Emergency Medicine Quotes

Tell us please, what treatment in an emergency is administered by ear?"....I met his gaze and I did not blink. "Words of comfort," I said to my father.

Simon whispered to me, “But is everything okay?” “No,” Tori said. “I kidnapped her and forced her to escape with me. I’ve been using her as a human shield against those guys with guns, and I was just about to strangle her and leave her body here to throw them off my trail. But then you showed up and foiled my evil plans. Lucky for you, though. You get to rescue poor little Chloe again and win her undying gratitude.” “Undying gratitude?” Simon looked at me. “Cool. Does that come with eternal servitude? If so, I like my eggs sunnyside up.” I smiled. “I’ll remember that.” *** “Oh, right. You must be starving.” Simon reached into his pockets. “I can offer one bruised apple and one brown banana. Convenience stores aren’t the place to buy fruit, as I keep telling someone.” “Better than these. For you, anyway, Simon.” Derek passed a bar to Tori. “Because you aren’t supposed to have those, are you?” I said. “Which reminds me…” I took out the insulin. “Derek said it’s your backup.” “So my dark secret is out.” “I didn’t know it was a secret.” “Not really. Just not something I advertise.” ... “Backup?” Tori said. “You mean he didn’t need that?” “Apparently not,” I murmured. Simon looked from her to me, confused, then understanding. “You guys thought…” “That if you didn’t get your medicine in the next twenty-four hours, you’d be dead?” I said. “Not exactly, but close. You know, the old ‘upping the ante with a fatal disease that needs medication’ twist. Apparently, it still works.” “Kind of a letdown, then, huh?” “No kidding. Here we were, expecting to find you minutes from death. Look at you, not even gasping.” “All right, then. Emergency medical situation, take two.” He leaped to his feet, staggered, keeled over, then lifted his head weakly. “Chloe? Is that you?” He coughed. “Do you have my insulin?” I placed it in his outstretched hand. “You saved my life,” he said. “How can I ever repay you?” “Undying servitude sounds good. I like my eggs scrambled.” He held up a piece of fruit. “Would you settle for a bruised apple?” I laughed.

It was a lie but he believed in telling lies to people. Truth telling and medicine just didn't go together except in dire emergencies, if then.

That if you didnt get your medicine in the next twenty-four hours you'd be dead?" i said, " Not exactly, but close. you know, the old ' upping the ante with a fatal disease that needs medication twist. APerently it still works." "Kind of a letdown, then, huh?" "No kidding. Look at you, your not even gasping." " All right then, emergency medical situation, take two." he leaped to his feet, stagored, kneeled over, then lifted his head weakly. Chloe? Is that you?" he couphed, " DO you have my insulin?" i placed it in his outstreched hand. "You savedmy life, how can i ever repay you?" he said. "undying servitude sounds good. i like my eggs scrambled." he held up a piece of fruit, "Would you settle for a bruised apple?" i lauphed. "YOu guys are wierd." tori said. simon sat on the crate beside me. "thats right. we are totally wierd and completely uncool. you popularity is plummeting just by being near us. so why dont you-" "Chloe?" derek inturupted. "Hows your arm?" "HEr-?" simon swore under his breath. "Way to keep showing me up. first food. now her arm" he turned to me"How is it?

Science fiction, particularly visionary fiction, is where I go when I need the medicine of possibility applied to the trauma of human behavior.

Backup?" Tori said. "You mean he didn't need that?" "Apparently not," I murmured. Simon looked from her to me, confused, then understanding. "You guys thought..." "That if you didn't get your medicine in the next twenty-four hours, you'd be dead?" I said. "Not exactly, but close. You know, the old 'upping the ante with a fatal disease that needs medication' twist. Apparently, it still works." "Kind of a letdown, then, huh?" "No kidding. Here we were, expecting to find you minutes from death. Look at you, not even gasping." "All right, then. Emergency medical situation, take two." He leaped to his feet, staggered, keeled over, then lifted his head weakly. "Chloe? Is that you?" He coughed. "Do you have my insulin?" I placed it in his outstretched hand. "You saved my life," he said. "How can I ever repay you?" "Undying servitude sounds good. I like my eggs scrambled." He held up a piece of fruit. "Would you settle for a bruised apple?

Emergencies are crucibles that contain and reveal the daily, slower-burning problems of medicine and beyond—our vulnerabilities; our trouble grappling with uncertainty, how we die, how we prioritize and divide what is most precious and vital and limited; even our biases and blindnesses.

The fundamental answer to why so many humans are now getting sick from previously rare illnesses is that many of the body's features were adapted in environments from which we evolved, but have become maladapted in the modern environments we have now created. This idea, known as the mismatch hypothesis, is the core of the new emerging field of evolutionary medicine, which applies evolutionary biology to health and disease.

THERE HAVE ALWAYS BEEN ITINERANTS, drifters, hobos, restless souls. But now, in the second millennium, a new kind of wandering tribe is emerging. People who never imagined being nomads are hitting the road. They’re giving up traditional houses and apartments to live in what some call “wheel estate”—vans, secondhand RVs, school buses, pickup campers, travel trailers, and plain old sedans. They are driving away from the impossible choices that face what used to be the middle class. Decisions like: Would you rather have food or dental work? Pay your mortgage or your electric bill? Make a car payment or buy medicine? Cover rent or student loans? Purchase warm clothes or gas for your commute? For many the answer seemed radical at first. You can’t give yourself a raise, but what about cutting your biggest expense? Trading a stick-and-brick domicile for life on wheels?

Panicking never helps.

When he emerged, I’d stand on the stool amidst the steam and the aroma of uncapped Old Spice, watching my face wobble and drip in the medicine cabinet mirror.

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

Right," said Marisol. "So, I don't explain modern medicine to you, and then a medical emergency occurs to me. It could be solved with the application of a little first aid, but you don't know that, and so I die. I die at your feet. Is that what you want, Jon?" "No," said Jon. "What's first aid? Is there a ... second aid?

For, medicine being a compendium of the successive and contradictory mistakes of medical practitioners, when we summon the wisest of them to our aid, the chances are that we may be relying on a scientific truth the error of which will be recognized in a few years’ time. So that to believe in medicine would be the height of folly, if not to believe in it were not greater folly still, for from this mass of errors there have emerged in the course of time many truths.

A case could be made that even the shift into R&D on information technologies and medicine was not so much a reorientation towards market-driven consumer imperatives, but part of an all-out effort to follow the technological humbling of the Soviet Union with total victory in the global class war: not only the imposition of absolute U.S. military dominance overseas, but the utter rout of social movements back home. The technologies that emerged were in almost every case the kind that proved most conducive to surveillance, work discipline, and social control. Computers have opened up certain spaces of freedom, as we’re constantly reminded, but instead of leading to the workless utopia Abbie Hoffman or Guy Debord imagined, they have been employed in such a way as to produce the opposite effect.

According to Richard Gerber, M.D.: “The ultimate approach to healing will be to remove the abnormalities at the subtle-energy level which led to the manifestation of illness in the first place.”2 Norm Shealy, M.D., founding president of the American Holistic Medical Association, has flatly stated that “energy medicine is the future of all medicine.”3 This emerging approach is actually both contemporary and ancient. According to Albert Szent-Györgyi, Nobel laureate in Medicine: “In every culture and in every medical tradition before ours, healing was accomplished by moving energy.

Once upon a time Karen saw somebody nobody else could see. She thought to ask an old man: who were you? Once upon a time I thought to dream of medicine. Now I dream of medicine by the sea.

Taxes are what we pay for civilized society, for modernity, and for prosperity. The wealthy pay more because they have benefitted more. Taxes, well laid and well spent, insure domestic tranquility, provide for the common defense, and promote the general welfare. Taxes protect property and the environment; taxes make business possible. Taxes pay for roads and schools and bridges and police and teachers. Taxes pay for doctors and nursing homes and medicine. During an emergency, like an earthquake or a hurricane, taxes pay for rescue workers, shelters, and services. For people whose lives are devastated by other kinds of disaster, like the disaster of poverty, taxes pay, even, for food.

We have to become still in the midst of the turmoil so we can observe clearly how our actions and the actions of others, past and present, fit together in the tapestry of life. In the timeless instant when we stop moving and simply witness the moment, the dust settles and the big picture emerges.

