Medications Best Quotes

Every healthy man in the world wakes up with a stiffy. A fatty. Morning wood. I’m sure there’s some medical explanation for the phenomenon, but I just like to think of it as a little present from God. A chance to begin the day with your best dick forward.

Suddenly I wanted to get better. Mania wasn't fun anymore. It wasn't creative or visionary. It was mean parody at best, a cheap chemical trick. I needed to stop and get better. I'd take whatever they gave me, I pledged silently. I'd take Trilafon or Thorazine or whatever. I just wanted to sleep.

Remember that the best medical treatment is a sense of relativism. No matter how badly you might feel, take comfort in knowing there's someone who feels much worse.

Hugs should be available at the medical stores 24/7. Sometimes, they are the best healers for almost everything.

Being mortal is about the struggle to cope with the constraints of our biology, with the limits set by genes and cells and flesh and bone. Medical science has given us remarkable power to push against these limits, and the potential value of this power was a central reason I became a doctor. But again and again, I have seen the damage we in medicine do when we fail to acknowledge that such power is finite and always will be. We’ve been wrong about what our job is in medicine. We think our job is to ensure health and survival. But really it is larger than that. It is to enable well-being. And well-being is about the reasons one wishes to be alive. Those reasons matter not just at the end of life, or when debility comes, but all along the way. Whenever serious sickness or injury strikes and your body or mind breaks down, the vital questions are the same: What is your understanding of the situation and its potential outcomes? What are your fears and what are your hopes? What are the trade-offs you are willing to make and not willing to make? And what is the course of action that best serves this understanding?

Her body became liquid, and she thought, if they could bottle him, he would make the best pain medication.

moms aren’t the best audience for medication humor.

I gave you Jake because you’re headstrong and accident prone, and he’s our medic and I trust him to patch you up. I gave you Jake because you’re the best map reader we’ve got, and he’s damn near blind. And I gave you Jake because you absolutely never believe in yourself—and he finds a way to believe in you every damn day.

psychoanalysis is not a science: it is at best a medical process, and perhaps even more like witch-doctoring.

It's really a very simple arrangement, little mother. He fully understands that either they get healthy, or he gets sick. That sort of encourages him to do his best.

Nobel Prize winner Arthur Schawlow invented the laser in 1957 and, sure, lasers were used in the lunar landing and they have medical and military purposes, but I think we can all agree that their best application is laser pointers and laser tag.

There are two visions of America a half century from now. One is of a society more divided between the haves and the have-nots, a country in which the rich live in gated communities, send their children to expensive schools, and have access to first-rate medical care. Meanwhile, the rest live in a world marked by insecurity, at best mediocre education, and in effect rationed health care―they hope and pray they don't get seriously sick. At the bottom are millions of young people alienated and without hope. I have seen that picture in many developing countries; economists have given it a name, a dual economy, two societies living side by side, but hardly knowing each other, hardly imagining what life is like for the other. Whether we will fall to the depths of some countries, where the gates grow higher and the societies split farther and farther apart, I do not know. It is, however, the nightmare towards which we are slowly marching.

What is the meaning of life?" "What is consciousness and the mind?” "Why am I here?" “What is my relationship to God and the universe?" These questions have been asked for centuries, but they are irrelevant to achieving social progress. These are unanswerable questions because they don’t have referents in the real world. The posing of such ambiguous questions doesn’t express concern for fellow human beings, or a desire to elevate their condition. Such musings are gibberish in terms of practicality, and as impotent as wailing over an injured person instead of seeking medical attention for them.

Love is a chemical reaction, But it cannot be fully understood or defined by science. And though a body cannot exist without a soul, It too cannot be fully understood or defined by science. Love is the most powerful form of energy, But science cannot decipher its elements. Yet the best cure for a sick soul is love, But even the most advanced physician Cannot prescribe it as medicine. INCOMPLETE SCIENCE by Suzy Kassem

Were these boys in their right minds? Here were two boys with good intellect, one eighteen and one nineteen. They had all the prospects that life could hold out for any of the young; one a graduate of Chicago and another of Ann Arbor; one who had passed his examination for the Harvard Law School and was about to take a trip in Europe,--another who had passed at Ann Arbor, the youngest in his class, with three thousand dollars in the bank. Boys who never knew what it was to want a dollar; boys who could reach any position that was to boys of that kind to reach; boys of distinguished and honorable families, families of wealth and position, with all the world before them. And they gave it all up for nothing, for nothing! They took a little companion of one of them, on a crowded street, and killed him, for nothing, and sacrificed everything that could be of value in human life upon the crazy scheme of a couple of immature lads. Now, your Honor, you have been a boy; I have been a boy. And we have known other boys. The best way to understand somebody else is to put yourself in his place. Is it within the realm of your imagination that a boy who was right, with all the prospects of life before him, who could choose what he wanted, without the slightest reason in the world would lure a young companion to his death, and take his place in the shadow of the gallows? ...No one who has the process of reasoning could doubt that a boy who would do that is not right. How insane they are I care not, whether medically or legally. They did not reason; they could not reason; they committed the most foolish, most unprovoked, most purposeless, most causeless act that any two boys ever committed, and they put themselves where the rope is dangling above their heads.... Why did they kill little Bobby Franks? Not for money, not for spite; not for hate. They killed him as they might kill a spider or a fly, for the experience. They killed him because they were made that way. Because somewhere in the infinite processes that go to the making up of the boy or the man something slipped, and those unfortunate lads sit here hated, despised, outcasts, with the community shouting for their blood. . . . I know, Your Honor, that every atom of life in all this universe is bound up together. I know that a pebble cannot be thrown into the ocean without disturbing every drop of water in the sea. I know that every life is inextricably mixed and woven with every other life. I know that every influence, conscious and unconscious, acts and reacts on every living organism, and that no one can fix the blame. I know that all life is a series of infinite chances, which sometimes result one way and sometimes another. I have not the infinite wisdom that can fathom it, neither has any other human brain

The most traumatic aspects of all disasters involve the shattering of human connections. And this is especially true for children. Being harmed by the people who are supposed to love you, being abandoned by them, being robbed of the one-on-one relationships that allow you to feel safe and valued and to become humane—these are profoundly destructive experiences. Because humans are inescapably social beings, the worst catastrophes that can befall us inevitably involve relational loss. As a result, recovery from trauma and neglect is also all about relationships—rebuilding trust, regaining confidence, returning to a sense of security and reconnecting to love. Of course, medications can help relieve symptoms and talking to a therapist can be incredibly useful. But healing and recovery are impossible—even with the best medications and therapy in the world—without lasting, caring connections to others.

This wasn’t what she expected. Never, in her wildest dreams. This... this was the Blood Queen of Garbhán Isle? Scourge of the Madron lands? Destroyer of Villages? Demon Killer of Women and Children? She who had blood pacts with the darkest of gods? This was Annwyl the Bloody? Talaith watched, fascinated, as Annwyl held onto Morfyd the Witch’s wrists. Morfyd — the Black Witch of Despair, Killer of the Innocent, Annihilator of Souls, and all around Mad Witch of Garbhán Isle or so she was called on the Madron lands — had actually tried to sneak up on Annwyl to put ointment on the nasty wound the queen had across her face. But as soon as the warrior saw her, she squealed and grabbed hold of her. Now Annwyl lay on her back, Morfyd over her, trying her best to get Annwyl to stop being a ten year old. “If you just let me—” “No! Get that centaur shit away from me, you demon bitch!” “Annwyl, I’m not letting you go home to my brother looking like that. You look horrific.” “He’ll have to love me in spite of it. Now get off!” ... “Ow!” “Crybaby.” No, this isn’t what Talaith expected. Annwyl the Blood Queen was supposed to be a vicious, uncaring warrior bent on revenge and power. She let her elite guard rape and and pillage wherever they went, and she used babies as target practice while their mothers watched in horror. That’s what she was supposed to be and that’s what Talaith expected to find. Instead, she found Annwyl. Just Annwyl. A warrior who spent most of her resting time reading or mooning over her consort. She was silly, charming, very funny, and fiercely protective of everyone. Her elite guard, all handpicked by Annwyl, were sweet, vicious fighters and blindingly loyal to their queen.

This has been the century of strangers, brown, yellow and white. This has been the century of the great immigrant experiment. It is only this late in the day that you can walk into a playground and find Isaac Leung by the fish pond, Danny Rahman in the football cage, Quang O’Rourke bouncing a basketball, and Irie Jones humming a tune. Children with first and last names on a direct collision course. Names that secrete within them mass exodus, cramped boats and planes, cold arrivals, medical checks. It is only this late in the day, and possibly only in Willesden, that you can find best friends Sita and Sharon, constantly mistaken for each other because Sita is white (her mother liked the name) and Sharon is Pakistani (her mother thought it best — less trouble).

Let's be clear. The debate over health care in this country is not a debate about medical treatment or the best way to prevent disease. It is a debate about economics and class politics. Either we maintain a profit-driven health care system whose main function is to enrich certain individuals and institutions, or we develop a nonprofit, cost-effective system that provides quality health care for all people as a right of citizenship.

