White privilege for canines

by philg

In a group chat, a friend posted a picture of the Samoyed puppy he hopes to adopt. Here’s Alex the puppy, from 1996:

Response from another friend:

I am disturbed by the whiteness of your dog. Not a speck of brown. And that smug look on his face. Gloating in his entitlement. He needs a shock collar so he can experience the life of a BIPOC dog. A shock whenever police are near for example. A shock for social justice.

Another exchange from the same group…

White guy: “Koreans do not like big dogs” I am told.

(immediately following) Immigrant from Korea: Small dogs much more tender.

A participant wrote about taking his teenage son to the Kennedy Space Center. Asked what he’d learned, the lad replied “I learned that the Shuttle was primarily designed by women, black guys, and Asians.” (For the tourists NASA has produced a bunch of reenactment videos with present-day actors pretending to be 1970s engineers.)

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Fauci: not everyone in the military is a hero

by philg

There are more than 2 million members of the U.S. military.

Let’s start out with the heroes… a transient A-10 at our local Air Force base, back in October:

And let’s hope that the pilot has been triply heroic now by agreeing to two vaccine shots!

An inconvenient truth from America’s top scientist: just as not everyone in the military can be a combat pilot, it seems that not everyone in the military can be a hero, contrary to what we’ve been told. “Fauci Says Military Who Refuse Covid-19 Vaccine Are ‘Part Of The Problem’ After High Rate Of Service Members Refuse Jab” (Forbes🙂

… the U.S. military is one of a number of frontline professions reporting startlingly high rates of vaccine refusal, despite clear evidence that the vaccines are safe and effective.

“You’ve got to think of your own health, which is really very important, but you got to think about your societal obligation,” Fauci said at a virtual town hall for Blue Star Families, a non-profit focused on helping military families.

Out of 2 million, how many have been felled by what science tells us is a pathogen that requires the most dramatic adjustments to human society since the Black Death of 1348?

The U.S. military, which has been deployed around the country to assist with the pandemic response, has struggled with Covid-19 outbreaks, recording 163,574 cases and 24 deaths throughout the pandemic.

(For comparison, NHTSA says that several hundred U.S. military personnel die in traffic accidents each year, an example of the general rule that I articulated a year ago: Why do we care about COVID-19 deaths more than driving-related deaths?)

If U.S. military personnel could cut their driving by 10 percent, therefore, they could save more lives than by taking a vaccine that was 100 percent effective against COVID-19. So maybe the “you’ve got to think of your own health” advice from Dr. Fauci is medically unsound (i.e., better to spend an afternoon coming up with ways to cut driving miles per year than to drive to a vaccine clinic). Fauci adds, however, that it is each service member’s “societal obligation.” Contrary to Dr. Fauci’s own previous statement, COVID-19 isn’t actually dangerous to a healthy 35-year-old enlisted soldier, but, without a vaccine, he/she/ze/they could be a carrier:

Vaccines are the “best and most important intervention we have” to stop the pandemic, he said, together with public health measures like masking and social distancing.

“Because by getting infected, even though you may not know it, you may be inadvertently transmitting the infection to someone else, even though you have no symptoms,” Fauci said, adding: “in reality, like it or not, you’re propagating this outbreak.”

So… vaccines reduce infection and transmission to the point that everyone has a societal obligation to test out an “investigational” pharmaceutical?

I.e., from the same doctor/government official: (a) the vaccine is so effective at preventing transmission that those who face almost no personal risk from the virus must take it, (b) the vaccine is so ineffective at preventing transmission (absent a nasopharynx removal), that Americans should continue to keep their lives on hold until the PCR machines stop giving us numbers that we don’t want to hear.

And don’t forget to wear a mask after you’ve dead… (from our neighborhood, October 25, 2020):

Related:

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Gender studies: Maverique or Nuetrois?

by philg

An applicant for a Vermont state-sponsored job was confronted with the following form:

Note that it is unclear whether Nuetrois is a new gender identity or simply a variant spelling of the familiar gender identity Neutrois.

