My psychiatrist, a relatively-well-known expert in his field: Here’s the thing about doctors: you can’t trust us. You should never trust doctors, because we do not know what we’re doing. Some of us THINK we –
Me: I mean, some of you – I feel like you pay attention to –
Him: No!!! I don’t know what I’m doing, no doctor ever does! It’s part of the job, it’s – just, do your own research, go on PubMed and stuff, tell me if you think I’m wrong, get a second and third and fourth opinion if you think I’m – it’s just, medicine is a bad field! It’s so unscientific and we’re not held to any real kind of STANDARD and we’re just so SMUG – just, don’t trust us! NEVER TRUST DOCTORS.
Me: Okay, so, I swear you this solemn oath: I will look up every medical thing I am ever subjected to on PubMed.
Him, now feeling uncertain of himself again: …except, of course, don’t spend TOO much time on there, don’t tired yourself out – because, you know, we don’t need you getting all hypochondriac and anxious about – everything. And look at the – methodology and everything, obviously, you have to keep in mind that most research is also bad, it’s just – doctors! WE don’t have ANY standards, so –
Me: Yeah, I know, I know, you gotta strike a reasonable uh – paranoia balance?, or, uh –
Him: Yes, right. It’s important to have a REASONABLE LEVEL of paranoia.
Dr James Barry, the first doctor to perform a successful C section wherein both mother and child survived, was a huge champion of handwashing at a time when most doctors didn’t wash their hands. For this reason, many of the chilldbirths he delivered resulted in healthier babies and mothers. He was also a gay trans man, who specifically wrote that upon his death he wished for his body to be taken in its nightshirt, wrapped in his sheets as a shroud, and placed into the coffin so that nobody would see his body. His wishes were not respected, and as a result he was outed at his death.
i’ve also been informed he had a poodle. He named his poodle Psyche. I’d just like to congratulate him on being an excellent human being, who not only pioneered modern medicine but also had good taste in dogs. that is all.
types of responses to this post
i thought this was fake but it’s not
here’s the sawbones episode about him
cis people
He was also reportedly quite the ladies’ man, and he’d apparently carried a child to term and gave birth.
he’s one of my favorite historical figures and ive read a lot on him including the biography Scanty Particulars by Rachel Holmes. a lot of the details of his life are difficult to figure out, partly cause he was very private and partly cause he had so many rumors surrounding him. here are some of my fave facts about him:
-he was very concerned with protecting poor people, women and people of color, aka all the people most of upper class british society at the time cared the least about. he worked to reform prisons and hospitals in south africa at risk to his own career, and also improved the conditions under which poor enlisted british soldiers and their families lived
-he was kind of a known hothead. he was rumored to have fought at least one duel (probably not true though). florence nightingale hated him even though they had similar ideas about medicine because they had such a clash of personalities in the brief time they worked together
-he was a vegetarian and took a goat with him on sea voyages so he could always have fresh milk
-even though he had an abrasive personality and made a lot of enemies, his patients, especially the women, really loved him because they felt like he knew what he was doing and actually cared about their health
-he died poor because the british army ripped him off >:/
edit i almost forgot the best thing. he didn’t just have one poodle named psyche. he had a bunch. when one died he would get a new poodle and name that one psyche too
my professor spent our entire seminar whining about how there’s too many girls in our group and not enough boys. he was like “i’m not saying women can’t be good surgeons but we need more men” no, we don’t. men suck. deal with it.
CRY ALL YOU FUCKING WANT YOUR TEARS DON’T MEAN SHIT TO ME. YOUR TEARS MEAN DICK TO ME JUST SO YOU KNOW
Okay so not to be that person who adds on to a post with their own story but my mom is a doctor and when I was eleven she took me to these all-female seminar led by a woman who was the head of a hospital because my mom is an empowered and independent woman who wanted her daughter to be the same way and so there’s like thirty females surgeons in the room, all sitting around his huge circlular confrenece table and talking about their experiences in becoming surgeons
most of them were like “everyone told me I should become a nurse or a pediatrician” and “people assume that I don’t know what I’m doing” you know, your average sexist bs
one of the women’s last name was starboard (yeah I know great name) and she was talking about how even though now she was one of the most accomplished surgeons at the hospital, the male scrub techs (read: guys who didn’t go to fucking medical school) and some of the male doctors call her starbitch in the OR because they (scrub techs mostly, strangely enough) try to suggest different ways to care for the patient and she always tells them no you didn’t go to med school and I did and so they would go out of their way to get the male doctors to treat the patient differently and then she would have to argue with him to prove what she was doing es right but sometimes the male doctor would come and take over the case anyway and this went on for a while
but then the hospital statistics changed bc this woman was literally being prevented from treating her patients bc the men were interfering and so the administrative head heard about this (she was female) and she was like y’all better stop or y’all better start looking for new jobs and then starboard was allowed to work on her patients and got the scrub techs replaced and all of the sudden, the patients were suddenly doing much better during and after surgery.
