Clinical Posting Quotes

I’m a modern man, a man for the millennium. Digital and smoke free. A diversified multi-cultural, post-modern deconstruction that is anatomically and ecologically incorrect. I’ve been up linked and downloaded, I’ve been inputted and outsourced, I know the upside of downsizing, I know the downside of upgrading. I’m a high-tech low-life. A cutting edge, state-of-the-art bi-coastal multi-tasker and I can give you a gigabyte in a nanosecond! I’m new wave, but I’m old school and my inner child is outward bound. I’m a hot-wired, heat seeking, warm-hearted cool customer, voice activated and bio-degradable. I interface with my database, my database is in cyberspace, so I’m interactive, I’m hyperactive and from time to time I’m radioactive. Behind the eight ball, ahead of the curve, ridin the wave, dodgin the bullet and pushin the envelope. I’m on-point, on-task, on-message and off drugs. I’ve got no need for coke and speed. I've got no urge to binge and purge. I’m in-the-moment, on-the-edge, over-the-top and under-the-radar. A high-concept, low-profile, medium-range ballistic missionary. A street-wise smart bomb. A top-gun bottom feeder. I wear power ties, I tell power lies, I take power naps and run victory laps. I’m a totally ongoing big-foot, slam-dunk, rainmaker with a pro-active outreach. A raging workaholic. A working rageaholic. Out of rehab and in denial! I’ve got a personal trainer, a personal shopper, a personal assistant and a personal agenda. You can’t shut me up. You can’t dumb me down because I’m tireless and I’m wireless, I’m an alpha male on beta-blockers. I’m a non-believer and an over-achiever, laid-back but fashion-forward. Up-front, down-home, low-rent, high-maintenance. Super-sized, long-lasting, high-definition, fast-acting, oven-ready and built-to-last! I’m a hands-on, foot-loose, knee-jerk head case pretty maturely post-traumatic and I’ve got a love-child that sends me hate mail. But, I’m feeling, I’m caring, I’m healing, I’m sharing-- a supportive, bonding, nurturing primary care-giver. My output is down, but my income is up. I took a short position on the long bond and my revenue stream has its own cash-flow. I read junk mail, I eat junk food, I buy junk bonds and I watch trash sports! I’m gender specific, capital intensive, user-friendly and lactose intolerant. I like rough sex. I like tough love. I use the “F” word in my emails and the software on my hard-drive is hardcore--no soft porn. I bought a microwave at a mini-mall; I bought a mini-van at a mega-store. I eat fast-food in the slow lane. I’m toll-free, bite-sized, ready-to-wear and I come in all sizes. A fully-equipped, factory-authorized, hospital-tested, clinically-proven, scientifically- formulated medical miracle. I’ve been pre-wash, pre-cooked, pre-heated, pre-screened, pre-approved, pre-packaged, post-dated, freeze-dried, double-wrapped, vacuum-packed and, I have an unlimited broadband capacity. I’m a rude dude, but I’m the real deal. Lean and mean! Cocked, locked and ready-to-rock. Rough, tough and hard to bluff. I take it slow, I go with the flow, I ride with the tide. I’ve got glide in my stride. Drivin and movin, sailin and spinin, jiving and groovin, wailin and winnin. I don’t snooze, so I don’t lose. I keep the pedal to the metal and the rubber on the road. I party hearty and lunch time is crunch time. I’m hangin in, there ain’t no doubt and I’m hangin tough, over and out!

Yet Irina had once tucked away, she wasn't sure when or why, that happiness is almost definitionally a condition of which you are not aware at the time. To inhabit your own contentment is to be wholly present, with no orbiting satellite to take clinical readings of the state of the planet. Conventionally, you grow conscious of happiness at the very point that it begins to elude you. When not misused to talk yourself into something - when not a lie - the h-word is a classification applied in retrospect. It is a bracketing assessment, a label only decisively pasted onto an era once it is over.

For a few years after we either reach herd immunity or have a widely distributed vaccine, people will still be recovering from the overall clinical, psychological, social, and economic shock of the pandemic and the adjustments it required, perhaps through 2024. I’ll call this the intermediate pandemic period. Then, gradually, things will return to “normal”—albeit in a world with some persistent changes. Around 2024, the post-pandemic period will likely begin.

