yankee Panda, you’ve made my blood boil and my head nod. I’ll miss your words. Good luck with the book.

  16. don’t be afraid to start-up again after residency is done. last year and boards are the hardies part but there’s light at the end of the tunnel. thanks for th entertainment. Ian.

  17. Panda, stumbled onto your blog about a year or so ago and have been hooked ever since. I think I’ve read every single article you’ve written and frankly, they were all pretty damn good. I don’t doubt that if you ever write a book it will be a good one.

    Also, my favorite quote from your blog (one that has stuck in my mind far better than any esoteric fact about embryology) is “no wonder your knee hurts because every time you stand up its like you’re squat-thrusting a small German car”! That stuff is hilarious and I’ll miss it. Enjoy your much deserved extra time with your family.

  18. I figured this was coming, but I’m still incredibly disappointed to hear it. But time marches on…

    Thank you for the time and effort you’ve put into your blog. It has been by far the most enjoyable medblog I read, and it is one of but a few from which I look forward to receiving new goodies via RSS.

    Good luck to you, Uncle Panda.

    Hope to see you on SDN…

  19. I just discovered your blog a couple of weeks ago but became instantly addicted and tore through all of your archives in about a week. It’s sad to see you go, but I too will be on the long list awaiting your future book. Good luck and thanks for the brilliant commentary.

  20. I will miss your articles and view point a great deal Panda. Thanks for all your insight. Thanks for the laughs. Thanks for making this all a little more bearable.

    PS please continue the occ. post in SDN forums- keeps everyone a little more honest.

  21. Panda,
    You will always be an inspiration to me. I appreciate your words last year when I didn’t get a job. Now that I too get to finally go into EM, I hope that our paths will one day cross again.

  22. Damn, this is the worst entry you’ve written, because it’s going to be your last. Please leave the articles online – I like to give people the links to the articles.

    I’ve been reading this blog faithfully for over two years now, and I’ll really really miss it. True story.

    I won’t miss im1dc, haha.

  23. This is a sad day in the medical blogging world. I’ve been reading your blog since the very beginning and have thoroughly enjoyed it these past few years. It’s helped me laugh my way through medical school, and even call out a few fellow students on the usual garbage you hear about CAM and other nonsense. Good luck to you in the future, I hope you find that your new career was worth all the sacrifice.

  24. Dr Panda Bear..

    With any luck, your book royalties will fund a luxurious retirement…

    I will always greatly respect your views and look forward to seeing your book.

    Fair winds and following seas,
    HM2(FMF) “Doc” Heidrich

  25. Panda, I may disagree completely with your politics but I have greatly enjoyed reading your blog. Thank you for sharing so many of your experiences with us and all the best for the future.

  26. Cosign on what TheProwler said…keep ’em up! I need something to read as soon as this stupid internship is over!

  27. I became addicted to PB MD about a year ago. This has been an amazing resource for pre-medical students like me and undoubtedly many others. I commend you on your superb writing talent and wide range of readers. I have nothing but respect for you and I wish to thank you for the many articles you’ve written offering your interesting viewpoints and introspection as you journey through medical education and doctorhood. I will buy your book the day it is released. Best of luck and keep posting on SDN!


  28. You’ve seen me through admissions and the first two years of med school, I do appreciate it, more than I can express. Best to you and yours, I wish you every good thing in your career and in life. Hope to read you again some-day.

  29. We will miss you, but we understand. Good luck with all future endevours, and as for feeling frustrated with the whole student thing, remember that when you are a real Dr. and try to change some things if you can.
    Take care

  30. Panda–

    You will be sorely missed! You have written wonderful posts on your experiences; I look forward to your book! On the other hand, do what ya gotta for your health, family and career now; you won’t regret it!!

    Many of us have spent quite a few years with a net household debt due to med school loans; you will get out of it.


  31. I’m amazed that a former marine and civil engineer consistently writes better than 95% of professional journalists. Your blog is impeccably written and edited, thoughtful and witty. There are often times I nearly choke from laughing while reading. The time you spend to produce such a quality result must be immense – or you are an incredibly gifted writer. Perhaps you have yet another career as an author or journalist to come.

  32. Thank you so much for your time on your own blog. It has inspired a lot of people including myself. I hope everything will be smooth as you planned in your final year of residency.