How about Maverique?

Maverique is a gender identity that is characterized by autonym towards manhood or womanhood, while having the internal conviction that it is unrelated or not derived from none of the binary genders,[1] while this is not a genderlessness or a gender apathy nor a gender neutrality.

That’s from the Simple English Wikipedia.

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Traveling to scold the COVID sinners

by philg

A Maskachusetts resident who has achieved Super Karen status when it comes to advocacy of masks and shutdown (daily Facebook postings for our full year (so far) of “14 days to flatten the curve”) went down to Wicked Florida for the February school break that we have here. He hung his phone out of a car window and made a video of people mixing in various open-to-the-street venues on the beach in Ft. Lauderdale, captioned

Wonder what happens if you party like it’s 1999…you get the highest virus transmission rate in the country. Looks like fun though I think I’ll just keep on driving!

Among the various comments, one from a Floridian:

in your statement above, “because these folks ignore the rules they are going to cause a problem and creat a backlash that will cause shutdowns and restrictions”. Aren’t you also doing that by out of state travel?

My answer to her:

I think [he] is working in an established literary tradition. Devout Christians, for example, used to go to whorehouses, strip clubs, and gay bars so that they could then write about the awful sins that were taking place.

Now that Christianity is on the wane here in the U.S., are posts like this guy’s evidence that Shutdown Karenhood is one of the replacements?

From a club in Miami, end of January:

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The emergency continues on two fronts: insurrection and coronaplague

by philg

The 2,200 members of the Capitol Police and 3,800 officers of the D.C. Police and the FBI and the Secret Service are not sufficient to protect our nation from an ongoing insurrectionmergency. “Capitol Police Call For Extension Of National Guard Help” (NPR):

U.S. Capitol Police requested a 60-day extension for a portion of the National Guard troops currently in Washington, D.C., Thursday as the threat of a possible attack from militia groups looms over the city.

How are we doing in Year 2 of “14 Days to Flatten the Curve”? “It’s Too Soon to Lift COVID Restrictions: Fauci” (U.S. News):

Coronavirus restrictions should not be lifted until the daily toll of new U.S. cases falls below 10,000, “and maybe even considerably less than that,” Dr. Anthony Fauci said Thursday.

The last time the United States saw that low a number was almost a year ago. The daily case count hasn’t fallen below 50,000 since mid-October, and the seven-day average on Wednesday was more than 64,000, CNN reported.

Who wants to make a prediction as to when positive PCR tests (“cases”) will fall below 10,000 per day? (let’s say that it needs to be a 7-day moving average of 10,000/day so that we exclude reporting glitches)

Given that Americans love to run PCR tests, even on those who have zero symptoms, my guess is “never”. Example: friends in NYC are trying to sort out a cancer question regarding the mom. A coronaplague test was required before she could get a follow-up cancer test. She tested positive and therefore her cancer appointments were canceled. One of her two children tested positive. (The husband is vaccinated so he refused to participate in the festival of testing.) She never had any Covid-19 symptoms, but the family remembered that both kids had slight sore throats a week or two before the test. As long as we have a lot of checkpoints at state borders (the Maskachusetts travel order, for example), national borders, schools (can’t return without a Covid test), hospitals (can’t get treatment without a Covid test), etc., if we’re still running PCR at the same number of cycles we should still have at least 10,000 positives per day forever.

(Separately, consider this NYC family. They’ve endured a year of lockdown in an apartment. Their kids haven’t seen the inside of a school since March 2020. They’ve avoided gatherings with friends and family. Now the mom and the kids have exactly the same medical status that they would have had if there had never been any kind of shutdown or masquerade. Aside from wars, in all of U.S. history, has there ever been a sacrifice more meaningless and useless?)