Today, our view of genuine reality is increasingly clouded by professionals whose technical expertise often introduces a superficial and soulless model of the person that denies moral significance. Perhaps the most devastating example for human values is the process of medicalization through which ordinary unhappiness and normal bereavement have been transformed into clinical depression, existential angst turned into anxiety disorders, and the moral consequences of political violence recast as post-traumatic stress disorder. That is, suffering is redefined as mental illness and treated by professional experts, typically with medication. I believe that this diminishes the person,

When he wrote back, he pretended to be his old self, he lied his way into sanity. For fear of his psychiatrist who was also their censor, they could never be sensual, or even emotional. His was considered a modern, enlightened prison, despite its Victorian chill. He had been diagnosed, with clinical precision, as morbidly oversexed, and in need of help as well as correction. He was not to be stimulated. Some letters—both his and hers—were confiscated for some timid expression of affection. So they wrote about literature, and used characters as codes. All those books, those happy or tragic couples they had never met to discuss! Tristan and Isolde the Duke Orsino and Olivia (and Malvolio too), Troilus and Criseyde, Once, in despair, he referred to Prometheus, chained to a rock, his liver devoured daily by a vulture. Sometimes she was patient Griselde. Mention of “a quiet corner in a library” was a code for sexual ecstasy. They charted the daily round too, in boring, loving detail. He described the prison routine in every aspect, but he never told her of its stupidity. That was plain enough. He never told her that he feared he might go under. That too was clear. She never wrote that she loved him, though she would have if she thought it would get through. But he knew it. She told him she had cut herself off from her family. She would never speak to her parents, brother or sister again. He followed closely all her steps along the way toward her nurse’s qualification. When she wrote, “I went to the library today to get the anatomy book I told you about. I found a quiet corner and pretended to read,” he knew she was feeding on the same memories that consumed him “They sat down, looked at each other, smiled and looked away. Robbie and Cecilia had been making love for years—by post. In their coded exchanges they had drawn close, but how artificial that closeness seemed now as they embarked on their small talk, their helpless catechism of polite query and response. As the distance opened up between them, they understood how far they had run ahead of themselves in their letters. This moment had been imagined and desired for too long, and could not measure up. He had been out of the world, and lacked the confidence to step back and reach for the larger thought. I love you, and you saved my life. He asked about her lodgings. She told him. “And do you get along all right with your landlady?” He could think of nothing better, and feared the silence that might come down, and the awkwardness that would be a prelude to her telling him that it had been nice to meet up again. Now she must be getting back to work. Everything they had, rested on a few minutes in a library years ago. Was it too frail? She could easily slip back into being a kind of sister. Was she disappointed? He had lost weight. He had shrunk in every sense. Prison made him despise himself, while she looked as adorable as he remembered her, especially in a nurse’s uniform. But she was miserably nervous too, incapable of stepping around the inanities. Instead, she was trying to be lighthearted about her landlady’s temper. After a few more such exchanges, she really was looking at the little watch that hung above her left breast, and telling him that her lunch break would soon be over.

According to an article in the Washington Post: The Food and Drug Administration has repeatedly urged antidepressant manufacturers not to disclose to physicians and the public that some clinical trials of the medications in children found that drugs were no better than sugar pills, according to documents and testimony released at a congressional hearing yesterday. Regulators supressed the negative information on the grounds that it might scare families and physicians away from the drugs, according to testimony by drug company executives. For at least three medications, they said, the FDA blocked the companies' plans to reveal the negative studies in drug labels.

He tried to get help from the VA but he couldn’t, as so many other returning soldiers have discovered. He suffered terribly—nightmares, insomnia, flashbacks. He drank too much to mask these symptoms, and unfortunately alcohol only exacerbated the condition. It’s called post-traumatic stress and it is a recognized psychiatric disorder. It was around long before we had such a serious-sounding clinical name for it. In the Civil War, it was called a ‘soldier’s heart,’ which I think is the most accurate of the descriptions; in World War One, it was ‘shell shock,’ and during World War Two, ‘battle fatigue.’ In other words, war changes every soldier, but it has always profoundly damaged some of them.

The evidence of inflammation in people with ME/CFS is important because the incremental aerobic exercise recommended by the Wessely School and encapsulated in NICE’s Clinical Guideline 53 is contra-indicated in cases of inflamed and damaged tissue and inevitably results in post-exertional relapse with malaise, which is the cardinal symptom of ME/CFS.

In 2004, the FDA urged drug companies to adopt a 'Don't ask, don't tell' policy with respect to their clinical-trial data showing that antidepressants are not better than placebos for depressed children. If the data were made public, they cautioned, it might lead doctors to not prescribe antidepressants. The FDA believed that the jury was still out on antidepressants for children. Even if the clinical trials show negative results, an FDA spokesperson was reported to have said to a Washington Post reporter, it doesn't mean that the drugs are ineffective. The assumption seems to have been that doctors should prescribe medications that have not been shown to work, until it has been proven that they don't work.

