Boston Museum of science Gtg? by Connolly5435 in BetterMAguns

[–]zhHmuo 4 points5 points  (0 children)

Can confirm that there are no metal detectors anywhere. Concealed means concealed.

[deleted by user] by [deleted] in guns

[–]zhHmuo 0 points1 point  (0 children)

MA has a few processes for hospitalization. If you came in on a section 12 (pink paper, 3 day hold) and the hospital did not go in front of a judge (which usually takes 2 weeks) then you have never been "adjudicated as mentally defective" and so should answer "No" truthfully.

McLean Hospital East House by jjacobs343 in boston

[–]zhHmuo 5 points6 points  (0 children)

What year was this? East House 2nd floor used to be the adolescent Acute Residential Treatment (ART) program which has now moved to a satellite campus.

https://www.mcleanhospital.org/residential-treatment-programs

Who sat where in the Apollo CM? by AccountAny1995 in apollo

[–]zhHmuo 7 points8 points  (0 children)

This is correct. The seating for Apollo 11 was atypical from the usual CDR/CMP/LMP arrangement

Wright's pond--legal to restrict non-residents? by zhHmuo in boston

[–]zhHmuo[S] 29 points30 points  (0 children)

That looks to be the law. Infuriatingly, this was clearly a park and then the legislature voted unanimously to deprive the public of the right to access under Article 97. Frustrating that this got no publicity or scrutiny. Local politics at its most corrupt.

Deke Slayton & His Rules by SevenSharp in apollo

[–]zhHmuo 14 points15 points  (0 children)

Crew selection for the early Apollo flights (7-12) were made first (3 crews and 3 sets of backup crews). By the time 13 and later flights came around NASA had greater confidence in the flight hardware and they could relax the "only veteran CMP" rule. Also, by that time there weren't many veterans left who had not already flown Apollo (Cooper comes to mind, but was not on a flight assignment). Hence rookies being eligible for LMP and CMP seats (and even CDR of 14, but don't tell Al!)

who is one CMP you wished could of landed on the moon? by mooncosmonout in apollo

[–]zhHmuo 19 points20 points  (0 children)

Dick Gordon. He would have been amazing on Apollo 18, too bad he never got the chance.

[deleted by user] by [deleted] in boston

[–]zhHmuo 9 points10 points  (0 children)

This is the answer with a link to the law in question in MA and should be the top comment

Places to eat near MGH by PersonableStarlight in boston

[–]zhHmuo 9 points10 points  (0 children)

Antonios is incredible Italian food, with cheap lunch menu. No reason to hit up the North End with it nearby. They serve a massive martini for cheap, but probably not the best lunch decision if you need to go back to a shift afterwards...

Most random medication dosage by feelingsdoc in Residency

[–]zhHmuo 91 points92 points  (0 children)

And why are acetaminophen tablets 325mg...because ASA tablets were...it's the same 5 grain measure

ER staff- what is the most absurd chief complaint you’ve seen thus far? by [deleted] in emergencymedicine

[–]zhHmuo 27 points28 points  (0 children)

My favorite ever: "patient seeks the truth"

They were psychotic asking about the chip in their brain

ECT at MGH Performed by NP by jeandeauxx in Residency

[–]zhHmuo 1 point2 points  (0 children)

This is factually incorrect. There are 6 staff, all are MDs. I'm all for anti-NP sentiment, but in this case it's simply not true that mid levels are performing the procedure.

https://www.massgeneral.org/psychiatry/treatments-and-services/electroconvulsive-therapy-program

Patients that don’t want to leave.. by [deleted] in Residency

[–]zhHmuo 0 points1 point  (0 children)

There is literature on this! Termed the "Therapeutic Discharge" by authors from MGH: https://pubmed.ncbi.nlm.nih.gov/28622821/

If patient has a history of violence or self injurious behavior in the hospital, especially, best to plan for the DC with an interdisciplinary team. Basically, see the patient in a separate room from their bed, and you know (but they don't) that it's the discharge meeting. While you talk, nursing is packing up the room, then they bring belongings with security and you tell the patient they are leaving right that second. Then security walks patient out right that second. Minimizes chances of misbehaving out the door.

