Emergency Department Quotes

I slowly climbed back to my feet, walked back into the emergency department through the silently swishing glass doors, and, covered in my girlfriend's blood, lied perfectly for the first time in my life. "I tried to stop her.

Why do I take a blade and slash my arms? Why do I drink myself into a stupor? Why do I swallow bottles of pills and end up in A&E having my stomach pumped? Am I seeking attention? Showing off? The pain of the cuts releases the mental pain of the memories, but the pain of healing lasts weeks. After every self-harming or overdosing incident I run the risk of being sectioned and returned to a psychiatric institution, a harrowing prospect I would not recommend to anyone. So, why do I do it? I don't. If I had power over the alters, I'd stop them. I don't have that power. When they are out, they're out. I experience blank spells and lose time, consciousness, dignity. If I, Alice Jamieson, wanted attention, I would have completed my PhD and started to climb the academic career ladder. Flaunting the label 'doctor' is more attention-grabbing that lying drained of hope in hospital with steri-strips up your arms and the vile taste of liquid charcoal absorbing the chemicals in your stomach. In most things we do, we anticipate some reward or payment. We study for status and to get better jobs; we work for money; our children are little mirrors of our social standing; the charity donation and trip to Oxfam make us feel good. Every kindness carries the potential gift of a responding kindness: you reap what you sow. There is no advantage in my harming myself; no reason for me to invent delusional memories of incest and ritual abuse. There is nothing to be gained in an A&E department.

Only in the mid-nineteenth century, after the growth of industrial cities and a rash of urban riots—after dread of the so-called dangerous classes surpassed dread of the state—did police departments emerge in the United States.

David knew that all the question marks of his life were in the hand of God. He knew it was impossible to be in God's hand and in the enemy's hand at the same time. The gloom begins to disappear and fear departs as faith emerges in glorious triumph. This man is rising out of his testing and adversity to learn to put his utter dependence on the Lord.

Of all genital injuries in the emergency department, 3 percent are due to pubic hair removal.

In the City Market is the Meet Café. Followers of obsolete, unthinkable trades doodling in Etruscan, addicts of drugs not yet synthesized, pushers of souped-up harmine, junk reduced to pure habit offering precarious vegetable serenity, liquids to induce Latah, Tithonian longevity serums, black marketeers of World War III, excusers of telepathic sensitivity, osteopaths of the spirit, investigators of infractions denounced by bland paranoid chess players, servers of fragmentary warrants taken down in hebephrenic shorthand charging unspeakable mutilations of the spirit, bureaucrats of spectral departments, officials of unconstituted police states, a Lesbian dwarf who has perfected operation Bang-utot, the lung erection that strangles a sleeping enemy, sellers of orgone tanks and relaxing machines, brokers of exquisite dreams and memories tested on the sensitized cells of junk sickness and bartered for raw materials of the will, doctors skilled in the treatment of diseases dormant in the black dust of ruined cities, gathering virulence in the white blood of eyeless worms feeling slowly to the surface and the human host, maladies of the ocean floor and the stratosphere, maladies of the laboratory and atomic war... A place where the unknown past and the emergent future meet in a vibrating soundless hum... Larval entities waiting for a Live One...

We quickly became friends with other art faculty members such as the ceramist Jim Leedy and his wife Jean and art historian/artist Bill Kortlander and his wife Betty. I also began taking classes in Southeast Asian history with John Cady, who had resigned from his position at the U.S.[CB4] [mo5]  State Department because he thought it would be a huge mistake to get involved in a “land war in Southeast Asia.” In 1966, his warnings were starting to become all too obvious as the Vietnam war grew and protests against it emerged. Dr. Cady was in the thick of the protests and was even being shadowed by the F.B.I. After I finished my BFA in art in 1966, I began work on a master’s degree in history at Dr. Cady’s urging. He and his wife became frequent guests at our parties

There was no way she'd allow him to see her do 97 percent of her normal activities. She was a monster. A monster who was flat as a board with no ass. In fact, the only thing she had going on in the curves department was an enormous cystic pimple on her chin that hurt when she touched it. Yeah, no.

I will be conveyed to an Emergency Room of some kind, where I will be detained as long as I do not respond to questions, and then, when I do respond to questions, I will be sedated; so it will be an inversion of standard travel, the ambulance and ER: I'll make the journey first, then depart.

The War Department in Washington briefly weighed more ambitious schemes to relieve the Americans on a large scale before it was too late. But by Christmas of 1941, Washington had already come to regard Bataan as a lost cause. President Roosevelt had decided to concentrate American resources primarily in the European theater rather than attempt to fight an all-out war on two distant fronts. At odds with the emerging master strategy for winning the war, the remote outpost of Bataan lay doomed. By late December, President Roosevelt and War Secretary Henry Stimson had confided to Winston Churchill that they had regrettably written off the Philippines. In a particularly chilly phrase that was later to become famous, Stimson had remarked, 'There are times when men have to die.

So at most companies, an unspoken compact emerges: It's okay to be ambitious, but if you play too rough, your peers will unite against you. On the other hand, if you focus on boosting your own department, rather than undermining your rival, you'll probably get taken care of over time.

They were also the person who kept the ox-sector Emergency Department of the largest hospital in the galaxy purring like an only slightly dyspeptic cat.

I don’t know anyone who works in the emergency department that does. A higher power that allows what we see to happen isn’t someone I want to spend eternity with.

The magistrates’ court is the accident and emergency department of criminal justice: any moment, a problem will walk through the door and the prosecutor will have to deal with it blind.

The pain-treatment revolution had many faces and these mostly belonged to well-meaning doctors and dedicated nurses. But in the Rust Belt, another kind of pain had emerged. Waves of people sought disability as a way to survive as jobs departed.

The least attractive-sounding of this trinity is the concept of ‘intersectionality’. This is the invitation to spend the rest of our lives attempting to work out each and every identity and vulnerability claim in ourselves and others and then organize along whichever system of justice emerges from the perpetually moving hierarchy which we uncover. It is a system that is not just unworkable but dementing, making demands that are impossible towards ends that are unachievable. But today intersectionality has broken out from the social science departments of the liberal arts colleges from which it originated. It is now taken seriously by a generation of young people and – as we shall see – has become embedded via employment law (specifically through a ‘commitment to diversity’) in all the major corporations and governments. New

Management is doing things right; leadership is doing the right things.” Warren Bennis, On Becoming a Leader

Over the years Jim had heard, and more often overheard, objections to the Program’s expanding practice: Many people who worked and paid taxes struggled to pay for health insurance. Why should their money go to providing what some would consider concierge medicine for these people who lived at public expense? For people who produced nothing except indecent public spectacles, and didn’t even try to take care of themselves? Heard from inside a shelter clinic or McInnis House or out on the van, such protests seemed irrelevant. What was the alternative? Ignore chronically homeless people, as the city used to do, or imitate draconian regimes and imprison all rough sleepers in a stadium? In fact, the Program lightened the burdens that homeless people placed on other medical organizations, and did so while providing good care at lower cost than in hospital emergency departments.

Department of Defense” ever won a war; see the histories. But it seems to be a standard civilian reaction to scream for defensive tactics as soon as they do notice a war. They then want to run the war—like a passenger trying to grab the controls away from the pilot in an emergency.

Man is himself, like the universe he inhabits, like the demoniacal stirrings of the ooze from which he sprang, a tale of desolations. He walks in his mind from birth to death the long resounding shores of endless disillusionment. Finally, the commitment to life departs or turns to bitterness. But out of such desolation emerges the awesome freedom to choose—to choose beyond the narrowly circumscribed circle that delimits the animal being. In that widening ring of human choice, chaos and order renew their symbolic struggle in the role of titans. They contend for the destiny of a world.

[T]his jealousy gave him, if anything, an agreeable chill, as, to the sad Parisian who is leaving Venice behind him to return to France, a last mosquito proves that Italy and summer are still not too remote. But, as a rule, with this particular period of his life from which he was emerging, when he made an effort, if not to remain in it, at least to obtain a clear view of it while he still could, he discovered that already it was too late; he would have liked to glimpse, as though it were a landscape that was about to disappear, that love from which he had departed; but it was so difficult to enter into a state of duality and to present to oneself the lifelike spectacle of a feeling one has ceased to possess, that very soon, the clouds gathering in his brain, he could see nothing at all, abandoned the attempt, took the glasses from his nose and wiped them; and he told himself that he would do better to rest for a little, that there would be time enough later on, and settled back into his corner with the incuriosity, the torpor of the drowsy sleeper in the railway-carriage that is drawing him, he feels, faster and faster out of the country in which he has lived for so long and which he had vowed not to allow to slip away from him without looking out to bid it a last farewell.

as Lynch pored over financial spreadsheets at work, he wondered: What if there really is a Z? What if the jungle had concealed such a place? Even today, the Brazilian government estimates that there are more than sixty Indian tribes that have never been contacted by outsiders. “These forests are . . . almost the only place on earth where indigenous people can survive in isolation from the rest of mankind,” John Hemming, the distinguished historian of Brazilian Indians and a former director of the Royal Geographical Society, wrote. Sydney Possuelo, who was in charge of the Brazilian department set up to protect Indian tribes, has said of these groups, “No one knows for sure who they are, where they are, how many they are, and what languages they speak.” In 2006, members of a nomadic tribe called Nukak-Makú emerged from the Amazon in Colombia and announced that they were ready to join the modern world, though they were unaware that Colombia was a country and asked if the planes overhead were on an invisible road.