CBT is a much publicised and debated psychotherapeutic intervention for ME/CFS….The premise that cognitive therapy (eg. changing ‘illness beliefs’) and graded activity can ‘reverse’ or cure this illness is not supported by post-intervention outcome data. In routine medical practice, CBT has not yielded clinically significant outcomes for patients with ME/CFS.

That question became even more salient to me as I began my clinical work with troubled children. I soon found that the vast majority of my patients had lives filled with chaos, neglect and/or violence. Clearly, these children weren’t “bouncing back”—otherwise they wouldn’t have been taken to a child psychiatry clinic! They’d suffered trauma—such as being raped or witnessing murder—that would have had most psychiatrists considering the diagnosis of post-traumatic stress disorder (PTSD), had they been adults with psychiatric problems. And yet these children were being treated as though their histories of trauma were irrelevant, and they’d “coincidentally” developed symptoms, such as depression or attention problems, that often required medication.

I’ve canceled your clinic on Tuesday. We’re meeting Ravi. Dr. V. V. Ravichandran at General Hospital. He’s brilliant . . . The first Indian full professor in surgery at the Madras Medical College. When the governor needed surgery, his wife quietly sent for Ravi. Everyone knows he’s the best, but on top of that he’s a lovely man and a good teacher. I knew him when we were posted together in Tanjore.

On the basis of wide clinical experiences, I contend that it is a matter of love in only a few cases when man and woman in our civilization engage in the sexual act. The rage which usurps the initial love impulses, hate, and sadistic emotion are all part and parcel of modern man's contempt for sex. I am not speaking of the clear cases in which the sexual act is performed for profit or subsistence. I am speaking of the majority of people of all social strata. It is on the basis of these clinical findings that the Latin saying, "Omne animal post coitum triste?' has become a scientific axiom. There is only one error in this statement: man ascribes his own disappointment to the animal.

What are the health effects of the choice between austerity and stimulus? Today there is a vast natural experiment being conducted on the body economic. It is similar to the policy experiments that occurred in the Great Depression, the post-communist crisis in eastern Europe, and the East Asian Financial Crisis. As in those prior trials, health statistics from the Great Recession reveal the deadly price of austerity—a price that can be calculated not just in the ticks to economic growth rates, but in the number of years of life lost and avoidable deaths. Had the austerity experiments been governed by the same rigorous standards as clinical trials, they would have been discontinued long ago by a board of medical ethics. The side effects of the austerity treatment have been severe and often deadly. The benefits of the treatment have failed to materialize. Instead of austerity, we should enact evidence-based policies to protect health during hard times. Social protection saves lives. If administered correctly, these programs don’t bust the budget, but—as we have shown throughout this book—they boost economic growth and improve public health. Austerity’s advocates have ignored evidence of the health and economic consequences of their recommendations. They ignore it even though—as with the International Monetary Fund—the evidence often comes from their own data. Austerity’s proponents, such as British Prime Minister David Cameron, continue to write prescriptions of austerity for the body economic, in spite of evidence that it has failed. Ultimately austerity has failed because it is unsupported by sound logic or data. It is an economic ideology. It stems from the belief that small government and free markets are always better than state intervention. It is a socially constructed myth—a convenient belief among politicians taken advantage of by those who have a vested interest in shrinking the role of the state, in privatizing social welfare systems for personal gain. It does great harm—punishing the most vulnerable, rather than those who caused this recession.

Americans today enjoy a prosperity like no other people in human history. So if money produces pleasure and pleasure produces happiness, we should be the happiest people ever assembled on this planet. The fact is, we are not. How can this be? This is the question New Republic editor Gregg Easterbrook addresses in his provocative book The Progress Paradox: How Life Gets Better While People Feel Worse. Easterbrook reviews the extraordinary progress made since the time of our great-great grandparents: Average life expectancy has increased dramatically; we are far healthier, without the threat of dreaded diseases like polio and smallpox; the typical American adult has twice the purchasing power his or her parents had in 1960, with the quality of life immeasurably improved.[11] We ought to be very happy, Easterbrook concludes. Yet Americans rank number sixteen in a survey of the happiest people in the world. (Nigerians rank number one.)[12] Americans tell pollsters that the country is on the wrong course, that their parents had it better than they do, that people feel incredibly stressed out. More people are popping Prozac and Zoloft pills; the number of people clinically depressed has increased tenfold in the post–World War II era. Remember the paradoxes we talked about earlier? Well, here is another: Life is better, but we feel worse.

