Surgeon General Quotes

Very simply, we subsidize high-fructose corn syrup in this country, but not carrots. While the surgeon general is raising alarms over the epidemic of obesity, the president is signing farm bills designed to keep the river of cheap corn flowing, guaranteeing that the cheapest calories in the supermarket will continue to be the unhealthiest.

My calculations - allowing for a 12 percent margin of error, based on the radius of the corresponding confidence interval and the surgeon general's warning - concluded that they probably didn't stay behind for the tacos.

I give in and light another cigarette even though last night the surgeon general came on the television set and shook his finger at everybody, trying to convince us that smoking will kill us. But Mother once told me tongue kissing would turn me blind and I'm starting to think it's all just a big plot between the surgeon general and Mother to make sure no one ever has any fun.

Montana should come with a surgeon general warning that it's addictive. The sky is big and blue, and the air is always fresh and crisp and scented with pine. There's a frontier spirit, but also a calmness, beauty in the landscape that slows your pulse.

According to the surgeon general, obesity today is officially an epidemic; it is arguably the most pressing public health problem we face, costing the health care system an estimated $90 billion a year. Three of every five Americans are overweight; one of every five is obese. The disease formerly known as adult-onset diabetes has had to be renamed Type II diabetes since it now occurs so frequently in children. A recent study in the Journal of the American Medical Association predicts that a child born in 2000 has a one-in-three chance of developing diabetes. (An African American child's chances are two in five.) Because of diabetes and all the other health problems that accompany obesity, today's children may turn out to be the first generation of Americans whose life expectancy will actually be shorter than that of their parents. The problem is not limited to America: The United Nations reported that in 2000 the number of people suffering from overnutrition--a billion--had officially surpassed the number suffering from malnutrition--800 million.

The curve of her smile promised things that were probably illegal, and bad for you, and would carry warnings from the Surgeon General, but that you’d still want to do over and over again.

The U.S. Surgeon General has declared that attacks by male partners are the number one cause of injury to women between the ages of fifteen and forty-four.

the AAF surgeon general suggests that in the Fifteenth Air Force, between November 1, 1943, and May 25, 1945, 70 percent of men listed as killed in action died in operational aircraft accidents, not as a result of enemy action.

surgeon general Vivek Murthy in the Harvard Business Review. “Loneliness and weak social connections are associated with a reduction in life span similar to that caused by smoking 15 cigarettes a day.

The Library of Congress reports that the Army Office of the Surgeon General for Medical Statistics "does not have figures on single or multiple amputees." Either the government doesn't think them important, or, in the words of a researcher for one of the national television networks, "the military itself, while sure of how many tons of bombs it has dropped, is unsure of how many legs and arms its men have lost.

The risks of smoking have been known since the 1930s; the U.S. surgeon general report of 1964 squarely faced down the tobacco industry. That put the tobacco propaganda machine into overdrive to squelch the science and any scientists who stood in their way.

In August, Dr. Jerome Adams, the United States Surgeon General, warned about the risks of cannabis for young adults—explicitly noting the cannabis-schizophrenia link.

Nayyup, nayyup, Ah'll not sell smokeweed to a boy. Never have done." "Good idea, too," Eddie said. "One step below devil grass, and the Surgeon General says thankya.

So let me get this straight – this is a long sentence. We are going to be gifted with a health care plan that we are forced to purchase, and fined if we don’t, which reportedly covers 10 million more people without adding a single new doctor, but provides for 16,000 new IRS agents, written by a committee whose chairman doesn’t understand it, passed by Congress, that didn’t read it, but exempted themselves from it, and signed by a president who smokes, with funding administered by a treasury chief who didn’t pay his taxes, for which we will be taxed for four years before any benefits take effect, by a government which has bankrupted Social Security and Medicare, all to be overseen by a surgeon general who is obese and financed by a country that is broke. So what the blank could possibly go wrong?

In 2001 the office of the surgeon general of the United States issued a report that found social rejection to be a greater risk factor for adolescent violence than gang membership, poverty, or drug use.

A report issued by the AAF surgeon general suggests that in the Fifteenth Air Force, between November 1, 1943, and May 25, 1945, 70 percent of men listed as killed in action died in operational aircraft accidents, not as a result of enemy action.

In April of 2006, the Church-owned Desert Morning News, in a remarkable week-long series on suicide in Utah, reported: "A former surgeon general who recently spoke in Utah about suicide prevention said he was impressed with the state's warm and friendly people...But, he added, 'In New York, we kill each other. In Utah, you kill yourselves.'" The newspaper gave the shocking statistic that Utah leads the entire nation in suicides among men aged 15 to 24. Utah also has the 11th highest suicide rate over all age groups. (36)

Some days should come with cautionary labels. You know, like 'Surgeon General's Warning: Getting out of bed may result in headaches, vomiting, and homicide.

Television is the last technology we should be allowed to invent and put out without a surgeon general’s warning.

The tale of the Surgeon's Daughter formed part of the second series of Chronicles of the Canongate, published in 1827; but has been separated from the stories of the Highland Widow, &c., which it originally accompanied, and deferred to the close of this collection, for reasons which printers and publishers will understand, and which would hardly interest the general reader. The Author

No is easier to do, yes is easier to say. No is no to one thing. Yes is no to a thousand things. No is a precision instrument, a surgeon’s scalpel, a laser beam focused on one point. Yes is a blunt object, a club, a fisherman’s net that catches everything indiscriminately. No is specific. Yes is general.

Surgeon General’s Advice to Avoid Influenza Avoid needless crowding. . . . Smother your coughs and sneezes. . . . Your nose not your mouth was made to breathe thru. . . . Remember the 3 Cs, clean mouth, clean skin, and clean clothes. . . . Food will win the war. . . . [H]elp by choosing and chewing your food well. . . . Wash your hands before eating. . . . Don’t let the waste products of digestion accumulate. . . . Avoid tight clothes, tight shoes, tight gloves—seek to make nature your ally not your prisoner. . . . When the air is pure breathe all of it you can—breathe deeply.

Unfortunately, not every dead body goes to what might be considered “noble ends.” There is a slim possibility that your donated head will be the head, the head that holds the key to the mysteries of the twenty-first century’s great disease epidemics. But it is equally possible your body will end up being used to train a new crop of Beverly Hills plastic surgeons in the art of the facelift. Or dumped out of a plane to test parachute technology. Your body is donated to science in a very . . . general way. Where your parts go is not up to you.

It is almost impossible for contemporaries to judge the true value of discoveries, or to give the proper position to the men of their own time who make these discoveries. The Surgeon-General of the Public Health Service expected the greatest results to flow from his commission of medical officers, but the conclusions of the Board turned out to be all wrong, while he did not notice the report from his own subordinate, Dr. H. R. Carter, which turned out to be pure gold and was one of the great steps in establishing the true method of the transmission of Yellow Fever.

the two halves of the fourth lobe: the temporal (as in the temples of your head). Not surprisingly, they handle the processing of sounds in general and the understanding of speech in particular.

DURING THE PAST TWO TO THREE DECADES, we have acquired substantial evidence that most chronic diseases in America can be partially attributed to bad nutrition. Expert government panels have said it, the surgeon general has said it and academic scientists have said it. More people die because of the way they eat than by tobacco use, accidents or any other lifestyle or environmental factor.

In the 1950s, Dr. Dorothy Brown, the first Black female general surgeon in the United States and a Tennessee state representative, became the first state legislator to introduce a bill to legalize abortion.