I notice young girls picking flowers off her gravestone; their clean hearts are soapstone. Their small sorrows are for children alone. And all of their stories will never be told.

The cascade of toxins and debris generated by humans destabilizes nutrient return cycles, causing crop failure, global warming, climate change and, in a worst-case scenario, quickening the pace towards ecocatastrophes of our own making. As ecological disrupters, humans challenge the immune systems of our environment beyond their limits. The rule of nature is that when a species exceeds the carrying capacity of its host environment, its food chains collapse and diseases emerge to devastate the population of the threatening organism. I believe we can come into balance with nature using mycelium to regulate the flow of nutrients. The age of mycological medicine is upon us. Now is the time to ensure the future of our planet and our species by partnering, or running, with mycelium.

Removing pubic hair does not improve cleanliness, and there is emerging data that it is associated with an increased risk of infections like HPV and herpes, although the exact mechanism is not known.

Since we all have varying degrees of tolerance for pain, and have equally varied experiences with different types of pain, it makes the scale feel kind of meaningless -- especially when you consider that the person trying to ascertain how much pain the patient is in has his or her own experiences with pain that are thrown into the mix, too. A doctor trying to figure out how much pain a patient is in, when she says it's 'worse than a broken leg,' but 'not as bad as childbirth,' is still only going to be able to guess what that means based on his or her own experiences -- and perceptions -- of pain.

For, medicine being a compendium of the successive and contradictory mistakes of doctors, even when we call in the best of them the chances are that we may be staking our hopes on some medical theory that will be proved false in a few years. So that to believe in medicine would be utter madness, were it not still a greater madness not to believe in it, for from this accumulation of errors a few valid theories have emerged in the long run.

Tears are not weakness–they are mercy. Quran is medicine. Duaa is salvation. Prostration is recovery, and the last third of the night is our emergency room. Cry to Allah and you will heal. Break to Allah and He will mend your heart.

is not possible to get that precipitate back into solution. Most herbalists simply shake the bottle prior to dispensing and suggest the user do the same before ingesting it. I do it this way and it seems to work fine, medicinally speaking.

What I propose to look at is a global outbreak that might be termed a Level 4 event worldwide outbreak of a Biosafety Level 4 emerging virus that travels in the air from person to person, and is vaccineless and untreatable with modern medicine.

you should know about precipitation, a very neglected area of herbal medicine. The constituents that you have extracted from the herbs are held in suspension in a liquid medium. Over time, some of these constituents will precipitate out and settle on the bottom of the tincture bottle.

Until fairly recently, every family had a cornucopia of favorite home remedies--plants and household items that could be prepared to treat minor medical emergencies, or to prevent a common ailment becoming something much more serious. Most households had someone with a little understanding of home cures, and when knowledge fell short, or more serious illness took hold, the family physician or village healer would be called in for a consultation, and a treatment would be agreed upon. In those days we took personal responsibility for our health--we took steps to prevent illness and were more aware of our bodies and of changes in them. And when illness struck, we frequently had the personal means to remedy it. More often than not, the treatment could be found in the garden or the larder. In the middle of the twentieth century we began to change our outlook. The advent of modern medicine, together with its many miracles, also led to a much greater dependency on our physicians and to an increasingly stretched healthcare system. The growth of the pharmaceutical industry has meant that there are indeed "cures" for most symptoms, and we have become accustomed to putting our health in the hands of someone else, and to purchasing products that make us feel good. Somewhere along the line we began to believe that technology was in some way superior to what was natural, and so we willingly gave up control of even minor health problems.

It is undignified to inject yourself with hormones designed to slow or enhance ovarian production. It is undignified to have your ovaries monitored by transvaginal ultrasound; to be sedated so that your eggs can be aspirated into a needle; to have your husband emerge sheepishly from a locked room with the “sample” that will be combined with your eggs under supervision of an embryologist. The grainy photo they hand you on transfer day, of your eight-celled embryo (which does not look remotely like a baby), is undignified, and so is all the waiting and despairing that follows.

This is something that has been going on forever,” Craig Spencer, the director of global health in emergency medicine at Columbia University, says about the variability of human response to infection. “I wouldn’t be surprised if people are walking about with long Epstein-Barr virus, or long influenza. We all know someone who is low energy, who’s told to work harder. We have all heard about chronic Lyme sufferers, and those with ME/CFS. But they get written off.” Spencer understands something about how infections can do long-term damage, because he contracted Ebola while working in Guinea, fell ill upon his return to New York City, and then struggled with the virus’s ongoing effects. (Studies have suggested that the Ebola virus may linger in the body for years.) The difference between long COVID and other infection-associated illnesses is that it is happening “on such a huge scale—unlike anything we’ve seen before. It is harder for the medical community to write off,” Spencer told me. Indeed, many researchers I spoke with for this book hope that the race to understand long COVID will advance our understanding of other chronic conditions that follow infection, transforming medicine in the process.

Monica nudged her husband’s shoulder. “On-time flights are easier when you’re behind the controls.” Trent Fairchild and his two brothers owned and operated Fairchild Charters. A private air charter company with a fleet of jets, big and small, not to mention more helicopters than one could count, which was why they were attending the conference of International Emergency Medicine . . . a conference where professionals worked to improve the emergency response to natural disasters all over the world. “Is Glen with you?” Glen was Trent’s brother and liaison to the fixed-wing portion of air travel for the sick and injured.

Every day," I said, "every day I go to work and I see my granddad. I see the drunks and the addicts, the people who have fallen right off the edge of the earth. I see people who have made every bad move anyone could make, made every major mistake there was to be made, and by the time I see them, they are paying for it, sometimes with their lives. That's why they came to the ER. "When you work in emergency medicine, you are seeing patients who are the least common denominator as far as human beings go; people who are heartbreakingly stupid and ditty and drunk and high and obnoxious--unbelievably obnoxious. These people have all flowed out of the darkest side of life. And when you are finished with them, that's mostly where they'll return. So each of you who is thinking you want to go into emergency medicine will have to ask yourself, 'Do I really want to do this?'" I tapped my chest. "I know the answer for myself--every day I work I'm taking care of someone who is just like my grandfather, someone just like my mother. But everyone in this room needs to ask himself or herself, 'Do I want to spend the rest of my life with addicts and idiots and drunks and psychotics? Is this what will make me happy?'" I peered at all of them over the top of the microphone. "Very few sane people answer yes.

you come to rely, more than anything else, on first sight. You walk into the room and you think, sick or not sick. Not sick goes home as fast as possible. Sick, you watch. You draw blood, you order X rays, you give them fluids. You are careful, because a little bell went off in your head when you walked into the room and saw them.

The conceptual problem at the center of contemporary healthcare is the confusion between disease processes and disease origins. Instead of asking why an illness occurs and trying to remove the conditions that led to it, medical researchers try to understand the mechanisms through which the disease operates, so that they can then interfere with them. These mechanisms, rather than the true origins, are seen as the causes of disease in current medical thinking. In the process of reducing illness to disease, the attention of physicians has moved away from the patient as a whole person. By concentrating on smaller and smaller fragments of the body – shifting its perspective from the study of bodily organs and their functions to that of cells and, finally, to the study of molecules – modern medicine often loses sight of the human being, and having reduced health to mechanical functioning, it is no longer able to deal with the phenomenon of healing. Over the past four decades, the dissatisfaction with the mechanistic approach to health and healthcare has grown rapidly both among healthcare professionals and the general public. At the same time, the emerging systems view of life has given rise to a corresponding systems view of health, as we discuss in Chapter 15, while health consciousness among the general population has increased dramatically in many countries. The

Homelessness was fed by racism, income inequality, and a cascade of other related forces. These included insufficient investments in public housing, as well as tax and zoning codes that had spurred widespread gentrification and driven up rents. Many poor and moderately poor Americans lived with the fear of losing housing, which can itself harm bodies and minds as well as social relations in families. One recent study had found that “unstable housing” was accompanied by a twofold increase in diabetic emergencies. Illnesses such as diabetes, and all sorts of accidents and injuries, could lead to homelessness, which itself bred other illnesses, such as PTSD—redefined by one practitioner of street medicine as “persistent traumatic stress disorder.

ACTIVATED CHARCOAL Another low-hanging fruit of detoxification is activated charcoal, a form of carbon that has a massive surface area and a strong negative charge. Activated charcoal has been used for more than ten thousand years by Chinese medicine healers, Ayurvedic practitioners, and Western medicine doctors alike. It’s still used in emergency rooms today to treat poisoning.