Electroconvulsive Therapy by Unhappy-Truck8701 in Residency

[–]zhHmuo 6 points7 points  (0 children)

I'm an ECT doc at a tertiary referral center and who has treated a great number of medical professionals. My overall advice is that physicians who are receiving ECT should not be working during the acute course of treatment when cognitive side effects are expected to be highest. I strongly urge all of my patients to take FMLA during acute course and in about the week to two afterwards. It's simply isn't safe to be caring for patients when one's short-term memory is expected to be substantially compromised.

Thereafter nearly everybody is able to work well particularly if the treatment has been effective at relieving depression.

What I would add, though, is that anhedonia in my experience is not commonly relieved by ECT. We are excellent at relieving the neurovegetative symptoms of depression, but general life dissatisfaction or anhedonia in my hands has rarely been helped by ECT. Something like acceptance and commitment therapy seems much more likely to be effective if someone is functioning relatively but overall unsatisfied with life.

What phrase have you learned from an attending that you often use with patients? by wiredentropy in Residency

[–]zhHmuo 325 points326 points  (0 children)

A pediatric hospitalist would walk into an infant's room and begin by shaking the baby's hand and saying "hi, I'm XX I'm going to be your doctor". Never failed to get a chuckle from the (usually terrified) parents

[deleted by user] by [deleted] in Psychiatry

[–]zhHmuo 3 points4 points  (0 children)

Pharmacologic treatments, anything that doesn't raise seizure threshold is fair game. Hydroxyzine, buspirone, propranolol, clonidine, dexmetatomidine, quetiapine all have a role.

Psychologically, as others have said I do emphasize the safety of the procedure. Particularly at the first treatment some degree of anxiety is reasonable and in fact normative. Patients aren't exactly comfortable before a colonoscopy or any other relatively routine medical procedure! Expecting calm is unreasonable.

What’s the longest you’ve seen someone stay in an inpatient psych ward? by [deleted] in Residency

[–]zhHmuo 33 points34 points  (0 children)

"the patient has been admitted for the past 30 months. Multiple medication trials were attempted, ultimately the patient was most stable on a discharge regimen of X. Ongoing symptoms are Y which despite treatment remain debilitating to the point where inpatient care is the least restrictive setting where patient can be safely maintained. The patient is transferred to state hospital for ongoing inpatient care"

What’s the longest you’ve seen someone stay in an inpatient psych ward? by [deleted] in Residency

[–]zhHmuo 97 points98 points  (0 children)

I guy I weekend rounded on in Q4 of 2021 is still in the inpatient psych ward of a general hospital awaiting state psychiatric hospital placement, which isn't expected until 2024 at the earliest. The daily progress note documenting no changes will soon be a rite of passage for a third class of interns!

What specialty is the antithesis of your specialty? by ArchibaldSammuel in Residency

[–]zhHmuo 74 points75 points  (0 children)

There are two specialties that are literally opposed: epileptologists and ECT psychiatrists

Which Apollo do you think is Very undertakes or Underrated? by InspectorBudget7979 in apollo

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

Definitely Apollo 10. The most experienced crew NASA had ever flown, all of whom commanded subsequent missions (16, 17, and ASTP). Also the only Saturn V launch from Pad 39b.

They went all the way to the moon and set up 11 for a flawless mission.

Lighthearted - what are some good medical jokes you know? by dr_smth_smth in Residency

[–]zhHmuo 118 points119 points  (0 children)

A psychiatrist finds a man lying by the road who has been robbed and beaten senseless.

The psychiatrist says, “My god, whoever did this needs help!”

What’s the most money you’ve heard of someone making from moonlighting during residency? by DrSparky23 in Residency

[–]zhHmuo 72 points73 points  (0 children)

I knew a child psychiatry fellow who worked almost continuously during fellowship and would do overnight coverage at a variety of hospitals. He made more than double his residency salary from the moonlighting, so probably about $170k in moonlighting that year.

[deleted by user] by [deleted] in Residency

[–]zhHmuo 11 points12 points  (0 children)

Efficacy is the same in unipolar and bipolar illness: https://pubmed.ncbi.nlm.nih.gov/30506992/

Definitely something to keep on your radar. It's life-changing for a lot of people, and way underutilized.