In the air corps, 35,946 personnel died in nonbattle situations, the vast majority of them in accidental crashes.*1 Even in combat, airmen appear to have been more likely to die from accidents than combat itself. A report issued by the AAF surgeon general suggests that in the Fifteenth Air Force, between November 1, 1943, and May 25, 1945, 70 percent of men listed as killed in action died in operational aircraft accidents, not as a result of enemy action.

I deeply respect doctors, but I want to be very clear on something: at every hospital in the United States, many doctors are doing the wrong things, pushing pills and interventions when an ultra-aggressive stance on diet and behavior would do far more for the patient in front of them. Suicide and burnout rates are astronomical in health care, with approximately four hundred doctors per year killing themselves. (That’s equivalent to about four medical school graduating classes just dropping dead every year by their own hand.) Doctors have twice the rate of suicide as the general population. Based on my own experience with depression as a young surgeon, I think a contributor to this phenomenon is an insidious spiritual crisis about the efficacy of our work and a sense of being trapped in a system

before many doctors were too busy to serve. Russell Nelson changed all of that in his service as stake president and general president of the Sunday School. He blessed the church..I give Russell M. Nelson credit for changing the stereotype that doctors are too busy to serve in the church,

The argument that “people now have more freedom than ever” is based on the fact that we are allowed to do almost anything we please as long as it has no practical consequences. See ISAIF, §72. Where our actions have practical consequences that may be of concern to the system (and few important practical consequences are not of concern to the system), our behavior, generally speaking, is closely regulated. Examples: We can believe in any religion we like, have sex with any consenting adult partner, take a plane to China or Timbuktu, have the shape of our nose changed, choose any from a huge variety of books, movies, musical recordings, etc., etc., etc. But these choices normally have no important practical consequences. Moreover, they do not require any serious effort on our part. We don’t change the shape of our own nose, we pay a surgeon to do it for us. We don’t go to China or Timbuktu under our own power, we pay someone to fly us there. On the other hand, within our own home city we can’t go from point A to point B without our movement being controlled by traffic regulations, we can’t buy a firearm without undergoing a background check, we can’t change jobs without having our background scrutinized by prospective employers, most people’s jobs require them to work according to rules, procedures, and schedules prescribed by their employers, we can’t start a business without getting licenses and permits, observing numerous regulations, and so forth.

And, quite possibly, this lack (or seeming lack) of participation by a person's soul in the virtue of which he or she is the agent has, apart from its aesthetic meaning, a reality which, if not strictly psychological, may at least be called psysiognomical. Since then, whenever in the course of my life I have come across, in convents for instance, truly saintly embodiments of practical charity, they have generally had the cheerful, practical, brusque and unemotioned air of a busy surgeon, the sort of face in which one can discern no commiseration, no tenderness at the sight of suffering humanity, no fear of hurting it, the impassive, unsympathetic, sublime face of true goodness.

General Taylor participated in the celebration of the Fourth of July, a very hot day, by hearing a long speech from the Hon. Henry S. Foote, at the base of the Washington Monument. Returning from the celebration much heated and fatigued, he partook too freely of his favorite iced milk with cherries, and during that night was seized with a severe colic, which by morning had quite prostrated him. It was said that he sent for his son-in-law, Surgeon Wood, United States Army, stationed in Baltimore, and declined medical assistance from anybody else. Mr. Ewing visited him several times, and was manifestly uneasy and anxious, as was also his son-in-law, Major Bliss, then of the army, and his confidential secretary. He rapidly grew worse, and died in about four days.

The doctors are busy with the repulsive but beneficent work of amputation. You see the sharp, curved knife enter the healthy, white body, you see the wounded man suddenly regain consciousness with a piercing cry and curses, you see the army surgeon fling the amputated arm into a corner, you see another wounded man, lying in a litter in the same apartment, shrink convulsively and groan as he gazes at the operation upon his comrade, not so much from physical pain as from the moral torture of anticipation. — You behold the frightful, soul-stirring scenes; you behold war, not from its conventional, beautiful, and brilliant side, with music and drum-beat, with fluttering flags and galloping generals, but you behold war in its real phase — in blood, in suffering, in death.

Original Statement by Hunger Strikers to Psychiatric Association, National Alliance for the Mentally Ill and the U.S. Office of the Surgeon General 1. A Hunger Strike to Challenge International Domination by Biopsychiatry. This fast is about human rights in mental health. The psychiatric pharmaceutical complex is heedless of its oath to “first do no harm.” Psychiatrists are able with impunity to: Incarcerate citizens who have committed crimes against neither persons nor property. Impose diagnostic labels on people that stigmatize and defame them. Induce proven neurological damage by force and coercion with powerful psychotropic drugs. Stimulate violence and suicide with drugs promoted as able to control these activities. Destroy brain cells and memories with an increasing use of electroshock (also known as electro-convulsive therapy). Employ restraint and solitary confinement—which frequently cause severe emotional trauma, humiliation, physical harm, and even death—in preference to patience and understanding. Humiliate individuals already damaged by traumatizing assaults to their self-esteem. These human rights violations and crimes against human decency must end. While the history of psychiatry offers little hope that change will arrive quickly, initial steps can and must be taken. At the very least, the public has the right to know IMMEDIATELY the evidence upon which psychiatry bases its spurious claims and treatments, and upon which it has gained and betrayed the trust and confidence of the courts, the media, and the public.21

The rise of loneliness as a health hazard tracks with the entrenchment of values and practices that supersede any notion of "individual choices." The dynamics include reduced social programs, less available "common" spaces such as public libraries, cuts in services for the vulnerable and the elderly, stress, poverty, and the inexorable monopolization of economic life that shreds local communities. By way of illustration, let's take a familiar scenario: Walmart or some other megastore decides to open one of its facilities in a municipality. Developers are happy, politicians welcome the new investment, and consumers are pleased at finding a wide variety of goods at lower prices. But what are the social impacts? Locally owned and operated small businesses cannot compete with the marketing behemoth and must close. People lose their jobs or must find new work for lower pay. Neighborhoods are stripped of the familiar hardware store, pharmacy, butcher, baker, candlestick maker. People no longer walk to their local establishment, where they meet and greet one another and familiar merchants they have known, but drive, each isolated in their car, to a windowless, aesthetically bereft warehouse, miles away from home. They might not even leave home at all — why bother, when you can order online? No wonder international surveys show a rise in loneliness. The percentage of Americans identifying themselves as lonely has doubled from 20 to 40 percent since the 1980s, the New York Times reported in 2016. Alarmed by the health ravages, Britain has even found it necessary to appoint a minister of loneliness. Describing the systemic founts of loneliness, the U.S. surgeon general Vivek Murthy wrote: "Our twenty-first-century world demands that we focus on pursuits that seem to be in constant competition for our time, attention, energy, and commitment. Many of these pursuits are themselves competitions. We compete for jobs and status. We compete over possessions, money, and reputations. We strive to stay afloat and to get ahead. Meanwhile, the relationships we prize often get neglected in the chase." It is easy to miss the point that what Dr. Murthy calls "our twenty-first-century world" is no abstract entity, but the concrete manifestation of a particular socioeconomic system, a distinct worldview, and a way of life.