In chapter 9, I shared with you the power of food in the form of an all-fat ketogenic diet to break seizures in children. For them, food is medicine. Depression and anxiety are increasingly being understood in terms of aberrant electrical brain waves, and doctors in the emerging field of “nutritional psychiatry” are prescribing diets that can lessen anxiety and improve your mood.

When a theological world view dominated, deviance was sin; when the nation-states emerged from the decay of feudalism, most deviance became designated as crime; and in our own scientifically oriented world, various forms of deviance are designated increasingly as medical problems. Thus we view the medical paradigm as the ascending paradigm for deviance designations in our postindustrial society.

To comprehend the interactions between Homo sapiens and the vast and diverse microbial world, perspectives must be forged that meld such disparate fields as medicine, environmentalism, public health, basic ecology, primate biology, human behavior, economic development, cultural anthropology, human rights law, entomology, parasitology, virology, bacteriology, evolutionary biology, and epidemiology.

The fundamental answer to why so many humans are now getting sick from previously rare illnesses is that many of the body’s features were adaptive in the environments for which we evolved but have become maladaptive in the modern environments we have now created. This idea, known as the mismatch hypothesis, is the core of the new, emerging field of evolutionary medicine, which applies evolutionary biology to health and disease.17

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.

For, medicine being a compendium of the successive and contradictory mistakes of medical practioners, when we summon the wisest of them to our aid, the chances are that we may be relying on a scientific truth the error of which will be recognised in a few years’ time. So that to believe in medicine would be the height of folly, if not to believe in it were not greater folly still, for from this mass of errors there have emerged in the course of time many truths.

allopathic medicine is very good at managing trauma, acute bacterial infections, medical and surgical emergencies, and other crises. It is very bad at managing viral infections, chronic degenerative disease, allergy and autoimmunity, many of the serious kinds of cancer, mental illness, “functional” illness (disturbances of function in the absence of major physical or chemical changes), and all those conditions in which the mind plays an active role in creating susceptibility to disease.

In Indian Medicine, energy is a continuum that does not change. We as energy beings have our own special vibration, and we connect with other energy by a process of phasing our energy into our center or spirit self, then emerging or opening our hands to receive the energy of the Universal Circle. Instead of seeing energy as just being work, the elder teachers consider it associated with each of the Four Directions as physical, mental, spiritual, and natural. It can be directed, interfered with, and taught.

In his seminal book Antifragile, Nassim Nicholas Taleb shows how the linear model is wrong (or, at best, misleading) in everything from cybernetics, to derivatives, to medicine, to the jet engine. In each case history reveals that these innovations emerged as a consequence of a similar process utilized by the biologists at Unilever, and became encoded in heuristics (rules of thumb) and practical know-how. The problems were often too complex to solve theoretically, or via a blueprint, or in the seminar room. They were solved by failing, learning, and failing again.

Having a body, we have seen, does not entail knowing a body. Whereas a cow automatically eats whatever grasses supply needed nutrients, people must determine for themselves what to put into their bodies, with the result that there is room to make mistakes. Mistakes arise, in part, from ignorance. Yet ignorance is not the only problem produced by this arrangement. The fact that we are not compelled by our bodies' precise needs—understood as particular kinds of food and drink, rather than food and drink tout court—allows the formation of desires that have little or nothing to do with the needs on which bodily health depends.

The main medicinal species that most people use, Prefix-or-not-cordyceps sinensis, is a parasite on caterpillars, specifically the larvae of the ghost moth (which is why it is sometimes called the caterpillar fungus). The fungal spores invade the caterpillar (which lives underground), and they sprout into active mycelia (which spread throughout the caterpillar body via the circulatory system), eventually killing the caterpillar (which then mummifies). The mycelia ultimately fill the corpse, leaving the exoskeleton intact, and the mushroom sprouts from the body (via the head) the next summer, and, hey, we got medicine. (Yum!)

When a domain reaches a point where the knowledge for skillful professional practice cannot be acquired in a decade, more or less, then several adaptive developments are likely to occur. Specialization will usually increase (as it has, for example, in medicine), and practitioners will make increasing use of books and other external reference aids in their work. Architecture is a good example of a domain where much of the information a professional requires is stored in reference works, such as catalogues of available building materials, equipment, and components, and official building codes. No architect expects to keep all of this in his head or to design without frequent resort to these information sources. In fact architecture can almost be taken as a prototype for the process of design in a semantically rich task domain. The emerging design is itself incorporated in a set of external memory structures: sketches, floor plans, drawings of utility systems, and so on. At each stage in the design process, partial design reflected in these documents serves as a major stimulus suggesting to the designer what he should attend to next. This direction to new sub-goals permits in turn new information to be extracted from memory and reference sources and another step to be taken toward the development of the design.

Malthus’s poor laws were wrong; British attitudes to famine in India and Ireland were wrong; eugenics was wrong; the Holocaust was wrong; India’s sterilisation programme was wrong; China’s one-child policy was wrong. These were sins of commission, not omission. Malthusian misanthropy – the notion that you should harden your heart, approve of famine and disease, feel ashamed of pity and compassion, for the good of the race – was wrong pragmatically as well as morally. The right thing to do about poor, hungry and fecund people always was, and still is, to give them hope, opportunity, freedom, education, food and medicine, including of course contraception, for not only will that make them happier, it will enable them to have smaller families.

On January 28, 1983, on the eve of the launch of the Human Genome Project, Carrie Buck died in a nursing home in Waynesboro, Pennsylvania. She was seventy-six years old. Her birth and death had bookended the near century of the gene. Her generation had borne witness to the scientific resurrection of genetics, its forceful entry into public discourse, its perversion into social engineering and eugenics, its postwar emergence as the central theme of the “new” biology, its impact on human physiology and pathology, its powerful explanatory power in our understanding of illness, and its inevitable intersection with questions of fate, identity, and choice. She had been one of the earliest victims of the misunderstandings of a powerful new science. And she had watched that science transform our understanding of medicine, culture, and society.

The global centre of power shifted to Europe only between 1750 and 1850, when Europeans humiliated the Asian powers in a series of wars and conquered large parts of Asia. By 1900 Europeans firmly controlled the world’s economy and most of its territory. In 1950 western Europe and the United States together accounted for more than half of global production, whereas China’s portion had been reduced to 5 per cent.5 Under the European aegis a new global order and global culture emerged. Today all humans are, to a much greater extent than they usually want to admit, European in dress, thought and taste. They may be fiercely anti-European in their rhetoric, but almost everyone on the planet views politics, medicine, war and economics through European eyes, and listens to music written in European modes with words in European languages. Even today’s burgeoning Chinese economy, which may soon regain its global primacy, is built on a European model of production and finance.

the disparity between Eastern and Western spirituality resembles that found between Eastern and Western medicine—with the arrow of embarrassment pointing in the opposite direction. Humanity did not understand the biology of cancer, develop antibiotics and vaccines, or sequence the human genome under an Eastern sun. Consequently, real medicine is almost entirely a product of Western science. Insofar as specific techniques of Eastern medicine actually work, they must conform, whether by design or by happenstance, to the principles of biology as we have come to know them in the West. This is not to say that Western medicine is complete. In a few decades, many of our current practices will seem barbaric. One need only ponder the list of side effects that accompany most medications to appreciate that these are terribly blunt instruments. Nevertheless, most of our knowledge about the human body—and about the physical universe generally—emerged in the West. The rest is instinct, folklore, bewilderment, and untimely death.

