“If you are distressed by anything external, the pain is not due to the thing itself, but to your estimate of it; and this you have the power to revoke at any moment.”
I am a Christian. Jesus Christ is my personal savior. I can reconcile my faith with a host of scientific facts including evolution. But as we’ve seen, there are plenty of believers who apparently cannot.
It is distressing because it is difficult to view such individuals as anything but morons. The following is a video posted to GodTube, which is currently being (rightly) mocked on Reddit. You can use the terminology of evolution correctly all you want and create reasonably good looking CG models but it doesn’t make your points any more valid.
Watch For Lightning When Making This Type of Mockery
Some people will tell you 2+2 = 5 and no amount of effort will convince them that their little closed definition is wrong. ‘Creationists’ have no place arguing the science of evolution. They’ve created their own rules, their own definitions which make debate or discussion impossible.
In the end you just gotta let some of them be. Sometimes it ain’t even worth taking a horse to water if you know it won’t drink.
While You Were Busy Watching Dancing With The Stars A Little Bit More of Your Right To Privacy Died
So this 9th Circuit Court decision looked a little more outrageous when I first saw it, but it still remains a fine excuse to bring up the political topic most important to me. Civil liberties.
I’m sure it will come as a surprise to many but Border and Customs Agents can essentially seize any electronic device you are transporting into the U.S. and hold it for as long as it takes them to ’search’ it. And such is what they’ve been doing more of late.
Laptops may be scrutinized and subject to a “forensic analysis” under the so-called border search exemption, which allows searches of people entering the United States and their possessions “without probable cause, reasonable suspicion or a warrant”…
The 9th Circuit Court recently reaffirmed the legality of data on electronic devices being scrutinized under the border search exemption to the 4th Amendment. What I really disagree with is the breadth of the border search exemption, but ruling it extends to data on electronic devices is nothing new. As Wired and Yahoo! blogs point out such searches of computers has been upheld since at least 2004. But the claim that searches of US citizens at the border “are reasonable simply by virtue of the fact that they occur at the border,” (as the Supreme Court has put it) and current U.S. Customs law are far too broad of a mandate for current U.S. Customs.
Some discretion is being used in determining who gets searched and who does not. Allowing Border Agents such authority has some benefits, they are the ones on the front line, but it also has major pitfalls in terms of our privacy.
Let me frame the the security versus freedom issue. These are on a scale. We could always be safer at the expense of further rights. We could all renounce our right to privacy further and have cameras in our homes and renounce our right to property further and have the taxes to pay for people to monitor those cameras. True, the yield for each further bit of privacy we forfeit is probably less but the maxim holds.
That might seem like an obvious definition of the debate but I’m currently annoyed by arguments such as those claiming that if you’re not a criminal you have nothing to fear or asserting that the U.S. has to protect its borders. Such are ridiculous in that they contribute nothing in trying to define how to tilt the scale of freedom versus safety.
In any case, the border exemption is far too broad at present. I hate it.
As for the extension of such to electronic data, there is a reasonableness to the legal argument considering how the border exemption has been defined. However, the pragmatic result seems fishy at best.
We should try to maximize the return on our forfeit of liberties (such as the right to privacy). The return for checking IDs, checking citizenship, checking large vehicles for illegal immigrants or devices of terrorism is considerably higher than that for checking a number of laptops based on the suspicions of some GED carrying Border Agent.
I would’ve hoped, however much their legal arguments were in line with prior court holdings, that the 9th Circuit Court (here and here and here) would’ve had some gall and would’ve help reverse the general decline in our civil liberties.
Can something be both annoying and touching at the same time? The story I came into the hospital to this morning certainly comes close.
I went in to pre-round this morning on my gyn patients. Getting report from the nurse and reading the notes on one particular patient revealed a rather strange call the OB/Gyn resident had taken last night.
It seems sometime in the early, early morning the patient had started complaining to her nurse that her “heart hurt.” The patient has a history of these vague complaints without elaborating. She’s been in the hospital a long time and craves attention.
In anycase, apparently without further assessment the nurse pages the on-call resident at about 2 am and relates “chest pain.”