From December, approaching the Hudson River Corridor from Teterboro (a VFR interlude in an instrument practice flight in a Cirrus):

Related:

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Wrong again: Chinese-built RVs are not cheaper

by philg

Me in 2005: “Ideas for Building RVs in China”. I figured that the Chinese would be able to build competitive basic motorhomes at prices lower than what American firms charge because so much hand labor is involved.

(On the blog post associated with this, a reader was way ahead of the curve:

I think you are drawing the market too narrowly by saying that your product is “Intended for a married couple with two children to go camping.” What about shooting for a market that includes “a family of four to go camping”, which could include gay and lesbian couples and their kids? I would think they would be equally, if not more, likely to want to camp (a gay friend of mine recently spent a weekend at a “gay” campground in Texas) as straight folk. However, they would not fall within your “married” categtory because they are not married, due to homophobic folk in their home states who fear that to permit that would lead to the demise of the straight marriage. Please excuse the brief political rant, but my main point is, no need to target such a narrow market.

Today she would be considered a hater for not including the trans and other folks within the LGBTQIA+ rainbow?)

Instead of same-but-cheaper, it looks as though the Chinese are innovating in ways that Americans couldn’t have imagined, but the prices are actually higher. See “An Entire Second Floor Pops Out of this Tiny RV, Complete with a Working Elevator to Get Up There” (Gizmodo):

The SAIC Maxus Life Home V90 Villa Edition, designed and built in China, appears to offer the best of both mobile worlds. The vehicle has a relatively small footprint (it’s only slightly larger than what you see most van-lifers driving around in), but it employs slide-out walls to greatly increase the floor space to around 215 square feet inside while the RV is parked. There’s a fairly spacious sleeping berth located above the driver’s cab which leaves more room in the back for a large L-shaped couch and a respectably sized kitchen. … Where the V90 really wows, however, is the sunroom that automatically extends from the roof giving the RV an entire second floor of living space, including a walk-out balcony.

You can potentially convince SAIC Maxus to build one for you if you’re willing to cough up a little over $413,000, and whatever shipping costs are needed to export it outside of China, plus whatever additional upgrades are needed to legally drive it on US roads.

Here’s a photo:

(Should the gal above be a little more, um, robust in order to fit in with the typical American RV traveler?)

A similar-length U.S.-made Winnebago is about $172,000, i.e., less than half as much. So it seems that I have been proven wrong yet again.

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Happy 27th birthday to the cable modem

by philg

“Big Cable Company to Offer A High-Speed Internet Link” (New York Times, March 9, 1994):

Continental Cablevision Inc., the nation’s third-largest cable television company, said yesterday that it had begun offering a high-speed link to the Internet data network over the same coaxial cables that carry television channels into the home.

The Internet connection is initially available only to Continental customers in Cambridge, Mass., but company officials said it would eventually be offered to nearly three million customers nationwide. Continental, based in Boston, provides cable service to Westchester County, N.Y., and in California, Idaho and Michigan.

However, at a rate of $125 a month for residential customers, and higher for business customers, the service is unlikely to displace the MTV’s and the Home Box Offices at the top of a 500-channel hit parade, even in Cambridge, the sort of academic-technical redoubt where enthusiasts consider Internet access more important than the telephone.

At the same time, telephone and data-communications companies are constantly expanding the capacity of twisted-pair phone lines and speeding the installation of fiber optic lines, which also offer data-transfer speeds fast enough to handle video signals.

“Cable is a kludge,” remarked Mr. Harris of Jupiter Communications, using a computer term for an inelegant solution to a technical problem. “The market is aching to have everything in full motion, and cable is sort of a middle-of-the-road solution.”

Here we are, 27 years later, and Cambridge, thanks to the miracle of government regulation, still doesn’t have fiber to the home!

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Tip from a self-driving car engineer: don’t choose black

by philg

A friend is shopping for a new car. He happens to have been working for the past five years on various Silicon Valley self-driving car efforts. What’s he looking at for a new car for himself? A C8 Corvette! (Why not the product of the finest minds of Silicon Valley? “Can any expensive car have a worse interior than Tesla? Seems impossible. They shaved every possible penny there.”)

