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March 8, 2025 | SUBSCRIBE | SHOP | ARCHIVE
Written by Dr. Nick Golinvaux
Good morning. I am oh-so-close to completing the guide I promised you on managing arthritis pain — without a doctor.
Next week, it'll be in your inboxes.
In the meantime, if you've ever wondered what medical residency is (or what the heck is a fellowship? Is that part of med school?), I've got you covered.
**This newsletter has occasional affiliate links (at no cost to you). These small commissions will always be re-invested into Rules of Thumb to improve the experience for all.**
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FIRST-HAND KNOWLEDGE
How did your doctor become a doctor?
TV shows make medical training look like a drama-filled journey of true love and excitement — but the reality involves a lot more organic chemistry and a lot less elevator romance.
From the brutal "weed-out" classes of college to 28-hour residency shifts, the path to becoming a doctor is...long.
Each stage presents its own unique challenges — like learning 30,000 medical terms in your first two years or waiting for a computer algorithm to determine the next five years of your life.
Whether you (or someone you know) are considering medical school or just curious about how your doctor got their credentials, this is an insider look at medical training from start to finish.
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X-RAY OF THE WEEK
The peril of the bystander
What you're looking at here is what's called an axial cut of a neck CT scan.
Sort of imagine we used a bread slicer and cut thin slices to look at, starting from the top of your head.
The white bones you see here are the vertebral bones of the neck. Way up high, by the base of the skull.
And that bright white gleaming star just in front of the neck bones?
That, sadly, is a bullet. A bullet absorbed by a bystander.
A bullet that stopped less than a centimeter shy of the vertebral artery (which travels in that dark circle just below the bullet).
Somehow, some way, this person survived...with relatively few side effects. A true miracle!
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RAISE YOUR HAND IF YOU'RE A: TRAVELER
Those suitcases are injury machines
This is probably news to nobody, but holy cow is travel a recipe for injury!
I flew for the first time in a while recently...and all I could think about the whole time was how all the lunging and jerking with awkward suitcases couldn't be more tailormade to cause overuse injuries like tennis elbow, De Quervain's, rotator cuff tears, and back pain.
I mean, how awkward is it to get a 50 pound bag into the trunk of an SUV? Much less, rolling it through a parking garage, up an escalator, and onto the checked bag scale?
Not to mention the artificial rush of security screening, cramped aisleways of the plane that require lifting your carry-on over your head...only to repeat the entire thing on the other side.
Here's my takeaway. Let time be your friend.
For each of the difficult physical tasks listed above, if you had just 5 extra seconds to slow down and lift that bag the right way (eg, in front of you with your biceps and legs), rather than hurriedly lurching with a flick of the wrists and a twist of your back?
You'd save yourself a boatload of injury potential.
Next time, I'm adding 15 minutes to my travel time just so I have the mental padding to LIFT NO BAGS IN A HURRY!
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MEME TIME
Honestly, terrifying...
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7:7 PM • Jan 28, 2025
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No wonder they are so fussy!
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🩸 FINGER ON THE PULSE
A picture's worth...
Glowing slugs and a volcanic eruption in the snow? It'll take you five seconds not to miss these unbelievable science images of the month.
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IF YOU'RE HURTING, I CAN HELP
Your Guide: Carpal Tunnel Syndrome
This is my masterclass on carpal tunnel syndrome. In this short book, I share everything you ever wanted to know about numb hands and how to fix them.
It's more education than the average visit to a specialist — for less than the average co-pay.
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Thank you for reading and engaging with Rules of Thumb! Subscribe for free to receive new posts.
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Nick Golinvaux, MD
Hand & Upper Extremity Orthopedic Surgeon
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PS. If you enjoyed this newsletter, please forward it to a friend! If you’re the lucky friend, subscribe here.
PPS. Rules of Thumb is a completely free resource to all those who want to learn more about the human body. Support Rules of Thumb here 🙏.
***Please do not use this email to try to obtain medical advice. I cannot legally or ethically provide that. If you are having a medical emergency, please call 911 and do not attempt to contact me through email.***
Rules of Thumb Archive • www.nickgolinvauxmd.com
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DISCLAIMER
Because, you know, lawyer stuff
If you are having a medical emergency, call 911. Do not attempt to contact or obtain medical services through this site. This content is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this site or materials linked from this site is at the user's own risk. The content of this site is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their healthcare professionals for any such conditions. The content is my own and does not necessarily reflect the views of my employer.
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