Medical Residency Quotes

Life's like a penis; When it's soft you can't beat it; When it's hard you get screwed. - The Fat Man, Medical Resident in The House of God

Considering I'm a struggling medical resident and you're a fucking millionaire, I'm getting the short end of the stick," I grumbled. "Don't insult me. I'm a billionaire.

Something as trivial as a little gift of candy to medical residents improves the speed and accuracy of their diagnoses. In general, positive emotion enables us to broaden our understanding of what confronts us. This

There are no emergency autopsies,” another resident pointed out to me. “Your patients never complain. They don’t page you during dinner. And they’ll still be dead tomorrow.

LADY BRACKNELL. May I ask if it is in this house that your invalid friend Mr. Bunbury resides? ALGERNON. [Stammering.] Oh! No! Bunbury doesn't live here. Bunbury is somewhere else at present. In fact, Bunbury is dead, LADY BRACKNELL. Dead! When did Mr. Bunbury die? His death must have been extremely sudden. ALGERNON. [Airily.] Oh! I killed Bunbury this afternoon. I mean poor Bunbury died this afternoon. LADY BRACKNELL. What did he die of? ALGERNON. Bunbury? Oh, he was quite exploded. LADY BRACKNELL. Exploded! Was he the victim of a revolutionary outrage? I was not aware that Mr. Bunbury was interested in social legislation. If so, he is well punished for his morbidity. ALGERNON. My dear Aunt Augusta, I mean he was found out! The doctors found out that Bunbury could not live, that is what I mean - so Bunbury died. LADY BRACKNELL. He seems to have had great confidence in the opinion of his physicians. I am glad, however, that he made up his mind at the last to some definite course of action, and acted under proper medical advice. And now that we have finally got rid of this Mr. Bunbury, may I ask, Mr. Worthing, who is that young person whose hand my nephew Algernon is now holding in what seems to me a peculiarly unnecessary manner?

Considering I'm a struggling medical resident and you're a fucking millionaire, I'm getting the short end of the stick," "Don't insult me. I'm a billionaire.

We reside as well on a planet where the efficacy of medical science is questioned and media personalities argue whether a clot of cells has more value than a woman's life. To put it another way, these are unutterably stupid times.

LAWS OF THE HOUSE OF GOD I Gomers don’t die. II Gomers go to ground. III At a cardiac arrest, the first procedure is to take your own pulse. IV The patient is the one with the disease. V Placement comes first. VI There is no body cavity that cannot be reached with a #14 needle and a good strong arm. VII Age + BUN = Lasix dose. VIII They can always hurt you more. IX The only good admission is a dead admission. X If you don’t take a temperature, you can’t find a fever. XI Show me a BMS who only triples my work and I will kiss his feet. XII If the radiology resident and the BMS both see a lesion on the chest X ray, there can be no lesion there. XIII The delivery of medical care is to do as much nothing as possible.

There was and still is a tremendous fear that poor and working-class Americans might one day come to understand where their political interests reside. Personally, I think the elites worry too much about that. We dumb working folk were clubbed into submission long ago, and now require only proper medication for our high levels of cholesterol, enough alcohol to keep the sludge moving through our arteries, and a 24/7 mind-numbing spectacle of titties, tabloid TV, and terrorist dramas. Throw in a couple of new flavours of XXL edible thongs, and you've got a nation of drowsing hippos who will never notice that our country has been looted, or even that we have become homeless ourselves.

As a former gas station attendant, parking lot attendant, medical resident and current Goldman Sachs screwee, I am offended.

Could it be that despite all the years I spent in medical school and residency training acquiring specialized knowledge and practical skills, that this expertise mattered little to my patients' overall health?

You will know if you are too acidic if you get sick often, get urinary tract infections, suffer from headaches, and have bad breath and body odor (when you do not use antiperspirant). Acidosis is the medical term for a blood alkalinity of less than 7.35. A normal reading is called homeostasis. It is not considered a disease; although in and of itself it is recognized as an indicator of disease. Your blood feeds your organs and tissues; so if your blood is acidic, your organs will suffer and your body will have to compensate for this imbalance somehow. We need to do all we can to keep our blood alkalinity high. The way to do this is to dramatically increase our intake of alkaline-rich elements like fresh, clean air; fresh, clean water; raw vegetables (particularly their juices); and sunlight, while drastically reducing our intake of and exposure to acid-forming substances: pollution, cigarettes, hard alcohol, white flour, white sugar, red meat, and coffee. By tipping the scales in the direction of alkalinity through alkaline diet and removal of acid waste through cleansing, and acidic body can become an alkaline one. "Bear in mind that some substances that are alkaline outside the body, like milk, are acidic to the body; meaning that they leave and acid reside in the tissues, just as many substances that are acidic outside the body, like lemons and ripe tomatoes, are alkaline and healing in the body and contribute to the body's critical alkaline reserve.

Although Garfield was dangerously ill, the idea of taking him to a hospital was never considered. Hospitals were only for people who had nowhere else to go. “No sick or injured person who could possibly be nursed at home or in a medical man’s private residence,

I enjoyed the intellectual rigor and scientific challenge of death investigation. Everyone there, from new students to the most senior doctors, seemed happy, eager to learn, and professionally challenged. None of the medical examiners had cots in their offices. “There are no emergency autopsies,” another resident pointed out to me. “Your patients never complain. They don’t page you during dinner. And they’ll still be dead tomorrow.

