Medical Student Quotes

A schoolchild should be taught grammar--for the same reason that a medical student should study anatomy. Having learned about the exciting mysteries of an English sentence, the child can then go forth and speak and write any damn way he pleases.

Customer: Do you have any medical textbooks? Bookseller: Sorry, no. They go out of date so quickly we don't stock them, but I can order one in for you. Customer: I'm not worried about it being in date. Bookseller: Does your university not request you have a specific edition? Customer: Oh, I'm not a medical student. I just want to learn how to do stitches. Bookseller: ... Right. Customer: Do you have a book on sewing instead?

Wouldn't it be great,as Scott Peck suggests, if all medical students had to undergo the symptoms and feeling of a spectrum of illnesses. From acute infections to terminal cancer - and Kuru, the laughing sickness. Just a month for each exposure, controlled of course, and a good heavy dose of excruciating pain. So they'll know what that feels like.

Most medical students go through a brief period when they develop all manner of imaginary illnesses – I myself had leukaemia for at least four days – until they learn, as a matter of self-preservation, that illnesses happen to patients, not to doctors.

After graduation, due to special circumstances and perhaps also to my character, I began to travel throughout America, and I became acquainted with all of it. Except for Haiti and Santo Domingo, I have visited, to some extent, all the other Latin American countries. Because of the circumstances in which I traveled, first as a student and later as a doctor, I came into close contact with poverty, hunger and disease; with the inability to treat a child because of lack of money; with the stupefaction provoked by the continual hunger and punishment, to the point that a father can accept the loss of a son as an unimportant accident, as occurs often in the downtrodden classes of our American homeland. And I began to realize at that time that there were things that were almost as important to me as becoming famous for making a significant contribution to medical science: I wanted to help those people.

Thank you! It’s really cool to have a boyfriend who’s a medical student.” Gideon grinned. “I swear that’s the last time I ever vaccinate anyone. Patients are so ungrateful.

I was once asked if I had any ideas for a really scary reality TV show. I have one reality show that would really make your hair stand on end: "C-Students from Yale." George W. Bush has gathered around him upper-crust C-students who know no history or geography, plus not-so-closeted white supremacists, aka Christians, and plus, most frighteningly, psychopathic personalities, or PPs, the medical term for smart, personable people who have no consciences. To say somebody is a PP is to make a perfectly respectable diagnosis, like saying he or she has appendicitis or athlete's foot . . . PPs are presentable, they know full well the suffering their actions may cause others, but they do not care. They cannot care because they are nuts. They have a screw loose! . . . So many of these heartless PPs now hold big jobs in our federal government, as though they were leaders instead of sick. They have taken charge of communications and the schools, so we might as well be Poland under occupation. They might have felt that taking our country into an endless war was simply something decisive to do. What has allowed so many PPs to rise so high in corporations, and now in government, is that they are so decisive. They are going to do something every fuckin' day and they are not afraid. Unlike normal people, they are never filled with doubts, for the simple reasons that they don't give a fuck what happens next. Simply can't. Do this! Do that! Mobilize the reserves! Privatize the public schools! Attack Iraq! Cut health care! Tap everybody's telephone! Cut taxes on the rich! Build a trillion-dollar missile shield! Fuck habeas corpus and the Sierra Club and In These Times, and kiss my ass! There is a tragic flaw in our precious Constitution, and I don't know what can be done to fix it. This is it: Only nut cases want to be president.

One of the first things we teach medical students is to listen to the patient by taking a careful medical history. Ninety percent of the time, you can arrive at an uncannily accurate diagnosis by paying close attention, using physical examination and sophisticated lab test to confirm your hunch (and to increase the bill to the insurance company).

Medical education does not exist to provide student with a way of making a living, but to ensure the health of the community.

Everything teeters between pathos and bathos: here you are, violating society's most fundamental taboos and yet formaldehyde is a powerful appetite stimulant, so you also crave a burrito.

Arguing with somebody is never pleasant, but sometimes it is useful and necessary to do so. Just the other day, for example, it was useful and necessary for me to have an unpleasant argument with a medical student because if he hadn't let me borrow his speedboat I would now be chained inside a very small waterproof room, instead of sitting in a typewriter factory typing our this woeful tale.

Sometimes we called one another by our future doctor names. We did it partly to be funny, but mostly because we liked it when people did it back to us.

Stress and sleep deprivation had a funny way of liberating the mind from previously held truisms, replacing them with a more compliant desperation.

It is the curse of humanity that it learns to tolerate even the most horrible situations by habituation.” “Medical education does not exist to provide students with a way of making a living, but to ensure the health of the community.” “The physicians are the natural attorneys of the poor, and the social problems should largely be solved by them.

How do we seize the past? Can we ever do so? When I was a medical student some pranksters at the end-of-the-term dance released into the hall a piglet which had been smeared with grease. It squirmed between legs, evaded capture, squealed a lot. People fell over trying to grasp it, and were made to look ridiculous in the process. The past often seems to behave like that piglet.

A doctor should be a clown at heart, a scientist at brain and a mother at conscience.

When my parents passed on, and we read their wills, we discovered something we didn’t at all expect, especially from our devoutly Catholic mother: they had both left instructions that their bodies be donated to science. We were bewildered and we were pissed. They wanted their cadavers to be used by medical students, they wanted their flesh to be cut into and their cancerous organs examined. We were breathless. They wanted no elaborate funerals, no expense incurred for such stuff – they hated wasting money or time on ceremony, on appearances. When they died there was little left – the house, the cars. And their bodies, and they gave those away. To offer them to strangers was disgusting, wrong, embarrassing. And selfish to us, their children, who would have to live with the thought of their cold weight sinking on silver tables, surrounded by students chewing gum and making jokes about the location of freckles. But then again: Nothing can be preserved. It’s all on the way out, from the second it appears, and whatever you have always has one eye on the exit, and so screw it. As hideous and uncouth as it is, we have to give it all away, our bodies, our secrets, our money, everything we know: All must be given away, given away every day, because to be human means: 1. To be good 2. To save nothing

If you are ready to give up everything else and study the whole history and background of the market and all principal companies whose stocks are on the board as carefully as a medical student studies anatomy—if you can do all that and in addition you have the cool nerves of a gambler, the sixth sense of a clairvoyant and the courage of a lion, you have a ghost of a chance.

Babies used to make me nervous, but these squirmy things are awesome once you’ve read the manual.

When I was a medical student some pranksters at an end-of-term dance released into the hall a piglet which had been smeared with grease. It squirmed between legs, evaded capture, squealed a lot. People fell over trying to grasp it, and were made to look ridiculous in the process. The past often seems to behave like that piglet.

Richard had long ago made it clear that he viewed medical students as nothing more than an annoyance. Part canker, part pustule, we functioned – were he ever so generous to use that word – as vestigial organs, adding to the team like supernumerary nipples.

beating the dead animals in the dissecting room with a stick.” “Beating them with a stick!” “Yes, to see whether bruises could be made after death. I saw him at it with my own eyes.” “But he is not a medical student?” “No. I have no idea what he wants to do with his studies. But here

Making money in the markets is tough. The brilliant trader and investor Bernard Baruch put it well when he said, “If you are ready to give up everything else and study the whole history and background of the market and all principal companies whose stocks are on the board as carefully as a medical student studies anatomy—if you can do all that and in addition you have the cool nerves of a gambler, the sixth sense of a clairvoyant and the courage of a lion, you have a ghost of a chance.

Thus, whatever the medical student has been taught, and even genuinely believes, about the ideals of medicine, the primacy of empathy, the value of the doctor-patient relationship--all of this is swamped once he or she steps into the wards. [...] It's no wonder that empathy gets trounced in the actual world of clinical medicine; everything that empathy requires seems to detract from daily survival.

But aesthetic value does not rise from the work's apparent ability to predict a future: we do not admire Cézanne because of the Cubists drew on him. Value rises from deep in the work itself - from its vitality, its intrinsic qualities, its address to the senses, intellect, and imagination; from the uses it makes of the concrete body of tradition. In art there is no progress, only fluctuations of intensity. Not even the greatest doctor in Bologna in the 17th century knew as much a bout the human body as today's third-year medical student. But nobody alive today can draw as well as Rembrandt or Goya.

Ordering drinks always floored me. I didn't know whisky from gin and never managed to get anything I really liked the taste of. Buddy Willard and the other college boys I knew were usually too poor to buy hard liquor or they scorned drinking altogether. It's amazing how many college boys don't drink or smoke. I seemed to know them all. The farthest Buddy Willard ever went was buying us a bottle of Dubonnet, which he only did because he was trying to prove he could be aesthetic in spite of being a medical student. "I'll have a vodka," I said. The man looked at me more closely. "With anything?" "Just plain," I said. "I always have it plain." I thought I might make a fool of myself by saying I'd have it with ice or gin or anything. I'd seen a vodka ad once, just a glass full of vodka standing in the middle of a snowdrift in a blue light, and the vodka looked clear and pure as water, so I thought having vodka plain must be all right. My dream was someday ordering a drink and finding out it tasted wonderful.

The world doesn't need more smart doctors, it needs more warm and wise doctors. Be the wisdom yourself - be the warmth yourself, and be the doctor that the doctors have forgotten to be, for it is time to save medicine, to save humanity.

The midpoint in medicine between excessive emotional involvement with patients and a complete lack of empathy is not a simple one to locate.

There is no painkiller as effective as love, no anti-depressant as soothing as cheer, no defibrillator as powerful as wisdom.

many medical schools inform their students that within several years half of what they’ve been taught will be wrong, and the teachers just don’t know which half.