We are told that we are sinning (by emitting CO2), that we have original sin (human greed), which has banished us from Eden (the pre-industrial world), for which we must confess (by condemning irresponsible consumerism), atone (by paying carbon taxes), repent (insisting that politicians pay lip service to climate-change alarm), and seek salvation (sustainability). The wealthy can buy indulgences (carbon offsets) so as to keep flying their private jets, but none must depart from faith (in carbon dioxide) as set out in scripture (the reports of the Intergovernmental Panel on Climate Change). It is the duty of all to condemn heretics (the ‘deniers’), venerate saints (Al Gore), heed the prophets (of the IPCC). If we do not, then surely Judgement Day will find us out (with irreversible tipping points), when we will feel the fires of hell (future heatwaves) and experience divine wrath (worsening storms). Fortunately, God has sent us a sign of the sacrifice we must make – I have sometimes been struck by the way a wind farm looks like Golgotha.

Consider this sobering statistic: Shortly before the 2009 H1N1 pandemic, CIDRAP undertook a national survey of hospital pharmacists and intensive care and emergency department doctors, as we detailed in chapter 18. The update of that survey identified more than 150 critical lifesaving drugs for all types of diseases frequently used in the United States, without which many patients would die within hours. All of them are generic and many, or their active pharmaceutical ingredients, are manufactured primarily in China or India. At the beginning of the COVID-19 outbreak, sixty-three were already unavailable to pharmacies on short notice or on shortage status under normal conditions—just one example of how vulnerable we are.

The U.S. War Department had even pondered tunneling beneath the seabed: a detailed study deemed the project “feasible,” requiring one year and 15,000 men to excavate 55,000 tons of spoil. Wiser heads questioned “the strategic and functional” complexities, such as the inconvenience of the entire German Seventh Army waiting for the first tunneler to emerge. The study was shelved.

And even modern governments have an element of the crime syndicate about them. Police forces repeatedly harbour criminals all over the world: the US Department of Homeland Security is only a little more than a decade old, but in 2011 over three hundred of its employees were arrested for crimes such as drug smuggling, child pornography and selling intelligence to drug cartels. Like

For years after the American Revolution, the public opposed to the creation of police departments, fearing that they would become forces of repression... Only in the mid 19th century, after the growth of industrial cities and a rash of urban riots - after the dread of the so-called dangerous classes surpassed the dread of the state - did police departments emerge in the United States.

Only in the mid-nineteenth century, after the growth of industrial cities and a rash of urban riots—after dread of the so-called dangerous classes surpassed dread of the state—did police departments emerge in the United States. By the time of Anna’s death, the informal system of citizen policing had been displaced, but vestiges of it remained, especially in places that still seemed to exist on the periphery of geography and history.

Because nobody brought that up to you?” “No, we had no idea that there were any problems that would suggest that.” Besides, as she pointed out later in her testimony, she was not an expert on poison. Dr. Henry testified that Peru was not mentioned in papers on tropical sprue, and that even where the disease was common, those who contracted it had lived in the area for a long time, at least a year. Typhoid fever didn’t fit either. “Even though it’s an acute infection, [it] does not cause a tremendous elevation of the white blood cell count.” Dr. Henry believed that Mike had been septic more than once during his three hospitalizations. Dr. Pam McCoy, the ER physician at the UK Medical Center, testified next. “I work with residents and medical students. I teach them how to work in an emergency department. And usually . . . I go see patients, they go see patients with me; we talk about how you see a patient in the emergency department, how you take care of people, how you put in stitches, that sort of thing.

Abbott’s one big idea in Health was for the Commonwealth to take control of all the nation’s hospitals. This required a shift in his thinking. In the Keating years he had declared that Australia had “a perfectly good system of government provided each tier minds its own business.” He didn’t think so any longer. “As a new backbencher, I had not anticipated how hard this was, given that voters don’t care who solves their problems, they just want them solved.” As Minister for Health he lit on a new guiding conservative principle: “Power divided is power controlled.” He had in mind an enormous reform that would reshape Canberra’s relations with the states. He was roundly mocked in cabinet. His senior bureaucrats put a lot of work into talking him down. Did he really want to be responsible for every asthma patient who had to wait too long in an emergency department? Eventually he was persuaded that Commonwealth public servants could not run hospitals any better than state public servants. This was the argument that got him, but he found it frustrating.

Many people are bothered about the number of privately owned guns in the United States, but what about publicly owned ones? In recent years the United States government (not the military) has purchased 1.6 billion rounds of ammunition, enough to shoot the entire population five times over. The Social Security Administration ordered 174,000 rounds of hollow-point bullets. The Internal Revenue Service, the Department of Education, the Bureau of Land Management, even the National Oceanographic and Atmospheric Administration, all have guns.

He went upstairs and opened the telegram; it was addressed to a department in the British Consulate, and the figures which followed had an ugly look like the lottery tickets that remained unsold on the last day of a draw. There was 2674 and then a string of five-figure numerals: 42811 79145 72312 59200 80947 62533 10605 and so on. It was his first telegram and he noticed that it was addressed from London. He was not even certain (so long ago his lesson seemed) that he could decode it, but he recognised a single group, 59200, which had an abrupt and monitory appearance as though Hawthorne that moment had come accusingly up the stairs. Gloomily he took down Lamb's 'Tales from Shakespeare' - how he had always detested Elia and the essay on Roast Pork. The first group of figures, he remembered, indicated the page, the line and the word with which the coding began. 'Dionysia, the wicked wife of Cleon,' he read, 'met with an end proportionable to her deserts'. He began to decode from 'deserts'. To his surprise something really did emerge. It was rather as though some strange inherited parrot had begun to speak.

For years after the American Revolution, the public opposed the creation of Police departments, fearing that they would become forces of oppression...Only in the mid -nineteenth century, after the growth of industrial cities and a rash of urban riots- after dread of the so-called dangerous classes surpassed the dread of the state- did police departments emerge in the United States.... By the time of Anna's death, the informal system of policing had been displaced,,but vestiges of it remained, especially in places that seemed to exist on the periphery of geography and history.

Here are the commons symptoms that result from micromanagement: 1. The team shows a lack of initiative. Members will not take action unless directed. 2. The team does not seek solutions to problems; instead, its members sit and wait to be told about a solution. 3. Even in an emergency, a team that is being micromanaged will not mobilize and take action. 4. Bold and aggressive action becomes rare. 5. Creativity grinds to a halt. 6. The team tends to stay inside their own silo; not stepping out to coordinate efforts with other departments or divisions for fear of overstepping their bounds. 7. An overall sense of passivity and failure to react.

For years after the American Revolution, the public opposed the creation of police departments, fearing that they would become forces of repression. Instead, citizens responded to a hue and cry by chasing after suspects. Benjamin N. Cardozo, the future Supreme Court justice, once noted that these pursuits were made “not faintly and with lagging steps, but honestly and bravely and with whatever implements and facilities are convenient and at hand.” Only in the mid-nineteenth century, after the growth of industrial cities and a rash of urban riots—after dread of the so-called dangerous classes surpassed dread of the state—did police departments emerge in the United States.

At around 8 pm we heard the sound of sirens. As the sound drew nearer and nearer, we caught sight of a fire truck. As it reached the hotel, the truck pulled into the parking lot with emergency lights shining and horns blasting. It came to a stop in front of our congregation. We didn’t see a fire or any other emergency in the immediate vicinity, so this was quite unexpected. Perhaps our smell had been reported as some kind of toxic leak or spill? Firemen began to pour out of the truck carrying different trays covered in foil. I could hardly believe my eyes. The local Franklin Fire Department had brought us all a spaghetti and meatball dinner! They also brought salad and pudding for desert. This was an example of trail magic at its finest.

More panic. More emergencies and disasters. Soon, emergencies fell into a sort of natural ranking: drop-everything emergencies, do-what-you-can emergencies, and you’ll just-have-to-wait emergencies. Disasters, too, had their own ratings: unavoidable, did-the-best-we-could, my fault/your fault. Then there were godlike moments when a decision had to be made as to who most deserved to die. By the afternoon of her second day, Dtui wondered whether her heart had shrunk. She felt less. People had become less human. Death had become less of a tragedy. Her patients weren’t blacksmiths or housewives, they were percentages. “With this little skill and this little pharmaceutical backup, this patient—let’s call her number seven—has a forty percent chance of survival.” It amazed and saddened her that, in order to do her job properly, she had to stop caring.