A similar concern about using the web to provide just-in-time information shows up among physicians arguing the future of medical education. Increasingly, and particularly while making a first diagnosis, physicians rely on handheld databases, what one philosopher calls “E-memory.” The physicians type in symptoms and the digital tool recommends a potential diagnosis and suggested course of treatment. Eighty-nine percent of medical residents regard one of these E-memory tools, UpToDate, as their first choice for answering clinical questions. But will this “just-in-time” and “just enough” information teach young doctors to organize their own ideas and draw their own conclusions?

So long as the processes of healing were not understood and man thought that the power to heal resided in substances and things outside of him, he logically sought for extrinsic means of healing, and a healing art was a logical development. The system of medicine, as we know it today, was a logical development out of the fallacy that healing power resides in extrinsic sources.

As part of this menu of services, the clinic also did abortions. Bruce Kessel had been trained in abortion care as a matter of course when he was a medical resident in the early eighties. The way Bruce told it, the years after Roe were an exuberant time, and physicians who cared, as he did, about public health and family planning rejoiced over the freedoms and possibilities that legal abortion promised women.

The troubled middle is…a place where it’s possible to truly love animals and still accept their occasional role as resources, objects, and tools. Those of us in the troubled middle believe that animals deserve to be treated well, but we don’t want to ban their use in medical research. We care enough to want livestock to be raised humanely, but don’t want to abandon meat-eating altogether. ‘Some argue that we are fence-sitters, moral wimps,’ Herzog, himself a resident of the troubled middle, writes. ‘I believe, however, that the troubled middle makes perfect sense because moral quagmires are inevitable in a species with a huge brain and a big heart. They come with the territory.

Are we really supposed to know what we want to do for the rest of our lives at the ripe old age of seventeen?” “Don’t you want to know?” “I guess? I wish I could live ten lives at once.” “Ugh. You just don’t want to choose.” “That’s not what I mean. I don’t want to get stuck doing something that doesn’t mean anything to me. This track I’m on? It goes on forever. Yale. Medical school. Residency. Marriage. Children. Retirement. Nursing home. Funeral home. Cemetery.

Surgeons are independent doers, ready to act. They prefer not to ask for help, thank you, or to place trust in much outside their own abilities. They work hard, expect perfection, and do not accept excuses. To the residents, some surgeon mentors were decent human beings; others were tyrants. Personalities aside, the central fact was this: Surgeons use their hard-earned physical skills to get results in the operating room (or create their own problems). They rely on themselves for success or failure. They are the captains of their ships. They do not need or want to rely on medication or another person to improve the quality of a patient’s life. Surgery is a specialty of instant gratification, for patient and surgeon alike.

They demanded legal clarity. So, beginning with California, states passed laws exempting doctors from prosecution if they prescribed opiates for pain within the practice of responsible health care. Numerous states approved so-called intractable pain regulations: Ohio, Oregon, Washington, and others. Soon what can only be described as a revolution in medical thought and practice was under way. Doctors were urged to begin attending to the country’s pain epidemic by prescribing these drugs. Interns and residents were taught that these drugs were now not addictive, that doctors thus had a mission, a duty, to use them. In some hospitals, doctors were told they could be sued if they did not treat pain aggressively, which meant with opiates. Russell

A note about me: I do not think stress is a legitimate topic of conversation, in public anyway. No one ever wants to hear how stressed out anyone else is, because most of the time everyone is stressed out. Going on and on in detail about how stressed out I am isn’t conversation. It’ll never lead anywhere. No one is going to say, “Wow, Mindy, you really have it especially bad. I have heard some stories of stress, but this just takes the cake.” This is entirely because my parents are immigrant professionals, and talking about one’s stress level was just totally outlandish to them. When I was three years old my mom was in the middle of her medical residency in Boston. She had been a practicing obstetrician and gynecologist in Nigeria, but in the United States she was required to do her residency all over again. She’d get up at 4:00 a.m. and prepare breakfast, lunch, and dinner for my brother and me, because she knew she wouldn’t be home in time to have dinner with us. Then she’d leave by 5:30 a.m. to start rounds at the hospital. My dad, an architect, had a contract for a building in New Haven, Connecticut, which was two hours and forty-five minutes away. It would’ve been easier for him to move to New Haven for the time of the construction of the building, but then who would have taken care of us when my mom was at the hospital at night? In my parents’ vivid imaginations, lack of at least one parent’s supervision was a gateway to drugs, kidnapping, or at the very minimum, too much television watching. In order to spend time with us and save money for our family, my dad dropped us off at school, commuted the two hours and forty-five minutes every morning, and then returned in time to pick us up from our after-school program. Then he came home and boiled us hot dogs as an after-school snack, even though he was a vegetarian and had never eaten a hot dog before. In my entire life, I never once heard either of my parents say they were stressed. That was just not a phrase I grew up being allowed to say. That, and the concept of “Me time.