For many, an explosion of mental problems occurred during the first months of the pandemic and will continue to progress in the post-pandemic era. In March 2020 (at the onset of the pandemic), a group of researchers published a study in The Lancet that found that confinement measures produced a range of severe mental health outcomes, such as trauma, confusion and anger.[153] Although avoiding the most severe mental health issues, a large portion of the world population is bound to have suffered stress to various degrees. First and foremost, it is among those already prone to mental health issues that the challenges inherent in the response to the coronavirus (lockdowns, isolation, anguish) will be exacerbated. Some will weather the storm, but for certain individuals, a diagnostic of depression or anxiety could escalate into an acute clinical episode. There are also significant numbers of people who for the first time presented symptoms of serious mood disorder like mania, signs of depression and various psychotic experiences. These were all triggered by events directly or indirectly associated with the pandemic and the lockdowns, such as isolation and loneliness, fear of catching the disease, losing a job, bereavement and concerns about family members and friends. In May 2020, the National Health Service England’s clinical director for mental health told a Parliamentary committee that the “demand for mental healthcare would increase ‘significantly’ once the lockdown ended and would see people needing treatment for trauma for years to come”.[154] There is no reason to believe that the situation will be very different elsewhere.

Mithoefer completed an FDA- and DEA-approved trial of MDMA for the treatment of severe PTSD, with stunning results. In 2011, with the support of MAPS, he and his team created a double-blind design in which twelve severely traumatized patients were given MDMA and psychotherapy, and eight patients were given an active placebo and psychotherapy. The researchers used the Clinician Administered PTSD Scale (CAPS) as a means of measuring symptom reduction after intervention. In the placebo group, only two out of the eight subjects had a significantly lowered CAPS score post-intervention, whereas in the MDMA group, ten out of the twelve subjects had significantly lowered CAPS scores and were able to maintain those scores at a two-month follow-up. Furthermore, in the MDMA group, ten of the twelve patients were so improved that they no longer met the DSM criteria for PTSD. The second phase of the study allowed seven subjects who had previously taken the placebo (six of whom had failed to respond to the placebo and one of whom had relapsed after the placebo) to now try MDMA. They found a clinical response rate of 100 percent, and the three people who had previously said they weren’t able to perform their jobs on account of their PTSD were now able to work once again.

The diagnostic criteria for myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) define two distinct clinical entities. Cognitive impairment and post-exertional “malaise” (a long-lasting aggravation of typical symptoms, e.g., muscle weakness and cognitive “brain fog”, after minor exertion) are obligatory for the diagnosis ME, while chronic fatigue is the only mandatory symptom for the diagnosis CFS.

Although myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) are considered to be synonymous, the definitional criteria for ME and CFS define two distinct, partially overlapping, clinical entities. ME, whether defined by the original criteria or by the recently proposed criteria, is not equivalent to CFS, let alone a severe variant of incapacitating chronic fatigue. Distinctive features of ME are: muscle weakness and easy muscle fatigability, cognitive impairment, circulatory deficits, a marked variability of the symptoms in presence and severity, but above all, post-exertional “malaise”: a (delayed) prolonged aggravation of symptoms after a minor exertion.

The label ‘Chronic Fatigue Syndrome’ was first proposed by Holmes et al. (1988) of the Centers for Disease Control (CDC). This name was recommended to replace that of a number of terms that implied a causal pathology (e.g. ‘Myalgic Encephalomyelitis’, ‘Post-Viral Fatigue Syndrome’ and ‘chronic Epstein-Barr virus syndrome’), as there was a lack of correlation between biological markers and symptomatology. Hence, this new label reflected the prime clinical characteristic of the condition without alluding to an underlying physical aetiology and, in turn, the definition was based upon signs and symptoms of the patient group. However, many individuals use the term Myalgic Encephalomyelitis (indicating muscle pain and inflammation of the brain), a fact that is reflected by the titles of the two largest charitable organisations in the UK, the ME Association and Action for ME.

One 2004 study of women who’d had an abortion found that about two-thirds of them had received no counseling ahead of time, and only 11 percent who did receive counseling said it was adequate. Just 17 percent said they were counseled on abortion alternatives, and about two-thirds reported feeling pressured to choose abortion. A majority said they weren’t sure of their decision at the time they received an abortion.74 Some women obtain an abortion under duress from their partner, whether literal force or other coercion such as financial pressure or threats to leave the relationship.75 According to some surveys, a majority of women who seek abortion do so because of lack of support from a partner.76 “I can’t tell you how many [post-abortive black] women have fallen into my arms in tears because their significant other put a gun to their head or threatened to kill them or had someone escort them into an abortion clinic to keep them there to make them have an abortion,” pro-life leader Catherine Davis, founder of the Restoration Project, told one of us (Alexandra) in a 2020 interview.77