A Safety Travel with Sinclair James International Traveling to somewhere completely foreign to you may be challenging but that is what travelers always look for. It can be a good opportunity to find something new and discover new places, meet new people and try a different culture. However, it can involve a lot of risk as well. You may be surprised to find yourself naked and penniless on the side of the road trying to figure out what you did wrong. These kinds of situations come rarely when you are careful and cautious enough but it is not impossible. Sinclair James International Travel and Tours, your Australian based traveling guide can help you travel safely through the following tips: 1. Pack all Security Items In case of emergencies, you should have all the safety tools and security items with you. Carry a card with your name and number with you and don’t forget to scribble down the numbers of local police station, fire department, list of hospitals and other necessary numbers that you may need. Place them in each compartment and on your pockets. If ever you find yourself being a victim of pick pocketing in Manila, Philippines or being driven around in circles in the streets of Bangkok, Thailand, you will definitely find these numbers very helpful. It is also advisable to put your name and an emergency number in case you are in trouble and may need someone else to call. 2. Protect your Passport Passports nowadays have RFID which can be scanned from a distance. We have heard some complaints from fellow travelers of being victims of scams which involves stealing of information through passports. An RFID blocking case in a wallet may come in handy to prevent hackers from stealing your information. 3. Beware of Taxis When you exit the airport, taxis may all look the same but some of them can be hiding a defective scam to rob tourists during their drive. It is better to ask an official before taking a taxi as many unmarked ones claim that they are legitimate. Also, if the fare isn’t flat rate, be sure you know the possible routes. Some drivers will know better and will take good care of you, but others will take longer routes to increase the fare. If you know your options, you can suggest a different route to avoid paying too much. 4. Be aware of your Rights Laws change from state to state, and certainly from country to country, but ignorance to them will get you nowhere. In fact, in many cases you can get yourself out of trouble by knowing the laws that will affect you. When traveling to other countries, make sure to review the laws and policies that can affect your activities. There are a lot of misconceptions and knowing these could save you a headache. Sinclair James International

Dr. Lydia Ciarallo in the Department of Pediatrics, Brown University School of Medicine, treated thirty-one asthma patients ages six to eighteen who were deteriorating on conventional treatments. One group was given magnesium sulfate and another group was given saline solution, both intravenously. At fifty minutes the magnesium group had a significantly greater percentage of improvement in lung function, and more magnesium patients than placebo patients were discharged from the emergency department and did not need hospitalization.4 Another study showed a correlation between intracellular magnesium levels and airway spasm. The investigators found that patients who had low cellular magnesium levels had increased bronchial spasm. This finding confirmed not only that magnesium was useful in the treatment of asthma by dilating the bronchial tubes but that lack of magnesium was probably a cause of this condition.5 A team of researchers identified magnesium deficiency as surprisingly common, finding it in 65 percent of an intensive-care population of asthmatics and in 11 percent of an outpatient asthma population. They supported the use of magnesium to help prevent asthma attacks. Magnesium has several antiasthmatic actions. As a calcium antagonist, it relaxes airways and smooth muscles and dilates the lungs. It also reduces airway inflammation, inhibits chemicals that cause spasm, and increases anti-inflammatory substances such as nitric oxide.6 The same study established that a lower dietary magnesium intake was associated with impaired lung function, bronchial hyperreactivity, and an increased risk of wheezing. The study included 2,633 randomly selected adults ages eighteen to seventy. Dietary magnesium intake was calculated by a food frequency questionnaire, and lung function and allergic tendency were evaluated. The investigators concluded that low magnesium intake may be involved in the development of both asthma and chronic obstructive airway disease.

This time he asks his audience to join him in a mental exercise. As Boyd states, Imagine that you are on a ski slope with other skiers [. . .]. Imagine that you are in Florida riding in an outboard motorboat, maybe even towing water-skiers. Imagine that you are riding a bicycle on a nice spring day. Imagine that you are a parent taking your son to a department store and that you notice he is fascinated by the toy tractors or tanks with rubber caterpillar treads’.38 Now imagine that you pull the ski’s off but you are still on the ski slope. Imagine also that you remove the outboard motor from the motor boat, and you are not longer in Florida. And from the bicycle you remove the handle- bar and discard the rest of the bike. Finally, you take off the rubber treads from the toy tractor or tanks. This leaves only the following separate pieces: skis, outboard motor, handlebars and rubber treads. However, he challenges his audience, what emerges when you pull all this together?39 SNOWMOBILE

By the time of the Cuban Missile Crisis, Eisenhower’s test ban had failed, and the United States and the Soviet Union had both returned to nuclear weapons testing. Twice during the height of the Cuban Missile Crisis, on October 20 and October 26, 1962, the United States detonated two nuclear weapons—code-named Checkmate and Bluegill Triple Prime—in space. These tests, which sought to advance knowledge in ARPA’s pursuit of the Christofilos effect, are on the record and are known. What is not known outside Defense Department circles is that in response, on October 22 and October 28, 1962, the Soviets also detonated two nuclear weapons in space, also in pursuit of the Christofilos effect. In recently declassified film footage of an emergency meeting at the White House, Secretary of Defense McNamara can be heard discussing one of these two Soviet nuclear bomb tests with the president and his closest advisors. “The Soviets fired three eleven-hundred-mile missiles yesterday at Kapustin Yar,

Cookies are the cornerstone of pastry. But for many of us, they are also at the core of our memories, connecting our palate to our person. Cookies wait for us after school, anxious for little ones to emerge from a bus and race through the door. They fit themselves snugly in boxes, happy to be passed out to neighbors on cold Christmas mornings; trays of them line long tables, mourning the loss of the dearly departed. While fancy cakes and tarts walk the red carpet, their toasted meringue piles, spun sugar, and chocolate curls boasting of rich rewards that often fail to sustain, cookies simply whisper knowingly. Instead of pomp and flash, they offer us warm blankets and cozy slippers. They slip us our favorite book, they know the lines to our favorite movies. They laugh at our jokes, they stay in for the night. They are good friends, they are kind words. They are not jealous, conceited, or proud. They evoke a giving spirit, a generous nature. They beg to be shared, and rejoice in connection. Cookies are home.

Within the evangelical community, Dobson emerged as Obama’s fiercest critic. In June 2008 he lashed out at Obama on his radio program, accusing him of distorting the Bible to fit his worldview, of having a “fruitcake interpretation of the Constitution,” and of appealing to the “lowest common denominator of morality.” Dobson especially took issue with a speech Obama had given in 2006 in which he had defended the right of people of faith to bring their religious beliefs into the public square, while also pointing out that Christians disagreed among themselves on how best to do so. Whose Christianity would win out? “Would we go with James Dobson’s, or Al Sharp-ton’s?” Obama had asked. “Which passages of Scripture should guide our public policy?” Should Old Testament passages dictate that slavery was acceptable but eating shellfish was not? “Or should we just stick to the Sermon on the Mount—a passage that is so radical that it’s doubtful that our own Defense Department would survive its application?” Dobson was not amused. 5

On my next-to-last day in the country, I flew into Tokyo from Sapporo and needed to get to Tokyo’s main railroad station, called Shinjuku. I climbed into a taxi at the airport and said to the driver, “Shinjuku station, please.” He didn’t seem to have any idea what I meant. I repeated my request, as articulately as I could, and he looked at me as if I had asked him to take me to Boise. I pulled a map of Tokyo out and showed him Shinjuku station. He studied this with a look of great dissatisfaction, but at length put the car in gear and we set off. We drove for what seemed hours through the endless, numbing sprawl of Tokyo. Eventually we entered a long, deep tunnel—a kind of underground freeway, it seemed. About a mile along, the driver pulled into an emergency parking bay and stopped. He pointed to a metal door cut into the tunnel wall and indicated that I should get out and go through that door. “You want me to go through that door?” I said in disbelief. He nodded robustly and presented me with a bill for about a zillion yen. Everything was beginning to seem more than a touch surreal. He took my money, gave me several small bills in change, and encouraged me to depart, with a little shooing gesture. This was crazy. We were in a tunnel, for crying out loud. If I got out and he drove off, I would be hundreds of feet under Tokyo in a busy traffic tunnel with no sidewalk or other escape. You’ll understand when I say this didn’t feel entirely right. “Through that door there?” I said again, dubiously. He nodded and made another shooing gesture. I got out with my suitcase and went up three metal steps to the door and turned the handle. The door opened. I looked back at the driver. He nodded in encouragement. Ahead of me, lit with what seemed emergency lighting, was the longest flight of stairs I had ever seen. It took a very long while to climb them all. At the top I came to another door, exactly like the one at the bottom. I turned the handle and cautiously opened it, then stepped out onto the concourse of the world’s busiest railway station. I don’t know whether this is the way lots of people get to Shinjuku or whether I am the only person in history ever to have done so. But what I do know is this: it’s why I like to travel.

Fox was the most junior member of a group assigned to the Team Disney Building in Burbank. Her first job was typical grunt work, laying out bathrooms in the executive wing. MICHAEL GRAVES: Bernadette was driving everyone insane. She wanted to know how much time the executives spent in their offices, how often they’d be in meetings, at what time of day, how many people would be in attendance, the ratio of men to women. I picked up the phone and asked her what the hell she was doing. She explained, “I need to know what problems I’m solving with my design.” I told her, “Michael Eisner needs to take a piss, and he doesn’t want everyone watching.” I’d like to say I kept her around because I recognized the talent that would emerge. But really, I liked the sweaters. She knitted me four, and I still have them. My kids keep trying to steal them. My wife wants to give them to Goodwill. But I won’t part with them. The Team Disney Building was repeatedly delayed because of the permitting process. During an all-firm meeting, Fox presented a flowchart on how to game the building department. Graves sent her to Los Angeles to work on-site. MICHAEL GRAVES: I was the only one sad to see her go.

