Medical Records Quotes

Cognitive robotics can integrate information from pre-operation medical records with real-time operating metrics to guide and enhance the precision of physicians’ instruments. By processing data from genuine surgical experiences, they’re able to provide new and improved insights and techniques. These kinds of improvements can improve patient outcomes and boost trust in AI throughout the surgery. Robotics can lead to a 21% reduction in length of stay.

These were times when all were judged squarely and fairly on their musical tastes, and a personal music collection read as private medical records.

If you don't take good care of your credit, then your credit won't take good care of you.

If repairing one's credit is as easy as sending some dispute letters to the credit bureaus then why doesn't everyone have good credit?

Are you willing to accept anything less than the credit you want, the credit you need and the credit you deserve?

And that will be on my medical records for ever. Everyone will always know I’m a nutter. Behavioural problems. I’m just a bloody label… A label written on a white board in a single room without a radio, in a place where everyone else was at least 20 years older than me. Can’t think about it. It’s anger that goes nowhere.

Very often conditions are recorded as observable "under thy fingers" [...] Among such observations it is important to notice that the pulsations of the human heart are observed.

However, The haven-Slocum Theory also points out that this course is not without risk. An even greater number of people dwelling on The Navidson Record have shown an increase in obsessiveness, insomnia, and incoherence: "Most of those who chose to abandon their interest soon recovered. A few, however, required counseling and in some instances medication and hospitalization. Three cases resulted in suicide.

Racism is both overt and covert. It takes two, closely related forms: individual whites acting against individual blacks, and acts by the total white community against the black community. We call these individual racism and institutional racism. The first consists of overt acts by individuals, which cause death, injury or the violent destruction of property. This type can be recorded by television cameras; it can frequently be observed in the process of commission. The second type is less overt, far more subtle, less identifiable in terms of specific individuals committing the acts. But it is no less destructive of human life. The second type originates in the operation of established and respected forces in the society, and thus receives far less public condemnation than the first type. When white terrorists bomb a black church and kill five black children, that is an act of individual racism, widely deplored by most segments of the society. But when in that same city - Birmingham, Alabama - five hundred black babies die each year because of the lack of proper food, shelter and medical facilities, and thousands more are destroyed and maimed physically, emotionally and intellectually because of conditions of poverty and discrimination in the black community, that is a function of institutional racism. When a black family moves into a home in a white neighborhood and is stoned, burned or routed out, they are victims of an overt act of individual racism which many people will condemn - at least in words. But it is institutional racism that keeps black people locked in dilapidated slum tenements, subject to the daily prey of exploitative slumlords, merchants, loan sharks and discriminatory real estate agents. The society either pretends it does not know of this latter situation, or is in fact incapable of doing anything meaningful about it.

Well, how are they going to find you missing?’ Koroviev soothed him, and some papers and ledgers turned up in his hands. ‘By your medical records?’ ‘Yes . . .’ Koroviev flung the medical records into the fireplace. ‘No papers, no person,’ Koroviev said with satisfaction.

It was a Different Time. People were Friendly. We trusted each other. Hell, you could afford to get mixed up with wild strangers in those days -- without fearing for your life, or your eyes, or your organs, or all of your money, or even getting locked up in prison forever. There was a sense of possibility. People were not so afraid, as they are now. You could run around naked without getting shot. You could check into a roadside motel on the outskirts of Ely or Winnemucca or Elko where you were lost in a midnight rainstorm -- and nobody called the police on you, just to check out your credit and your employment history and your medical records and how many parking tickets you owed in California.

In the nineteenth century, girls who learned to develop orgasmic capacity by masturbation were regarded as medical problems. Often they were 'treated' or 'corrected' by amputation or cautery of the clitoris or 'miniature chastity belts,' sewing the vaginal lips together to put the clitoris out of reach, and even castration by surgical removal of the ovaries. But there are no references in the medical literature to the surgical removal of testicles or amputation of the penis to stop masturbation in boys. In the United States, the last recorded clitoridectomy for curing masturbation was performed in 1948-- on a five-year-old girl.

Nick Dawson, a leader of the Society of Participatory Medicine, uses Evernote as his electronic medical record, pulling in data from sensors and sharing with providers or family members.64

Disturbing as it may be, the raw truth is that often enough, the people showing up to your medical emergency do so because this was the only respectable job they could get with a GED and a clean driving record.

At birth, every child was given a Kiyomo Bracelet to wear. Each bead had a purpose—from storing medical records to taking a picture or projecting a free-floating informational screen, much like a web page but suspended in midair.

Mind you, I cannot swear that my story is true. It may have been a dream; or worse, a symptom of some severe mental disorder. But I believe it is true. After all, how are we to know what things there are on earth? Strange monstrosities still exist, and foul, incredible perversions. Every war, each new geographical or scientific discovery, brings to light some new bit of ghastly evidence that the world is not altogether the same place we fondly imagine it to be. Sometimes peculiar incidents occur which hint of utter madness. How can we be sure that our smug conceptions of reality actually exist? To one man in a million dreadful knowledge is revealed, and the rest of us remain mercifully ignorant. There have been travelers who never came back, and research workers who disappeared. Some of those who did return were deemed mad because of what they told, and others sensibly concealed the wisdom that had so horribly been revealed. Blind as we are, we know a little of what lurks beneath our normal life. There have been tales of sea serpents and creatures of the deep; legends of dwarfs and giants; records of queer medical horrors and unnatural births. Stunted nightmares of men's personalities have blossomed into being under the awful stimulus of war, or pestilence, or famine. There have been cannibals, necrophiles, and ghouls; loathsome rites of worship and sacrifice; maniacal murders, and blasphemous crimes. When I think, then, of what I saw and heard, and compare it with certain other grotesque and unbelievable authenticities, I begin to fear for my reason. ("The Mannikin")

From the cover blurb on the University of Wisconsin Press edition, writer unknown: Discussing memoirs, diaries, collaborative narratives, photo documentaries, essays, and other forms of life writing, G. Thomas Couser shows that these books are not primarily records of medical conditions; they are a means for individuals to recover their bodies (or those of loved ones) from marginalization and impersonal medical discourse. Responding to the recent growth of illness and disability narratives in the United States....

Equally worrying, and far less recognized, medicine has been slow to confront the very changes that it has been responsible for—or to apply the knowledge we have about how to make old age better. Although the elderly population is growing rapidly, the number of certified geriatricians the medical profession has put in practice has actually fallen in the United States by 25 percent between 1996 and 2010. Applications to training programs in adult primary care medicine have plummeted, while fields like plastic surgery and radiology receive applications in record numbers. Partly, this has to do with money—incomes in geriatrics and adult primary care are among the lowest in medicine. And partly, whether we admit it or not, a lot of doctors don’t like taking care of the elderly.

I’d come across a strap-on penis. It seemed pretty old and was Band-Aid colored, about three inches long and not much bigger around than a Vienna sausage, which was interesting to me. You’d think that if someone wanted a sex toy she’d go for the gold, sizewise. But this was just the bare minimum, like getting AAA breast implants. Who had this person been hoping to satisfy, her Cabbage Patch doll? I thought about taking the penis home and mailing it to one of my sisters for Christmas but knew that the moment I put it in my knapsack, I’d get hit by a car and killed. That’s just my luck. Medics would come and scrape me off the pavement, then, later, at the hospital, they’d rifle through my pack and record its contents: four garbage bags, some wet wipes, two flashlights, and a strap-on penis.

How to recognize a medical serial killer: • majority of cases take place in a hospital setting • attention-seeking behavior • odd behavior after a patient death or seeming “happy” • disciplinary record • thrill seeker • tendency to predict when a patient will die • frequently moving hospitals • insulin poisoning the most common method

Isn't it sad that we have to gain control of the artificial numbers placed upon us by others to regain some control of our lives?

If I were a real girl, that ‘it’s not you’ thing would be the kiss of death.” Grabbing the second suitcase, Jonah conceded, “Fair enough. For the record, you’re totally a real girl. Woman,” he corrected.

The base doctor had no charts; Cordelia’s medical records were of course all behind enemy lines in Vorbarr Sultana at present. He shook his head and keyed up a new form on his report panel. “I’m sorry, Lady Vorkosigan. We’ll simply have to begin at the beginning. Please bear with me. Do I understand correctly you’ve had some sort of female trouble?” No, most of my troubles have been with males. Cordelia bit her tongue.

Dad worries that the Government will force us to go but it can’t, because it doesn’t know about us. Four of my parents’ seven children don’t have birth certificates. We have no medical records because we were born at home and have never seen a doctor or nurse.* We have no school records because we’ve never set foot in a classroom. When I am nine, I will be issued a Delayed Certificate of Birth, but at this moment, according to the state of Idaho and the federal government, I do not exist.

A Canadian physiologist named Norman Kasting discovered that bleeding animals induces the release of the hormone vasopressin; this reduces their fevers and spurs their immune system into higher gear. The connection isn’t unequivocally proven in humans, but there is much correlation between bloodletting and fever reduction in the historic record. Bleeding also may have helped to fight infection by reducing the amount of iron available to feed an invader, providing an assist to the body’s natural tendency to hide iron when it recognizes an infection.