I was coming down off the last painkiller left in my dresser drawer after Autumn tossed my stash. In that moment I was so groggy and happy I would have accepted a date with Oscar the Grouch - and planned to do some serious feeling up on the green furry beast too. Yeah, stooping to pharmaceutical-inspired sex fantasies about garbage can Sesame Street characters - that had to be the best Just Say No drug lecture a girl in a leg cast could ever receive to make her go cold turkey off the meds.

Finally, I would like to assure my many Buddhist, Christian, Hindu, Jewish, and Muslim friends that I am sincerely happy that the religion which Chance has given you has contributed to your peace of mind (and often, as Western medical science now reluctantly admits, to your physical well-being). Perhaps it is better to be un-sane and happy, than sane and un-happy. But it is the best of all to be sane and happy. Whether our descendants can achieve that goal will be the greatest challenge of the future. Indeed, it may well decide whether we have any future.

no disease suffered by a live man can be known, for every living person has his own peculiarities and always has his own peculiar, personal, novel, complicated disease, unknown to medicine -- not a disease of the lungs, liver, skin, heart, nerves, and so on mentioned in medical books, but a disease consisting of one of the innumerable combinations of the maladies of those organs. This simple thought could not occur to the doctors (as it cannot occur to a wizard that he is unable to work his charms) because the business of their lives was to cure, and they received money for it and had spent the best years of their lives on that business. But above all that thought was kept out of their minds by the fact that they saw they were really useful [...] Their usefulness did not depend on making the patient swallow substances for the most part harmful (the harm was scarcely perceptible because they were given in small doses) but they were useful, necessary, and indispensable because they satisfied a mental need of the invalid and those who loved her -- and that is why there are, and always will be, pseudo-healers, wise women, homoeopaths, and allopaths. They satisfied that eternal human need for hope of relief, for sympathy, and that something should be done, which is felt by those who are suffering.

You will not remember much from school. School is designed to teach you how to respond and listen to authority figures in the event of an emergency. Like if there's a bomb in a mall or a fire in an office. It can, apparently, take you more than a decade to learn this. These are not the best days of your life. They are still ahead of you. You will fall in love and have your heart broken in many different, new and interesting ways in college or university (if you go) and you will actually learn things, as at this point, people will believe you have a good chance of obeying authority and surviving, in the event of an emergency. If, in your chosen career path, there are award shows that give out more than ten awards in one night or you have to pay someone to actually take the award home to put on your mantlepiece, then those awards are more than likely designed to make young people in their 20's work very late, for free, for other people. Those people will do their best to convince you that they have value. They don't. Only the things you do have real, lasting value, not the things you get for the things you do. You will, at some point, realise that no trophy loves you as much as you love it, that it cannot pay your bills (even if it increases your salary slightly) and that it won't hold your hand tightly as you say your last words on your deathbed. Only people who love you can do that. If you make art to feel better, make sure it eventually makes you feel better. If it doesn't, stop making it. You will love someone differently, as time passes. If you always expect to feel the same kind of love you felt when you first met someone, you will always be looking for new people to love. Love doesn't fade. It just changes as it grows. It would be boring if it didn't. There is no truly "right" way of writing, painting, being or thinking, only things which have happened before. People who tell you differently are assholes, petrified of change, who should be violently ignored. No philosophy, mantra or piece of advice will hold true for every conceivable situation. "The early bird catches the worm" does not apply to minefields. Perfection only exists in poetry and movies, everyone fights occasionally and no sane person is ever completely sure of anything. Nothing is wrong with any of this. Wisdom does not come from age, wisdom comes from doing things. Be very, very careful of people who call themselves wise, artists, poets or gurus. If you eat well, exercise often and drink enough water, you have a good chance of living a long and happy life. The only time you can really be happy, is right now. There is no other moment that exists that is more important than this one. Do not sacrifice this moment in the hopes of a better one. It is easy to remember all these things when they are being said, it is much harder to remember them when you are stuck in traffic or lying in bed worrying about the next day. If you want to move people, simply tell them the truth. Today, it is rarer than it's ever been. (People will write things like this on posters (some of the words will be bigger than others) or speak them softly over music as art (pause for effect). The reason this happens is because as a society, we need to self-medicate against apathy and the slow, gradual death that can happen to anyone, should they confuse life with actually living.)

Our best medical journals are now brimming with high-profile, rigorous studies that show a stunning correlation between high blood sugar and risk for dementia.

When I went on my first antidepressant it had the side effect of making me fixated on suicide (which is sort of the opposite of what you want). It’s a rare side effect so I switched to something else that did work. Lots of concerned friends and family felt that the first medication’s failure was a clear sign that drugs were not the answer; if they were I would have been fixed. Clearly I wasn’t as sick as I said I was if the medication didn’t work for me. And that sort of makes sense, because when you have cancer the doctor gives you the best medicine and if it doesn’t shrink the tumor immediately then that’s a pretty clear sign you were just faking it for attention. I mean, cancer is a serious, often fatal disease we’ve spent billions of dollars studying and treating so obviously a patient would never have to try multiple drugs, surgeries, radiation, etc., to find what will work specifically for them. And once the cancer sufferer is in remission they’re set for life because once they’ve learned how to not have cancer they should be good. And if they let themselves get cancer again they can just do whatever they did last time. Once you find the right cancer medication you’re pretty much immune from that disease forever. And if you get it again it’s probably just a reaction to too much gluten or not praying correctly. Righ

Headache, hmm?" His expression went serious. "Do you know what's the best cure for that?" "What?" "Orgasm." He said it so matter-of-factly I had to sputter a laugh. "Multiple, if possible," he continued. "It's a proven medical fact that one physiologic event, like orgasm, can cancel out the effects of another physiological process, such as a headache." His expression was perfectly serious, but I said, "You're full of shit." "Perhaps. If so, you should call my bluff. Just open the door and we'll test it out.

Later that day, shortly before the sun sank in the wintry sky, despite the best efforts of the medics, Arra Sails closed her eyes, made peace with the gods of the vampires, breathed her last...and died.

Ella finished her burger and dug into a side of fries. Hi watched, enraptured. She couldn't help but notice. “Would you like one?” “What? Sure.” Hi smiled, made no move. After a moment, Ella nudged the bowl his way. “Careful, they're still hot.” “Oh, no problem.” Hi fumbled for a fry. “I like food that's hot.” I caught Shelton slowly shaking his head. “Oh, shoot!” Ella winced. “I forgot to stop by the office. My mother had to drop off my shin guards.” She slid her fries over to Hi. “Enjoy. They're hot, which apparently you like.” “Got that right. Hot hot hot!” Hi awkwardly shoved another fry into his mouth. “Okay, wow.” Ella gathered her things, then brushed my cheek with a kiss. “Later, Tor.” Shouldering her bag, she hurried from the cafeteria. A loud thunk drew my attention back to the table. Hi's forehead was resting on his tray. “Tell me that wasn't as bad as I think.” “Worse,” Shelton said. “So, so much worse.” Then head rose, then thunked back down. “I don't remember parts. I think I lost time.” I patted his shoulder. “That's probably for the best.” “Such.” Thunk. “A.” Thunk. “Dumbass.” Thunk. Shelton laughed nervously. “See? That's why I don't talk.” Hi's face shot up. “Tell her I have brain seizures. A serious medical condition. Or that I have an evil twin who sometimes takes my place, but can't talk for crap.” “Got it," I promised. His head dropped once more.

The great unspoken paradox of the arduous process of psychoanalysis is that the best patients are the ones who never really needed it in the first place. Abnormal

Richard, Bill has the socialist disease in its worst form; he thinks the world owes him a living. He told me sincerely - smugly! - that of course everyone was entitled to the best possible medical and hospital service - free of course, unlimited of course, and of course the government should pay for it.

Our culture treats people with depression is as if there is something wrong with them; a biological imbalance best treated with medication. But if it’s impossible to understand biology outside the context of environment, and there is a frightening increase in male suicide and depression, perhaps we need to take a closer look at the other variable - our environment.

Once a patient goes brain dead and relatives sign his organ donation consent form, he will get the best medical treatment of his life. A hospital code blue may be a call for doctors to rush to the bedside of a beating heart cadaver who needs his or her heart defibrillated.

A young woman attending the best medical school in the world," Ransom mused aloud, "far from home, taking classes in a foreign language. You're a determined woman, doctor." "No medical school here would admit a female," Garret said pragmatically. "I had no choice." "You could have given up." "That is never an option," she assured him, and he smiled.

Our children pay a heavy price when we lack consciousness. Overindulged, over-medicated, and over-labeled, many of them are unhappy. This is because, coming from unconsciousness ourselves, we bequeath to them our own unresolved needs, unmet expectations, and frustrated dreams. Despite our best intentions, we enslave them to the emotional inheritance we received from our parents, binding them to the debilitating legacy of ancestors past. The nature of unconsciousness is such that, until it’s metabolized, it will seep through generation after generation. Only through awareness can the cycle of pain that swirls in families end. T

Love is a chemical reaction, but it cannot be fully understood or defined by science. And though a body cannot exist without a soul, it too cannot be fully understood or defined by science. Love is the most powerful form of energy, but science cannot decipher its elements. Yet the best cure for a sick soul is love, but even the most advanced physician cannot prescribe it as medicine.