Yes, there is a human nature and that human nature is build for love and contact. It is build for connection, it is build for mutual protection, it is build for mutual aid. And when we rear people in base of all society on the lines that transgress those needs, we're gonna get exactly what we have today. Which is a society which is increasingly conflicted, increasingly fractured, increasingly disconnected and where human pathology is, despite all the advances of medicine, chronic human pathology is on the rise. Western medicine does not recognize that the pathologies are manifestations of our life, that diseases don't have a life of their own, that diseases express the life of the individual. And if that individual's life is changed, so can the disease in many, many cases. And furthermore, that human beings have an innate healing capacity. There is a healing capacity in all living beings, plant or animal. And along with the wonders and contributions of Western medicine we could do so much more if we actually respected and evoked and encouraged that healing capacity that is within the individual, which is very much connected to the emergence of the true self. Now, for that, you need the truth. That means, we actually have to look at what is going on. And there is so much denial in this society. My own profession is a prime example. The average doctor does not hear the information I gave you about asthma. They couldn't explain it, even though the physiology is straightforward. For all the trauma in this society, the average physician does not hear the word "trauma" in all their years of training. Not that they don't get a lecture, not that they don't get a course, they don't even hear the word, except in the physical sense, physical trauma. Teachers are not taught that the human child's brain is still developing and that the conditions for healthy brain development is the presence of nurturing and responsive adults. And that schools are not knowledge factories, they are places where human development needs to be nurtured. That's a very different proposition for an educational system. And the courts don't get it. The courts think that if a human is behaving badly, it is a choice they're making, therefore they need to be punished. For some strange reason, certain minority groups have to be punished more than the average, like in my country 5% of the population is native, and they are 25% of the jail population now. And of course when we ask the question if the science is straightforward — as I believe it to be — and the conclusions are as clear as I believe them to be, why don't we just embrace it and follow it and do something about it? Well.. the reason for that is obvious, because if everything I just said happens to be true, which I firmly believe to be true, and if it is.. everything would have to change. How we teach parents would have to change, how we treat family would have to change, how we support young parents would have to change, how we pass laws, how we educate people, how we run the economy. We have to do something different. Getting to that something different has to begin with an inquiry and I hope I've said enough to encourage you to continue on that path of inquiry.

One man who did not understand was the New Zealanders’ legendary commander, Lieutenant General Bernard C. Freyberg. English-born but raised in New Zealand, Freyberg had been a dentist before finding his true calling as warrior of Homeric strength and courage. Known as Tiny to his troops, he had a skull the size of a medicine ball, with a pushbroom mustache and legs that extended like sycamore trunks from his khaki shorts. In the Great War, he had won the Victoria Cross on the Somme, served as a pallbearer for his great friend Rupert Brooke, and emerged so seamed by shrapnel that when Churchill once persuaded him to display his wounds the count reached twenty-seven. More were to come. Oarsman, boxer, swimmer of the English Channel, he had been medically retired for “aortic incompetence” in the 1930s before being summoned back to uniform. No greater heart beat in British battle dress. Churchill a month earlier had proclaimed Freyberg “the salamander of the British empire,” an accolade that raised Kiwi hackles—“Wha’ in ’ell’s a ‘sallymander’?”—until the happy news spread that the creature mythically could pass through fire unharmed.

Dii Nvwati (Cherokee). Translation: Skunk medicine. The skunk asks us to defend ourselves effectively, without causing further conflict. Self-protection but do no harm. Gangsterish peace-making. That is the kind of masculinity that I try to embody. With my leadership, with my poise, with my privileges. As my body continues on a journey of thickening, muscle hardening, limbs lengthening, Ayurvedic drying, shorter synapse pathways, fuzzier intuition, and choppier verbal articulation all facilitated by weekly testosterone injections these are poignant lessons to forward. The objective is for men and masculine people to not yield our power to others… Women and femme people don’t need our paternalistic sickle to swath as we ‘tap out.’ We must figure out power without domination. The skunk asks us to use our powers effectively, without wiping ourselves out. Without recapitulating top down, give-less-to-get-more social structures. Just as the skunk does not seek to be the bear, let us not attempt to trade places with the oppressor. Let us navigate a road of paradigm shifting that seeks to salve both current social and economic injuries, but also prepare a sustainable method of being for seven generations to come.

First, bring your attention to the moment, and breathe deeply. Then, get your mind to your mouth, and drink as slowly and purposefully as you can. (When you drink, you rebuild the energies surrounding your Throat Chakra. Any time you feel lost in thoughts or unable to express your desires, swallow and relax your neck.)"Let yourself answer for a moment. Yeah, it's a big question— even a daunting one — but it's one you can use to step more deeply into the intended purpose of your life. The first step in understanding what you need to feel more fully alive is to recognize and express your personal truth. •       Simply sit down with it as the answer comes to you. Bring it in. Inhabit the body, and feel it. When you understand the deepest personal truths, they will open up other truths from there. Of examples, if your greatest personal reality is that energy is real, then other truths emerge: If energy is real, magic is real; if magic is real, anything is possible; if anything is possible, you are boundless; if you are boundless, your wildest dreams will come true. •       Unlimited vision, lovely girl. Know that you are treasured beyond measure and trust when you conduct yourself in service of the highest reality of All Beings. Let the true reality of harmony envelope you. •       Ask your elders and spirit guides to be with you while you absorb what you've seen as you feel connected to reality at every point. Welcome its presence as it surrounds you. They're here to help you love each other and honor yourself deeper than ever. When in this blanket of support and wisdom you feel fully enveloped, close your induction with the universal blessing: Amen.

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.

Financial Times commentator Martin Wolf concluded in 2010: "We already know that the earthquake of the past few years has damaged Western economies, while leaving those of emerging countries, particularly Asia, standing. It has also destroyed Western prestige. The West has dominated the world economically and intellectually for at least two centuries. That epoch is now over. Hitherto, the rulers of emerging countries disliked the West's pretensions, but respected its competence. This is true no longer. Never again will the West have the sole word." I was reminded of the Asian financial crisis in 1997. When Asian economies were devastated by similarly foolish borrowing the West – including the International Monetary Fund and World Bank – prescribed bitter medicine. They extolled traditional free market principles: Asia should raise interest rates to support sagging currencies, while state spending, debt, subsidies should be cut drastically. Banks and companies in trouble should be left to fail, there should be no bail-outs. South Korea, Thailand, Indonesia were pressured into swallowing the bitter medicine. President Suharto paid the ultimate price: he was forced to resign. Anger against the IMF was widespread. I was in Los Angeles for a seminar organised by the Claremont McKenna College to discuss, among other things, the Asian crisis. The Thai speaker resorted to profanity: F-- the IMF, he screamed. The Asian press was blamed by some Western academics. If we had the kind of press freedoms the West enjoyed, we could have flagged the danger before the crisis hit. Western credibility was torn to shreds when the financial tsunami struck Wall Street. Shamelessly abandoning the policy prescriptions they imposed on Asia, they decided their banks and companies like General Motors were too big to fail. How many Asian countries could have been spared severe pain if they had ignored the IMF? How vain was their criticism of the Asian press, for the almost unfettered press freedoms the West enjoyed had failed to prevent catastrophe.

What are these substances? Medicines or drugs or sacramental foods? It is easier to say what they are not. They are not narcotics, nor intoxicants, nor energizers, nor anaesthetics, nor tranquilizers. They are, rather, biochemical keys which unlock experiences shatteringly new to most Westerners. For the last two years, staff members of the Center for Research in Personality at Harvard University have engaged in systematic experiments with these substances. Our first inquiry into the biochemical expansion of consciousness has been a study of the reactions of Americans in a supportive, comfortable naturalistic setting. We have had the opportunity of participating in over one thousand individual administrations. From our observations, from interviews and reports, from analysis of questionnaire data, and from pre- and postexperimental differences in personality test results, certain conclusions have emerged. (1) These substances do alter consciousness. There is no dispute on this score. (2) It is meaningless to talk more specifically about the “effect of the drug.” Set and setting, expectation, and atmosphere account for all specificity of reaction. There is no “drug reaction” but always setting-plus-drug. (3) In talking about potentialities it is useful to consider not just the setting-plus-drug but rather the potentialities of the human cortex to create images and experiences far beyond the narrow limitations of words and concepts. Those of us on this research project spend a good share of our working hours listening to people talk about the effect and use of consciousness-altering drugs. If we substitute the words human cortex for drug we can then agree with any statement made about the potentialities—for good or evil, for helping or hurting, for loving or fearing. Potentialities of the cortex, not of the drug. The drug is just an instrument. In analyzing and interpreting the results of our studies we looked first to the conventional models of modern psychology—psychoanalytic, behavioristic—and found these concepts quite inadequate to map the richness and breadth of expanded consciousness. To understand our findings we have finally been forced back on a language and point of view quite alien to us who are trained in the traditions of mechanistic objective psychology. We have had to return again and again to the nondualistic conceptions of Eastern philosophy, a theory of mind made more explicit and familiar in our Western world by Bergson, Aldous Huxley, and Alan Watts. In the first part of this book Mr. Watts presents with beautiful clarity this theory of consciousness, which we have seen confirmed in the accounts of our research subjects—philosophers, unlettered convicts, housewives, intellectuals, alcoholics. The leap across entangling thickets of the verbal, to identify with the totality of the experienced, is a phenomenon reported over and over by these persons.