Semantic Memory is general knowledge about the world, everything from who Isaac Newton was, to what a bagel tastes like, and where your office is—all the kinds of basic facts and meanings that computers and robots don’t understand. Thankfully, in normal brain aging, this huge knowledge base not only remains generally stable in an older adult but can continue to grow as a person learns more.

granted equal knowledge, are there great generals as there are great surgeons, who, when the symptoms exhibited by two cases of illness are identical to the outward eye, nevertheless feel, for some infinitesimal reason, founded perhaps on their experience, but interpreted afresh, that in one case they ought to do this, in another case that; that in one case it is better to operate, in another to wait?

In medicine, we have long faced a conflict between the imperative to give patients the best possible care and the need to provide novices with experience. Residencies attempt to mitigate potential harm for supervision and graduated responsibility. And there is reason to think patients actually benefit from teaching. Studies generally find teaching hospitals have better outcomes than non teaching hospitals. Residents may be amateurs, but having them around checking on patients, asking questions, and keeping faculty on their toes seems to help. But there is still no getting around those first few unsteady times a young physician tries to put in a central line, remove a breast cancer, or sew together two segments of colon. No matter how many protections we put in place, on average these cases go less well with a novice then with someone experienced.

Asking a writer why they like to write {in the theoretical sense of the question} is like asking a person why they breathe. For me, writing is a natural reflex to the beauty, the events, and the people I see around me. As Anais Nin put it, "We write to taste life twice." I live and then I write. The one transfers to the other, for me, in a gentle, necessary way. As prosaic as it sounds, I believe I process by writing. Part of the way I deal with stressful situations, catty people, or great joy or great trials in my own life is by conjuring it onto paper in some way; a journal entry, a blog post, my writing notebook, or my latest story. While I am a fair conversationalist, my real forte is expressing myself in words on paper. If I leave it all chasing round my head like rabbits in a warren, I'm apt to become a bug-bear to live with and my family would not thank me. Some people need counselors. Some people need long, drawn-out phone-calls with a trusted friend. Some people need to go out for a run. I need to get away to a quiet, lonesome corner--preferably on the front steps at gloaming with the North Star trembling against the darkening blue. I need to set my pen fiercely against the page {for at such moments I must be writing--not typing.} and I need to convert the stress or excitement or happiness into something to be shared with another person. The beauty of the relationship between reading and writing is its give-and-take dynamic. For years I gathered and read every book in the near vicinity and absorbed tale upon tale, story upon story, adventures and sagas and dramas and classics. I fed my fancy, my tastes, and my ideas upon good books and thus those aspects of myself grew up to be none too shabby. When I began to employ my fancy, tastes, and ideas in writing my own books, the dawning of a strange and wonderful idea tinged the horizon of thought with blush-rose colors: If I persisted and worked hard and poured myself into the craft, I could create one of those books. One of the heart-books that foster a love of reading and even writing in another person somewhere. I could have a hand in forming another person's mind. A great responsibility and a great privilege that, and one I would love to be a party to. Books can change a person. I am a firm believer in that. I cannot tell you how many sentiments or noble ideas or parts of my own personality are woven from threads of things I've read over the years. I hoard quotations and shadows of quotations and general impressions of books like a tzar of Russia hoards his icy treasures. They make up a large part of who I am. I think it's worth saying again: books can change a person. For better or for worse. As a writer it's my two-edged gift to be able to slay or heal where I will. It's my responsibility to wield that weapon aright and do only good with my words. Or only purposeful cutting. I am not set against the surgeon's method of butchery--the nicking of a person's spirit, the rubbing in of a salty, stinging salve, and the ultimate healing-over of that wound that makes for a healthier person in the end. It's the bitter herbs that heal the best, so now and again you might be called upon to write something with more cayenne than honey about it. But the end must be good. We cannot let the Light fade from our words.

...The world's benefactor has no choice; he is the surgeon who wields the healing scalpel. He does not want the violence, but the reality (which he has invented) drives him to use violence, in a way, against his will. Throwing a bomb into a crowded department store thus becomes an act of revolutionary love for mankind (and, in general, to quote Lübbe again, 'his primary intention is not to throw bombs into department stores or police stations, but rather into public consciousness.')

In particular, anyone who appears to be good is most likely a hypocrite. The genuinely good, a rare breed, never appear so. ‘Whenever in the course of my life I have come across, in convents for instance, truly saintly embodiments of practical charity, they have generally had the cheerful, practical, brusque and unemotioned air of a busy surgeon, the sort of face in which one can discern no commiseration, no tenderness at the sight of suffering humanity, no fear of hurting it, the impassive, unsympathetic, sublime face of true goodness.

Looking back on all my interviews for this book, how many times in how many different contexts did I hear about the vital importance of having a caring adult or mentor in every young person’s life? How many times did I hear about the value of having a coach—whether you are applying for a job for the first time at Walmart or running Walmart? How many times did I hear people stressing the importance of self-motivation and practice and taking ownership of your own career or education as the real differentiators for success? How interesting was it to learn that the highest-paying jobs in the future will be stempathy jobs—jobs that combine strong science and technology skills with the ability to empathize with another human being? How ironic was it to learn that something as simple as a chicken coop or the basic planting of trees and gardens could be the most important thing we do to stabilize parts of the World of Disorder? Who ever would have thought it would become a national security and personal security imperative for all of us to scale the Golden Rule further and wider than ever? And who can deny that when individuals get so super-empowered and interdependent at the same time, it becomes more vital than ever to be able to look into the face of your neighbor or the stranger or the refugee or the migrant and see in that person a brother or sister? Who can ignore the fact that the key to Tunisia’s success in the Arab Spring was that it had a little bit more “civil society” than any other Arab country—not cell phones or Facebook friends? How many times and in how many different contexts did people mention to me the word “trust” between two human beings as the true enabler of all good things? And whoever thought that the key to building a healthy community would be a dining room table? That’s why I wasn’t surprised that when I asked Surgeon General Murthy what was the biggest disease in America today, without hesitation he answered: “It’s not cancer. It’s not heart disease. It’s isolation. It is the pronounced isolation that so many people are experiencing that is the great pathology of our lives today.” How ironic. We are the most technologically connected generation in human history—and yet more people feel more isolated than ever. This only reinforces Murthy’s earlier point—that the connections that matter most, and are in most short supply today, are the human-to-human ones.

THAT DAY, while we were in school, four men in a jeep came to visit Ghosh. They took him away as if he were a common criminal, his hands jacked up behind his back. They slapped him when he tried to protest. Hema learned this from W. W. Gonad, who told the men they were surely mistaken in taking away Missing’s surgeon. For his impertinence W.W. got a boot in his stomach. Hema refused to believe Ghosh was gone. She ran home, certain that she’d find him sunk into his armchair, his sockless feet up on the stool, reading a book. In anticipation of seeing him, in the certainty that he would be there, she was already furious with him. She burst through the front door of our bungalow. “Do you see how dangerous it is for us to associate with the General? What have I been telling you? You could get us all killed!” Whenever she came at him like that, all her cylinders firing, it was Ghosh’s habit to flourish an imaginary cape like a matador facing a charging bull. We found it funny, even if Hema never did. But the house was quiet. No matador. She went from room to room, the jingle of her anklets echoing in the hallways. She imagined Ghosh with his arm twisted behind his back, being punched in the face,

In Detroit, Dr. Forest Dodrill, a surgeon at Wayne State University, collaborated with engineers at General Motors Research to develop a mechanical pump capable of supporting the circulation of an adult. The resulting stainless-steel and glass device, the Dodrill-GMR mechanical heart pump, had multiple cylinders from which blood circulated and, perhaps not surprisingly, bore an uncanny resemblance to a Cadillac V-12 automobile engine. The device was intended to temporarily replace either the right or left ventricle and was first used in 1952 to support a patient for fifty minutes while Dr. Dodrill repaired a mitral valve.