Big data is based on the feedback economy where the Internet of Things places sensors on more and more equipment. More and more data is being generated as medical records are digitized, more stores have loyalty cards to track consumer purchases, and people are wearing health-tracking devices. Generally, big data is more about looking at behavior, rather than monitoring transactions, which is the domain of traditional relational databases. As the cost of storage is dropping, companies track more and more data to look for patterns and build predictive models".

Our aim for ever must be the pursuit of the knowledge of Man in his entirety. To study the flesh, the skin, the bones, the organs, the nerves of Man, is to equip our minds with a knowledge that will enable us to search beyond the body. The noble profession at whose threshold you stand as neophytes is not an end in itself. The science of Anatomy contributes to the great sum of all Knowledge, which is the Truth: the whole Truth of the Life of Man upon this turning earth. And so: Observe precisely. Record exactly. Neglect nothing. Fear no foe. Never swerve from your purpose. Pay no heed to Safety. For I believe that all men can be happy and that the good life can be led upon this earth. I believe that all men must work towards that end. And I believe that that end justifies any means…. Let no scruples stand in the way of the progress of medical science!

To my thinking the greatest advance in recorded medical history is the thirty-minute walk before breakfast. Premiums for life insurance are usually paid for the benefit of someone else. If you want any life insurance for yourself you had better pay the daily premium of a thirty-minute walk.

Destroyed, that is, were not only men, women and thousands of children but also restaurants and inns, laundries, theater groups, sports clubs, sewing clubs, boys’ clubs, girls’ clubs, love affairs, trees and gardens, grass, gates, gravestones, temples and shrines, family heirlooms, radios, classmates, books, courts of law, clothes, pets, groceries and markets, telephones, personal letters, automobiles, bicycles, horses—120 war-horses—musical instruments, medicines and medical equipment, life savings, eyeglasses, city records, sidewalks, family scrapbooks, monuments, engagements, marriages, employees, clocks and watches, public transportation, street signs, parents, works of art. “The whole of society,” concludes the Japanese study, “was laid waste to its very foundations.”2698 Lifton’s history professor saw not even foundations left. “Such a weapon,” he told the American psychiatrist, “has the power to make everything into nothing.

Let’s talk about you. What do you think about? What do you want? What do you see around you?” “Why do you want to talk about that?” “Because, Kyle, I have been surrounded with all kinds of human beings-smart, stupid, pragmatic, dogmatic, generous, selfish, far-seeing, short-sighted, insightful, thoughtless, emotional, tone-deaf, passionate, detatched-but never anyone quite like you. I’m curious about you.” I thought about it. “A lot of people are curious about me. When I was little, the doctors ran all kinds of tests. Until Mom told them I’m not an experiment and they had to stop.” “I know you’re not. I looked up your medical records. Their diagnoses were more about explaining the way you are than understanding who you are.

In all cases, life had already ceased for the patient. In fact, life had ceased before the code started. That was the time when the patient had stopped breathing or the heart had stopped beating. That was when the patient had really died. Yet we officially record the time of death as the moment when we adjourn our battle, not the moment the cells have adjourned theirs.

From almost every standpoint ethyl alcohol must be regarded as the most important poison with which medical men and jurists have to deal,” Gettler wrote in a paper, listing a seemingly endless record of fatalities. “No other poison causes so many deaths or leads to or intensifies so many diseases, both physical and mental, as does [this] alcohol in the many forms in which it is taken.

The DSMs have a mixed record. They have served an extremely valuable function in improving the reliability of psychiatric diagnosis and in encouraging a revolution in psychiatric research. But they have also had the very harmful unintended consequence of triggering and helping to maintain a runaway diagnostic inflation that threatens normal and results in massive overtreatment with psychiatric medication.

to be recorded as they were under normal circumstances. Just beyond the public areas lay a sprawling multifloor substructure of 153 classified rooms, including a massive power plant, medical clinic, dentist’s office, a 400-seat cafeteria, laundry facilities, three 25,000-gallon water tanks, and three 14,000-gallon fuel tanks, as well as a two-story communication facility for incoming and outgoing messages.

A despatch from California describes a theosophist colony as donning white robes en masse for some “glorious fulfilment” which never arrives, whilst items from India speak guardedly of serious native unrest toward the end of March. Voodoo orgies multiply in Hayti, and African outposts report ominous mutterings. American officers in the Philippines find certain tribes bothersome about this time, and New York policemen are mobbed by hysterical Levantines on the night of March 22–23. The west of Ireland, too, is full of wild rumour and legendry, and a fantastic painter named Ardois-Bonnot hangs a blasphemous “Dream Landscape” in the Paris spring salon of 1926. And so numerous are the recorded troubles in insane asylums, that only a miracle can have stopped the medical fraternity from noting strange parallelisms and drawing mystified conclusions.

It is necessary to make this point in answer to the `iatrogenic' theory that the unveiling of repressed memories in MPD sufferers, paranoids and schizophrenics can be created in analysis; a fabrication of the doctor—patient relationship. According to Dr Ross, this theory, a sort of psychiatric ping-pong 'has never been stated in print in a complete and clearly argued way'. My case endorses Dr Ross's assertions. My memories were coming back to me in fragments and flashbacks long before I began therapy. Indications of that abuse, ritual or otherwise, can be found in my medical records and in notebooks and poems dating back before Adele Armstrong and Jo Lewin entered my life. There have been a number of cases in recent years where the police have charged groups of people with subjecting children to so-called satanic or ritual abuse in paedophile rings. Few cases result in a conviction. But that is not proof that the abuse didn't take place, and the police must have been very certain of the evidence to have brought the cases to court in the first place. The abuse happens. I know it happens. Girls in psychiatric units don't always talk to the shrinks, but they need to talk and they talk to each other. As a child I had been taken to see Dr Bradshaw on countless occasions; it was in his surgery that Billy had first discovered Lego. As I was growing up, I also saw Dr Robinson, the marathon runner. Now that I was living back at home, he was again my GP. When Mother bravely told him I was undergoing treatment for MPD/DID as a result of childhood sexual abuse, he buried his head in hands and wept. (Alice refers to her constant infections as a child, which were never recognised as caused by sexual abuse)

The few cures we have recorded could be multiplied many times over, many of them experienced by people who had failed to find relief through conventional medical treatment. If a story from Scotland is to be believed, the success of one holy well, St. Drostan's at Newdosk (Angus), was so distasteful to the local doctors that they decided to poison the well. When the people heard of their intention, they banded together to attack and kill the doctors!

And he carefully stored what he considered the most vital piece of equipment: a satellite phone with solar-powered batteries, which would allow the men not only to record short audio dispatches but also to check in every day with an ALE operator and report their coordinates and medical condition. If the team failed to communicate for two consecutive days, ALE would dispatch a search-and-rescue plane—what Worsley called “the most expensive taxi ride in the world.

Distraction leaches the authenticity out of our communications. When we are not emotionally present, we are gliding over the surface of our interactions and we never tangle in the depths where the nuances of our skills are tested and refined. A medical professor describes the easy familiarity with which her digital-native resident students master medical electronic records—but is troubled by the fact that they enter data with their eyes focused on their digital devices, not on the patient in the room with them. Preoccupation with technology acts as a screen between the student and the patient’s real emotion, real fear, and real concern. It may also prevent these residents from noticing physical symptoms that the patient fails to mention. The easy busyness of medical record entry is a way to sidestep the more challenging dynamics of human connection. But experienced physicians know that interpersonal skills are essential to mastering the art and science of medical diagnosis.

Many coroners are licensed physicians who have no training in forensics, while in hundreds of communities across the country—including Marin County—the coroner isn’t required to have any medical training at all, much less a medical degree. He or she just needs to have a clean record, meaning no felony convictions, be twenty-one or older, and have a high school diploma. Some counties don’t even require that, however. One county in Indiana elected a coroner who was eighteen and still in high school.

BEFORE I GO,” she shouted, “I THOUGHT YOU’D BE INTERESTED TO HEAR—” She held up her hands to quiet the audience. “Does anyone remember a Mrs. George Fillis—the woman who had the audacity to tell us she wanted to become a heart surgeon?” She reached into her apron pocket and pulled out a letter. “I have an update. It seems that Mrs. Fillis has not only completed her premed studies in record time but has also been accepted to medical school. Congratulations Mrs. George—no, I’m sorry—Marjorie Fillis. We never doubted you for a second.

We can’t allow ourselves to be used in this way, to be used against the future. We can’t permit our data to be used to sell us the very things that must not be sold, such as journalism. If we do, the journalism we get will be merely the journalism we want, or the journalism that the powerful want us to have, not the honest collective conversation that’s necessary. We can’t let the godlike surveillance we’re under be used to “calculate” our citizenship scores, or to “predict” our criminal activity; to tell us what kind of education we can have, or what kind of job we can have, or whether we can have an education or a job at all; to discriminate against us based on our financial, legal, and medical histories, not to mention our ethnicity or race, which are constructs that data often assumes or imposes. And as for our most intimate data, our genetic information: if we allow it to be used to identify us, then it will be used to victimize us, even to modify us—to remake the very essence of our humanity in the image of the technology that seeks its control. Of course, all of the above has already happened.