    (I hoped you could just leave the articles behind but since you are writing a book, my wish is in no luck.)

    Thank you again! My first and last post for you!


  33. Panda,

    Thank you for taking the time over the past few years to write so many articles on everything from complementary and alternative medicine to survival during third year to applying to residency. I have thoroughly enjoyed your articles ever since I stumbled upon your blog a little over a year ago. It has definitely been my favorite part of getting online each week. You’ve seen all the responses that you have received in just one day of announcing your desire to quit blogging. I think that says a lot about all of the lives you have touched with your writing. Good luck on your book as well as your final year of residency.

    Half M.D.

  34. Damn you Panda!!! First i find out the truth about that Solylent Green stuff, now this….i don’t know what to do.

    I have enjoyed your blog and i know that the demands of residency continue to get worse over time you feel some increased pressure with only 364 days to go…but “attending-hood” comes with its own set of problems.

    BUTT (yes, i did intend that spelling!) If blogging is a means of releasing that inner bile that builds up from hours of beating your head against a wall dealing with some of your chronic patients because of that damn Hippocratic slogan you muttered under your breath at graduation, don’t forget to find something else (non-alcohol i hope!) to help you maintain the stress relief. Keep the sense of humor and your ability to vocalize — it helps others feel better since they have the same thoughts but cannot find the strength to verbalize them.

    You do good work, will continue to do good work, and I know that we have not heard the last of the Panda….(don’t they have all of your kind tagged on GPS anyway to see your breeding habits)

    Good luck in your last year of residency….by the way…ATTENDING is just a fancy way of saying “I’m still a resident, just a much older resident, but i drive a better car!”

  35. While I totally respect your decision to end the blog, I can see how it might infringe on the time you want to spend with your family, I can’t say I’m happy to see you go. Your blog has been one of the funniest, most informative blogs I have ever had the pleasure to read. What I really find sad is that I only just found it last October. I guess now I can go through and read the archives but I will miss the updates. Please do post if that book is ever published. I for one would buy it.

  36. Gone but never forgotten. Good luck! Kudos to your family without who none of it would have been possible.

  37. Panda, I found your blog during my first year in ’05. I’ve read it off and on and it helped me get through many a genetics and EBM lectures.

    I guess all good things must come to an end. I’m applying to EM this fall and reading your posts throughout med school has galvanized my desire for EM through their hilarity and honesty.

    I wish you would keep your blog available online to serve as a warning or guide to those considering medicine as a career. Either way, consider this an advance order for your future book release.

    I hope one day we cross paths and I can buy you a cold one so I can share my stories to make you laugh as you have done for me.

    “There’s no lost and found box, but there’s an ass box.”

    EM-saving the world from it’s PCP

  38. For those of you who are using Firefox and would like to create a copy of this entire website so that you still have Panda’s blogging goodness after he pulls the plug, I highly suggest the Spiderzilla extension.

    I have used it to create a ~20 MB folder consisting of all articles on this website. Spiderzilla downloads everything, maintaining directory structure, and enforces local links so that you’re essentially browsing an offline website. Very simple.

  39. Panda, I discovered your website in undergrad and have since read every article in the archives. I truly appreciate your honesty about medical training. Because of that I cannot say that I wasn’t warned before it was too late! I’ll keep my eyes open for your book.

    Enjoy your last year of residency and congrats on the job! God bless.

  40. I’m sorry that we won’t be hearing more from you. Thanks for all of the great posts, and good luck in the future.

  41. I would like to make a plug for you to re-think your decision. I respect all of your reasons for quitting but here is mine for you to stay.

    Medical students, if anything, are getting more and more starry-eyed. In the name of anonimity I will decline to describe the nonsense that has been going on at my school these days but suffice to say that every voice against drinking the Kool-aid is a good voice. Yours is particularly effective.

  42. I’m with scalpel. If you’d ever like to be a guest blogger, let me know. I’ll miss your writing! Thanks for all the hard work. It is appreciated.

  43. Panda,

    Ever consider uploading your blog to a free blog hosting site like blogger or wordpress.

    This way, your archives will still be available and you won’t have to worry about paying monthly subscription costs.

    Sounds like a win-win for all involved.