By the nineteenth century, society had given up burning witches. Yet the sexual exploitation of children continued. In late-nineteenth-century Britain, for example, men who raped young girls were excused because they did it to cure venereal disease. There was a widely held belief that children would take "poisons" out of the body. In fact, leprosy, venereal disease, depression, and impotence were part of a wide range of maladies believed cured by having sex with the young. An English medical text of the time reads, "Breaking a maiden's seal is one of the best antidotes for one's ills. Cudgeling her unceasingly, until she swoons away, is a mighty remedy for man's depression. It cures all impotence.

I would earnestly ask my sisters to keep clear of both the jargons now current everywhere (for they are equally jargons); of the jargon, namely, about the "rights" of women, which urges women to do all that men do, including the medical and other professions, merely because men do it, and without regard to whether this is the best that women can do; and of the jargon which urges women to do nothing that men do, merely because they are women, and should be "recalled to a sense of their duty as women," and because "this is women's work," and "that is men's," and "these are things which women should not do," which is all assertion and nothing more. Surely woman should bring the best she has, whatever that is, to the work of God's world, without attending to either of these cries.

Operating theaters are not nearly as popular as dramatic theaters, musical theaters, and movie theaters, and it is easy to see why. A dramatic theater is a large, dark room in which actors perform a play, and if you are in the audience, you can enjoy yourself by listening to the dialog and looking at the costumes. A musical theater is a large, dark room in which musicians preform a symphony, and if you are in the audience you can enjoy yourself by listening to the melodies and watching the conductor wave his little stick around. And a movie theater is a large, dark room in which a projectionist shows a film, and if you are in the audience, you can enjoy yourself by eating popcorn and gossiping about movie stars. But an operating theater is a large, dark room in which doctors preform medical procedures, and if you are in the audience, the best thing to do is to leave at once because there is never anything on display in an operating theater but pain, suffering and discomfort, and for this reason most operating theaters have been closed down or have been turned into restaurants.

Voluntary euthanasia occurs only when, to the best of medical knowledge, a person is suffering from an incurable and painful or extremely distressing condition. In these circumstances one cannot say that to choose to die quickly is obviously irrational.

How did we forget these lessons from the past? How did we go from knowing that the best athletes in the ancient Greek Olympics must consume a plant-based diet to fearing that vegetarians don’t get enough protein? How did we get to a place where the healers of our society, our doctors, know little, if anything, about nutrition; where our medical institutions denigrate the subject; where using prescription drugs and going to hospitals is the third leading cause of death? How did we get to a place where advocating a plant-based diet can jeopardize a professional career, where scientists spend more time mastering nature than respecting it? How did we get to a place where the companies that profit from our sickness are the ones telling us how to be healthy; where the companies that profit from our food choices are the ones telling us what to eat; where the public’s hard-earned money is being spent by the government to boost the drug industry’s profits; and where there is more distrust than trust of our government’s policies on foods, drugs and health? How did we get to a place where Americans are so confused about what is healthy that they no longer care?

It’s always best to be ready for a medical emergency and nothing says “prepared” like having a tobacco smoke enema kit next to your first aid supplies.

Spiritual depression presents itself in much the same way as clinical depression—but not quite. The marks of distinction are crucial, yet hard for the untrained to recognize. They make the difference between interpreting the source of depression as a problem that may require medication or as a process of transformation that is best served by reflection, discussion of the stages of the dark night, and understanding the nature of mystical prayer. I have met many people who have been treated for depression and other conditions when they were, in fact, in the deep stages of a spiritual crisis. Without the proper support, that crisis becomes misdirected into a problem with relationships, a problem with one’s childhood, or a chronic malaise. Spiritual crises are now a very real part of our spectrum of health challenges and we need to acknowledge them with the same authority as we do clinical depression.

Mental disorders should be diagnosed only when the presentation is clear-cut, severe, and clearly not going away on its own. The best way to deal with the everyday problems of living is to solve them directly or to wait them out, not to medicalize them with a psychiatric diagnosis or treat them with a pill.

I mean to say, I know perfectly well that I've got, roughly speaking, half the amount of brain a normal bloke ought to possess. And when a girl comes along who has about twice the regular allowance, she too often makes a bee line for me with the love light in her eyes. I don't know how to account for it, but it is so." "It may be Nature's provision for maintaining the balance of the species, sir."... "At breakfast this morning, when I was eating a sausage, she told me I shouldn't, as modern medical science held that a four-inch sausage contained as many germs as a dead rat. The maternal touch, you understand; fussing over my health.... What's to be done, Jeeves?" "We must think, sir." "You think. I haven't the machinery." "I will most certainly devote my very best attention to the matter, sir, and will endeavour to give satisfaction." Well, that was something. But I was ill at east. Yes, there is no getting away from it, Bertram was ill at ease.

The thing about being barren is that you’re not allowed to get away from it. Not when you’re in your thirties. My friends were having children, friends of friends were having children, pregnancy and birth and first birthday parties were everywhere. I was asked about it all the time. My mother, our friends, colleagues at work. When was it going to be my turn? At some point our childlessness became an acceptable topic of Sunday-lunch conversation, not just between Tom and me, but more generally. What we were trying, what we should be doing, do you really think you should be having a second glass of wine? I was still young, there was still plenty of time, but failure cloaked me like a mantle, it overwhelmed me, dragged me under, and I gave up hope. At the time, I resented the fact that it was always seen as my fault, that I was the one letting the side down. But as the speed with which he managed to impregnate Anna demonstrates, there was never any problem with Tom’s virility. I was wrong to suggest that we should share the blame; it was all down to me. Lara, my best friend since university, had two children in two years: a boy first and then a girl. I didn’t like them. I didn’t want to hear anything about them. I didn’t want to be near them. Lara stopped speaking to me after a while. There was a girl at work who told me—casually, as though she were talking about an appendectomy or a wisdom-tooth extraction—that she’d recently had an abortion, a medical one, and it was so much less traumatic than the surgical one she’d had when she was at university. I couldn’t speak to her after that, I could barely look at her. Things became awkward in the office; people noticed. Tom didn’t feel the way I did. It wasn’t his failure, for starters, and in any case, he didn’t need a child like I did. He wanted to be a dad, he really did—I’m sure he daydreamed about kicking a football around in the garden with his son, or carrying his daughter on his shoulders in the park. But he thought our lives could be great without children, too. “We’re happy,” he used to say to me. “Why can’t we just go on being happy?” He became frustrated with me. He never understood that it’s possible to miss what you’ve never had, to mourn for it.

If you tell someone you have depression, they will often say, "Oh, I've been depressed before, too." The difference lies between being depressed and having depression. Everyone's been depressed at one time or another, but these are far from being the same things. One is a passing mood. The other is a chronic illness that does not come and go, ebb and flow, is here one day and gone the next. The difference between being depressed and having depression is that one is a mood and the other is an illness. One is a momentary bout of melancholy. The other is a debilitating condition that requires medical treatment. Would you feel better about having a cancerous lesion if I likened it to the rash I had last week? The difference between being depressed and having depression is the difference between a mood that will soon pass, and a serious illness that disrupts your ability to function and will take years to treat. The difference between being depressed and having depression is the difference between Cleveland and Bangkok, or your frying pan and the surface of the sun. So, no, we (depressives) do not feel better when you tell us about your rash. We'll do our best to be polite about it, but no, it really doesn't help at all.

Billy tries to imagine the vast systems that support these athletes. They are among the best-cared for creatures in the history of the planet, beneficiaries of the best nutrition, the latest technologies, the finest medical care, they live at the very pinnacle of American innovation and abundance, which inspires an extraordinary thought - send them to fight the war! Send them just as they are this moment, well rested, suited up, psyched for brutal combat, send the entire NFL! Attack with all our bears and raiders, our ferocious redskins, our jets, eagles, falcons, chiefs, patriots, cowboys - how could a bunch of skinny hajjis in man-skits and sandals stand a chance against these all-Americans? Resistance is futile, oh Arab foes. Surrender now and save yourself a world of hurt, for our mighty football players cannot be stopped, they are so huge, so strong, so fearsomely ripped that mere bombs and bullets bounce off their bones of steel. Submit, lest our awesome NFL show you straight to the flaming gates of hell!

However well you do in the competition for the greatest toys, longest life, and healthiest brain, the best medical research indicates that eventually you’re going to be dead. And you’re going to stay dead for many years longer than you were alive, and all that will be left of you is people’s memories of you, which is to say, your reputation.

The Family and Medical Leave Act, for example, only entitles spouses, grown children, and parents to take time off to care for a sick loved one. If a childless single person falls ill, only her parents have the legal right to take off work to care for her. If they’re deceased or not up to the task, she’s out of luck. Even if she has a sister, niece, or best friend willing to take a leave, they won’t be legally entitled to do so. No one has the right to care for her.