The resident shows up at the patient’s bedside and the patient denies “chest pain” but tells the resident she wanted to see a doctor because her “heart is breaking,” because her children haven’t come and visited her in the hospital.
Sigh. I think everyone can agree having the doc (or anyone) woken up at 2 am so you can tell them something like this is inappropriate and inconsiderate. But boy is that a sad story.
I’ve got a sinus infection probably and was quite a bit under the weather yesterday and today. A good day though for sleeping and putting on the iPod. I’ve been toying around with some of the social music/internet radio sites around and so below is pretty much the playlist of what has gotten me through this little blip.
I’ll be honest, I think something like political connections has a place (a small place) in a medical school admissions decision. Distinguishing students for admission becomes almost a crap shoot once you reach those essentially qualified academically. I’m sure the applications and CVs and awards and service commitments all blend together. Political connections are, in perhaps an unfortunate reality, something that may benefit the school and thus arguably community health. Why not put them into consideration?
Whatever my controversial opinion above, in this instance the weight of such connections appears to have been overvalued. And more stunning is the backdoor method by which the admission went down.
[The father] is a known fundraiser in the medical community. In 2005, he held a fundraiser in his own home where more than 150 physicians raised more than $100,000 for [Florida governor] Crist, according to a news release from the Florida Medical Political Action Committee.
Kone said he thought he was within his rights to admit a student absent committee support, but the move breaks with procedures described by the Liaison Committee on Medical Education, which provides accreditation to UF and medical schools throughout the U.S. and Canada.
“The final responsibility for selecting students to be admitted for medical study must reside with a duly constituted faculty committee,” according to the accrediting body’s standards.
[…]
Dr. Craig Tisher, former dean of UF’s College of Medicine, said he never broke with Ira Gessner, chairman of the Medical Selection Committee.
“During the five years that I was dean, I did not go against the wishes of the admissions committee,” Tisher said. “I let them make the selections, and I relied upon the judgment of the people who were interviewing the students and the chairman of the admissions committee, Dr. Gessner. All I can tell you is I didn’t exercise that prerogative (to overrule the committee), if in fact that prerogative exists.”
In the spirit of Orac over at Respectful Insolence I’m posting some woo I recently ran across as I left my school’s library.
My Favorite Part: Leaving Out “Back Pain”
I have no idea the faculty involved in this research or what their funding is. I did a little Google search on Nithya Spiritual Healing and turned up a bit.
Nithya Spiritual Healing Broken Down In A Video
And here’s some about Nithyananda, the swami (?) creator of Nithya Spiritual Healing. There is more about him on Wikipedia. My favorite thing though is the disclaimers put up for anyone interested in becoming a Nithya Spiritual Healer,
Understand and acknowledge that the practice of Nithya Spiritual Healing is a religious and spiritual prayer and meditation service only. It does not involve the diagnosis or treatment of any medical or psychological conditions and does not involve the use of any physical intervention or manipulation of the human body. Any benefit that an individual experiences comes from within him or herself, based on his or her body’s ability to heal on its own.
[…]
Do not use the word “Patient” to describe someone who elects to receive your Nithya Spiritual Healing services.
[…]
If you are a licensed physician or other licensed health care practitioner, advise anyone to whom you are providing Nithya Spiritual Healing services that such services do not constitute diagnosis, care or treatment or the practice of medicine or any other health care profession. Further, do not engage or claim to engage in medical diagnosis, care or treatment or in the practice of medicine or any other health care profession in conjunction with any of your activities as an Nithya Spiritual Healing Practitioner.
Hopefully there is some private funding behind this little research endeavor and it doesn’t represent your tax dollars at work.
Human ovaries tend to shut down by age 50 or even younger, yet women commonly live on healthily for decades. This flies in the face of evolutionary theory that losing fertility should be the end of the line, because once breeding stops, evolution can no longer select for genes that promote survival.