  44. You can put me on preorder now for that book, Panda. I always imagined that this blog would end with you sitting back in a lawn chair, drink of choice in hand, watching your landscaping service mow the lawn. I hope you continue to haunt SDN, and make sure to let us know how money corrupts in about a year…

    (Ironically, I still mow my own yard. -PB) 

  45. I’ve been reading your blog for a couple of years now – and you still haven’t convinced me not to go to medical school. And while I disagree with you on many things, your blog has always been a great read.

    I hope you will keep this site online even when you stop updating it. There are free hosts available and keeping this blog on the would, IMHO, be a Good Thing to do.

    And who knows, maybe in a few years when you’re an attending and rolling in cash you might find the time to start updating again. 😉

    Thank you and good luck!

  46. I’ve been reading your blog for a year and have enjoyed every entry. I’d love to be kept up to date on the progress of your book. Put me down for a copy.
    good luck with your family, dogs, residency, and career.

    loyal pharmacist reader

  47. PB, You will be missed. I had just wondered to myself a week ago how you could keep this up with all your other responsibilities. The good news is that with the projected doctor shortage (85,000 by the year 2020) your financial situation should get a lot better.
    Bad news is, you may be working harder than you already are and spending even less time with your family. I hope your sense of humor will pull you through.
    Keep writing sir,even if only for yourself, and hope to see you again somewhere in the blogosphere or my local bookstore!

  48. Dr. Panda
    I just wanted to say thanks for all that you have contributed. I found you blog about a year ago and have consistently checked back weekly for more of your wit and prose. I will be starting medical school in August but have struggled with finding something else to do for some time. Yet, staying in contact with blogs like yours and others have made me decide to jump in, put my head down, and do it. Being able to read about your experiences has been an honor. If nothing else, please realize that you have made a tangible difference in at least one lowly pre-meds life. I wish you the best of luck in the future.
    Yours truly,

  49. Of course you still mow your own yard. You’ll always mow your own yard. A landscaping service just wouldn’t do it the proper way.

    Sorry to hear you are leaving but I expected it with the tone of your last dozen or so posts. Thanks for all the entertainment. At the risk of sounding creepy it’s too bad we never met in real life, your viewpoints may be drastically different from mine in a number of areas but I have the feeling we’d get along well.

    Best of luck to you in that long hard slog back to financial solvency.

  50. As a non-traditional premed about to make the plunge into medical school, I extend my most heartfelt thanks for doing such an excellent job with your blog. Way too many people jump into medicine a bubble-headed optimism and fail to consider the numerous problems with medicine and medical training. Although you haven’t talked me out of making the switch, you have helped to cure me of some unrealistic expectations that I had about the process. I’m not sure you quite appreciate how wonderful of a resource your blog was. If you get some time in the future, please know that there are many of us who would love to read your blog from an attending’s point of view.

    All The Best,

  51. You were one of the first blogs I read… You taught me a few things, and I thank you for that.

    Good luck with everything, sir.

  52. I always looked forward to a new post.

    Thank You and Good luck.

    I would love to see you start blogging again in a few years with the perspective of attending practice.

  53. I’ve been using the internet for 15 years now, and yours is the only blog I ever checked frequently for updates. Always a pleasure to read your thoughts.

    Sucks that you’re pulling the plug on it, but that’s understandable. Rest assured i’ll be one of the first to buy your book, whenever you decide to write it 🙂

    All the best Dr.Bear,


  54. listened to your no frills advice when i was ambivalent abt medicine…thanks for your time and input.. you’re an amazing writer and wish you the best of luck on that sure you wont need it though!

  55. Although our politics and really, view of the world of humans are as polar as seemingly possible, I have been an ardent reader. You are a thinking human – and a feeling one too. That gets lots of points from me.

    I, too, wish you Godspeed in your professional and family/individual life as you go forward.

    Thanks for your passion – your time – your willingness to put it “out there” for all.

    A good Panda Bear are you!


  56. I had an inkling this was coming, but I won’t bother trying to rehash what so many have already said.

    I, too, am attempting to make a third career (military and then electrical engineer) out of medicine, and would like to think I’m going onward as pragmatically as possible. You have enlightened me (and many others, I gather) as to the reality behind the sheen and veneer of medicine, and I am extremely grateful. You have given me a duplicitous outlook, hope and hardness, that will serve me well and hopefully keep me grounded and aware of what is TRULY important.

