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Have an interesting ER story? If I use it, I'll give you a free book. For more Q & A, see my Test your knowledge of ER terms by solving my ER crossword puzzle that was featured in the Prudential Securities Healthcare Group 2002 calendar. Or take the ER-MCAT to see if you have what it takes to be an ER physician. Including my:
Amy reviews ER computer games |
ER doc too busy to make love to the woman he's dating? Q: I started dating (if you can even call it that) an ER doc about a month
ago. He is always really tired or really busy works 14 shifts a month, but
what exactly is a "shift"? I know they're rotating shifts. I REALLY like this
guy and can't tell if he truly works a ton of hours or if he's just blowing me
off. I'm thinking "if you're too busy to f*ck me, you are TOO BUSY" but I'd like
to give him the benefit of the doubt. Should I continue to wait for his call or
move on? You know that writer's block you get when you sit down to write the essay portion of your personal profile for online dating? And you know the difficulty you have trying to think of a catchy headline? Well, MyProfileWriter allows you to create a profile essay and headline without typing, just by clicking! A reader thinks I'm arrogant Q: Hi, I'm writing about your answer to the question of how to become an ER tech (assistant.) in your answer you stated that the girl who asked the question sounded very intelligent and that she should go for RN or MD. I believe that that was great advise and that everyone should strive to be their best, but I am an EMT seeking an ER Tech position. I take pride in my skills and the work I put into getting my certificates. I am a very intelligent person and I do hope to continue on to nursing. I'm also a 20 year old who is married and has a 3 year old diabetic son. Attaining my goals are going to take a little longer but I'm confident that I will succeed. With all due respect, I think you sound a little arrogant. A: What on Earth is wrong with complimenting someone? The justification for your comment is inscrutable. You seem to be a proponent of the Law of Jante, and hence do not understand one of the fundamental keys to incentivize individual success. “People who repeatedly attack your confidence and self-esteem are quite aware of your potential, even if you are not.” “Whoever is trying to bring you down is already beneath you.” Pride, one of the 11 basic emotions, evolved and persists precisely because it is adaptive — that is, because it confers a survival advantage. Put simply, pride helps motivate people to do what they should do. In past times, cavemen and women didn't have state social workers put them in legal hot water for not taking care of their children; then and now, childcare is motivated in part by the pride taken in doing it and doing it well. More generally, pride results when we do things well and specifically when we go the extra mile striving for excellence. And you — evidently thinking you have more wisdom than God or Mother Nature that instilled pride in humans — seemingly assume that the world would be a better place if you could extinguish pride. Think again. Pride is useful mental fuel for those who know how to harness it: just about everyone, some of us more than others. Regarding your statement, "I think you sound a little arrogant." I don't know what prompted that characterization, which strikes me as a non sequitur, and suggests that you equate high self-esteem with narcissism even though they are not synonymous. Related:
I readily admit that I am very proud of my accomplishments. I had a superb undergraduate GPA, aced the MCAT, got into medical school after 3 years of college, graduated in the top 1% of my class, and was such a shoo-in for an ER residency position (the most coveted residency at that time) that I was offered an under-the-table deal because they wanted to ensure that no other hospital lured me away. During and after medical school I took Accutane: an acne drug that can cause pseudotumor cerebri; it gave me excruciating chronic headaches that made it difficult to concentrate—but when you're young and foolish enough to value appearance over feeling good, I put up with pain that would send most people to an emergency room. I've designed and built hundreds of things from scratch, such as a pocket echophonocardiograph and the world's best electronic stethoscope that gives the user the acoustic impression that he is actually inside the patient's chest not the typical muffled, muddy sounds that most stethoscopes give. I've written several books and developed dozens of websites that are packed with information (like this one) or are truly innovative. Once I discovered how to unleash my creativity, I did much more, such as inventing devices that cure certain infections much faster and more reliably than antibiotics. I sold that technology to a company founded by a friend of Bill Gates, but leapfrogging the capabilities of all pharmaceutical companies was what I'd call a single (to use a baseball analogy); my best ideas are comparatively like a home run that wins the World Series. I can't yet talk about them, but they will change the world for the better, save countless lives, and put smiles on billions of faces. So am I proud? You bet! You're proud of what
you have accomplished, and when you accomplish more, you'll be even more proud.
