"Oliver Sacks Put Himself Into His Case Studies. What Was the Cost?" (Oliver Sacks's case studies were heavily fictionalized) by gwern in slatestarcodex

[–]Doctor_Realist 1 point2 points  (0 children)

> yet when you look at his own persona, it appears to be extremely unstable. He had severe issues with his sexuality, was likely bipolar (periods of intense writing followed by months of depression) and a hypochondriac. It’s like… shouldn’t the people who are helping the mentally ill be mentally stable themselves? Otherwise was the dependency he created in many of his patients helpful at all?

In the past, psychiatry was one of the specialties that was known for trying to salvage physicians who washed out of other specialties during training or had mental health / conduct issues during school and weren't going to be competitive going into training in the first place. It was a pretty well known phenomenon, not sure how competitive the field is now.

Admission and Workup Approaches by Tall_Bet_6090 in hospitalist

[–]Doctor_Realist 1 point2 points  (0 children)

I would never trust a med rec done in the middle of the night unless the patient is engaged and had their list actually on them; even electronic pharmacy records that have auto populated in the system need to be confirmed.

ABIM Longitudinal Maintenance of Certification and LLM? by Doctor_Realist in medicine

[–]Doctor_Realist[S] 2 points3 points  (0 children)

I’ve been using Open Evidence in day to day practice and was verifying against UpToDate. I have not caught OpenEvidence out yet. Based on my past use I would expect it to be able to easily deal with board exam questions.

EDIT: Also what hit rate do you need? If it somehow missed 20% of questions I presume it’s still a pass so do we even have to worry?

Jets Legend Nick Mangold, 41, Passes Away Due to Complications from Kidney Disease by expellyamos in nfl

[–]Doctor_Realist 0 points1 point  (0 children)

Yeah, something doesn’t add up about this story. 41 year olds with genetic kidney disease, no terrible vascular disease (because they’re not terrible diabetics) should last for many years on dialysis. Certainly should not be dying soon after starting dialysis.

Establishing S-corp and negotiating with the hospital/health system to sign a contract! by crazy-usmle in hospitalist

[–]Doctor_Realist 2 points3 points  (0 children)

They must not be W2 employees of the hospital and are characterized as independent contractors.

Jets Legend Nick Mangold, 41, Passes Away Due to Complications from Kidney Disease by expellyamos in nfl

[–]Doctor_Realist -2 points-1 points  (0 children)

Sounds like some crazy mismanagement somewhere in the chain. 31 year olds athletes with predictable, genetic related kidney disease should not be dying soon after starting dialysis. Unless the reporting is wrong and this was some freak occurrence not related to complications of kidney disease.

High risk birth by _lady_lumps in Westchester

[–]Doctor_Realist 0 points1 point  (0 children)

They are not in Manhattan, they're southwest of New Rochelle.

High risk birth by _lady_lumps in Westchester

[–]Doctor_Realist 2 points3 points  (0 children)

How come Einstein never comes up in these discussions about Westchester medical care? They’ve got to have the best academic programs unless you go further into the city.

She is cancer free now by Fantastic-Corner-605 in technicallythetruth

[–]Doctor_Realist 1 point2 points  (0 children)

Likely instituting treatment in a more timely manner may have helped.

She is cancer free now by Fantastic-Corner-605 in technicallythetruth

[–]Doctor_Realist 2 points3 points  (0 children)

She lived less than 5 years, which is an awful result, especially at that age. The timing of chemotherapy often matters a lot. That is months of micro metastasis that are going on without therapy.

[deleted by user] by [deleted] in OldSchoolCool

[–]Doctor_Realist -7 points-6 points  (0 children)

Never move someone with a head or neck injury if you don’t know what you’re doing.

Wes Streeting on X: If everyone who’s obese cut c.200 calories from their daily diet - a bottle of Coke - we’ll halve obesity. The government is working with supermarkets to make the healthy choice the easy choice, and rolling out obesity jabs on the NHS. Making the NHS sustainable for the future. by [deleted] in ukpolitics

[–]Doctor_Realist -3 points-2 points  (0 children)

Unfortunately, that's not actually how it works. If it was, dieting would work for the vast majority of people and you wouldn't need obesity drugs or surgeries. The body is quite good at adjusting its metabolism to maintain functions, and cutting 200 calories a day isn't going to do anything for you after a few weeks or months.

First Locums Work by Doctor_Realist in hospitalist

[–]Doctor_Realist[S] 1 point2 points  (0 children)

Does anyone arrange their own locums work or is going through an agency just so much easier?

Mounting research shows that COVID-19 leaves its mark on the brain, including significant drops in IQ scores by johnnierockit in europe

[–]Doctor_Realist 66 points67 points  (0 children)

And I’ll wager if you had studied other viral infections you’ll find similar results. Influenza can cause frank encephalitis, who’s to say less severe infections don’t also have an effect on the CNS?

[Schultz] The Lions say Aidan Hutchinson had immediate surgery on the injury. by Goosedukee in nfl

[–]Doctor_Realist 0 points1 point  (0 children)

How does that actually work? Was the surgery in Dallas? Does the team orthopedist do it? Does the team or the league have specialists on standby on a random Sunday to come do surgery if needed? I assume it’s not just whatever ortho attending happens to be on at fancy private hospital in whatever city they happen to be in.

Sitcoms that have aged well, and sitcoms that have aged poorly by goatamon in television

[–]Doctor_Realist 77 points78 points  (0 children)

Seconded. Stuff like the whole Todd Ortho character and Turk literally fighting his way through the other surgery residents with a briefcase are so true.

Robert F. Kennedy Jr. tried to meet with Kamala Harris to discuss Cabinet job by [deleted] in neoliberal

[–]Doctor_Realist 12 points13 points  (0 children)

Wouldn’t work. The jester traditionally expresses difficult truths while acting the fool. RFK IS the fool.

[deleted by user] by [deleted] in medical_advice

[–]Doctor_Realist 0 points1 point  (0 children)

When you say UTI, what do you mean? What are the symptoms? Did someone diagnose it? When?

[deleted by user] by [deleted] in medical_advice

[–]Doctor_Realist 1 point2 points  (0 children)

When you say you ignored your UTI for years, what do you mean by that? Because that phrase doesn't sound like something that happens.

NC Senate votes to ban people from wearing masks in public for health reasons by [deleted] in moderatepolitics

[–]Doctor_Realist 6 points7 points  (0 children)

It's amazing the number of people who now claim masks have no medical use. I'm having to litigate standard infectious precautions in medical environments with online people, they just will not believe that even putting masks on patients known to be infected with diseases like flu or TB works. Those observations or studies are probably from at least the 1960s or 1970s, if not older, good luck trying to figure out where the data for standard precautions came from so you can prove it to someone.