Templates for Protest Letters 1. TO TACKLE A SURPRISE OUT-OF-NETWORK BILL Dear Sir or Madam: The bills enclosed were for out-of-network services performed on __________ during my admission to __________ Medical Center, a hospital that is in my insurance network. I went to __________ Medical Center precisely because it was in my network. I was not informed of these providers’ out-of-network status and did not consent to being treated by any out-of-network providers. Since I did not give informed consent for treatment beyond the terms and network of my insurance policy, I suggest you contact my insurer to work out payment; I will pay only that portion of the bill that I would have paid for in-network services. Please stop this effort to collect a bill I do not owe for a service I was never informed would be out-of-network. If I get another notice, I will report this collection effort to the __________ State Department of Insurance and __________ State Department of Consumer Affairs. Sincerely, 2. TO OBTAIN MEDICAL RECORDS AND ITEMIZED BILLS Dear Sirs or Madam: I have now requested my medical records/itemized bill __________ times and have yet to receive the material. It is my right to receive these

One year later the society claimed victory in another case which again did not fit within the parameters of the syndrome, nor did the court find on the issue. Fiona Reay, a 33 year old care assistant, accused her father of systematic sexual abuse during her childhood. The facts of her childhood were not in dispute: she had run away from home on a number of occasions and there was evidence that she had never been enrolled in secondary school. Her father said it was because she was ‘young and stupid’. He had physically assaulted Fiona on a number of occasions, one of which occurred when she was sixteen. The police had been called to the house by her boyfriend; after he had dropped her home, he heard her screaming as her father beat her with a dog chain. As before there was no evidence of repression of memory in this case. Fiona Reay had been telling the same story to different health professionals for years. Her medical records document her consistent reference to family problems from the age of 14. She finally made a clear statement in 1982 when she asked a gynaecologist if her need for a hysterectomy could be related to the fact that she had been sexually abused by her father. Five years later she was admitted to psychiatric hospital stating that one of the precipitant factors causing her breakdown had been an unexpected visit from her father. She found him stroking her daughter. There had been no therapy, no regression and no hypnosis prior to the allegations being made public. The jury took 27 minutes to find Fiona Reay’s father not guilty of rape and indecent assault. As before, the court did not hear evidence from expert witnesses stating that Fiona was suffering from false memory syndrome. The only suggestion of this was by the defence counsel, Toby Hed­worth. In his closing remarks he referred to the ‘worrying phenomenon of people coming to believe in phantom memories’. The next case which was claimed as a triumph for false memory was heard in March 1995. A father was aquitted of raping his daughter. The claims of the BFMS followed the familiar pattern of not fitting within the parameters of false memory at all. The daughter made the allegations to staff members whom she had befriended during her stay in psychiatric hospital. As before there was no evidence of memory repression or recovery during therapy and again the case failed due to lack of corrobo­rating evidence. Yet the society picked up on the defence solicitor’s statements that the daughter was a prone to ‘fantasise’ about sexual matters and had been sexually promiscuous with other patients in the hospital. ~ Trouble and Strife, Issues 37-43

Romanians, however, paid a terrible price for Ceauşescu’s privileged status. In 1966, to increase the population—a traditional ‘Romanianist’ obsession—he prohibited abortion for women under forty with fewer than four children (in 1986 the age barrier was raised to forty-five). In 1984 the minimum marriage age for women was reduced to fifteen. Compulsory monthly medical examinations for all women of childbearing age were introduced to prevent abortions, which were permitted, if at all, only in the presence of a Party representative. Doctors in districts with a declining birth rate had their salaries cut. The population did not increase, but the death rate from abortions far exceeded that of any other European country: as the only available form of birth control, illegal abortions were widely performed, often under the most appalling and dangerous conditions. Over the ensuing twenty-three years the 1966 law resulted in the death of at least ten thousand women. The real infant mortality rate was so high that after 1985 births were not officially recorded until a child had survived to its fourth week—the apotheosis of Communist control of knowledge. By the time Ceauşescu was overthrown the death rate of new-born babies was twenty-five per thousand and there were upward of 100,000 institutionalized children. The

[...] He also used his medical practice as a source of experimental data, but was not above using himself as a test subject. There is something so wonderful - and more than a little ironic - in this image of Snow the teetotaler, arguably the finest medical mind of his generation, performing his research. He sits alone in his cluttered flat, frogs croaking around him, illuminated only by candlelight. After a few minutes tinkering with his latest experimental inhaler, he fastens the mouthpiece over his face and releases the gas. Within seconds, his head hits the desk. Then, minutes later, he wakes, consults his watch through blurred vision. He reaches for his pen, and starts recording the data.

I have not attempted to cover all aspects of the ethics of in vitro fertilization and embryo experimentation. To do that, it would be necessary to investigate several other issues, including the appropriateness of allocating scarce medical resources to this area at a time when the world has a serious problem of overpopulation. Further uses of IVF, such as donating or selling embryos to others, employing a surrogate to bear the child, using IVF to enable older women to have children (in 2008, a 70-year-old Indian woman used the technique to become the oldest woman reliably recorded as having had a child), or selecting from among a number of embryos for the one that meets some criteria of genetic desirability, raise separate ethical issues.

During a staff debriefing, doctors and doctors-to-be explored the Hippocratic Oath, again, the one about not doing harm. Supporters apparently argue, “What’s the point of causing more suffering in this situation, when soothing is so readily available (for the survivors, that is)?” Of course, this is a personal opinion, a value judgement not necessarily shared by all medical professionals. For the record, I personally doubted the doctor’s choice, despite the circumstances, and wonder whether it was right to lie to the survivors, in the Grandest Scheme of the Cosmos. I can imagine myself responding to an order like “Tell me he died peacefully” with something more akin to “I’m so sorry, but I can’t,” and cross the subsequent bridges accordingly.

At the same time that he was devising a response to the Afghanistan incursion, Carter had to confront a much more acute crisis in Iran, where he had brought the greatest disaster of his presidency down upon himself. In November 1977, he welcomed the shah of Iran to the White House, and on New Year’s Eve in Tehran, raising his glass, he toasted the ruler. Though the shah was sustained in power by a vicious secret police force, Carter praised him as a champion of “the cause of human rights” who had earned “the admiration and love” of the Iranian people. Little more than a year later, his subjects, no longer willing to be governed by a monarch imposed on them by the CIA, drove the shah into exile. Critically ill, he sought medical treatment in the United States. Secretary of State Cyrus Vance warned that admitting him could have repercussions in Iran, and Carter hesitated. But under pressure from David Rockefeller, Henry Kissinger, and the head of the National Security Council, Zbigniew Brzezinski, he caved in. Shortly after the deposed shah entered the Mayo Clinic, three thousand Islamic militants stormed the US embassy compound in Tehran and seized more than fifty diplomats and soldiers. They paraded blindfolded US Marine guards, hands tied behind their backs, through the streets of Tehran while mobs chanted, “Death to Carter, Death to the Shah,” as they spat upon the American flag and burned effigies of the president—scenes recorded on camera that Americans found painful to witness.

Probability theory naturally comes into play in what we shall call situation 1: When the data-point can be considered to be generated by some randomizing device, for example when throwing dice, flipping coins, or randomly allocating an individual to a medical treatment using a pseudo-random-number generator, and then recording the outcomes of their treatment. But in practice we may be faced with situation 2: When a pre-existing data-point is chosen by a randomizing device, say when selecting people to take part in a survey. And much of the time our data arises from situation 3: When there is no randomness at all, but we act as if the data-point were in fact generated by some random process, for example in interpreting the birth weight of our friend’s baby.

but the poor boy is in a fair way to becoming an alto, a counter-tenor for life.’ ‘Hoot,’ said Graham, grinning still. ‘Does the swelling affect the vocal cords?’ ‘The back of my hand to the vocal cords,’ said Stephen. ‘Have you not heard of orchitis? Of the swelling of the cods that may follow mumps?’ ‘Not I,’ said Graham, his smile fading. ‘Nor had my messmates,’ said Stephen, ‘though the Dear knows it is one of the not unusual sequelae of cynanche parotidaea, and one of real consequence to men. Yet to be sure there is something to be said in its favour, as a more humane way of providing castrati for our choirs and operas.’ ‘Does it indeed emasculate?’ cried Graham. ‘Certainly. But be reassured: that is the utmost limit of its malignance. I do not believe that medical history records any fatal issue – a benign distemper, compared with many I could name. Yet Lord, how concerned my shipmates were, when I told them, for surprisingly few seem to have had the disease in youth – ’ ‘I did not,’ said Graham, unheard. ‘Such anxiety!’ said Stephen, smiling at the recollection. ‘Such uneasiness of mind! One might have supposed it was a question of the bubonic plague. I urged them to consider how very little time was really spent in coition, but it had no effect. I spoke of the eunuch’s tranquillity and peace of mind, his unimpaired intellectual powers – I cited Narses and Hermias. I urged them to reflect that a marriage of minds was far more significant than mere carnal copulation. I might have saved my breath: one could almost have supposed that seamen lived for the act of love.