One day over breakfast, a medical resident asked how Dr. Apgar would make a systematic assessment of a newborn. “That’s easy,” she replied. “You would do it like this.” Apgar jotted down five variables (heart rate, respiration, reflex, muscle tone, and color) and three scores (0, 1, or 2, depending on the robustness of each sign). Realizing that she might have made a breakthrough that any delivery room could implement, Apgar began rating infants by this rule one minute after they were born. A baby with a total score of 8 or above was likely to be pink, squirming, crying, grimacing, with a pulse of 100 or more—in good shape. A baby with a score of 4 or below was probably bluish, flaccid, passive, with a slow or weak pulse—in need of immediate intervention. Applying Apgar’s score, the staff in delivery rooms finally had consistent standards for determining which babies were in trouble, and the formula is credited for an important contribution to reducing infant mortality. The Apgar test is still used every day in every delivery room.

attention deficit disorder in his own son. “I had worked in an ADHD clinic during my residency, and had strong feelings that this was overdiagnosed,” he said. “That it was a ‘savior’ diagnosis for too many kids whose parents wanted a medical reason to drug their children, or to explain their kids’ bad behavior.

The benefits of gun ownership have generally gone ignored in medical journals that have studied gun ownership, what is called the public health literature. There is no mention that widespread gun ownership deters criminals from breaking into homes. There is no mention that gun ownership helps protect residents from harm in the event of a break-in, or that mass public shooters consistently attack gun-free zones where they don’t have to worry about victims being able to defend themselves. And gun owners—contrary to what the media advises—should not unquestioningly store their guns locked and unloaded. That defeats the purpose of being ready at a moment’s notice.

A study of 222 white medical students and residents published in the Proceedings of the National Academy of Sciences in 2016 showed that half of the students and residents endorsed at least one false idea about biological differences between Black people and white people, including that Black people’s nerve endings are less sensitive than those of white people.

As we stood on our doorsteps and clanged our pans, politicians were handing out billion-pound contracts to their mates. As we put rainbows in our windows, nursing home residents were being all but murdered by their idiotic policies. And throughout, as NHS staff put their lives at risk, as they worked double and triple shifts, as the PPE cut into their faces, as they moved out of their family homes for months on end, the ghouls in charge seemed far more concerned with their own appearances and legacies. And there’s still nothing approaching an assurance that the NHS won’t be sold off in five years’ time, plunging us into an unfair insurance-based system that mostly benefits the former politicians who stuff the boardrooms of private medicine.

I do believe in teaching and all that crap, and I was excited about having medical students when I first started out in residency. But since then, I’ve learned a very important lesson: most medical students are very annoying. Occasionally, we’ll get some rare gem who is just wonderful and who makes our lives easier. But the vast majority seem to be lazy, whiny, and disinterested.

If there is anything in life I know to be true, it is that life itself is a matter of the spirit. A man with a broken spirit, whose soul nourished nothing except the belief that the poison within his own heart is shared by the whole human race, and hopes anything beyond the desire that everyone he meets will share in his misery, is sick indeed, and his body, however healthy in its potential, is on a path toward corruption; but the person with a purpose, warmed by the impression that, for all his other shortcomings, something resides within him that is capable of loving and of being loved, can bear all things, believe all things, endure all things. That person's body will heal faster than medical minds imagine. It will overcome pain; in many cases, it will not feel it at all.

When we think of an institution, we can usually see it as embodied in a building: the Vatican, the Pentagon, the Sorbonne, the Treasury, the Massachusetts Institute of Technology, the Kremlin, the Supreme Court. What we cannot see, until we become close students of the institution, are the ways in which power is maintained and transferred behind the walls and beneath the domes, the invisible understandings which guarantee that it shall reside in certain hands but not in others, that information shall be transmitted to this one but not to that one, the hidden collusions and connections with other institutions of which it is supposedly independent. When we think of the institution of motherhood, no symbolic architecture comes to mind, no visible embodiment of authority, power, or of potential or actual violence. Motherhood calls to mind the home, and we like to believe that the home is a private place. Perhaps we imagine row upon row of backyards, behind suburban or tenement houses, in each of which a woman hangs out the wash, or runs to pick up a tear-streaked two-year-old; or thousands of kitchens, in each of which children are being fed and sent off to school. Or we think of the house of our childhood, the woman who mothered us, or of ourselves. We do not think of the laws which determine how we got to these places, the penalties imposed on those of us who have tried to live our lives according to a different plan, the art which depicts us in an unnatural serenity or resignation, the medical establishment which has robbed so many women of the act of giving birth, the experts—almost all male—who have told us how, as mothers, we should behave and feel. We do not think of the Marxist intellectuals arguing as to whether we produce “surplus value” in a day of washing clothes, cooking food, and caring for children, or the psychoanalysts who are certain that the work of motherhood suits us by nature. We do not think of the power stolen from us and the power withheld from us, in the name of the institution of motherhood.

How many people devote countless hours of effort, requiring deep reservoirs of self-control, in order to get into medical school, where even greater self-control is required to make it through the internships and residencies, only to find out that being a doctor does not make them terribly happy. Fewer than half of the doctors in the United States say they would choose the same career if they had it to do over.