There must have been a strong element of reality in those Virtues and Vices of Padua, since they appeared to me to be as much alive as the pregnant servant-girl, while she herself appeared scarcely less allegorical than they. And, quite possibly, this lack (or seeming lack) of participation by a person’s soul in the significant marks of its own special virtue has, apart from its aesthetic meaning, a reality which, if not strictly psychological, may at least be called physiognomical. Later on, when, in the course of my life, I have had occasion to meet with, in convents for instance, literally saintly examples of practical charity, they have generally had the brisk, decided, undisturbed, and slightly brutal air of a busy surgeon, the face in which one can discern no commiseration, no tenderness at the sight of suffering humanity, and no fear of hurting it, the face devoid of gentleness or sympathy, the sublime face of true goodness.

Unless you are as smart as Johann Karl Friedrich Gauss, savvy as a half-blind Calcutta bootblack, tough as General William Tecumseh Sherman, rich as the Queen of England, emotionally resilient as a Red Sox fan, and as generally able to take care of yourself as the average nuclear missile submarine commander, you should never have been allowed near this document. Please dispose of it as you would any piece of high-level radioactive waste and then arrange with a qualified surgeon to amputate your arms at the elbows and gouge your eyes from their sockets. This warning is necessary because once, a hundred years ago, a little old lady in Kentucky put a hundred dollars into a dry goods company which went belly-up and only returned her ninety-nine dollars. Ever since then the government has been on our asses. If you ignore this warning, read on at your peril--you are dead certain to lose everything you've got and live out your final decades beating back waves of termites in a Mississippi Delta leper colony

The identity of Jack the Ripper is surely one of the all-time classic crime mysteries. In the late 19th Century, the Ripper is believed by general consensus to have committed five murders (although a number of later killings did also bear his hallmarks, and the fifth of the ‘confirmed’ killings still raises a number of doubts). At the time police were stumped, even arresting a man purely on anti-Semitic hearsay before apologising and letting him go. Since then, more than eighty suspects have been proposed, from members of royalty to mad surgeons, and even a suggestion that the Ripper was in fact ‘Jill’ rather than ‘Jack’. The case became muddied when a number of letters were sent to the police; some obvious hoaxes, some in fact likely to have been written in the killer’s own hand. One even included half a kidney (it should be noted that one of the victim’s had a kidney removed at the scene of the attack) with a note saying the other half had been fried and was very nice to eat. Everyone has their own view on who the Ripper was, and why the killings stopped just as suddenly as they began.

Army studies indicate that if a wounded soldier arrives alive at a combat support hospital where surgeons and nurses can treat him, the chances of his surviving are extremely high—greater than 90 percent. “Surviving,” of course, doesn’t necessarily entail keeping arms or legs or retaining the ability to function independently back home. The leading cause of preventable death on the battlefield is bleeding. Having a leg blown off by an IED, for instance, can be fatal if quick steps are not taken to control the blood loss. Even deadlier is internal bleeding, a problem for which medics generally don’t have a good answer. A soldier who is bleeding internally needs to be evacuated and delivered to a surgeon immediately if he is to have any hope of survival. The second-leading cause of preventable death is something called tension pneumothorax. If a bullet punctures a soldier’s lung, air can leak from that hole into the “pleural space,” or cavity outside the lungs. That air can build up and eventually interfere with the functioning of the heart. This can be a relatively simple problem to correct: a medic can simply stick a big needle in the soldier’s chest to relieve the pressure in the pleural space.

There is an implication to be found in the statement of Surgeon Verneuil, though probably not meant by him, to which assent must be given when understood. It is TRUE that there is no such THING as tetanus, small pox. syphilis, etc., as is implied by the general use of nosological terms. Disease is not a thing, an entity: it is a condition, and the error of regarding the condition of disease as an entity has confirmed, where it has not originated, much of the prevailing erroneous treatment of the sick. Nosological terms have a use; it is that of bringing to the mind of the physician a group of pathological symptoms, which may or may not be present in the case of the patient under consideration; from them, *when present*, the diseased condition of the patient can be recognized and treated. Unfortunately, through not understanding this truth, attempts are frequently made to treat, *not the patient*, but the name, which has been given to a collection of morbid symptoms. A broken limb is a thing; the inflammation which results from it is a condition, and if gangrene ensues the *gangrene* is not a *thing*, but a condition to be taken into consideration with all the other symptoms in the treatment of the patient. The surgeon, Verneuil, had probably a glimmering perception of this truth, but he misapplied it, for his theory and practice, as a physician, and the theory and practice of nearly all modern medicine assume that the condition to be treated is a thing having a name and this name is treated instead of the patient. –Source: *The Blood and its Third Anatomical Element* by Antoine Béchamp, 1912, Translated by Montague R. Leverson

They emerged from the tropical vegetation, greeted by a general cheer. Stephen advanced, carrying his hurly: he was feeling particularly well and fit; he had his land-legs again, and no longer stumped along, but walked with an elastic step. Jack came to meet him, and said in a low voice, 'Just keep your end up, Stephen, until your eye is in; and watch out for the Admiral's twisters,' and then as they neared the Admiral, 'Sir, allow me to name my particular friend Dr. Maturin, surgeon of the Leopard. 'How d'ye do, Doctor?' said the Admiral. 'I must beg your pardon, sir, for my late appearance: I was called away on -- ' 'No ceremony, Doctor, I beg,' said the Admiral, smiling: the Leopard's hundred pounds were practically in his pocket, and this man of theirs did not look very dangerous. 'Shall we begin?' 'By all means,' said Stephen. 'You go down to the other end,' murmured Jack, a chill coming over him in spite of the torrid sun. 'Should you like to be given a middle, sir?' called the umpire, when Stephen had walked down the pitch. 'Thank you, sir,' said Stephen, hitching at his waistband and gazing round the field, 'I already have one.' A rapacious grin ran round the Cumberlands: they moved much closer in, crouching, their huge crab-like hands spread wide. The Admiral held the ball to his nose for a long moment, fixing his adversary, and then delivered a lob that hummed as it flew. Stephen watched its course, danced out to take it as it touched the ground, checked its bounce, dribbled the ball towards the astonished cover-point and running still he scooped it into the hollow of his hurly, raced on with twinkling steps to mid-off, there checked his run amidst the stark silent amazement, flicked the ball into his hand, tossed it high, and with a screech drove it straight at Jack's wicket, shattering the near stump and sending its upper half in a long, graceful trajectory that reached the ground just as the first of La Fleche's guns, saluting the flag, echoed across the field.