All knowledge that takes special training to acquire is the province of the Magician energy. Whether you are an apprentice training to become a master electrician and unraveling the mysteries of high voltage; or a medical student, grinding away night and day, studying the secrets of the human body and using available technologies to help your patients; or a would-be stockbroker or a student of high finance; or a trainee in one of the psychoanalytic schools, you are in exactly the same position as the apprentice shaman or witch doctor in tribal societies. You are spending large amounts of time, energy, and money in order to be initiated into rarefied realms of secret power. You are undergoing an ordeal testing your capacities to become a master of this power. And, as is true in all initiations, there is no guarantee of success. [Magician energy]

The calcium in your bones came from a star. We are all made from recycled bits and pieces of the universe. This matters because origins matter. For example, if you were born to a reigning monarch but kidnapped by the black market baby underground shortly after birth and sent to America where you were raised by common, unremarkable people from Ohio, and when you were in your thirties working as a humble UPS driver, dignitaries landed their helicopter on the roof of your crummy apartment building and informed you of their thirty-plus year search for you, His Royal Highness, the course of your life might change. You know? Our familial genetic origins -medical histories- inform us of medical conditions which exist in our families and when we know about these specific conditions, we can sometimes take certain actions to prevent them. Which is why I think it’s important to consider that billions of years before we were students and mothers and dog trainers and priests, we were particles that would form into star after star after star until forever passed, and instead of a star what formed was life; simplistic, crude, miraculous. And after another infinity, there we were. And this is why for you, anything is possible. Because you are made out of everything.

Our schools will not improve if we continue to focus only on reading and mathematics while ignoring the other studies that are essential elements of a good education. Schools that expect nothing more of their students than mastery of basic skills will not produce graduates who are ready for college or the modern workplace. *** Our schools will not improve if we value only what tests measure. The tests we have now provide useful information about students' progress in reading and mathematics, but they cannot measure what matters most in education....What is tested may ultimately be less important that what is untested... *** Our schools will not improve if we continue to close neighborhood schools in the name of reform. Neighborhood schools are often the anchors of their communities, a steady presence that helps to cement the bond of community among neighbors. *** Our schools cannot improve if charter schools siphon away the most motivated students and their families in the poorest communities from the regular public schools. *** Our schools will not improve if we continue to drive away experienced principals and replace them with neophytes who have taken a leadership training course but have little or no experience as teachers. *** Our schools cannot be improved if we ignore the disadvantages associated with poverty that affect children's ability to learn. Children who have grown up in poverty need extra resources, including preschool and medical care.

Several years ago, researchers at the University of Minnesota identified 568 men and women over the age of seventy who were living independently but were at high risk of becoming disabled because of chronic health problems, recent illness, or cognitive changes. With their permission, the researchers randomly assigned half of them to see a team of geriatric nurses and doctors—a team dedicated to the art and science of managing old age. The others were asked to see their usual physician, who was notified of their high-risk status. Within eighteen months, 10 percent of the patients in both groups had died. But the patients who had seen a geriatrics team were a quarter less likely to become disabled and half as likely to develop depression. They were 40 percent less likely to require home health services. These were stunning results. If scientists came up with a device—call it an automatic defrailer—that wouldn’t extend your life but would slash the likelihood you’d end up in a nursing home or miserable with depression, we’d be clamoring for it. We wouldn’t care if doctors had to open up your chest and plug the thing into your heart. We’d have pink-ribbon campaigns to get one for every person over seventy-five. Congress would be holding hearings demanding to know why forty-year-olds couldn’t get them installed. Medical students would be jockeying to become defrailulation specialists, and Wall Street would be bidding up company stock prices. Instead, it was just geriatrics. The geriatric teams weren’t doing lung biopsies or back surgery or insertion of automatic defrailers. What they did was to simplify medications. They saw that arthritis was controlled. They made sure toenails were trimmed and meals were square. They looked for worrisome signs of isolation and had a social worker check that the patient’s home was safe. How do we reward this kind of work? Chad Boult, the geriatrician who was the lead investigator of the University of Minnesota study, can tell you. A few months after he published the results, demonstrating how much better people’s lives were with specialized geriatric care, the university closed the division of geriatrics.

...never [enter] into dispute or argument with another. I never saw an instance of one of two disputants convincing the other by argument. I have seen many, on their getting warm, becoming rude, & shooting one another. ... When I hear another express an opinion which is not mine, I say to myself, he has a right to his opinion, as I to mine; why should I question it? His error does me no injury, and shall I become a Don Quixote, to bring all men by force of argument to one opinion? ... There are two classes of disputants most frequently to be met with among us. The first is of young students, just entered the threshold of science, with a first view of its outlines, not yet filled up with the details & modifications which a further progress would bring to their knoledge. The other consists of the ill-tempered & rude men in society, who have taken up a passion for politics. ... Consider yourself, when with them, as among the patients of Bedlam, needing medical more than moral counsel. Be a listener only, keep within yourself, and endeavor to establish with yourself the habit of silence, especially on politics. In the fevered state of our country, no good can ever result from any attempt to set one of these fiery zealots to rights, either in fact or principle. They are determined as to the facts they will believe, and the opinions on which they will act. Get by them, therefore, as you would by an angry bull; it is not for a man of sense to dispute the road with such an animal.

For me, hands are hard." She looks up from what she's doing. "Because you're holding this disconnected hand, and it's holding you back." Cadavers occasionally effect a sort of accidental humanness that catches the medical professional off guard. I once spoke to an anatomy student who described a moment in the lab when she realized that the cadaver's arm was around her waist. It becomes difficult, under circumstances such as these, to retain one's clinical remove.

One of the most extraordinary stories of reframing is that of Roger Bannister, the first person to run a mile in less than four minutes. Bannister was a medical school student who couldn’t afford a trainer or a special runner’s diet. He didn’t even have time to run more than thirty minutes a day, squeezed in around his medical studies. Yet Bannister did not focus on all the reasons why he logically had no chance of reaching his goal. He instead refocused on accomplishing his goal in his own way. On the morning he made world history, he got up, ate his usual breakfast, did his required hospital rounds, and then caught a bus to the track.

I remember going to the British Museum one day to read up the treatment for some slight ailment of which I had a touch – hay fever, I fancy it was. I got down the book, and read all I came to read; and then, in an unthinking moment, I idly turned the leaves, and began to indolently study diseases, generally. I forget which was the first distemper I plunged into – some fearful, devastating scourge, I know – and, before I had glanced half down the list of “premonitory symptoms,” it was borne in upon me that I had fairly got it. I sat for awhile, frozen with horror; and then, in the listlessness of despair, I again turned over the pages. I came to typhoid fever – read the symptoms – discovered that I had typhoid fever, must have had it for months without knowing it – wondered what else I had got; turned up St. Vitus’s Dance – found, as I expected, that I had that too, – began to get interested in my case, and determined to sift it to the bottom, and so started alphabetically – read up ague, and learnt that I was sickening for it, and that the acute stage would commence in about another fortnight. Bright’s disease, I was relieved to find, I had only in a modified form, and, so far as that was concerned, I might live for years. Cholera I had, with severe complications; and diphtheria I seemed to have been born with. I plodded conscientiously through the twenty-six letters, and the only malady I could conclude I had not got was housemaid’s knee. ... I had walked into that reading-room a happy, healthy man. I crawled out a decrepit wreck. I went to my medical man. He is an old chum of mine, and feels my pulse, and looks at my tongue, and talks about the weather, all for nothing, when I fancy I’m ill; so I thought I would do him a good turn by going to him now. “What a doctor wants,” I said, “is practice. He shall have me. He will get more practice out of me than out of seventeen hundred of your ordinary, commonplace patients, with only one or two diseases each.” So I went straight up and saw him, and he said: “Well, what’s the matter with you?” I said: “I will not take up your time, dear boy, with telling you what is the matter with me. Life is brief, and you might pass away before I had finished. But I will tell you what is NOT the matter with me. I have not got housemaid’s knee. Why I have not got housemaid’s knee, I cannot tell you; but the fact remains that I have not got it. Everything else, however, I HAVE got.” And I told him how I came to discover it all. Then he opened me and looked down me, and clutched hold of my wrist, and then he hit me over the chest when I wasn’t expecting it – a cowardly thing to do, I call it – and immediately afterwards butted me with the side of his head. After that, he sat down and wrote out a prescription, and folded it up and gave it me, and I put it in my pocket and went out. I did not open it. I took it to the nearest chemist’s, and handed it in. The man read it, and then handed it back. He said he didn’t keep it. I said: “You are a chemist?” He said: “I am a chemist. If I was a co-operative stores and family hotel combined, I might be able to oblige you. Being only a chemist hampers me.” I read the prescription. It ran: “1 lb. beefsteak, with 1 pt. bitter beer every 6 hours. 1 ten-mile walk every morning. 1 bed at 11 sharp every night. And don’t stuff up your head with things you don’t understand.” I followed the directions, with the happy result – speaking for myself – that my life was preserved, and is still going on.

A great anatomist used to close his opening lecture to beginning medical students with words that apply equally to our own undertaking. “In this course,” he would say, “we shall be dealing with flesh and bones and cells and sinews, and there are going to be times when it’s all going to seem terribly cold-blooded. But never forget. It’s alive!” II.

As a doctor, you don’t practice medicine, rather you become the medicine yourself.

There may be medical tools in your hands to treat the patient, but those hands must be that of a loving, warm and conscientious human being.

MEDICINE means Mercy - Empathy - Dare - Integrity - Care - Ingenuity - Nobility - and Ethics.

