and you don’t even get to nut :/
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and you don’t even get to nut :/
Guys, please, i didn't even make the anomalocaris drawing, i just thought it looked funky and posted it, please i dont want this to be my legacy
Not to mention the normalization of 12, 16, and 24 hour shifts in the medical field, as well as there being no legal recourse to refuse being mandated to stay beyond 24 hours when you don't have relief.
Worker abuse, systemic medical abuse, and ableism all in one go.
it also kills thousands of patients a year. sleep deprivation is indistinguishable from being drunk in terms of how badly it affects reaction time, rational thought, decision making, and manual dexterity. people are making just as many life-or-death decisions about patients at the ends of those 24 hour shifts as they are at the beginning. we need a national medical worker's strike and we need it yesterday
@appalachiananarchist idk if you’ve seen this yet but I’d like to see your take on this
I have a lot to say about this.
Regarding general inaccessibility:
Medicine is not friendly to disability, period. Signed, a disabled doctor.
Because medicine is hostile toward disabled doctors/students, we haven't placed much focus on finding ways to arrange accommodations for doctors, normalizing asking for accommodations, or viewing disability as anything other than a red flag that gets your application side-eyed. Medical training, as I will discuss below, is a really inhumane process sometimes. The things that are physically and emotionally expected of people are simply not survivable for people with various types of illnesses or disabilities. The people making decisions about who gets accepted to school and who doesn't take this into account. Anyone who says "no they don't!" or "that's not legal!" can message me directly. Again, signed, a disabled doctor who was questioned at length about it when applying to school and residency.
The end result is that many disabled would-be doctors get pushed out of the field early, already skewing practitioners toward people who are generally healthier and able bodied, and therefore less empathetic toward the disabled and chronically ill.
Quick side note before I go on: Even though the structure of training and practice is not disability-friendly, that doesn't mean disabled doctors don't make it through or that doctors who start off healthy/able-bodied cannot become ill or disabled later. There is an odd view that we are inhuman robots who do not understand or experience poor health ever, which worsens ableist expectations of medical practitioners and trainees & the overall problem here.
Due to inaccessibility and discouragement during the selection process, we are already starting with a sample of healthier-than-average people. Then the training and practice itself just kind of squeezes the remaining empathy out of people. Some of that is necessary. If I felt the full force of empathy for every patient who hurt, who cried, who died, I would not be able to walk out of the room and deal with the next patient. But even then, it isn't that I don't FEEL the emotions - I just compartmentalize them, deal with them later, when people don't immediately need me. The problem comes when the superhuman expectations on trainees and practitioners makes you so jaded that your ability to feel these emotions at all gets damaged.
It is...hard to feel sympathetic toward a patient with a chief complaint of "tiredness" when you are on day 14 of a stretch of 12 hour shifts, but also had to cover a 24 last night in which you were up all night running code blues, and now have morning clinic office hours. It's hard to be sympathetic towards another's depression when you haven't slept normally in weeks, haven't spent any time with your family in as long, have lost all your friends, missed most weddings/birthdays/funerals in the family for years, and have sacrificed most if not all hobbies (all of these things are common especially in residency). I have seen residents and doctors go through some really inhumane things, especially during residency training, and it absolutely changes you when the people around you care so little for your needs. Cries for help are often met with professional concerns for your ability to continue. Medicine teaches us that our suffering does not matter, needing help is weakness, & stoicism is necessary, so when we see our patients come to us for help for things that we also experience, it is really, really easy to feel bitter toward them. It is WRONG, of course, but easy. People are just people.
I can say both anecdotally and from personal experience: the lifestyle balance can improve, if you seek it out, after residency, but the years of being treated like a robot and the "tough it out" mindset that was hammered into our heads during that time doesn't just go away, and it impacts the way we communicate with and think about patients forever.
Side note 2: Obviously not every doctor has had experiences like the above, but it is really common, and was much worse in the older generations of doctors. Obviously not every doctor has been so deeply affected to the point of bitterness. I am just discussing in broad strokes some common things I have heard, seen, and personally experienced among myself and my colleagues.
Regarding the shift & work hours, specifically:
People who support long shifts can generally be divided into 2 camps: the "this is how I trained so you will too/it builds character/if you can't handle this you can't handle medicine" camp, which can be immediately disregarded as an appeal to authority and tradition, and the "frequent care transitions are dangerous to patients" camp, which deserves discussion.
When a doctor goes off shift and a new one comes on to take their place, a transition of care occurs. All the important information about a patient has to be quickly communicated between providers. Information gets lost because human communication is never perfect. Due to this, deceasing the number of transitions between doctors per day is best for patient care.
Doing the more standard 8 hour shifts (in hospitals, anyway) would mean having 3 doctors working that day and require 2 trade offs. This means employing (and therefore paying) more people, and increases risk of information loss or miscommunication during the day.
In the inpatient setting, I really think 12 hour shifts are fine. You can have a day and night shift doc, 1 transition. This issue I have is not with 12 hour shifts themselves, but that people are sometimes expected to work way too many in a row. I have had to do 14+ days of 12s without any breaks, and that wears you down fast when you consider how mentally exhausting this type of work is. You have to always be at your best or you could kill someone.
