Neurophobia’, a term first coined by Jozefowicz in 1994, describes medical students’ fear of neurology 2. It is a chronic illness that begins early in medical school 4. Physicians and medical students alike often state that neurology is the most difficult subject in the medical school curriculum, and that their knowledge about the subject matter is limited, leading to a lack of confidence in managing neurology patients 5, 6, 7. [link]
There are lots of other phobias, too. Pick one up as you check out of med school.
Marriage, however, proved to be a towering practical problem — Princeton, where Feynman was now pursuing a Ph.D., threatened to withdraw the fellowships funding his graduate studies if he were to wed, for the university considered the emotional and pragmatic responsibilities of marriage a grave threat to academic discipline. [Here]
The above is about Richard Feynman, but reminds me of a story closer to home, told to me by a consultant dermatologist (who I will call CS) and former academic. CS, then a senior registrar, on entering the departmental library, was pleased to see the elderly professor reaching for books on the top shelf. CS, with evident pride, told the professor that he had good news: he was engaged to be married. The professor replied: ‘Sorry to hear that CS, I had high hopes for you’.
It was not deliberate policy; it simply seemed to be only men who applied, usually refugees from the twin miseries of academia: low salaries and high tables.
Ah, those were the days…
The Fear Index, Robert Harris
When you ask me that question I am gonna revert to my ethnic heritage and answer your question with a question: On what planet do you spend most of your time? As you stand there with a picture of the President defaced to look like Hitler, and compare the effort to increase health care to the Nazis, my answer to you is, as I said before, it is a tribute to the First Amendment that this kind of vile, contemptible nonsense is so freely propagated. Ma’am, trying to have a conversation with you would be like arguing with a dining room table: I have no interest in doing it.
Barney Frank, in response to questioner at a town-meeting in Dartmouth, Massachusetts, broadcast on CNN (18 August 2009).
One thing about trying to put the Internet and computing in context, is that you are forced to look back at the history of other communication revolutions (pace Tim Wu, John Naughton etc). It is now a well trodden path, but one I still find fascinating. Even down to the details of how the cost of distributing images or 3D moulages had an effect on my own specialty. The following caught my eye — or maybe my nose.
“When paper was embraced in Europe, it became arguably the continent’s earliest heavy industry. Fast-flowing streams (first in Fabriano, Italy, and then across the continent) powered massive drop-hammers that pounded cotton rags, which were being broken down by the ammonia from urine. The paper mills of Europe reeked, as dirty garments were pulped in a bath of human piss.”
”On the business side , its advertising inventory, whether it is sold directly or via third parties, is made of different kinds of ads, ranging from high-value brands such as Rolex or Lexus to low-paying advertisers, like the toe fungus ads used to fill unsold spaces.”
You can’t sell news for what it costs to make – The Walkley Magazine – Medium
Well, I thought the Swiss connection with Sherlock Holmes were the Reichenbach falls (I had to visit, a few years back). But no, I read that:
Except in Switzerland, where the stories were banned from railway bookstalls for fear they’d inspire criminality, Sherlock Holmes was big business from the moment of his inception.
But of more interest to the medic:
In 1882, as a newly qualified doctor with a practice in Southsea, Arthur Conan Doyle found himself chronically short of sick people. He therefore used the empty office hours to write his tales about the “consulting detective” who was based on Joseph Bell, the Edinburgh surgeon who knew at a glance what was wrong with the patients parading before him
There is a widespread delusion in the UK that you can accurately plan how many doctors you need. This is a mistake, both for society and for the doctors themselves. As we move forward, I think we will see more medics emulating one of the great ones.
And, as for the book, reviewed in the FT (‘The life and death of Sherlock Holmes’), it highlights that Holmes’ nemesis was not Moriarty, but lawyers.
WHAT do you call someone who is over 65 but not yet elderly? This stage of life, between work and decrepitude, lacks a name. “Geriactives” errs too much on the side of senescence. “Sunsetters” and “nightcappers” risk being patronising. Perhaps “Nyppies” (Not Yet Past It) or “Owls” (Older, Working Less, Still earning) ring truer.
I am OK with soon (as in the David Bowie song) being patronised. I like ‘sunsetters’ best. Sipping G+T watching the sun go down, in Africa.
Note added in proof: Here are some more:
Hopskis: Healthy Old People Spending Kids’ Inheritance
Woopies and Jollies: Well Off Older People, and Jolly Old Ladies with Lots of Loot
“Just fun or a prejudice? – physician stereotypes in common jokes and their attribution to medical specialties by undergraduate medical students”
Paper here. Seriously.
My mother in law has two ‘Italian’ cats. One has worms, the other apparently not. Medication time. The diseased cat refuses the medication, whatever enticements are on offer. The undiseased (or cat at ease) scoffs not only his own medication, but that of his partner.
There are plenty of cats in South Wales, and I doubt that coal dust kills off the worms. Julian (Tudor-Hart), where did the idea come from? [ Yes, before you write in, not quite the inverse care as JTH meant it, but metaphors are the viruses of novelty, so who knows.]
Via Bruce Schneier:
The trouble began last year when he noticed strange things happening: files went missing from his computer; his Facebook picture was changed; and texts from his daughter didn’t reach him or arrived changed. “Nobody believed me,” says Gary. “My wife and my brother thought I had lost my mind. They scheduled an appointment with a psychiatrist for me.”
But he built up a body of evidence and called in a professional cybersecurity firm. It found that his email addresses had been compromised, his phone records hacked and altered, and an entire virtual internet interface created. “All my communications were going through a man-in-the-middle unauthorised server,” he explains.
How to select medical students…………..