Hi there, cutie." Ash turned his head to find an extremely attractive college student by his side. With black curly hair, she was dressed in jeans and a tight green top that displayed her curves to perfection. "Hi." "You want to go inside for a drink? It's on me." Ash paused as he saw her past, present, and future simultaneously in his mind. Her name was Tracy Phillips. A political science major, she was going to end up at Harvard Med School and then be one of the leading researchers to help isolate a mutated genome that the human race didn't even know existed yet. The discovery of that genome would save the life of her youngest daughter and cause her daughter to go on to medical school herself. That daughter, with the help and guidance of her mother, would one day lobby for medical reforms that would change the way the medical world and governments treated health care. The two of them would shape generations of doctors and save thousands of lives by allowing people to have groundbreaking medical treatments that they wouldn't have otherwise been able to afford. And right now, all Tracy could think about was how cute his ass was in leather pants, and how much she'd like to peel them off him. In a few seconds, she'd head into the coffee shop and meet a waitress named Gina Torres. Gina's dream was to go to college herself to be a doctor and save the lives of the working poor who couldn't afford health care, but because of family problems she wasn't able to take classes this year. Still Gina would tell Tracy how she planned to go next year on a scholarship. Late tonight, after most of the college students were headed off, the two of them would be chatting about Gina's plans and dreams. And a month from now, Gina would be dead from a freak car accident that Tracy would see on the news. That one tragic event combined with the happenstance meeting tonight would lead Tracy to her destiny. In one instant, she'd realize how shallow her life had been, and she'd seek to change that and be more aware of the people around her and of their needs. Her youngest daughter would be named Gina Tory in honor of the Gina who was currently busy wiping down tables while she imagined a better life for everyone. So in effect, Gina would achieve her dream. By dying she'd save thousands of lives and she'd bring health care to those who couldn't afford it... The human race was an amazing thing. So few people ever realized just how many lives they inadvertently touched. How the right or wrong word spoken casually could empower or destroy another's life. If Ash were to accept Tracy's invitation for coffee, her destiny would be changed and she would end up working as a well-paid bank officer. She'd decide that marriage wasn't for her and go on to live her life with a partner and never have children. Everything would change. All the lives that would have been saved would be lost. And knowing the nuance of every word spoken and every gesture made was the heaviest of all the burdens Ash carried. Smiling gently, he shook his head. "Thanks for asking, but I have to head off. You have a good night." She gave him a hot once-over. "Okay, but if you change your mind, I'll be in here studying for the next few hours." Ash watched as she left him and entered the shop. She set her backpack down at a table and started unpacking her books. Sighing from exhaustion, Gina grabbed a glass of water and made her way over to her... And as he observed them through the painted glass, the two women struck up a conversation and set their destined futures into motion. His heart heavy, he glanced in the direction Cael had vanished and hated the future that awaited his friend. But it was Cael's destiny. His fate... "Imora thea mi savur," Ash whispered under his breath in Atlantean. God save me from love.

The traditional gross anatomy lab represented a sort of sink-or-swim mentality about dealing with death. To cope with what was being asked of them, medical students had to find ways to desensitize themselves. They quickly learned to objectify cadavers, to think of the dead as structures and tissues, and not a former human being. Humor--at the cadaver's expense--was tolerated, condoned even.

We routinely put the less experienced teachers with the neediest students. No other profession does this. A challenging medical case gets the attention of top specialists and skilled surgeons. It would be considered malpractice to put someone unskilled or new to the profession on a complicated medical case. Yet, in education, we subject our neediest dependent learners to inadequate instruction given their needs, or we allow them to lose valuable instructional time because of questionable discipline practices.

Women, as we know, used to be judged incapable of medicine. That changed in 1876, when, after a tenacious fight led by Britain’s first female doctor, Elizabeth Garret Anderson, the law was changed to prohibit women’s exclusion from medical schools. Now, more than 140 years later, female medical students outnumber men. Yet, according to Lawson, our predisposition to avoid antisocial hours and put family before career means we are more

By the end of medical school, most students tended to focus on "lifestyle" specialities - those with more humane hours, higher salaries, and lower pressures - the idealism of their med school application essays tempered or lost. As graduation neared and we sat down, in a Yale tradition, to re-write our commencement oath - a melding of the words of Hippocrates, Maimonides, Osler, along with a few other great medical forefathers - several students argued for the removal of language insisting that we place our patients' interests above our own. (The rest of us didn't allow this discussion to continue for long. The words stayed. This kind of egotism struck me as antithetical to medicine and, it should be noted, entirely reasonable. Indeed, this is how 99 percent of people select their jobs: pay, work environment, hours. But thats the point. Putting lifestyle first is how you find a job - not a calling).

Be aware of the whole domain of sickness - be aware of its implications in human life - be aware of its farthest reach in the life of the patient as well as the lives of the next of kin - be aware of its deepest roots, for that very awareness is the very foundation of true diagnosis, which automatically brings along the awareness of wellness.

Dr. Spencer Eth, who ran the psychiatry department at the now-defunct St. Vincent’s Hospital in Greenwich Village, was curious where survivors had turned for help, and early in 2002, together with some medical students, he conducted a survey of 225 people who had escaped from the Twin Towers. Asked what had been most helpful in overcoming the effects of their experience, the survivors credited acupuncture, massage, yoga, and EMDR, in that order.1 Among rescue workers, massages were particularly popular.

Virchow would write, ‘My politics were those of prophylaxis, my opponents preferred those of palliation.’ He had a knack for aphorism. ‘Medicine is a social science, and politics is nothing but medicine on a large scale.’ ‘It is the curse of humanity that it learns to tolerate even the most horrible situations by habituation.’ ‘Medical education does not exist to provide students with a way to make a living, but to ensure the health of the community.’ ‘The physicians are the natural attorneys of the poor, and the social problems should largely be solved by them.’ This last was Farmer’s favorite. Virchow put the world together in a way that made sense to Farmer. ‘Virchow had a comprehensive vision,’ he said. ‘Pathology, social medicine, politics, anthropology. My model.

Illness in this society, physical or mental, they are not abnormalities. They are normal responses to an abnormal culture. This culture is abnormal when it comes to real human needs. And.. it is in the nature of the system to be abnormal, because if we had a society geared to meet human needs.. would we be destroying the Earth through climate change? Would we be putting extra burden on certain minority people? Would we be selling people a lot of goods that they don't need, and, in fact, are harmful for them? Would there be mass industries based on manufacturing, designing and mass-marketing toxic food to people? So we do all that for the sake of profit. That's insanity. It is not insanity from the point of view of profit, but it is insanity from the point of view of human need. And so, in so many ways this culture denies and even runs against counter to human needs. When you mentioned trauma.. given how important trauma is in human life and what an impact it has.. why have we ignored it for so long? Because that denial of reality is built in into this system. It keeps the system alive. So it is not a mistake, it is a design issue. Not that anybody consciously designed it, but that's just how the system survives. Now.. the average medical student to THIS DAY (I say the average.. there are exceptions) still doesn't get a single lecture on trauma in 4 years of medical school. They should have a whole course on it, Because I can tell you that trauma is related to addiction, all kinds of mental illness and most physical health conditions as well. And there is a whole lot of science behind that, but they don't study that science. Now that reflects this society's denial of trauma, the medical system simply reflects the needs of the larger society, I should say, the dominant needs of the larger society.

Coach Slader caught up followed closely by a trail of curious students all as surprised as I at this turn of events.Coach spoke in a delicate voice, like he didn’t want to spook a dangerous animal. “Jayden, what are you doing?” “She needs medical attention.” The guy didn’t pause stride. “Yes, but—” “I’m taking her to the nurse.” “Okay, but—” “She’s too weak to walk.” I huffed. “I am not. Put me down.” In one swift movement the boy stopped, dumped me on my feet and stepped back. My knees buckled and before you could say “Bob’s your uncle” he scooped me up again and kept walking. A chorus of giggles erupted behind us. “See,” he said.I put my arms around his neck and shut up.

From elementary school through high school, my siblings and I were hectored to excel in every class, to win medals in science fairs, to be chosen princess of the prom, to win election to student government. Thereby and only thereby, we learned, could we expect to gain admission to the right college, which in turn would get us into Harvard Medical School: life's one sure path to meaningful success and lasting happiness.

When one hears hoofbeats, medical students are taught, one must think of horses, not zebras. But the doctor who sees my blood count will surely think of horses. He will arrive at a perfectly logical conclusion. It will no occur to him that, this time, it is truly a zebra galloping by.

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.

Eat carbohydrates and blood sugar rises. Every first-year medical student knows this, every nurse or diabetes educator knows this, every person with diabetes who performs finger-stick blood sugars before and after meals knows this. Eat any food with more than just a few grams of carbohydrates and blood sugar will rise; the more carbohydrates you eat, the higher blood sugar will rise. Everyone also knows that foods like butter do not raise blood sugar, nor will a fatty cut of meat, olives, green bell peppers, broccoli, or chicken liver. And since the 1980s, when the sharp upward climb in type 2 diabetes (and obesity) began, the only component of diet that has increased is carbohydrates, not fat or proteins.4

Doctor Benway is operating in an auditorium filled with students: "Now, boys, you won't see this operation performed very often and there's a reason for that ... You see it has absolutely no medical value. No one knows what the purpose of it originally was or if it had a purpose at all. Personally I think it was a pure artistic creation from the beginning. Just as a bull fighter with his skill and knowledge extricates himself from danger he has himself invoked, so in this operation the surgeon deliberately endangers his patient, and then, with incredible speed and celerity, rescues him from death at the last possible split second ... "Did any of you ever see Doctor Tetrazzini perform? I say perform advisedly because his operations were performances. He would start by throwing a scalpel across the room into the patient and then make his entrance like a ballet dancer. His speed was incredible: `I don't give them time to die,' he would say. Tumors put him in a frenzy of rage. `Fucking undisciplined cells!' he would snarl, advancing on the tumor like a knife-fighter.

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.

Oh, shit.” “What?” “Wouldn’t I have a ring? I didn’t even think to buy one!” “Oh, right.” I reach into my pocket and pull a ring box out, setting it onto the console between us. “There you go.” Anna stares down at it. “This is so surreal.” “What’s that? “This just—even as a little girl,” she says breathily. “This is exactly how I dreamed it would happen.” “Are you ever serious?” Her smile straightens and she gapes at me. “You’ve told me I’m supposed to be a married medical student on the way back from Cambodia. I’m wearing actual Chanel and two days ago had my labia waxed by a woman with hands bigger than yours. My fake husband just dropped a ring box onto the console between us and said, ‘There you go.’ And you want me to be serious?