Pride is one thing, and arrogance is something altogether different. The two are not direct synonyms. According to my American Heritage dictionary, pride
means "pleasure or satisfaction taken in an achievement" or "a sense of one's
own proper dignity or value; self-respect." Arrogant means, "making or disposed
to make claims to unwarranted importance." Example: September 23, 2021: Theranos founder Elizabeth Holmes reportedly sent a text to her ex-boyfriend and former COO referring to herself as 'best business person of the year'. When I think of arrogance, I think of Hollywood folks who believe they're America's royalty. Their success is attributable to their good looks. Take away their pulchritude, and what do you have? Not much. Their talent? Ha, I'm laughing about that. Take Ben Affleck, for example. I mentioned him only because
I saw him in a movie last night, and I was stunned by his performance … not
because it was good, but because it was so pathetic. As a doc with years of
experience in the ER, I can tell if someone is on drugs or has brain damage. I
don't know if laypeople key in on the speech patterns that alert docs to those
possibilities, but the cadence and intonation of his speech, and his glassy-eyed
countenance, made me wonder if he was drunk, on drugs, deficient in some
nutrient vital to mentation, or if his neurons had a third-rate wiring job. He
is treated like royalty just because he happens to be one bodaciously handsome
man. Let's say Affleck had twice the talent that he does, but he looked like the
Wal-Mart greeter I saw this morning, or he looked like me, you, or just another
face in the crowd. Would he still be a star? The answer to that rhetorical
question is obvious, so let's move on. Related: My vision was so poor that I'd run into walls and couldn't see what teachers wrote on the chalkboard until I began wearing glasses at age 16. Before then, I used one finger to push on an eyeball to partially correct its astigmatism. It still mystifies me how I could go through that many years of school without one teacher noticing I was blind as a bat; aren't they trained to recognize such problems? I lived in a two-story farmhouse with peeling lead paint that I dutifully removed with a paint scraper over a period of months, wobbling on a rickety ladder, never wearing any mask or gloves to protect me from the neurotoxic lead. Ditto for when I spent oodles of time manually scraping lead paint off its inside trim. I simply didn't know better. Worse yet, when my Dad was still around, we'd decorate our Christmas tree with icicles made of pure lead. As a young child when the developing brain is especially vulnerable to lead I would roll those icicles into balls, and then eat cookies, without washing my hands. I was exposed to lead from other sources, such as helping my Dad work with lead type, cast lead bullets, and reload rifle and shotgun cartridges: more lead. With so much lead exposure, it's a wonder that I ever learned to tie my shoes. My sixth-grade teacher said I was “slow,” and I struggled my first two years of high school until I serendipitously stumbled upon a way to significantly increase brainpower. Before that, I was so tired of floundering academically I planned to drop out and get a job working in an auto assembly plant. I began working when I was in junior high school, and I kept working up to three jobs at a time to support myself in college and medical school. On my first morning delivering newspapers in college, a man amused by my appearance called me a “retarded boy” and told me to get out of there. I couldn't afford a winter coat, so I wore every shirt and jacket I had, trying to keep warm. I wasn't given any bag or advice on how to carry so many thick Sunday newspapers, so I improvised a solution by using my plastic laundry basket as a sled, which I pulled with a rope over the sidewalks covered with fresh snow. I used to drive junkers that often broke down, and had various mechanical problems that wasted my time (such as a car that wouldn't budge until it was warmed up for 20 to 30 minutes—that's 40 to 60 minutes wasted per day). One car smoked so much I had to drive it to college before sunrise and stay there until it was dark. If I didn't, the plume of oil smoke trailing it would result in another ticket I couldn't afford. I couldn't pay for a brake job on a car, so its passenger's side front wheel eventually locked when its caliper welded to the disc. Decades later, I still recall—as if it happened five minutes ago—driving to the home of an oral surgeon to mow his yard. When I did, my mower broke down, again, with me in a panic thinking I should be studying for a college exam, not immersed in mechanical problems rooted in poverty. I drove many miles home the same way, with the passenger's side tires on the road shoulder so the locked wheel would skid more easily on gravel. The driver's side rear wheel on my preceding car would sometimes partially lock while driving so I'd arrive with smoke coming off it (not far from the gas tank, BTW). I'd douse it with water to cool it off, generating clouds of steam. For most people, The Joy of Poverty is a very thin book, but The School of Hard Knocks teaches lessons ignored by the Ivy League. The children of Jeff