    Thanks for all the time spent on us, the loyal “pandites;” take care of you and yours, we hope to hear from you again (and I’ll definitely be looking forward to The Panda Chronicles once they’re published).

    Semper Fi

  57. Why are you pulling the plug on the blog? Close up the comments and let it sit as it is instead… it’s a great resource, and I, for one, refer back to some entries because I liked the way you phrased certain things.

    Is it a matter of money for webhosting, or just that you couldn’t be bothered?

    Because if it’s the cost and hassle of hosting this site, I would be happy to do it for you for nothing, and I’m sure any number of other medbloggers would as well. Zip the WP db file and theme files and send it over…

    Best of luck. It’s been enjoyable reading you this last year. 🙂

    (And FWIW, I also greatly prefer non-academic medical centers to teaching centers any day of the week.)

  58. Panda,

    Your blog, more than anything else on the Internet, has captured the medical school/becoming a doctor experience better than anything I’ve ever seen, heard, or read.

    You’ve painted a clear picture of the personal and emotional sacrifices the daily grind that doctor in training endure and that few (save for family) can ever imagine or any pop culture/TV drama could ever capture.

    Thanks for telling the truth: “Stifling egos and bad manners,” again, simply perfect.

  59. We’ll miss you, Panda.

    I took a lot away from reading your blog over the time, and I’m certain I am not the only one.

    I wish you the best of luck, and am sure you’ll find your balance, in all things.

  60. Dr. Panda, I’ll miss your sharp and evocative writing style. How can we find out when your book comes out if you take down this blog?

    I was wondering if you’ve read Dr. Joseph Sacco’s “Morphine, Ice Cream and Tears: Tales of a City Hospital.” It reads like the Catch-22 of an intern’s experiences, echoing many of the points you’ve made in this post and others. I think it’s out of print now, but you can get used copies via the behemoth of book sellers, Best wishes.

  61. Dr. Bear,

    You’ve been an amazing resource. I can’t thank you enough. Can’t wait until your book comes out!

  62. I found your blog last year, and think that it’s great. In many ways, your blog shares the thoughts and feelings of many residents across the nation. I’ve shared many of your posts with friends and families, and most are continually amazed with the things we see, things we as residents put up with, and what patients go through.

    Hopefully you’ll still post on SDN.

    Thank you for the blog, and I look forward to reading your book in the future.

  63. well that was rather depressing. thanks for the uplifting spiel as I sit here after my 10th hour of studying microbes and antibiotics I have never seen and may never see. 🙂

    When I think about the 250k+ debt I am putting myself into, I like to stop and remind myself that I’m not doing it for the money. I’m doing it for the title…

    no, wait. Actually, having worked in a different industry for a while I like to remind myself that most jobs are rather miserable (I know only 1 corporate lawyer who doesn’t hate his job). At least I’ll get to help people, maybe.

    Anyway, you’re almost there and I wish you and your family the best of luck. This was an awesome blog, and I hope you change your mind and leave the material up.

  64. Panda,

    I love the blog. Please don’t take it down. You can just go on an indefinite sabbatical. I’m sure once you start working, you can tell us the rest of the story–i.e., how much better life is now that you’re getting paid an actual salary instead of below minimum wage.

    Thanks for all the posts

  65. It’s been great! I have read everyone of your blogs (in 1-2 days!) and they are wonderful. I was already accepted to medical school before finding your blog, but it has really taught me what to expect! Thank you so much!

  66. Panda,

    This fan of several medblogs will miss you terribly…at times it seemed you were the only guy with some sense about complicated, thorny issues. No BS from your corner of the blogosphere…and that’s the way it should always be. I’ve enjoyed your miscellaneous ramblings, and I hope you’ll at least keep the archives around so your loyal readers can return if they so wish. Best of luck to you in the future, and I hope you’ll get the opportunity to return to the blogosphere.


  67. For the last two years, every time I get on the computer, I do the same thing:

    1) Check

    2) Check

    3) Check this blog.

    4) Either close the computer or go about whatever business I had in the first place.

    This is going to seriously throw my life out of whack for a while!

    Last night, my woman and I looked at my financial aid award letter for 3rd year. Like you, we’ve got a nice house worth of debt, but the only house we have to show for it is the house of cards that is my current precarious position in this medical education nightmare.

    Good luck with the next chapter–thanks for sharing your thoughts–take care.