What color? “Anything but black,” he replied. “The Zeus Bronze Metallic also might be too close to black.” What’s wrong with black? “It will be invisible to Lidar. The cameras might see it during the daytime, but it will be dangerous to drive at night because self-driving cars won’t see it.”

Readers: What do you think of the C8 in Zeus Bronze?

Compare to the Red Mist Metallic, which is the most popular color:

Some additional thoughts from our deeply embedded source…

When can we expect the promised age of self-driving cars?

Hard to answer as depends on legislation and business. Let’s go backwards and try to guess. What is the long-term future? Is it (a) autonomous cars try to mix into traffic with humans, or (b) human driving is illegal?

To get to (a), are the steps (1) start selling autonomous to fleet operators, (2) start selling autonomous to citizens, (3) stop making new human-driven cars, hence no wheel, and grandfather some human driven cars

For (1) to happen the cars have to get good enough, for (2) to happen the cars have to get cheap enough, for (3) to happen Biden/Harris will need the power to repurpose the roads for the greatest public good/safety (also nice because now the government will know where all of the citizens are going and when)

My guess is that the industry wants (a) for now but the government will want (b), which makes more efficient use of roads, simplifies the software, and also facilitates tracking everyone.

Right now (2021) self-driving car is expensive and dangerous. Reducing expense is possible once more money goes into the ecosystem, but it remains to be seen how safely they operate. Horse/car analogy does not make sense: man-driven flesh vehicle to man-driven ICE vehicle. Self driving is from man-driven vehicle to software-driven.

Why is this challenge so tough for software?

The problem with mixing software-driven and human-driven vehicles is exemplified by “is that guy watching Netflix while driving going to yield to my left turn?” Hard to get that right.

When will a family be able to buy a self-driving car, then, without a steering wheel and mix it up with human-driven contraptions?

Pure guess 25 years

A Tesla 3-owning friend:

Tesla owners think by 2017. Then by 2019. Then by 2020. Now by 2021. They pay $10,000 for “full self driving” software. Tucker Auto was shut down for less of a scam.

An immigrant from Eastern Europe participating in this discussion:

My father had a self-driving car for a decade in the 80s. It was called a company chauffeur. He couldn’t do much in the car because it is still less convenient. If it is a short drive, you won’t accomplish much. Read the news perhaps, or write a few emails. Phone calls you can make now.

The self-driving software engineer saw the biggest competition as coming from Uber and similar human-driven services. As long as low-skill labor in the U.S. remains cheap due to mass immigration, self-driving tech would have to be both inexpensive and nearly perfect to be competitive.

Shifting gears, so to speak, for a moment… what about the fact that cameras are being driven around 24/7 in vehicles that can stream footage up to the cloud? The government can already get footage from doorbell and house-attached cameras (see “Amazon Ring is creating the surveillance complex” by Mark Hurst). Will a police officer in 10 years be able to say “I want to see what was happening at the intersection of 8th and Main at 10:32 pm” and get footage from all of the self-driving cars that happened to be passing that location at the time?

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Fund burning of existing copies of harmful Dr. Seuss books?

by philg

Books containing harmful ideas will no longer be sold new, says “Dr. Seuss Enterprises Will Shelve 6 Books, Citing ‘Hurtful’ Portrayals” (NPR):

“In And to Think That I Saw It on Mulberry Street, for example, a character described as Chinese has two lines for eyes, carries chopsticks and a bowl of rice, and wears traditional Japanese-style shoes. In If I Ran the Zoo, two men said to be from Africa are shown shirtless, shoeless and wearing grass skirts as they carry an exotic animal. Outside of his books, the author’s personal legacy has come into question, too — Seuss wrote an entire minstrel show in college and performed as the main character in full blackface.”

Let’s look at If I Ran the Zoo. The used (“collectible”) book is still available at Amazon, however, for $1,700:

and it may be available in a lot of public libraries where young minds could fall into error.