when she told this story she was like “people still call me a bitch, and maybe I am because I won’t let them walk all over me, but when you’ve got something to do, when you’ve got a life to save, you have to ignore their bullshit so that you can save someone’s fuckin life. Sexism should never stop you from accomplishing that”
and little eleven-year-old me still remembers that bc I was insecure and awkward and here was this woman who just did what she had to do and ignored all the people trying to stop here and she really was better than all the male doctors (like her patient stats were better) and I thought I should share with you this inspiring woman with the cool last name
The most common cause of female infertility – polycystic ovary syndrome – may be caused by a hormonal imbalance before birth. The finding has led to a cure in mice, and a drug trial is set to begin in women later this year.
Polycystic ovary syndrome affects up to one in five women worldwide, three-quarters of whom struggle to fall pregnant. The condition is typically characterised by high levels of testosterone, ovarian cysts, irregular menstrual cycles, and problems regulating sugar, but the causes have long been a mystery. “It’s by far the most common hormonal condition affecting women of reproductive age but it hasn’t received a lot of attention,” says Robert Norman at the University of Adelaide in Australia.
Just going to point out that as much as this excerpt here describes it as affecting “fertility” and oh woe, they can’t get pregnant as easy…uh, it’s also something that can make them fucking miserable and POTENTIALLY KILL THEM
Here’s the thing: ovaries normally do produce cysts. They’re supposed to! To an extent. They produce like, a tiny number, maybe one, each menstrual cycle, because the egg that is ready to be hypothetically fertilized, is PUSHED OUT to the fallopian tube, by an actual cyst.
This is the normal process, in the “4 out of 5″ women who don’t have PCOS.
In PCOS, though, my understanding is that the cyst production does not happen in this nice, orderly fashion, only happening approximately every few weeks; instead, it goes haywire and happens all over the place and WAY too much (hence “polycystic”).
Left unchecked, this can cause the organ to become damaged, it can cause it to swell and even press on other things in the abdomen and put OTHER parts of the body at risk, can cause all sorts of awful things.
IIRC ( @tekka-wekka I think you know more about this than I do, by all means please correct me if I’m wrong about any of it?) it tends to cause a lot of pain or heavy bleeding during many people’s menstrual cycles and, as noted, causes them to be more irregular – so it’s basically a disability, one that can be LIFE-THREATENING.
And guess what the main treatment for PCOS is, to keep the cysts in line and regulate the menstrual cycle properly?
Hormone-regulating pills.
You know, the ones normally labeled “birth control”.
This was what Sandra Fluke was testifying about a few years back, during health care debates, by the way. She had a friend who had EXACTLY this condition, and the fact that Georgetown’s student health coverage would NOT cover her “birth control” medication meant that she went without it for three months…and her ovaries, filled with cysts, enlarged so much that she required EMERGENCY SURGERY (to remove them entirely, IIRC).
Which is why Sandra Fluke was FIRMLY arguing for increased access to “birth control” medications; because leaving aside questions of autonomy, it’s an actual literal life-or-death health necessity for many people! Such as those with PCOS in specific!
But I digress.
My point is: this is a condition that goes beyond “fertility” issues; it requires a LOT of people to go on pretty much (IIRC) permanent hormonal regulation to carefully regulate their menstrual cycles in order to NOT DIE. Because, left untreated, it can, in fact, literally pose that risk. (And depending on the specific hormonal birth control in question – this may have the trade off of things like a higher stroke risk, so that’s…that’s a thing, too, oops)
So uh. This?
This is REALLY good news.
But not JUST for folks with PCOS who want to have biological children; it’s literally just good news in general, because this could be LIFE-SAVING research??
I just wanted to point that out because, like, I don’t think a lot of people are aware of PCOS and how it can potentially KILL YOU, and there’s a lot of misconceptions about ovarian/uterine health in general, and like… and I think some folks might scroll past this thinking it’s mostly about “fertility”?