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.

In consequence, the National General Assembly of the People of Cuba proclaims before America: the right of peasants to land; the right of the worker to the fruit of his labor; the right of children to receive education; the right of the sick to receive medical and hospital care; the right of the young to work; the right of students to receive free instruction, practical and scientific; the right of Negroes and Indians to 'a full measure of human dignity'; the right of woman to civil, social and political equality; the right of the aged to secure old age; the right of intellectuals, artists and scientists to fight through their work for a better world; the right of States to nationalize imperialist monopolies as a means of recovering national wealth and resources; the right of countries to engage freely in trade with all other countries of the world; the right of nations to full sovereignty; the right of people to convert their fortresses into schools and to arm their workers, peasants, students, intellectuals, Negroes, Indians, women, the young, the old, all the oppressed and exploited; that they may better defend, with their own hands, their rights and their future.

Sophia was asked to speak to the students of a local medical school. “Sophia, what do we need to be better doctors?” the students asked. “Doctors,” Sophia said, “need strong stomachs and strong powers of observation.” Then she opened a canister. The putrid smell quickly moved through the classroom. Sophia stuck a finger in the jar, pulled it up, and then licked it. She passed the jar around encouraging each doctor in training to do the same. Each did, and though many felt nauseas, no one got sick. “You all have very strong stomachs,” she said. “But your powers of observation need some work.” “What do you mean?” they asked. “We did just what you did.” “There is one difference,” she replied. “The finger I dipped in the jar was not the finger I licked.

Using your wealth to purchase other people’s loyalty is a game as old as humanity itself. Rich men use their wealth to attract women, unscrupulous employers use material incentives and disincentives to manipulate their workers, and wealthy countries like the USA use their national wealth to keep their citizens loyal to the cause of aggressive and genocidal Imperialism. But historical longevity and common practice don’t make the manipulation or exploitation morally or ethically right. Organized religions are inherently POLITICAL organizations. There is a fundamental difference between the financial enterprise and political machinations of an organized religion versus a mass of independent unaffiliated believers, philosophers, and mystics who do not support any organized religion. Christianity and Islam are known as proselytizing religions because they make an organized and systemic effort to gain converts, and they often provide services, products, or employment to attract converts. Judaism, Hinduism, and Buddhism show far less zeal about gaining converts, which is why you almost never hear about Jewish, Hindu, or Buddhist missionaries. Modern medical and nursing schools usually teach their students the moral principle that the provision of medical services should never be used as a means to proselytize or promote a religion, but that does not deter many Christian health care providers from doing exactly that. Most of the medical and charitable organizations based in Christian countries are fronts for Christian proselytizing activities.

For those who must deal with human corpses regularly, it is easier (and, I suppose, more accurate) to think of them as objects, not people. For most physicians, objectification is mastered their first year of medical school, in the gross anatomy lab, or “gross lab,” as it is casually and somewhat aptly known. To help depersonalize the human form that students will be expected to sink knives into and eviscerate, anatomy lab personnel often swathe the cadavers in gauze and encourage students to unwrap as they go, part by part.

I wasn’t going to medical school—what did I care? I didn’t think the grades mattered. They weren’t a systematic appraisal of what I knew. I was more interested in hanging out with someone like Aristotle Skalides, a wandering intellectual and would-be academic who wasn’t a student but who liked to engage young people in the coffee shop in discussions about philosophy. Spending an hour with him at the coffee shop was like going and spending an hour in the classroom. I was more interested in my general education than the courses.

But what if you can’t find a colleague with a compatible schedule? When Taylor went away to speak at a conference for a week, I needed to re-create the experience of making an effort pact with another person. Thankfully, I found Focusmate. With a vision to help people around the world stay focused, they facilitate effort pacts via a one-to-one video conferencing service. While Taylor was away, I signed up at Focusmate.com and was paired with a Czech medical school student named Martin. Because I knew he would be waiting for me to co-work at our scheduled time, I didn’t want to let him down. While Martin was hard at work memorizing human anatomy, I stayed focused on my writing. To discourage people from skipping their meeting times, participants are encouraged to leave a review of their focus mate.5 Effort pacts make us less likely to abandon the task at hand. Whether we make them with friends and colleagues, or via tools like Forest, SelfControl, Focusmate, or kSafe, effort pacts are a simple yet highly effective way to keep us from getting distracted.

Perhaps you think that better-educated people would do better? Or people who are more interested in the issues? I certainly thought that once, but I was wrong. I have tested audiences from all around the world and from all walks of life: medical students, teachers, university lecturers, eminent scientists, investment bankers, executives in multinational companies, journalists, activists, and even senior political decision makers. These are highly educated people who take an interest in the world. But most of them—a stunning majority of them—get most of the answers wrong. Some of these groups even score worse than the general public; some of the most appalling results came from a group of Nobel laureates and medical researchers. It is not a question of intelligence. Everyone seems to get the world devastatingly wrong. Not only devastatingly wrong, but systematically wrong. By which I mean that these test results are not random. They are worse than random: they are worse than the results I would get if the people answering my questions had no knowledge at all.

In 1884, the American physician William Pancoast injected sperm from his “best-looking” student into an anesthetized woman—without her knowledge—whose husband had been deemed infertile. Nine months later, she gave birth to a healthy baby. Pancoast eventually told her husband what he had done, but the two men decided to spare the woman the truth. Pancoast’s experiment remained a secret for twenty-five years. After his death in 1909, the donor—a man ironically named Dr. Addison Davis Hard—confessed to the underhanded deed in a letter to Medical World.)

Young women routinely went to law school; half the medical faculty in prerevolutionary times were women, as were a quarter of economics students. Oddly, even when the anti-Semitic decrees had made legal careers inaccessible to Jews, government schools for girls remained open to Jewish girls.

It seems obvious that throughout history, as one of the few professions open to women, midwifery must have attracted women of unusual intelligence, competence, and self-respect§. While acknowledging that many remedies used by the witches were “purely magical” and worked, if at all, by suggestion, Ehrenreich and English point out an important distinction between the witch-healer and the medical man of the late Middle Ages: . . . the witch was an empiricist; She relied on her senses rather than on faith or doctrine, she believed in trial and error, cause and effect. Her attitude was not religiously passive, but actively inquiring. She trusted her ability to find ways to deal with disease, pregnancy and childbirth—whether through medication or charms. In short, her magic was the science of her time. By contrast: There was nothing in late mediaeval medical training that conflicted with church doctrine, and little that we would recognize as “science”. Medical students . . . spent years studying Plato, Aristotle and Christian theology. . . . While a student, a doctor rarely saw any patients at all, and no experimentation of any kind was taught. . . . Confronted with a sick person, the university-trained physician had little to go on but superstition. . . . Such was the state of medical “science” at the time when witch-healers were persecuted for being practitioners of “magic”.15 Since asepsis and the transmission of disease through bacteria and unwashed hands was utterly unknown until the latter part of the nineteenth century, dirt was a presence in any medical situation—real dirt, not the misogynistic dirt associated by males with the female body. The midwife, who attended only women in labor, carried fewer disease bacteria with her than the physician.

Today, one must dig to uncover the history of Black Fort Greene, whose pioneers seem in danger of being forgotten. Dr. McKinney’s former brownstone at 205 DeKalb Avenue—the site of her thriving medical practice—would be listed for sale in 2016 for nearly $2.7 million, without any mention of its history. Instead, the names of Brooklyn’s slave-holding families dominate the terrain. Boerum Hill (named for Simon Boerum, a man with three slaves). Wyckoff Street (Peter Wyckoff, enslaver of seven). Ditmas Park (four slaves). Luquer Street (thirteen). Van Brunt Street (seven). Cortelyou Road (two). Both Van Dam and Bayard streets are named for the owners of slave ships, while Stuyvesant Heights is named for the man who governed the New Netherland colony of the Dutch West India Company, which shipped tens of thousands of slaves. Even the McKinney school began with a slave-owning name. Back when Dasani’s grandmother was a student, this was still the Sands Junior High School, named for Joshua Sands (enslaver of six) and his brother Comfort Sands (three). None of this is known to Dasani, whose parents only talk about the slavery of their Southern ancestors. The North is where they came to be free.

We know from history that much of what doctors do at any particular time is ineffective or even dangerous when viewed in retrospect. Years ago a famous professor warned his graduating medical students that half of what he'd taught them was wrong, but the trouble was he didn't know which half...the principle still applies: we don't know which of the well-intentioned therapies of the present will end up looking like the leeches and bloodletting of ancient time or like the thalidomide, Dalkon shields, and tonsillectomies of a more recent era gone by. Accordingly, the pronouncements of doctors should be viewed with healthy skepticism.

Doctor's Sonnet A doctor is one who's gentle as a bird, A doctor is one who's brave as a soldier, A doctor is one who's amusing as a clown, A doctor is one who's caring as a mother. Treating the sick is not a comfort job, It is a difficult life without leisure and lure. If all you want are wealth and tranquility, Trade in your medical license for a liquor store. The world is filled with doctors most cold, Many don't practice medicine but self-centricity. Instruments and intellect don't make a doctor, Without warmth all pills lose their efficacy. Healthcare means aid first talk rules later. Better a kindhearted fool than a heartless monster.