Wake up every day, expecting not to know what's going to happen, and look for the events to unfold with curiosity. Instead of stressing and managing, just be present at anything that pops up with the intention of approaching it with your best efforts. Whatever happens in the process of spiritual awakening is going to be unpredictable and moving forward, if you're just the one who notices it, not fighting or making a big project out there. •       You may have emotional swings, energetic swings, psychic openings, and other unwanted shifts that, as you knew, feel unfamiliar to your personality. Be the beholder. Don't feel like you have something to fix or alter. They're going to pass. •       If you have severe trauma in your history and have never had therapy, it might be very useful to release the pains of memories that arise around the events. Therapy teaches you how to express, bear witness, release, and move forward. Your therapist needn't know much about kundalini as long as he or she doesn't discount that part of your process. What you want to focus on is the release of trauma-related issues, and you want an experienced and compassionate therapist who sees your spiritual orientation as a motivation and support for the healing process. •       This process represents your chance to wake up to your true nature. Some people wake up first, and then experience the emergence of a kundalini; others have the kundalini process going through as a preparation for the emergence. The appearance happens to do the job of wiping out, so is part of either pattern. Waking up means realizing that whoever looks through your eyes, lives through your senses, listens to your thoughts, and is present at every moment of your experience, whether good or bad, is recognized or remembered. This is a bright, conscious, detached and unconditionally loving presence that is universal and eternal and is totally free from all the conditions and memories you associate with as a personal identity. But as long as you believe in all of your personal conditions and stories, emotions, and thoughts, you have to experience life filtered by them. This programmed mind is what makes the game of life to be varied and suspense-filled but it also causes suffering and fear of death. When we are in Samadhi and Satori encounters, we glimpse the Truth about the vast, limitless space that is the foundation for our being. It is called gnosis (knowledge) or the One by the early Gnostics. Some spiritual teachings like Advaita Vedanta and Zen go straight for realization, while others see it as a gradual path through years of spiritual practices. Anyway, the ending is the same. As Shakespeare said, when you know who you are, the world becomes a stage and you the player, and life is more light and thoughts less intrusive, and the kundalini process settles down into a mellow pleasantness. •       Give up places to go and to be with people that cause you discomfort.

The trends speak to an unavoidable truth. Society's future will be challenged by zoonotic viruses, a quite natural prediction, not least because humanity is a potent agent of change, which is the essential fuel of evolution. Notwithstanding these assertions, I began with the intention of leaving the reader with a broader appreciation of viruses: they are not simply life's pathogens. They are life's obligate partners and a formidable force in nature on our planet. As you contemplate the ocean under a setting sun, consider the multitude of virus particles in each milliliter of seawater: flying over wilderness forestry, consider the collective viromes of its living inhabitants. The stunnig number and diversity of viruses in our environment should engender in us greater awe that we are safe among these multitudes than fear that they will harm us. Personalized medicine will soon become a reality and medical practice will routinely catalogue and weigh a patient's genome sequence. Not long thereafter one might expect this data to be joined by the patient's viral and bacterial metagenomes: the patient's collective genetic identity will be recorded in one printout. We will doubtless discover some of our viral passengers are harmful to our health, while others are protective. But the appreciation of viruses that I hope you have gained from these pages is not about an exercise in accounting. The balancing of benefit versus threat to humanity is a fruitless task. The viral metagenome will contain new and useful gene functionalities for biomedicine: viruses may become essential biomedical tools and phages will continue to optimize may also accelerate the development of antibiotic drug resistance in the post-antibiotic era and emerging viruses may threaten our complacency and challenge our society economically and socially. Simply comparing these pros and cons, however, does not do justice to viruses and acknowledge their rightful place in nature. Life and viruses are inseparable. Viruses are life's complement, sometimes dangerous but always beautiful in design. All autonomous self-sustaining replicating systems that generate their own energy will foster parasites. Viruses are the inescapable by-products of life's success on the planet. We owe our own evolution to them; the fossils of many are recognizable in ERVs and EVEs that were certainly powerful influences in the evolution of our ancestors. Like viruses and prokaryotes, we are also a patchwork of genes, acquired by inheritance and horizontal gene transfer during our evolution from the primitive RNA-based world. It is a common saying that 'beauty is in the eye of the beholder.' It is a natural response to a visual queue: a sunset, the drape of a designer dress, or the pattern of a silk tie, but it can also be found in a line of poetry, a particularly effective kitchen implement, or even the ruthless efficiency of a firearm. The latter are uniquely human acknowledgments of beauty in design. It is humanity that allows us to recognize the beauty in the evolutionary design of viruses. They are unique products of evolution, the inevitable consequence of life, infectious egotistical genetic information that taps into life and the laws of nature to fuel evolutionary invention.

...emergency medicine is extended periods of intense boredom, interrupted by occasional spurts of sheer terror...

Shamans, as the classicist E.R. Dodds defines them, have "received a call to a religious life. As a result of this call [they undergo] a period of rigorous training, which commonly involves solitude and fasting, and may involve a psychological change of sex." Once the shaman emerges from this religious training, he possesses, according to Dodds, the power, real or assumed, of passing at will into a state of mental dissociation. In that condition he is not thought...to be possessed by an alien spirit; but his own soul is thought to leave the body and travel to distant parts, most often to the spirit world. A shaman...has the power of bilocation. From these experiences, narrated by him in extempore song, he derives skill in divination, religious poetry, and magical medicine which makes him socially important. He becomes the repository of a supernormal wisdom. Thus, shamans seek a balance between the mythical/magical and the real Earth; that is, they are students of the plants, animals, rivers, and the rest of nature. They instinctively feel and see magic in the state of nature and have an intensified intimacy with nature beyond any of their lay counterparts in society-their selves are fractally enmeshed with the patterns of the natural world. Not only do shamans move between the normal and supernormal, between the human and natural worlds, they also develop a heightened state of empathy with their fellow human beings.

Harvard Business School alum Rick Krieger and some partners decided to start QuickMedx, the forerunner of CVS MinuteClinics, after Krieger spent a frustrating few hours waiting in an emergency room for his son to get a strep-throat test. CVS MinuteClinic can see walk-in patients instantly and nurse practitioners can prescribe medicines for routine ailments, such as conjunctivitis, ear infections, and strep throat. Because most people don’t want to go to the doctor if they don’t have to, there are now more than a thousand MinuteClinic locations inside CVS pharmacy stores in thirty-three states.

Septic patients have a systemic inflammatory response syndrome (SIRS) as a consequence of infection. Severe sepsis refers to septic patients with evidence of organ hypoperfusion. Septic shock is present when septic patients exhibit hypotension unresponsive to intravenous fluid resuscitation.

Perception of reality emerges from the brain and dissolves in the brain.

A New England Journal of Medicine study calculated that dietary supplements are responsible for 23,000 emergency room visits per year in the United States.