As soon as the hijackers’ names had been publicly released, Acxiom had searched its massive data banks, which take up five acres in tiny Conway, Arkansas. And it had found some very interesting data on the perpetrators of the attacks. In fact, it turned out, Acxiom knew more about eleven of the nineteen hijackers than the entire U.S. government did—including their past and current addresses and the names of their housemates. We may never know what was in the files Acxiom gave the government (though one of the executives told a reporter that Acxiom’s information had led to deportations and indictments). But here’s what Acxiom knows about 96 percent of American households and half a billion people worldwide: the names of their family members, their current and past addresses, how often they pay their credit card bills whether they own a dog or a cat (and what breed it is), whether they are right-handed or left-handed, what kinds of medication they use (based on pharmacy records) … the list of data points is about 1,500 items long.

Yet there is dynamism in our house. Day to day, week to week, Cady blossoms: a first grasp, a first smile, a first laugh. Her pediatrician regularly records her growth on charts, tick marks indicating her progress over time. A brightening newness surrounds her. As she sits in my lap smiling, enthralled by my tuneless singing, an incandescence lights the room. Time for me is now double-edged: every day brings me further from the low of my last relapse but closer to the next recurrence—and, eventually, death. Perhaps later than I think, but certainly sooner than I desire. There are, I imagine, two responses to that realization. The most obvious might be an impulse to frantic activity: to “live life to its fullest,” to travel, to dine, to achieve a host of neglected ambitions. Part of the cruelty of cancer, though, is not only that it limits your time; it also limits your energy, vastly reducing the amount you can squeeze into a day. It is a tired hare who now races. And even if I had the energy, I prefer a more tortoiselike approach. I plod, I ponder. Some days, I simply persist. If time dilates when one moves at high speeds, does it contract when one moves barely at all? It must: the days have shortened considerably. With little to distinguish one day from the next, time has begun to feel static. In English, we use the word time in different ways: “The time is two forty-five” versus “I’m going through a tough time.” These days, time feels less like the ticking clock and more like a state of being. Languor settles in. There’s a feeling of openness. As a surgeon, focused on a patient in the OR, I might have found the position of the clock’s hands arbitrary, but I never thought them meaningless. Now the time of day means nothing, the day of the week scarcely more. Medical training is relentlessly future-oriented, all about delayed gratification; you’re always thinking about what you’ll be doing five years down the line. But now I don’t know what I’ll be doing five years down the line. I may be dead. I may not be. I may be healthy. I may be writing. I don't know. And so it's not all that useful to spend time thinking about the future - that is, beyond lunch.

We could have dramatically reduced COVID fatalities and hospitalizations using early treatment protocols and repurposed drugs including ivermectin and hydroxychloroquine and many, many others.” Dr. McCullough has treated some 2,000 COVID patients with these therapies. McCullough points out that hundreds of peer-reviewed studies now show that early treatment could have averted some 80 percent of deaths attributed to COVID. “The strategy from the outset should have been implementing protocols to stop hospitalizations through early treatment of Americans who tested positive for COVID but were still asymptomatic. If we had done that, we could have pushed case fatality rates below those we see with seasonal flu, and ended the bottlenecks in our hospitals. We should have rapidly deployed off-the-shelf medications with proven safety records and subjected them to rigorous risk/benefit decision-making,” McCullough continues. “Using repurposed drugs, we could have ended this pandemic by May 2020 and saved 500,000 American lives, but for Dr. Fauci’s hard-headed, tunnel vision on new vaccines and remdesivir.

McCullough observes that, “We could have dramatically reduced COVID fatalities and hospitalizations using early treatment protocols and repurposed drugs including ivermectin and hydroxychloroquine and many, many others.” Dr. McCullough has treated some 2,000 COVID patients with these therapies. McCullough points out that hundreds of peer-reviewed studies now show that early treatment could have averted some 80 percent of deaths attributed to COVID. “The strategy from the outset should have been implementing protocols to stop hospitalizations through early treatment of Americans who tested positive for COVID but were still asymptomatic. If we had done that, we could have pushed case fatality rates below those we see with seasonal flu, and ended the bottlenecks in our hospitals. We should have rapidly deployed off-the-shelf medications with proven safety records and subjected them to rigorous risk/benefit decision-making,” McCullough continues. “Using repurposed drugs, we could have ended this pandemic by May 2020 and saved 500,000 American lives, but for Dr. Fauci’s hard-headed, tunnel vision on new vaccines and remdesivir.

Give us an idea of…” Noya Baram rubs her temples. “Oh, well.” Augie begins to stroll around again. “The examples are limitless. Small examples: elevators stop working. Grocery-store scanners. Train and bus passes. Televisions. Phones. Radios. Traffic lights. Credit-card scanners. Home alarm systems. Laptop computers will lose all their software, all files, everything erased. Your computer will be nothing but a keyboard and a blank screen. “Electricity would be severely compromised. Which means refrigerators. In some cases, heat. Water—well, we have already seen the effect on water-purification plants. Clean water in America will quickly become a scarcity. “That means health problems on a massive scale. Who will care for the sick? Hospitals? Will they have the necessary resources to treat you? Surgical operations these days are highly computerized. And they will not have access to any of your prior medical records online. “For that matter, will they treat you at all? Do you have health insurance? Says who? A card in your pocket? They won’t be able to look you up and confirm it. Nor will they be able to seek reimbursement from the insurer. And even if they could get in contact with the insurance company, the insurance company won’t know whether you’re its customer. Does it have handwritten lists of its policyholders? No. It’s all on computers. Computers that have been erased. Will the hospitals work for free? “No websites, of course. No e-commerce. Conveyor belts. Sophisticated machinery inside manufacturing plants. Payroll records. “Planes will be grounded. Even trains may not operate in most places. Cars, at least any built since, oh, 2010 or so, will be affected. “Legal records. Welfare records. Law enforcement databases. The ability of local police to identify criminals, to coordinate with other states and the federal government through databases—no more. “Bank records. You think you have ten thousand dollars in your savings account? Fifty thousand dollars in a retirement account? You think you have a pension that allows you to receive a fixed payment every month?” He shakes his head. “Not if computer files and their backups are erased. Do banks have a large wad of cash, wrapped in a rubber band with your name on it, sitting in a vault somewhere? Of course not. It’s all data.” “Mother of God,” says Chancellor Richter, wiping his face with a handkerchief.

Reviewing the records of two million recruits, Feyrer and his colleagues also checked the natural iodine levels in their hometowns. Nationwide, the researchers found, the introduction of iodine raised the average IQ by an estimated 3.5 points. And in the parts of the country where natural iodine levels were lowest, Feyrer and his colleagues estimated that scores leaped 15 points. It may be hard to believe that such a straightforward change in people’s diets could have such a tremendous effect on intelligence. But as public health workers continue to bring iodine to more of the world, the same jumps happen. In 1990, Robert DeLong, an expert on iodine at Duke University, traveled to the Taklamakan Desert in western China. The region has extremely low levels of iodine in the soil, and the people in the region have resisted attempts to introduce iodized salt. It didn’t help that the people of the region, the Uyghurs, distrusted the government in Beijing. Rumors spread that government-issued iodized salt had contraceptives in it, as a way to wipe out the community. DeLong and his Chinese medical colleagues approached local officials with a different idea: They would put iodine in the irrigation canals. Crops would absorb it in their water, and people in the Taklamakan region would eat it in their food. The officials agreed to the plan, and when DeLong later gave children from the region IQ tests, their average score jumped 16 points.

Hardy reinforces his narrative with stories of heroes who didn’t have the right education, the right connections, and who could have been counted out early as not having the DNA for success: “Richard Branson has dyslexia and had poor academic performance as a student. Steve Jobs was born to two college students who didn’t want to raise him and gave him up for adoption. Mark Cuban was born to an automobile upholsterer. He started as a bartender, then got a job in software sales from which he was fired.”8 The list goes on. Hardy reminds his readers that “Suze Orman’s dad was a chicken farmer. Retired General Colin Powell was a solid C student. Howard Schultz, the CEO of Starbucks, was born in a housing authority in the Bronx … Barbara Corcoran started as a waitress and admits to being fired from more jobs than most people hold in a lifetime. Pete Cashmore, the CEO of Mashable, was sickly as a child and finished high school two years late due to medical complications. He never went to college.” What do each of these inspiring leaders and storytellers have in common? They rewrote their own internal narratives and found great success. “The biographies of all heroes contain common elements. Becoming one is the most important,”9 writes Chris Matthews in Jack Kennedy, Elusive Hero. Matthews reminds his readers that young John F. Kennedy was a sickly child and bedridden for much of his youth. And what did he do while setting school records for being in the infirmary? He read voraciously. He read the stories of heroes in the pages of books by Sir Walter Scott and the tales of King Arthur. He read, and dreamed of playing the hero in the story of his life. When the time came to take the stage, Jack was ready.