When it’s actually a condition that impacts WAY more than that, and chances are very very good you actually know someone with this condition, whether you realize it or not.
Reblogging for the additional info. Most of the folks I know with this don’t give a shit about fertility. They just want to stop needing S5+ painkillers to function at least 25% of the time.
fanfic: this character has had several bottles of hard liquor and they’re just slurring their speech slightly and for some reason are not in the hospital with alcohol poisoning
me: ….you’ve literally never had a drink in your life have you
very good point.
Alcohol For the Non-Drinking Fanfic Writer, a primer by me
There’s a shit ton of variability in response to alcohol depending on body mass, history of drinking (your liver can upregulate the CYP450 enzyme responsible for metabolizing alcohol but only to a certain point; chronic alcoholics hit a point where their livers are so trashed they lose this and go back to getting drunk off small amounts of alcohol), and ethnicity (people of East Asian descent are more likely to lack a critical enzyme for breaking down one of the metabolic steps in the degradation of ethanol and are stuck in the shittiest part of it, with flushing and nausea), and other factors.
But if I had to guesstimate for writing:
1 drink (a tall glass of beer, a can of beer, or a shot of hard alcohol in a cocktail or alone): are you a burly dude? you may or may not feel it. are you a tiny lady? you will probably notice it.
2 drinks: burly dude may or may not be noticing it. tiny lady like me: this is a sweet spot where you’re talkative but not drunk. (Note: people don’t go from zero to “so drunk you remember nothing/are profoundly disinhibited.” There’s a lot of ground to cover in between.)
4 drinks: burly dude still feeling it, tiny lady ready to FUCKING FIGHT YOU
5 drinks: burly dude, slow down, buddy, you gonna polish off that six-pack by yourself? That’s going to hurt in the morning. Tiny lady: oh my GOD stop. Go to bed.
This is where we draw the cut-off for a “binge,” if you were wondering. More than this and you’re officially binge-drinking, where your odds of serious harm go up sharply. From alcohol, but also from the bad decision dinosaur that plagues you when you binge-drink.
a fifth of anything by yourself: Sir. Sir, can you hear me? Sir, I need you to open your eyes. Squeeze my fingers. Sir, you’re in the emergency room.
Splitting a bottle of wine between two adults: generally like three drinks each, you’ll feel it but you’ll survive. (A bottle of wine between three adults: usually not quiiiiiite enough.)
An entire bottle of wine by yourself: oh, so you enjoy suffering?
Other Fun Medical Alcohol Facts: high-proof alcohol like vodka will temporarily paralyze your pyloric sphincter, so the alcohol can’t get into your gut for about twenty minutes. Then, when it DOES get into your small intestine, enjoy getting uncomfortably drunk too fast.
Alcohol is a zero-order metabolizer: that means that nothing on Earth can sober you up except time*, and the time it takes is linear, directly related to how much you drank. Most of us can clear about a drink an hour, so if you’re drinking slowly you can stay roughly sober all day. Most of us don’t drink that slowly. Hangovers are made awful by a metabolic intermediate (literal acid in your blood!!!! it’s so shitty!!!!!!!) that makes you nauseated and feel super gross, and not every drinking episode will lead to a hangover, and severity of hangover varies greatly by person and amount drunk.
So please never write someone having coffee to “sober up.“ Now they’re drunk AND they can’t sleep. Bad combo. Sucks for driving. Splashing cold water on your face? No. Amphetamines? Good Lord what’s wrong with you. Look, the room’s gonna spin, you fucked up your endolymph in your semicircular canals, deal with it. You can partially override that with proprioceptive feedback–keeping one foot on the floor to get tactile input–but it’s just gonna suck for a while.
The variability in capacity is real; my aunt-in-law, who is roughly my size, can drink me under the table easily. She’s a high-powered business executive who has martinis with lunch. I tried to keep up with her once and had to call in sick. So you don’t HAVE to write a character having a “normal” alcohol tolerance, but don’t get into “yep, definitely alcohol poisoning” territory, please.
This has been Please Don’t Show Up In My Emergency Room, I Hate Getting Barfed On by your local friendly medical trainee.
*this is technically not true, but no substance you can get your hands on will do it. hmu if you want to hear the story of the EtOH receptor antagonist andwhy it never went to market, what with all the dying.
what’s the EtOH receptor antagonist???
okay whew. here we go. there has been a LOT more interest in this than I was expecting (I was expecting none, to be clear), and it has been approx. 8 billion years since I was in undergrad, which is the last time I can reasonably claim to have been CURRENT on Neuro research. (I did my master’s at an institution that does not have what one might call a robust Neuro department and mainly did Stats.) So if a real live Neuro person comes on here and contradicts me, you should probably believe them.
