Organ Donation: Check the “Selfish Bastard” Box For Me Too
by: Ross
The Wall Street Journal published an op-ed this week by Dick Teresi, who discusses some of the reasons why it might be a bad idea to have organ donor status on your driver's license. Mr. Teresi, author of a book on the subject, presents a number of reasons why organ donation might not be what you expect. For one thing, many people who mark "organ donor" on their licenses expect that they will be fully, unambiguously dead in the event that their organs are harvested for transplant. Yet Mr. Teresi describes how the best organ donors are in fact brain-dead patients who are still biologically alive. Because the brain is not an organ subject to transplant, an accident victim with isolated brain damage can be kept on life support so that all of his other organs remain alive. Since time from the death of the donor (and therefore removal of vascular support for the organ in question) is a major factor in determining how likely a transplant is to succeed, brain dead patients are sort of a gold mine in transplant medicine. If brain damage is the only issue, these patients can yield a higher number of healthy organs for transplant.
This, of course, presents a certain problem for physicians. When you have a patient whose heart is still beating, how do you determine if he is dead enough to slice him open (while his heart is still beating, mind you) and harvest his organs? How can you be certain that, though he is apparently "dead to the world," that he won't feel the pain while you carry out the procedure?
Mr. Teresi's point in the article is that physicians don't have good enough methods for this. See his description of the tests which are commonly done:
The exam for brain death is simple. A doctor splashes ice water in your ears (to look for shivering in the eyes), pokes your eyes with a cotton swab and checks for any gag reflex, among other rudimentary tests. It takes less time than a standard eye exam. Finally, in what's called the apnea test, the ventilator is disconnected to see if you can breathe unassisted. If not, you are brain dead. (Some or all of the above tests are repeated hours later for confirmation.)
These tests are specifically designed to check for lack of function in a lower part of the brain known as the brain stem, which mainly produces automatic responses in the body. If this part of the brain is dead, it is very unlikely that any other brain function exists. Unfortunately, physicians are out of the habit of checking for higher brain function, a check they could do relatively simply through electroencephalography (EEG).
In one of his more disturbing observations, Teresi points out that "beating-heart cadavers" often respond like conscious, living people to the scalpel blade--with substantial increases in blood pressure and heart rate. He even shares a story of an anesthesiologist who saw a brain dead patient regain autonomous respiration and who fought against his organ harvest on this basis. The other physicians on the case ignored him and did the harvest anyway, on the basis that he was unlikely to recover regardless of whether he was breathing or not.
Teresi's recommendation to not be an organ donor on your license is explained as follows: if you don't mark organ donor, and you thereby retain the right to informed consent, the physicians have to consult with your family before they harvest your organs. In this case, your family can insist that an EEG (or whatever other tests may be best in this case) be done to rule out any possibility of higher brain function. Otherwise, the docs can just splash some water in your ears and get on with cutting you open.
All of this information is pretty new to me. I'm not far enough along in my medical training to have any first-hand observations of how transplant harvests are done on brain dead patients, and I can't confirm the veracity of Teresi's reports. Nevertheless, I have long refused to be an organ donor on my driver's license for another reason: I don't trust physicians I don't know to have my best interests in mind. Even as a 16-year-old kid applying for my first driver's license, it only took me a second to realize that I have many organs and only one me, and that a physician with a shoddy set of ethics could easily put less effort into saving me if he knew that my organs could save 3 other patients. Before I got to medical school, I had debates (on a number of occasions) with people who told me that this was stupid--doctors would never do that. Their first commitment is to you. They didn't convince me, and for good reason. Because when I got to medical school, I realized all the more how right I was and how wrong they were.
The crux of the argument given by the "organ donors" with whom I debated is that doctors are taught a stringent ethical code, which teaches them to uphold first and foremost the health of the patient whom they are treating. They point out that the physician even takes an oath to the effect he should "first do no harm" to his patient. However, the oath to which they refer, the Hippocratic Oath, is no longer widely undertaken by physicians entering the field. It has long fallen out of vogue in favor of newer, more socially conscious physician oaths such as the Declaration of Geneva, in which the physician "consecrate[s] [his] life to the service of humanity." To be sure, the Declaration of Geneva still has a (slightly diluted) exhortation to put the patient first, but the problem is that it's combined with a primary obligation to humanity--i.e., plural.