He is thinking if there is any way by which he can explain just how and what it is he suffers. He is wondering if there is anyone in the whole wide world with a heart big enough to comprehend what it is he wants to tell. There are so many little things to say first, and will anyone have the patience to listen to the end? Suffering is no one thing: it is composed of invisible atoms infinite in number, each one a universe in the great macrocosm of pain. He could begin anywhere, with anything, with a silly word even, a word such as flapdoodle, and he could erect a cathedral of staggering dimensions which would not occupy so much as a pocket in the crevice of the tiniest atom. To say nothing of the surrounding terrain, of the circumambient aura, of things like coast lines, volcanic craters, fathomless lagoons, pearl studs and tons of chicken feathers. The musician has an instrument to work with, the surgeon has his implements, the architect his plans, the general his pawns, the idiot his idiocy, but the one who is suffering has everything in the universe except relief. He can run out to the periphery a trillion times but the circle never straightens out. He knows every diameter but no egress. Every exit is closed, whether it be an inch away or a billion light years distant. You crash a gate made of arms and legs only to get a butt blow behind the ear. You pick up and run on bloody, sawed-off stumps, only to fall into an endless ravine. You sit in the very center of emptiness, whimpering inaudibly, and the stars blink at you. You fall into a coma, and just when you think you've found your way back to the womb they come after you with pick and shovel, with acetylene torches. Even if you found the place of death they would find a way to blow you out of it. You know time in all its curves and infidelities. You have lived longer than it takes to grow all the countless separate parts of a thousand new universes. You have watched them grow and fall apart again. And you are still intact, like a piece of music which goes on being played forever. The instruments wear out, and the players too, but the notes are eternal, and you are made of nothing but invisible notes which even the faintest zephyr can shake a tune out of.

WARNING: THE SURGEON GENERAL’S CRUSADE AGAINST THIS PRODUCT MAY DISTRACT YOU FROM THE MYRIAD WAYS YOUR GOVERNMENT FAILS TO PROTECT YOUR HEALTH.

General, but heartily evaluated by me, Surgeon Particular. I rarely discriminate my alcohol, but today I decide to stick to generation-proved staples of comfort and problem solving: vodka and whiskey. Starting in reverse alphabetical order I take a shot of cinnamon whiskey, which sails down smoother than Titanic, traces of familiar warmth reminiscent in my stomach for a minute straight, tongue pleasantly on fire. Next comes a complimentary and mandatory apple martini (Friday night’s special for ladies), provided

In 1990, the Journal of the American Medical Association reported, “Studies of the Surgeon General’s office reveal that domestic violence is the leading cause of injury to women between the ages of fifteen and forty-four, more common than automobile accidents, muggings, and cancer deaths combined.

Research consistently shows that most children from divorced families do not have psychological problems. For example, one major national study, conducted by Nick Zill, Donna Morrison, and Mary Jo Cairo, looked at children between the ages of twelve and twenty-one. It found that 21 percent of those whose parents had divorced had received psychological help. In comparison, 11 percent of children from married families had received psychological help. That’s nearly a 100 percent increase between groups. That may alarm you until you realize that a statistic like this taken out of context can be misleading for several reasons. Why? First, seeing a therapist is not necessarily a bad thing. In fact, it can be a good thing. (I certainly think it is.) Second, remember that many children from divorced families are brought to see a therapist as part of a custody proceeding or because one of their parents has psychological problems. In other words, the fact that these children saw a mental health professional does not automatically mean they had serious problems. They might have been seeing a mental health professional for reasons that had nothing to do with them personally, or they might have been receiving care that helped prevent a manageable problem from blossoming into something more serious. In a nation where, according to the U.S. surgeon general, less than half of all children and adolescents with serious emotional disturbances ever receive professional care, we need to abandon the stigma we attach to mental health care and view such care as an indication of a situation’s being addressed, not a problem itself.

a surgeon implants a material, as a general rule she/he should be capable of managing most of the complications including removal and revision. With that said, some complications will and should require consultation from appropriate specialists. Casual implantation of bolsters, especially those that are permanent, is not a wise idea.

This was typical Trevor, refusing to reach out for help. “The marines provide guard services at all the navy hospitals. My little brother guards the office of the surgeon general. Since you’re conducting this study at the behest of the surgeon general, I expect the military might provide security.” For the first time, Trevor perked up. “They would do that?” “It couldn’t hurt to ask. Wait . . . I’ll ask. I don’t want you making a hash out of this.” A ghost of a smile hovered on his mouth. “Are you suggesting you’re better at dealing with people than I am?” She stood and shook out her skirt. “Trevor, on any given day you might beat me in trigonometry. Or chemistry. Or a footrace. On very rare occasions you will beat me in a spelling contest. But you will never, not even on your best day, beat me in the category of basic human warmth.” Amusement lurked in his dark eyes. “You’re probably right.” He stood and, to her great surprise, took her hand and kissed the back of it. “Thanks, Kate.” Then he let go of her hand and sauntered off in that long-legged stride of his. The spot where his lips had touched her hand tingled during the entire walk home.

Dr. Satcher was responding to the high incidence of sexually transmitted diseases as well as other concerns about sex in the United States: that nearly half of all pregnancies were unintended, the highest rate among the developed countries; that almost one in four women and one in five men have been victims of forced sex; and that more than a hundred thousand children a year are victims of sexual abuse. Noting that each of these problems has lifelong consequences not just for the individuals but also for their families, their communities, and the entire nation, Satcher was prompted to seek out scientific research and to explore public health strategies to address these issues. The result was a thin booklet, published in 2001 as The Surgeon General’s Call to Action to Promote Sexual Health and Responsible Sexual Behavior. In it he wrote, Sexual health is inextricably bound to both physical and mental health. . . . Sexual health is not limited to the absence of disease or dysfunction, nor is its importance confined to just the reproductive years. . . . It includes freedom from sexual abuse and discrimination and the ability of individuals to integrate their sexuality into their lives, derive pleasure from it, and to reproduce if they so choose.

3. And finally, innovation is an effect in economy and society, a change in the behaviour of customers, of teachers, of farmers, of eye surgeons – of people in general. Or it is a change in a process – that is, in how people work and produce something. Innovation therefore always has to be close to the market, focused on the market, indeed market-driven.

U.S. Surgeon General C. Everett Koop, MD. When he was 40 years old, two separate neurological clinics diagnosed him as having incurable back pain, which radiated down his leg. His pain, however, was completely relieved by prolotherapy, which was basically unknown to modern medicine at the time. Because of his own healing, he used prolotherapy for the remaining 20 years that he practiced medicine. "Although patients may have had back pain for several years, one to four prolotherapy treatments is often enough to relieve their pain," Dr. Darrow says. "If there is improvement after four treatments, the injections will be continued, usually to a maximum of eight times." One of Dr. Darrow's patients,

Very simply, we subsidize high-fructose corn syrup in this country, but not carrots. While the surgeon general is raising alarms over the epidemic of obesity, the president is signing farm bills designed to keep the river of cheap corn flowing, guaranteeing that the cheapest calories in the supermarket will continue to be the unhealthiest.

Writing, as most art, is considered to be essentially superfluous. Who is an artist before a surgeon? Or a scientist? But the fact that tyrants and political forces of every age have been threatened by art again and again, condemned it as degenerate or poisonous, and have silenced, brutalized, or murdered artists because of their work only serves to illustrate how significant art is, that it is our one greatest power. I would even go so far as to say that the tyrant ‘understands’ art more than the devotee, for the latter is generally too ‘pious’ and adoring, almost like a simple-minded believer overwrought by faith who simply loves and finds everything ‘great,’ whereas the former suffers the transformative threat of art more, is even endangered by it, hence their terror.

I have had occasion to meet with, in convents for instance, literally saintly examples of practical charity, they have generally had the brisk, decided, undisturbed and slightly brutal air of a busy surgeon, the face in which one can discern no commiseration, no tenderness at the sight of suffering humanity, and no fear of hurting it, the face devoid of gentleness or sympathy, the sublime face of true goodness.