My dear Gorgas, Instead of being simply satisfied to make friends and draw your pay, it is worth doing your duty, to the best of your ability, for duty’s sake; and in doing this, while the indolent sleep, you may accomplish something that will be of real value to humanity. Your good friend, Reed Dr. Walter Reed encouraging Dr. William Gorgas who went on to make history eradicating Yellow Fever in Havana, 1902 and Panama, 1906, liberating the entire North American continent from centuries of Yellow Fever epidemics.

I don’t think the people today who start hearing voices, stop eating and sleeping, and run amuck are likely to get good treatment. Having more knowledge, better diagnostic capabilities, better medications with fewer side effects, can’t make up for the fact that most patients are being treated by doctors, therapists, and hospitals, who are operating under constraints and incentives that reward non-treatment, non-hospitalization, non-therapy, non-follow-up, non-care. Lost to follow-up is the best outcome a health insurer can hope for.

When pressed to tell people how I got myself into my current nepotism-gone-bad situation, I like to describe it as a mini-breakdown. The prefix makes all the difference. It makes it sound more like a vacation than a condition best treated with medication and art therapy.

can’t be life. sadly, so many people are setting the bar really low in terms of their personal lives working a job they hate content with struggling settling for relationships that aren’t actual relationships life for so many is not living at all and that’s the problem you get what you allow watching others live life instead of living your best life and they wonder why everyone is self-medicating suppressing their pain pretending to be happy instead of trying to cultivate a lifestyle that brings them peace

Dr. Inchbald tried his best to comply. 'I've come to the conclusion that God is sovereign, even over science, and that I cannot pretend to fully know His ways. They really are mysterious, as the saying goes. And they are not of the mind of men, no matter how hard we try to wrap our minds about these ways. I can marvel at the intricacies of the human body, which really are pretty miraculous to behold. In fact, I don't know how one can go to medical school and not be in greater awe of a Creator than ever before.

Kovacs, I hate these goddamn freaks. They’ve been grinding us down for the best part of two and a half thousand years. They’ve been responsible for more misery than any other organisation in history. You know they won’t even let their adherents practise birth control, for Christ’s sake, and they’ve stood against every significant medical advance of the last five centuries. Practically the only thing you can say in their favour is that this d.h.f. thing has stopped them from spreading with the rest of humanity.

Aristotle tells us that the high-pitched voice of the female is one evidence of her evil disposition, for creatures who are brave or just (like lions, bulls, roosters and the human male) have large deep voices…. High vocal pitch goes together with talkativeness to characterize a person who is deviant from or deficient in the masculine ideal of self-control. Women, catamites, eunuchs and androgynes fall into this category. Their sounds are bad to hear and make men uncomfortable…. Putting a door on the female mouth has been an important project of patriarchal culture from antiquity to the present day. Its chief tactic is an ideological association of female sound with monstrosity, disorder and death…. Woman is that creature who puts the inside on the outside. By projections and leakages of all kinds—somatic, vocal, emotional, sexual—females expose or expend what should be kept in…. [As Plutarch comments,] “…she should as modestly guard against exposing her voice to outsiders as she would guard against stripping off her clothes. For in her voice as she is blabbering away can be read her emotions, her character and her physical condition.”… Every sound we make is a bit of autobiography. It has a totally private interior yet its trajectory is public. A piece of inside projected to the outside. The censorship of such projections is a task of patriarchal culture that (as we have seen) divides humanity into two species: those who can censor themselves and those who cannot…. It is an axiom of ancient Greek and Roman medical theory and anatomical discussion that a woman has two mouths. The orifice through which vocal activity takes place and the orifice through which sexual activity takes place are both denoted by the wordstoma in Greek (os in Latin) with the addition of adverbs ano and kato to differentiate upper mouth from lower mouth. Both the vocal and the genital mouth are connected to the body by the neck (auchen in Greek, cervix in Latin). Both mouths provide access to a hollow cavity which is guarded by lips that are best kept closed.

It’s one of the best working examples I know of C. S. Lewis’s principle of sneaking past “watchful dragons.” Lewis wrote in an essay called “Sometimes Fairy Stories May Say Best What’s to be Said,” I thought I saw how stories of this kind could steal past a certain inhibition which had paralysed much of my own religion in childhood. Why did one find it so hard to feel as one was told one ought to feel about God or the sufferings of Christ? I thought the chief reason was that one was told one ought to. An obligation to feel can freeze feelings. And reverence itself did harm. The whole subject was associated with lowered voices; almost as if it were something medical. But supposing that by casting all these things into an imaginary world, stripping them of their stained-glass and Sunday School associations, one could make them for the first time appear in their real potency? Could one not thus steal past those watchful dragons? I thought one could.

Today, the lay midwife is a response to a growing home-birth movement. In my own community most physicians have decided to withhold prenatal care from the home-birther. This is judgmental and vindictive. These doctors have decided that home birth is not safe, and by withholding prenatal care they are doing their best to make sure it is unsafe. Often it is lay midwives who step forward to fill the void and help eliminate the unnecessary dangers of home birth. They are essential for screening out women who really should not have a home birth. For considerably less money than a physician charges, they spend many more hours with a pregnant woman before, during, and after the birth. and in most places they courageously face the opposition of the established medical community.

Money had replaced community mental healthcare the way medication had replaced state hospitals. Medication did not go looking for those who resisted taking it, and money could not administer itself. Neither came with counseling or support. The SSI checks Michael received, and the Medicaid requirements he was eligible for, did not create a caring community or even an indifferent one. Nevertheless, checks and pills were what remained of a grand promise, the ingredients of a mental healthcare system that had never been baked but were handed out like flour and yeast in separate packets to starving people.

Finally, I would like to assure my many Buddhist, Christian, Hindu, Jewish, and Muslim friends that I am sincerely happy that the religion which Chance has given you has contributed to your peace of mind (and often, as Western medical science now reluctantly admits, to your physical well-being). Perhaps it is better to be un-sane and happy, than sane and un-happy. But it is best of all to be sane and happy.

On the Rebbe’s willingness to offer opinions and advice on a large range of issues, including theology, business, family affairs, and even medical questions: “[First] I am not afraid to answer that I don’t know. If I know, then I have no right not to answer. When someone comes to you for help and you can help him to the best of your knowledge, and you refuse him this help, you become a cause of his suffering.

My best guess about my own attraction to the habit is that I belong to a class of people whose lives are insufficiently structured... We embrace a toxin as deadly as nicotine...because we have not yet found pleasures or routines that can replace the comforting, structure bringing rhythm of need and gratification that the cigarette habit offers. One word for this structuring might be "self medication"; another might be "coping".

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

They don’t even visit the dying anymore. Their argument being that if someone is dying, there’s no point interrupting a good game of golf, and they’d best just get on with dying. However, they do give you a helpline number for an organisation called ‘Dying To Help You Out.’ A volunteer talks you through the process of dying alone without medical attention: “feeling a bit chilled are you, love, don’t fret, it’s just your lifeblood congealing in your veins, you’ll be gone any second now, hang on pet, I’ve got a corpse on line nine, if I don’t get back before you peg it, have a nice afterlife,” and then they bugger of leaving you with Robbie Williams singing Angels.

Doc Roe was right there, trying to patch us up. Without him, we wouldn't be alive. Roe was the best medic we ever had. He was born to be a medic. You could always depend on him. You hollered, 'Medic!" he was right there come hell or high water, he knew what he was doing. He was compassionate, took care of you mentally, physically, every way. They put me on a stretcher before Joe. I said, 'I told you I'd beat you back to the States,' and then I passed out.

Ebook readers might cause problems. This has become a controversial topic as more and more people use and love ereaders. A close friend of mine doesn’t go anywhere without her Kindle and will probably be buried with it. A Wolf, she was dismayed when I shared the findings of a new Harvard Medical School study:23 reading an ebook in the hour before bed delayed sleep more than reading a print book under normal lamplight, and it also increased sleep inertia the next day.

I have another scan this week," I say lightly, hoping to reassure my loved ones that it is safe to rejoin my orbit. There is always another scan, because this is my reality. But the people I know are often busy contending with mildly painful ambition and the possibility of reward. I try to begrudge them nothing, except I'm not alongside them anymore. In the meantime, I have been hunkering down with old medical supplies and swelling resentment. I tried— haven't I tried? — to avoid fights and remember birthdays. I showed up for dance recitals and listened to weight-loss dreams and kept the granularity of my medical treatments in soft focus. A person like that would be easier to love, I reasoned. I try a small experiment and stop calling my regular rotation of friends and family, hoping that they will call me back on their own. _This is not a test. This is not a test._ The phone goes quiet, except for a handful of calls. I feel heavy with strange new grief. Is it bitter or unkind to want everyone to remember what I can't forget? Who wants to be confronted with the reality that we are all a breath away from a problem that could alter our lives completely? A friend with a very sick child said it best: I'm everyone's inspiration and and no one's friend. I am asked all the time to say that, given what I've gained in perspective, I would never go back. Who would want to know the truth? Before was better.