Bezos, Bill Gates, and other tycoons are blessed yet cursed with money, name recognition, and perks galore eroding their desire to succeed. Consequently, few do anything great, as evidenced by Malcolm Forbes's What Happened to Their Kids: Children of the Rich and Famous. As I write this, I'm thinking of Walter Carr, whose car broke down hours before his first day at a new job 20 miles away. He began walking there, assisted by police officers who fed and gave him a ride, after which his boss, Bellhops CEO Luke Marklin, gave him a car: his 2014 Ford Escape. My poverty forced me to sometimes room with people who were exasperating or even downright nuts (as in renting a room from a paranoid schizophrenic who was off her meds and out of control), and that wasted time, too. When my Mom's (and later my) money ran out I sometimes starved* and developed diseases stemming from nutritional deficiencies, but I was either too stupid or too hard-headed or too proud (that word again!) to ask for help. My acne was so bad I wasted thousands of hours popping pimples and trying to unclog my sebaceous glands—up to two hours per day! * Related: September 1, 2021: Food insecurity during college years linked to lower graduation rate During part of college and early medical school I lived with a woman who loved to start fights. Day after day, she would start arguments from out of the blue with NOTHING to justify them. I'd be sitting, quietly studying, and she'd come in and pour five pounds of sugar onto my head (true story) and into my open books (some granules are probably still lodged there) or just nag and nag and nag until I couldn't take it any longer—to the point I considered dropping out of medical school to get away from her psychological abuse. One day I asked why she did it; she explained that she grew up in a family where fighting was the norm (true; we lived with them; I witnessed it), and she was trying to recreate that disharmony in our relationship. I explained that I hated fighting (having seen my father excel in it) and wanted a peaceful, harmonious relationship. She was determined not to give it to me. She's not otherwise a bad person (we're still friends), but concocting reasons to frequently go to war is not my idea of what a good life should include. I had a bleeding ulcer that bored a hole in my gut twice the size of a bullet. The only doc I could afford to see was such a quack he couldn't diagnose an ulcer, and instead opined that I had a back problem, for which he prescribed a 4-millimeter shoe lift! While my classmates were studying, I was writhing in pain and shitting out blood for years because I thought he must know what he was doing … he was a doctor, wasn't he? I performed minor surgery (dermabrasion, excision of gangrenous tissue, and suturing a fingertip cut) without
anesthesia a few times on myself because I couldn't afford to see a surgeon. When I was younger and even poorer, one of my knees would swell internally so much that I couldn't begin to bend it. I had other joint pain so bad it was difficult to sleep, but I didn't get even an aspirin for it. I had untreated strep throat that led to rheumatic heart disease. I developed objective tinnitus so severe it'd awaken me as soon as I entered anything deeper than a light sleep. Did it last for weeks? No, many years. Without medical insurance, I had to put up with the tingling in my hands and feet after I broke my neck. So did I
lead a charmed life? Not quite. In a blog article, I mentioned more challenges I faced. Before lead and mercury ravaged my brain, I was naturally sunny, almost always in a good mood and serene except when I had good reason to be anxious, such as when I was bullied at school or huddling in fear at night unable to sleep at age eight or nine listening to my Mom scream and cry as she was beaten by my father. After those neurotoxins did their dirty work, I was so consumed by anxiety in college that I self-medicated with OTC sleep meds until I was blitzed as if I were drunk. Decades later as the mercury effects slowly abated, my girlfriend — a psychologist — frequently comments on my upbeat mood, calling me Dr. Sunshine, sometimes triggering pangs of regret for decades of needless suffering. Many of my classmates in medical school had advanced degrees, such as Ph.D.s in
pharmacology and biochemistry. Many of them came from well-to-do, famous
families, and had all the advantages money can buy: the best prep
schools, the best colleges, the best medical care, the best food, the best
lodging, the best advisors, the best connections for those all-important letters
of recommendation, and even a reliable car. Most importantly, many of those
students were supported by their parents, eliminating their need to work. So, as I
was slaving away mowing thousands of lawns, baking in a couple of factories while getting ripped off by union bosses, and
performing countless odd jobs (some of which were brutal, dangerous, or just
plain God-awful), my cohorts could have been studying, doing research, prepping
for the MCAT or the boards, or doing something else that would have given them a
competitive edge over me. Frankly, I was intimidated by their achievements,
their money, their connections, and their other advantages. But guess what?