The most popular explanation, the “grandmother hypothesis,” argues that a generous post-reproductive life span makes sense if a grandmother improves the survival and reproduction of her grandchildren…
“The problem is that these grandmother benefits aren’t big enough to ever favor stopping breeding between the ages of 40 and 50,” says Michael Cant, an evolutionary biologist at the University of Exeter in England and co-author of a new study on the genesis of menopause published this week in Proceedings of the National Academy of Sciences USA. “When you look at data from hunter-gatherers and other natural fertility populations, the sums just don’t add up.” Grandmothers do benefit their descendants, he says, but the genetic payoff is small compared with those of producing another child.
Cant and co-author Rufus Johnstone, an evolutionary biologist at the University of Cambridge in England, used game theory to argue that menopause is early cessation of reproduction that originated through reproductive conflict between generations. In most cooperatively breeding species, reproduction is suppressed in younger females, who act as helpers to older reproducing females. By contrast, they say, younger women in human social groups win the reproductive sweepstakes, because the older ones stop having babies.
“We showed that, compared to other primates that exhibit a post-reproductive life span, humans really stand out, because there is absolutely no overlap in reproduction between generations,” Cant says. “Women stop breeding on average when the next generation starts to breed.”
This makes evolutionary sense, Cant and Johnstone say, because, contrary to most mammals, young women tend to move to their mates’ communities, where they become immigrants whose only genetic kin are their own children. There is no genetic profit in helping their mothers-in-law bear more children, because they will not share any genes with those children. But an older woman who helps her son’s wife reproduce will benefit by bequeathing 25 percent of her genes to her grandchildren.
Looks like I’ll be consolidating and taking out a loan next year all under a new lender.
The collapse of the $330 billion auction-rate securities market has brought debt sales by U.S. public student-loan agencies to a halt.
The squeeze means students and parents have fewer options to fund college educations. University financial-aid offices are scrambling to update lists of active lenders and help students find less costly private loan alternatives, said Phillip Day, head of National Association of Student Financial Aid Administrators in Washington.
Of the top 10 largest issuers of auction-rate debt among municipal issuers tracked by Thomson from 2000 through 2007, half were student lenders.
Lender profitability suffered after the U.S. government last year slashed subsidies on guaranteed student loans made through the Federal Family Education Loan Program that back most student-loan auction bonds, according to UBS.
My lender, who has not sold my loans (at least based on the most recent data available to me online), is one of a handful who are bailing out on new loans. I’d love to find a new lender next year who is still taking on consolidations, so I’m making payments only to a single servicer. I’m not sure what consolidating would do to my rate and my ultimate bottom line. I guess I’ll crunch all of that before I put my name to a new Master Promissory Note.
Let me be equivocal in saying that I would never dare to pass judgment on the merits of the claims Dan Walter makes or on the anger he appears to harbor. I’ve never been through anything like he lays out. What I do question is his strategy in trying to seek some sort of remedy and the generalizations he makes from his experience.
Okay, Not An Ablation But The Only Cath Image I Could Find Under A CC License
For a while national email listservs for use by medical students have been getting strange emails from a man named Dan Walter. Most of them reference back to a blog he’s running called Adventures in Cardiology. In the blog he details what he perceives as terrible medical care his wife got at the hands of Johns Hopkins staff. Specifically he targets an electrophysiologist whom his wife presented to for an ablation to correct her apparently chronic a fib.
His efforts extend away from the blog and out onto internet forums, about.com (see here and here), and even to posting phony profiles of the cardiologist he is targeting on physician review sites. At Wellness.com, Mr. Walter appears to have posed as the cardiologist and posted this,
I’m an ambitious doctor who puts my career above the safety of my patients.
This seems like a terribly inappropriate way to address an issue like this. I can understand why one, after going through something as terrible as what Mr. Walter describes, would like to find a place to rant. But emailing medical students, posting an obscure blog, posting phony physician profiles aren’t going to cost JH hospital or the cardiologist a lot of business I imagine. And in some cases you have to wonder if what Mr. Walter has done rises to libel.
In addition, I think some of the generalizations about medical care he makes are misleading for any future patients who may visit his website,
What we didn’t know is that [our electrophysiologist] - according to what he later told colleagues - follows the practice at most teaching hospitals wherein “the attending shows up to be there during the burn.”