The distinguished scientist Herr Professor Luitpold Blumenduft tendered medical evidence to the effect that the instantaneous fracture of the cervical vertebrae and consequent scission of the spinal cord would, according to the best approved traditions of medical science, be calculated to inevitably produce in the human subject a violent ganglionic stimulus of the nerve centres, causing the pores of the corpora cavernosa to rapidly dilate in such a way as to instantaneously facilitate the flow of blood to that part of the human anatomy known as the penis or male organ resulting in the phenomenon which has been denominated by the faculty a morbid upwards and outwards philoprogenetive erection in articulo mortis per diminutionem capitis.

Worse were the disaster tourists: those whom I didn’t know well but who came out of the woodwork, showing up unannounced at my hospital room door with an overzealous desire to help or to bear witness to the medical carnival that my life had become. They would gape at my bald head, all misty-eyed, and I’d find myself having to console them. Or they’d bombard me with unsolicited medical advice, telling me about a great doctor they knew or a friend of a friend who’d cured their own cancer with things like essential oils, apricot kernels, coffee enemas, or a juice cleanse. I knew that most meant well and were doing the best they knew how, so I smiled and nodded, but I was silently fuming. As I got sicker, fewer and fewer came—and when they did, I began pretending to be asleep.

We are dealing, then, with an absurdity that is not a quirk or an accident, but is fundamental to our character as people. The split between what we think and what we do is profound. It is not just possible, it is altogether to be expected, that our society would produce conservationists who invest in strip-mining companies, just as it must inevitably produce asthmatic executives whose industries pollute the air and vice-presidents of pesticide corporations whose children are dying of cancer. And these people will tell you that this is the way the "real world" works. The will pride themselves on their sacrifices for "our standard of living." They will call themselves "practical men" and "hardheaded realists." And they will have their justifications in abundance from intellectuals, college professors, clergymen, politicians. The viciousness of a mentality that can look complacently upon disease as "part of the cost" would be obvious to any child. But this is the "realism" of millions of modern adults. There is no use pretending that the contradiction between what we think or say and what we do is a limited phenomenon. There is no group of the extra-intelligent or extra-concerned or extra-virtuous that is exempt. I cannot think of any American whom I know or have heard of, who is not contributing in some way to destruction. The reason is simple: to live undestructively in an economy that is overwhelmingly destructive would require of any one of us, or of any small group of us, a great deal more work than we have yet been able to do. How could we divorce ourselves completely and yet responsibly from the technologies and powers that are destroying our planet? The answer is not yet thinkable, and it will not be thinkable for some time -- even though there are now groups and families and persons everywhere in the country who have begun the labor of thinking it. And so we are by no means divided, or readily divisible, into environmental saints and sinners. But there are legitimate distinctions that need to be made. These are distinctions of degree and of consciousness. Some people are less destructive than others, and some are more conscious of their destructiveness than others. For some, their involvement in pollution, soil depletion, strip-mining, deforestation, industrial and commercial waste is simply a "practical" compromise, a necessary "reality," the price of modern comfort and convenience. For others, this list of involvements is an agenda for thought and work that will produce remedies. People who thus set their lives against destruction have necessarily confronted in themselves the absurdity that they have recognized in their society. They have first observed the tendency of modern organizations to perform in opposition to their stated purposes. They have seen governments that exploit and oppress the people they are sworn to serve and protect, medical procedures that produce ill health, schools that preserve ignorance, methods of transportation that, as Ivan Illich says, have 'created more distances than they... bridge.' And they have seen that these public absurdities are, and can be, no more than the aggregate result of private absurdities; the corruption of community has its source in the corruption of character. This realization has become the typical moral crisis of our time. Once our personal connection to what is wrong becomes clear, then we have to choose: we can go on as before, recognizing our dishonesty and living with it the best we can, or we can begin the effort to change the way we think and live.

The I Ching insists upon self-knowledge throughout. The method by which this is to be achieved is open to every kind of misuse, and is therefore not for the frivolous-minded and immature; nor is it for intellectualists and rationalists. It is appropriate only for thoughtful and reflective people who like to think about what they do and what happens to them -- a predilection not to be confused with the morbid brooding of the hypochondriac. As I have indicated above, I have no answer to the multitude of problems that arise when we seek to harmonize the oracle of the I Ching with our accepted scientific canons. But needless to say, nothing "occult" is to be inferred. My position in these matters is pragmatic, and the great disciplines that have taught me the practical usefulness of this viewpoint are psychotherapy and medical psychology. Probably in no other field do we have to reckon with so many unknown quantities, and nowhere else do we become more accustomed to adopting methods that work even though for a long time we may not know why they work. Unexpected cures may arise from questionable therapies and unexpected failures from allegedly reliable methods. In the exploration of the unconscious we come upon very strange things, from which a rationalist turns away with horror, claiming afterward that he did not see anything. The irrational fullness of life has taught me never to discard anything, even when it goes against all our theories (so short-lived at best) or otherwise admits of no immediate explanation. It is of course disquieting, and one is not certain whether the compass is pointing true or not; but security, certitude, and peace do not lead to discoveries.

My mom was a sayyed from the bloodline of the Prophet (which you know about now). In Iran, if you convert from Islam to Christianity or Judaism, it’s a capital crime. That means if they find you guilty in religious court, they kill you. But if you convert to something else, like Buddhism or something, then it’s not so bad. Probably because Judaism, Christianity, and Islam are sister religions, and you always have the worst fights with your sister. And probably nothing happens if you’re just a six-year-old. Except if you say, “I’m a Christian now,” in your school, chances are the Committee will hear about it and raid your house, because if you’re a Christian now, then so are your parents probably. And the Committee does stuff way worse than killing you. When my sister walked out of her room and said she’d met Jesus, my mom knew all that. And here is the part that gets hard to believe: Sima, my mom, read about him and became a Christian too. Not just a regular one, who keeps it in their pocket. She fell in love. She wanted everybody to have what she had, to be free, to realize that in other religions you have rules and codes and obligations to follow to earn good things, but all you had to do with Jesus was believe he was the one who died for you. And she believed. When I tell the story in Oklahoma, this is the part where the grown-ups always interrupt me. They say, “Okay, but why did she convert?” Cause up to that point, I’ve told them about the house with the birds in the walls, all the villages my grandfather owned, all the gold, my mom’s own medical practice—all the amazing things she had that we don’t have anymore because she became a Christian. All the money she gave up, so we’re poor now. But I don’t have an answer for them. How can you explain why you believe anything? So I just say what my mom says when people ask her. She looks them in the eye with the begging hope that they’ll hear her and she says, “Because it’s true.” Why else would she believe it? It’s true and it’s more valuable than seven million dollars in gold coins, and thousands of acres of Persian countryside, and ten years of education to get a medical degree, and all your family, and a home, and the best cream puffs of Jolfa, and even maybe your life. My mom wouldn’t have made the trade otherwise. If you believe it’s true, that there is a God and He wants you to believe in Him and He sent His Son to die for you—then it has to take over your life. It has to be worth more than everything else, because heaven’s waiting on the other side. That or Sima is insane. There’s no middle. You can’t say it’s a quirky thing she thinks sometimes, cause she went all the way with it. If it’s not true, she made a giant mistake. But she doesn’t think so. She had all that wealth, the love of all those people she helped in her clinic. They treated her like a queen. She was a sayyed. And she’s poor now. People spit on her on buses. She’s a refugee in places people hate refugees, with a husband who hits harder than a second-degree black belt because he’s a third-degree black belt. And she’ll tell you—it’s worth it. Jesus is better. It’s true. We can keep talking about it, keep grinding our teeth on why Sima converted, since it turned the fate of everybody in the story. It’s why we’re here hiding in Oklahoma. We can wonder and question and disagree. You can be certain she’s dead wrong. But you can’t make Sima agree with you. It’s true. Christ has died. Christ is risen. Christ will come again. This whole story hinges on it. Sima—who was such a fierce Muslim that she marched for the Revolution, who studied the Quran the way very few people do read the Bible and knew in her heart that it was true.