The Historical Setting of Genesis Mesopotamia: Sumer Through Old Babylonia Sumerians. It is not possible at this time to put Ge 1–11 into a specific place in the historical record. Our history of the ancient Near East begins in earnest after writing has been invented, and the earliest civilization known to us in the historical record is that of the Sumerians. This culture dominated southern Mesopotamia for over 500 years during the first half of the third millennium BC (2900–2350 BC), known as the Early Dynastic Period. The Sumerians have become known through the excavation of several of their principal cities, which include Eridu, Uruk and Ur. The Sumerians are credited with many of the important developments in civilization, including the foundations of mathematics, astronomy, law and medicine. Urbanization is also first witnessed among the Sumerians. By the time of Abraham, the Sumerians no longer dominate the ancient Near East politically, but their culture continues to influence the region. Other cultures replace them in the political arena but benefit from the advances they made. Dynasty of Akkad. In the middle of the twenty-fourth century BC, the Sumerian culture was overrun by the formation of an empire under the kingship of Sargon I, who established his capital at Akkad. He ruled all of southern Mesopotamia and ranged eastward into Elam and northwest to the Mediterranean on campaigns of a military and economic nature. The empire lasted for almost 150 years before being apparently overthrown by the Gutians (a barbaric people from the Zagros Mountains east of the Tigris), though other factors, including internal dissent, may have contributed to the downfall. Ur III. Of the next century little is known as more than 20 Gutian kings succeeded one another. Just before 2100 BC, the city of Ur took control of southern Mesopotamia under the kingship of Ur-Nammu, and for the next century there was a Sumerian renaissance in what has been called the Ur III period. It is difficult to ascertain the limits of territorial control of the Ur III kings, though the territory does not seem to have been as extensive as that of the dynasty of Akkad. Under Ur-Nammu’s son Shulgi, the region enjoyed almost a half century of peace. Decline and fall came late in the twenty-first century BC through the infiltration of the Amorites and the increased aggression of the Elamites to the east. The Elamites finally overthrew the city. It is against this backdrop of history that the OT patriarchs emerge. Some have pictured Abraham as leaving the sophisticated Ur that was the center of the powerful Ur III period to settle in the unknown wilderness of Canaan, but that involves both chronological and geographic speculation. By the highest chronology (i.e., the earliest dates attributed to him), Abraham probably would have traveled from Ur to Harran during the reign of Ur-Nammu, but many scholars are inclined to place Abraham in the later Isin-Larsa period or even the Old Babylonian period. From a geographic standpoint it is difficult to be sure that the Ur mentioned in the Bible is the famous city in southern Mesopotamia (see note on 11:28). All this makes it impossible to give a precise background of Abraham. The Ur III period ended in southern Mesopotamia as the last king of Ur, Ibbi-Sin, lost the support of one city after another and was finally overthrown by the Elamites, who lived just east of the Tigris. In the ensuing two centuries (c. 2000–1800 BC), power was again returned to city-states that controlled more local areas. Isin, Larsa, Eshnunna, Lagash, Mari, Assur and Babylon all served as major political centers.

Of course, the Kremlin policy is utterly mad. Even with the help of useful fools like Gen. Butler, Moscow’s strategists are bound to fail (in the long run) – especially in Europe; for the natural instincts of sensible people are bound to awaken. However grim the situation may look, however horrific the military disasters to come, the circus clowns will be forced from the stage. Fear of death has a way of focusing the mind, and the threat of enslavement rallies many whose timidity would otherwise be assumed. It does not matter that these people are “late to the party.” As war grows closer, more observers will see the situation for what it is. Shortly before her death last year, a Russian historian wrote to me as follows: “Moscow is performing substantial war preparations. Training both military and civil defense [personnel] including the Moscow Metro, every day; medicine is in full readiness for [the coming] emergency….” J.R.Nyquist

But when the agricultural villages of the Neolithic expanded into larger towns that grew to more than two thousand inhabitants, the capacity of the human brain to know and recognize all of the members of a single community was stretched beyond its natural limits. Nevertheless, the tribal cultures that had evolved during the Upper Paleolithic with the emergence of symbolic communication enabled people who might have been strangers to feel a collective sense of belonging and solidarity. It was the formation of tribes and ethnicities that enabled the strangers of the large Neolithic towns to trust each other and interact comfortably with each other, even if they were not all personally acquainted. The transformation of human society into urban civilizations, however, involved a great fusion of people and societies into groups so large that there was no possibility of having personal relationships with more than a tiny fraction of them. Yet the human capacity for tribal solidarity meant that there was literally no upper limit on the size that a human group could attain. And if we mark the year 3000 BC as the approximate time when all the elements of urban civilization came together to trigger this new transformation, it has taken only five thousand years for all of humanity to be swallowed up by the immense nation-states that have now taken possession of every square inch of the inhabited world. The new urban civilizations produced the study of mathematics, astronomy, philosophy, history, biology, and medicine. They greatly advanced and refined the technologies of metallurgy, masonry, architecture, carpentry, shipbuilding, and weaponry. They invented the art of writing and the practical science of engineering. They developed the modern forms of drama, poetry, music, painting, and sculpture. They built canals, roads, bridges, aqueducts, pyramids, tombs, temples, shrines, castles, and fortresses by the thousands all over the world. They built ocean-going ships that sailed the high seas and eventually circumnavigated the globe. From their cultures emerged the great universal religions of Christianity, Buddhism, Confucianism, Islam, and Hinduism. And they invented every form of state government and political system we know, from hereditary monarchies to representative democracies. The new urban civilizations turned out to be dynamic engines of innovation, and in the course of just a few thousand years, they freed humanity from the limitations it had inherited from the hunting and gathering cultures of the past.

10. What realities are captured in the story of Lou Sanders and his daughter, Shelley, regarding home care for an aging and increasingly frail parent? What conflicts did Shelley face between her intentions and the practical needs of the family and herself? What does the book illustrate about the universal nature of this struggle in families around the globe? 11. A key concept that emerges from the author’s interviews is “home.” Much more than just the place where you go to bed at night, home evokes a set of values and freedoms for many as they face old age. As you consider the life you want lead in old age, what does home mean to you? 12. Reading about Bill Thomas’s Eden Alternative in Chapter 5, what came to mind when he outlined the Three Plagues of nursing home existence: boredom, loneliness, and helplessness? What do you think matters most when you envision eldercare? 13. What can be learned from the medical treatment choices that were made in the final days of Sara Monopoli’s life? 14. What are your feelings about hospice care? When is the appropriate time to introduce hospice in the treatment of those with life-threatening illness?

One assumption that is already being shattered is the idea that only routine, semi-skilled jobs like taxi driving, food delivery, or household chores are susceptible. Even traditional professions like medicine and law are proving to be susceptible to platform models. We’ve already mentioned Medicast, which applies an Uber-like model to finding a doctor. Several platform companies are providing online venues where legal services are available with comparable ease, speed, and convenience. Axiom Law has built a $200 million platform business by using a combination of data-mining software and freelance law talent to provide legal guidance and services to business clients; InCloudCounsel claims it can process basic legal documents such as licensing forms and nondisclosure agreements at a savings of up to 80 percent compared with a traditional law firm.11 In the decades to come, it seems likely that the platform model will be applied—or at least tested—in virtually every market for labor and professional services. How will this trend impact the service industries—not to mention the working lives of hundreds of millions of people? One likely result will be an even greater stratification of wealth, power, and prestige among service providers. Routine and standardized tasks will move to online platforms, where an army of relatively low-paid, self-employed professionals will be available to handle them. Meanwhile, the world’s great law firms, medical centers, consulting partnerships, and accounting practices will not vanish, but their relative size and importance will shrink as much of the work they used to do migrates to platforms that can provide comparable services at a fraction of the cost and with far greater convenience. A surviving handful of world-class experts will increasingly focus on a tiny subset of the most highly specialized and challenging assignments, which they can tackle from anywhere in the world using online tools. Thus, at the very highest level of professional expertise, winner-take-all markets are likely to emerge, with (say) two dozen internationally renowned attorneys competing for the splashiest and most lucrative cases anywhere on the globe.

The term “myalgic encephalomyelitis” (muscle pain, “myalgic”, with “encephalomyelitis” inflammation of the brain and spinal cord) was first included by the World Health Organization (WHO) in their International Classification of Diseases in 1969. It is ironic that Donald Acheson, who subsequently became the Chief Medical Officer first coined the name in 1956.8 In 1978 the Royal Society of Medicine accepted ME as a nosological organic entity.9 The current version of the International Classification of Diseases—ICD‐10, lists myalgic encephalomyelitis under G.93.3—neurological conditions. It cannot be emphasised too strongly that this recognition emerged from meticulous clinical observation and examination.

In a collapse, there will likely be a lot more diarrheal disease than gunfights at the O.K. corral. History teaches us that, in the Civil War, there were more deaths from dysentery than there were from bullet wounds.