On the topic of quotations, though, a longer recent discussion about Hanlon’s Razor on the Farnam Street blog includes this rather nice one from the German general Kurt von Hammerstein-Equord:
I divide my officers into four groups. There are clever, diligent, stupid, and lazy officers. Usually two characteristics are combined. Some are clever and diligent – their place is the General Staff. The next lot are stupid and lazy – they make up 90 percent of every army and are suited to routine duties. Anyone who is both clever and lazy is qualified for the highest leadership duties, because he possesses the intellectual clarity and the composure necessary for difficult decisions. One must beware of anyone who is stupid and diligent – he must not be entrusted with any responsibility because he will always cause only mischief.
A large part of Kahn’s legend rests on his fame as a pedagogue, and although his parallel teaching career was driven by financial necessity, he became renowned for his ability to inspire students with a more elevated vision of professional practice than the technically advanced but psychically stunted approach characteristic of postwar American architectural education. (emphasis mine)
From a (book) review in the NYRB about the late architect Louis Kahn (Salk institute etc). “Psychically stunted.” Sounds like some other sort of professional education I am more familiar with.
I guess you could call this inverse dermatology.
Thanks to Betsy DeVos & Co., “school choice” has become a hot-button issue in the US. But across the pond in Germany, choice looks a lot less like private school vouchers and a lot more like…democracy. At Dolli-Einstein-Haus elementary school, kindergarteners exercise their voting rights weekly through “kids’ councils,” collectively choosing everything from class activities to what’s served at snack. The one limit on their civil liberties? Teachers reserve the right to decide when a kid needs a diaper change—to which we say, fair enough.
Some nice memes in this letter from an MD student in Australia. Please discuss. Pharma might be interested
Considering this, if we thought about the pervasive attitudes that inform our definition of a “good” medical student as a disease, it’s hard to believe that we would not try to treat it.
Edward Tufte’s ‘The Cognitive Style of Powerpoint’ is funny. The problem is that it is not just funny, but deadly serious. Literally. His argument and case studies concern how humans died because people failed to understand how to communicate. And the title says it all. Powerpoint (at least its templates) degrades communication.
Communication is a big thing in medical education, and it is not unusual to have to sit through tedious talks on the subject. They usually start with Powerpoint slides, so at least you know that they are not going to say anything worthwhile and you can get your phone out and play.
Below is a memo, from Jeff Bezos, of Amazon.
Perhaps the single most important thing we could do to improve university education to is to remove all copies of Powerpoint. Words matter. Sentences even more.
I saw this giant problem in my education, and I actually designed a course called, “Physician Heal Thyself, Evidence-based lifestyle.” I brought in all these doctors who are experts in sleep medicine, sleep, fitness nutrition, food as medicine, functional medicine, integrative medicine, osteopathy and acupuncture. I got them all in a room and said I want you to teach students what we’re missing. We need to make this medical school education and have to implement this into the board certification programs as well as board exams. If it’s not required, it’s not going to be taught.
No, I am not taking this too seriously. Awhile back, I compiled a list of all the things we needed to
inflict on / ask medical students to know : I had to buy a larger hard drive. And as for this ‘new medicine’ George Bernard Shaw described it a long time ago.
Emma Morano’s singular achievement in life may have been perseverance. She lived for 117 years, crediting her longevity to raw eggs and her lack of a husband. She died on April 15.
For a flavour:
Now if I had to pick, I would overcome my suckerproneness and take the butcher any minute.
Incerto here. Deadly serious.
Their conclusion was that there are 25m tonnes of spiders around the world and that, collectively, these arachnids consume between 400m and 800m tonnes of animal prey every year. This puts spiders in the same predatory league as humans as a species, and whales as a group. Each of these consumes, on an annual basis, in the region of 400m tonnes of other animals.
Martin Nyffeler of the University of Basel and Klaus Birkhofer of Lund University, quoted in the Economist.
“An estimated 400–800 million tons of prey are annually killed by the global spider community” Link
This weekend, my wife and oldest daughter visited her first-choice college, the University of Tennessee. There was one curious moment in an otherwise wonderful weekend. The tour guide noted that the university was there to help students get through the trauma of exams. It brought in masseuses to massage away the stress. It rolls out a sheet of paper, passes out crayons, and lets the students express their rage against algebra. Oh, and it vowed to bring in puppies, so students could cuddle something cute to take the edge off their anxiety.
‘Some diversity training-programs, for example, are like blistering — they are somewhat painful to endure and have no beneficial effects.’
Timothy Wilson in Redirect, the book that nobody from HR seems to have read.
There is only one way to ensure that assessment is light-touch. Universities should rebrand themselves as banks.
Comment (Mintaka) on an article on the TEF from one of the HE commissars (Nick Hillman).
In 1924, a 30-year old journalist on the Daily Express came to Cambridge aiming to interview Haldane. She was Charlotte Burghes, née Franken, and she had a young son, Ronnie. Haldane and Charlotte became lovers, but before they could marry she had to seek a divorce, a procedure that carried substantial social stigma at that time. A university committee resolved to strip Haldane of his readership, which was only restored by successful legal action.
“books of the type written by the current hotshot Op-Ed writer at the New York Times may get some hype at publication time, manufactured or spontaneous, but their five year survival is generally inferior to that of pancreatic cancer.”
Nassim Taleb Numbers matter: the Lindy effect at work.
After my earlier post, Alun a dentist and advisor to dentists reminded my of a few more and some now ones”
This stops here….
Except that the Economist (14/1/2017) offers some additional ones (beyond a “distutility of…”)
– a quandary of economists
– a befuddlement of economists
– and my favourite: a surplus of economists
Which all leaves me a a little discombobulated.