Sometimes Partridge imagines that this isn't real, that, instead, it's just some elaborate reenactment of destruction, not the actual destruction itself. He remembers once being in a museum on a class trip. There were miniature displays with live actors in various wings, talking about what things were like before the Return of Civility. Each display was dedicated to a theme: before the impressive prison system was built, before difficult children were properly medicated, when feminism didn't encourage femininity, when the media was hostile to government instead of working toward a greater good, before people with dangerous ideas were properly identified, back when government had to ask permission to protect its good citizens from the evils of the world and from the evils among us, before the gates had gone up around neighborhoods with buzzer systems and friendly men at gatehouses who knew everyone by name. In the heat of the day, there were battle reenactments on the museum's wide lawn that showed the uprisings waged in certain cities against the Return of Civility and its legislation. With the military behind the government, the uprisings - usually political demonstrations that became violent - were easily tamped down. The government's domestic militia, the Righteous Red Wave, came to save the day. The recorded sounds were deafening, Uzis and attack sirens pouring from speakers. The kids in his class bought bullhorns, very realistic hand grenades, and Righteous Red Wave iron-on emblems in the gift shop. He wanted a sticker that read THE RETURN OF CIVILITY - THE BEST KIND OF FREEDOM written over a rippling American flag, with the words REMAIN VIGILANT written beneath it. But his mother hadn't given him money for the gift shop, no wonder. Of coarse, he knew now that the museum was propaganda.

As Dr. Fauci’s policies took hold globally, 300 million humans fell into dire poverty, food insecurity, and starvation. “Globally, the impact of lockdowns on health programs, food production, and supply chains plunged millions of people into severe hunger and malnutrition,” said Alex Gutentag in Tablet Magazine.27 According to the Associated Press (AP), during 2020, 10,000 children died each month due to virus-linked hunger from global lockdowns. In addition, 500,000 children per month experienced wasting and stunting from malnutrition—up 6.7 million from last year’s total of 47 million—which can “permanently damage children physically and mentally, transforming individual tragedies into a generational catastrophe.”28 In 2020, disruptions to health and nutrition services killed 228,000 children in South Asia.29 Deferred medical treatments for cancers, kidney failure, and diabetes killed hundreds of thousands of people and created epidemics of cardiovascular disease and undiagnosed cancer. Unemployment shock is expected to cause 890,000 additional deaths over the next 15 years.30,31 The lockdown disintegrated vital food chains, dramatically increased rates of child abuse, suicide, addiction, alcoholism, obesity, mental illness, as well as debilitating developmental delays, isolation, depression, and severe educational deficits in young children. One-third of teens and young adults reported worsening mental health during the pandemic. According to an Ohio State University study,32 suicide rates among children rose 50 percent.33 An August 11, 2021 study by Brown University found that infants born during the quarantine were short, on average, 22 IQ points as measured by Baylor scale tests.34 Some 93,000 Americans died of overdoses in 2020—a 30 percent rise over 2019.35 “Overdoses from synthetic opioids increased by 38.4 percent,36 and 11 percent of US adults considered suicide in June 2020.37 Three million children disappeared from public school systems, and ERs saw a 31 percent increase in adolescent mental health visits,”38,39 according to Gutentag. Record numbers of young children failed to reach crucial developmental milestones.40,41 Millions of hospital and nursing home patients died alone without comfort or a final goodbye from their families. Dr. Fauci admitted that he never assessed the costs of desolation, poverty, unhealthy isolation, and depression fostered by his countermeasures. “I don’t give advice about economic things,”42 Dr. Fauci explained. “I don’t give advice about anything other than public health,” he continued, even though he was so clearly among those responsible for the economic and social costs.

In the future that globalists and feminists have imagined, for most of us there will only be more clerkdom and masturbation. There will only be more apologizing, more submission, more asking for permission to be men. There will only be more examinations, more certifications, mandatory prerequisites, screening processes, background checks, personality tests, and politicized diagnoses. There will only be more medication. There will be more presenting the secretary with a cup of your own warm urine. There will be mandatory morning stretches and video safety presentations and sign-off sheets for your file. There will be more helmets and goggles and harnesses and bright orange vests with reflective tape. There can only be more counseling and sensitivity training. There will be more administrative hoops to jump through to start your own business and keep it running. There will be more mandatory insurance policies. There will definitely be more taxes. There will probably be more Byzantine sexual harassment laws and corporate policies and more ways for women and protected identity groups to accuse you of misconduct. There will be more micro-managed living, pettier regulations, heavier fines, and harsher penalties. There will be more ways to run afoul of the law and more ways for society to maintain its pleasant illusions by sweeping you under the rug. In 2009 there were almost five times more men either on parole or serving prison terms in the United States than were actively serving in all of the armed forces.[64] If you’re a good boy and you follow the rules, if you learn how to speak passively and inoffensively, if you can convince some other poor sleepwalking sap that you are possessed with an almost unhealthy desire to provide outstanding customer service or increase operational efficiency through the improvement of internal processes and effective organizational communication, if you can say stupid shit like that without laughing, if your record checks out and your pee smells right—you can get yourself a J-O-B. Maybe you can be the guy who administers the test or authorizes the insurance policy. Maybe you can be the guy who helps make some soulless global corporation a little more money. Maybe you can get a pat on the head for coming up with the bright idea to put a bunch of other guys out of work and outsource their boring jobs to guys in some other place who are willing to work longer hours for less money. Whatever you do, no matter what people say, no matter how many team-building activities you attend or how many birthday cards you get from someone’s secretary, you will know that you are a completely replaceable unit of labor in the big scheme of things.

Astonishment: these women’s military professions—medical assistant, sniper, machine gunner, commander of an antiaircraft gun, sapper—and now they are accountants, lab technicians, museum guides, teachers…Discrepancy of the roles—here and there. Their memories are as if not about themselves, but some other girls. Now they are surprised at themselves. Before my eyes history “humanizes” itself, becomes like ordinary life. Acquires a different lighting. I’ve happened upon extraordinary storytellers. There are pages in their lives that can rival the best pages of the classics. The person sees herself so clearly from above—from heaven, and from below—from the ground. Before her is the whole path—up and down—from angel to beast. Remembering is not a passionate or dispassionate retelling of a reality that is no more, but a new birth of the past, when time goes in reverse. Above all it is creativity. As they narrate, people create, they “write” their life. Sometimes they also “write up” or “rewrite.” Here you have to be vigilant. On your guard. At the same time pain melts and destroys any falsehood. The temperature is too high! Simple people—nurses, cooks, laundresses—behave more sincerely, I became convinced of that…They, how shall I put it exactly, draw the words out of themselves and not from newspapers and books they have read—not from others. But only from their own sufferings and experiences. The feelings and language of educated people, strange as it may be, are often more subject to the working of time. Its general encrypting. They are infected by secondary knowledge. By myths. Often I have to go for a long time, by various roundabout ways, in order to hear a story of a “woman’s,” not a “man’s” war: not about how we retreated, how we advanced, at which sector of the front…It takes not one meeting, but many sessions. Like a persistent portrait painter. I sit for a long time, sometimes a whole day, in an unknown house or apartment. We drink tea, try on the recently bought blouses, discuss hairstyles and recipes. Look at photos of the grandchildren together. And then…After a certain time, you never know when or why, suddenly comes this long-awaited moment, when the person departs from the canon—plaster and reinforced concrete, like our monuments—and goes on to herself. Into herself. Begins to remember not the war but her youth. A piece of her life…I must seize that moment. Not miss it! But often, after a long day, filled with words, facts, tears, only one phrase remains in my memory (but what a phrase!): “I was so young when I left for the front, I even grew during the war.” I keep it in my notebook, although I have dozens of yards of tape in my tape recorder. Four or five cassettes… What helps me? That we are used to living together. Communally. We are communal people. With us everything is in common—both happiness and tears. We know how to suffer and how to tell about our suffering. Suffering justifies our hard and ungainly life.

As it turned out, Mary Jo White and other attorneys for the Sacklers and Purdue had been quietly negotiating with the Trump administration for months. Inside the DOJ, the line prosecutors who had assembled both the civil and the criminal cases started to experience tremendous pressure from the political leadership to wrap up their investigations of Purdue and the Sacklers prior to the 2020 presidential election in November. A decision had been made at high levels of the Trump administration that this matter would be resolved quickly and with a soft touch. Some of the career attorneys at Justice were deeply unhappy with this move, so much so that they wrote confidential memos registering their objections, to preserve a record of what they believed to be a miscarriage of justice. One morning two weeks before the election, Jeffrey Rosen, the deputy attorney general for the Trump administration, convened a press conference in which he announced a “global resolution” of the federal investigations into Purdue and the Sacklers. The company was pleading guilty to conspiracy to defraud the United States and to violate the Food, Drug, and Cosmetic Act, as well as to two counts of conspiracy to violate the federal Anti-kickback Statute, Rosen announced. No executives would face individual charges. In fact, no individual executives were mentioned at all: it was as if the corporation had acted autonomously, like a driverless car. (In depositions related to Purdue’s bankruptcy which were held after the DOJ settlement, two former CEOs, John Stewart and Mark Timney, both declined to answer questions, invoking their Fifth Amendment right not to incriminate themselves.) Rosen touted the total value of the federal penalties against Purdue as “more than $8 billion.” And, in keeping with what had by now become a standard pattern, the press obligingly repeated that number in the headlines. Of course, anyone who was paying attention knew that the total value of Purdue’s cash and assets was only around $1 billion, and nobody was suggesting that the Sacklers would be on the hook to pay Purdue’s fines. So the $8 billion figure was misleading, much as the $10–$12 billion estimate of the value of the Sacklers’ settlement proposal had been misleading—an artificial number without any real practical meaning, designed chiefly to be reproduced in headlines. As for the Sacklers, Rosen announced that they had agreed to pay $225 million to resolve a separate civil charge that they had violated the False Claims Act. According to the investigation, Richard, David, Jonathan, Kathe, and Mortimer had “knowingly caused the submission of false and fraudulent claims to federal health care benefit programs” for opioids that “were prescribed for uses that were unsafe, ineffective, and medically unnecessary.” But there would be no criminal charges. In fact, according to a deposition of David Sackler, the Department of Justice concluded its investigation without so much as interviewing any member of the family. The authorities were so deferential toward the Sacklers that nobody had even bothered to question them.