Expertise is the mantra of modern medicine. In the early twentieth century, you needed only a high school diploma and a one-year medical degree to practice medicine. By the century’s end, all doctors had to have a college degree, a four-year medical degree, and an additional three to seven years of residency training in an individual field of practice—pediatrics, surgery, neurology, or the like. In recent years, though, even this level of preparation has not been enough for the new complexity of medicine.

I can’t give this letter a storybook ending in the world’s eyes. Today finds Bob back to his regular schedule and the boys spending extra time talking with me flopped across the foot of my bed, which seems to be my permanent residence for now. My head symptoms have not changed. The medication has not settled well, and so the struggle continues. Whether I am in the valley or soaring above the mountain tops, God is there with me. I thank God that I am able to be His child. Now that’s a true storybook ending!

I came across Nell like you would a Robert Mapplethorpe at a street art fair, gobsmacked that something so valuable would be lumped in with a bunch of other crap like that. She’d been slumped against the bathroom wall in Butterfields, a dorm we later took to calling Butterfingers, for the lacrosse team residents who manhandled girls made Gumby-legged by Popov vodka. Even with her mouth hanging open, her tongue dry and pebbled white from all the medically sanctioned stimulants, there was no question that she had a movie star face. “Hey,” I said, my

I started to question what was being taught—I didn’t get much guidance in medical school or residency on what to do when your patient can’t pay for health insurance or when she has lost childcare for the third time in two months and is being fired from her job. Instead, I was taught to prescribe medications or provide psychotherapy for issues that were clearly systemic. While there is certainly a great need for both of these medical interventions, the lack of attention to the inhumanity of our social policies left me feeling powerless—just like my patients.

How the sadness is handled by the physician has a powerful impact on the medical care received by the patients. If the grief is relentlessly suppressed--as in Eva's experience during residency--the result can be a numb physician who is unable to invest in a new patient. This lack of investment can lead to rote medical care--impersonal at best, shoddy at worst. At the other end of the spectrum is the doctor who is inundated with grief and can't function because of the overwhelming sorrow. Burnout is significant in both these cases, and that erodes the quality of medical care.

LAWS OF THE HOUSE OF GOD I Gomers don’t die. II Gomers go to ground. III At a cardiac arrest, the first procedure is to take your own pulse. IV The patient is the one with the disease. V Placement comes first. VI There is no body cavity that cannot be reached with a #14 needle and a good strong arm. VII Age + BUN=Lasix dose. VIII They can always hurt you more. IX The only good admission is a dead admission. X If you don’t take a temperature, you can’t find a fever. XI Show me a BMS who only triples my work and I will kiss his feet. XII If the radiology resident and the BMS both see a lesion on the chest X ray, there can be no lesion there. XIII The delivery of medical care is to do as much nothing as possible.

In the horrible places, the battle for control escalates until you get tied down or locked into your Geri-chair or chemically subdued with psychotropic medications. In the nice ones, a staff member cracks a joke, wags an affectionate finger, and takes your brownie stash away. In almost none does anyone sit down with you and try to figure out what living a life really means to you under the circumstances, let alone help you make a home where that life becomes possible. This is the consequence of a society that faces the final phase of the human life cycle by trying not to think about it. We end up with institutions that address any number of societal goals—from freeing up hospital beds to taking burdens off families’ hands to coping with poverty among the elderly—but never the goal that matters to the people who reside in them: how to make life worth living when we’re weak and frail and can’t fend for ourselves anymore.

One attribute associated with human intelligence is language, which, when defined as the use of sign sequences within a complex grammar, appears to be uniquely human. What’s interesting about language — at least from a neuroscientist’s perspective — is that it resides on only one side of the brain (the left side in most right-handers). What makes it mind-boggling is that the two sides of a human brain appear nearly identical in both large- and small-scale organization. In other words, there appears to be no physical difference between the two halves. Neuroscientists know of no circuit or structure or cell unique to the left side of the brain that would explain its language capacity compared to the lack of it on the right side. Yet, as seen in patients whose left and right brain halves have been disconnected for medical reasons, the left side is capable of carrying on a conversation about recent experience, but the right side is not.

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.

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

In 2016, a group of doctors surveyed 222 white medical students and residents on their beliefs about their patients’ bodies, asking them to judge the veracity of statements such as “Black people’s blood coagulates more quickly than whites’ ” and “Blacks’ nerve endings are less sensitive than whites’.” Half of the students and residents ascribed to at least one of these false beliefs. Like the doctor who brutalized John Brown, 40 percent of the first-year medical students and 25 percent of the residents agreed with the statement “Blacks’ skin is thicker than whites’.” These beliefs had real-world consequences: when given two mock medical scenarios, one featuring a Black patient and one featuring a white patient, the students and residents who endorsed more of the false beliefs assumed that the Black patient felt less pain than her white counterpart. Worse, they were less likely to adequately treat the Black patient’s pain than they were the white patient’s. Even now, medicine seems in thrall to Mitchell’s assertion that not all pain is equal, disbelieves the essential truth that the “capacity to suffer” is a human universal.