Making money in the markets is tough. The brilliant trader and investor Bernard Baruch put it well when he said, “If you are ready to give up everything else and study the whole history and background of the market and all principal companies whose stocks are on the board as carefully as a medical student studies anatomy—if you can do all that and in addition you have the cool nerves of a gambler, the sixth sense of a clairvoyant and the courage of a lion, you have a ghost of a chance.” In retrospect, the mistakes that led to my crash seemed embarrassingly obvious. First, I had been wildly overconfident and had let my emotions get the better of me. I learned (again) that no matter how much I knew and how hard I worked, I could never be certain enough to proclaim things like what I’d said on Wall $ treet Week: “There’ll be no soft landing. I can say that with absolute certainty, because I know how markets work.” I am still shocked and embarrassed by how arrogant I was. Second, I again saw the value of studying history. What had happened, after all, was “another one of those.” I should have realized that debts denominated in one’s own currency can be successfully restructured with the government’s help, and that when central banks simultaneously provide stimulus (as they did in March 1932, at the low point of the Great Depression, and as they did again in 1982), inflation and deflation can be balanced against each other. As in 1971, I had failed to recognize the lessons of history. Realizing that led me to try to make sense of all movements in all major economies and markets going back a hundred years and to come up with carefully tested decision-making principles that are timeless and universal. Third, I was reminded of how difficult it is to time markets. My long-term estimates of equilibrium levels were not reliable enough to bet on; too many things could happen between the time I placed my bets and the time (if ever) that my estimates were reached. Staring at these failings, I realized that if I was going to move forward without a high likelihood of getting whacked again, I would have to look at myself objectively and change—starting by learning a better way of handling the natural aggressiveness I’ve always shown in going after what I wanted. Imagine that in order to have a great life you have to cross a dangerous jungle. You can stay safe where you are and have an ordinary life, or you can risk crossing the jungle to have a terrific life. How would you approach that choice? Take a moment to think about it because it is the sort of choice that, in one form or another, we all have to make.

I know an American family that spent several years living in England. They had one son, who was an average student: not great, but not terrible. When the family returned home to the United States, the parents enrolled him in the local public school. Mom was startled by the continual drumbeat from teachers and other parents: “Maybe your son has ADHD. Have you considered trying a medication?” She told me, “It was weird, like everybody was in on this conspiracy to medicate my son. In England, none of the kids is on medication. Or if they are, it’s a secret. But I really don’t think many are. Here it seems like almost all the kids are on medication. Especially the boys.

Of course, the cadavers, in life, donated themselves freely to this fate, and the language surrounding the bodies in front of us soon changed to reflect that fact. We were instructed to no longer call them “cadavers”; “donors” was the preferred term. And yes, the transgressive element of dissection had certainly decreased from the bad old days. (Students no longer had to bring their own bodies, for starters, as they did in the nineteenth century. And medical schools had discontinued their support of the practice of robbing graves to procure cadavers—that looting itself a vast improvement over murder, a means once common enough to warrant its own verb: burke, which the OED defines as “to kill secretly by suffocation or strangulation, or for the purpose of selling the victim’s body for dissection.”) Yet the best-informed people—doctors—almost never donated their bodies. How informed were the donors, then? As one anatomy professor put it to me, “You wouldn’t tell a patient the gory details of a surgery if that would make them not consent.” Even if donors were informed enough—and they might well have been, notwithstanding one anatomy professor’s hedging—it wasn’t so much the thought of being dissected that galled. It was the thought of your mother, your father, your grandparents being hacked to pieces by wisecracking twenty-two-year-old medical students. Every time I read the pre-lab and saw a term like “bone saw,” I wondered if this would be the session in which I finally vomited. Yet I was rarely troubled in lab, even when I found that the “bone saw” in question was nothing more than a common, rusty wood saw. The closest I ever came to vomiting was nowhere near the lab but on a visit to my grandmother’s grave in New York, on the twentieth anniversary of her death. I found myself doubled over, almost crying, and apologizing—not to my cadaver but to my cadaver’s grandchildren. In the midst of our lab, in fact, a son requested his mother’s half-dissected body back. Yes, she had consented, but he couldn’t live with that. I knew I’d do the same. (The remains were returned.) In

This was what he taught at the Collège de France. And in the entire neighborhood, in all the nearby Faculties, in the literature, law, history and philosophy courses, at the Institute and at the Palais de Justice, in the buses, the métros, in all the government offices, sensible men, normal men, active men, worthy, wholesome, strong men, triumphed. Avoiding the shops filled with pretty things, the women trotting briskly along, the café waiters, the medical students, the traffic policemen, the clerks from notary offices, Rimbaud or Proust, having been torn from life, cast out from life and deprived of support, were probably wandering aimlessly through the streets, or dozing away, their heads resting on their chests, in some dusty public square.

Things changed after that between me and Mark. I stopped being mortified that people might mistake me for one of his acolytes. I was his Boswell, don’t you know. I interviewed him about his childhood—his father was a psychiarist in Beverly Hills. I cataloged the contents of his van. I followed him around at work, sitting in while he examined patients. He had been a bit of a prodigy when we were in college. After his father developed a tumor, Mark, who was pre-med, started studying cancer with an intensity that convinced many of his friends that his goal was to find a cure in time to save his father. As it turned out, his father didn’t have cancer. But Mark kept on with his cancer studies. His interest was not in fact in oncology—in finding a cure—but in cancer education and prevention. By the time he entered medical school, he had created, with another student, a series of college courses on cancer and coauthored The Biology of Cancer Sourcebook, the text for a course that was eventually offered to tens of thousands of students. He cowrote a second book, Understanding Cancer, that became a bestselling university text, and he continued to lecture throughout the United States on cancer research, education, and prevention. “The funny thing is, I’m not really interested in cancer,” Mark told me. “I’m interested in people’s response to it. A lot of cancer patients and suvivors report that they never really lived till they got cancer, that it forced them to face things, to experience life more intensely. What you see in family practice is that families just can’t afford to be superficial with each other anymore once someone has cancer. Corny as it sounds, what I’m really interested in is the human spirit—in how people react to stress and adversity. I’m fascinated by the way people fight back, by how they keep fighting their way to the surface.” Mark clawed at the air with his arms. What he was miming was the struggle to reach the surface through the turbulence of a large wave.

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.

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.

Some parents resist the idea of ADD for fear of seeing their children labeled and categorized. They do not like the idea of pinning a medical diagnosis on a child who, except in certain areas of functioning, seems quite well. Such fears are not baseless. Too often ADD seems no more than a judgment that characterizes a child as a problem student, incapable of normal activity. How people use language is quite revealing. People commonly say that this adult or that child “is ADD.” That, indeed, is labeling, identifying the whole person with an area of weakness or impairment. No one is ADD, and no one should be defined or categorized in terms of it or any other particular problem. Recognizing a child’s ADD should be simply a way of understanding that helping him calls for some knowledgeable and creative approaches, not a judgment that there is anything fundamentally or irretrievably wrong with him. This recognition should enable us to support the child in fullfilling his potential, not to further limit him. That even open-minded people may have difficulty coming to terms with this diagnosis is only to be expected. Our usual mode of thinking about illness (or anything else, for that matter) is not comfortable with ambiguity. A patient either has pneumonia or does not; she either has some illness affecting the mind or does not. There is a popular discomfort with any condition of the mind perceived as “abnormal.” But what if illness is not a separate category, if there is no line of distinction between the “healthy” and the “nonheaithy,” if the “abnormality” is just a greater concentration in an individual of disturbed brain processes found in everyone? Then perhaps there are no fixed, immutable brain disorders, and we could all be vulnerable to mental breakdowns or malfunctions under the pressure of stressful circumstances. We could all go crazy. Maybe we already have.

Many doctors (and medical students) display uncertainty about whether or not CFS/ME is real…Patients with CFS/ME often experience suspicion by health professionals…The (often unintentional) marginalization of many CFS/ME patients represents a failure in medical professionalism, one that may lead to further ethical and practical consequences both for progressive research into CFS/ME and for ethical care... With one exception, doctors attending the seminar were either defensive or silent. In their eyes, the ME patients present were conforming to stereotype (angry, unscientific, unreasonable) and therefore they – the doctors – would not engage with them. Paradoxically, these doctors were themselves conforming to another stereotype, as described by the speaker: ‘Knowledge-formation is also influenced by social and cultural factors. Such encounters have an inherent power differential; there is significant potential…to be unjust from an epistemic point of view.

But no matter how carefully we schedule our days, master our emotions, and try to wring our best life now from our better selves, we cannot solve the problem of finitude. We will always want more. We need more. We are carrying the weight of caregiving and addiction, chronic pain and uncertain diagnosis, struggling teenagers and kids with learning disabilities, mental illness and abusive relationships. A grandmother has been sheltering without a visitor for months, and a friend's business closed its doors. Doctors, nurses, and frontline workers are acting as levees, feeling each surge of the disease crash against them. My former students, now serving as pastors and chaplains, are in hospitals giving last rites in hazmat suits. They volunteer to be the last person to hold his hand. To smooth her hair. The truth if the pandemic is the truth of all suffering: that it is unjustly distributed. Who bears the brunt? The homeless and the prisoners. The elderly and the children. The sick and the uninsured. Immigrants and people needing social services. People of color and LGBTQ people. The burdens of ordinary evils— descriminations, brutality, predatory lending, illegal evictions, and medical exploitation— roll back on the vulnerable like a heavy stone. All of us struggle against the constraints places on our bodies, our commitments, our ambitions, and our resources, even as we're saddled with inflated expectations of invincibility. This is the strange cruelty of suffering in America, its insistence that everything is still possible.

