keithflower

John, I've been following your work for years (including back in the old lemonodor years). I just wanted to say thank you here, for sharing your expertise for all on this topic, and for all the other tremendous work you've done. What an inspiration.

I feel for you my friend.

From my experience, having young kids is a very difficult time for relationships. Couple that with all the challenges around the pandemic and other current craziness, and things get even tougher.

From my experience also, as your child gets older that part of the stress tends to settle down and things feel better and relationships do generally improve.

Having said that, I'm a big fan of couples' counseling, which I think all couples can benefit from, regardless of the state of their relationship. IMHO, the ability to communicate is of primary importance, and it's not something that we're just born knowing how to do. One huge benefit from couples counseling is learning open communication with kindness.

Here's hoping things get better soon. Take care of yourselves!

I'm betting on some kind of glitch on the State Department website, but it's an interesting historical note that when Richard Nixon formally resigned in August 1974, he did so via a brief letter to then Secretary of State Kissinger.

I support this ban.

I’m a physician. In addition to this president inciting a riot, this president and his supporters are complicit in using social media to promote unscientific, self-serving views that strike at the health of my patients and adversely affect American healthcare in general.

Enough is enough.

Looks like they are fixing this, but good grief, isn't anyone in Stanford's well-paid hierarchy looking out for these young doctors?

Residents, nurses, and other front-line healthcare workers should be receiving these inoculations TODAY.

Residents have enough stress without needing to demonstrate to force an organization to simply review the results of "algorithms" and do the right thing.

Having followed this story for some time, I grieve with the family as much as an outsider can.

This brave family's story is an inspiration.

Dr. Might's linked post includes many ways to help honor Bertrand's legacy, and to help others.

Thanks to Bertrand, Dr. Might, and his family for bringing more light into the world.

Thank you for all of it, Dr. Graham!

What a life.

Worthy of HN border acknowledgment, please.

Emacs with org-mode.

Your selective quotation misses the main point of Wallace's piece. He is wrestling with the ethics of causing gratuitous suffering.

The 'grasshopper' quote is Wallace actually quoting the Maine Lobster Promotion Council, possibly not an unbiased source for science. Wallace goes on to say:

Though it sounds more sophisticated, a lot of the neurology in this latter claim [grasshopper quotation] is still either false or fuzzy. The human cerebral cortex is the brain-part that deals with higher faculties like reason, metaphysical self-awareness, language, etc. Pain reception is known to be part of a much older and more primitive system of nociceptors and prostaglandins that are managed by the brain stem and thalamus.

Wallace goes on to write:

The basic scenario is that we come in from the store and make our little preparations like getting the kettle filled and boiling, and then we lift the lobsters out of the bag or whatever retail container they came home in …whereupon some uncomfortable things start to happen. However stuporous the lobster is from the trip home, for instance, it tends to come alarmingly to life when placed in boiling water. If you’re tilting it from a container into the steaming kettle, the lobster will sometimes try to cling to the container’s sides or even to hook its claws over the kettle’s rim like a person trying to keep from going over the edge of a roof. And worse is when the lobster’s fully immersed. Even if you cover the kettle and turn away, you can usually hear the cover rattling and clanking as the lobster tries to push it off. Or the creature’s claws scraping the sides of the kettle as it thrashes around. The lobster, in other words, behaves very much as you or I would behave if we were plunged into boiling water (with the obvious exception of screaming). A blunter way to say this is that the lobster acts as if it’s in terrible pain, causing some cooks to leave the kitchen altogether and to take one of those little lightweight plastic oven timers with them into another room and wait until the whole process is over.

See a physician.

Ask permission to talk to the outgoing manager. If they balk at transparency, you'll know where the "communications" problem lay.

The rotation I did through a hospice service when I was a fourth year medical student was one of the most meaningful experiences of my life.

Hospice staff are experts at effective pain-wrangling (pain in all its many manifestations), and, as they say, in helping people live until they die.

I'm grateful for the teaching - from both clinicians and patients.