There were 255 people in my medical school class besides myself, and I beat 254 of them. If you
had overcome the difficulties I faced and accomplished what I did, you'd be
proud, too. In my opinion, justifiable pride in one's accomplishments is far preferable to the duplicitous false modesty our society tacitly encourages. I like people who are straight-shooters and say exactly what they think instead of stumbling through life playing mind games with themselves and others. I don't understand people who lambaste Donald Trump and Donny Deutsch (host of CNBC's The Big Idea Show) for being arrogant. They have high opinions of themselves but that pride is warranted and based on their achievements, not fantasy. Thus, their apparent arrogance is nothing but an acknowledgement of reality. While discussing the subject of braggarts on The Big Idea Show, Mr. Trump said, "You have to have the goods." Well, he does. I think his apparent bluster annoys people who secretly wish they had accomplished much more. Rather than blaming themselves for wasting their lives watching sports and frittering their time away in other unproductive ways, they assail the poster boys of success, such as Trump and Deutsch. Speaking as a doctor, this is a pathological misdirection of anger. Incidentally, anger and other emotions exist to modify behavior in adaptive ways that foster success and survival. Whether it is pride telling me I did a good job or disgust telling me that I did not, I listen to my emotions. If you want to be very successful, you should do the same. Years after medical school, alarmed by how I'd wasted much of my potential, I rekindled it using an outside-the-box motivational method that worked wonders and sent my creativity and productivity into overdrive. In conclusion, I should mention that success is often achieved because of prior adversity, not in spite of it. People who've led cushy lives often never learn to dig deep into themselves and find latent strengths. Quoting from the cover of Scientific American MIND (March/April 2014): “CREATIVITY UPDATE: Embrace Your Inner Eccentric and How Hardship Actually Helps.” Anyone who reads this and this and concludes I am arrogant has an obvious supratentorial defect. The article Early traumas and young people's reactions to terror said people are “at increased risk [of post-traumatic stress reactions] if they have experienced violence or sexual abuse in early life.” Being shot, cut, threatened, beat up, and called names like “nigger nose” and “nigger lips” bothered me less than being feet away from my Mom when she was repeatedly beat up when I—then in mid-elementary school—was too young to defend her. I was also emotionally scarred by seeing her repeatedly cry about bills she couldn't pay at that time, which was years before my first job in 7th grade. But we succeeded in spite of those and myriad other stresses, and she rose out of poverty, achieving a peak net worth of $1.6 million (adjusted for inflation in 2016 dollars) in spite of having a high-school education and misogynistic bosses who felt entitled to pay her less because she was a woman; her best-paying job was as a grocery store clerk. So, Mr. EMT seeking an ER Tech position, I am not sure what makes you feel entitled to write to people you don't know and criticize them when you don't know 1% of what they've gone through. Remember the quote, “Be kind; everyone you meet is fighting a hard battle.” IDEAS.TED.COM: Tapping Into the Power of Humble Narcissism: No, “humble narcissism” is not an oxymoron; it's a combination of qualities that the best leaders and companies have. Organizational psychologist Adam Grant explains why. Sidestepping the pitfalls of overconfidence with plausible deniability Scientific American: How to Resist the Lure of Overconfidence: A practical guide to putting things in perspective The value of pride: The intensity of pride people feel for a given act or trait is set by an implicit mental map of what others value Self-Confidence, Overconfidence and Prenatal Testosterone Exposure: Evidence from the Lab Study: People may use overconfidence to persuade or deceive others Research shows that people feel best about themselves when their self-esteem is proportionate to the basis for it, not being too high or too low. See Too Much Undeserved Self-Praise Can Lead to Depression based on Emotional costs of inaccurate self-assessments: Both self-effacement and self-enhancement can lead to dejection. Perhaps that's why the Millennial generation (Generation Y) is so troubled: Narcissistic, broke, and 7 other ways to describe the Millennial generation. Also see The Feel-Good Curriculum: The Dumbing Down Of America's Kids In The Name Of Self-esteem. Yea, team! Winning fans see self-esteem boost More research: Cheerful Women Are Not Associated With Leadership Qualities, but Proud Ones Are, Study Finds. Article: How Your Big