On the morning of November 22nd, a Friday, it became clear the gap between living and dying was closing. Realizing that Aldous [Huxley] might not survive the day, Laura [Huxley's wife] sent a telegram to his son, Matthew, urging him to come at once. At ten in the morning, an almost inaudible Aldous asked for paper and scribbled "If I go" and then some directions about his will. It was his first admission that he might die ... Around noon he asked for a pad of paper and scribbled LSD-try it intermuscular 100mm In a letter circulated to Aldous's friends, Laura Huxley described what followed: 'You know very well the uneasiness in the medical mind about this drug. But no 'authority', not even an army of authorities, could have stopped me then. I went into Aldous's room with the vial of LSD and prepared a syringe. The doctor asked me if I wanted him to give the shot- maybe because he saw that my hands were trembling. His asking me that made me conscious of my hands, and I said, 'No, I must do this.' An hour later she gave Huxley a second 100mm. Then she began to talk, bending close to his ear, whispering, 'light and free you let go, darling; forward and up. You are going forward and up; you are going toward the light. Willingly and consciously you are going, willingly and consciously, and you are doing this beautifully — you are going toward the light — you are going toward a greater love … You are going toward Maria's [Huxley's first wife, who had died many years earlier] love with my love. You are going toward a greater love than you have ever known. You are going toward the best, the greatest love, and it is easy, it is so easy, and you are doing it so beautifully.' All struggle ceased. The breathing became slower and slower and slower until, 'like a piece of music just finishing so gently in sempre piu piano, dolcamente,' at twenty past five in the afternoon, Aldous Huxley died.

when it comes to the bread and butter of human misery, try a major depression. It can be life-threatening, it can destroy lives, demolish the families of sufferers. And it is dizzyingly common—the psychologist Martin Seligman has called it the common cold of psychopathology. Best estimates are that from 5 to 20 percent of us will suffer a major, incapacitating depression at some point in our lives, causing us to be hospitalized or medicated or nonfunctional for a significant length of time. Its incidence has been steadily increasing for decades—by the year 2020, depression is projected to be the second leading cause of medical disability on earth.

Consider the top man–machine medical diagnosticians, circa 2035. They will make life-and-death decisions for patients, hospitals, and other doctors. But what in a malpractice case should count as persuasive evidence of a medical mistake? The judgment of either “man alone” or “machine alone” won’t do the trick, because neither is up to judging the team. Sometimes it will be possible to ascertain that a top human team member was in fact a fraud, but more typically the joint human–cyber diagnostic decisions themselves will be our highest standards for what is best. Having one team dispute the choice of another may indicate a mistake, but it will hardly show malfeasance. When

What worries me is the acceptance of the importance of feelings without any effort to understand their complex biological and sociocultural machinery. The best example of this attitude can be found in the attempt to explain bruised feelings or irrational behavior by appealing to surface social causes or the action of neurotransmitters, two explanations that pervade the social discourse as presented in the visual and printed media; and in the attempt to correct personal and social problems with medical and nonmedical drugs. It is precisely this lack of understanding of the nature of feelings and reason (one of the hallmarks of the "culture of complaint") that is cause for alarm.

We do not (and will not) have the resources to properly care for our increasing elderly population, yet we insist on medical intervention to keep them alive. To allow them to die would signal the failure of our supposedly infallible modern medical system. The surgeon Atul Gawande wrote in a devastating New Yorker article on aging that “there have been dozens of best-selling books on aging but they tend to have titles like ‘Younger Next Year,’ ‘The Fountain of Age,’ ‘Ageless,’ ‘The Sexy Years.’ Still, there are costs to averting our eyes from the realities. For one thing, we put off changes that we need to make as a society. . . . In thirty years, there will be as many people over eighty as there are under five.

In the mid-1980s, the medical world wrestled with how to use the new opiates that pharmaceutical companies were developing to treat pain. David Procter was an early and aggressive adopter. He prescribed opiates for neck, leg, and lower back pain, arthritis, and lower lumbar spine pain. He combined them with benzodiazepines—anxiety relievers, of which Valium and Xanax, Procter’s favorite, are the best known. In Portsmouth, people had anxiety and they had pain. Appalachia had a long history of using benzodiazepines—dating to the release of Valium in the early 1960s. Little old ladies used it. In this part of the country, anything that relieved pain was welcome. But opiates and benzos together also led quickly to addiction.

Healing Foods When you’re looking to boost the immune system and support the reproductive system, the best foods to concentrate on are wild blueberries, sesame tahini, avocados, black beans, asparagus, apples, spinach, black grapes, and cucumbers. They’ll help by variously providing antioxidants, preventing hot flashes, providing critical nutrients to fortify vital organs, reducing inflammation, and keeping hormone levels balanced. Herbs and Supplements to Address General Symptoms Silver hydrosol: kills viruses, bacteria, and other microbes on contact and supports the immune system. Zinc: kills viruses, boosts the immune system, and helps protect the endocrine system. Licorice root: aids the adrenal glands and helps balance the body’s levels of cortisol and cortisone. L-lysine: impairs the ability of virus cells to move and reproduce. Vitamin B12 (as methylcobalamin and/or adenosylcobalamin): strengthens the central nervous system. Nascent iodine: stabilizes and strengthens the thyroid and the rest of the endocrine system. Ashwagandha: fortifies the adrenal glands and helps balance the production of cortisol.

Even the editors of main journals themselves recognise that peer review may not be the best system ever devised by mankind. Here is what Richard Horton, the editor of The Lancet, has to say on the matter: “The mistake, of course, is to have thought that peer review was any more than a crude means of discovering the acceptability — not the validity — of a new finding. Editors and scientists alike insist on the pivotal importance of peer review. We portray peer review to the public as a quasi-sacred process that helps to make science our most objective truth teller. But we know that the system of peer review is biased, unjust, unaccountable, incomplete, easily fixed, often insulting, usually ignorant, occasionally foolish, and frequently wrong.

Hope is prayer’s second cousin, darkly dressed and hovering around the outside edge of the family photograph. If prayer is a plea to the Almighty for a precedented miracle—prayer’s memory is long—hope is a plea to nothing, to everything, to any possible refutation of the facts. It is tethered to the dreadful single-digit percentage, the medical equipment humming, the long sleepless night. Prayer can (or once could) deliver a miracle; hope can only give a body another week, maybe another month. Sometimes the dying can set goals and reach them: just let me see my son get married, my granddaughter turn ten, my family carve into the Thanksgiving turkey. Hope can outlast dress fittings, gift wrapping, and potato mashing, but it can’t deliver anything more. What hope does best is make plans. Sometimes those plans are to desperately avoid the worst.

There is one notable exception to Jablonski and Chaplin’s equation—and it’s the exception that proves the rule. The Inuit—the indigenous people of the subarctic—are dark-skinned, despite the limited sunlight of their home. If you think something fishy’s going on here, you’re right. But the reason they don’t need to evolve the lighter skin necessary to ensure sufficient vitamin D production is refreshingly simple. Their diet is full of fatty fish—which just happens to be one of the only foods in nature that is chock-full of vitamin D. They eat vitamin D for breakfast, lunch, and dinner, so they don’t need to make it. If you ever had a grandmother from the Old World try to force cod liver oil down your throat, she was onto something for the same reason—since it’s full of vitamin D, cod liver oil was one of the best ways to prevent rickets, especially before milk was routinely fortified with it.   IF YOU’RE WONDERING how people who have dark skin make enough vitamin D despite the fact that their skin blocks all those ultraviolet rays, you’re asking the right questions. Remember, ultraviolet rays that penetrate the skin destroy folate—and ultraviolet rays that penetrate the skin are necessary to create vitamin D. Dark skin evolved to protect folate, but it didn’t evolve

But if you are a poor creature—poisoned by a wretched upbringing in some house full of vulgar jealousies and senseless quarrels—saddled, by no choice of your own, with some loathsome sexual perversion—nagged day in and day out by an inferiority complex that makes you snap at your best friends—do not despair. He knows all about it. You are one of the poor whom He blessed. He knows what a wretched machine you are trying to drive. Keep on. Do what you can. One day (perhaps in another world, but perhaps far sooner than that) He will fling it on the scrap-heap and give you a new one. And then you may astonish us all—not least yourself: for you have learned your driving in a hard school. (Some of the last will be first and some of the first will be last). ‘Niceness’—wholesome, integrated personality—is an excellent thing. We must try by every medical, educational, economic, and political means in our power to produce a world where as many people as possible grow up ‘nice’; just as we must try to produce a world where all have plenty to eat. But we must not suppose that even if we succeeded in making everyone nice we should have saved their souls. A world of nice people, content in their own niceness, looking no further, turned away from God, would be just as desperately in need of salvation as a miserable world—and might even be more difficult to save.

One of the outstanding features of Vanni society was the degree of integration of disabled people into the mainstream. They could be seen actively participating in many spheres, carrying out work with grit and amazing agility. People with one arm would ride motorbikes with heavy loads behind them on their motorbikes. You would hardly have known that some people you worked with were missing a leg from below the knee. Disability had been normalized. Serving these people was the only prosthetic-fitting service in Vanni, Venpuraa. This also expanded its service with the introduction of new technology. A common phrase one heard even prior to the Mullivaikaal genocide was about so and so having a piece of shrapnel in some part of their body. Many people lived with such pieces in their body and suffered varying degrees of pain as a result. Visiting medical experts did their best to remove the ones causing the most severe pain.