Jon,” she was saying to the boy across the table from her. “I am in so much pain from stubbing my toe! I need aspirin.” “What’s aspirin?” asked the boy, sounding panicked. He was obviously Nephilim, through and through and through. Magnus could tell without seeing his runes. In fact, he was prepared to bet the boy was a Cartwright. Magnus had known several Cartwrights through the centuries. The Cartwrights all had such distressingly thick necks. “You buy it in a pharmacy,” said the girl. “No, don’t tell me, you don’t know what a pharmacy is either. Have you ever left Idris in your whole life?” “Yes!” said Jon, possibly Cartwright. “On many demon-hunting missions. And once Mama and Papa took me to the beach in France!” “Amazing,” said the girl. “I mean that. I’m going to explain all of modern medicine to you.” “Please don’t do that, Marisol,” said Jon. “I did not feel good after you explained appendectomies. I couldn’t eat.” Marisol made a face at her plate. “So what you’re saying is, I did you a huge favor.” “I like to eat,” said Jon sadly. “Right,” said Marisol. “So, I don’t explain modern medicine to you, and then a medical emergency occurs to me. It could be solved with the application of a little first aid, but you don’t know that, and so I die. I die at your feet. Is that what you want, Jon?” “No,” said Jon. “What’s first aid? Is there a . . . second aid?” “I can’t believe you’re going to let me die when my death could so easily be avoided, if you had just listened,” Marisol went on mercilessly. “Okay, okay! I’ll listen.” “Great. Get me some juice, because I’ll be talking for a while. I’m still very hurt that you even considered letting me die,” Marisol added as Jon scrambled up and made for the side of the room where the unappetizing food and potentially poisonous drinks were laid out. “I thought Shadowhunters had a mandate to protect mundanes!” Marisol shouted after him. “Not orange juice. I want apple juice!

HT-1 This point is difficult to access, as it is well protected by the structure of the human body. HT-1is a bilateral Vital Point that is located in the armpit at the junction of the inner arm with the torso. It is associated with the Heart Meridian and is the point that the internal aspects of that meridian leaves the inner torso and emerges close to the surface of the skin. It does not have a direct connection to any Extraordinary Vessels, but is highly sensitive to attack. Traditional Chinese Medicine state that this is a no-needle point in many related textbooks. On the surface, this point would appear to be a difficult one to access during an altercation, but it is accessible. HT-1 becomes easily accessible if the opponent’s arm is raised, which occurs in the short instances that they are throwing a punch. A quick finger thrust or one-knuckle fist strike can easily activate it, but it requires a fair amount of precision to land. Combat science teaches us that precision generally diminishes during an altercation, but I add the above variant for those that would be willing to put in the training time for achieve such a strike. Just remember that the likelihood of landing such a technique during an actual altercation is remote, even with copious amounts of practice. A more realistic attack to HT-1 is when you have used your opponent’s arm to take them to the ground. Once established, as a generally rule of thumb, it is advised that if you have established control over an opponent’s arm that you should maintain that control until you deliver a blow that ends the fight. So, with that in mind, one of my favorite attacks to HT-1 after driving an opponent to ground while having established and maintained arm control, that you jerk the arm towards yourself as you throw a kick into this Vital Point. The type of kick will be dependent on the positioning of your opponent. If he is bladed on the ground (laying on one side with the arm you control in the air) a hard side kick or stomp works well. If the opponent starts turning, or squaring his shoulders towards you as he hits the ground in an attempt to regain his feet, then a forceful forward, or straight kick, can work. I would suggest working with a training partner to determine the various configurations that a downed opponent would react when you maintain control of one of their arms. Notice that I did not advise that you kick your training partner in HT-1, which is ill advised since it theoretically can cause disruptions to the heart and according to Traditional Chinese Medicine theory even death. Again, this technique is not for demonstration or sport-oriented martial arts, but mature and thoughtful training practice can provide a wealth of knowledge on how best to attack a Vital Point, even if it is not actually struck.

I’m sympathetic to the idea of drug legalization as a response to this. We made a tragic mistake through the twentieth century in gradually criminalizing drugs that ought to have been dealt with—were being dealt with—medically. We created a profit center for mafias around the world. We stopped considering ways to reduce overdose deaths—studying, for example, how safe injection sites work elsewhere. Among other things, criminalization also prevented us from fully studying these drugs for their medicinal benefits and harms. The problem is, I don’t trust American capitalism to do drug legalization responsibly. The last fifty years are replete with examples of corporations turning addictive services and substances against us, fine-tuning their addictiveness, then marketing them aggressively. Remember when social media was going to be the great technological connective tissue, bringing people together, inaugurating a new era of understanding? Instead, it midwifed an era of virulent tribalism. The opioid epidemic began with legal drugs, irresponsibly marketed and prescribed. The Sacklers are only one example of a tendency that nestles into every corner of American capitalism when it is allowed to extract maximum profit from products and services that neuroscience shows our brains are vulnerable to. Meanwhile, alcohol and cigarettes kill more than any other drug by far, because they are legal and widely available. Alcohol also drives arrests and incarceration more than any other single drug. Our brains are no match for the consumer and marketing culture to emerge in the last few decades. They are certainly no match for the highly potent illegal street drugs now circulating.

Dandelions. The dandelion flower head can change into a white, globular seed head overnight. Each seed has a tiny parachute that allows it to spread far and wide in the wind. The entire plant has medicinal properties. Dandelions are often mistakenly identified as weeds, aggressively removed, but are hard to uproot; the top is pulled but the long taproot remains. Resilience. Resistance. Regeneration. Decentralization. brown, adrienne maree. Emergent Strategy (p. 34). AK Press. Kindle Edition.

Visualize. Here’s a visualization practice my friend and mentor Pia taught me: Find a comfortable chair and sit upright. Take 10 deep breaths, relax your shoulders, and clear your mind. Visualize walking through a forest, or a field of cornstalks, or a lush garden. Visualize coming to an open beach. Hold that scene in your mind’s eye for as long as you can, and see what emerges. Objects or people that emerge from the left represent the past. Those from the right represent the future. Record the images in your journal. Writing helps to consolidate the experience. Do timed automatic writings to quiet your rational mind. See 13. Survive love and loss for directions. Record your dreams in a journal. Note patterns, repetitions, symbols, and archetypes, rather than literal events. Before sleep, invite your subconscious for revelation through dreams. Pay attention to your body’s signals: twinges, goosebumps, or nausea, for example. Intuitive signals tend to be fleeting, whereas signals that represent physical imbalances or disease tend to be longer-lasting. Enlist the gift of hindsight. This can help to correlate images and signs with actual happenings, and decipher between intuition and wishful or fearful thinking. Record these notes into your dream journal, which may be used for all intuition-related reflections. Be patient. Developing intuition is like learning a new language. It takes time, repetition, and practice. Practice humility and trust. Like analytical thinking, intuition isn’t 100 percent accurate 100 percent of the time.

It is common for healthcare professionals to be able to maintain a demanding work schedule, coping well with frequent medical emergencies and tragedies—until something falls apart in their personal lives.

I met Dr. Freeman in 1991 when he came to Harvard to talk to my fellowship program about his New England Journal of Medicine article. With calm deliberation, this tall, elegant physician disrupted my vision of Harlem and other Black communities throughout the United States. He detailed a cascade of health conditions triggered by inadequate facilities, lack of access to health insurance, and a shortage of medical personnel, healthy food, safe neighborhoods, and basic education. He called the problem a national tragedy, an emergency analogous to a hurricane, flood, or other ruinous natural disaster, yet one for which no one was sounding the alarm.

Some of those encounters have impacted me greatly, leaving me with indescribable and unforgettable moments of joy, and other times inflicting emotional wounds that never fully heal.

What applies to art and medicine applies to all people working in every area, argued biologist, philosopher, artist, and art historian C. H. Waddington. In 1972 he wrote in his far-sighted book Biology and the History of the Future, “The acute problems of the world can be solved only by whole men [and women], not by people who refuse to be, publicly, anything more than a technologist, or a pure scientist, or an artist. In the world of today, you have got to be everything or you are going to be nothing.” Buckminster Fuller concurred. In his essay “Emergent Humanity,” he warned that in evolution “overspecialization leads to extinction. We need the philosopher-scientist-artist—the comprehensivist, not merely more deluxe quality technician-mechanics.

From the outset, hydroxychloroquine (HCQ) and other therapeutics posed an existential threat to Dr. Fauci and Bill Gates’ $48 billion COVID vaccine project, and particularly to their vanity drug remdesivir, in which Gates has a large stake.1 Under federal law, new vaccines and medicines cannot quality for Emergency Use Authorization (EUA) if any existing FDA-approved drug proves effective against the same malady:

down, the vital questions are the same: What is your understanding of the situation and its potential outcomes? What are your fears and what are your hopes? What are the trade-offs you are willing to make and not willing to make? And what is the course of action that best serves this understanding? The field of palliative care emerged over recent decades to bring this kind of thinking to the care of dying patients. And the specialty is advancing, bringing the same approach to other seriously ill patients, whether dying or not. This is cause for encouragement. But it is not cause for celebration. That will be warranted only when all clinicians apply such thinking to every person they touch. No separate specialty required. If to be human is to be limited,

Dr. Matthew Steiner, an adventurous ER Physician from Brazil, Indiana, blends a passion for emergency medicine with a love for golf, music, and travel. From fleeing Saigon at 9 to excelling in Ohio, he’s a medical missionary who cherishes helping others globally. Aspiring to continue groundbreaking work in emergency care.