Ego Can Actually Help Your Coworkers: “Egos are necessary and, believe it or not, they don't have to be obnoxious and productivity-killing. They can actually make you, and everyone around you, better.” In my blog (this isn't it), I presented a true case illustrating how my self-confidence/ego saved at least one life and likely countless more in the future. A Big Ego Is Crucial For Success Article by Dr. Craig Malkin: Why a Little Narcissism Can Be Healthy Article: Bragging Rights: Study Shows That Interventions Help Women's Reluctance to Discuss Accomplishments Article by Lisa Seacat DeLuca: My Innovation Journey, So Far (she has reason to brag; why shouldn't she?) Article: When Being Called 'Incredibly Good' Is Bad for Children. Article: Kid swagger: How children react to winning and losing Self-affirmations may calm jitters, boost performance Article by Jessica Peyton Roberts: It's Not Bragging if It's True: Asserting Yourself When Writing Resumes and Cover Letters “Never underestimate a man who overestimates himself.” “Forget everything Mom told you about being humble and succeeding with modesty: the job usually goes to the one who brags loudest, says a new study by the University of British Columbia. When faced with two applicants with equal experience and qualifications, the interviewer will usually pick the more narcissistic of the two, found UBC psychology professor Del Paulhus.” (source) Comment: I figured that out long ago. My lack of self-confidence was pathological and painful; it took decades of accomplishments to erase some of those overly negative self-assessments and replace them with realistic ones. My girlfriend is a nurse and psychologist who detests arrogant doctors. If I were one, she wouldn't date me, nor would she try to boost my self-esteem and tell me that I'm much too hard on myself. And I am; I am my own worst critic. “Public opinion is a weak tyrant compared with our own private opinion. What a man thinks of himself, that it is which determines, or rather indicates, his fate.” It is very advantageous to think I am never good enough because that keeps me working overtime and incentivized me to achieve things I otherwise likely wouldn't have done. Thus while social rejection can fuel motivation, personal rejection can, too. I've solved some of mankind's most pressing problems; now all I need is investors to turn my prototyped and proven ideas into products that will have people calling me the next Steve Jobs, but what I'll do for you will dwarf the benefits of iPods, iPads, and iPhones. Consequently, I learned to love my lack of self-confidence because it helped me do much more to help others. When you find out what inventions I have up my sleeve, you will be thrilled with what they can do for you, with benefits that now seem like a pipe dream. Therefore, it is best when people internally lack self-confidence so they always work hard but externally appear brimming with narcissistic ego. Appearing on Fox News (7-10-2014), Drexel University psychologist Dr. Charles Williams corroborated this by pointing to evidence that narcissistic people are more likely to become CEOs and earn more than more humble CEOs. Despite what people say about how they hate narcissists, they gravitate to them, throw money at them, and vote for them. People who are naturally humble, such as myself, can feign some of the manifestations of narcissism to reap some of its rewards. I knew that decades before professors let others in on this secret. I never liked doing that, but I cannot control what others choose to reward. Since we live in The Age of Blame, we could blame the narcissists and ones feigning it, but it makes more sense to blame the sheeple who set the rules and create the incentives for narcissistic behavior. If the incentives vanished, the dreaded behavior would, too. Humility is a double-edged sword for some leaders, study shows Excerpt from Career Chutzpah: Why We Don't Ask for What We Need in the Workplace by Industrial & Organizational Psychologist Dr. Marla Gottschalk: “In today's fast paced workplace, playing the ‘shrinking violet’ is likely a losing strategy. We need to get over that.” “The single most important trait: arrogance—great for entrepreneurship!” “Whether you think that you can, or that you can't, you are usually right.” “… it's real money at stake, it's big egos at stake …” “It helps to have an ego …” Super-you: How to harness your inner braggart No discussion of self-esteem and bragging is complete without mentioning Muhammad Ali, who repeatedly and boldly proclaimed, “I am the greatest!” and “I'm the king of the world!” During his memorial ceremony, a friend (John Ramsey) recounted telling him, “Muhammad, you're the greatest.” Muhammad responded, “Tell me something I don't already know.” Ali was one of the most admired and universally loved people to ever live. “The moment you doubt whether