Dr. Charles Carrico was the first doctor to examine Kennedy as the President was being wheeled into the hospital. Carrico observed two wounds: a small bullet wound in the front lower neck and a large, gaping wound in the President’s head.3 He also noted that Kennedy “was blue-white or ashen in color, had slow, agonal spasmodic respiration without any coordination; made no voluntary movements; had his eyes open with the pupils dilated without any reaction to light; evidenced no palpable pulse; and had a few chest sounds which were thought to be heart beats.”4 No less than twelve doctors were soon at work on the President and Governor Connally. This group included four general surgeons, four anesthesiologists, the hospital’s chief neurologist, a urological surgeon, an oral surgeon, and a heart specialist.5

In the two decades since the NIH, the surgeon general, and the National Academy of Sciences first declared that all Americans should consume low-fat diets, the research has also failed to support the most critical aspect of this recommendation: that such diets will lead to a longer and healthier life. On the contrary, it has consistently indicated that these diets may cause more harm than good.

Once it became clear that the delay was a critical mistake, and that the army was seething with mutiny, Ts‘ao Ts’ao had two options: apology and excuses, or a scapegoat. Understanding the workings of power and the importance of appearances as he did, Ts‘ao Ts’ao did not hesitate for a moment: He shopped around for the most convenient head and had it served up immediately. Occasional mistakes are inevitable—the world is just too unpredictable. People of power, however, are undone not by the mistakes they make, but by the way they deal with them. Like surgeons, they must cut away the tumor with speed and finality. Excuses and apologies are much too blunt tools for this delicate operation; the powerful avoid them. By apologizing you open up all sorts of doubts about your competence, your intentions, any other mistakes you may not have confessed. Excuses satisfy no one and apologies make everyone uncomfortable. The mistake does not vanish with an apology; it deepens and festers. Better to cut it off instantly, distract attention from yourself, and focus attention on a convenient scapegoat before people have time to ponder your responsibility or your possible incompetence. I would rather betray the whole world than let the world betray me. General Ts‘ao Ts’ao, c. A.D. 155-220

AS YOU ARE AWARE, EACH YEAR THE U.S. SURGEON General emerges from relative obscurity into the limelight of public attention and if he sees his shadow, we have six more weeks of winter.

But my favourite cautionary tale is of Australian junior doctor Barry Marshall and his pathologist colleague Robin Warren. In the early 1980s they disagreed with the general medical consensus that most stomach ulcers were caused by stress, bad diet, alcohol, smoking and genetic factors. Instead Marshall and Warren were convinced that a particular bacterium, Helicobacter pylori, was the cause. And if they were right, the solution to many patients’ ulcers could be a simple course of antibiotics, not the risky stomach surgery that was often on the cards. Barry must have picked the short straw, because instead of setting up a test on random members of the public – and having to convince those well-known fun-skewerers of human trials: ethics committees – he just went ahead and swallowed a bunch of the little bugs. Imagine the joy, as his hypothesis was proved right! Imagine the horror, as his stomach became infected, which led to gastritis, the first stage of the stomach ulcers! Imagine his poor wife and family, as the vomiting and halitosis became too much to bear! Dr Marshall lasted 14 days before taking antibiotics to kill the H. pylori, but it was another 20 years before he and Warren were awarded the 2005 Nobel Prize for Physiology or Medicine. So, hang on, is self-experimenting really that bad if it wins you a Nobel Prize? I guess you can only have a go and find out…but please don’t go as far as US army surgeon Jesse Lazear: in trying to prove that yellow fever was contagious, and that infected blood could be transferred via mosquito bites, he was bitten by one and died. The mosquito that caused his death might not even have been part of his experiment. It’s thought that it could just have been a local specimen. But one that enjoyed both biting humans and dramatic irony. Gastrointestinal elements

We Eat the Wrong Kinds of Fats: A typical American diet averages 34 to 40 percent fat. Even as far back as 1988, the Surgeon General’s Report on Nutrition and Health attributed 35 percent of cancer deaths to diet, saying

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

Amid all this, I read Good Habits, Bad Habits: The Science of Making Positive Changes That Stick, a fascinating book by Wendy Wood, a psychology professor at the University of Southern California, who argues that habits change when they’re harder to practice. Addiction isn’t about rational decisions, she wrote. If it were, Americans would have quit smoking soon after 1964, when the US Surgeon General issued his first report on its risks. American nicotine addicts kept smoking, knowing they were killing themselves, because nicotine had changed their brain chemistry, and cigarettes were everywhere. We stopped smoking, Wood argues, by making it harder to do—adding “friction” to the activity. In other words, we limited access to supply. We removed cigarette vending machines, banned smoking in airports, planes, parks, beaches, bars, restaurants, and offices. By adding friction to smoking, we also removed the brain cues that prompted us to smoke: bars where booze, friends, and cigarettes went together, for example.

This is why the people who end up in authority are generally not those focused on whatever the purpose of the community is, but those who are focused on achieving positions of authority. This is why you have career politicians, why administrators end up pulling ten times the salary of a surgeon or an academic under their administration, why performing well in an exam or a test is not actually the same as being good at the thing the exam is supposed to be testing. Because the metagame outweighs the game.

Destruction, especially in spiritual circles, is often perceived as a negative thing. In the mystery traditions, it is an often-necessary means in order to transmute into finer states of being. This is the crux of the experience of the Sephirah of Geburah, which means “severity.” It is at this stage in pathworking, also, when sacrifice is necessary. In the curanderismo traditions, swords are often used to battle and cut away aspects of a person’s lower self that no longer serve their highest good. The cut must be clean, precise, and exact. The recipient must be ready to be rid of that aspect forever. Generally known in esoteric circles as the Path of Karmic Adjustment, this is where the lords of karma operate upon us like surgeons in order to restore cosmic balance within our soul. This path is connected to Geburah, and while that Sephirah specifically calls us to banish our dross, this path is also connected to Tiphareth and so beseeches redemption. This means we must face ourselves—our entire life circumstance—as it really is and be ready and willing to change what is necessary in order keep our devotion intact. This requires brutal honesty, discernment, and a lot of courage. We also see the obvious connection to the astrological sign Libra (the scales) as well as the symbology of the tarot trump Justice.

she decided. “You know it.” Jeffords said, “I thought my destiny was to be shish kebab.” Now that his ordeal and the escape therefrom were over, and he'd cleaned himself up as best he could with no change of clothing, he no longer looked so much terrified as worn down by a long-term but not quite terminal disease. His eyes were wide, and shadowed all around with light gray, like dustings from a tombstone. His lips were pale, mouth wider than before in an unconscious rictus, and twitching from time to time. The tops of his ears seemed to lean closer to his head. His hands moved constantly, and Meehan didn't look forward to watching him try to eat an omelet. To calm him, if possible, Meehan said, “Well, it's over.” “I don't know about that,” Jeffords said. “I had to make contact with Bruce, of course, tell Bruce to get the word to the president and to stomp on Arthur hard, because everybody in DC”—lowering his voice, looking guiltily around like a conspirator in a silent movie—“is very worried about this situation. This could blow up in everybody's faces, this could be worse than Watergate, worse than Iran-Contra, worse than the little blue dress.” Meehan said, “You people kinda specialize in farce down there in DC, don't you?” “Not on purpose,” Jeffords said. “No, I didn't say you did anything on purpose, down there in DC,” Meehan agreed. “But when you say everybody in DC is worried about this operation, just how many people is everybody? How many people are looking over my shoulder here? The Joint Chiefs of Staff ? The attorney general? The surgeon general?