His offense with trainees (mind you these are medical doctors) providing care to patients doesn’t appear limited to the comments above.
This presents another teaching opportunity, so they find someone who has never actually repaired a mitral valve. He opens her up and decides upon seeing the mess that he will just replace the valve, sentencing my wife to the high-wire balancing act of taking warfarin for the rest of her life. (You should look up Warfarin. It’s more commonly known as rat poison. No kidding.)
As Mr. Walter presents it, it doesn’t appear that anyone but who was in the cath lab and the operating room knows if the fact that trainees were involved in his wife’s care contributed to the terrible and tragic outcome she had. The fact is though that research, in general, does not support poorer outcomes when residents are involved in patient care. This is across a whole host of specialties, a whole host of procedures and operations. Mr. Walter seems to be drawing a whole lot of generalizations from his anecdote.
I think we can be reasonably sure (but obviously not know with certainty) that the CT or GS resident who aided in the heart surgery did not, singlehandedly make the determination that the mitral valve needed to be replaced. And I would hope Mr. Walter and his family could take some solace in knowing that the balance between whether to put in a bioprosthetic versus mechanical valve is one without a clear tilt often. So while we can rant against life long anticoagulation and the dangers of coumadin, different dangers exist with putting in a biologic valve and sparing a patient the coumadin.
These serve as just examples of what I think are overly general criticisms. There are more throughout the blog.
I feel for Mr. Walter and his wife. The concern I have is that Mr. Walter seems to be making broad claims and implying, for other patients who might visit his site, that some of the things his wife went through, some of the choices made in her care are ALWAYS inappropriate. I would just say: A resident or fellow being involved in a patient’s care does not generally put that patient in danger, a mechanical valve isn’t always the wrong thing, etc.
Patients need to be advocates for themselves. They often aren’t enough. But there is a very clear, may I say bright and flashing, line between advocating for your care and complaining when you’re in the hospital. And if there’s one complaint I think many roll their eyes at it is the uninsured patient who thinks they’ve been in the hospital too long. I heard a story about a resident giving a patient with just such a complaint a mildly apt analogy.
“If McDonald’s was giving away hamburgers for free you’d take one right? And don’t you think there would be a line for those hamburgers? Everyone would want one for free, right? And would you complain about the line?”
Tastes Even Better Because It Is Free
No doubt no one likes their time being wasted. No doubt, from all I’ve seen and heard, public hospitals are a helluva lot less efficient than the rest of healthcare. But, unless such a wait is actively and significantly endangering a patient and absolutely opposed to the concrete standard of care then I don’t think many want to hear the complaint of inconvenience from a patient for who the taxpayers are picking up the tab.
At the bedside it’s a sigh and a nod of the head but maybe someday I’ll have the gall to repeat the analogy above and kind’ve put the situation in perspective for a patient.
At 4:00 AM on November 5, 1983, four divers were in a Decompression chamber system attached to a diving bell on the rig, being assisted by two dive tenders. One diver was about to close the door between the chamber system and the trunk when the chamber was explosively decompressed from a pressure of 9 atm to 1 atm in a fraction of a second. Five of the men were killed; the other was severely injured.
The situation just before this accident occurred was as follows. Decompression chambers 1 and 2 were connected via a trunk to a diving bell. This connection was sealed by a clamp operated by two tenders (T1 and T2), who were themselves experienced divers. A third chamber was connected to this system, but was not involved. On this day, divers D1 (35 years old) and D2 (38 years old) were resting in chamber 2 at a pressure of 9 atm. The diving bell with divers D3 (29 years old) and D4 (34 years old) had just been winched up after a dive and joined to the trunk. Leaving their wet gear in the trunk, the divers then climbed through the trunk into chamber 1.
The normal procedure would have been as follows: (a) close the bell door, (b) the diving supervisor would then slightly increase the bell pressure to seal this door tightly, (c) close the door between the trunk and chamber 1, (d) slowly depressurize the trunk to 1 atm, and (e) open the clamp to separate the bell from the chamber system.