you can fly, you cease forever to be able to do it.” “Men who are more ‘of themselves,’ more out there and conquering—this has been a mating advantage, so to suggest to men, ‘Hey, take a step back, don't puff out your chest so much’—well, you may not get dates and you might not get the promotion and your family might go hungry.” “Self-esteem is the switch in the circuit of your life that dims or [brightens] your future. Bring it low and you dont shine your light; raise it up and you brighten the corner where you are.” “The worst enemy to creativity is self-doubt.” “Fear defeats more people than any other one thing in the world.” “If a man thinks he is not conceited, he is very conceited indeed.” The logic of modesty -- why it pays to be humble “False humility is quite like the worst of both worlds: both that of Meekness and that of Conceit.” Are You Over-Confident? Take This Test... That reminds me of the Lake Wobegon effect, named after Garrison Keillor's fictional town where “all the children are above average.” In real life, almost everyone thinks they're above average. As LinkedIn influencer Don Peppers wrote, “the only group of people known to exhibit highly accurate self-assessments, with realistic memories of their achievements, are the clinically depressed!” Another LinkedIn influencer, venture capitalist Yoshito Hori, wrote that Asian investors “prefer speakers who deliver their presentations in a quieter, humbler manner” while Western investors “prefer their speakers to be aggressive, physically dynamic and somewhat self-promoting [with] a show of energy.” He added, “the high-energy style that works well in the West can come across as disagreeably boastful and egoistic in Asia.” Forget Modesty, Narcissists Best Suited for Job Interview Success Bragging as a strategy: What boasting buys, and costs, a candidate Men are almost 40% more likely to be narcissists. Science explains why they often become leaders “Early in life I had to choose between honest arrogance and hypocritical humility. I chose the former and have seen no reason to change.” “False modesty can be worse than arrogance.” “I can talk about humility, but I'm not humble. I mean, if you say, ‘I'm humble,’ you've just contradicted yourself.” (source) “You need to have tremendous confidence in your work, even a touch of arrogance, chutzpah. Many very fine researchers lack intellectual daring. It's human nature to want to be cozy, secure. But that can be a cul-de-sac.” Why Are People Overconfident So Often? It's All About Social Status Vanity is Good: A Hierarchy of Social Drivers A bit of disgust can change how confident you feel Stress in adolescence prepares rats for future challenges Link between depression and academic self-esteem in gifted children Why the best hire might not have the perfect resume The following song, A Daisy A Day, reminds me of the love that one of my relatives, President Chester Arthur, had for his wife Ellen. Note how Jud Strunk said he was proud he wrote it. Is there anything wrong with saying that? Absolutely not! It is a beautiful song; he should be justifiably very proud of it. Strunk died at age 45 when he suffered a heart attack while taking off in his airplane, which crashed. “Humility, I have learned, must never be confused with meekness. Humility is being open to the ideas of others.” “There is overwhelming evidence that the higher the level of self-esteem, the more likely one will be to treat others with respect, kindness, and generosity.” “As a surgeon you have to have a controlled arrogance. If it's uncontrolled, you kill people, but you have to be pretty arrogant to saw through a person's chest, take out their heart and believe you can fix it.” “I'm Billy the Kid, the fastest draw. It's not arrogance. It's the truth.” “I would just say that nobody could do what I do unless you had a big ego. It's the only way you can really put it. You have to be arrogant enough to challenge the arrogance of the human race.” More research: Self-esteem mapped in the human brain More research: Personnel management - when self-doubt misjudges achievement Arrogance non-trivia: A petty dispute between two notable actors (Edwin Forrest and William Charles Macready), primarily revolving around which was better at portraying the major roles of Shakespeare, led to the Astor Place Riot on May 10, 1849 in Manhattan that killed between 22 and 31 people and injured over 120. The “we're one of the top hospitals” scam Q: In an advertisement in the newspaper, our local hospital proclaimed it was voted "one of the top 100 hospitals in the country." Frankly, this is hard to believe. Given that there are 50 states, that leaves an average of two hospitals per state that won this award. That hospital is just a hole-in-the-wall, and we have several university hospitals that are considerably better. So how did they win this award? A: I have a one-word