Who are we, the people who have ADHD? We are the problem kid who drives his parents crazy by being totally disorganized, unable to follow through on anything, incapable of cleaning up a room, or washing dishes, or performing just about any assigned task; the one who is forever interrupting, making excuses for work not done, and generally functioning far below potential in most areas. We are the kid who gets daily lectures on how we’re squandering our talent, wasting the golden opportunity that our innate ability gives us to do well, and failing to make good use of all that our parents have provided. We are also sometimes the talented executive who keeps falling short due to missed deadlines, forgotten obligations, social faux pas, and blown opportunities. Too often we are the addicts, the misfits, the unemployed, and the criminals who are just one diagnosis and treatment plan away from turning it all around. We are the people Marlon Brando spoke for in the classic 1954 film On the Waterfront when he said, “I coulda been a contender.” So many of us coulda been contenders, and shoulda been for sure. But then, we can also make good. Can we ever! We are the seemingly tuned-out meeting participant who comes out of nowhere to provide the fresh idea that saves the day. Frequently, we are the “underachieving” child whose talent blooms with the right kind of help and finds incredible success after a checkered educational record. We are the contenders and the winners. We are also imaginative and dynamic teachers, preachers, circus clowns, and stand-up comics, Navy SEALs or Army Rangers, inventors, tinkerers, and trend setters. Among us there are self-made millionaires and billionaires; Pulitzer and Nobel prize winners; Academy, Tony, Emmy, and Grammy award winners; topflight trial attorneys, brain surgeons, traders on the commodities exchange, and investment bankers. And we are often entrepreneurs. We are entrepreneurs ourselves, and the great majority of the adult patients we see for ADHD are or aspire to be entrepreneurs too. The owner and operator of an entrepreneurial support company called Strategic Coach, a man named Dan Sullivan (who also has ADHD!), estimates that at least 50 percent of his clients have ADHD as well.

Imagine a “Surgeon General’s Warning”—like on a pack of Marlboros—on the Facebook log-in page describing how the product uses sophisticated tools to intentionally manipulate your brain chemistry for the purpose of selling advertisements. Governments could take a first step toward real transparency by requiring that Big Tech firms publicly disclose their own research findings regarding the impacts of design features on human attention.

According to former US surgeon general Vivek Murthy, loneliness increases your risk of premature death as much as smoking fifteen cigarettes a day does.

[....] some people need more than just a good listener. These individuals are magnets for guilt. They have a deep-seated habit of blaming themselves for anything bad that happens in their general vicinity, whether they deserve it or not. They’re the type who gets robbed in Central Park and feels terrible because they didn’t have a second watch to give the mugger! Often this mind-set is part of a pattern that started early in life when they were raised by critical parents who were never satisfied with anything they did. Just as God often decides to work through a skilled surgeon to heal someone of physical disease, sometimes God chooses to work through pastors and Christian counselors

The surgeon-general of the US Army estimated that American front-line forces suffered a 10 per cent rate of psychiatric breakdown.

Dr. H. K. Beecher is the name of one of the first serious students of pain in the United States. In 1946, he published an article in the Annals of Surgery titled “Pain in Men Wounded in Battle” (Vol. 123, p. 96). For years it was widely quoted because of its most interesting observation. But now Dr. Beecher is passing into obscurity, for what he had to say is no longer acceptable to students of pain. Dr. Beecher questioned 215 seriously wounded soldiers at various locations in the European theater during World War II shortly after they had been wounded and found that 75 percent of them had so little pain that they had no need for morphine. Reflecting that strong emotion can block pain, Dr. Beecher went on to speculate: “In this connection it is important to consider the position of the soldier: His wound suddenly releases him from an exceedingly dangerous environment, one filled with fatigue, discomfort, anxiety, fear and real danger of death, and gives him a ticket to the safety of the hospital. His troubles are over, or he thinks they are.” This observation is reinforced by a report of the United States surgeon general during World War II, noted in Martin Gilbert’s book The Second World War: A Complete History (New York: Henry Holt, 1989), that in order to avoid psychiatric breakdown, infantrymen had to be relieved of duty every so often. The report said, “A wound or injury is regarded not as a misfortune, but a blessing.

CIA officers who conducted Bluebird interrogations at Camp King and Villa Schuster counted on guidance from “Doc Fisher,” a German physician who had worked at Walter Reed General Hospital in Washington and spoke good English. “Doc Fisher” was General Walter Schreiber, the former surgeon general of the Nazi army. During the war he had approved experiments at the Auschwitz, Ravensbrück, and Dachau concentration camps in which inmates were frozen, injected with mescaline and other drugs, and cut open so the progress of gangrene on their bones could be monitored.

During my years caring for patients, the most common pathology I saw was not heart disease or diabetes,” observed Vivek Murthy, the former surgeon general of the United States. “It was loneliness.” He described it as “a growing health epidemic” that can lead to stress, inflammation, obesity, diabetes, heart disease and early death. It may be one reason suicide rates are at a modern high. Murthy calculates that loneliness and social isolation are even more associated with early death than obesity, and have approximately the same impact on lifespan as smoking fifteen cigarettes a day.

I’m Jay Powers, the circulating nurse”; “I’m Zhi Xiong, the anesthesiologist”—that sort of thing. It felt kind of hokey to me, and I wondered how much difference this step could really make. But it turned out to have been carefully devised. There have been psychology studies in various fields backing up what should have been self-evident—people who don’t know one another’s names don’t work together nearly as well as those who do. And Brian Sexton, the Johns Hopkins psychologist, had done studies showing the same in operating rooms. In one, he and his research team buttonholed surgical staff members outside their operating rooms and asked them two questions: how would they rate the level of communications during the operation they had just finished and what were the names of the other staff members on the team? The researchers learned that about half the time the staff did not know one another’s names. When they did, however, the communications ratings jumped significantly. The investigators at Johns Hopkins and elsewhere had also observed that when nurses were given a chance to say their names and mention concerns at the beginning of a case, they were more likely to note problems and offer solutions. The researchers called it an “activation phenomenon.” Giving people a chance to say something at the start seemed to activate their sense of participation and responsibility and their willingness to speak up. These were limited studies and hardly definitive. But the initial results were enticing. Nothing had ever been shown to improve the ability of surgeons to broadly reduce harm to patients aside from experience and specialized training. Yet here, in three separate cities, teams had tried out these unusual checklists, and each had found a positive effect. At Johns Hopkins, researchers specifically measured their checklist’s effect on teamwork. Eleven surgeons had agreed to try it in their cases—seven general surgeons, two plastic surgeons, and two neurosurgeons. After three months, the number of team members in their operations reporting that they “functioned as a well-coordinated team” leapt from 68 percent to 92 percent. At the Kaiser hospitals in Southern California, researchers had tested their checklist for six months in thirty-five hundred operations. During that time, they found that their staff’s average rating of the teamwork climate improved from “good” to “outstanding.” Employee satisfaction rose 19 percent. The rate of OR nurse turnover—the proportion leaving their jobs each year—dropped from 23 percent to 7 percent. And the checklist appeared to have caught numerous near errors. In

Vivek Murthy, former surgeon general of the United States, wrote in the Harvard Business Review that “Loneliness and weak social connections are associated with a reduction in lifespan similar to that caused by smoking 15 cigarettes a day.”6 A meta-analysis from the Association for Psychological Science warns that loneliness and social isolation significantly decrease length of life.7

For instance, in some situations well-developed knowledge about how to achieve desired results makes routines and plans generally unfold as expected; for example, following a recipe to bake a cake or drawing patients’ blood in a phlebotomy lab. I call these consistent contexts. Other times you’re in brand-new territory—forced to try things to see what works. The pioneering cardiac surgeons we met at the start of this chapter were clearly in new terrain, and most of their failures were intelligent. Other examples of novel contexts include designing a new product or figuring out how to get protective masks to millions of people during a worldwide pandemic.