Would it make sense for a billionaire Silicon Valley progressive to fund the purchase of all extant copies of these harmful works and then burn them? A typical public library would presumably be happy to receive $1,700 for a worn book that had originally cost them $10. Like the Pfizer vaccine that is not banned in India (“mostly false” and a “conspiracy theory” according to Newsweek; it is just that the vaccine is not approved and therefore illegal to use), the libraries wouldn’t be banning If I Ran the Zoo. It would just be deaccessioned to make room for better/newer books.

(If your budget is smaller and you’re looking for bedtime stories that don’t offend modern merchants, Amazon will sell you a new copy of Mein Kampf for $22.49 ($10.99 Kindle):

“I am convinced that we cannot possibly dispense with the trade unions. On the contrary, they are among the most important institutions in the economic life of the nation. Not only are they important in the sphere of social policy but also, and even more so, in the national political sphere. For when the great masses of a nation see their vital needs satisfied through a just trade unionist movement the stamina of the whole nation in its struggle for existence will be enormously reinforced thereby.” and “For this, to be sure, from the child’s primer down to the last newspaper, every theater and every movie house, every advertising pillar and every billboard, must be pressed into the service of this one great mission”)

The Russians and Dutch rebels behind Library Genesis have preserved a PDF of the not-banned Dr. Seuss work. The world of 1950 contains some all-white neighborhoods:

But one can travel to find Asians (“who all wear their eyes at a slant”):

He goes to Nantucket without a Gulfstream? My rating: #MostlyFalse

The remote African island of “Yerka,” not as realistically depicted as in National Geographic:

As with the 2016 election, it all comes down to the Russians:

Update, evening of 3/3: at least some sellers are hoping to get $5,000 per copy.

What was the book worth before it was not-banned? $1.25 on eBay, January 4, 2021:

How about on March 3, 2021 for a “brand new” copy with no historical pedigree? $405 on eBay:

Related:

  • the Cobra effect (if a billionaire offers $1,700 per copy, maybe more copies will magically appear?)
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Medical School 2020, Year 3, Week 16 (Inpatient Gyn)

by philg

Gynecology rotation starts at 7:30 am in the outpatient surgery center. The chief texted the previous night to skip hospital rounds and just meet the team at the outpatient surgery center for the first 8:00 am case (this is an inpatient week, but if there are no scheduled surgeries at the hospital we go with an attending to the outpatient center). I appreciate the extra sleep! Our first patient is a 27-year-old who had an unfortunate uterine perforation after IUD placement by a Planned Parenthood Nurse Practitioner. “I think it was her first IUD placement. Looking back, she was so nervous.” After a brief physical, we have about 30 minutes before the OR is ready.

Did it hurt getting the IUD placed? “It hurt so bad, but they told me that’s expected. Over the next week, the intense pain got better, but I just kept having these sharp lightning bolts of pain once or twice a day.” She saw an Ob/Gyn for a regular check up three months later who ordered an abdominal x-ray that showed a “T”-shaped device in the right upper quadrant. 

The 70-year-old attending arrives. She meets the patient and confirms the consent is signed. I grab gloves for the attending, intern and myself. We perform a laparoscopic removal of the IUD. It was lodged in the omentum requiring three port placements (three holes in the belly). Throughout the entire procedure, the 60-year-old anesthesiologist, a former dentist, tried to convince me that anesthesia is the best route. “Hospitalists are miserable,” he began. “They have 80 patients, they work 12-hour shifts. It’s not good for the patient, but it’s the way medicine has gone. In anesthesia, we have only one patient at a time, and we are done after you leave the office. And the physiology is just awesome.”

As the OR is prepared by the nurse, surgical tech, and OR tech,s for the next case, we head to post-op to talk to our recovering patient. After a brief conversation with the patient and her mother, we head to the nurse’s station where the intern is instructed to prescribe 10 OxyContin 5 mg. “It’s crazy how much opioid pills we still give out. Epic defaults to 30 pills for a prescription,” says the attending. “I still have dozens of narco left over from my breast cancer surgery. Everyone is talking about the opioid problem and how doctors created this monster, perhaps, but I still blame the government. They started to adjust reimbursement rates based on patient-reported pain scales. No wonder the ED gave out Oxy like candy.”