BUT. Here is the story, as I recall it:
Alcohol, or, as we fancy-schmancy-pantsy medical types like to call it to distinguish it from the bajillion other alcohols out there (”alcohol” describes a general type of molecule in chemistry, not the good ol’-fashioned Get You Drunk molecule) ethanol, abbreviated EtOH, is what’s generally called a “sedative-hypnotic.” What that means is that it doesn’t work on opioid receptors, it doesn’t work on cannabinoid receptors. It does stuff to your GABA receptors–GABA being the major inhibitory neurotransmitter–and it also binds to other stuff. We still don’t have its actions in the brain fully mapped. But we know, and we’ve known for a while, that it does stuff to GABA receptors.
A major pharmaceutical company developed an honest-to-God antagonist. If you’re not a pharm person, you may be going, “a what now?” First point: damn near everything your brain does is determined by neurotransmitters and the receptors that love them. Neurotransmitters interact with their receptors in a variety of ways, with a HUGE variety of end results. Humans love jamming other chemicals that are not neurotransmitters into their receptors. Why do opioids work? Because they mimic NTs we make ourselves. Why does cannabis get us high? Because it mimics endogenous (”originating inside”, self-made) NTs. Manmade molecules that alter us are hijacking built-in systems. Don’t even get me started on how fucking bananas cool it is that neurons can adapt to neurotransmitter levels, and in a super awesome sci-fi-like variety of ways. Take a Neuro class! Take five! Take seventeen! Most fun I ever had was in a Neuro lab.
So what’s an antagonist? It’s something that, one way or another, makes it so the NT can’t do its thing at the receptor.
The line of thinking went, if we can keep ethanol from doing its thing at the GABA receptor, we can make people sober again. They can drink and then take a pill and be sober. Wouldn’t that be AMAZING? Wouldn’t that be lucrative? These are questions that drug companies think about a LOT.
So they made the chemical! Its name is
Ro15-4513. You can Google it and get a WAY less interesting description of what went down. But how my professor explained it to us is like this:
It works. It’s an ethanol antagonist at the GABA receptor. You take it and it blows the ethanol off the receptor and you’re sober. And… because humans are awful, you get drunk again. You take another pill. You’re sober again. The time that pill is active is less than the time it takes your body to metabolize ethanol, so you’ve still got all that ethanol swishing around in your system waiting to murder you via aspirating your own vomit the hot second it wears off, but by God, you’re sober.
Except, as mentioned, the GABA receptor is not the only place where ethanol does stuff. One of the effects it has, since it’s such a teeny tiny molecule, is fucking with the lipid bilayer that forms the bulk of your cell membrane. If you’re a Neuro person, you’re getting cold chills right about now, because the only reason neurotransmission works is the properties of the lipid bilayer. You have to be able to transmit electricity down the axon of the neuron to generate an action potential. The lipid bilayer is what allows you to do that.
The pill does nothing for that. So if you take enough of the pill, and keep drinking, there comes a point where you’ve fucked the lipid bilayer beyond repair. You can’t transmit messages. Your brain doesn’t remember how to tell your body to do things like breathe, or not have seizures. And you die!
So, in summary, we have a pill that could make you a responsible designated driver, but actually fucking kills you because people have no self-control.
Moral of the story: Neuroscience Is Super Fun!!!!! It was my gateway drug into medicine. I would never have gone to medical school if it weren’t for my Behavioral Neuroscience professors.
today on: humanity’s hubris has led to so many things being bad when they were designed to be good
I’m starting to appreciate more just how scary it is to be a doctor.
You have a patient come in with a stomach ache, nausea, feels tired and sort of generally miserable, no other obvious characteristic symptoms.
Out of 100 patients like this, 90* will be a minor gastroenteritis or whatever, maybe you ate something bad, here’s some nausea medication, go home and eat bland foods and get enough fluid and sleep it off.
And 7 will be appendicitis or gallstones or pancreatitis and need to be admitted to the hospital, 1 will be a heart attack with atypical symptoms, 1 will be the first sign of cancer, and 1 will be some weirdo disorder with a name like “Coleman’s 4268py deletion snydrome, Type II”** that you never heard of.