  68. don’t ever give up your willingness to stand up for what you believe. Above all, I consider that your signature.

    come back with vengeance some day.


  69. I’ve been reading your blog for at least 2 years now, maybe more. You have been a consistent voice of truth and clarity during the rollercoaster that has been my medical education. I have sent links to your articles more times than I can count. Thank you for everything and I would gladly buy any book that you write. Good luck and Congratulations with being so close to the end.


  70. Dear Panda Bear: I am one of those ‘old fossils’ but with a young heart and mind. I am close to 40 years ahead of you on the curve of life. Been blogging for about five years, and came across your blog about a year ago. I think your generation of med students, interns and residents are lucky to have this new medium to express your misgivings. In my day it was a ‘dark secret’ that anyone of us were fearful to express during our “brainwashing”. Be not faint of heart….you will make it and make a great contribution, and you will make a difference to thousands of people’s lives……My favorite saying was “you cannot suck blood out of a stone.” That too goes for money. If our society wants health care….let them pay for it. Times have changed radically and students interns and residents can no longer afford the high debt. It is a very frustrating situation. When you finish I hope you have found a niche with a reasonable schedule, have time to recreate and be with your precious family.
    I don’t know how wives do it, except for their love of their husbands……

  71. Dr. Panda,

    I came across this site a couple years back when I was still a slightly naive pre-med. I just graduated, and definitely owe you for all the humourous, insightful, and highly educational content you have provided. Good luck with life, and I hope to read your book soon!

  72. Sorry to see you leave, but completely understand. Excellent writing. I can’t even begin to tell you how many times I sent a link to someone for recommended reading. Good luck.


  73. I have enjoyed reading your blog since you tell everything so sincere. I wish you the best in your final year as a resident and future job prospects.

  74. PB,

    I’ve been reading your blog since I found out about it through SDN, and you’ve provided some great food for thought to this lowly premed. I find myself referencing your articles on healthcare and politics often.
    I certainly understand your reasons, but I do hope that you will come back to the blogosphere someday. You keep people honest!
    Add me to that growing list of book buyers! It should be required reading for all premeds.

    See you later…


  75. Panda, I’m an aspiring med student and have been an avid reader of yours for over a year now. Your blog contains a unique blend of wit and insight, with a refreshing lack of BS. Thanks for doing you best to tell it like it is. Good luck with everything, and I look forward to seeing this all in print one day.

  76. firstly i want to thank you for all
    the effort you put into making this an excellent
    blog.I want to wish you luck in all your future
    endeavors,i really hope that maybe after you finish your residency training that you might
    be able to start bloging again.

    p.s do you ever find it strange that all these people who you’ve never met and probably never will care so much about you ?

  77. Thank you for all the work that you have put into this blog. I have very much enjoyed reading it over the last couple of years. Best of luck in your future endeavors.

  78. We will miss you dreadfully. Your words about single payer/socialized/whatever medicine, coming from somebody in the trenches, mean more than any politician’s.

  79. You will be missed. Thank you for being a class act. I wish we could clone you.

    Good luck and I hope should I ever need a visit to the ED, that I wind up in yours.

    Blessings to you and yours


  80. God bless you and your family and I wish you every success. I’ve enjoyed your blog and admittedly was also looking forward to your political opinions as the presidential election get closer.

    Your in the home stretch.

    Your book no doubt will be an excellent read. 🙂

  81. Hey Panda,
    I’ve read much of what you have to say both on SDN and here. Thank you for your frank and honest look at what medical school and beyond has to offer us. I wish you the best!!

  82. Wow. I just found out about your blog and the first thing I read was:

    I’ve [decided] to stop blogging.

    Good luck though! To the both of us! I still have four years of medical school ahead of me.

  83. What a shame. I wish you would reconsider and go to a once-monthly posting, or add a tip jar linked to a PayPal account so people could give you a little cash to make it worthwhile. But I understand if you don’t.

    I really enjoyed your blog.

  84. I’m going to miss reading your wonderful stories! I hope you get that book out fast, because I’m gonna have a hard time going cold-turkey.

  85. Panda,

    Thank you. Your blog has been a daily fix for me for the last year and a half; it’s the perfect antidote for my med school’s touchy-feely CAM stuff. I don’t alway agree with what you say, but I always find your comments stimulating. How will we know when your book comes out?