Before our next procedure (hysteroscopy, camera through the cervix into the uterus to look for, and possibly biopsy, cancerous polyps), I chat with the attending about the future of Ob/Gyn: “Ob/Gyn was a beautiful field because it combines surgery with long-term patient relationships. I am the primary care provider for a lot of my patients. We’re succumbing to the specialization tsunami. I’ve been grandfathered in, but most hospitals require you to choose a track: gynecology or obstetrics.” She continued, “The days of having clinic in the morning with two afternoons of gyn surgeries alternating with a week of obstetrics are ending. Administration is chipping away at the scope of practice for every field.”

After a total of three procedures, I leave the outpatient OR at noon to attend lectures at the hospital on urinary incontinence by a “UroGyn” (Urogynecologist, 4-year OB/Gyn residency followed by 3-year fellowship). 

The next day starts with hospital rounds before surgery at 6:30 am in the main hospital OR. We have two laparoscopic fibroid removals and a hysterectomy scheduled. Dr. McSteamy is the attending. He is a 37-year-old whose recent marriage occasioned despair among the residents (all female, except for one gay guy, a junior resident, who shared their grief). The chief, now four years out of medical school, struggles with basic laparoscopic techniques, incorrectly locating the ureters, a critical item given the risk of damage during the procedure. She also has a six-month-old at home, which might explain some of her deficiencies, but her parents have moved here to assist the software engineer husband in taking care of the baby. She is trying to find a job next year as a general practitioner in a smaller hospital setting. 

During the second hysterectomy, the junior resident gets a page for two ED admits. He and I step out to evaluate a 24-year-old bartender with a three-day history of excruciating labial pain. She had a similar episode several years ago. Her right labia majora is swollen, erythematous (reddened), and extremely painful when she walks or moves. As I prepare to present the findings to Dr. McSteamy, I look up management of Bartholin abscess in my trusted Comprehensive Handbook of Obstetrics and Gynecology by Zheng, a $30 book that fits into a scrubs pocket. The bartholin glands, located at 4 and 8 o’clock in the vaginal introitus, secrete lubricating fluid through a small duct. Some women develop a blockage in the duct leading to an enlarging cyst that becomes infected. Once McSteamy is out of surgery, we head down as a team to examine the patient. We then gather supplies (numbing medication, Wort catheter, scalpel, iodine prep) to drain the abscess. Before we go in, the ED attending asks if the resident has performed one of these. No. Dr. McSteamy then describes the procedure. The ED attending also wants to watch as she has never seen one performed. We transfer the patient into an ED procedure room with stirrups. The resident injects lidocaine in the 3 cm labial abscess and she cries out in pain. After 5 minutes, the resident makes a small incision in the labia, which results in screams and “sorry, sorry.” He then slips a 3 mm-diameter drainage catheter into the abscess. She is supposed to leave this in for 2-4 weeks, but the attending admits that most will fall out within a week. If this happens again she might consider getting a bartholin gland excision or marsupialization surgery (turns the gland inside-out) to maintain duct patency. 

Friday morning: round on two post-op patients and then am sent off to study before a mandatory class meeting at 1:00 pm. Nervous Nancy is in the student lounge watching Grey’s Anatomy on her phone. She is on outpatient Ob/Gyn week and was told not to bother driving to the clinic today. “Whenever I get nervous before exams, I instinctively watch Grey’s Anatomy. My excuse is I might learn something from it while calming my nerves by binge-watching.” We talk about her experience on Obstetrics. “I sometimes think, screw I am going to have a baby even though I am vastly irresponsible and underprepared. Look at these moms. Then I remember that they are terrible people.” I recount my experience with the G9P8 having the ninth baby. When asked why she keeps having babies, she responds: “Well all my children are in foster care so I need to have another one to actually keep one.” Nervous Nancy laughs, and says, “I’ve seen those too. Maybe your children are in foster care because you are a crack addict.”