If I were a doctor, this would make me terrified to ever tell a patient “maybe you ate something bad, go home and sleep it off.” Even though that’s usually the right answer, and even though it’s a waste of time and money to do an EKG and CT and 4268py test on everyone with a tummy ache–it’s got to be anxiety-provoking to not be certain that you aren’t missing something. And at some point you will send someone home only to get a call the next day that they collapsed and now they’re in the ICU (or the morgue). And it’s got to be really hard to go back to work after that and say “go home and sleep it off” to your next patient, even though that’s still usually the right answer.
I’m understanding more these days how tough it is to live with that kind of risk and responsibility.
*not actual statistics
**not an actual thing
Accurate.
These kinds of sobering thoughts almost made me quit during 1st year of medical school multiple times. And the times when the 1-in-100 (or 1000, or 10,000) “worst outcome” has happened, in the many years since then, has certainly tested my resolve.
But I have learned to learn from those times. I refine my differential diagnosis, I sharpen my senses. I vow to avenge that death/bad outcome like a father over his murdered son’s grave, while also vowing not to start ordering CT scans for every stomach ache.
That’s what doctors do. Must do, to survive with our souls intact.
So it’s Flu Season again, and this recipe for Tea To Fix What Ails You was given to me by a Christian friend, and I’ve taken to calling it JESUS TEA due to it’s miraculous properties. Even though it, technically, contains no tea. This tea is as caffinie-free as anything processed in a US plant can get, but be sure to check the provenance and all ingredients in case of allergies.
You will Need:
A Bigass Pot, becuase this is something you make in large quantities
working stovetop
those lil cloth sachets you use for wassail/empty teabags/those lil reuseable loose-leaf tea steepers.
Recipe:
about a quart of water
1 cup apple cider
about half a lemon’s worth of juice
a shitwhack of honey- try to get as local as possible and generally the less-processed the better if you want to build a resistance to local allergens. If you have allergy concerns or don’t like the taste of honey, go ahead and use more processed stuff/another sweetener instead.
three tablespoons/three bags chamomile tea
three tablespoons/three bags rooibos tea
teaspoon crushed cloves
1 cinnamon stick (more if you like it spicier)
¼ tsp nutmeg
1/8 tsp cayenne or white pepper
Bring water to a simmer in the pot. Add the chamomile, rooibos and spices to steep about 4-5 minutes or longer if you like tea-flavored tar which given you have the flu you probably do. Add Cider, Lemon Juice and Honey until dissolved. Drink all of this in the course of an hour to stay hydrated, make more pots as needed or until you pass out.
FOR MAXIMUM EFFECTIVENESS: gargle warm salt water first for as long as you can, it’ll break up the mucus in your throat and soothe the soreness.
This stuff is hecking delicious, and my dad claims it cured his cold. I’ve taken to drinking it just because it tastes good! Thank you for sharing! 😀 I also found that you can freeze this stuff in convenient single serving sizes, ready to be heated in the microwave when you don’t have enough spoons to make it fresh. Granted fresh is usually best for most food and drinks, but it’s still good.
I also calculated a single serving version, which I’m putting here in case anyone wants to make it that way:
1 cup hot water
¼ cup apple cider (or more, I prefer 1/3 cup)
1 tbsp honey (or more, to taste)
a dash of lemon juice
½ tsp spice mixture
1 ½ tbsp tea mixture
Mix the spices together in one container, and mix the two kinds of tea together in another. Measure out of these the above amounts. (Don’t try to store the two things together, the spices will sink to the bottom and you won’t get the right measurements.)
Use a tea infuser/tea bag/cheesecloth/whatever to keep the herb bits from floating off into your drink. Steep for the usual 4-5 minutes, then add the cider, honey, and lemon.
Side note: ground cloves is cheaper for me so I use ½ tsp of
that instead of 1 of whole. I also like cinnamon a lot so I use ¼ tsp
ground cinnamon instead of a stick (also sticks are really expensive here). If you use a stick, break it into
little pieces. The downside of ground cinnamon is that it
kind of congeals if you don’t stir it periodically, so keep a spoon
handy as you drink.
Since people have been asking for this (I guess the flu/common cold is going around agian), have it again, NOW WITH SINGLE SERVING SIZE, THANK YOU @snowfox102 for doing the math for me!
Is it possible to substitute the chamomile for something else?
Pretty much any herbal tea but mint will work? Rose hip’s good, or you can just double the rooibos. You can even put in black or green tea. I don’t becuase those both have caffiene and I want to be awake as little as possible when I’m sick.
i'll apple your turnover 