enslaved person is given a new name and a new identity as a whore.”19 A nine-country study by a team of clinical psychologists headed by Melissa Farley found that 68 percent of sex slaves suffered symptoms of post–traumatic stress disorder. The study concluded that, “existing in a state of social death, the prostitute is an outsider who is seen as having no honor or public worth. Those in prostitution, like slaves and concentration camp prisoners, may lose their identities as individuals, becoming primarily what masters, Nazis or customers want them to be.”20

slavery while on a sales trip to the New World in 1829. Traveling through Mexico, Florida, Louisiana, and Cuba, he was especially horrified by the racial character of slavery. On his return to France, he condemned the exploitation of slaves in an article titled “Des Noirs,” but he stopped short of calling for immediate emancipation, suggesting instead a gradual process of manumission over some forty to sixty years. It was only when he learned that plantation owners refused to educate their slaves that he turned against gradualism and came out in favor of “the immediate abolition of slavery”—the subtitle of his 1842 account of his trip to the West Indies. Tireless in his advocacy of abolition, he served as undersecretary for the colonies and president of the Commission on Slavery, and became, in effect, the architect of the post-slavery order in the Antilles. The novelist Victor Hugo offered a telling description of the ceremony at which Schœlcher announced the final abolition of slavery, held in Guadeloupe on May 19, 1848:

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From a medical standpoint, the third and the most probable explanation is that Jesus was indeed dead, and what his disciples experienced were mere hallucinations evoked by the grief over the loss of their beloved teacher. It is clinically known as “Post-Bereavement Hallucinations Experiences” or PBHE.

He moved closer to her, and McKenna buried her hands in her lap. “Just what is it that you pursue, Marshal Caradon?” “You know . . . I wish we could get to the place where you’d stop calling me Marshal Caradon.” He reached over and trailed his fingers along the curve of her wrist and over the back of her hand. McKenna tried hard to resist the shiver working through her, and couldn’t. So she stood. She’d wanted Wyatt Caradon to be different from the other men she’d known. But maybe she wanted that so badly that she was blind to what he was. “I think a certain formality between a man and woman is healthy . . . Marshal Caradon.” He stood with her. “I’d agree with you on that. Unless the man and woman have earned the right to move on to . . . something more. For instance . . .” He braced one arm on the post behind her head and leaned in, and the top step suddenly became even narrower. “Say they’ve done some things like . . . sew up a man together in a doc’s clinic, or shared what it feels like to lose someone precious and then find her again. Or maybe they’ve gone to a nice dinner togeth—Oh wait!” He snapped his fingers. “We haven’t done that yet.” She was tempted to smile, and yet couldn’t. He must’ve sensed her initial reaction because he moved closer. She’d instigated this little meeting and yet now she wished she hadn’t. “Miss Ashford . . .” His voice was almost a whisper. “May I please call you McKenna?” Despite not wanting to, her body reacted to his closeness. And she decided the straightforward approach was best. “Yes, Marshal Caradon, you may.” She put a hand against his chest. “If you’ll tell me why you smell like stale cigars, whiskey, and cheap women.

Of course, a severe mental illness is another matter. You’re not a bad person if you end a relationship with a partner who is grappling with severe psychopathology and is unable to think and function independently. What’s tricky for many couples, however, is navigating the middle ground: What do you do about mental health issues that are extremely challenging but that some relationships could possibly accommodate? This category includes addiction, clinical depression, phobias, post-traumatic stress disorder, and severe personality or mood disorders. If any of this sounds familiar, don’t rely on this book alone to make decisions about your future. Seek the additional advice and support of a knowledgeable and experienced mental health professional.

The NeuroAffective Relational Model (NARM) is one of the first therapeutic models that provides a framework and clinical guidelines specifically designed for the treatment of complex trauma, or as it is now officially referred to as Complex Post-Traumatic Stress Disorder (C-PTSD).3 While other therapeutic models are adapting their treatment protocols to address adverse childhood experiences and complex trauma, NARM was specifically designed to address the long-term impacts of ACEs and C-PTSD.

For decades, doctors and nurses trained in Western medicine had been dismissive of whole categories of diagnoses that predominated among the Indigenous population. Villagers would often visit healers and shamans who treated ailments such as mal de ojo (evil eye), pérdida del alma (loss of the soul), and el susto (the fright). Some of these afflictions dated to pre-Columbian times and went by a range of different names. El susto, the anthropologist Linda Green wrote, was “understood by its victims to be the loss of the essential life force as a result of fright.” In more conventional terms, its symptoms included depression, lethargy, insomnia, nightmares, diarrhea, and vomiting. To anyone mindful of La Violencia of the war years, the connection to post-traumatic stress was unavoidable. These conditions were, as Green put it, “social memory embodied.” In the summer of 2016, the Health Ministry announced that it would open clinics and hire personnel to treat seven different types of “ancestral maladies” that were contributing to high mortality rates in the countryside. “Independently of whether you believe it or don’t believe in this, we have seen that it’s necessary to be vigilant,” Lucrecia told one newspaper.