In a town in Liberia, a young woman named Fatu Kekula, who was a nursing student, ended up caring for four of her family members at home when there was no room for them in a hospital—her parents, her sister, and a cousin. She didn’t have any protective gear, so she created a bio-hazmat suit out of plastic garbage bags. She tied garbage bags over her feet and legs, put on rubber boots over the bags, and then put more bags over her boots. She put on a raincoat, a surgical mask, and multiple rubber gloves, and she covered her head with pantyhose and a garbage bag. Dressed this way, Fatu Kekula set up IV lines for her family members, giving them saline solution to keep them from becoming dehydrated. Her parents and sister survived; her cousin died. And she herself remained uninfected. Local medical workers called Fatu Kekula’s measures the Trash Bag Method. All you needed were garbage bags, a raincoat, and no small amount of love and courage. Medical workers taught the Trash Bag Method, or variants of it, to people who couldn’t get to hospitals

told his students in “The World Since 1914” class that there was little point in discussing the Third World when they knew so little about how their own society works: “So I told them about the USA — really very hair-raising when it is all laid out in sequence: . . . . 1. cosmic hierarchy; 2. energy; 3. agriculture; 4. food; 5. health and medical services; 6. education; 7. income flows and the worship of GROWTH; 8. inflation. . . showing how we are violating every aspect of life by turning everything into a ripoff because we. . . have adopted the view that insatiable individualistic greed must run the world.” 7 He feared “that the students will come to feel that all is hopeless, so I must. . . show them how solutions can be found by holistic methods seeking diversity, de-centralization, communities. . .etc.” 8 Pleased with the class response, he later recalled: “The students were very excited and my last lecture in which I put the whole picture together was about the best lecture I ever gave. That was 10 Dec. [1975], my last full day of teaching after 41 years.

Will those insights be tested,or simply used to justify the status quo and reinforce prejudices? When I consider the sloppy and self-serving ways that companies use data, I'm often reminded of phrenology, a pseudoscience that was briefly the rage in the nineteenth century. Phrenologists would run their fingers over the patient's skull, probing for bumps and indentations. Each one, they thought, was linked to personality traits that existed in twenty-seven regions of the brain. Usually the conclusion of the phrenologist jibed with the observations he made. If the patient was morbidly anxious or suffering from alcoholism, the skull probe would usually find bumps and dips that correlated with that observation - which, in turn, bolstered faith in the science of phrenology. Phrenology was a model that relied on pseudoscientific nonsense to make authoritative pronouncements, and for decades it went untested. Big Data can fall into the same trap. Models like the ones that red-lighted Kyle Behm and black-balled foreign medical students and St. George's can lock people out, even when the "science" inside them is little more than a bundle of untested assumptions.

Will those insights be tested, or simply used to justify the status quo and reinforce prejudices? When I consider the sloppy and self-serving ways that companies use data, I'm often reminded of phrenology, a pseudoscience that was briefly the rage in the nineteenth century. Phrenologists would run their fingers over the patient's skull, probing for bumps and indentations. Each one, they thought, was linked to personality traits that existed in twenty-seven regions of the brain. Usually the conclusion of the phrenologist jibed with the observations he made. If the patient was morbidly anxious or suffering from alcoholism, the skull probe would usually find bumps and dips that correlated with that observation - which, in turn, bolstered faith in the science of phrenology. Phrenology was a model that relied on pseudoscientific nonsense to make authoritative pronouncements, and for decades it went untested. Big Data can fall into the same trap. Models like the ones that red-lighted Kyle Behm and black-balled foreign medical students and St. George's can lock people out, even when the "science" inside them is little more than a bundle of untested assumptions.

Only date people who respect your standards and make you a better person when you’re with them. Consider the message of the movie A Walk to Remember. Landon Carter is the reckless leader who is skating through high school on his good looks and bravado. He and his popular friends at Beaufort High publicly ridicule everyone who doesn’t fit in, including the unfashionable Jamie Sullivan, who wears the same sweater day after day and gives free tutoring lessons to struggling students. By accident, events thrust Landon into Jamie’s world and he can’t help but notice that Jamie’s different. She doesn’t care about conforming and fitting in with the popular kids. Landon’s amazed at how sure of herself she seems and asks, “Don’t you care what people think about you?” As he spends more time with her, he realizes she has more freedom than he does because she isn’t controlled by the opinions of others, as he is. Soon, despite their intentions not to, they have fallen in love and Landon has to choose between his status at Beaufort...and Jamie. “This girl’s changed you,” his best friend yells, “and you don’t even know it.” Landon admits, “She has faith in me. She wants me to be better.” He chooses her. After high school graduation, Jamie reveals to Landon that she’s dying of leukemia. During her final months, Landon does all he can to make her dreams come true, including marrying her in the same church her mother and father were married in. They spend a wonderful summer together, truly in love. Despite Jamie’s dream for a miracle, she dies. Heartbroken, but inspired by Jamie’s belief in him, Landon works hard to go to medical school. But he laments to her father that he couldn’t fulfill her last desire, to see a miracle. Jamie’s father assures him that Jamie did see a miracle before she died, for someone’s heart had truly changed. And it was his. Now that’s a movie to remember! Never apologize for having high standards and don’t ever lower your standards to please someone else.

For the rest of Kat’s childhood, she moved from one relative’s house to another’s, up and down the East Coast, living in four homes before entering high school. Finally, in high school, she lived for a few years with her grandmother, her mom’s mom, whom she called “G-Ma.” No one ever talked about her mom’s murder. “In my family, my past was ‘The Big Unmentionable’—including my role in putting my own father in jail,” she says. In high school, Kat appeared to be doing well. She was an honor student who played four varsity sports. Beneath the surface, however, “I was secretly self-medicating with alcohol because otherwise, by the time everything stopped and it got quiet at night, I could not sleep, I would just lie there and a terrible panic would overtake me.” She went to college, failed out, went back, and graduated. She went to work in advertising, and one day, dissatisfied, quit. She went back to grad school, piling up debt. She became a teacher. Kat quit that job too, when a relationship she had formed with another teacher imploded. At the age of thirty-four, Kat went to stay with her brother and his family in Hawaii. She got a job as a valet, parking cars. “I’d come home from parking cars all day and curl up on my bed in the back bedroom of my brother’s house, and lie there feeling desperate and alone, my heart beating with anxiety.

In a physician's office in Kearny Street three men sat about a table, drinking punch and smoking. It was late in the evening, almost midnight, indeed, and there had been no lack of punch. The gravest of the three, Dr. Helberson, was the host—it was in his rooms they sat. He was about thirty years of age; the others were even younger; all were physicians. "The superstitious awe with which the living regard the dead," said Dr. Helberson, "is hereditary and incurable. One needs no more be ashamed of it than of the fact that he inherits, for example, an incapacity for mathematics, or a tendency to lie." The others laughed. "Oughtn't a man to be ashamed to lie?" asked the youngest of the three, who was in fact a medical student not yet graduated. "My dear Harper, I said nothing about that. The tendency to lie is one thing; lying is another." "But do you think," said the third man, "that this superstitious feeling, this fear of the dead, reasonless as we know it to be, is universal? I am myself not conscious of it." "Oh, but it is 'in your system' for all that," replied Helberson; "it needs only the right conditions—what Shakespeare calls the 'confederate season'—to manifest itself in some very disagreeable way that will open your eyes. Physicians and soldiers are of course more nearly free from it than others." "Physicians and soldiers!—why don't you add hangmen and headsmen? Let us have in all the assassin classes." "No, my dear Mancher; the juries will not let the public executioners acquire sufficient familiarity with death to be altogether unmoved by it." Young Harper, who had been helping himself to a fresh cigar at the sideboard, resumed his seat. "What would you consider conditions under which any man of woman born would become insupportably conscious of his share of our common weakness in this regard?" he asked, rather verbosely. "Well, I should say that if a man were locked up all night with a corpse—alone—in a dark room—of a vacant house—with no bed covers to pull over his head—and lived through it without going altogether mad, he might justly boast himself not of woman born, nor yet, like Macduff, a product of Cæsarean section." "I thought you never would finish piling up conditions," said Harper, "but I know a man who is neither a physician nor a soldier who will accept them all, for any stake you like to name." "Who is he?" "His name is Jarette—a stranger here; comes from my town in New York. I have no money to back him, but he will back himself with loads of it." "How do you know that?" "He would rather bet than eat. As for fear—I dare say he thinks it some cutaneous disorder, or possibly a particular kind of religious heresy." "What does he look like?" Helberson was evidently becoming interested. "Like Mancher, here—might be his twin brother." "I accept the challenge," said Helberson, promptly. "Awfully obliged to you for the compliment, I'm sure," drawled Mancher, who was growing sleepy. "Can't I get into this?" "Not against me," Helberson said. "I don't want your money." "All right," said Mancher; "I'll be the corpse." The others laughed. The outcome of this crazy conversation we have seen.

It may seem paradoxical to claim that stress, a physiological mechanism vital to life, is a cause of illness. To resolve this apparent contradiction, we must differentiate between acute stress and chronic stress. Acute stress is the immediate, short-term body response to threat. Chronic stress is activation of the stress mechanisms over long periods of time when a person is exposed to stressors that cannot be escaped either because she does not recognize them or because she has no control over them. Discharges of nervous system, hormonal output and immune changes constitute the flight-or-fight reactions that help us survive immediate danger. These biological responses are adaptive in the emergencies for which nature designed them. But the same stress responses, triggered chronically and without resolution, produce harm and even permanent damage. Chronically high cortisol levels destroy tissue. Chronically elevated adrenalin levels raise the blood pressure and damage the heart. There is extensive documentation of the inhibiting effect of chronic stress on the immune system. In one study, the activity of immune cells called natural killer (NK) cells were compared in two groups: spousal caregivers of people with Alzheimer’s disease, and age- and health-matched controls. NK cells are front-line troops in the fight against infections and against cancer, having the capacity to attack invading micro-organisms and to destroy cells with malignant mutations. The NK cell functioning of the caregivers was significantly suppressed, even in those whose spouses had died as long as three years previously. The caregivers who reported lower levels of social support also showed the greatest depression in immune activity — just as the loneliest medical students had the most impaired immune systems under the stress of examinations. Another study of caregivers assessed the efficacy of immunization against influenza. In this study 80 per cent among the non-stressed control group developed immunity against the virus, but only 20 per cent of the Alzheimer caregivers were able to do so. The stress of unremitting caregiving inhibited the immune system and left people susceptible to influenza. Research has also shown stress-related delays in tissue repair. The wounds of Alzheimer caregivers took an average of nine days longer to heal than those of controls. Higher levels of stress cause higher cortisol output via the HPA axis, and cortisol inhibits the activity of the inflammatory cells involved in wound healing. Dental students had a wound deliberately inflicted on their hard palates while they were facing immunology exams and again during vacation. In all of them the wound healed more quickly in the summer. Under stress, their white blood cells produced less of a substance essential to healing. The oft-observed relationship between stress, impaired immunity and illness has given rise to the concept of “diseases of adaptation,” a phrase of Hans Selye’s. The flight-or-fight response, it is argued, was indispensable in an era when early human beings had to confront a natural world of predators and other dangers. In civilized society, however, the flight-fight reaction is triggered in situations where it is neither necessary nor helpful, since we no longer face the same mortal threats to existence. The body’s physiological stress mechanisms are often triggered inappropriately, leading to disease. There is another way to look at it. The flight-or-fight alarm reaction exists today for the same purpose evolution originally assigned to it: to enable us to survive. What has happened is that we have lost touch with the gut feelings designed to be our warning system. The body mounts a stress response, but the mind is unaware of the threat. We keep ourselves in physiologically stressful situations, with only a dim awareness of distress or no awareness at all.