Residents' Survival Guide Who Work 110 Hours per Week • When there is a question between a resident and a nurse, the nurse always wins. • Residents can be replaced. Nurses cannot. • When in doubt about a patient, call your senior staff to keep them informed. • Always ask for help if you don’t know how to do something surgically. • When called by the nurse, see the patient and the nurse to assess a problem. • Answer your pages promptly. • Learn to prioritize the many tasks that you have. • Tell it like it is! Don’t lie! Get the correct information. • Engage in damage control when making a mistake. Accept liability for actions. • Be courteous to others. Remember that respect breeds respect. • Be a team player. What goes around comes around. • Own your education. Invest time and effort in surgical practice. • Be punctual; others depend on you. Respect their time. • Document for the record often, wholly and accurately. • Be helpful to fellow residents who become your colleagues and friends for life. • Develop the skills to be efficient, dependable, and trustworthy. • Sign in and sign out to avoid errors in management. • Write a summary note to ensure continuity of patient care upon leaving the service.

Yet the homogeneity of contemporary humanity is most apparent when it comes to our view of the natural world and of the human body. If you fell sick a thousand years ago, it mattered a great deal where you lived. In Europe, the resident priest would probably tell you that you had made God angry and that in order to regain your health you should donate something to the church, make a pilgrimage to a sacred site, and pray fervently for God’s forgiveness. Alternatively, the village witch might explain that a demon had possessed you and that she could cast it out using song, dance, and the blood of a black cockerel. In the Middle East, doctors brought up on classical traditions might explain that your four bodily humors were out of balance and that you should harmonize them with a proper diet and foul-smelling potions. In India, Ayurvedic experts would offer their own theories concerning the balance between the three bodily elements known as doshas and recommend a treatment of herbs, massages, and yoga postures. Chinese physicians, Siberian shamans, African witch doctors, Amerindian medicine men—every empire, kingdom, and tribe had its own traditions and experts, each espousing different views about the human body and the nature of sickness, and each offering their own cornucopia of rituals, concoctions, and cures. Some of them worked surprisingly well, whereas others were little short of a death sentence. The only thing that united European, Chinese, African, and American medical practices was that everywhere at least a third of all children died before reaching adulthood, and average life expectancy was far below fifty.14 Today, if you happen to be sick, it makes much less difference where you live. In Toronto, Tokyo, Tehran, or Tel Aviv, you will be taken to similar-looking hospitals, where you will meet doctors in white coats who learned the same scientific theories in the same medical colleges. They will follow identical protocols and use identical tests to reach very similar diagnoses. They will then dispense the same medicines produced by the same international drug companies. There are still some minor cultural differences, but Canadian, Japanese, Iranian, and Israeli physicians hold much the same views about the human body and human diseases. After the Islamic State captured Raqqa and Mosul, it did not tear down the local hospitals. Rather, it launched an appeal to Muslim doctors and nurses throughout the world to volunteer their services there.15 Presumably even Islamist doctors and nurses believe that the body is made of cells, that diseases are caused by pathogens, and that antibiotics kill bacteria.

A 2016 study published in Proceedings of the National Academy of Sciences of the United States of America suggested that health care providers may underestimate black patients' pain in part due to a belief that they simply don't actually feel as much pain - a myth that dates all the way back to the days of slavery. For centuries, the claim that black people were biologically different from whites was 'championed by scientists, physicians, and slave owners alike to justify slavery and the inhumane treatment of black men and women in medical research,' the authors wrote. Black people were thought to have 'thicker skulls, less sensitive nervous systems,' and a super-human ability to 'tolerate surgical operations with little, if any, pain at all.' In the first phase of the study, over two hundred white medical students and residents were asked whether a series of statements about differences between black and white patients were true or false. Some of the statements were true, while others - for example, 'blacks' skin is thicker than whites' and 'blacks' nerve endings are less sensitive than whites' - were false. They found that a full half of the respondents thought that one or more the false statements - many of which were 'fantastical in nature' - were possibly, probably, or definitely true. Also, notably, many of them didn't agree with the statements that were actually true; only half of the residents knew that white patients are less likely to have heart disease than black patients are. When asked to read case studies of two patients complaining of pain, one white and one black, the respondents who had endorsed more false beliefs were more likely to believe that the black patient felt less pain, and undertreated them accordingly.

Did you know that if you’re a middle-aged woman, you have only a small window of opportunity between the beginning of perimenopause and the start of menopause to start estrogen replacement therapy to protect not only your brain but also your bones and cardiovascular system? I did not, until I dug into the science, because as a woman who was diagnosed with a stage 0 breast lump, I was scared off like so many of us from the results of the Women’s Health Initiative, which got blasted out all over the news and initially showed a link between estrogen replacement therapy and breast cancer, but guess what? That study had so many flaws, its findings are little more than useless and possibly harmful. Worse, women like me without uteri show a decrease in breast cancer with estrogen replacement therapy. But this information never made it either into the headlines or into our gynecologists’ offices. I had to find it in scientific publications such as The Lancet online. In fact, get this: Our medical system barely trains gynecologists in menopausal medicine. A recent study found that only 20 percent of ob-gyn residency programs in the U.S. provide any menopause training. Yes, any. Which means that 80 percent of all gynecological residents in school today are getting no training whatsoever in post-reproductive women’s health. These are people whose job it is to know everything going on in our ladyparts, but they have not been taught the basic tenets of how to care for either us or our plumbing after we stop menstruating. And by “us” I mean 30 percent of all women alive on earth at any given moment. Half of my middle-aged female friends deal with chronic urinary tract infections. Oh, well, we think, throwing up our hands in defeat and consuming far too many antibiotics than are rational or safe or even good for the future safety of humanity. It took Dr. Rachel Rubin, a urologist in Washington, D.C., reaching out to me over Twitter to explain that UTIs in menopausal women do not have to be recurrent. They can be mitigated with, yes, vaginal estrogen. Not once was I ever

The good news is that there is a guide, a kind of medical advocate, an inner compass—and it resides within each of us.

