tellak

> The American medical system acts like the smallest bit of discomfort warrants being knocked out.

There is a tremendous variation in both pain tolerance and anxiety. You sound like you’re in the minority.

The anesthetist still gets paid. His concern is if you freak out (this happens more often then you may think), he may at minimum have paperwork to do and worse you may sue him for malpractice (“well he didn’t clearly explain it would be that bad during the consent process).. again this problem happens more than you may think. Ie the negative ev for them if you do not do the typical protocol is considerable.

I tried to keep my statements factual and my own opinion out of it.

While “shit” was a bit tongue in cheeky the term “dirty” is used among practitioners because of the wide range of metabolic side effects that the atypical psychotics have. Seroquel is a metabolically “dirty” drug. Taken in therapeutic doses long term a high percentage of people will end up with metabolic syndrome derangements.

Likewise, in the US and Canada, is not indicated for sleep disorder/insomnia use either. In Lexicomp it’s not even listed for off-label use. That’s just a fact, I don’t know what you’re trying to convince me of. In the US there is also a storied history with Astra-Zeneca and a lawsuit due to their practices of pushing off-label use resulting in a $.5 billion settlement.

Another fact is that Seroquel was one of the most heavily marketed drugs ever to primary care providers. As my 100s of dollars of Seroquel branded swag my office accumulated 15 or so years ago will attest to (I am not a psychiatrist).

My own personal experience has been that most psychiatrists I’ve spoken to at a large academic center, are appalled at the idea of using seroquel for insomnia long term due to serious side effects and the consensus is that it’s MOA is mostly due to its antihistamine property. That’s really all I was saying.

Also most atypicals are not highly sedating, lurasidone especially so. I have not heard of it seriously being mentioned likely for primary insomnia.

The original commenter mentioned a “knee operation”

Propofol is an anesthetic, seroquel is not... it’s an antipsychotic. The thing with antipsychotics is they’re shit or “dirty” drugs... seroquel is not even indicated for insomnia (and depending on who you ask is a terrible choice.. a lot of family med/internists use it, psychiatrists often cringe). It works because it has a strong antihistamine side effect, so it’s basically a very potent Benadryl.

The point being, you’re still arousable. A vigorous rub of the sternum will likely wake you up. Not so much on propofol.

Early in residency, had a guy once that seemed “out” as normal during an operation. No abnormalities. In the recovery room claims he heard everything we were saying in the OR. We of course initially thought he was full of shit, but he quoted verbatim much of the chit chat the team was having (not that any of it was bad thankfully). This is very much not typical.

Were you under with propofol the whole time though? Usually the propofol is just to put you down (it is very short acting) you’re intubated, and then anesthesia is maintained with a volatile fluorane such as sevo.

50% is “super conservative”?? By what reasoning? How is that more appropriate than 5% or .5% or .05%? Either you have a justification for that estimate or you’re just making something up, which doesn’t mean squat.

You’re so confused.

> FLAC has no benefit over traditional 16/24 encoded content

Yes it does. It’s anywhere from 70-30% the size depending on genre. That’s a benefit.

> you might think that FLAC/lossless is audibly better.

No I think and expect it to sound audibly identical. That’s the whole point.

> why the C programming language is the way it is.

I’m curious specifically why you think this is. The 6502 with its poor register set and special purpose addressing mode seems to make it a relatively terrible/challenging C target.

It’s not a big deal. I only mentioned as a response because the op started off saying they were from a family of MDs.

Also the vast majority of practicing physicians are expected to have detailed expertise to understand the indications, application, and interpretation of imaging within their speciality. Most imaging orders are issued by medical or surgical staff, not radiologists.

> That’s asinine, obviously he doesn’t mean more data is always better even if the test is invasive or dangerous.

With him classifying all MDs as idiots, no it is not asinine.

I’ve known few academic physicians that would turn down data if it can be ethically obtained.

The difference between the medical profession and, say Google, is that we as a general rule do not consider the populace one big lab to experiment on as we please. The consequences are more than a little different.

It’s not like things were always this way in medicine either.

I am actually an MD.

> Had we enforced a full-body MRI for every patient, we would quickly amass enough imaging data to know which anomalies are malignant and which are not to a very high degree

How, pray tell, are we actually determining which are malignant and which are not?? I’ll give you a hint: the charitable explanation is you are completely ignorant, the less charitable one is that you consider Mengele and Ishii modern medicine heroes. And that is even if the determination by imaging alone is even possible.

Once again I have to point out on HN... not everyone in the medical world is an idiot incapable of analytical thinking, it is just that a lot of us care about ethics. Our patients, even in research, are more than just numbers.

There new guidelines in the US that still recommend aspirin based on cardiovascular risk. That aspirin increases the risk of bleeding is old news. The difficulty has been in quantifying the risk/benefit. You should consult with your doctor about your specific circumstance.

If that’s what he’s saying, he’s wrong. Python threads are based on native threads. They are parallel executed, they just don’t do so very well because of the GIL.

Your example is the epitome of bullshit.

There is a tremendous amount of tech in medicine and considerable investment at larger healthcare systems. If medical coding were such a simple automateable problem it would have been done (I mean it’s freaking billing... absolutely the strongest and direct financial incentives to solve).

The first mistake/flaw you’re making is that the healthcare provider uses codes. That is most often not the case. Even if they do, it gets more complicated with submitting claims.

There are plenty of LUTs in healthcare that are managed by the EMR, billing ain’t one.