I can hardly believe that our nation’s policy is to seek peace by going to war. It seems that President Donald J. Trump has done everything in his power to divert our attention away from the fact that the FBI is investigating his association with Russia during his campaign for office. For several weeks now he has been sabre rattling and taking an extremely controversial stance, first with Syria and Afghanistan and now with North Korea. The rhetoric has been the same, accusing others for our failed policy and threatening to take autonomous military action to attain peace in our time. This gunboat diplomacy is wrong. There is no doubt that Secretaries Kelly, Mattis, and other retired military personnel in the Trump Administration are personally tough. However, most people who have served in the military are not eager to send our young men and women to fight, if it is not necessary. Despite what may have been said to the contrary, our military leaders, active or retired, are most often the ones most respectful of international law. Although the military is the tip of the spear for our country, and the forces of civilization, it should not be the first tool to be used. Bloodshed should only be considered as a last resort and definitely never used as the first option. As the leader of the free world, we should stand our ground but be prepared to seek peace through restraint. This is not the time to exercise false pride! Unfortunately the Trump administration informed four top State Department management officials that their services were no longer needed as part of an effort to "clean house." Patrick Kennedy, served for nine years as the “Undersecretary for Management,” “Assistant Secretaries for Administration and Consular Affairs” Joyce Anne Barr and Michele Bond, as well as “Ambassador” Gentry Smith, director of the Office for Foreign Missions. Most of the United States Ambassadors to foreign countries have also been dismissed, including the ones to South Korea and Japan. This leaves the United States without the means of exercising diplomacy rapidly, when needed. These positions are political appointments, and require the President’s nomination and the Senate’s confirmation. This has not happened! Moreover, diplomatically our country is severely handicapped at a time when tensions are as hot as any time since the Cold War. Without following expert advice or consent and the necessary input from the Unites States Congress, the decisions are all being made by a man who claims to know more than the generals do, yet he has only the military experience of a cadet at “New York Military Academy.” A private school he attended as a high school student, from 1959 to 1964. At that time, he received educational and medical deferments from the Vietnam War draft. Trump said that the school provided him with “more training than a lot of the guys that go into the military.” His counterpart the unhinged Kim Jong-un has played with what he considers his country’s military toys, since April 11th of 2012. To think that these are the two world leaders, protecting the planet from a nuclear holocaust….

There is no one disabled future. But in mine, there is guaranteed income, housing, access, food, water, and education for all—or money has been abolished. I get paid to write from my bed. The births of disabled, Autistic, Mad, Neurodivergent, Deaf, and sick kids are celebrated, and there are memorials and healing and reparation sites on every psych ward, institution, nursing home, youth lockup, and “autistic treatment center” where our people have been locked up and abused. Anyone who needs care gets it, with respect and autonomy, not abuse. Caregivers are paid well for the work we do and are often disabled ourselves. Disabled folks are the ones teaching medical school students about our bodies. Schools have been taken apart and remade so that there’s not one idea of “smart” and “stupid,” but many ways of learning. There is a disability justice section in every bookstore and a million examples of sick and disabled and Deaf and autistic and Mad folks thriving. I have a really sick lipstick-red spiral ramp curving around my house. Because it’s beautiful. Because I want it. Because I get to live free. -LEAH

I don’t know if I’ll get in at Stanford,” one premed said to me after he had sent in his application. “Or anywhere else,” he added. Another mentioned a different school, but the students’ worries were essentially the same. I seldom got involved in what I called freaking out, but this kind of talk happened often, especially during our senior year. One time when this freaking out was going on and I didn’t enter in, one of my friends turned to me, “Carson, aren’t you worried?” “No,” I said. “I’m going to the University of Michigan Medical School.” “How can you be so sure?” “It’s real simple. My father owns the university.” “Did you hear that?” he yelled at one of the others. “Carson’s old man owns the University of Michigan.” Several students were impressed. And understandably because they came from extremely wealthy homes. Their parents owned great industries. Actually, I had been teasing, and maybe it wasn’t playing fair. As a Chrisitan, I believe that God— my Heavenly Father— not only created the universe, but He controls it. And, by extension, God owns the University of Michigan and everything else. I never did explain.

Gadgetry will continue to relieve mankind of tedious jobs. Kitchen units will be devised that will prepare ‘automeals,’ heating water and converting it to coffee; toasting bread; frying, poaching or scrambling eggs, grilling bacon, and so on. Breakfasts will be ‘ordered’ the night before to be ready by a specified hour the next morning. Communications will become sight-sound and you will see as well as hear the person you telephone. The screen can be used not only to see the people you call but also for studying documents and photographs and reading passages from books. Synchronous satellites, hovering in space will make it possible for you to direct-dial any spot on earth, including the weather stations in Antarctica. [M]en will continue to withdraw from nature in order to create an environment that will suit them better. By 2014, electroluminescent panels will be in common use. Ceilings and walls will glow softly, and in a variety of colors that will change at the touch of a push button. Robots will neither be common nor very good in 2014, but they will be in existence. The appliances of 2014 will have no electric cords, of course, for they will be powered by long- lived batteries running on radioisotopes. “[H]ighways … in the more advanced sections of the world will have passed their peak in 2014; there will be increasing emphasis on transportation that makes the least possible contact with the surface. There will be aircraft, of course, but even ground travel will increasingly take to the air a foot or two off the ground. [V]ehicles with ‘Robot-brains’ … can be set for particular destinations … that will then proceed there without interference by the slow reflexes of a human driver. [W]all screens will have replaced the ordinary set; but transparent cubes will be making their appearance in which three-dimensional viewing will be possible. [T]he world population will be 6,500,000,000 and the population of the United States will be 350,000,000. All earth will be a single choked Manhattan by A.D. 2450 and society will collapse long before that! There will, therefore, be a worldwide propaganda drive in favor of birth control by rational and humane methods and, by 2014, it will undoubtedly have taken serious effect. Ordinary agriculture will keep up with great difficulty and there will be ‘farms’ turning to the more efficient micro-organisms. Processed yeast and algae products will be available in a variety of flavors. The world of A.D. 2014 will have few routine jobs that cannot be done better by some machine than by any human being. Mankind will therefore have become largely a race of machine tenders. Schools will have to be oriented in this direction…. All the high-school students will be taught the fundamentals of computer technology will become proficient in binary arithmetic and will be trained to perfection in the use of the computer languages that will have developed out of those like the contemporary “Fortran". [M]ankind will suffer badly from the disease of boredom, a disease spreading more widely each year and growing in intensity. This will have serious mental, emotional and sociological consequences, and I dare say that psychiatry will be far and away the most important medical specialty in 2014. [T]he most glorious single word in the vocabulary will have become work! in our a society of enforced leisure.

As she explained to her students, patients often awoke from very bad illnesses or cardiac arrests, talking about how they had been floating over their bodies. “Mm-hmmm,” Norma would reply, sometimes thinking, Yeah, yeah, I know, you were on the ceiling. Such stories were recounted so frequently that they hardly jolted medical personnel. Norma at the time had mostly chalked it up to some kind of drug reaction or brain malfunction, something like that. “No, really,” said a woman who’d recently come out of a coma. “I can prove it.” The woman had been in a car accident and been pronounced dead on arrival when she was brought into the emergency room. Medical students and interns had begun working on her and managed to get her heartbeat going, but then she had coded again. They’d kept on trying, jump-starting her heart again, this time stabilizing it. She’d remained in a coma for months, unresponsive. Then one day she awoke, talking about the brilliant light and how she remembered floating over her body. Norma thought she could have been dreaming about all kinds of things in those months when she was unconscious. But the woman told them she had obsessive-compulsive disorder and had a habit of memorizing numbers. While she was floating above her body, she had read the serial number on top of the respirator machine. And she remembered it. Norma looked at the machine. It was big and clunky, and this one stood about seven feet high. There was no way to see on top of the machine without a stepladder. “Okay, what’s the number?” Another nurse took out a piece of paper to jot it down. The woman rattled off twelve digits. A few days later, the nurses called maintenance to take the ventilator machine out of the room. The woman had recovered so well, she no longer needed it. When the worker arrived, the nurses asked if he wouldn’t mind climbing to the top to see if there was a serial number up there. He gave them a puzzled look and grabbed his ladder. When he made it up there, he told them that indeed there was a serial number. The nurses looked at each other. Could he read it to them? Norma watched him brush off a layer of dust to get a better look. He read the number. It was twelve digits long: the exact number that the woman had recited. The professor would later come to find out that her patient’s story was not unique. One of Norma’s colleagues at the University of Virginia Medical Center at the time, Dr. Raymond Moody, had published a book in 1975 called Life After Life, for which he had conducted the first large-scale study of people who had been declared clinically dead and been revived, interviewing 150 people from across the country. Some had been gone for as long as twenty minutes with no brain waves or pulse. In her lectures, Norma sometimes shared pieces of his research with her own students. Since Moody had begun looking into the near-death experiences, researchers from around the world had collected data on thousands and thousands of people who had gone through them—children, the blind, and people of all belief systems and cultures—publishing the findings in medical and research journals and books. Still, no one has been able to definitively account for the common experience all of Moody’s interviewees described. The inevitable question always followed: Is there life after death? Everyone had to answer that question based on his or her own beliefs, the professor said. For some of her students, that absence of scientific evidence of an afterlife did little to change their feelings about their faith. For others,

