It was a legitimately nonprofit hospital and he probably was overpaid, but at least he was a practicing physician at one point and did seem to give a damn about his staff.

I once worked at a hospital in the ER where the department director was a union-busting bastard, but the CEO was pretty reasonable. After I left, one of the other ER techs went to the CEO about our pay being messed up and got everyone $5-6/hour raises to actual market rate. Also, there were a few weeks when we were really understaffed that the hospital encouraged admin folks to volunteer as “candystripers” in the ER to do stuff like help clean/turn over rooms, and answer patient call lights for water, blankets, etc. And the CEO was down in the ER for a couple hours every evening helping out most of that time period. It was encouraging to see the CEO of the hospital putting on some gloves and helping us with basic stuff like cleaning and stocking.

The problem with AI and poorly educated professionals is not the ability to diagnose and treat based on evidence-based medicine. The problem is that you have to know enough about medicine, and enough about real human people to know what kinds of questions to ask in the first place. If nothing else, there is a massive amount of information gained from a patient’s body language, mannerisms, behavior, and the physical exam itself that would be extremely hard to quantify in a meaningful way for someone without the background education and experience to come to any useful conclusions.

Were I in any other field, I might agree with you, but given that I am in the medical field, stupidity and incompetence cost real human lives and I cannot tolerate that if it can be at all avoided.

It’s not quite a catchphrase yet, but when discussing cases or whatever, I frequently use the sentence: “I’m not sure, lemme go look that up.”

I worked professionally in medicine for a few years before starting medical school, and thus far my approach has been to entirely disregard anything they said on the subject and continue as normal unless the nonsense they’re spouting has the potential to cause serious harm. Our patient care professor is training us to listen attentively, then dismantle the nonsense as politely as possible while guiding the patient’s viewpoint back to something approaching reality.

There’s some things you look for that are difficult to describe to someone who hasn’t seen it before. That’s part of why experience is so valuable in Emergency Medicine, and it’s not uncommon to put your best nurses out in triage. People will do this kinda twitchy/wilting/loss of focus/change in pallor/change in posture right before they go down. I don’t have a good way to describe it, and it might be easier to draw even, because it really is a body language thing and the general appearance of the patient that can inform your decision making.

I have thought about trying to plan out a learning algorithm that could spit out suggestions for triage level and preliminary tests based on input data like vital signs, symptoms, and complaints… but I would never implement something like that as anything beyond a tool for the nurses at triage to use. There would have to always be an option to override the algorithm because there’s some aspects of patient presentation that are not easily quantifiable. I’d never be able to explain it in a way that one could input it into a computer, but even with my limited experience, I can tell which patients are going to crump on me.

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.

At least I can rest assured of the fact that AI will be next to useless in my intended field. Emergency medicine is an environment where you get a random constellation of symptoms and complaints with very little direction on which are related to the current illness, and which ones are not currently relevant. Also, in the time it would take to get all the info into the AI for a trauma/cardiac/code situation, the patient might be dead or rapidly heading in that direction.

I try to remind myself that I’ve only gotten as far as I have because of hard work. I don’t have any special talent, I’m not some kind of genius, I just know how to work hard for the things that matter.

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

Let’s rewind to the part where you look at why they are mortal enemies, and realize that the same problem is still happening in the West Bank at the same time as the mass murder in Gaza.

Israel lost 0.014% of its population to the Hamas attack. Gaza has lost about 0.52% of its population to Israel’s rampage and that over 40% of those deaths are children. How is that comparable at all?

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.

Elective limb amputations, probably.

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.

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.

I’m always rather disheartened when I talk to people about the expectations placed on residents in the American medical system because a common response is to say that it doesn’t matter and they deserve it because they’re going to be doctors making a good salary soon enough. I’m in my second year of medical school now, so residency’s a little ways off, but I can’t help but think that people will think of me as spoiled and entitled for pushing back against the 80 hour work weeks that are normal in residency.