[T]he definitional shift away from the medical/individual model makes room for new understandings of how best to solve the “problem” of disability. In the alternative perspective, which I call the political/relational model, the problem of disability no longer resides in the minds or bodies of individuals but in built environments and social patterns that exclude or stigmatize particular kinds of bodies, minds, and ways of being. For example, under the medical/individual model, wheelchair users suffer from impairments that restrict their mobility. These impairments are best addressed through medical interventions and cures; failing that, individuals must make the best of a bad situation, relying on friends and family members to negotiate inaccessible spaces for them. Under a political/relational model of disability, however, the problem of disability is located in inaccessible buildings, discriminatory attitudes, and ideological systems that attribute normalcy and deviance to particular minds and bodies. The problem of disability is solved not through medical intervention or surgical normalization but through social change and political transformation.

When I visited Watson and its programmers recently at IBM’s main research facility—where the machine, consisting of a stack of servers, resides alone in a basement, humming quietly and waiting for questions to crunch on—I inquired (directing my queries to the nearby humans, not the machine) whether Watson might ever turn the tables on us and start asking us wickedly complex questions. While that’s not its purpose, its programmers point out something interesting and quite promising: As Watson comes in increasing contact with doctors and medical students currently using the system, the machine is slowly training them to ask more and better questions in order to pull the information they need out of the system. As it trains them to be better questioners, Watson will almost certainly help them to be better doctors.

What programs would a prison need to utilize in order to maximize the likelihood that the people sent to it would renounce violence as a behavioral strategy? To begin with, it would need to be an anti-prison. Beginning with its architecture, it would need to convey an entirely different message. Current prisons are modeled architecturally after zoos — or rather, after the kinds of zoos that used to exist, but that have been replaced with zoological parks because the animals' keepers began to realize that the old zoos, with concrete floors and walls and steel bars were too inhumane for animals to survive in. Yet we still keep our human animals in zoos that no humane society would permit for animals. And the architecture itself conveys that message to the prisoners: "You are an animal, for this is a zoo, and zoos are what animals are put in." And then we act surprised when the men and women we treat that way actually behave like animals, both when they are in this human zoo and after they return to the community. So we would need to build an anti-prison that would actually look as if it had been built for human beings rather than animals, i.e. that was as home-like and pleasant and civilized and human as possible. Once we had done that, we could offer those who had been sent there the opportunity to acquire as much education and/or vocational training as they had the ability and energy and interest to obtain. We would of course need to provide treatment for whatever medical, dental, psychiatric, or substance-abuse problems they had, and would want to incorporate many of the principles of a therapeutic community into the everyday routines of this residential school, with frequent group discussions with the other residents and staff members with training in psychotherapy. The goal would be to replace the "monster factories" that most prisons now are with therapeutic communities designed to enable people who are deeply damaged, and damaging, to recover their humanity or to gain a degree of humanity they had never been able to acquire; in short, to help them heal themselves and learn, in the process, how to heal others and even repair some of the damage they have done.

Months beforehand I started focusing my Manhattanite efficiency on getting registered in Italy, Andrea leading me by the hand through the wilderness of Old World red tape. The first step was “getting my documents together,” an Italian ritual repeated before every encounter with officialdom. Sticking to a list kindly provided by the Italian Consulate, I collected my birth certificate, passport, high school diploma, college diploma, college transcript, medical school diploma, medical school transcript, certificates of internship and residency, National Board Examination certificates, American Board of Internal Medicine test results, and specialization diploma. Then I got them transfigured into Italian by the one person in New York authorized by the Italian Consulate to crown his translation with an imprimatur. We judiciously gave him a set of our own translations as crib notes, tailored by my husband to match the Rome medical school curriculum. I wrote a cover letter from Andrea’s dictation. It had to be in my own hand, on a folded sheet of double-sized pale yellow ruled Italian paper embossed with a State seal, and had to be addressed “To the Magnificent Rector of the University of Rome.” You have to live in Italy a while to appreciate the theatrical elegance of making every fiddler a Maestro and every teacher a Professoressa; even the most corrupt member of the Italian parliament is by definition Honorable, and every client of a parking lot is by default, for lack of any higher title, a Doctor (“Back up, Dotto’, turn the wheel hard to the left, Dotto’”). There came the proud day in June when I got to deposit the stack of documents in front of a smiling consular official in red nail polish and Armani. After expressing puzzlement that an American doctor would want to move to her country (“You medical people have it so good here”), she Xeroxed my certificates, transcripts, and diplomas, made squiggles on the back to certify the Xeroxes were “authentic copies,” gave me back the originals, and assured me that she’d get things processed zip zip in Italy so that by the time I left for Rome three months later I’d have my Italian license and be ready to get a job. Don’t call me, I’ll call you. When we were about to fly in September and I still hadn’t heard from her, I went to check. Found the Xeroxes piled up on Signora X’s desk right where I’d left them, and the Signora gone for a month’s vacation. Slightly put out, I snatched up the stack to hand-carry over (re-inventing a common expatriate method for avoiding challenges to the efficiency of the Italian mails), prepared to do battle with the system on its own territory.