Deprive a cat of sleep and it would die in two weeks. Deprive a human and he would become psychotic. His work was killing people. How was he supposed to frighten these guys? Run up behind them in a halloween mask and shout boo? He never saw the point of views -- what did it matter if it was an ocean or a brick wall you were looking at? People travelled hundreds, sometimes thousands of miles to commit suicide someplace with a beautiful view. Did a view matter when oblivion beckoned? They could put him in a garbage bin after he was gone, for all he cared. That's all the human race was anyway. Garbage with attitude. A cutting word is worse than a bowstring. A cut may heal but a cut of the tongue does not. The Sakawa students were all from poor, underprivileged backgrounds. Sakawa was a mix of religious juju and modern internet technology. They were taught, in structured classes, the art of online fraud as well as arcane African rituals -- which included animal sacrifice -- to have a voodoo effect on their victims, ensuring the success of each fraud. of which there was a wide variety. The British Empire spend five hundred years plundering the world. The word is 'thanks'. 'That's what it is, Roy! He won't come out, he has locked the doors! What if he self-harms, Roy! I mean -- what if he kills himself?' 'I will have to take him off my Christmas list.' "Any chance you can recover any of it?' 'You sitting near a window, Gerry?' 'Near a window? Sure, right by a window?' 'Can you see the sky?' 'Uh-huh. Got a clear view.' 'See any pigs flying past?' To dream of death is good for those in fear, for the death have no more fears. '...Cleo took me to the opera once. I spent the whole time praying for a fat lady to come on stage and start singing. Or a heart attack --whichever come sooner.' '..there is something strongly powerful -- almost magnetic -- about internet romances. A connection that is far stronger than a traditional meeting of two people. Maybe because on the internet you can lie all the time, each person gives the other their good side. It's intoxicating. That's one of the things which makes it so dangerous -- and such easy pickings for fraudsters.' He was more than a little pleased that he was about to ruin his boss's morning -- and, with a bit of luck, his entire day. ..a guy who had been born angry and had just got even angrier with each passing year. '...Then at some point in the future, I'll probably die in an overcrowded hospital corridor with some bloody hung-over medical student jumping up and down on my chest because they couldn't find a defibrillator. 'Give me your hand, bro,' the shorter one said. 'That one, the right one, yeah.' On the screen the MasterChef contestant said, 'Now with a sharp knife...' Jules de Copland drove away from Gatwick Airport in.a new car, a small Kia, hired under a different name and card, from a different rental firm, Avis. 'I was talking about her attitude. But I'll tell you this, Roy. The day I can't say a woman -- or a man -- is plug ugly, that's the day I want to be taken out and shot.' It seems to me the world is in a strange place where everyone chooses to be offended all the time. 'But not too much in the way of brains,' GlennBranson chipped in. 'Would have needed the old Specialist Search Unite to find any trace of them.' 'Ever heard of knocking on a door?' 'Dunno that film -- was it on Netflix?' 'One word, four letters. Begins with an S for Sierra, ends with a T for Tango. Or if you'd like the longest version, we've been one word, six letters, begins with F for Foxtrot, ends with D for Delta.' No Cop liked entering a prison. In general there was a deep cultural dislike of all police officers by the inmates. And every officer entering.a prison, for whatever purposes, was always aware that if a riot kicked off while they were there, they could be both an instant hostage and a prime target for violence.

The driver, whose name was Chase, pulled up in a silver Honda. He was cute, with a gap in his front two teeth—maybe age twenty-six at most. He looked like he was trying to grow a mustache, and his brown hair was past his ears under a baseball cap that read FML. He babbled that he was an actor, or was trying to become one. His favorite philosophy about acting was Uta Hagen’s, something about being a student of humanity. Well, for a student of humanity he was shitty at reading people. In my head I just kept saying, Shut up, shut up! I wanted to say, Don’t you know I am dying? But even in my dying I couldn’t be mean to him for fear that he would think I was a bitch. Why did I even care what he thought? Was my death unimportant? How could I prioritize the feelings of this vacant, mustached kid over my own—me, who was probably dying? I repeated, “That’s nice” and “Oh, interesting,” and lay down in the backseat. I didn’t announce that I would be laying down, I just did it. He wasn’t paying any attention to what I was doing, instead going on about an upcoming audition for a prescription allergy medication where he would play the son-in-law of a woman with adult allergies. He said he had mixed feelings about it, because he didn’t want to limit his range to pharmaceuticals. The part he really wanted was an audition for Samsung next week. He was trying out to play the phone. “It’s not easy to make it in this town. I’m going up against two hundred other potential phones, at least,” he said, looking in the mirror at the traffic behind him. I noticed he had green eyes. He really was cute. I waited for him to comment on me lying supine in his backseat, but he didn’t ask if I was okay. I suppose this was normal behavior in California. I closed my eyes and concentrated on my breathing. I wasn’t dead. I was breathing in the back of this cute idiot’s car. When we pulled up at Annika’s house, he stopped and said, “Okay, we’re here. Wish me luck at Samsung!” I opened my eyes and squinted at him. I wanted to tell him that I hoped he never got a part.

On the one hand, I recognize the power of the placebo effect: if you believe it’s working, it may well work. If you think an object brings you luck, you are more confident. And yet what the Italian students in the “lucky” seats showed wasn’t confidence; it was overconfidence. They thought they were doing better, but the evidence didn’t actually back them up. And then there’s the flip side of the placebo, the nocebo effect: the belief in evil signs or bad luck. It turns out people can literally scare themselves to death. If you think you’ve been cursed or otherwise made ill, you may end up actually getting sick, failing to improve poor health, or, yes, dying altogether. In one medically documented instance, a man was given three months to live after a diagnosis of metastatic cancer of the esophagus. He died shortly after. When his body was autopsied, doctors realized that he had been misdiagnosed: he did indeed have cancer, but a tiny, non-metastatic tumor on his liver. Clinically speaking, it could not have killed him. But, it seems, being told he was dying of a fatal illness brought about that very outcome. In another case, a man thought he was hexed by a voodoo priest. He came close to death, only to recover miraculously after an enterprising doctor “reversed” the curse through a series of made-up words. In yet a third, a man almost died in the emergency room after overdosing on pills. He’d been in a drug trial for depression and decided to end his life with the antidepressants he’d been prescribed. His vitals were so bad when he was admitted that doctors didn’t think he would make it—until they discovered his blood was completely clear of any drugs. He’d been taking a placebo. Once he found out he had not in fact taken a life-threatening quantity of pills, he recovered quickly. The effect our mind has on our body makes for a scary proposition. Belief is a powerful thing. Our mental state is crucial to our performance. And ultimately, while some superstitions may give you a veneer of false confidence, they also have the power to destroy your mental equilibrium. I like to think of this as the black cat effect. You see one cross the parking lot as you walk to a tournament. You brood about the bad luck. Your game is thrown off. You blame the cat. You bust. You feel validated. Superstitions are false attributions, so they give you a false sense of your own abilities and in the end, impede learning.

To their surprise, they found that dopamine actively regulates both the formation and the forgetting of new memories. In the process of creating new memories, the dCA1 receptor was activated. By contrast, forgetting was initiated by the activation of the DAMB receptor. Previously, it was thought that forgetting might be simply the degradation of memories with time, which happens passively by itself. This new study shows that forgetting is an active process, requiring intervention by dopamine. To prove their point, they showed that by interfering with the action of the dCA1 and DAMB receptors, they could, at will, increase or decrease the ability of fruit flies to remember and forget. A mutation in the dCA1 receptor, for example, impaired the ability of the fruit flies to remember. A mutation in the DAMB receptor decreased their ability to forget. The researchers speculate that this effect, in turn, may be partially responsible for savants’ skills. Perhaps there is a deficiency in their ability to forget. One of the graduate students involved in the study, Jacob Berry, says, “Savants have a high capacity for memory. But maybe it isn’t memory that gives them this capacity; maybe they have a bad forgetting mechanism. This might also be the strategy for developing drugs to promote cognition and memory—what about drugs that inhibit forgetting as a cognitive enhancers?” Assuming that this result holds up in human experiments as well, it could encourage scientists to develop new drugs and neurotransmitters that are able to dampen the forgetting process. One might thus be able to selectively turn on photographic memories when needed by neutralizing the forgetting process. In this way, we wouldn’t have the continuous overflow of extraneous, useless information, which hinders the thinking of people with savant syndrome. What is also exciting is the possibility that the BRAIN project, which is being championed by the Obama administration, might be able to identify the specific pathways involved with acquired savant syndrome. Transcranial magnetic fields are still too crude to pin down the handful of neurons that may be involved. But using nanoprobes and the latest in scanning technologies, the BRAIN project might be able to isolate the precise neural pathways that make possible photographic memory and incredible computational, artistic, and musical skills. Billions of research dollars will be channeled into identifying the specific neural pathways involved with mental disease and other afflictions of the brain, and the secret of savant skills may be revealed in the process. Then it might be possible to take normal individuals and make savants out of them. This has happened many times in the past because of random accidents. In the future, this may become a precise medical process.