  86. Thank you, and I have to say that I agree with your observations about academia. More than 20 years later, the bills are long paid, the material sacrifices forgotten, but I still bear scars from the sadistic cultural environment of the teaching hospital.

  87. Kurt wrote “More than 20 years later, the bills are long paid, the material sacrifices forgotten, but I still bear scars from the sadistic cultural environment of the teaching hospital.”

    Maybe Panda could discuss this. I’ve also noticed that nursing education, screwed up as it is, has sadistic teachers that seem more interested in failing students that helping them progress.

  88. Panda thank you so much for all your contributions. I’ve been reading your blog since my first year in medical school. I just graduated last week so I’ve very much grown up and went through my med school life with your blog.
    It was nice to see the perspective of another sane person going through the medical school process and to know that it wasn’t just me that had a weird feeling about the way things were done. Other times it was just nice to enjoy your unique humor. Above all I always had a good time reading your blog.
    Good luck and be sure to let us know when that book comes out!

  89. So long, and thank you. You’ve been the voice of sanity in so many ways, but real life must come first. God bless.

  90. Completely understand and wish you nothing but the best….

    Thanks for sharing yourself, thoughts and valuable contributions through a great blog.

    Hope to hear from you again someday.

  91. Panda, your blog has been a wonderful source of inspiration and provided a safe haven of logic and reason for me in an otherwise insane world. Although I will grieve this terrific loss, I understand and congratulate you on allocating more time to your family. Enjoy the tremendous wealth I am sure you will accumulate through hard work and shrewd investing. … Then think about running for office. You’d be amazing.

  92. I have just discovered your blog so I will be reading frantically until you pull all the back posts. However as a 44 nurse with a Ehlers- Danlos, vascular type, your compassion and desire to be an excellent physician come through in your writings. You write that you feel that at times the care you give is futile, but for many people, like me, it isn’t about a cure, which isn’t likely, it is about about good care, and a good life, both out of the hospital and in. Quality doctors greatly contribute to that, so thanks and take care.

  93. Panda-

    All the best. Your book will be a best-seller and vindicate the blog.

    You’re one helluva writer. You have my utmost respect.

    Best of luck to you.

  94. Thank you for taking our random, incoherent, inarticulate mumblings and objections and turning them into beautiful music. You have a gift that allows you to express exactly what most of us are thinking, but can’t seem to put into the proper words. These entries should remain, immortalized, for everyone to see, and for years to come.

    Thank you for sharing your gift with us.


  95. Thank you for the time and energy you spent blogging. I was an aspiring EM resident but instead went for peds. (Being married to an lawyer to be helps) I read your blog weekly and have very much enjoyed your viewpoints. Best of luck in your future attending position. – Allie

  96. I am a recent discoverer of your blog, and share both the dismay as well as the understanding and best wishes expressed above. May I ask whether you have considered some sort of a PayPal arrangement whereby those of us who’d be sure to buy your book in the future, could in a meaningful way in the here and now, recognize the value we place on your work.

  97. Hey Panda–

    Just dropped by to catch up on my blog reading amidst the chaos of wrapping up medical school and saw you are stopping the blogging. I can totally sympathize about the lack of time. You have been a wonderful source of inspiration for my own blog, and have shown me that writing honest, witty accounts of our experiences in this insane world of medicine are of great interest to a broad audience. Thank you for the link and all of the traffic you have sent my way over the years. And please write that book someday when you have time.

    All the best–

    The Lone Coyote

  98. PB-
    You’re pretty much the reason that I started blogging. You’ve been a source of information and entertainment in the messed-up little world we call medicine for a few years now. Thank you.

    Best of luck with year 4 and keeping the family strong. We need more well-balanced/critically thinking doctors out there like yourself. Take care

  99. Help! I only just found your blog this past evening, and it’s going away! I can tell already it’s a bountiful site that I want a little more time to check out. Please don’t take it down yet? Let us look at things a little longer, and as I saw mentioned above, the book oughtta be great.

  100. Thank you for:

    Making us laugh
    Making us tear up
    Asking our opinions
    Sharing your thoughts and feelings
    Teaching us about residency (and beyond!)
    Opening our eyes
    Your insight

    And mostly, Thank you for helping to bring us all a bit closer together, whether we be medically inclined or not, with your amazing style of writing and sharing.