In one department of his [Joseph Black's] lecture he exceeded any I have ever known, the neatness and unvarying success with which all the manipulations of his experiments were performed. His correct eye and steady hand contributed to the one; his admirable precautions, foreseeing and providing for every emergency, secured the other. I have seen him pour boiling water or boiling acid from a vessel that had no spout into a tube, holding it at such a distance as made the stream's diameter small, and so vertical that not a drop was spilt. While he poured he would mention this adaptation of the height to the diameter as a necessary condition of success. I have seen him mix two substances in a receiver into which a gas, as chlorine, had been introduced, the effect of the combustion being perhaps to produce a compound inflammable in its nascent state, and the mixture being effected by drawing some string or wire working through the receiver's sides in an air-tight socket. The long table on which the different processes had been carried on was as clean at the end of the lecture as it had been before the apparatus was planted upon it. Not a drop of liquid, not a grain of dust remained.

for nearly a decade, the World Bank has been reiterating its finding that “crime and violence have emerged in recent years as major obstacles to the realization of development objectives.”8 The Bank has stated flatly, “In many developing countries, high levels of crime and violence not only undermine people’s safety on an everyday level, they also undermine broader development efforts to improve governance and reduce poverty.”9 Multiple studies by the United Nations Office on Drugs and Crime (UNODC) have concluded that restraining violence is a precondition to poverty alleviation and economic development, plainly stating that “a foundational level of order must be established before development objectives can be realized.”10 Leaders of the United Kingdom’s Department for International Development (DFID) have concluded, “Poor people want to feel safe and secure just as much as they need food to eat, clean water to drink and a job to give them an income. Without security there cannot be development.”11 When it comes to violence, researchers are increasingly concerned that development experts are missing Amartya Sen’s insight that “development [is] a process of expanding the real freedoms people enjoy,” and are failing to appreciate the idea “that freedom from crime and violence are key components of development. Freedom from fear is as important as freedom from want. It is impossible to truly enjoy one of these rights without the other.”12

Emergency food has become very useful indeed, and to a very large assortment of people and institutions. The United States Department of Agriculture uses it to reduce the accumulation of embarrassing agricultural surpluses. Business uses it to dispose of nonstandard or unwanted product, to protect employee morale and avoid dump fees, and, of course, to accrue tax savings. Celebrities use it for exposure. Universities and hospitals, as well as caterers and restaurants, use it to absorb leftovers. Private schools use it to teach ethics, and public schools use it to instill a sense of civic responsibility. Churches use it to express their concern for the least of their brethren, and synagogues use it to be faithful to the tradition of including the poor at the table. Courts use it to avoid incarcerating people arrested for Driving While Intoxicated and a host of other offense. Environmentalists use it to reduce the solid waste stream. Penal institutions use it to create constructive outlets for the energies of their inmates, and youth-serving agencies of all sorts use it to provide service opportunities for young people. Both profit-making and nonprofit organizations use it to absorb unneeded kitchen and office equipment. A wide array of groups, organizations, and institutions benefits from the halo effect of 'feeding the hungry,' and this list does not even include the many functions for ordinary individuals--companionship, exercise, meaning, and purpose. . .If we didn't have hunger, we'd have to invent it.

On the other side of the mountain, Drizzt Do'Urden opened his eyes from his daytime slumber. Emerging from the cave into the growing gloom, he found Wulfgar in the customary spot, poised meditatively on a high stone, staring out over the plain. "You long for your home?" the drow asked rhetorically. Wulfgar shrugged his huge shoulders and answered absently, "Perhaps." The barbarian had come to ask many disturbing questions of himself about his people and their way of life since he had learned respect for Drizzt. The Drow was an enigma to him, a confusing combination of fighting brilliance and absolute control. Drizzt seemed able to weigh every move he ever made in the scales of high adventure and indisputable morals. Wulfgar turned a questioning gaze on the drow. "Why are you here?" he asked suddenly. Now it was Drizzt who stared reflectively into the openness before them. The first stars of the evening had appeared, their reflections sparkling distinctively in the dark pools of the elf's eyes. But Drizzt was not seeing them; his mind was viewing long past images of the lightless cities of the drow in their immense cavern complexes far beneath the ground. "I remember," Drizzt recalled vividly, as terrible memories are often vivid, "'the first time I ever viewed this surface world. I was a much younger elf then, a member of a large raiding party. We slipped out from a secret cave and descended upon a small elven village." The drow flinched at the images as they flashed again in his mind. "My companions slaughtered every member of the wood elf clan. Every female. Every child." Wulfgar listened with growing horror. The raid that Drizzt was describing might well have been one perpetrated by the ferocious Tribe of the Elk. "My people kill," Drizzt went on grimly. "They kill without mercy." He locked his stare onto Wulfgar to make sure that the barbarian heard him well. "They kill without passion." He paused for a moment to let the barbarian absorb the full weight of his words. The simple yet definitive description of the cold killers had confused Wulfgar. He had been raised and nurtured among passionate warriors, fighters whose entire purpose in life was the pursuit of battle-glory - fighting in praise of Tempos. The young barbarian simply could not understand such emotionless cruelty. A subtle difference, though, Wulfgar had to admit. Drow or barbarian, the results of the raids were much the same. "The demon goddess they serve leaves no room for the other races," Drizzt explained. "Particularly the other races of elves." "But you will never come to be accepted in this world," said Wulfgar. "Surely you must know that the humans will ever shun you." Drizzt nodded. "Most," he agreed. "I have few that I can call friends, yet I am content. You see, barbarian, I have my own respect, without guilt, without shame." He rose from his crouch and started away into the darkness. "Come," he instructed. "Let us fight well this night, for I am satisfied with the improvement of your skills, and this part of your lessons nears its end." Wulfgar sat a moment longer in contemplation. The drow lived a hard and materially empty existence, yet he was richer than any man Wulfgar had ever known. Drizzt had clung to his principles against overwhelming circumstances, leaving the familiar world of his own people by choice to remain in a world where he would never be accepted or appreciated. He looked at the departing elf, now a mere shadow in the gloom. "Perhaps we two are not so different," he mumbled under his breath.

Another obstacle was the stubbornness of the countries the pipeline had to cross, particularly Syria, all of which were demanding what seemed to be exorbitant transit fees. It was also the time when the partition of Palestine and the establishment of the state of Israel were aggravating American relations with the Arab countries. But the emergence of a Jewish state, along with the American recognition that followed, threatened more than transit rights for the pipeline. Ibn Saud was as outspoken and adamant against Zionism and Israel as any Arab leader. He said that Jews had been the enemies of Arabs since the seventh century. American support of a Jewish state, he told Truman, would be a death blow to American interests in the Arab world, and should a Jewish state come into existence, the Arabs “will lay siege to it until it dies of famine.” When Ibn Saud paid a visit to Aramco’s Dhahran headquarters in 1947, he praised the oranges he was served but then pointedly asked if they were from Palestine—that is, from a Jewish kibbutz. He was reassured; the oranges were from California. In his opposition to a Jewish state, Ibn Saud held what a British official called a “trump card”: He could punish the United States by canceling the Aramco concession. That possibility greatly alarmed not only the interested companies, but also, of course, the U.S. State and Defense departments. Yet the creation of Israel had its own momentum. In 1947, the United Nations Special Committee on Palestine recommended the partition of Palestine, which was accepted by the General Assembly and by the Jewish Agency, but rejected by the Arabs. An Arab “Liberation Army” seized the Galilee and attacked the Jewish section of Jerusalem. Violence gripped Palestine. In 1948, Britain, at wit’s end, gave up its mandate and withdrew its Army and administration, plunging Palestine into anarchy. On May 14, 1948, the Jewish National Council proclaimed the state of Israel. It was recognized almost instantly by the Soviet Union, followed quickly by the United States. The Arab League launched a full-scale attack. The first Arab-Israeli war had begun. A few days after Israel’s proclamation of statehood, James Terry Duce of Aramco passed word to Secretary of State Marshall that Ibn Saud had indicated that “he may be compelled, in certain circumstances, to apply sanctions against the American oil concessions… not because of his desire to do so but because the pressure upon him of Arab public opinion was so great that he could no longer resist it.” A hurriedly done State Department study, however, found that, despite the large reserves, the Middle East, excluding Iran, provided only 6 percent of free world oil supplies and that such a cut in consumption of that oil “could be achieved without substantial hardship to any group of consumers.