P4 - The good news is that there is at least one emerging technology out there that is looking mighty promising right now: it’s called helium persufflation, and I’m currently orchestrating the funding of the most critical research into making it work. Over the course of 2023 LEV Foundation has coordinated an effort, conceived by Martin O’Dea and Dr. Aubrey de Grey, to lay to rest the lamentable opinion that aging, along with the disease and death it brings, is inevitable - and by extension, that attempts to combat it are unworthy of serious recognition or support. We assert instead that an immediate expansion of work to extend healthy lifespans is not only credible, but indeed crucial to the quality of our collective future. In collaboration with primary author Professor Brian Kennedy, with input and enthusiastic endorsement from iconic researchers and leaders across the field of longevity medicine and allied fields, we are now able to publish the result of that effort - the Dublin Longevity Declaration: Consensus Recommendation to Immediately Expand Research on Extending Healthy Human Lifespans. Whatever your background, we encourage everyone who reads the Declaration and agrees with its message to add your signature, and encourage your friends and colleagues to consider doing the same: www. dublinlongevitydeclaration. org More on all of this here: www. quora. com/profile/Aubrey-de-Grey/answers

Even as I approached the emergency room that first night, my thoughts were the measured, structured thoughts of a physician. I was unable to relate to myself as a patient. Presented with the problem of pain, I responded by listing differential diagnoses and prognosticating for myself. When I found myself dizzy and unable to stand in OB triage, the physician in me perversely enjoyed experiencing shock firsthand. The intensity of my focus on medicine was such that I felt fortunate to have the learning opportunity, to personally engage with the pathophysiology I had studied for so long. I knew I was dying, and I was still awestruck by the science of my decline.

Dr. Evan Leonard is a dedicated clinician, educator, and lifelong learner with a passion for making a difference in the lives of others. With a background in emergency and critical care medicine, Evan has honed his skills as a practitioner and educator, earning recognition for his contributions to the field. As an adjunct professor, he is committed to empowering the next generation of healthcare professionals with the knowledge and skills they need to succeed. Outside of work, Evan enjoys pursuing his diverse interests, from sports to literature and is always eager to engage with others in meaningful ways.

clinical picture

The goal of Look Ahead was to reduce heart disease, a common complication of diabetes. The study, conducted in sixteen clinical centers in the United States, assigned about five thousand adults with type 2 diabetes to either a low-fat diet with intensive lifestyle modification or to usual care. The study, published in the New England Journal of Medicine in 2013,33 was terminated prematurely for “futility.” Analysis by independent statisticians found no reduction of heart disease among participants assigned to the intensive low-fat diet, and no prospect of ever seeing such a benefit emerge.

Far from the cinematic drama of hospital emergency rooms, Slow Medicine embraces the unsung work of daily attention that is the greatest need and firmest foundation for longevity and quality of life at the farthest reach of age. Excellent chronic care attends to the day-to-day needs and conditions of the patient—by offering emotional support and social stimulation, supplying better nutrition, easing chronic skin and nail conditions, and making sleeping, moving, bathing, dressing, and voiding easier. Slow Medicine is the careful practice that most reliably sustains fragile patterns of well-being. This foundation for better elder care strengthens, rather than replaces, the selective use of high-tech care. During the time of the writing of this book, I have lived the

Xenophon tells us that Socrates never neglected the body and did not praise those who did. We can imagine that it was because the physical body—volatile, unseen, and implicated in an automatized natural world—could seem so daemonic that entrusting life, both biological life and ethical life, to its dynamics could seem like ceding control of the human.

Modern biomimicry is far more than just copying nature's shapes. It includes systematic design and problem-solving processes, which are now being refined by scientists and engineers in universities and institutes worldwide. The first step in any of these processes is to clearly define the challenge we're trying to solve. Then we can determine whether the problem is related to form, function, or ecosystem. Next, we ask what plant, animal, or natural process solves a similar problem most effectively. For example, engineers trying to design a camera lens with the widest viewing angle possible found inspiration in the eyes of bees, which can see an incredible five-sixths of the way, or three hundred degrees, around their heads. The process can also work in reverse, where the exceptional strategies of a plant, animal, or ecosystem are recognized and reverse engineered. De Mestral's study of the tenacious grip of burrs on his socks is an early example of reverse engineering a natural winner, while researchers' fascination at the way geckos can hang upside down from the ceiling or climb vertical windows has now resulted in innovative adhesives and bandages. Designs based on biomimicry offer a range of economic benefits. Because nature has carried out trillions of parallel, competitive experiments for millions of years, its successful designs are dramatically more energy efficient than the inventions we've created in the past couple of hundred years. Nature builds only with locally derived materials, so it uses little transport energy. Its designs can be less expensive to manufacture than traditional approaches, because nature doesn't waste materials. For example, the exciting new engineering frontier of nanotechnology mirrors nature's manufacturing principles by building devices one molecule at a time. This means no offcuts or excess. Nature can't afford to poison itself either, so it creates and combines chemicals in a way that is nontoxic to its ecosystems. Green chemistry is a branch of biomimicry that uses this do-no-harm principle, to develop everything from medicines to cleaning products to industrial molecules that are safe by design. Learning from the way nature handles materials also allows one of our companies, PaxFan, to build fans that are smaller and lighter while giving higher performance. Finally, nature has methods to recycle absolutely everything it creates. In natures' closed loop of survival on this planet, everything is a resource and everything is recycled-one of the most fundamental components of sustainability. For all these reasons, as I hear one prominent venture capitalist declare, biomimicry will be the business of the twenty-first century. The global force of this emerging and fascinating field is undeniable and building on all societal levels.

Alternative medicine had begun its remarkable ascent in a general climate of unreason. Incrementally, over the past two decades, we have seen the emergence of a culture that is curiously indifferent to the concept of truth. There is not one truth now, but many—all of them interchangeable, all of them of equal weight, and all deserving of equal consideration. In this Wonderland of relative facts, parallel truths and intellectual legerdemain, basing an argument on flawed reasoning does not automatically disqualify or even devalue it. To the contrary: logical fallacies are tolerated—indeed, often celebrated—as manifestations of a much-needed diversity.

FSM is an emerging technique for treating diverse health conditions. Pairs of frequencies of microampere-level electrical stimulation are applied to particular places on the skin of a patient

the homunculus narrator experiences everything backward—his first memory is Unverdorben’s death. He has no control over Unverdorben’s actions, nor access to his memories, but passively travels through life in reverse order. At first Unverdorben appears to us as a doctor, which strikes the narrator as quite a morbid occupation—patients shuffle into the emergency room, where staff suck medicines out of their bodies and rip off their bandages, sending them out into the night bleeding and screaming. But near the end of the book, we learn that Unverdorben was an assistant at Auschwitz, where he created life where none had been before—turning chemicals and electricity and corpses into living persons. Only now, thinks the narrator, does the world finally make sense.

second major driver of open knowledge has emerged. These are MOOCs (massive open online courses), which broadcast lectures to tens of thousands of people who have an Internet connection and want to sign up.

You need to have a diploma from nursing school and be certified as a registered nurse.             Ideally, you should have at least two to three years of clinical experience as an outpatient nurse or as an emergency room nurse.             You should be certified in Basic Life Support and Advanced Cardiac Life Support (ACLS). Some cruise lines request Advanced Trauma Life Support (ATLS) certification as well.             You may need to have experience in dealing with laboratory procedures and basic x-ray procedures as there is not likely to be a lab tech or x-ray tech on duty.             You should have a background in general medicine and/or emergency medicine.             You should have past experience caring for patients in a trauma, cardiac care, emergency care, or internal medicine practice.             Because cruise liners travel to often to foreign lands and have people of all different cultures on board, you may need to have knowledge of other languages besides English.   As