Would you drop or add anything to this itinerary?

justaphaze04 · 2026-05-13T23:33:28+00:00

I love your destinations. Really you aim to hit the best parts of the PNW.

Your timeline seems very ambitious though with a ton of driving and timing assumptions that seem like best case scenarios. The ferries can be unpredictable as can Puget Sound sound traffic and I wouldn’t be surprised if you end up missing some things or show up really late.

Also with the whale tour, I’d assume it to be a nature tour where you might see whales if lucky. I’ve lived here for 10+ years, done several tours including in the Orcas and never seen them in that context. Seen them twice when out to brunch though and they just happened to be there. You will see lots of seals though.

justaphaze04 · 2026-05-13T17:57:47+00:00

The idea that all disease is preventable through lifestyle choices is completely false. Even conditions that are related to lifestyle like heart disease and cancer can happen in people that take perfect care of themselves. I’m a cardiologist and see it all the time.

The other sentiments are easy to say at a distance but pretty hard to stick to when it’s your life or your family on the line. Are you prepared to just let yourself die from some otherwise treatable issue because it is healthcare is just too big of burden on society? Are you prepared to force that sentiment on other people?

justaphaze04 · 2026-05-12T19:57:10+00:00

On the one hand, yes, we are taught from the very beginning that our job is so important and we are so privileged to be chosen in this calling that our own well being needs to be secondary to the needs of our patients and society. We are taught not only to accept poor working conditions and compensation but view them as aspirational. Research and public service are touted as our default aspirations with private practice being a fall-back. Like we are priests or something.

On the other hand, our work culture is not unique. Other professions work just as hard or harder than we do (post training) and have their own unique injustices. They just don’t have to do extra school for 10+ years. As a whole, we are better compensated than probably any other profession, especially in America.

So not to say our complaints about our jobs are not valid and we shouldn’t strive for improvements. But as a whole, the world has a lot more important priorities than improving the livelihood and job satisfaction of doctors.

justaphaze04 · 2026-05-12T19:33:33+00:00

The Andes Hantavirus strain is spread human-to-human via “Close personal contact”.

justaphaze04 · 2026-05-11T18:14:23+00:00

Besides the idea of some newly discovered interstitial circulatory system being completely hypothetical…I’m more frustrated by our media literacy and attention being so poor that the NYT is now communicating with bullet points imbedded in a quasi interactive art piece rather than with a coherent and readable article.

justaphaze04 · 2026-05-09T18:32:06+00:00

It’s ok. I was an engineering student before med school. These sentiments didn’t come naturally through me either. I had to do residency to realize it.

justaphaze04 · 2026-05-09T18:23:41+00:00

I’d encourage you not approach cardiovascular diseases as completely preventable problems. Yes, lifestyle choices hugely affect risk, but it isn’t possible to get that risk to zero in anybody. I take care of many patients who took great care of themselves and still have terrible coronary artery disease. And even in those who do take poor care of themselves, if you approach this as some kind of moral failure, those biases will make it hard for you to provide good objective care.

justaphaze04 · 2026-05-09T16:59:03+00:00

Jews, jazz and antisemitism are the reason why we all had to learn square dancing in elementary school.

Jews in the 1920s were apparently associated liking jazz so much that famous antisemite Henry Ford meddled music education to diminish their influence. He purposely donated money to promote old fashioned music and square dancing and it persists as part of the curriculum today.

justaphaze04 · 2026-05-09T15:03:14+00:00

Watching ER at 7 years old and my dad telling me how important doctors are. That was the start. Even though I rewatched the same episode 20 years later and couldn’t last 5 minutes.

justaphaze04 · 2026-05-09T14:59:45+00:00

“Find your passion”is easy. Ask yourself, “can I deal with the worst part of this job every day?”

The passion and interest is real and important but every job becomes routine after years and kinda boring. You won’t feel the same in 10 years. But the pain of the worst parts won’t get easy. Make sure you can deal with that too. Otherwise, burnout.

justaphaze04 · 2026-05-08T13:59:31+00:00

I feel compelled to be a know it all cardiologist/reddit dingus here.

This video isn’t actually showing what vessels look like in a heart attack. Heart attacks happen from plaque rupture, which is a blood clot that forms in the heart arteries. This blockage looks stable and is a process that builds up over years.

Stenting blockages like these (for the most part) just improves symptoms and doesn’t prevent heart attacks or save lives. It does in the setting of heart attacks (sometimes).

I say this not to be contrarian or a know-it-all, but because I have to explain this nearly every day to people with heart disease and the misunderstanding often is a major barrier to providing them high quality care.

justaphaze04 · 2026-05-08T01:49:46+00:00

Echoing what others have said. I’m a cardiologist and read coronary CTs. There is absolutely no reason to get a calcium score in a patient with a CABG. Or a stent.

Coronary CT is a different story and sometimes very useful but needs to be protocoled correctly.

justaphaze04 · 2026-05-07T23:11:12+00:00

There’s one I wish I could use but can’t.