He ran long at the White House, and arrived late to his next meeting with Hillary Clinton, Jake Sullivan and Frank Ruggiero—their first major strategy session on Taliban talks after the secret meeting with A-Rod. She was waiting in her outer office, a spacious room paneled in white and gilt wood, with tasseled blue and pink curtains and an array of colorfully upholstered chairs and couches. In my time reporting to her later, I only ever saw Clinton take the couch, with guests of honor in the large chair kitty-corner to her. She’d left it open for him that day. “He came rushing in. . . . ” Clinton later said. “And, you know, he was saying ‘oh I’m so sorry, I’m so sorry.’ ” He sat down heavily and shrugged off his coat, rattling off a litany of his latest meetings, including his stop-in at the White House. “That was typical Richard. It was, like, ‘I’m doing a million things and I’m trying to keep all the balls in the air,’ ” she remembered. As he was talking, a “scarlet red” flush went up his face, according to Clinton. He pressed his hands over his eyes, his chest heaving. “Richard, what’s the matter?” Clinton asked. “Something horrible is happening,” he said. A few minutes later, Holbrooke was in an ambulance, strapped to a gurney, headed to nearby George Washington University Hospital, where Clinton had told her own internist to prepare the emergency room. In his typically brash style, he’d demanded that the ambulance take him to the more distant Sibley Memorial Hospital. Clinton overruled him. One of our deputies on the SRAP team, Dan Feldman, rode with him and held his hand. Feldman didn’t have his BlackBerry, so he scrawled notes on a State Department expense form for a dinner at Meiwah Restaurant as Holbrooke dictated messages and a doctor assessed him. The notes are a nonlinear stream of Holbrooke’s indomitable personality, slashed through with medical realities. “Call Eric in Axelrod’s office,” the first read. Nearby: “aortic dissection—type A . . . operation risk @ > 50 percent”—that would be chance of death. A series of messages for people in his life, again interrupted by his deteriorating condition: “S”—Secretary Clinton—“why always together for medical crises?” (The year before, he’d been with Clinton when she fell to the concrete floor of the State Department garage, fracturing her elbow.) “Kids—how much love them + stepkids” . . . “best staff ever” . . . “don’t let him die here” . . . “vascular surgery” . . . “no flow, no feeling legs” . . . “clot” . . . and then, again: “don’t let him die here want to die at home w/ his fam.” The seriousness of the situation fully dawning on him, Holbrooke turned to job succession: “Tell Frank”—Ruggiero—“he’s acting.” And finally: “I love so many people . . . I have a lot left to do . . . my career in public service is over.” Holbrooke cracked wise until they put him under for surgery. “Get me anything you need,” he demanded. “A pig’s heart. Dan’s heart.

What do citizens expect of government agencies entrusted with crime control, risk control, or other harm reduction duties? The public does not expect that governments will be able to prevent all crimes or contain all harms. But they do expect government agencies to provide the best protection possible, and at a reasonable price, by being:           Vigilant, so they can spot emerging threats early, pick up on precursors and warning signs, use their imaginations to work out what could happen, use their intelligence systems to discover what others are planning, and do all this before much harm is done.           Nimble, flexible enough to organize themselves quickly and appropriately around each emerging crime pattern rather than being locked into routines and processes designed for traditional issues.           Skillful, masters of the entire intervention tool kit, experienced (as craftsmen) in picking the best tools for each task, and adept at inventing new approaches when existing methods turn out to be irrelevant or insufficient to suppress an emerging threat.8 Real success in crime control—spotting emerging crime problems early and suppressing them before they do much harm—would not produce substantial year-to-year reductions in crime figures, because genuine and substantial reductions are available only when crime problems have first grown out of control. Neither would best practices produce enormous numbers of arrests, coercive interventions, or any other specific activity, because skill demands economy in the use of force and financial resources and rests on artful and well-tailored responses rather than extensive and costly campaigns. Ironically, therefore, the two classes of metrics that still seem to wield the most influence in many departments—crime reduction and enforcement productivity—would utterly fail to reflect the very best performance in crime control. Further, we must take seriously the fact that other important duties of the police will never be captured through crime statistics or in measures of enforcement output. As NYPD Assistant Commissioner Ronald J. Wilhelmy wrote in a November 2013 internal NYPD strategy document:

If a department appreciates that complexity, does well on vigilance, nimbleness, and skill, and therefore excels at spotting emerging problems early and suppressing them before they do much harm, what will success look like? How will such a department demonstrate its crime control expertise? The answer is that evaluation of performance will consist largely of problem-specific project accounts describing emerging crime patterns and what happened to each one. Each project account will describe how the department spotted the problem in the first place, how it analyzed and subsequently understood the problem, what the department and its partners did about the problem, and what happened as a result. Some in policing call that the scanning, analysis, response, and assessment (SARA) model. It is a straightforward problem-oriented account that has little to do with aggregate numbers of any particular kind.

As devious as this plot was, it could never have succeeded to the degree that it did had Clinton not abetted it with such vigor. That summer, she failed to emerge as the overwhelming front-runner everyone had expected, weighed down by stories on Clinton Foundation “buckraking” and the revelation that she had kept a private e-mail server as secretary of state and destroyed much of her correspondence. She also refused to release transcripts of highly paid speeches she’d delivered to Goldman Sachs and other Wall Street firms. In August, e-mails surfaced showing that Bill Clinton, through the foundation, had sought State Department permission to accept speaking fees in repressive countries such as North Korea and the Republic of the Congo. A poll the same day found that the word voters associated most with his wife was “liar.” Clinton’s tone-deaf response to the steady drip of revelations only deepened their impact because

Likewise, when the credit card took off in California in the 1960s, driven by Joseph Williams of Bank of America, there was nothing new about buying on credit. It was as old as Babylon. There was not even anything new about charge cards. Diner’s Club had been issuing cards for the convenience of restaurant users since the early 1950s and department stores for longer than that. What the BankAmericard achieved, especially once it emerged as Visa from the chaos of the mass mailings in the late 1960s, under Dee Hock’s reinvention, was the democratisation of credit. The electronic possibility that your card could be authorised for a purchase anywhere in the country or even the world was a powerful lubricant to specialisation and exchange in the economy of the late twentieth century, allowing consumers to express their choice to borrow against future earnings when it made sense. There was, of course, irresponsibility, but the credit card did not lead, as most intellectual grandees had feared,

If a patient arrives via ambulance and is seriously injured or really sick or has a heart attack, a doctor checks him out and sends him to the nearest real emergency department connected to a hospital with facilities like operating rooms and a cardiac laboratory. Aside from the risk of delays in treatment, the sequence results in bills for two separate high-level ER visits and a charge for emergency transport.

Heavy drug and alcohol use degrades the health of homeless people. Drug overdose is the leading cause of death among the homeless.44 Skin infections and disease are more common due to injecting drugs like heroin and meth. Respiratory diseases are common due to smoking tobacco, crack, heroin, fentanyl, and meth.45 And about two-thirds of the time of hospital emergency departments in San Francisco is spent serving the homeless.46 Social

Doyle was puzzled by the instructions and by the fact that they carried no signature. He looked again at the label. It had been typed on the standard office machine of the radio department. This also puzzled him. He turned toward the door, intending to ask Rogers for a comment. Rogers had disappeared. Doyle shrugged and turned back to the heater. For a moment he toyed with the heater, then plugged it into the workbench’s double-outlet plug. He flicked the switch on the outlet plug. The resulting explosion broke windows in the workshop, and shook the main police headquarters building over two hundred feet away. It was a miracle that Doyle escaped death. His left hand, left leg, and right foot were smashed. His left eardrum was fractured. He was rushed to Bayonne Hospital, where he underwent an emergency operation. The next day Rogers visited Vincent Doyle in the hospital, and asked through his tears: “How can I get the guy who did this to you?” Two weeks later Rogers was charged with the attempted murder of Vincent Doyle.

Department stores in particular had difficulty surviving the onslaught of low-price competitors. Their inability to adapt to changing consumer tastes and the emergence of new retail channels that targeted specific market segments—the so-called category killers in hardware, toys, and furniture—deeply eroded their market share. While in the 1960s and 1970s most clothing was sold in full-service department stores, by 1990 such stores accounted for only 29 percent of sales.

A June 2023 report from the Inspector General of the Department of Justice states that “threats posed by domestic extremists have not only increased over the past few years, but are also becoming more complicated due to the emergence of new violent ideologies, the impact of social media, and the response to recent political and social events.

I believe in the power of business to positively shape the world. It was the business opportunity offered by the legalization of cannabis that provided the practical incentives to destigmatize its use and reverse decades of injustice and harmful propaganda. Whether it is cannabis legalization or emerging products, technologies or industries, we must embrace disruption. Change is good, change is opportunity. Change is evolution.

Once we walked into the emergency department, it looked like a scene from a Western movie. Quaadir, King, Nasir, Dutch, Markese, Sarge, Rahmeek, Killa, Hassan, and Boogie were all standing front and center with their guns out, and another crew of men I never seen before also had their guns out.

Australian biologist Charles Birch once said that ‘you cannot participate more in a life than to participate in the suffering of that life’.

Aristotle said it best: ‘We are what we repeatedly do. Excellence then, is not an act, but a habit.

Initially working out of our home in Northern California, with a garage-based lab, I wrote a one page letter introducing myself and what we had and posted it to the CEOs of twenty-two Fortune 500 companies. Within a couple of weeks, we had received seventeen responses, with invitations to meetings and referrals to heads of engineering departments. I met with those CEOs or their deputies and received an enthusiastic response from almost every individual. There was also strong interest from engineers given the task of interfacing with us. However, support from their senior engineering and product development managers was less forthcoming. We learned that many of the big companies we had approached were no longer manufacturers themselves but assemblers of components or were value-added reseller companies, who put their famous names on systems that other original equipment manufacturers (OEMs) had built. That didn't daunt us, though when helpful VPs of engineering at top-of-the-food-chain companies referred us to their suppliers, we found that many had little or no R & D capacity, were unwilling to take a risk on outside ideas, or had no room in their already stripped-down budgets for innovation. Our designs found nowhere to land. It became clear that we needed to build actual products and create an apples-to-apples comparison before we could interest potential manufacturing customers. Where to start? We created a matrix of the product areas that we believed PAX could impact and identified more than five hundred distinct market sectors-with potentially hundreds of thousands of products that we could improve. We had to focus. After analysis that included the size of the addressable market, ease of access, the cost and time it would take to develop working prototypes, the certifications and metrics of the various industries, the need for energy efficiency in the sector, and so on, we prioritized the list to fans, mixers, pumps, and propellers. We began hand-making prototypes as comparisons to existing, leading products. By this time, we were raising working capital from angel investors. It's important to note that this was during the first half of the last decade. The tragedy of September 11, 2001, and ensuing military actions had the world's attention. Clean tech and green tech were just emerging as terms, and energy efficiency was still more of a slogan than a driver for industry. The dot-com boom had busted. We'd researched venture capital firms in the late 1990s and found only seven in the United States investing in mechanical engineering inventions. These tended to be expansion-stage investors that didn't match our phase of development. Still, we were close to the famous Silicon Valley and had a few comical conversations with venture capitalists who said they'd be interested in investing-if we could turn our technology into a website. Instead, every six months or so, we drew up a budget for the following six months. Via a growing network of forward-thinking private investors who could see the looming need for dramatic changes in energy efficiency and the performance results of our prototypes compared to currently marketed products, we funded the next phase of research and business development.