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.

Meditation + Mental Strength An emotion is our evolved biology predicting the future impact of a current event. In modern settings, it’s usually exaggerated or wrong. Why is meditation so powerful? Your breath is one of the few places where your autonomic nervous system meets your voluntary nervous system. It’s involuntary, but you can also control it. I think a lot of meditation practices put an emphasis on the breath because it is a gateway into your autonomic nervous system. There are many, many cases in the medical and spiritual literature of people controlling their bodies at levels that should be autonomous. Your mind is such a powerful thing. What’s so unusual about your forebrain sending signals to your hindbrain and your hindbrain routing resources to your entire body? You can do it just by breathing. Relaxed breathing tells your body you’re safe. Then, your forebrain doesn’t need as many resources as it normally does. Now, the extra energy can be sent to your hindbrain, and it can reroute those resources to the rest of your body. I’m not saying you can beat whatever illness you have just because you activated your hindbrain. But you’re devoting most of the energy normally required to care about the external environment to the immune system. I highly recommend listening to the Tim Ferriss’s podcast with Wim Hof. He is a walking miracle. Wim’s nickname is the Ice Man. He holds the world record for the longest time spent in an ice bath and swimming in freezing cold water. I was very inspired by him, not only because he’s capable of super-human physical feats, but because he does it while being incredibly kind and happy—which is not easy to accomplish. He advocates cold exposure, because he believes people are too separate from their natural environment. We’re constantly clothed, fed, and warm. Our bodies have lost touch with the cold. The cold is important because it can activate the immune system. So, he advocates taking long ice baths. Being from the Indian subcontinent, I’m strongly against the idea of ice baths. But Wim inspired me to give cold showers a try. And I did so by using the Wim Hof breathing method. It involves hyperventilating to get more oxygen into your blood, which raises your core temperature. Then, you can go into the shower. The first few cold showers were hilarious because I’d slowly ease myself in, wincing the entire way. I started about four or five months ago. Now, I turn the shower on full-blast, and then I walk right in. I don’t give myself any time to hesitate. As soon as I hear the voice in my head telling me how cold it’s going to be, I know I have to walk in. I learned a very important lesson from this: most of our suffering comes from avoidance. Most of the suffering from a cold shower is the tip-toeing your way in. Once you’re in, you’re in. It’s not suffering. It’s just cold. Your body saying it’s cold is different than your mind saying it’s cold. Acknowledge your body saying it’s cold. Look at it. Deal with it. Accept it, but don’t mentally suffer over it. Taking a cold shower for two minutes isn’t going to kill you. Having a cold shower helps you re-learn that lesson every morning. Now hot showers are just one less thing I need out of life. [2] Meditation is intermittent fasting for the mind. Too much sugar leads to a heavy body, and too many distractions lead to a heavy mind. Time spent undistracted and alone, in self-examination, journaling, meditation, resolves the unresolved and takes us from mentally fat to fit.

EFM certainly seems like a good idea. A machine that measures and records a baby’s response to contractions provides scientific data about a particular woman’s labor. Logic says—and many people assume—that EFM improves birth outcomes. Actually, three decades of research shows that EFM doesn’t improve birth outcomes. When EFM is used during labor, no fewer babies die and no fewer have problems at birth. However, more women have cesareans when EFM is used.21 If EFM doesn’t help babies and puts mothers at higher risk of surgical intervention, it is not safer care. In 1988, a Harvard Medical School report described EFM as a “failed technology” but also predicted that doctors wouldn’t stop using it because they fear being sued. Fear of malpractice litigation is pervasive in obstetrics. Doctors too often make patient-care decisions based on their fear of a lawsuit rather than on evidence-based standards of practice established by their profession.

Technology was supposed to bring the latest fiber-optic cables into every house in Celebration. It promised a computerized community network that would let any resident pull up his or her medical records at the hospital, monitor his or her child's network at school and communicate with teachers and administrators, or simply chat with neighbors or order carry out from one of the restaurants.

By April 23, 2014, thirty-four cases and six deaths from Ebola in Liberia were recorded. By mid-June, 16 more people died. At the time it was thought to be malaria but when seven more people died the following month tests showed that was the Ebola virus. The primary reason for the spreading of the Ebola virus was the direct contact from one person to the next and the ingesting of bush meat. Soon doctors and nurses also became infected. On July 2, 2014, the head surgeon of Redemption Hospital was treated at the JFK Medical Center in Monrovia, where he died from the disease. His death was followed by four nurses at Phebe Hospital in Bong County. At about the same time two U.S. health care workers, Dr. Kent Brantly and a nurse were also infected with the disease. However, they were medically evacuated from Liberia to the United States for treatment where they made a full recovery. Another doctor from Uganda was not so lucky and died from the disease. Arik Air suspended all flights between Nigeria and Liberia and checkpoints were set up at all the ports and border crossings. In August of 2014, the impoverished slum area of West Point was cordoned off. Riots ensued as protesters turned violent. The looting of a clinic of its supplies, including blood-stained bed sheets and mattresses caused the military to shoot into the crowds. Still more patients became infected, causing a shortage of staff and logistics. By September there had been a total of 3,458 cases of which there were 1,830 deaths according to the World Health Organization. Hospitals and clinics could no longer handle this crisis and patients who were treated outside died before they could get help. There were cases where the bodies were just dumped into the Mesurado River. The Ivory Coast out of compassion, opened carefully restricted humanitarian routes and resumed the previously suspended flights to Liberia. Ellen Johnson Sirleaf the president of Libera sent a letter to President Barack Obama concerning the outbreak of Ebola that was on the verge of overrunning her country. The message was desperate, “I am being honest with you when I say that at this rate, we will never break the transmission chain and the virus will overwhelm us.” Having been a former finance minister and World Bank official, Johnson Sirleaf was not one for histrionics however she recognized the pandemic as extremely dangerous. The United States responded to her request and American troops came in and opened a new 60-bed clinic in the Sierra Leone town of Kenema, but by then the outbreak was described as being out of control. Still not understanding the dangerous contagious aspects of this epidemic at least eight Liberian soldiers died after contracting the disease from a single female camp follower. In spite of being a relatively poor country, Cuba is one of the most committed in deploying doctors to crisis zones. It sent more than 460 Cuban doctors and nurses to West Africa. In October Germany sent medical supplies and later that month a hundred additional U.S. troops arrived in Liberia, bringing the total to 565 to assist in the fight against the deadly disease. To understand the severity of the disease, a supply order was placed on October 15th for a 6 month supply of 80,000 body bags and 1 million protective suits. At that time it was reported that 223 health care workers had been infected with Ebola, and 103 of them had died in Liberia. Fear of the disease also slowed down the functioning of the Liberian government. President Sirleaf, had in an emergency announcement informed absent government ministers and civil service leaders to return to their duties. She fired 10 government officials, including deputy ministers in the central government who failed to return to work.

aware of the source of error and can repeat the measurement then ignore the known incorrect outlier value when planning care. However, clinicians cannot remove the erroneous measurement from the medical record

Clinicians are often aware of the source of error and can repeat the measurement then ignore the known incorrect outlier value when planning care. However, clinicians cannot remove the erroneous measurement from the medical record

They determined that the death count based solely on the medical autopsies had underestimated the damage. Between 14 and 20 July, 739 more Chicago residents died than in a typical week for that month. In fact, public health scholars have established that the proportional death toll from the heat wave in Chicago has no equal in the record of U.S. heat disasters.