Operations (a) and (b) had been completed and D4 was about to carry out operation (c) when, for some reason, one of the tenders opened the clamp. This resulted in the high pressure within the system being released into the external atmosphere, causing explosive decompression. A tremendous blast shot from the chambers through the trunk, pushing the bell away and hitting the two tenders. The tender who opened the clamp died, and the other was severely injured.
The kind’ve trauma involved in an accident like this is pretty tragic.
Because the use of eggs was forbidden during Lent, they were brought to the table on Easter Day, coloured red to symbolize the Easter joy. This custom is found not only in the Latin but also in the Oriental Churches. The symbolic meaning of a new creation of mankind by Jesus risen from the dead was probably an invention of later times. The custom may have its origin in paganism, for a great many pagan customs, celebrating the return of spring, gravitated to Easter. The egg is the emblem of the germinating life of early spring. Easter eggs, the children are told, come from Rome with the bells which on Thursday go to Rome and return Saturday morning. The sponsors in some countries give Easter eggs to their god-children. Coloured eggs are used by children at Easter in a sort of game which consists in testing the strength of the shells (Kraus, Real-Encyklop die, s. v. Ei). Both coloured and uncoloured eggs are used in some parts of the United States for this game, known as “egg-picking”. Another practice is the “egg-rolling” by children on Easter Monday on the lawn of the White House in Washington.
I wish everyone who is celebrating it a happy Easter.
“We Have Transformed Our Energy State Into Something Different. That Is The Definition of Disease”
Much thanks to the blog Bad Science for publicizing the homeopathic weirdness of optometrist Charlene Werner (I can’t even bring myself to put the title Dr. in front of her name). It is funny to watch though.
I haven’t posted on avian flu in a while. That’s probably because as far as the main stream media is concerned that story is dead.
This Movie About An Avian Flu Pandemic Was Aired As A Network MOW
While it pains me to link to a website which calls itself, “The world’s most popular natural health newsletter,” I think it is pretty clear that the threat from bird flu was overstated.
I used to get these weird comments from avian flu alarmists sites, telling me how real the threat was. But the further we pull away from coverage of avian flu, the more convinced I am that it wasn’t really difficult to predict that this made for media crisis would pander out.
But avian flu has not gone away. Nor has it become less lethal or less widespread in birds. Experts argue that preparations against it have to continue, even if the virus’s failure to mutate into a pandemic strain has given the world more breathing room.
There were 86 confirmed human cases last year compared with 115 in 2006, according to the World Health Organization, and 59 deaths compared with 79. Experts assume that the real numbers are several times larger, because many cases are missed, but that is still a far cry from a pandemic.
Dr. David Nabarro, the senior United Nations coordinator for human and avian flu, recently conceded that he worried somewhat less than he did three years ago. “Not because I think the threat has changed,” he quickly added, but because the response to it has gotten so much better.”
No doubt it remains a disease to be addressed and not ignored. But as the next 1918 flu? How can you make a prediction like that with a straight face?
I did my undergrad work in USC's School of Cinema-Television Cinematic Arts. I have a Bachelors of Fine Arts in Writing for Screen & Television. I loved it, but a future of waiting tables and taking meetings with B-List producers was not for me.
This blog is ostensibly to discuss healthcare policy and maybe educate a few of my fellow medical students. But it will stray into current events, politics, and other science topics when they draw my interest
Other odd notes about me:
I've skied half the resorts on this list (Squaw Valley/Lake Tahoe, Snowbird/Park City, Whistler, Taos, Vail)
I "played" lacrosse in high school and through a club level team in college
Nothing on this website is to be taken as medical advice. I am not a physician. Please consult a physician concerning any health related questions.
This blog is entirely self funded. It accepts no advertising or other supporting revenue. The author has no relevant financial relationships to disclose.
Unless otherwise noted the media on this blog is under the copyright of the blog author, used under a Creative Common or free use license with appropriate accreditation or is in the public domain. If you believe images or video posted on this blog are copyrighted works used inappropriately please contact me.
Endorsements
"Please be more precise in your practice of medicine than you are in your blogging!"
- Mark Lanier