By drawing on Taylor and Arendt, I have made alternative claims for the visioning process: that it is a necessary and powerful way for groups of staff to exercise freedom together, of imagining a new future, but that it is a temporary and partial process which cannot map out all aspects of knowing how to take the next steps. As generalisations, such statements only take us so far in knowing how to act. Rather, it is incumbent upon staff in organisations continuously to look for ways to discuss, argue over, rework and functionalise these idealisations. I am arguing that change is not something which can be just designed and prescribed by senior managers in an idealised strategy process, but is happening every day in every department and unit in the organisation. Being open to what the organisation is already becoming allows for the possibility of the practical implications of a visioning process to emerge. The dangers of not being open implies that we already know what’s best for the organisation irrespective of the variety of work environments where staff are already largely doing their best to make things work. It then has the potential for bullying and even violence, where by violence I take Arendt’s definition of the prevention of the necessary daily struggles over power.

How many lives per year would be lost if emergency physicians and EDs did not exist?

The Midwife KAREN R. HANSON1 (1996) My ministry as a [hospital] chaplain [in] a Level One trauma center is intense and challenging. Our department responds to all critical cases that come into the Emergency Department, as well as critical incidents and deaths that occur throughout the hospital. [This] work requires a solid sense of identity and purpose. For me, the image of minister, or chaplain, as spiritual

Most careers have a defined period of optimum level of function. The US experience suggests ten years for most emergency physicians.

Nature normally hates power laws. In ordinary systems all quantities follow bell curves, and correlations decay rapidly, obeying exponential laws. But all that changes if the system is forced to undergo a phase transition. Then power laws emerge-nature's unmistakable sign that chaos is departing in favor of order. The theory of phase transitions told us loud and clear that the road from disorder to order is maintained by the powerful forces of self-organization and is paved by power laws. It told us that power laws are not just another way of characterizing a system's behavior. They are the patent signatures of self-organization in complex systems.

What do you want that couldn’t wait until the morning?” Arik asked as he led the way inside. The Pride’s king headed to the bar he’d had installed in the corner of his living room. He pulled a bottle of whiskey from a shelf. He poured them each a generous dollop. “I want permission to go after the Northern Lakes Pack.” “Am I going to regret asking why?” “They’re threatening Arabella.” “Who’s that?” “Jeoff’s sister.” Arik tossed back the fiery liquid before asking with a frown, “Why the fuck would I let you start a war over Jeoff’s sister?” “Because those pricks attacked us on home turf.” A snort escape Arik. “Ah yes, that puny attempt at a kidnapping. You caused quite a stir with your antics. Part of your stunt even made it onto YouTube before we could squash it. I had to have our PR department spin a Twitter thread on how it was part of a scene being taped for a movie.” “You can’t blame me for that. I had to stop them.” He did, but what he didn’t tell Arik was he’d never once thought of the repercussions of his actions. He saw Arabella in danger and had to go to her rescue. Bystanders and witnesses be damned. “I can see why you’d feel like you had to act. I mean, they made you look silly by catching you off guard like that, but, next time, could you be a little more discreet?” “No.” Why lie? The reply took his leader aback. “What do you mean no? Discretion is a fact of life. One girl isn’t worth drawing undue attention to ourselves.” “One girl might not be, but my mate is.” Want to stop conversation dead? Drop a bombshell. “Close your mouth, Arik, before you catch flies.” Only Arik’s mate could hope to tease him like that and get away with it. Dressed in yoga pants and a sweatshirt, Kira emerged from the bedroom and perched on a barstool. “Did you hear what he said?” a still astonished Arik demanded. “Yes. He’s fallen victim to the love bug. I think it’s cute.” “I would have said impossible,” Arik muttered. “You and me both, old friend. But, the fact of the matter is, I’m like ninety-nine percent sure that Arabella is supposed to be mine.” “And the one percent that isn’t sure?” “Is going to get eaten by my lion.

If you can’t play with the big dogs get back on the porch.

Labor and employment firm Fisher & Phillips LLP opened a Seattle office by poaching partner Davis Bae from labor and employment competitor Jackson Lewis PC. Mr. Bea, an immigration specialist, will lead the office, which also includes new partners Nick Beermann and Catharine Morisset and one other lawyer. Fisher & Phillips has 31 offices around the country. Sara Randazzo LAW Cadwalader Hires New Partner as It Looks to Represent Activist Investors By Liz Hoffman and David Benoit | 698 words One of America’s oldest corporate law firms is diving into the business of representing activist investors, betting that these agitators are going mainstream—and offer a lucrative business opportunity for advisers. Cadwalader, Wickersham & Taft LLP has hired a new partner, Richard Brand, whose biggest clients include William Ackman’s Pershing Square Capital Management LP, among other activist investors. Mr. Brand, 35 years old, advised Pershing Square on its campaign at Allergan Inc. last year and a board coup at Canadian Pacific Railway Ltd. in 2012. He has also defended companies against activists and has worked on mergers-and-acquisitions deals. His hiring, from Kirkland & Ellis LLP, is a notable step by a major law firm to commit to representing activists, and to do so while still aiming to retain corporate clients. Founded in 1792, Cadwalader for decades has catered to big companies and banks, but going forward will also seek out work from hedge funds including Pershing Square and Sachem Head Capital Management LP, a Pershing Square spinout and another client of Mr. Brand’s. To date, few major law firms or Wall Street banks have tried to represent both corporations and activist investors, who generally take positions in companies and push for changes to drive up share prices. Most big law firms instead cater exclusively to companies, worried that lining up with activists will offend or scare off executives or create conflicts that could jeopardize future assignments. Some are dabbling in both camps. Paul, Weiss, Rifkind, Wharton & Garrison LLP, for example, represented Trian Fund Management LP in its recent proxy fight at DuPont Co. and also is steering Time Warner Cable Inc.’s pending sale to Charter Communications Inc. Willkie Farr & Gallagher LLP and Gibson, Dunn & Crutcher LLP have done work for activist firm Third Point LLC. But most firms are more monogamous. Those on one end, most vocally Wachtell, Lipton, Rosen & Katz, defend management, while a small band including Schulte Roth & Zabel LLP and Olshan Frome Wolosky LLP primarily represent activists. In embracing activist work, Cadwalader thinks it can serve both groups better, said Christopher Cox, chairman of the firm’s corporate group. “Traditional M&A and activism are becoming increasingly intertwined,” Mr. Cox said in an interview. “To be able to bring that perspective to the boardroom is a huge advantage. And when a threat does emerge, who’s better to defend a company than someone who’s seen it from the other side?” Mr. Cox said Cadwalader has been thinking about branching out into activism since late last year. The firm is also working with an activist fund launched earlier this year by Cadwalader’s former head of M&A, Jim Woolery, that hopes to take a friendlier stance toward companies. Mr. Cox also said he believes activism can be lucrative, pooh-poohing another reason some big law firms eschew such assignments—namely, that they don’t pay as well as, say, a large merger deal. “There is real money in activism today,” said Robert Jackson, a former lawyer at Wachtell and the U.S. Treasury Department who now teaches at Columbia University and who also notes that advising activists can generate regulatory work. “Law firms are businesses, and taking the stance that you’ll never, ever, ever represent an activist is a financial luxury that only a few firms have.” To be sure, the handful of law firms that work for both sides say they do so

There will be no funeral homes, no hospitals, no abortion clinics, no divorce courts, no brothels, no bankruptcy courts, no psychiatric wards, and no treatment centers. There will be no pornography, dial-a-porn, no teen suicide, no AIDS, no cancer, no talks shows, no rape, no missing children . . . no drug problems, no drive-by shootings, no racial tension, and no prejudice. There will be no misunderstandings, no injustice, no depression, no hurtful words, no gossip, no hurt feelings, no worry, no emptiness, and no child abuse. There will be no wars, no financial worries, no emotional heartaches, no physical pain, no spiritual flatness, no relational divisions, no murders, and no casseroles. There will be no tears, no suffering, no separations, no starvation, no arguments, no accidents, no emergency departments, no doctors, no nurses, no heart monitors, no rust, no perplexing questions, no false teachers, no financial shortages, no hurricanes, no bad habits, no decay, and no locks. We will never need to confess sin. Never need to apologize again. Never need to straighten out a strained relationship. Never have to resist Satan again. Never have to resist temptation. Never!

