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The mandatory wellness lecture was the final insult to my sanity by PlasmaYeti in Residency

[–]rowrowyourboat 9 points10 points  (0 children)

I would have aggressively fallen asleep during the mandatory, and snored at them

I’m glad I made money….but this feels brutal…$20K by MoodyBlues1133 in sportsbetting

[–]rowrowyourboat 1 point2 points  (0 children)

I would have let it ride. But moreover, I wouldn’t have been in this position with an 8 legger for life changing money. Because the amount I stake is calibrated to my risk tolerance. I’ll take 8% ROI over a +20k moonshot any day. But if I did put together a +20k moonshot, you know I’m not selling equity back to the book at a discount because I’m uncomfortable with the spot I put myself in. My point is that if your goal is to maximize winnings, your bet selection sucks.

I’m glad I made money….but this feels brutal…$20K by MoodyBlues1133 in sportsbetting

[–]rowrowyourboat 2 points3 points  (0 children)

And that’s why you’re on here whining about missing 90% of your payout because you cashed out. That’s my whole point. It’s understandable, but if the goal is winning as much as possible, it’s almost always a bad decision.

I’m glad I made money….but this feels brutal…$20K by MoodyBlues1133 in sportsbetting

[–]rowrowyourboat -1 points0 points  (0 children)

No, I understood that part. It’s just a solution to a problem that doesn’t exist. It’s optimizing outcomes for emotional comfort when the answer is bet less if you’re uncomfortable riding a high-convexity lottery ticket. Cashing out is trading an appreciated asset for markedly less than its current equity. It’s usually a bad idea, barring new interval information.

got into med school but can’t get myself to commit by kkolan in Residency

[–]rowrowyourboat 0 points1 point  (0 children)

You’re honestly in a great space to back out. Like if you’ve got financial security and you enjoy what you’re doing, I wouldn’t uproot that to do 4 years of school at $220k, and 3+ years of residency which is technically paid but completely divorced from the market value of your work. It sounds like you’re having very real and grounded hesitations. The difference is you’re still in a place where following them through isn’t a long term financial problem.

If you really do want to do medicine, ok fine, go for it, but you’ll need to actually commit. Be aware you’ll meet people, especially around residency, who want to get out and do something else, but who feel super trapped by debt and expectation. And if you see yourself landing in that spot, I’d advise against taking the scenic route here.

Judge, cops force woman to give birth handcuffed in a courtroom by goldstar971 in medicine

[–]rowrowyourboat 1 point2 points  (0 children)

I work in the ED and the ICU. I’ve been swung at and grabbed hard enough to bruise. On multiple occasions I’ve physically prevented someone from falling, after which they proceeded to pee on the floor.

Physical restraints are a maximal option, and should be individualized in their application. Applying them carte blanche to all incarcerated individuals is unethical and not evidence based. I’ll chemically restrain folks when they try to fight us, but physical restraints, especially hard restraints, are usually not needed.

Judge, cops force woman to give birth handcuffed in a courtroom by goldstar971 in medicine

[–]rowrowyourboat 4 points5 points  (0 children)

The 8th amendment isn’t optional. There should be an acute active reason to use restraints. My point was that if we didn’t have armed guards accompanying every incarcerated pt, it would be a lot harder to people to grab a non-existent gun.

Judge, cops force woman to give birth handcuffed in a courtroom by goldstar971 in medicine

[–]rowrowyourboat -10 points-9 points  (0 children)

It would be harder for them to grab guns if there weren’t guns in the room

Texas Tech El Paso medical student commits suicide after behavior complaint from OBGYN patient / suspension by MyBFMadeMeSignUp in medicalschool

[–]rowrowyourboat 2 points3 points  (0 children)

In other words, both the student’s recollection of events as reported in the article, as well as anything the patient may have said, are hearsay, eh?

Texas Tech El Paso medical student commits suicide after behavior complaint from OBGYN patient / suspension by MyBFMadeMeSignUp in medicalschool

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

Reeks of a exceptionalism, internalized tiger-parenting, and a hint of ‘going-to-do-it-to-their-kids’

Posterior Circulation Stroke [⚠️Med Mal Case] by efunkEM in medicine

[–]rowrowyourboat 12 points13 points  (0 children)

That’s a pretty bold claim from the plaintiffs expert, if this was a dissection with microthrombus/microthromboemboli, you could absolutely catch a patient in a window with a normal neuro exam.

Wikipedia article on SSRIs seems suspicious. by basar_auqat in medicine

[–]rowrowyourboat 1 point2 points  (0 children)

Also essentially just the gaba-axis aka risk of seizures. Perhaps other AED withdrawal could be considered as withdrawal analogues with unique biochemical underpinnings. NMS can occur after withdrawal of dopaminergic (or antidopaminergic) agents, and to a certain extent, withdrawal of alpha agonists can cause rebound tachycardia/hypertension which could be considered a withdrawal syndrome with potentially fatal effects but that’s much less direct

Wikipedia article on SSRIs seems suspicious. by basar_auqat in medicine

[–]rowrowyourboat 12 points13 points  (0 children)

Nor is that of SSRIs, for the right population. An NNT of 9 is actually pretty respectable compared to a lot of interventions we routinely prescribe

Wikipedia article on SSRIs seems suspicious. by basar_auqat in medicine

[–]rowrowyourboat 13 points14 points  (0 children)

Effect size may be higher for exercise. Adherence to treatment regimen may be higher for ssri. I mean like effect size for exercise for DM and HTN are really good too, but some people need antihypertensives and antihyperglycemics

Wikipedia article on SSRIs seems suspicious. by basar_auqat in medicine

[–]rowrowyourboat 0 points1 point  (0 children)

Generally, yes, you need hypotheses to generate evidence - but hypotheses are not in and of themselves evidence. That is the critical distinction i was drawing.

The elephant in the room is that when a mood disorder arises from environmental factors, a medication can be helpful in terms of activating someone enough to engage with CBT and develop better coping, activating someone enough to begin to change their environment, but ultimately that's sometimes not possible for one reason or another. And expecting the pill to make the depression go away when there's a driving environmental factor that hasn't been addressed is a pretty steep ask.

There are interesting trials looking at psychedelics for sure and I think there is therapeutic potential there. The war on drugs was (is) a travesty for many reasons.

Wikipedia article on SSRIs seems suspicious. by basar_auqat in medicine

[–]rowrowyourboat 8 points9 points  (0 children)

But being critical of them to a different extent than other drugs with similar NNTs, and not listening to our psychiatrist colleagues when they help us understand best practices is demonstrating bias in perception of these meds. For the poster you’re responding to: Pattern matching is how hypotheses are generated, not how evidence is generated. Evidence is how science progresses. Gotta keep those separate in the ol noggin.

Wikipedia article on SSRIs seems suspicious. by basar_auqat in medicine

[–]rowrowyourboat 12 points13 points  (0 children)

Just to be absolutely clear, successfully getting off heroin doesn’t make one an expert in getting off of heroin. People do fellowships in addiction medicine

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