According to a memo that Keller himself wrote to the Brown Institutional Review Board on January 30, 1995, this patient (number 70) ingested eighty-two Tylenol pills in an apparent overdose attempt on January 19. Patient 70 was admitted to a hospital and terminated from the study shortly afterward, according to Keller’s memo to Brown IRB. Yet this teenage girl was not included in the group reported to have experienced serious adverse events while in the study. Instead, in another memo that Keller had written to the Brown IRB in 1995, she was described as having been terminated from the study for being “noncompliant.” In an even more mysterious turn, patient 70 was described in GlaxoSmithKline’s final report of the study as being a twelve-year-old boy. This boy was enrolled in the clinical trial a month after the teenage girl identified in Keller’s memos as patient 70 overdosed on Tylenol and withdrew from the study. The boy with the same patient number was removed from the study on March 22, 1995, after developing tachycardia (rapid heartbeat) while taking the tricyclic antidepressant known as imipramine, according to the company’s final report. There was no mention in the company’s posted final report or the 2001 journal paper that the original patient 70 was a young girl who had ingested eighty-two Tylenol pills in a clear bid to kill herself.

Trained Obstetrician and Gynaecologist in Dubai Dr Elsa de Menezes Fernandes is a UK trained Obstetrician and Gynaecologist. She completed her basic training in Goa, India, graduating from Goa University in 1993. After Residency, she moved to the UK, where she worked as a Senior House Officer in London at the Homerton, Southend General, Royal London and St. Bartholomew’s Hospitals in Obstetrics and Gynaecology. She completed five years of Registrar and Senior Registrar training in Obstetrics and Gynaecology in London at The Whittington, University College, Hammersmith, Ealing and Lister Hospitals and Gynaecological Oncology at the Hammersmith and The Royal Marsden Hospitals. During her post-graduate training in London she completed Membership from the Royal College of Obstetricians and Gynaecologists. In 2008 Dr Elsa moved to Dubai where she worked as a Consultant Obstetrician and Gynaecologist at Mediclinic City Hospital until establishing her own clinic in Dubai Healthcare City in March 2015. She has over 20 years specialist experience. Dr Elsa has focused her clinical work on maternal medicine and successfully achieved the RCOG Maternal Medicine Special Skills Module. She has acquired a vast amount of experience working with high risk obstetric patients and has worked jointly with other specialists to treat patients who have complex medical problems during pregnancy. During her training she gained experience in Gynaecological Oncology from her time working at St Bartholomew’s, Hammersmith and The Royal Marsden Hospitals in London. Dr Elsa is experienced in both open and laparoscopic surgery and has considerable clinical and operative experience in performing abdominal and vaginal hysterectomies and myomectomies. She is also proficient in the technique of hysteroscopy, both diagnostic and operative for resection of fibroids and the endometrium. The birth of your baby, whether it is your first or a happy addition to your family, is always a very personal experience and Dr Elsa has built a reputation on providing an experience that is positive and warmly remembered. She supports women’s choices surrounding birth and defines her role in the management of labour and delivery as the clinician who endeavours to achieve safe motherhood. She is a great supporter of vaginal delivery. Dr Elsa’s work has been published in medical journals and she is a member of the British Maternal and Fetal Medicine Society. She was awarded CCT (on the Specialist Register) in the UK. Dr Elsa strives to continue her professional development and has participated in a wide variety of courses in specialist areas, including renal diseases in pregnancy and medical complications in pregnancy.

VA/DoD Clinical Practice Guideline for the Management of Post-Traumatic Stress—released by the Department of Veterans Affairs and Department of Defense in 2010.