My lord.” St. Just stopped just inside the door and bowed to the older man. “I didn’t mean to impose, but came to fetch the mare and thought I’d—” “Here they come!” St. Just looked up to see a half-dozen very young ladies trotting up the hallway in a giggling, laughing cloud of skirts and smiles. “Another guest, girls! This is Lord Rosecroft. Make your curtsies and then line up.” The ladies assembled with an alacrity that would have done St. Just’s recruits in Spain proud. “All right, Rosecroft, best be about it. They get bold if you make ’em wait.” St. Just looked askance at his host, who was grinning like a fiend. “It’s the kissing bough,” Vim Charpentier said as he emerged from the hallway, a tumbler in his hand. “You have to kiss them each and every one, or they’ll pout. And, Rosecroft, they’ve been collecting kisses all afternoon between trips to the punch bowl, so you’d be well advised to acquit yourself to the best of your ability. They will compare notes all year. So far, I believe I’m your competition.” He took a sip of his drink, eyeing his cousins balefully. “I’ve charged headlong into French infantry,” St. Just said, smiling at the ladies, “praying I might survive to enjoy just such a gauntlet as this.” He went down the line, leaving a wake of blushes, kissing each cheek until he got to a little girl so small he had to hunker down to kiss her. “What’s your name, sweetheart?” “Cynthia Weeze Simmons.” “The prettiest has been saved for last.” He kissed a delicate cheek and rose. “Any more? I was cavalry, you know, legendary for our charm and stamina.” This was said to tease the young ladies, but they all looked at their grandfather without breaking ranks. “Once with you lot is enough,” the old man barked. “Shoo.” They departed amid more giggles. Sindal looked disgruntled. “You made that look easy.” “I have daughters, and I’m half Irish. It was easy, also fun.

The genuine beliefs, though not usually the professed precepts, of parents and teachers are almost unconsciously acquired by most children; and even if they depart from these beliefs in later life, something of them remains deeply implanted, ready to emerge in a time of stress or crisis.

This may not seem like leadership in action, but it is. Successful leadership isn’t dictatorship. It injects fundamental ideas and processes into the bloodstream of an organization and of individuals who see things the same way but lack the leverage to carry them out on their own. As a one-man or one-woman protectorate of a humane, sustainable business process, the leader sees to it that new ideas emerge and bloom when the timing is right. Dictators come and go, and when they go the dictatorship goes with them. When a true leader departs, the company he leaves behind is healthy, self-governing, vibrant, and intact.

Furthermore, after the Justice Department targeted a Fox News reporter for a criminal investigation under the Espionage Act, in a matter involving unauthorized disclosure of classified information, the attorney general provided Congress with misleading information about his knowledge and approval of the investigation. Specifically, he testified: With regard to the potential prosecution of the press for the disclosure of [classified] material, that is not something I’ve ever been involved in, heard of, or would think would be wise policy.14 It subsequently emerged, however, that the attorney general had actually approved a search warrant for the reporter’s private emails.

Increased investment by businesses and a slightly improved trade picture prompted the revision, which lifted the estimated annual rate of growth in April, May and June to 4.2 percent from the government's initial reading of 4 percent in late July. Since the economy emerged from the recession five years ago, companies have been hesitant to spend heavily on new capacity, but these figures and other recent data indicate that is finally changing. In a separate report Thursday, the Labor Department said initial claims for unemployment benefits dropped last week by 1,000, to 298,000, helping push the eight-week average for new claims to below 300,000 for the first time since April 2006, well before the onset of the recession.

critical thinking Scenario 1 Mrs. Hernandez is an 85-yearold female admitted to surgery for insertion of a hip prosthesis to treat a hip fracture. The surgical technologist assigned to transport the patient to the preoperative holding area performed a routine review of the patient’s medical chart in the emergency department. The medical chart indicates that Mrs. Hernandez is being treated forchronic hypertension. 1. Knowing that she has a concurrent diagnosis of hypertension, which additional related items should be checked on her chart? 2. How might this situation affect the preparations going on in the surgery department? 3. What action or actions should the surgical technologist take prior to bringing the patient to preoperative holding? Scenario 2 Mr. Van Nguyen is a 47-yearold male admitted to surgery for repair of a retinal detachment under general anesthesia. 1. Which diuretic may be administered intraoperatively? 2. The circulator should check the preference card for a standing order for what preoperative preparation of the patient specific to this situation? 124

Since 1945 Turkey has, of course, acquired far more importance for the US as a strategic ally, first in the Cold War and now the War on Terror. In the last twenty years, increasing pressure from the Armenian community, today much more salient than in the 1920s, and the emergence of an Armenian scholarship that has pioneered modern study of the exterminations of 1915-16 in the West, have made repression of the question more difficult. After previously unsuccessful attempts to get resolutions on it through Congress, in 2000 the House International Relations Committee voted for a bipartisan resolution condemning the Armenian genocide, while carefully exempting the Turkish Republic from any responsibility for it. Ankara’s response was to threaten withdrawal of American military facilities in Turkey, trade reprisals, and to talk of a risk of violence against Americans in Turkey – the State Department even had to issue a travel advisory – if the resolution were passed by Congress. Characteristically, Clinton intervened in person to prevent the resolution getting to the floor. In Ankara, Ecevit exulted that it was a demonstration of Turkish power.

By April 2014, when the epidemic was officially over, the sentinel sites had reported 8,750 patients seeking care. The health department’s epidemiologist, Dr. Henri-Pierre Mallet, calculated that 32,000 people, or about 12 percent of the country’s population, had Zika symptoms severe enough to warrant a visit to a doctor. He

Consequently, a wide variety of perspectives and frameworks have been developed for trying to understand what cities are, how they arose, how they function, and what their future is. Just within academia itself there is a dizzying array of separate departments, centers, and institutes representing a broad spectrum of alternative ways of perceiving cities: urban geography, urban economics, urban planning, urban studies, urbanomics, architectural studies, and many more, each with its own culture, paradigm, and agenda, though rarely interacting with one another. The situation is rapidly changing as new developments are being initiated, many stimulated by the advent of big data and the vision of smart cities, both somewhat naively touted as panaceas for solving all of our urban problems. But tellingly, there are as yet no explicit departments of “urban science” or “urban physics.” These represent a new frontier as the urgency to understand cities from a more scientific perspective emerges. This is the context of what I am presenting here, namely using scale as a powerful tool for opening a window onto the development of a quantitative conceptual integrated systemic framework for understanding cities.

Emergency department physicians spent 44 percent of their time entering data into electronic medical records, clicking up to 4,000 times during a 10-hour shift. —Becker’s Health IT & CIO Review magazine, October 11, 2013

Jillian and Anita found that heaping a bit of “process friction” on those doctors forced them to pause and think about whether patients’ symptoms indicated they really needed an ultrasound—or if that test would provide little or no useful information. Patients who were spared unnecessary ultrasounds spent less time waiting in a crowded emergency department and avoided the stress and hassle of another test. Eliminating unnecessary ultrasounds also reduced patients’ hospital bills and the workload on hospital radiologists, who are often busy and beleaguered.

Soon, they were above the stage itself, ensconced by enormous drapes that reached into the rafters. The heavy thud of wood and feet betrayed the gravity that was inaudible to the audience. Dancers and stage crew rushed amongst the wings. The choreographed chaos reminded Ethan of the emergency department.

If personal identity resides in the telling, then so does social identity. Families, nations, religions (but also corporations, universities, departments of sociology) know who they are by the stories they tell. The modern discipline of history is closely related to the emergence of the nation-state.

Bears in Ohio? There were at least 65 black bears sighted in Ohio in 2012, and their numbers are increasing, according to the Division of Wildlife. Most sightings near the Buckeye Trail have been in southeastern Ohio. In 1999 a black bear was spotted east of Athens, gorging itself on the 17-year cicadas that emerged that spring over much of Ohio. Bears eat mainly insects and grubs. They normally avoid people. If you spot one, simply back off and do not try to take photographs. Report the sighting to the Ohio Department of Natural Resources as soon as possible. And remember, always being quiet and considerate of the wildlife around you, large or small, is in your own best interest.

A book written by PLA Chinese military scientists and senior Chinese public health officials in 2015, titled The Unnatural Origin of SARS and New Species of Man-Made Viruses as Genetic Bioweapons, was obtained by the US State Department as it conducted an investigation into the origins of Covid-19. The 263-page volume was published in 2015 by the Chinese Military Medical Science Press, a government-owned publishing house managed by the General Logistics Department of the PLA. It describes SARS coronaviruses as heralding a “new era of genetic weapons” and says they can be “artificially manipulated into an emerging human disease virus, then weaponised and unleashed in a way never seen before”. Some of China’s senior public health and military figures are listed among the 18 authors of the document, including the former Deputy Director of China’s Bureau of Epidemic Prevention, Li Feng. Ten of the authors are scientists and weapons experts affiliated with the Air Force Medical University in Xi’an, which the Australian Strategic Policy Institute’s Defence Universities Tracker ranks as “very high-risk” for its level of defence research, including its work on medical and psychological sciences.