We head over to the school for confessions of a medical student. We were instructed to prepare by writing a two-paragraph anonymous confession from this year. We are divided into 10-person groups, each led by a physician who shuffles them and hands them out for presentation: 

  1. Dear patient, I know everything about you. I know your STD history, I know you have had more children than reported to your husband, and I know your mother died from colon cancer. But as I walk through the door I realized I forgot your name. Unnamed patient, I am sorry.
  2. We were so rushed one day on rounding that we didn’t not explain to a patient why we were performing a digital rectal exam. I felt we violated his dignity. We were trying to rule out colon cancer.
  3. I resent when doctors say “we have it so much easier than you did”. They don’t understand the stresses we are under from residency competitiveness and financial costs.
  4. It is such a relief to see bad doctors practicing. The imperfection reminds me that I don’t have to be perfect to become a doctor. Being a doctor is human, and humans are imperfect. Some are even bad at their job.
  5. I learn more from watching bad doctors make mistakes than from good doctors.
  6. We had a patient whose biopsy was delayed because of another patient requiring a more urgent read. We joked how annoying he was. He started to yell that he was going to sue the hospital so the team disliked him even more for him being so difficult. He started to have delirium. When I went in alone to check on him in the morning he was clam and present. He confided in me: “I don’t care about myself, my wife is not strong enough to handle another day of not knowing.” The wife broke down in the room. He then got delirious and started asking philosophical questions, “Where are you going?”, “Are you content?”, “What happens next?” It gave me chills.
  7. I can never do pediatrics. An anti-vaxxer mom and her three kids came to the pediatric clinic for a first visit after getting thrown by of their prior pediciatrian. The kids asked me why they can’t go to normal school instead of being homeschooled. It was terrifying seeing a crazy woman make decisions that will impact these kids’ lives with no one to stop her.
  8. We don’t do much good in the hospital or in medicine. So much waste, discharging patients for them to come back in a week. We just use all this expensive technology that prolongs a miserable life. The best care I’ve seen so far was when a surgeon decided to not operate and recommended comfort care.
  9. I kept telling my team that a patient had a certain diagnosis, albeit atypical presentation. They kept saying how it could never be that, and made fun of me. After a few days and it turned out I was right, but they never acknowledged what I had told them. In my evaluation they mentioned only trivial stuff: on time, attentive, knows patients.
  10. I feel disillusioned. Despite all this training I feel worthless and unable to manage any real problems my friends and family ask me about. Barbara Freiderson helped me: “The negative screams at you, but the positive only whispers.”

Nervous Nancy: “I just feel like I am always in the way. That no one is grateful for us, and the people that actually care for the patient would have it easier without us present.” The physician leader asks, “Do any of you wish you were invisible?” Every student grinned, and nodded. Gigolo Giorgio, who sports a beer belly after gaining several pounds on psychiatry comments: “I think you mean we all want to be flatter against the wall.” 

Statistics for the week… Study: 10 hours. Sleep: 6 hours/night; Fun: 1 night. Halloween celebration. Gigolo Giorgio hosts a pregame before the class Halloween party downtown. We reminisce about our rotation experiences. Buff Brad and his girlfriend dress up as Gamora and Warlock from Guardians of the Galaxy, Adrenaline Andrew and his girlfriend win first prize with homemade jellyfish costumes out of christmas lights and clear umbrellas. Classmates are downing shots and beer. Once we arrive at the rented out bar’s upstairs room, students dance Top 25 Pop hits while a line grows at the private bar for $5 mixed drinks. Gigolo Giorgio jokes: “[Put-Together Pete] is on his 24-hour night shift for surgery, we should all get blackout and visit him in the ED.”

The rest of the book: http://fifthchance.com/MedicalSchool2020

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