NPs working under a physician with actual oversight is fine. The ones I have problems with are the ones that have a physician sign the hundreds of notes a month while maybe reviewing a handful, and worse, the ones pushing for independent practice without even that sham of oversight involved.

Makeship is having a sale on their new Glow in the Dark plushies. It’s not a huge discount, but the proceeds go towards supporting independent artists which is always a good thing.

https://www.makeship.com/shop/gitd-2023

I’m grateful that none of our cadavers were unclaimed remains. All of them had info sheets with demographics, profession, and a brief health history. Our school also holds a Donor Memorial ceremony every year, but I don’t know if that’s common or ubiquitous among medical schools.

Internet access is as basic a utility as electricity and water these days. It is nigh impossible to function in society without access to the internet and pretending otherwise is just oblivious to the point of petulance.

If I was going to be selfish, yes, I would move to a country that has more progressive policies and government. I refuse to be selfish though. I’m in medical school and hoping to become an ER physician in the safety net county hospitals for the express purpose of doing everything I can to help the people that have no way of escaping. I probably would have a pretty easy time taking my medical degree and moving almost anywhere because doctors are in demand pretty much everywhere, but it would be against everything I stand for and would be in complete opposition to my goals. I know that I won’t be able to move the needle very much, and as an ER physician I’d be making a difference just to my patients and perhaps my community, but I still have to try. I want everyone to be able to access food, housing, education, and healthcare equally and I can’t work towards that reality if I just run away from the worst of it.

He accepted “no” for an answer the first time without any argument or attempt to coerce, listened when I explained why the answer was “no”, and offered comfort and sympathy in response to the reasoning with no expectation of the answer changing.

The one I wish I could forget is the Clarissa comic about the little girl that is being horribly sexually abused by her father and everyone around her either knows and pretends that they don’t, or just refuses to see the truth.

I was kind of startled by a picture of Putin I saw yesterday in a news story about Kim Jong Un. It looks like he has textbook moon facies from iatrogenic Cushing’s, so I think he’s just getting loaded up with steroids. It could just be weight gain, but his hands and torso don’t appear to have changed compared to older photos.

Apparently Georgia has some pretty draconian means-testing to qualify for a public defender. I remember reading something like 250% of the federal poverty line or thereabouts. (Which works out to about $36k per year, by the way.) They should really look into fixing that.

They are entirely different drugs with different mechanisms. Taking too much paracetamol/Tylenol/acetaminophen is extremely dangerous for your liver and dosing instructions should be followed exactly. Prolonged use of ibuprofen or other NSAIDs can lead to gastrointestinal ulcers and kidney damage, so only take it for as long as you have to. They both have instructions to take a dose every 6 to 8 hours, so if you’re in significant pain or you have a really bad fever, you can alternate them every 4 hours. For example, paracetamol at 8am, ibuprofen at noon, paracetamol at 4pm, etc.

Also, be careful of “cough” or “cold” medicines like NyQuil/DayQuil, because they usually have paracetamol/Tylenol in them and that counts towards the daily dose limit.

Interestingly, the recurrent laryngeal nerve is looped around that way because the structure of the nerve grows in before the structures of the aorta and other large vessels fully grow in and orient into their correct position, so the nerve ends up looping around them.

Having worked in ERs…nah. People can be pretty damn dumb sometimes.

Being lazy is vaguely kinda sorta correlated with cancer… but that doesn’t account for the fact that humans who are regularly active are also less likely to make other lifestyle choices that are more significantly tied to cancer like smoking and drinking.

This is the problem with a lot of population based studies. Obesity is linked with a lot of health problems like cardiovascular disease, but only some aspects of cardiovascular disease have causative links to obesity and others are sequelae of other factors that tend to be associated with obesity. For example, extra weight/adipose puts more stress on your heart by there just being more body mass to deliver blood to and more oxygen demand from muscles to just physically move the weight around (also a cause of joint problems)… but it’s the poor diet full of cholesterol that clogs up the arteries (aka atherosclerosis) causing myocardial infarction (heart attack).

Oh my fuck. I hate news stories like this. Aspartame falls into the same cancer risk category as eating red meat sometimes and being kinda lazy. A rigorous systematic review was conducted of dozens of studies of aspartame and they did not find a plausible biologic mechanism by which aspartame could cause cancer. Epidemiologically, it’s vaguely correlated, not causative of cancer.

Also, in the Reuters article it notes that a 132-lbs adult would have to drink 12 to 36 cans of diet coke a day for the dose/exposure to become relevant to the risk they’re talking about. This article is talking about one study that is at odds with the systematically reviewed data from 40 human observational studies, 12 experimental animal studies, and 1360 assay/experimental end points to look for the supposed link.

https://www.sciencedirect.com/science/article/pii/S0278691522007475#sec5

It really baffles me how far the GOP is willing to go against policies that would actually help Americans out of sheer spite. I guess I’m relieved that this won’t really affect me now that I’m in graduate school anyways, but it’s still extremely stressful not knowing whether or not things like PSLF will still exist when I’m done with school and have a student loan burden about twice the size of our mortgage.