By early 2014 there were sufficient indications that the High Court action would prove extraordinary by Irish legal standards. It had emerged that a telephone system that handled emergency calls, which had been installed in garda stations across Ireland in the 1980s, had a recording function. Such a recording function posed fundamental problems at a garda station–not least for some conversations between gardaí, which should have been treated as confidential. This system with a recording function was discontinued in November 2013. The garda commissioner at the time, Martin Callinan, had alerted the Department of Justice in March 2014 to the fact that the recording system had been in place. So seriously was the matter taken that it was immediately brought to the attention of Taoiseach Enda Kenny and discussed at a full Cabinet meeting on 25 March. By that time, the retirement of Commissioner Callinan had been confirmed in the wake of the controversy over the treatment of the so-called garda ‘whistle-blower’ Maurice McCabe. Bandon Garda Station, the centre of the du Plantier murder investigation, had such a telephone recording system and it had been in operation between 1997 and 2003–critical periods for the du Plantier investigation.

easy. “Social and economic conditions in western equatorial Africa changed dramatically in the 20th century, which could explain why the AIDS pandemic emerged at this time and not previously.” [The Real Origins of AIDS, Department of State, July 27, 2005. Dead link] The data

The first hints of this emerged in the early and mid-1990s, at the tail end of the crack epidemic. Suniya Luthar is now sixty-two, with an infectious smile, bright brown eyes, and short snow-white hair. Back then, she was a fledgling psychologist working as an assistant professor and researcher in the department of psychiatry at the Yale School of Medicine. She was studying resiliency among teenagers in low-income urban communities, and one of her early findings was that the most popular kids were also among the most destructive and aggressive at school. Was this a demographic phenomenon, she wondered, or merely an adolescent one, this tendency to look up to peers who acted out? To find out, she needed a comparison group. A research assistant suggested they recruit students from his former high school in an affluent suburb. Luthar’s team ultimately enlisted 488 tenth graders—about half from her assistant’s high school and half from a scruffy urban high school. The affluent community’s median household income was 80 percent higher than the national median, and more than twice that of the low-income community. The rich community also had far fewer families on food stamps (0.3 percent vs. 19 percent) and fewer kids getting free or reduced-price school lunches (1 percent vs. 86 percent). The suburban teens were 82 percent white, while the urban teens were 87 percent nonwhite. Luthar surveyed the kids, asking a series of questions related to depression and anxiety, drug use ranging from alcohol and nicotine to LSD and cocaine, and participation in delinquent acts at home, at school, and in the community. Also examined were grades, “social competence,” and teachers’ assessments of each student. After crunching the numbers, she was floored. The affluent teens fared poorly relative to the low-income teens on “all indicators of substance use, including hard drugs.” This flipped the conventional wisdom on its head. “I was quite taken aback,” Luthar recalls.

The entire market needed a sexy new appealing name. The Third World debt salesmen had plenty of ideas. First, they tried “less developed countries” debt, but the implications of “less developed” were too negative. Then came “LDC” debt and the hope that potential buyers might not remember the abbreviated L stood for “less.” However, that attempt failed, too. After all, this was before Kentucky Fried Chicken’s pioneering switch to KFC. Today’s consumers of fast-food poultry can be fooled; 1980s investors could not. Next the salesmen tried “developing nations” debt, which almost caught on but was still tied too closely to “less developed.” Finally one ingenious salesman suggested “emerging markets.” Everyone excitedly agreed, and departments all over Wall Street were renamed.

For years after the American Revolution, the public opposed to the creation of police departments, fearing that they would become forces of repression... Only in the mid 19th century, after the growth of industrial cities and a rash of urban riots - after the dread of the so-called dangerous classes surpassed the dread of the state - did police departments emerge in the United States.

A STEADY STREAM of semiconductor inventions emerged from Bell Labs between 1950 and 1960. Some had arisen from Baker’s research department and others from the much larger development department. As a result, there were now a multitude of new transistor types and important new methods of manufacturing, such as the technique—resembling art etchings done on a minuscule scale—known as photolithography.

Effective off-sites provide executives an opportunity to regularly step away from the daily, weekly, even monthly issues that occupy their attention, so they can review the business in a more holistic, long-term manner. Topics for reflection and discussion at a productive Quarterly Off-Site Review might include the following: Comprehensive Strategy Review: Executives should reassess their strategic direction, not every day as so many do, but three or four times a year. Industries change and new competitive threats emerge that call for different approaches. Reviewing strategies annually or semiannually is usually not often enough to stay current. Team Review: Executives should regularly assess themselves and their behaviors as a team, identifying trends or tendencies that may not be serving the organization. This often requires a change of scenery so that executives can interact with one another on a more personal level and remind themselves of their collective commitments to the team. Personnel Review: Three or four times a year, executives should talk, across departments, about the key employees within the organization. Every member of an executive team should know whom their peers view as their stars, as well as their poor performers. This allows executives to provide perspectives that might actually alter those perceptions based on different experiences and points of view. More important, it allows them to jointly manage and retain top performers, and work with poor performers similarly. Competitive and Industry Review: Information about competitors and industry trends bleeds into an organization little by little over time. It is useful for executives to step back and look at what is happening around them in a more comprehensive way so they can spot trends that individual nuggets of information might not make clear. Even the best executives can lose sight of the forest for the trees when inundated with daily responsibilities.

the lab’s essential public health functions could be compromised during the move and if the lab had fewer employees. The lab, now at a former Devon Energy Corp. field office building next to a cow pasture in Stillwater, has struggled to keep its top director and other key employees. Delays to get test results for basic public health surveillance for salmonella outbreaks and sexually transmitted infections have shaken the confidence of lab partners and local public health officials. As a new coronavirus emerges going into winter, the lab ranks last in the nation for COVID-19 variant testing. Many employees, who found out about the lab’s move from an October 2020 press conference, didn’t want to relocate to Stillwater. Those who did make the move in the first few months of 2021 found expensive lab equipment in their new workplace but not enough electrical outlets for them. The lab’s internet connection was slower than expected and not part of the ultra-fast fiber network used across town by Oklahoma State University. A fridge containing reagents, among the basic supplies for any lab, had to be thrown out after a power outage. Meanwhile, the Centers for Medicare and Medicaid Services finalized a correction plan after federal inspectors, prompted by an anonymous complaint, showed up unannounced at the lab in late September. “Although some aspects of the original report were not as favorable as we would have liked, the path of correction is clear and more than attainable,” Secretary of Health and Mental Health Kevin Corbett said Tuesday in a statement about the inspection. “We are well on our way to fully implementing our plan. (The Centers For Medicare and Medicaid Services) has confirmed we’ve met the requirements of being in compliance. We are looking forward to their follow-up visit.” In an earlier statement, the health department said the Stillwater lab now “has sufficient power outlets to perform testing with the new equipment, and has fiber connection that exceeds what is necessary to properly run genetic sequencing and other lab functions.” The department denied the lab had to throw out the reagents after a power outage.

2011, I led the Department of Energy’s Quadrennial Technology Review to develop strategies for government support of emerging clean energy technologies. In one town hall meeting, I faced advocates for four different vehicle technologies—internal combustion engines powered by biofuels, compressed natural gas, hydrogen-powered fuel cells, and battery-powered plug-ins. Each of them believed that their technology was the optimal vision for the future, and that all the government had to do was support the development of the appropriate fueling infrastructure. When I reminded them that the country could probably deploy no more than two new fueling technologies at scale, a squabble ensued. There are several reasons I believe that electricity will fuel the passenger vehicles of the future, but one of them is that the existing electrical grid is a good start on the fueling infrastructure. If a widespread transition to plug-in electric cars does come about, systems thinking will be even more important as the electrical and transportation systems would have to work together to accommodate charging millions of vehicles.

The concept of the end of policing and prisons was not new in 2020. There have been leftists advocating for police and prison abolition for as long as I’ve been politically conscious. Activists demanding the abolition of police had a large corpus of theoretical writing to draw from. But there was usually a key difference between the older school of police and prison abolition and the demands of the most impassioned days of 2020: the former almost always imagined that a world without formal policing would emerge only after other society-altering changes had taken place. Typically, this was defined as the fall of capitalism and the establishment of some sort of socialist system, a system without poverty and deprivation. In other words, the radicals I knew might imagine the end of the police, but they imagined that end would come after the revolution. To debate the concept in 2020 was to skip a lot of steps. This was a general issue in the first year after Floyd’s murder, a sense that people wanted to dodge the hard work that would have been necessary before society-altering changes could take place. In part because of the extremely low odds of success for a police abolition movement, many who supported defunding the police insisted that the intent had never been to abolish the police at all. In this telling, “defund the police” means reducing the budgets of police departments, drawing down their resources, and redirecting some of those funds to other uses,

Luo Ji spent the night in a fevered torpor, haunted endlessly by restless dreams in which the stars in the night sky swirled and danced like grains of sand on the skin of a drum. He was even aware of the gravitational interaction between these stars: It wasn’t three-body motion, but the 200-billion-body motion of all of the stars in the galaxy! Then the swirling stars clustered into an enormous vortex, and in that mad spiral the vortex transformed again into a giant serpent formed from the congealed silver of every star, which drilled into his brain with a roar.… At around four in the morning, Zhang Xiang was awakened by his phone. It was a call from the Planetary Defense Council Security Department leadership who, in severe tones, demanded that he report immediately on Luo Ji’s condition, and ordered the base to be put under a state of emergency. A team of experts was on its way over. As soon as he hung up the phone, it rang again, this time with a call from the doctor in the tenth basement, who reported that the patient’s condition had sharply deteriorated and he was now in a state of shock. Zhang Xiang descended the elevator at once, and the panicked doctor and nurse informed him that Luo Ji had begun spitting up blood in the middle of the