I think 24+ hour shifts should never happen. There is no good justification for it outside of true emergencies. The risk of hand offs is not greater than the risk of a sleep deprived doctor caring for you. We know way too much about how sleep deprivation works for any good doctor to feel this is ethical for their patients, who often have no idea just how little sleep we have got when they agree to be under our care. Our patients deserve so much better than this dishonesty and it should be considered equivalent in unprofessionalism to coming into work drunk or high. I once was in a trauma surgery where one of the residents actually dozed off while standing over the patient. Explain to me how that was safer than calling in another resident.
People like to say the long hours or multiple days/weeks without relief is a necessary part of medicine. It isn't. The problem could be improved by creating more doctors to meet demand. This would mean entirely revamping the medical school + residency process and creating more positions. Physician salaries would end up lower, but who cares if by increasing med school accessibility we lower its cost, so we don't all have 3-400K in student loan debt that necessitates high salaries to manage, and are not so bitter and sleep deprived that our divorce rate is like 70-80% and suicide rate is ridiculously high? We need a greater push in the culture of medicine to prioritize physical and mental well being of trainees and doctors so we aren't churning out people whose empathy has been burned out of them. We need a greater culture change to find ways to accommodate doctors with disabilities, to get more perspectives in the field and to force the issue of improving work-life balance in medicine.
That is really over simplified in terms of a solution, of course.
A genuine health care worker strike would probably be very effective. One time all the doctors at my hospital started mass transferring our post-cardiac arrest patients (big hospital money makers) out to other hospitals until our administration got a hypothermia protocol in place. The protocol was instituted within 24 hours. I don't think a traditional strike will happen, though, at least not among American doctors. Partly because you are talking about a bunch of beaten down rule-followers. Mostly because a doctor truly leaving their post means innocent people are irreparably damaged or die. It complicates matters.
@appalachiananarchist thank you for this addition I think it’s extremely important people hear the voice of a disabled doctor on this issue.
It sucks that striking is near impossible for doctors/nurses due to patients potentially dying. How do you think that this could happen without mass death?
I don't have a great answer. I think that, since a lot of the problems I discussed in this post are much bigger than individual clinic or hospital policies (meaning, things like number of residency slots, biases in admissions, and general culture) we could focus on action in non-clinical settings. There are a number of regulatory boards that oversee medical education, control the residency application and assignment process, and that supervise/certify physicians by specialty. All of these not only have a big role to play in the actual application process, but in setting precedents and standards nationwide. These organizations are not involved in direct patient care. Targeting changes in these non-clinical settings may be a way to combat some of these issues safely, though it would only be the tip of the iceberg in terms of fixing problems with the US medical system.
I may got inspired
Guys, please dont make me the guy known for a anomalocaris this is so me meme
Auburn University's avg. GPA from 1993 to 2023
Source: https://auburn.edu/administration/ir/factbook/retention-performance/term-gpa-class-gender.html
Based biofriendly lawn enthusiast vs. beta cuck HOA
CicadaCon ‘24
Inspired by this year's mass cicada event and the song "cicada waltz" by The Official Bard of Baldwin County
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Acoelomate
-- organisms lacking a body cavity
-- ex = phylum Platyhelminthes
-- organs may be embedded in parenchyma
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🚨💥🦠 NEW PRIMARY ENDOSYMBIOSIS DROPPED🦠💥🚨
A new haptophyte alga, Braarudosphaera bigelowii has managed to be cultured which contains what was thought to be an endosymbiotic nitrogen-fixing cyanobacyterium. Upon further study which was possible once B. bigelowii was cultured, it was shown that this purported endosymbiont imports proteins with a specific peptide tag from its host cell. This could indicate that the endosymbiont has lost part of its genome and transferred it to the host cell, which is the one who makes the proteins in those parts now. Along with the fact that it grows and divides synchronized with the host cell, this could indicate that the endosymbiont has become an organelle, which has been dubbed the nitroplast!
This would only be the 4th ever known case of primary endosymbiosis, after the original mitochondrion, the original chloroplast, and the cyanelles of Paulinella. This nitroplast, however, is remarkable for being the first ever known example of a nitrogen-fixing organelle in eukaryotes. This is of particular interest because it shows that potentially we could also engineer other eukaryotes (plants) to have a nitrogen-fixing organelle, which would remove the massive dependence on fertilizers as a nitrogen source in many plants, as they could fix it directly from the air!
B. bigelowii is also delightfully dodecahedral:
https://phys.org/news/2024-04-scientists-nitrogen-organelle-1.amp
I got the brand of neurospicy where whenever I see a small space, my immediate thought is "huh i wonder if you could fit a person in there," which led to a wonderful interaction in my chemistry lab today.
My TA: *looks inside flammable chemical cabinet* "oh wow theres nothing in here"
Another student: "it honestly looks much cleaner than the rest of the lab"
Me: *looking into my TA's soul* "i wonder what would happen if someone got put in there"
My TA: *looking horrified*
Me: "No WAIT not like THAT"
'Cus you know, it's biology.
My new sticker designs :)
Available on: Burboi's shop (redbubble.com)
every single day I think about how american black vultures are known for engaging in allopreening (preening between different species)
and they have a specific relationship with crested caracaras, in which the black vultures assist them by not only preening them after meals but also leading them to food in the first place— due to their superior sense of smell— while the caracaras assist the black vultures by acting as a warning signal in case of danger
and while this is more typical of black vultures, this is not common at all for any member of the falconidae family— it’s a special bond!
yet another post in favor of vultures everyone , hope you enjoy:) and I implore you to do some more research on these incredible birds !!