    The blogosphere is certainly going to be missing something once you are gone, but you will live on in our hearts and minds, and we could all use quite a few more doctors with your wit, intelligence, and caring in our lives.

    Although we will miss you, we all realize that we are better off with you concentrating on the final year, and will wait with baited breath until the book is published.

    Good luck to you in all of your endeavors.

  101. Dearest RedScrubs Scrubby Winner,
    Going over our records has brought to our attention that not all winners of the Scrubby Award have gotten their free set of red scrubs. We hate to see this happen. After all, they are free. Once again, this is not a gimmick to get you to buy a single thing. We’re just giving them away to the weekly blog winners. So, if you haven’t gotten your free set of red scrubs, then please shoot me a line so that we can correct a dastardly wrong!
    Sincerely yours,
    Dr. Incognito

  102. Sheesh Panda,

    That sound like a lot of freakin debt. Maybe you should have gone to PA school. You would have been done five years ago, have a quarter of the debt, and you would still be doing the exact same thing you are doing now. Hmmm, anyhow, good luck.

    (Well, no.  Not only will I be making a large multiple of what a PA makes at my first job but we only do the exact same thing in the same way that a fry cook and a chef do the exact same thing.  I mean, they both cook and put food on plates…but you get my point.  -PB) 

  103. I wish you all the best. I hope that you finally find everything that you’re looking for at the end of the ordeal. Yours is a voice of reason that will be sorely missed.

  104. Panda, you are the man. I will miss your blog. And as I am about to enter third year, your most recent post is quite disturbing. Luckily, I have a break to think about this stuff and I am only $48K in debt.

    Best to you, your family, and your career. Keep rocking the motherf*cking house!

  105. just curious, how much will you be making? plus are there any accurate websites out there that reflect the average actual pretax take home pay of physicians minus malpractice insurance costs?

    (Of course I can’t tell you how much I will be making.  But it’s well above the national average for Emergency Medicine.  As for salary surveys, they are all pre-tax salary.  If you, for example, see the average salary of anesthesiologist as $280,000, this is his salary exclusive of whatever his group is paying for malpractice.  My new employers are paying for my malpractice insurance and “tail” coverage as well as my contribution to my state’s Patient’s Compensation Fund so my salary is my salary.  -PB)

  106. You are a legend, man. Yes, you could have wittled away your pathetic life over structural drawings and BBQ/boating on the weekends while your wife and kids toted around from the shopping mall to play groups, soccer games or whatever in a 5 mpg Denali XL @ $160/tank. What you did was better. It doesn’t seem worth it now, but it will. You feel beaten up and abused, but not long from now it will be your turn to recoup and do what you want to do. A year from now you will have a bit more say in how you conduct your career and it will only get better from there on.

    Thank you for the wisdom … the inspiring and highly entertaining journal entries. Without all that suffering, you would have had nothing comparable to write about. People like you inspire us to make wise choices and let us tighten the abdominal muscles and guard our family jewels a few seconds before we are delivered a the requisite sharp blows and kicks that build our character in the “more beatings = tougher/better doctors” model of training. As the old guard of medicine retires, we can hope that the next generation of attendings will find a better and more efficient way to conduct business. They got their nest-egg and enjoyed rising cost amid failing performance and rising reputations. Amid this, you have brought much needed sarcastic humor into the dark crevices of medical education that a certain percentage of the population must endure if we are going to have enough doctors out there for the future.

  107. Thank you for your delightful blog. My husband was in a rough residency and the things you wrote made him feel like he was not alone in his journey as a resident. Luckily, he was able to transfer to what I think will be a much better program starting this July. No one outside of medicine really understand what the family or medical student/resident goes through. It’s amazing how you were able to write situations that just “nailed” how medical school/residency and life as a resident really is.

    Anyways, good luck and much success to you. I’m sure after the money starts rolling in, you will feel that all your hard work has finally paid off. Your blog will certainly be missed…

  108. jon on May 23, 2008 2:31 am

    Dr. Bear

    Did the above mentioned guy even read your blog? That comment is insulting to all of us…especially to you

  109. Panda, you have truly been an inspiration to me. From reading your stuff, early on I knew we agreed about a lot in regards to medical training.

    Never drink the Kool-Aid.

    Never buy what the man is selling.

    Rock on.