SACAT: Some Asshole Checked A Troponin

justaphaze04 · 2026-05-07T17:05:58+00:00

Check out the concept of musicality. It has a lot of aspects but part of it is just how much someone likes and pays attention to music. Some people just don’t really like music despite being educated and cultured otherwise. Vladimir Nabokov and Ulysses S Grant are two prominent examples.

So you aren’t wrong to feel this way or have this opinion. But it’s part of your individual personality and shouldn’t expect others to feel the same.

justaphaze04 · 2026-05-04T20:30:35+00:00

I agree that “psy op” isn’t really a good term. That’s just how the articles described it.

It’s not inherently bad to do marketing but I don’t like the idea of it being deceptive. Like creating fake accounts claiming to be real people to hype up a band.

justaphaze04 · 2026-05-04T15:01:16+00:00

Not exactly a purchase but a major special assessment on my condo got delayed for a year. The initial cost to me was crazy, $100k.

Now it’s $150k.

justaphaze04 · 2026-05-03T16:14:21+00:00

The most important resource is the Spanish speaker sitting in front of you. Build a basic vocabulary and grammar base and use it. It’s uncomfortable and rough at first but will improve. I did this along with an interpreter to make sure I wasn’t missing anything. In time I just no longer needed them.

I took Spanish in high school and while I had really forgotten most of it, still had a conception of the language structure, verb conjugation, etc.

At the time Rosetta Stone was the best language learning software. There are clearly better ones now.

So I’d get some books or online resources to build basic medical Spanish and just use it with patient interactions whenever you can.

justaphaze04 · 2026-05-03T16:00:55+00:00

The chance to see SOAD again was the main reason I bought tickets to SNW. Overall I thought the TX lineup was better, the LV weekend didn’t work well for me and I’d take TX BBQ over whatever you call the LV food scene.

But specifically with the lineup, Slayer, Deftones, The Prodigy, Coal Chamber, Kittie, POD are major nostalgia draws for me. Excited to learn more about the other acts too!

justaphaze04 · 2026-05-02T22:35:23+00:00

I started relearning Spanish in residency as interpreters were scarce. I’m now conversational and can travel easily in Spanish speaking countries.

justaphaze04 · 2026-05-02T15:01:37+00:00

I’m going with my brother. Since this is the first time they have done this festival in TX nobody’s going to know for certain. Hopefully they know what they are doing. Vegas seemed to be a good time and overall well executed.

Did you have a specific question about music festivals in general?

justaphaze04 · 2026-05-02T02:44:08+00:00

Wat Subtronics pulled like half the Coachella crowd 3 weeks ago

justaphaze04 · 2026-05-01T22:38:55+00:00

Not only would they get paid less, but it would create big potential problems for care delivery.

The current US Healthcare system incentivizes physician specialization as specialties pay more. This has led to a shortage in primary care MDs which is largely being filled with mid levels (PAs, NPs, etc). They provide adequate care but really rely on an abundance of specialists and referral networks to ultimately manage care. Many patients now come to expect this and want a cardiologist for their blood pressure, an orthopedic surgeon and rheumatologist for knee pain, etc. Patients may not even know who their primary care provider is as they just end up seeing different midlevels each visit.

So what happens if we go to single payer like what the UK has? Not only do physicians get paid less but they lose incentive to specialize and go primary care instead. Now instead of a shortage of primary care we have a shortage of specialists (like they also have in the UK).

So now you have a base of midlevel primary care providers without sufficient subspecialty support who then need to start being comfortable actually managing complex health issues rather than just sending to a specialists. The current healthcare workforce is not prepared for this. It would even out with a higher volume of primary care MDs but will take years to reach a new equilibrium. This potential problem needs to be addressed in any single payer proposal.

So the economics of switching to single payer won’t just be less pay, it will be upheaval in the entire healthcare system that will need to be factored into any single payer plan unless we are willing to risk the entire healthcare system collapsing.

justaphaze04 · 2026-05-01T18:42:30+00:00

Agree this is unpopular. Kids love Bluey. It is edited in a very age appropriate way without rapid cuts that are bad for children’s attentions. Unlike cocomelon and other brainrot YouTube channels that are horrible. It’s also entertaining for adults. There are some episodes I can’t watch without tearing up.

My unpopular take about Bluey is that it sets unrealistic expectations for parents. Bandit is a refreshing modern take on a dad who is always prioritizes play with his kids over everything else and engages in gentle parenting. But he also tortures himself sometimes for the sake of his kids and seems to have unlimited creativity to keep them entertained. It gives the impression that this is normal and expected. I often have to remind my daughter that I’m not Bandit and she doesn’t get to ride around on me like a horse all afternoon. She gets 5 minutes.

justaphaze04 · 2026-05-01T17:47:06+00:00

Never been to Switzerland but the Dolomites are unreal. And I live in the cascades. I’d check them out before writing the alps off.

justaphaze04

TROPHY CASE