Saffron The earliest recorded medical use of a spice appears to be more than 3,600 years ago, when saffron was evidently first used for healing.43 A few thousand years later, scientists finally put saffron to the test in a head-to-head trial against the antidepressant drug Prozac for the treatment of clinical depression. Both the spice and the drug worked equally well in reducing depression symptoms.44 As you can see in the box here, this may not be saying much, but at the very least, the saffron was safer in terms of side effects. For example, 20 percent of people in the Prozac group suffered sexual dysfunction, a common occurrence with many antidepressant medications, whereas no one in the saffron group did. However, saffron may be one of those rare cases in which the natural remedy is more expensive than the drug. Saffron is the world’s most expensive spice. It is harvested from crocus flowers, specifically the dried stigmas

records in any form I request under the Health Insurance Portability and Accountability Act within thirty days and for a reasonable handling and processing fee. If this material is not quickly forthcoming, I will file a complaint with the federal Health and Human Services’ Office for Civil Rights, which prosecutes HIPPA violations. Sincerely, 3. TO CHALLENGE OUTRAGEOUS CHARGES/BILLING ERRORS Dear Sirs or Madam: I’m writing to protest what I regard as excessive charges for my operation/hospitalization/procedure at your medical facility. The operation/hospitalization/procedure was billed to my insurer/me at $__________,__________. This total included several itemized charges that were well above norms for our nation and our region, such as a $__________,__________ charge for __________ and a $__________,__________ charge for __________. The Healthcare Bluebook says a “fair price” is $__________,__________ and $__________,__________. Likewise, my bill includes entries for treatments I simply did not receive, such as $__________ for __________ and $__________ for __________. Before sending in any payment, I’m requesting that your billing and coding department review my chart to revise the charges, or explain to me the size and the nature of such entries. I have been a loyal customer of your hospital for many years and have been happy with my excellent medical care. But if these billing issues are not resolved, I feel compelled to report them to the state attorney general/consumer protection agency, to investigate fraudulent or abusive billing practices. Sincerely,

Need some help?” He reached for the books in her arms before she could object. “Hey ...” She looked like a viper ready to strike, but then her pupils dilated as she stared up at him. “I’m sorry ... do I know you?” “No.” He offered her a smile, hoping to settle her nerves. He didn’t speak to many women, but when he did, he always got that same staggered expression. “But you looked as though you needed a third hand.” “I don’t think I could manage if I were an octopus.” He laughed. Beautiful and a sense of humor. Most of the women he knew were too serious. “Funny. Are you off to another lecture?” “No ... I’m late for work. I keep telling my boss not to schedule me on Tuesdays and Thursdays, but he doesn’t listen, and then — sorry. TMI. I tend to ramble on, something the professors keep fussing at me about. Thanks. I sent the message, so I can carry my books now. I’m not up on all these new gadgets.” She waved her phone. “This is my first cell phone. I can’t afford it, but I really needed it. ” She smacked her hand over her mouth and reached for her books. “See ... I never shut up.” Derrick couldn’t help but smile. She was so cute. “I’ll walk you to your car. That way if your boss replies, you can respond quickly.” Her eyes narrowed this time, a look he wasn’t accustomed to; the few women he talked to trusted him completely. Even the female professors said he had a wonderful bedside manner. “Umm ... it’s okay. I take the T.” “Would you like a lift, then, so you aren’t late?” She shook her head. “No. Thank you. I appreciate it ... but I don’t even know you.” “Derrick Ashton.” He offered her his hand. The young woman hesitantly extended her slender, creamy-skinned hand. Her hand looked so small and delicate in his larger, olive-skinned hand. “Nice to meet you, Derrick. I’m Janelle Heskin. But still ... ” Derrick released her after a second and lifted his hands in front of him. “I’m harmless, I swear. They wouldn’t have accepted me into medical school if I had a record, and I’m here because I want to help people, and you looked like you needed help.” She

Throughout most of his life, Washington’s physical vigor had been one of his most priceless assets. A notch below six feet four and slightly above two hundred pounds, he was a full head taller than his male contemporaries. (John Adams claimed that the reason Washington was invariably selected to lead every national effort was that he was always the tallest man in the room.) A detached description of his physical features would have made him sound like an ugly, misshapen oaf: pockmarked face, decayed teeth, oversized eye sockets, massive nose, heavy in the hips, gargantuan hands and feet. But somehow, when put together and set in motion, the full package conveyed sheer majesty. As one of his biographers put it, his body did not just occupy space; it seemed to organize the space around it. He dominated a room not just with his size, but with an almost electric presence. “He has so much martial dignity in his deportment,” observed Benjamin Rush, “that there is not a king in Europe but would look like a valet de chambre by his side.”10 Not only did bullets and shrapnel seem to veer away from his body in battle, not only did he once throw a stone over the Natural Bridge in the Shenandoah Valley, which was 215 feet high, not only was he generally regarded as the finest horseman in Virginia, the rider who led the pack in most fox hunts, he also possessed for most of his life a physical constitution that seemed immune to disease or injury. Other soldiers came down with frostbite after swimming ice-choked rivers. Other statesmen fell by the wayside, lacking the stamina to handle the relentless political pressure. Washington suffered none of these ailments. Adams said that Washington had “the gift of taciturnity,” meaning he had an instinct for the eloquent silence. This same principle held true on the physical front. His medical record was eloquently empty.11

During World War II, rationing in Russia had made vinyl prohibitively expensive, and cheap X-ray film became the bootleg music industry’s substitute. After purchasing a used X-ray plate for a ruble or two from a medical facility, music lovers could cut the plate into a disk with scissors or a knife before having it etched with their favorite tunes. Students studying engineering, I was told, particularly excelled in this bootlegging process. But even a thawed Khrushchev regime had its standards to uphold, and in 1959 the government began a crackdown on this illicit music market. One government tactic was to flood record shops with unplayable records, many intended to damage record players. Some of these records included threatening vocals placed in the middle of a recording, which screamed at the unsuspecting listener, “You like rock and roll? Fuck you, anti-Soviet slime!” Eventually the use of bone records declined as replacement technologies, such as magnetic reel-to-reel tape, took over. But until then, bone-record makers were hunted down and sent to the Gulags. Particularly offensive to the Soviet government were bootleggers who reproduced American jazz records, music Stalin had declared a “threat to civilization.” Despite

Short-term memory is  the memory process that allows you to do many things at once, or  ‘multitask.’ For example, when you are cooking breakfast, you can remember how long the eggs have been boiling, when the frying bacon needs to be turned, when in the process to turn on the coffee maker and start the toast, and when you can fit in peeling the oranges. In contrast, a person with short-term memory deficit can concentrate on only one thing at a time, and if a second thing distracts them, the first may leave their consciousness completely. Trying to concentrate on many things at once, as we do if we are multitasking, becomes difficult, and then impossible, for people with short-term memory loss. Think about the process of making breakfast described above. The cook has to remember to check on each item of food being prepared. They also have to recall all the steps required to cook each item from start to finish. Not only that, but they also need to use their short-term memory to remember which of those steps they’ve already done and what comes next. People with short-term memory loss due to dementia usually stop doing complex tasks like cooking very early in the disease process. These complex tasks are very common in the work world. If a person is still working when they start to develop dementia, they often lose their job because they can no longer function the way they need to in order to complete their work. Speaking from my own experience as a nurse on a hospital ward, I had to remember the names, diagnoses, room and bed number, and general health conditions of a dozen or more people; also, what medications they got and when, what care and treatments they needed to receive and how well those went, whether or not I’d recorded all this information, what I needed to ask physicians when they arrived on the ward; and, still be cooperative with the many interruptions that happened every hour. Most jobs have similar complexities. They require a reliable short-term memory.

intensive care units (ICUs) are physiologically fragile and unstable, generally have life-threatening conditions, and require close monitoring and rapid therapeutic interventions. They are connected to an array of equipment and monitors, and are carefully attended by the clinical staff. Staggering amounts of data are collected daily on each patient in an ICU: multi-channel waveform data sampled hundreds of times each second, vital sign time series updated each second or minute, alarms and alerts, lab results, imaging results, records of medication and fluid administration, staff notes and more.

It was also clear that although petabytes of data are captured daily during care delivery in the country’s ICUs, most of these data were not being used to generate evidence or to discover new knowledge. The challenge, therefore, was to employ existing technology to collect, archive and organize finely detailed ICU data, resulting in a research resource of enormous potential to create new clinical knowledge, new decision support tools, and new ICU technology. We proposed to develop and make public a “substantial and representative” database gathered from complex medical and surgical ICU patients.

Fiscal Numbers (the latter uniquely identifies a particular hospitalization for patients who might have been admitted multiple times), which allowed us to merge information from many different hospital sources. The data were finally organized into a comprehensive relational database. More information on database merger, in particular, how database integrity was ensured, is available at the MIMIC-II web site [1]. The database user guide is also online [2]. An additional task was to convert the patient waveform data from Philips’ proprietary format into an open-source format. With assistance from the medical equipment vendor, the waveforms, trends, and alarms were translated into WFDB, an open data format that is used for publicly available databases on the National Institutes of Health-sponsored PhysioNet web site [3]. All data that were integrated into the MIMIC-II database were de-identified in compliance with Health Insurance Portability and Accountability Act standards to facilitate public access to MIMIC-II. Deletion of protected health information from structured data sources was straightforward (e.g., database fields that provide the patient name, date of birth, etc.). We also removed protected health information from the discharge summaries, diagnostic reports, and the approximately 700,000 free-text nursing and respiratory notes in MIMIC-II using an automated algorithm that has been shown to have superior performance in comparison to clinicians in detecting protected health information [4]. This algorithm accommodates the broad spectrum of writing styles in our data set, including personal variations in syntax, abbreviations, and spelling. We have posted the algorithm in open-source form as a general tool to be used by others for de-identification of free-text notes [5].

records: selection bias, confounding, and missing data. These are explored in greater depth in other chapters of this text. Selection bias, or the failure of the population of study to represent the generalizable population, can occur if all the patients, including controls, are already seeking medical

Robert Liston, a famous surgeon, in setting out to best his own speed record for amputation of the leg, accidentally amputated one of his patient’s testicles and two of his assistant’s fingers.