SKIN PIGMENTATION. Pigmentation refers to skin coloring, which depends on specialized cells that produce melanin. Melanin is the pigment that imparts different shades and colors to the hair, skin, mucous membranes, and retina of the eye. Individuals with too little melanin production have fair skin, whereas those with high deposition have a darker complexion. Skin pigmentation problems arise when there is an excess of melanin production, resulting in dark spots, patches, or discoloration of the skin. It can change the color of the skin over time, resulting in an uneven skin tone. Whilst hyperpigmentation is not a dangerous illness, it may be a sign of another medical condition. As a result, a dermatologist should be consulted to determine the exact cause of the pigmentation. CAUSES OF SKIN PIGMENTATION. • Skin inflammation (post-inflammatory hyperpigmentation) • Drugs (such as minocycline, certain cancer chemotherapies, and birth control pills) • The disease of hormones. • Hemochromatosis (iron overload) • Sun exposure. • Pregnancy (melasma, or mask of pregnancy) • Certain birthmarks. or contact 0331 1117546

Members of Jane put together pop-up abortion clinics in whatever nice apartments they could find, they did extensive counseling and phone support, they provided post-abortion care—and often were the abortion providers.

high blood pressure, high cholesterol, mood disorders, post-traumatic stress disorder, and traumatic brain injury instead of relying only on drugs. The residents learned that diet and lifestyle are powerful treatments—often as effective, if not more so, than drugs. The patients in the traumatic brain injury clinic were also eager to learn what things they could do to speed the healing of their brains. In patient after patient, I watched symptoms and the need for drugs decrease as diet and lifestyles improved.

The ability to make machines can be used for more effective food production, distribution, clinical cures and better health. On the other hand, the same ability can be used to decimate species including human beings. The record of science taking a solo flight by discarding values in recent times has not impacted our technical progress, but it has resulted in the unprecedented loss of human lives in wars, extinction of species, ecological imbalances and irreversible damage to the environment.

Commenting on the hostile reaction to an article of his,"' Roy M. Poses, a specialist in analysis of clinical research, remarks: "Most distressing ... was the influence of a certain kind of post-modern thinking on publications about qualitative methods in respected medical and health care journals. These contained arguments that there is no external reality, and scoffed at scientists' attempts to be objective as possible as futile and foolish.

A boy in the domicile said you were here. . . . This is a shockingly understaffed clinic. I don’t understand why the syndics don’t request some more postings from the Medical Federation, or else cut down the number of admissions; some of these aides and doctors are working eight hours a day!

But before franking the letter for the post, next morning, Farley added a few scribbled lines in the margin: ‘In haste: much that I feared has been confirmed in these last hours. Shortly before matins, there was a knock on my door: it was Cunningham’s young assistant. He told me – oh so many things – I shall write of them all to you in time. Suffice it to say for the present, that everything is other than what it appears to be, a phantom of itself. The young man has promised to reveal everything to me if I would but accompany him to his birthplace. Fortunately the place of which he spoke is not far from the location of my clinic. We are to leave tomorrow: I shall write again and in greater detail, dear friend, once I know more ...

It is inconceivable to many modern scientists who have also studied Qur’an that how can a person without extensive travel, writing ability and attending modern universities of knowledge, could explain things about history, nature and make socio-political predictions that would appear perfectly correct afterwards. Dr. Keith Moore, former President of the Canadian Association of Anatomists and of the American Association of Clinical Anatomists remarked at a conference in Cairo that details of human development as mentioned in Qur’an must have come to Muhammad from God, or Allah, because most of this knowledge was not discovered until many centuries later.

Post-exertional malaise (PEM) is the hallmark clinical feature of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

According to Dr. Bessel van der Kolk, a clinical psychiatrist recognized for his work in post-traumatic stress, healing from trauma involves putting unspeakable events into words. Likewise, Dr. Daniel Siegel discusses the importance of “coherence” as a key component to healing from a traumatic childhood. Coherence is best defined as having a story that makes sense. This does not mean that you feel okay about what happened to you. Rather, coherence involves having an understanding about your past and how it informs who you are today. Let’s look at what facilitates coherence:

Oliver W. Addison attended Palmer College and Trident Technical College in Charleston and studied accounting, industrial health and safety, and automobile mechanics. In 2006 he was awarded the Doctor of Humane Letters by the Medical University of South Carolina. He worked for Norfolk Southern Railroad for a total of 28 years, 12 of them as a switchman and conductor and 16 as General Yard Master. He was awarded for having the safest terminal on the railroad in its size category and received accolades for on-time service for the industry. Mr. Addison has been a leader in Union Heights for 38 years and served on the Community Council for over 20 years. He recently received a commendation from the Medical University of South Carolina for his work in bringing a health clinic to the Union Heights community and developing programs for youth. Mr. Addison served on the Charleston County School Board for 8 years and was the board's chair for 1995-1996 and 2001-2002. For his work on the school board, he received a high-profile award from the Post and Courier newspaper.