At this point, some would say that this doesn't worry them too much. Surely a doctor would have the morals to know that you shouldn't let a patient die so that you can save 3 others. Yet I would urge you to question that assumption. Ethics are not systematically taught to medical students or physicians in training. At Temple, we had one real lecture on medical ethics in our first two years of medical school, and some scattered ethical recommendations throughout other lectures on clinical medicine. Not surprisingly, one of the main schools of ethics taught and promoted in this lecture was utilitarianism. This is not surprising because utilitarianism is far and away the most widespread secular, altruistic ethics in the United States. Utilitarianism holds that, in any ethical question, one must take whichever decision has the most utility--that is whichever decision promotes the greatest good for the greatest number. The greatest good for the greatest number. [it also happens to be the same ethical creed that leads people to think that killing newborn babies is no worse or different than abortion]
Needless to say, when I'm (ostensibly) brain dead on an operating table and 3 or more patients need my organs to survive, I don't think the numbers are in my favor. I agree that the vast majority of physicians would instinctively recoil at letting a patient die to save a greater number of transplant recipients. But I am not betting my life on the likelihood of the absence of just one self-righteous, altruistic physician who actually took to heart the evil creed of ethics taught in our modern medical schools.
If I die with viable organs, I couldn't care less what happens to them. My family knows that they are welcome to give consent to have my organs harvested under these circumstances. However, I better trust my fiancee, or my brother, or my mom or dad to choose my life over the lives of potential transplant recipients than I do an unknown physician, so I'm damn sure going to leave the decision in their hands. So the next time I'm at the DMV, and every time after that, I'm going to follow Mr. Teresi's example, and ask them to "just check the box that says 'I'm a heartless, selfish bastard.'"
Books I Read Last Year
by: Ross
So for a while I've been intending to start reviewing all the books I read on Think Twice. Fail. At the New Year, I thought to myself "Ross, you could just a do a Year-In-Review of all the books you've read." Fail again. So now it's March and, though it may seem a little late in the year to be reviewing books from 2011, I'm going to do it anyway. I would probably write more if I was doing individual reviews of books, but since they're all being lumped into one massive super-review, I'll just write as much as comes to mind for each book.
1. The Hunger Games Trilogy by Suzanne Collins
The Hunger Games: A+
Catching Fire: B+
Mockingjay: A-
I read The Hunger Games last February because it was suggested to me by Amazon, presumably because I had recently browsed a few other dystopian future novels and the Amazon brain thought I would like this one. Well, they were right on both counts. I generally enjoy dystopian future novels and I loved The Hunger Games. Seriously, I can't remember the last time I was this hooked by a book. I didn't want to put it down, and it's relatively short, so I finished it in ~1 day. The story projects a future in which the overlords of a fallen America subjugate everyone else by forcing them to give up two children for each of 12 Districts to fight to the death in a competition called (surprise, surprise) The Hunger Games. The main character is a girl named Katniss (all the good guys have really weird names, and all the bad guys have ancient Roman names, go figure) who is basically a total bad-ass. I doubt I'm revealing too much by revealing that she ends up duking it out in the Hunger Games, but other than that I'm going to cease and desist with spoilers and get to some more general reasons why I liked it. First, it was crazy action-packed--never a bad thing. Second, you get really sucked in by the perspective in the book. It's first-person present perspective (e.g., "I am doing X now"), which was really effective in this novel, and was also REALLY impressive given the action-packed theme, which usually doesn't fit well with first-person present. Think about how difficult it is to describe, for example, a fight scene using this perspective-- "Bob is punching me! Now I am punching Bob and totally beating him up! etc." It comes off rather poorly for most writers. Nevertheless, Collins does an awesome job with it. Third, who doesn't love a love triangle (notice how I saved triangle for third?). Overall, it earned the A+ and then some.
I wish I could say the same for its two sequels, Catching Fire and Mockingjay. They were still gripping novels and the writing was still skillful. But Catching Fire read like a repeat of the Hunger Games in almost every respect, which became pretty tiresome. Mockingjay was a slight improvement because the story wasn't as repetitive, but I had a different problem with this book. I read somewhere that Collins goal in the book was to depict the effect of war on children. I thought this was weird, as there isn't really any war in the first book at all. I don't want to give much away, but I basically got the jist from the last book that her view of war is that it is wrong as such. In other words, it's wrong to start a war and, having been attacked, it's wrong to defend oneself through war. This isn't explicitly stated, but her decisions about how to characterize key members of the resistance movement led me to sense that she was driving somewhere in this direction. Read the book, let me know if you agree.
2. The Millenium Trilogy by Stieg Larson
The Girl With the Dragon Tattoo: A+
The Girl Who Played With Fire: B
The Girl Who Kicked the Hornet's Nest: B
I listened to these books on audio from Audible.com, and I have to start out by saying that the audio versions were AWESOME. The guy who read them, Simon Vance, was superb--one of the best narrators I've ever listened to. Now on to the content. The first book in this series is really great. The main characters, a journalist and a goth girl, work together to solve an old mystery about a murder. That doesn't do it justice--it's super exciting. Go read it.
Unfortunately, as seems to be a pattern with my 2011 trilogies, the second two installments weren't as good. While the first book was a story in and of itself, the latter two books are really a part 1 and part 2 of the same drawn out story. It doesn't have the excitement of the historical mystery in the first book. Instead, the main girl, Lisbeth Salander, has a whole bunch of crazy s*** happen to her that she has to deal with. Not as good as Dragon Tattoo, but still worth the read.