WHAT EES ALL DEES STUFF? IN AFRICA WE DOAN HAVE ALL DEES STUFF!! WE HAVE DEE BABEE!!!" His message was simple. It goes to the heart of what we in HypnoBirthing frequently puzzle over: Why has all the "stuff" that denies the normalcy of birth and portrays it as an inevitably risky and dangerous medical event become a routine part of most childbirth education classes? Why are couples in a low- or no-risk category being prepared for circumstances that only rarely occur? Even more puzzling, why do parents accept the negative premise that birth is a dangerous, painful ordeal at best or a medical calamity at worst? Why do they blindly accept the "one-size-fits-all" approach?" If what couples are hearing in childbirth classes is far removed from what they want their birthing experiences to be, why do they spend so much time entertaining negative outcomes that can color and shape their birth expectations and ultimately affect their birth experience? In other words, if it's not what they're wanting, why would they "go there"? In HypnoBirthing, we doan have all dees stuff, and deliberately so." HypnoBirthing helps you to frame a positive expectation and to prepare for birth by developing a trust and belief in your birthing body and in nature's undeniable orchestration of birthing. By teaching you the basic physiology of birth and explaining the adverse effect that fear has upon the chemical and physiological responses of your body we help you to learn simple, self-conditioning techniques that will easily bring you into the optimal state of relaxation you will use during birthing. This will allow your birthing muscles to fully relax. In other words, we will help you prepare for the birth your plan and want for yourselves and your baby, rather than the birth that someone else directs. We will help you look forward to your pregnancy and birthing with joy and love, rather than fear and anxiety.

All they told me was that he was forty-two when he died. I just wanted...to find out more about what kind of person he was. I could tell you more, amanda thought to herself. A lot more. She'd suspected the truth since Morgan Tanner had called, and she'd made some calls to confirm her suspicions. Dawson, she'd learned, had been taking off life support at CarolinaEast Regional Medical Center late Monday night. He's been kept alive long after doctors knew he would never recover, because he was an organ donor. Dawson, she knews, had saved Alan's life-but in the end, he'd saved Jared's as well. And for that meant...everything. I gave you the best of me, he'd told her once, and with every beat of her son's heart, she knew he'd done exactly that. How about a quick hug," she said, "before we go inside?" Jared rolled his eyes, but he opened his arms anyway. "I love you, Mom," he mumbled, pulling her close. Amanda closed her eyes, feeling the steady rhythm in his chest. "I love you, too.

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.

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.

Lots of concerned friends and family felt that the first medication’s failure was a clear sign that drugs were not the answer; if they were I would have been fixed. Clearly I wasn’t as sick as I said I was if the medication didn’t work for me. And that sort of makes sense, because when you have cancer the doctor gives you the best medicine and if it doesn’t shrink the tumor immediately then that’s a pretty clear sign you were just faking it for attention. I mean, cancer is a serious, often fatal disease we’ve spent billions of dollars studying and treating so obviously a patient would never have to try multiple drugs, surgeries, radiation, etc., to find what will work specifically for them. And once the cancer sufferer is in remission they’re set for life because once they’ve learned how to not have cancer they should be good. And if they let themselves get cancer again they can just do whatever they did last time. Once you find the right cancer medication you’re pretty much immune from that disease forever. And if you get it again it’s probably just a reaction to too much gluten or not praying correctly. Right?

Dear patient (first name, last name)! You are presently located in our experimental state hospital. The measures taken to save your life were drastic, extremely drastic (circle one). Our finest surgeons, availing themselves of the very latest achievements of modern medicine, performed one, two, three, four, five, six, seven, eight, nine, ten operations (circle one) on you. They were forced, acting wholly in your interest to replace certain parts of your organism with parts obtained from other persons, in strict accordance with Federal Law (Rev. Stat. Comm. 1-989/0-001/89/1). The notice you are now reading was thoughtfully prepared in order to help you make the best possible adjustment to these new if somewhat unexpected circumstances in your life, which, we hasten to remind you, we have saved. Although it was found necessary to remove your arms, legs, spine, skill, lungs, stomach, kidneys, liver, other (circle one or more), rest assured that these mortal remains were disposed of in a manner fully in keeping with the dictates of your religion; they were, with the proper ritual, interred, embalmed, mummified, buried at sea, cremated with the ashes scattered in the wind—preserved in an urn—thrown in the garbage (circle one). The new form in which you will henceforth lead a happy and healthy existence may possibly occasion you some surprise, but we promise that in time you will become, as indeed all our dear patients do, quite accustomed to it We have supplemented your organism with the very best, the best, perfectly functional, adequate, the only available (circle one) organs at our disposal, and they are fully guaranteed to last a year, six months, three months, three weeks, six days (circle one).

[Lemaire] has been working on the thirteenth-root challenge for a number of years. Previously, his best time had been a sluggish 77 seconds. Afterward, he told the press, "The first digit is very easy, the last digit is very easy, but the inside numbers are extremely difficult. I use an artificial intelligence system on my own brain instead of on a computer. I believe most people can do it,but I also have a high-speed mind. My brain works sometimes very, very fast.... I use a process to improve my skills to behave like a computer. It's like running a program in my head to control my brain." "Sometimes," he said, "when I do multiplication my brain works so fast that I need to take medication. I think somebody without a very fast brain can also do this kind of multiplication but this may be easier for me because my brain is faster." He practices math regularly. So that he can think faster, he exercises, doesn't drink caffeine or alcohol, and avoids foods that are high in sugar or fat. His experience of math is so intense that he also has to take regular time off to rest his brain. Otherwise, he thinks there is a danger that too much math could be bad for his health and his heart.

Harm reduction is often perceived as being inimical to the ultimate purpose of “curing” addiction—that is, of helping addicts transcend their habits and to heal. People regard it as “coddling” addicts, as enabling them to continue their destructive ways. It’s also considered to be the opposite of abstinence, which many regard as the only legitimate goal of addiction treatment. Such a distinction is artificial. The issue in medical practice is always how best to help a patient. If a cure is possible and probable without doing greater harm, then cure is the objective. When it isn’t — and in most chronic medical conditions cure is not the expected outcome — the physician’s role is to help the patient with the symptoms and to reduce the harm done by the disease process. In rheumatoid arthritis, for example, one aims to prevent joint inflammation and bone destruction and, in all events, to reduce pain. In incurable cancers we aim to prolong life, if that can be achieved without a loss of life quality, and also to control symptoms. In other words, harm reduction means making the lives of afflicted human beings more bearable, more worth living. That is also the goal of harm reduction in the context of addiction. Although hardcore drug addiction is much more than a disease, the harm reduction model is essential to its treatment. Given our lack of a systematic, evidencebased approach to addiction, in many cases it’s futile to dream of a cure. So long as society ostracizes the addict and the legal system does everything it can to heighten the drug problem, the welfare and medical systems can aim only to mitigate some of its effects. Sad to say, in our context harm reduction means reducing not only the harm caused by the disease of addiction, but also the harm caused by the social assault on drug addicts.

I believe the perception of what people think about DID is I might be crazy, unstable, and low functioning. After my diagnosis, I took a risk by sharing my story with a few friends. It was quite upsetting to lose a long term relationship with a friend because she could not accept my diagnosis. But it spurred me to take action. I wanted people to be informed that anyone can have DID and achieve highly functioning lives. I was successful in a career, I was married with children, and very active in numerous activities. I was highly functioning because I could dissociate the trauma from my life through my alters. Essentially, I survived because of DID. That's not to say I didn't fall down along the way. There were long term therapy visits, and plenty of hospitalizations for depression, medication adjustments, and suicide attempts. After a year, it became evident I was truly a patient with the diagnosis of DID from my therapist and psychiatrist. I had two choices. First, I could accept it and make choices about how I was going to deal with it. My therapist told me when faced with DID, a patient can learn to live with the live with the alters and make them part of one's life. Or, perhaps, the patient would like to have the alters integrate into one person, the host, so there are no more alters. Everyone is different. The patient and the therapist need to decide which is best for the patient. Secondly, the other choice was to resist having alters all together and be miserable, stuck in an existence that would continue to be crippling. Most people with DID are cognizant something is not right with themselves even if they are not properly diagnosed. My therapist was trustworthy, honest, and compassionate. Never for a moment did I believe she would steer me in the wrong direction. With her help and guidance, I chose to learn and understand my disorder. It was a turning point.

Two decades ago the federal government invited 150,000 men and women to participate in an experiment of screening for cancer in four organs: prostate, lung, colon, and ovary. The volunteers were less likely to smoke, more likely to exercise, had higher socioeconomic status, and fewer medical problems than members of the general population. Those are the kinds of people who seek preventive intervention. Of course, they are going to do better. Had the study not been randomized, the investigators might have concluded that screening was the best thing since sliced bread. Regardless of which group they were randomly assigned to, the participants had substantially lower death rates than the general population—for all cancers (even those other than prostate, lung, colon, and ovary), for heart disease, and for injury. In other words, the volunteers were healthier than average. With randomization, the study showed that only one of the four screenings (for colon cancer) was beneficial. Without it, the study might have concluded that prostate cancer screening not only lowered the risk of death from prostate cancer but also deaths from leukemia, heart attack, and car accidents (although you would hope someone would raise the biological plausibility criterion here).

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.