Alone in their rooms, literally left to their own devices, young people are developing strange and dangerous pathologies. The U.S. surgeon general, in a rare public advisory issued in December 2021, warned of a “devastating” mental health crisis among American youth.

And your worker who ‘kisses ass’ is seen as management material not because they give their all to the company, but because they spend that effort they would otherwise give to the company on looking like they give it all to the company. They spend it on all the little social games instead, and because effort spent on the metagame is focused entirely about the appearance of virtue, it overshadows those who are actually performing the primary task, it overshadows actual virtue. And this is how human hierarchical structures end up working. This is why the people who end up in authority are generally not those focused on whatever the purpose of the community is, but those who are focused on achieving positions of authority. This is why you have career politicians, why administrators end up pulling ten times the salary of a surgeon or an academic under their administration, why performing well in an exam or a test is not actually the same as being good at the thing the exam is supposed to be testing. Because the metagame outweighs the game.

Have a Profession, Not a Job Everyone except trust fund babies and perennial welfare recipients need to work.  It is an unavoidable fact of life that if you don't want to be homeless, go hungry, constantly beg, or wish to have any semblance of a normal, healthy financial life you need to work.  But in the fact work traditionally consumes half of your waking life (more if you include commute), if your job has a point and purpose to it, then so too does your life.  This isn't to say there is anything wrong with being a general laborer, a barista, or a fast food worker.  We all start somewhere and these low-skilled, entry level jobs are a vital part of the economy and a starting point in everyone's working career.  But if you take the time to learn a skill, develop a trade, or earn an employable degree, you can have a profession, not merely a job.  This confers upon you and your life immediate purpose and value as now you get to declare yourself as an individual with a specific skill. “I'm a plumber.” “I'm a CPA.” “I'm a cop.” Or “I'm a programmer.” And this statement declares how you contribute to the economy, how you earn your keep in this society, and is usually the first thing people ask about you – what do you do? Furthermore, as it just so happens, being a professional pays more.  Admittedly, it takes some training and education, and for some particularly prestigious professions it can take years (for example, being a surgeon).  But if you go that extra mile and invest in yourself a year or eight to develop a skill or a trade, the remaining 50-60 years of your life will not only be more profitable, but will give you purpose and meaning for your entire working career.

Coppergate Clinic, located in York, is the premier destination for a wide range of surgical and non-surgical procedures focusing on face, body, and skin treatments. The clinic offers expert care from industry-leading surgeons, doctors, nurses, and aestheticians, ensuring exceptional treatment results in a boutique private hospital setting. Patients can access a comprehensive plastic surgery service, including breast, abdomen, body, and face procedures under twilight and general anaesthetic.

In September 1942, a month after Gandhi was jailed, Winston Churchill wrote to the secretary of state for India, Leo Amery: ‘Please let me have a note on Mr.Gandhi’s intrigues with Japan and the documents the Government of India published, or any other they possessed before on this topic.’ Three days later, Amery sent Churchill the note he asked for, which began: ‘The India Office has no evidence to show, or suggest, that Gandhi has intrigued with Japan.’ The ‘only evidence of Japanese contacts [with Gandhi] during the war’, the note continued, ‘relates to the presence in Wardha of two Japanese Buddhist priests who lived for part of 1940 in Gandhi’s Ashram’. Before the Quit India movement had even begun, Churchill had convinced himself that Gandhi was intriguing with the Japanese. In February 1943, when Gandhi went on a fast in jail, Churchill convinced himself that Gandhi was secretly using energy supplements. On 13 February, Churchill wired Linlithgow: ‘I have heard that Gandhi usually has glucose in his water when doing his various fasting antics. Would it be possible to verify this.’ Two days later, the viceroy wired back: ‘This may be the case but those who have been in attendance on him doubt it, and present Surgeon-General Bombay (a European) says that on a previous fast G. was particularly careful to guard against possibility of glucose being used. I am told that his present medical attendants tried to persuade him to take glucose yesterday and again today, and that he refused absolutely.’ On 25 February, as the fast entered its third week, Churchill wired the viceroy: ‘Cannot help feeling very suspicious of bona fides of Gandhi’s fast. We were told fourth day would be the crisis and then well staged climax was set for eleventh day onwards. Now at fifteenth day bulletins look as if he might get through. Would be most valuable [if] fraud could be exposed. Surely with all those Congress Hindu doctors round him it is quite easy to slip glucose or other nourishment into his food.’ By this time, the viceroy was himself increasingly exasperated with Gandhi. But there was no evidence that the fasting man had actually taken any glucose. So, he now replied to Churchill in a manner that stoked both men’s prejudices. ‘I have long known Gandhi as the world’s most successful humbug,’ fumed Linlithgow, ‘and have not the least doubt that his physical condition and the bulletins reporting it from day to day have been deliberately cooked so as to produce the maximum effect on public opinion.’ Then, going against his own previous statement, the viceroy claimed that ‘there would be no difficulty in his entourage administering glucose or any other food without the knowledge of the Government doctors’ (this when the same government doctors had told him exactly the reverse). ‘If I can discover any firm of evidence of fraud I will let you hear,’ said Linlithgow to Churchill, adding, somewhat sadly, ‘but I am not hopeful of this.’ This prompted an equally disappointed reply from Churchill: ‘It now seems certain that the old rascal will emerge all the better from his so-called fast'.

Studies generally find that teaching hospitals have better outcomes than non-teaching hospitals.

I am tired of the sickening sight of the battlefield with its mangled corpses & poor suffering wounded. Victory has no charms for men when purchased at such cost.

In 1994, Bill Clinton was forced by Republicans to fire his surgeon general, Joycelyn Elders, for saying—at a UN conference on AIDS—that perhaps schools should teach young students to masturbate. But two years later, her replacement, Audrey F. Manley, went on television to talk about “outercourse”—all the sexually pleasurable activities that one could enjoy without exchanging bodily fluids. And

Obstetrics went about improving the same way Toyota and General Electric went about improving: on the fly, but always paying attention to the results and trying to better them. And

When the surgeon general’s report on smoking and health was published in 1964, it unleashed a decades-long

The average doctor in a high-risk practice like surgery or obstetrics is sued about once every six years. Seventy percent of the time, the suit is either dropped by the plaintiff or won by the doctor in court. But the cost of defense is high, and when doctors lose, the average jury verdict is half a million dollars. General

Studies of the Surgeon General’s office reveal that domestic violence is the leading cause of injury to women between the ages of fifteen and forty-four, more common than automobile accidents, muggings, and cancer deaths combined.

According to the surgeon general, obesity today is officially an epidemic; it is arguably the most pressing public health problem we face, costing the health care system an estimated $90 billion a year. Three of every five Americans are overweight; one of every five is obese. The disease formerly known as adult-onset diabetes has had to be renamed Type II diabetes since it now occurs so frequently in children.

If the epidemic continues its mathematical rate of acceleration, civilization could easily disappear from the face of the earth.” —The Army Surgeon General, 1918