Dr David Ford Wilson's first experience of working with the human mind was when he was involved in neuroscience research at the University of Michigan. After this initial exposure, Dr David Ford Wilson enrolled in medical school before completing a residency at what he considers to be a life-changing residency at the University of Iowa Hospitals and Clinics.

Surprisingly, a number of old-timers from distinguished families had a different opinion. Under the landladies’ control (and with the cooperation of city and county government), prostitution had been properly regulated. The girls were healthy, received regular medical attention and had few illegitimate births resulting from their work. St. Augustine residents who were interviewed in the late 1970s and early 1980s said the girls who worked in these brothels were mostly well mannered and well dressed and were not considered “low-class.” With the closing of the brothels, however, prostitution moved into the streets, well outside of the city proper and its environs. It became associated with drug use, violent crime, increased incidence of sexually transmitted diseases and increased numbers of children born out of wedlock. In the opinion of one matron, closing the brothels was the worst thing that ever happened to the moral and social condition of St. Augustine. The rejoicing that came with the end of that form of immorality came at a high cost.

We convince ourselves that life will be better after we get married, have a baby, then another. Then we're frustrated that the kids aren't old enough and we'll be more content when they are. After that, we're frustrated that we have teenagers to deal with. We'll certainly be happy when they're out of that stage. We tell ourselves that our life will be complete when our spouse gets his or her act together, when we get a nicer car, are able to go on a nice vacation, when we retire. The truth is, there's no better time to be happy than right now. If not now, when? Your life will always be filled with challenges. It's best to admit this to yourself and decide to be happy anyway...

of menopause—not to mention a potentially increased risk of Alzheimer’s disease, as we’ll see in chapter 9. Medicine 2.0 would rather throw out this therapy entirely, on the basis of one clinical trial, than try to understand and address the nuances involved. Medicine 3.0 would take this study into account, while recognizing its inevitable limitations and built-in biases. The key question that Medicine 3.0 asks is whether this intervention, hormone replacement therapy, with its relatively small increase in average risk in a large group of women older than sixty-five, might still be net beneficial for our individual patient, with her own unique mix of symptoms and risk factors. How is she similar to or different from the population in the study? One huge difference: none of the women selected for the study were actually symptomatic, and most were many years out of menopause. So how applicable are the findings of this study to women who are in or just entering menopause (and are presumably younger)? Finally, is there some other possible explanation for the slight observed increase in risk with this specific HRT protocol?[*3] My broader point is that at the level of the individual patient, we should be willing to ask deeper questions of risk versus reward versus cost for this therapy—and for almost anything else we might do. The fourth and perhaps largest shift is that where Medicine 2.0 focuses largely on lifespan, and is almost entirely geared toward staving off death, Medicine 3.0 pays far more attention to maintaining healthspan, the quality of life. Healthspan was a concept that barely even existed when I went to medical school. My professors said little to nothing about how to help our patients maintain their physical and cognitive capacity as they aged. The word exercise was almost never uttered. Sleep was totally ignored, both in class and in residency, as we routinely worked twenty-four hours at a stretch. Our instruction in nutrition was also minimal to nonexistent. Today, Medicine 2.0 at least acknowledges the importance of healthspan, but the standard definition—the period of life free of disease or disability—is totally insufficient, in my view. We want more out of life than simply the absence of sickness or disability. We want to be thriving, in every way, throughout the latter half of our lives. Another, related issue is that longevity itself, and healthspan in particular, doesn’t really fit into the business model of our current