And whereas in WWI and WWII the symptoms of stress were apparent during or just after combat, and were treated using frontline clinical care (sometimes called “forward psychiatry”), combat stress during the brutal Vietnam War was rare.62 The spike in the prevalence of combat-related trauma among veterans of the Vietnam War only occurred well after the United States left Vietnam—hence the postwar development of the apt term “post-traumatic stress disorder.”63

Dr Elsa de Menezes Fernandes is a UK trained Obstetrician and Gynaecologist. She completed her basic training in Goa, India, graduating from Goa University in 1993. After Residency, she moved to the UK, where she worked as a Senior House Officer in London at the Homerton, Southend General, Royal London and St. Bartholomew’s Hospitals in Obstetrics and Gynaecology. She completed five years of Registrar and Senior Registrar training in Obstetrics and Gynaecology in London at The Whittington, University College, Hammersmith, Ealing and Lister Hospitals and Gynaecological Oncology at the Hammersmith and The Royal Marsden Hospitals. During her post-graduate training in London she completed Membership from the Royal College of Obstetricians and Gynaecologists. In 2008 Dr Elsa moved to Dubai where she worked as a Consultant Obstetrician and Gynaecologist at Mediclinic City Hospital until establishing her own clinic in Dubai Healthcare City in March 2015. She has over 20 years specialist experience.

Me Time” Any expert will tell you, the best thing a mom can do to be a better mom is to carve out a little time for herself. Here are some great “me time” activities you can do. Go to the bathroom a lot. Offer to empty the dishwasher. Take ninety-minute showers. (If you only shower every three or four days, it will be easier to get away with this.) Say you’re going to look for the diaper crème, then go into your child’s room and just stand there until your spouse comes in and curtly says, “What are you doing?” Stand over the sink and eat the rest of your child’s dinner while he or she pulls at your pant leg asking for it back. Try to establish that you’re the only one in your family allowed to go to the post office. “Sleep when your baby sleeps.” Everyone knows this classic tip, but I say why stop there? Scream when your baby screams. Take Benadryl when your baby takes Benadryl. And walk around pantless when your baby walks around pantless. Read! When your baby is finally down for the night, pick up a juicy book like Eat, Pray, Love or Pride and Prejudice or my personal favorite, Understanding Sleep Disorders: Narcolepsy and Apnea; A Clinical Study. Taking some time to read each night really taught me how to feign narcolepsy when my husband asked me what my “plan” was for taking down the Christmas tree. Just implementing four or five of these little techniques will prove restorative and give you the energy you need to not drink until nighttime.

Our captain, Nick Mackie, for some reason didn’t trust that Roger and I could interview anybody, so Mackie decided that the first round of interviews with witnesses at Lake Sam would be done by a team of local mental health professionals led by Dr. John Liebert and Dr. John Berberich, since deceased. Liebert is a forensic psychiatrist, and Berberich was a clinical psychologist, who advised police departments on internal issues. Both men taught at the University of Washington. Liebert advised King County Superior Court Judges on murder defendants’ potential for violence. For 20 years or more, he had interviewed every convicted murderer in the county and prepared a post-sentence report for the court.

Cleveland Clinic Case Study At Cleveland Clinic, we encourage different areas of the organization to perform the kind of analysis just described by holding them accountable for saving money. In 2009, Cleveland Clinic set an organizational goal of reducing the amount it was spending on supplies of various kinds. It took its inspiration from Apple, a company that maintains stringent control over the cost of supplies. To help the internal cost-cutting committees, we set out to raise care providers’ consciousness, putting price tags on instruments and supplies and posting the costs of supplies where caregivers could see them. The goal was to make caregivers mindful about supply use. These efforts helped the organization reach its goal of cutting spending on supplies by $100 million over two years. To promote ongoing cost awareness and savings, we created scorecards that quantify and measure quality and cost, and we set goals: “Cut your costs on heart valve implants by 20 percent while improving quality by 10 percent.” We check the progress on these scorecards every three months. If we don’t see movement in the right direction, we ask new questions and implement ways to encourage and reward cost-saving measures.

Pfizer’s clinical data predicted potentially fatal myocarditis in one in every 318 teens. Post-marketing data confirm astronomically high rates of myocarditis injuries.

For thousands and thousands of years, humans lived in small intergenerational groups. There were no mental health clinics—but there was plenty of trauma. I assume that many of our ancestors experienced post-traumatic problems: anxiety, depression, sleep disruptions. But I also assume that they experienced healing. Our species could not have survived if a majority of our traumatized ancestors lost their capacity to function well. The pillars of traditional healing were 1) connection to clan and the natural world; 2) regulating rhythm through dance, drumming, and song; 3) a set of beliefs, values, and stories that brought meaning to even senseless, random trauma; and 4) on occasion, natural hallucinogens or other plant-derived substances used to facilitate healing with the guidance of a healer or elder.