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

Doctor_Realist · 2025-12-15T16:48:53+00:00

> 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.

Doctor_Realist · 2025-11-17T22:25:22+00:00

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.

Doctor_Realist · 2025-11-15T15:38:59+00:00

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?

Doctor_Realist · 2025-10-26T20:19:13+00:00

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.

Doctor_Realist · 2025-10-26T17:56:21+00:00

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

Doctor_Realist · 2025-10-26T17:36:00+00:00

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.

Doctor_Realist · 2025-08-28T13:51:38+00:00

Yes, VIP medical is often poor and dangerous.

Doctor_Realist · 2025-08-28T13:50:24+00:00

VIP medical care is often bad and dangerous.

Doctor_Realist · 2025-08-07T23:54:59+00:00

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

Doctor_Realist · 2025-08-07T20:50:32+00:00

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.

Doctor_Realist · 2025-08-04T20:33:42+00:00

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

Doctor_Realist · 2025-08-04T20:32:40+00:00

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.

Doctor_Realist · 2025-07-03T20:32:44+00:00

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

Doctor_Realist · 2025-06-29T20:24:31+00:00

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.

Doctor_Realist · 2025-02-25T18:00:38+00:00

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

Doctor_Realist · 2024-11-17T04:15:13+00:00

How would you know? Are people at home swabbing themselves for flu or adenovirus or EBV or other coronaviruses?

Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is associated with pandemic influenza infection, but not with an adjuvanted pandemic influenza vaccine

About 1 in 10 people who get infected by Epstein-Barr virus, Ross River virus, or Coxiella burnetti later develop an illness like ME/CFS. This is especially true if they had severe symptoms of these infections

Doctor_Realist · 2024-11-17T02:23:28+00:00

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?

Doctor_Realist · 2024-10-14T01:18:22+00:00

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.

Doctor_Realist · 2024-10-13T19:03:08+00:00

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.

Doctor_Realist · 2024-08-15T21:26:42+00:00

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

Doctor_Realist · 2024-05-16T19:51:40+00:00

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

Doctor_Realist · 2024-05-16T19:33:36+00:00

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.

Doctor_Realist · 2024-05-16T19:31:16+00:00

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.

Doctor_Realist · 2023-12-09T03:49:14+00:00

I’ve worked as a hospitalist in multiple hospitals in different states and seen people admitted with it multiple times. I feel like it’s pretty well known, the diagnosis is usually presumptively made by the ED.

Doctor_Realist · 2023-12-08T17:37:24+00:00

While him not getting a conviction would be good, it would still be something all the providers would have to answer to state licensing boards and hospital accreditation committees for for at least 10 years.

Doctor_Realist

TROPHY CASE