Caught between taking the suffering of their soldiers seriously and pursuing victory over the Germans, the British General Staff issued General Routine Order Number 2384 in June of 1917, which stated, “In no circumstances whatever will the expression ‘shell shock’ be used verbally or be recorded in any regimental or other casualty report, or any hospital or other medical document.” All soldiers with psychiatric problems were to be given a single diagnosis of “NYDN” (Not Yet Diagnosed, Nervous).

The historical record also shows that attitudes toward homosexuality have little to do with whether people believe it occurs in animals or not, and consequently, in its "naturalness". True, throughout much of recorded history, the charge of "unnaturalness" - including the claim that homosexuality did not occur in animals - was used to justify every imaginable form of sanction, control, and repression against homosexuality. But many other interpretations of "naturalness" were also prevalent at various times. Indeed, the very fact that homosexuality was thought to be "unnatural" - that is, not found in nature - was sometimes used to justify its *superiority* to heterosexuality. In ancient Greece, for example, same-sex love was thought to be purer than opposite-sex love because it did not involve procreation or "animal-like" passions. On the other hand, homosexuality was sometimes condemned precisely because it was considered *closer* to "nature", reflecting the base, uncontrolled sexual instincts of the animal world. The Nazis used this reasoning (in part) to target homosexuals and other "subhumans" for the concentration camps (where homosexual men subjected to medical experiments were referred to as test animals), while sexual relations between women were disparaginly characterized as "animal love" in late eighteenth-century New England . The irrationality of such beliefs is highlighted in cases where charges of "unnaturalness" were combined, paradoxically, with accusations of animalistic behavior. Some early Latin texts, for instance, simultaneously condemned homosexuals for exhibiting behavior unknown in animals while also denouncing them for imitating particular species (such as the hyena or hare) that were believed to indulge in homosexuality. In our own time, the fact that a given characteristic of a minority human population is biologically determined has little to do with whether that population should be - or is - discriminated against. Racial minorities, for example, can claim a biological basis for their difference, yet this has done little to eliminate racial prejudice. Religious groups, on the other hand, can claim no such biological prerogative, and yet this does not invalidate the entitlement of such groups to freedom from discrimination. It should be clear, then, that whether homosexuality is biologically determined or not - none of these things guarantee the acceptance or rejection of homosexuality or in itself renders homosexuality "valid" or "illegitimate".

In March 1942, the Office of the Surgeon General noted a growing incidence of jaundice (yellowing of the skin caused by liver disease) among US Army personnel stationed in California, England, Hawaii, Iceland, and Louisiana. All of those jaundiced had recently received a yellow fever vaccine, which, in addition to containing yellow fever vaccine virus, contained human serum as a stabilizing agent. On April 15, 1942, the surgeon general ordered that yellow fever vaccination be discontinued and that all existing lots be recalled and destroyed. Shortly thereafter, manufacturers made a yellow fever vaccine with water instead of serum, but it was too late. The serum used to stabilize the yellow fever vaccine had been obtained from nurses, medical students, and interns at Johns Hopkins Hospital in Baltimore, several of whom had a history of jaundice and one of whom was actively infected at the time of the donation. By June 1942, fifty thousand US servicemen had been hospitalized with severe liver disease, and 150 had died from what would later be known as hepatitis B. Of the 141 lots of yellow fever vaccine provided to the army, seven were definitely contaminated. Among those who received one of those seven lots, 78 percent became infected. When the dust settled, 330,000 servicemen had been infected and one thousand had died. This was then and remains today one of the worst single-source outbreaks of a fatal infection ever recorded.

Before anesthesia, surgeons removed bladder stones, drained ovarian cysts, and amputated legs, but little else; they were rewarded for their speed more than their skill. A surgeon named Robert Liston, in an attempt to best his own speed record for amputating a leg, accidentally cut off one of his patient’s testicles and two of his assistant’s fingers.

blockchain technology records financial transactions made with digital currencies such as Bitcoin, it will in the future serve as a registrar for things as different as birth and death certificates, titles of ownership, marriage licenses, educational degrees, insurance claims, medical procedures and votes

Taiwan30 has used its National Health Insurance powerful IT to provide near real-time information on expenditures and utilization to prevent unnecessary expenditure. There is also a panel review system of medical records to keep healthcare costs down, whilst maintaining the quality of healthcare.

Even the editor of the highly respected Medical Record found more to fear than to admire in Lister’s theory. “Judging the future by the past,” he wrote, “we are likely to be as much ridiculed in the next century for our blind belief in the power of unseen germs, as our forefathers were for their faith in the influence of spirits, of certain planets and the like, inducing certain maladies.

Another doctor suggested a new anti-anxiety medication, which I duly added to the clutter of bottles by my bedside. And then, after a series of family consultations, a New York psychologist named Keith Westerfield surprised me first with a thoughtful explanation and then with a formal diagnosis of Asperger’s syndrome. I bought a book of essays on the condition, edited by Ami Klin, Fred R. Volkmar, and Sara S. Sparrow, and devoured it with stunned fascination. Despite the daunting medical language of some of the chapters, I felt as though I had stumbled upon my secret biography. Here it all was—the computer-like retention, the physical awkwardness, the difficulties with peers and lovers, the need for routine and repetition, the narrow, specialized interests (one article even mentioned silent film, old recordings, and true crime—had they created a developmental disorder just for me?). I was forty-five years old when I learned that I wasn’t alone.

You’re not going to change your life in a day. It took two years and antianxiety medication for me to stop getting overwhelmed about even getting out of bed. Do the next right thing and don’t worry about anything else coming down the pike.

Earlier O’Brien and Pottinger had aggressively argued against allowing the Chinese firm Huawei, the largest telecommunications equipment manufacturer in the world, into U.S. markets. O’Brien was convinced that Huawei wanted to use its fifth generation (5G) wireless network eventually to monitor every citizen in the world. It was another major national security threat to the United States. O’Brien said, “Backdoor your medical records, your social media posts, your emails, your financial records. Personal, private data on every American. Micro-target you based on your deepest fears.

I am only seven, but I understand that it is this fact, more than any other, that makes my family different: we don’t go to school. Dad worries that the Government will force us to go but it can’t, because it doesn’t know about us. Four of my parents’ seven children don’t have birth certificates. We have no medical records because we were born at home and have never seen a doctor or nurse. We have no school records because we’ve never set foot in a classroom. When I am nine, I will be issued a Delayed Certificate of Birth, but at this moment, according to the state of Idaho and the federal government, I do not exist.

Every day I learn that life is nothing like they taught us growing up. They tried to teach everyone the same useless thing and expected everyone to behave the same. And those of us that don't fit the criteria of their reality, they either medicate and deem us mentally ill so it's always on record for the world to never give us a fair chance.

Suddenly, a rush of adrenaline ran through me. Had she figured it out? Had she somehow gotten access to my medical records? Could she possibly know about my diagnosis? No. That’s impossible. I’d done everything in my power to keep all that information private. But this was Charlotte Darling we were talking about. Anything was possible.

Spanner's the facility doctor for Flaweds. Some people are put off by his drinking. Others are put off by his shoddy personal hygiene. I'm put off by his medical track record.

Reyes is ten years older than José and is afflicted with atrial fibrillation. He is on three medications, including a blood thinner, in addition to which something called a “Medtronic cardiac loop recorder” has been surgically implanted in his chest, in the hollow between two ribs; this device monitors his heart 24/7 and transmits the data to Medtronic in Minneapolis, from which it is available to his cardiologist by computer or smartphone. As José described it and as Reyes confirmed, the loop recorder has a five-year battery, can essentially transmit a continuous EKG to Medtronic from anywhere in the country as well as from many locations beyond its borders—and is approximately the size of one of these techno nettles that are stuck to her gear and clothes.

You sign up and give Picnic permission to get your medical records from all your doctors and providers, including scans and lab results. They combine it into one easy-to-read patient dashboard that’s accessible just to you as the patient.

From the 1940s to the ’60s, under government auspices, Quebec doctors employed by the religious communities falsified the medical records of the illegitimate orphans. They pronounced them ‘mentally unfit’ and ‘mentally retarded.’ In the blink of an eye, thousands of perfectly healthy children found themselves interned in asylums, mixed in with actual mental patients, for years on end. Simply because they had had the misfortune of being born illegitimate. Those children are now adults, and they’re still known as the Duplessis Orphans.

What Lucie was hearing surpassed all understanding. A mass derangement, with the aid of bogus medical records and money under the table.