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

I've read every letter that you've sent me these past two years. In return, I've sent you many form letters, with the hope of one day being able to give you the proper response you deserve. But the more letters you wrote to me, and the more of yourself you gave, the more daunting my task became. I'm sitting beneath a pear tree as I dictate this to you, overlooking the orchards of a friend's estate. I've spent the past few days here, recovering from some medical treatment that has left me physically and emotionally depleted. As I moped about this morning, feeling sorry for myself, it occurred to me, like a simple solution to an impossible problem: today is the day I've been waiting for. You asked me in your first letter if you could be my protege. I don't know about that, but I would be happy to have you join me in Cambridge for a few days. I could introduce you to my colleagues, treat you to the best curry outside India, and show you just how boring the life of an astrophysicist can be. You can have a bright future in the sciences, Oskar. I would be happy to do anything possible to facilitate such a path. It's wonderful to think what would happen if you put your imagination toward scientific ends. But Oskar, intelligent people write to me all the time. In your fifth letter you asked, "What if I never stop inventing?" That question has stuck with me. I wish I were a poet. I've never confessed that to anyone, and I'm confessing it to you, because you've given me reason to feel that I can trust you. I've spent my life observing the universe, mostly in my mind's eye. It's been a tremendously rewarding life, a wonderful life. I've been able to explore the origins of time and space with some of the great living thinkers.But I wish I were a poet. Albert Einstein, a hero of mine, once wrote, "Our situation is the following. We are standing in front of a closed box which we cannot open." I'm sure I don't have to tell you that the vast majority of the universe is composed of dark matter. The fragile balance depends on things we'll never be able to see, hear, smell, taste, or touch. Life itself depends on them. What's real? What isn't real? Maybe those aren't the right questions to be asking. What does life depend on? I wish I had made things for life to depend on. What if you never stop inventing? Maybe you're not inventing at all. I'm being called in for breakfast, so I'll have to end this letter here. There's more I want to tell you, and more I want to hear from you. It's a shame we live on different continents. One shame of many. It's so beautiful at this hour. The sun is low, the shadows are long, the air is cold and clean. You won't be awake for another five hours, but I can't help feeling that we're sharing this clear and beautiful morning. Your friend, Stephen Hawking

Marilee lay perfectly still,waiting for her world to settle.She had to fight the unreasonable urge to weep. Wyatt's face was pressed to the hollow of her throat,his breathing rough, his damp body plastered to hers. He nuzzled her neck. "Am I too heavy?" "Umm." It was all she could manage. "You all right?" "Umm." "Did anybody ever tell you that you talk too much?" "Umm." He brushed his mouth over hers. "If you hum a bit more,I might be able to name that tune." That broke the spell of tears that had been threatening and caused her to laugh. She wrapped her arms around his neck and kissed him back. "Have I told you how much I like your silly sense of humor?" "No,you haven't." He rolled to his side and gathered her into his arms,nuzzling her cheek,while his big hands moved over her hip,her back,her waist, as though measuring every inch of her. "What else do you like about me?" "You fishing for compliments?" "Of course I am." "Glutton. Your sense of humor isn't enough?" "Not nearly enough.How about my looks?" "They're okay,for a footloose rebel." "Stop.All these mushy remarks will inflate my ego." He gave a mock frown. "How about the way I kiss?" "You're not bad." "Not bad?" His hands stopped their movement. He drew a little away. "That's all you can say?" "If you recall,tonight was the first time we've kissed.I haven't had nearly enough practice to be a really good judge of your talent." "Then we'd better take care of that right now." He framed her face. With his eyes steady on hers, he lowered his mouth to claim her lips. Marilee's eyelids fluttered and she felt an explosion of color behind them. As though the moon and stars had collided while she rocketed through space. It was the most amazing sensation, and, as his lips continued moving over hers,she found herself wishing it could go on forever. When at last they came up for air, she took in a long,deep breath before opening her eyes. "Oh,yes,rebel.I have to say,I do like the way you kiss." "That's good,because I intend to do a whole lot more of it." He lay back in the grass,one hand beneath his head. "Now it's my turn.Want to know all the things I like about you?" "I'm afraid to hear it." Marilee lay on her side,her hand splayed across his chest. "Besides your freckles,which I've already mentioned,the thing about you I like best is your take-charge attitude." She chuckled. "A lot of guys feel intimidated by that." "They're idiots.Don't they know there's something sexy about a woman who knows what to do and how to do it? I've watched you as a medic and as a pilot, and I haven't decided which one turns me on more." "Really?" She sat up. "Want me to fetch my first-aid kit from the plane? I could always splint your arm or leg and really turn you on." He dragged her down into his arms and growled against her mouth, "You don't need to do a single thing to turn me on. All I need to do is look at you and I want you." "You mean now? Again? So soon?" "Oh,yeah." "Liar.I don't believe it's possible." "You ought to know by now that I never say anything I can't back up with action." "Prove it,rebel." "My pleasure." There was a wicked smile on his lips as he rolled over her and began to kiss her breathless,all the while taking her on a slow,delicious ride to paradise.

With one final flip the quarter flew high into the air and came down on the mattress with a light bounce. It jumped several inches off the bed, high enough for the instructor to catch it in his hand. Swinging around to face me, the instructor looked me in the eye and nodded. He never said a word. Making my bed correctly was not going to be an opportunity for praise. It was expected of me. It was my first task of the day, and doing it right was important. It demonstrated my discipline. It showed my attention to detail, and at the end of the day it would be a reminder that I had done something well, something to be proud of, no matter how small the task. Throughout my life in the Navy, making my bed was the one constant that I could count on every day. As a young SEAL ensign aboard the USS Grayback, a special operation submarine, I was berthed in sick bay, where the beds were stacked four high. The salty old doctor who ran sick bay insisted that I make my rack every morning. He often remarked that if the beds were not made and the room was not clean, how could the sailors expect the best medical care? As I later found out, this sentiment of cleanliness and order applied to every aspect of military life. Thirty years later, the Twin Towers came down in New York City. The Pentagon was struck, and brave Americans died in an airplane over Pennsylvania. At the time of the attacks, I was recuperating in my home from a serious parachute accident. A hospital bed had been wheeled into my government quarters, and I spent most of the day lying on my back, trying to recover. I wanted out of that bed more than anything else. Like every SEAL I longed to be with my fellow warriors in the fight. When I was finally well enough to lift myself unaided from the bed, the first thing I did was pull the sheets up tight, adjust the pillow, and make sure the hospital bed looked presentable to all those who entered my home. It was my way of showing that I had conquered the injury and was moving forward with my life. Within four weeks of 9/11, I was transferred to the White House, where I spent the next two years in the newly formed Office of Combatting Terrorism. By October 2003, I was in Iraq at our makeshift headquarters on the Baghdad airfield. For the first few months we slept on Army cots. Nevertheless, I would wake every morning, roll up my sleeping bag, place the pillow at the head of the cot, and get ready for the day.

A common problem plagues people who try to design institutions without accounting for hidden motives. First they identify the key goals that the institution “should” achieve. Then they search for a design that best achieves these goals, given all the constraints that the institution must deal with. This task can be challenging enough, but even when the designers apparently succeed, they’re frequently puzzled and frustrated when others show little interest in adopting their solution. Often this is because they mistook professed motives for real motives, and thus solved the wrong problems. Savvy institution designers must therefore identify both the surface goals to which people give lip service and the hidden goals that people are also trying to achieve. Designers can then search for arrangements that actually achieve the deeper goals while also serving the surface goals—or at least giving the appearance of doing so. Unsurprisingly, this is a much harder design problem. But if we can learn to do it well, our solutions will less often meet the fate of puzzling disinterest. We should take a similar approach when reforming a preexisting institution by first asking ourselves, “What are this institution’s hidden functions, and how important are they?” Take education, for example. We may wish for schools that focus more on teaching than on testing. And yet, some amount of testing is vital to the economy, since employers need to know which workers to hire. So if we tried to cut too much from school’s testing function, we could be blindsided by resistance we don’t understand—because those who resist may not tell us the real reasons for their opposition. It’s only by understanding where the resistance is coming from that we have any hope of overcoming it. Not all hidden institutional functions are worth facilitating, however. Some involve quite wasteful signaling expenditures, and we might be better off if these institutions performed only their official, stated functions. Take medicine, for example. To the extent that we use medical spending to show how much we care (and are cared for), there are very few positive externalities. The caring function is mostly competitive and zero-sum, and—perhaps surprisingly—we could therefore improve collective welfare by taxing extraneous medical spending, or at least refusing to subsidize it. Don’t expect any politician to start pushing for healthcare taxes or cutbacks, of course, because for lawmakers, as for laypeople, the caring signals are what makes medicine so attractive. These kinds of hidden incentives, alongside traditional vested interests, are what often make large institutions so hard to reform. Thus there’s an element of hubris in any reform effort, but at least by taking accurate stock of an institution’s purposes, both overt and covert, we can hope to avoid common mistakes. “The curious task of economics,” wrote Friedrich Hayek, “is to demonstrate to men how little they really know about what they imagine they can design.”8