  110. Thank you for all of the time you have spent on sharing your experiences here.

    You have a gift for communicating and, while I probably wouldn’t vote for you ( I’m a liberal ), I almost certainly would buy any book you’d publish.

    Hope to see that happen some day –

  111. Thanks for all your thought provoking pieces. Good luck as you leave residency. I’m looking forward to your book.

  112. Thank you for your writing. I’m entering medical school this fall with my bright-eyed optimism and idealism intact, and your blog has helped me to brace for the inevitable hammerfall.

    Hopefully I’ll make it through regardless of any shit I have to put up with. As long as I truly help one person it will all be worth it.

  113. It is sad to see you go and as others have requested, I wonder if it is at all feasible for you to leave this site up as an archive?

    While I am only a medical student and may not be able to fully appreciate your attitude towards medicine at this point I appreciate your voice on the matter. I hope to end up feeling differently than you at the end of all this, but regardless your site has allowed me a glimpse into what I have ahead of me.


  114. It is sad to see you go and as others have requested, I wonder if it is at all feasible for you to leave this site up as an archive?

    While I am only a medical student and may not be able to fully appreciate your attitude towards medicine at this point I appreciate your voice on the matter. I hope to end up feeling differently than you at the end of all this, but regardless your site has allowed me a glimpse into what I have ahead of me.

    Thanks Panda!

  115. I learned from your blog Panda, and there is no greater gift. Keep writing. Next time, when your book goes on sale, I can give you something for your effort.

  116. This is a real shame, I’ve only just discovered your blog and I love it. Thank you for taking so much time from your busy life to share your thoughts and knowledge with us – wish I’d found the blog ages ago. I’ve read a little way back into the archives, but there’s so much more to go; I hope it stays up a while longer. All your posts are worth reading. You have such a clear-headed and sensible way of looking at things, leavened with plenty of wit and humour.

    I wish you every success in your future career, you deserve it. And please, when you write your book, make sure it gets plenty of publicity so we know to go out and buy it straight away 😉

    Thank you. May God bless you and your family.

    Lord, you have assigned me my portion and my cup; you have made my lot secure.
    The boundary lines have fallen for me in pleasant places; surely I have a delightful inheritance.
    I will praise the LORD, who counsels me; even at night my heart instructs me.
    I have set the LORD always before me. Because he is at my right hand, I will not be shaken.
    (from Psalm 16)

  117. many thanks panda for your insightful blogs down through the years.As an EM trainee i too share many of your misgivings at the current state of modern medicine and indeed society in general.
    Yours has been a welcome counterpoint to the research/pharma/ego overload culture of medicine today. you will be sorely missed.

  118. You’ve made me a better patient! Thank you for your blog and I will be looking forward to reading your book whenever it comes out!

    Please don’t go the way of Charity Doc–I still miss him. You are of his caliber!

  119. Yeah, no more dispariging comments about poor/minority patients that show up in your ER! No more dispariging and border line racist comments about the benefits of diversity in medicine! Hip, hip, horay!

  120. Goodbye and much Good Luck to you, Panda Bear.

    Thank you for the opportunity to opine here from a very divergent pov than your’s or your soul mates.

    Below find yet another article that condemns today’s medical ethics, or rather the lack thereof, and one more reason I ask you “Who do you trust?”

    “Researchers Fail to Reveal Full Drug Pay”

    Published: June 8, 2008

    A world-renowned Harvard child psychiatrist whose work has helped fuel an explosion in the use of powerful antipsychotic medicines in children earned at least $1.6 million in consulting fees from drug makers from 2000 to 2007 but for years did not report much of this income to university officials, according to information given Congressional investigators.

    The story is available in the NYTimes 6-8-08, online and in print.

    I do hope you have not fallen into the trap of prescribing drugs to children that were recommended by these two doctors in what appears to be nothing more than big pig pharma paid propaganda.

  121. pathdr2b is a proponent of reverse racism if I ever saw one. She’s been banned from SDN and started her own Minority website, of course bashing whitey for all her problems in life. She’s a bitter fool, and nothing more.

  122. Shmo–

    You picked a really bad subspecialty, probably influenced by the TV show ER–that’s my guess based on experience (tons of kids today wanna be HOUSE);

    If you want to write a book, e- mail me. I got lots of ideas…and you can write.

    I can too.

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