explanation: payola. Every hospital I've worked in claimed it won similar awards and was, for example, one of the top 100 cardiology hospitals in the country. I wondered how that was possible, given that we didn't even have a cardiology department! Our cardiology patients were cared for by two Internal Medicine docs who anointed themselves the local cardiology specialists, and a ragtag group of ER docs, including yours truly. How such a make-do assemblage could constitute one of the top cardiology hospitals is beyond me. One night I worked with the usual complement of ER staff, which was a grand total of one nurse . . . but this nurse was one of the top 100 nurses in the country, no doubt. Anyway, to complete my illustration of just what a farce it was to proclaim us one of the top 100 cardiology hospitals in the country, this nurse and I were besieged by three patients in cardiac arrest, all of whom were dumped on our doorstep at the same time. If you've spent much time watching medical shows on television, you know that it takes more than two people to optimally code even one patient. But three at once? We quickly made the rounds as we went from patient to patient, with me trying to figure out which person was least dead. We focused on that one, saved his life, and bid the others farewell after we thanked them for visiting one of the top 100 cardiology hospitals in the country. I'm not privy to the machinations behind these scams, but I bet that the quid pro quo goes something like this: a hospital pays a fee to participate in a survey. Any hospital that pays the fee is voted one of the top hospitals. The hospital brass, astute graduates of the Machiavellian School of Business, figure that the bucks spent on the payoff will be recouped by additional revenues as more sheep flock to the Misleading Mecca of Medicine. UPDATE: After a local Top 100 hospital killed one of my friends and committed a long string of other errors, I was so skeptical of their Top 100 designation that I spent months investigating the hospital award racket, which I concluded was a clever scam in which awards can be purchased—indirectly, of course, for obvious reasons. Hospital big shots love these awards because they use them to justify their bloated salaries. Even though the hospital is so financially strapped that some nurses are losing the equivalent of a day's pay per week, the CEO is paid over a million dollars per year with yearly increases way above the rate of inflation. The rich get richer . . . . Article: Hospital rankings may rely on faulty data ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● You will have sex about 10,000 times during your life. Doesn't it make sense to read a book that can maximize your enjoyment, and the enjoyment you give to your partner? Cast away your preconceptions of sex books as being a rehash of things you already know and hence a waste of time. By reading this book, you will learn many things that Dr. Ruth and other sexologists have never considered.
The Science of Sex by Kevin Pezzi, MD Available in printed and Adobe Acrobat e-book versions (will display on any computer) ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ●
Best strategy for dealing with initially poor
college grades
Q: Also, I'm looking for a mentor, and I must say that I look up to you
a whole bunch. Would it be possible for you to mentor me? Review of Now available as a free e-book download What really goes on in emergency rooms? If you're a fan
of the television show ER, you might think that you know. Not so,
asserts Kevin Pezzi, M.D., an ER doctor and author of True Emergency Room Stories. Pezzi says the show ER only
scratches the surface; the truth is far more interesting and bizarre.
So bizarre, in fact, that the cases could shock even an experienced ER
physician. "I'm now a firm believer in the saying that truth is stranger
than fiction," he says. "I don't think that anyone could dream up such
unusual stories." The "Lucas strategy": is it cheating? Q: I am troubled by the "Lucas strategy" you recommended to someone with a poor undergraduate GPA who wished to become a doctor. Are you espousing cheating? A: No, I'm espousing a second chance. Even murderers are sometimes given redemption, aren't they? So why shouldn't someone whose only crime is partying too much in college be given another shot at fulfilling his dreams? Should a couple of wanton years haunt him forever? Keep in mind that anyone who follows the Lucas strategy is automatically penalized, both financially and in terms of time. Hence, this built-in punishment ensures that their second chance is no free lunch. They'll be chastened, trust me. Still more ER questions Part 2 Still more ER questions Part 3 If you want a beautiful garage that is easy to keep organized, see the GarageScapes web site: www.GarageScapes.com.
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