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

Finding a fine British International school can be a challenge if you live in a place like Dubai. Known as a melting pot of cultures, Dubai offers many choices when it comes to curriculum preferences. Digging the web for valuable options can leave in you bind as well. But, to find the right and affordable British school in Dubai you must have a clear picture of the options available. To make your work easier, here is a list to help you pick the best British curriculum school in Dubai. The best British International schools in Dubai Listed below are the top picks of English Schools in Dubai: The Winchester School This English school in Dubai is the right example of high-quality education at affordable rates. The Winchester School is an ideal pick as it maintains the desired level of British curriculum standards and has a KHDA rating as ‘good’. Admission: This school is fully inclusive for kids aged 1-13 and it conducts no entrance exam for foundation level. However, for other phases, necessary entrance tests are taken according to the standard. Also, admissions here do not follow the concept of waiting lists, which can depend on the vacant seats and disability criteria. Fees: AED 12,996- AED 22,996 Curriculum: National Curriculum of England-EYFS(Early Years Foundation Stage), IGCSE, International A-Level, and International AS Level. Location: The Gardens, Jebel Ali Village, Jebel Ali Contact: +971 (0)4 8820444, principal_win@gemsedu.com Website: The Winchester School - Jebel Ali GEMS Wellington Internation School GEMS Wellington Internation School is yet another renowned institute titled the best British curriculum school in Dubai. It has set a record of holding this title for nine years straight which reveals its commendable standards. Admission: For entrance into this school, an online registration process must be completed. A non-refundable fee of AED 500 is applicable for registration. Students of all gender and all stages can enroll in any class from Preschool to 12th Grade. Fees: AED 43,050- AED 93,658 Curriculum: GCSE, IB, IGCSE, BTEC, and IB DP Location: Al South Area Contact: +971 (0)4 3073000, reception_wis@gemsedu.com Website: Outstanding British School in Dubai - GEMS Wellington International School Dubai British School Dubai British School is yet another prestigious institute that is also a member of the ‘Taaleem’ group. It is also one of the first English schools to open and get a KHDA rating of ‘Outstanding’. Thus, it can be easily relied on to provide the curriculum of guaranteed quality. Admission: Here, the application here can be initiated by filling up an online form. Next, the verification requires documents such as copies of UAE Residence Visa, Identification card, Medical Form, Educational Psychologist’s reports, Vaccination report, and TC. Also, students of all genders and ages between 3-18 can apply here. Fees: AED 46,096- AED 69,145 Curriculum: UK National Curriculum, BTEC, GCSE, A LEVEL Location: Behind Spinneys, Springs Town Centre, near Jumeirah Islands. Contact: +971 (0)4 3619361 Website: Dubai British School Emirates Hills | Taaleem School Final takeaways The above-listed schools are some of the best English schools in Dubai that you can find. Apart from these, you can also check King’s School Dubai, Dubai College School, Dubai English Speaking School, etc. These offer the best British curriculum school in Dubai and can be the right picks for you. So, go on and find the right school for your kid.

Kundalini is a primitive spirit, a creative force that typically resides in a dormant state within our bodies. We realize our innate power and completeness upon awakening. We know there is everything within us that we need to be happy and fulfilled. Kundalini is not a physical reality but a perceptible reality. Once we have been awakened, we are shedding our old tendencies, and negativity like a snake sheds off its old skin. The kundalini is said to empower us with Shakti — that Divine Mother's primordial energy. Charged with this feminine creative force, we get filled with the vigor, enthusiasm, willpower, and self-confidence that we need to shake off negative memories and emotions hidden deep within our subconscious mind. Our mind is getting dormant. Issues and issues that had once held our focus now seem insignificant. Such a mind-state automatically produces intuitive wisdom.  Released from the endless chain of uncertainty and misunderstanding, insight is our guardian and guide.  The strength of discernment is unfailing. The reason kundalini awakening is such a remarkable aspect of spiritual awakening is that it is not based on complex theological arguments or religious norms that are culturally defined. Instead, Kundalini concentrates on the divine's immediate, ultimate experience within us. And regardless of your particular religious background and values, we can all use kundalini yoga to assist in our spiritual evolution. Most ancient myths allude to the meaning of kundalini. Tiresias narrative is a prime example. If Tiresias–the ancient Greek seer discovered two copulating snakes, he would stick his staff between them to distinguish them. He was immediately turned into a woman and remained like that for seven years until he was able to repeat his action and turn back into a male. In this novel, the force of change, powerful enough to completely reverse both male and female physical polarities, emerges from the fusion of the two serpents, passed on by the ring. Tiresias staff was later passed on to Hermes along with serpents. Several medical organizations use the ancient Greek icon of Hermes, the Greek god and messenger of all gods, called “Karykeion.” In occult Hermetic philosophy, Hermes Caduceus represents the masculine's potential as a central phallic rod surrounded by two coupling serpents ' writhing, woven Shakti energies. The rod also represents the spine (sushumna), while the serpents perform metaphysical currents (pranas) along the inda and pingala channels from the chakra at the base of the spine to the pineal gland in a double helix pattern.

Here's the thing about psychotropic medication: it's good for your mind but horrible for your body...… there were one or two pills designed to treat whatever mental disorder the resident had and about nine or ten others to treat the side effects from those pills. Sometimes the cure was worse than the malady.

During my early youth I carried all my earthly goods in my pants and coat pockets, that is when I had a coat, because I had to be ready to travel at any hour no matter where I happened to be, mostly on account of merciless truant officers. Since then, having become in the meantime well-to-do, I carried all my earthly riches in that shaky cardboard box. It makes you wonderfully independent. Even had these good men not asked for it, even had they not so highly solicited my medical knowledge, I would still have taken the medicine box along with me. This I did entirely instinctively and out of long and often very bitter experience. For it had often happened to me in the past that, when I thought of leaving my residence for only one hour, upon regaining full consciousness I discovered that I had landed on a different continent. Through such experiences one learns to become careful, so that toothbrush, shaving kit and a little pocket compass were constantly buttoned up inside my back pants pocket. How would I know where I might land if I flew away with these three nightbirds? ("Midnight Call")