3. The Hitchhiker's Guide to the Universe by Douglas Adams
Grade: A
Really, really funny.
4. The Paleo Solution by Robb Wolf
Grade: A
I thought this was quite good. I gave his 30-day challenge a try and I'm now a permanent convert to Paleo.
5. Loving Life by Craig Biddle
Grade: A+
I really loved this book, but I intend to do a more complete review in the future so that's all I'm going to say at the moment.
6. Objectivism: The Philosophy of Ayn Rand by Leonard Peikoff
Grade: A+
This was the textbook of my Objectivist Academic Center (OAC) course from last year, so I read and re-read this in my studies. I understand Objectivism much better now.
7. Atlas Shrugged by Ayn Rand
Grade: A+++
I obviously can't praise Atlas Shrugged enough. It's been my favorite book for many years and I usually re-read it at least once per year. This year I read it three more times in preparation for the ARI essay contest, an effort which really paid off.
8. On Writing Well by William Zinnser
Grade: A
This book was good for anyone looking to improve his writing. It has a good mix of practical tips for all kinds of writing and also a lot of shared experience from the writer.
9. Less Than Words Can Say by Richard Mitchell
Grade: A
This book is a scalding critique of the American public education system and the growing illiteracy of the uneducated young people who come out of it. The author, Richard Mitchell, is extremely witty and he seems to have an endless supply of acute observations about how poorly educated we actually are. Written in 1979, you can only imagine how much more relevant it is today.
10. Neverwhere by Neil Gaiman
Grade: A
I love Neil Gaiman, I'm a huge fan of his comic series The Sandman and his novel American Gods. I picked this one up after I finished my Atlas Shrugged essay because I needed to relax with an easy novel. I found that this is actually a novelization of a short miniseries that Gaiman wrote for BBC. Either way, the novel is really good. It's premised on the idea that there is a whole magical, fantastic underworld in London into which forgotten, homeless vagabonds disappear. The main character finds himself forgotten, at which point he has to explore London Below (as it's called) and help solve a murder mystery in order to get back to London Above. It was a great read, and I can't say anything negative about it. Gaiman is pure genius.
11. Anansi Boys by Neil Gaiman
Grade: A
This is the sequel to Gaiman's novel American Gods, which is story about gods of ancient myth who live in America. In this story, a London man named Fat Charlie finds out that he has a brother named Spider and that they are both sons of Anansi, the African spider god of mischief. Spider is basically a huge tool, and complicates things greatly, leading to major plot conflict. This was a really fun read. Highly recommended.
12. Israel: A History by Martin Gilbert
Grade: A
This was the last book I read last year. I finished it the day before New Years Eve. I was prompted to read it because I have long been a moral supporter of the state of Israel in their struggles with the PLO, Hezbollah, Hamas, et al. and, given the controversy over the issue, I wanted to have more facts. I selected this book for a number of reasons, one of which being that it was long and looked complete. Also, I perused the reviews of a large number of books on the history of Israel, and this was one of the few that seemed to not have been written from a perspective of deliberate argument against the Palestinian case. I wanted historical facts, not polemics. In any case, I thought the writing was very good, though overly detailed for my needs in many cases (e.g., a great deal of description of each Kibbutz, strategic descriptions of many battles, etc.). The book goes up to 2007 so it was easy to fill myself in with news articles to 2012. Also, the book had a ton of great maps. I'm generally very pleased with the book, but I would only recommend it with people who want a serious, detailed history of Israel--this book was a real time-commitment.
So that's 16 books last year, and that's not counting books I started last year and didn't finish yet. Also, it doesn't count the New Testament of the Bible and the Qur'an, each of which I read for cultural perspective but which I don't recommend to anyone. So all things considered I'm doing pretty well keeping up on my reading as a busy graduate student!
Abortion…After Birth?
by: Ross
I’m really surprised that this thing has flown under my radar so far, and it seems like it hasn’t had much mainstream news coverage, but apparently a daring duo of so-called medical ethicists have published a three-page article in the Journal of Medical Ethics (JME) which analyzes a practice which they euphemistically call “after-birth abortion”—i.e., killing babies[1]. Not to distort their view, they basically suggest that this procedure should only be carried out when the infant has some issue which would make life permanently suck for the parents, but nevertheless they still propose that the little babies could ethically be offed ex utero.
In their words:
...to bring up such children might be an unbearable burden on the family and on society as a whole, when the state economically provides for their care. On these grounds, the fact that a fetus has the potential to become a person who will have an (at least) acceptable life is no reason for prohibiting abortion. Therefore, we argue that, when circumstances occur after birth such that they would have justified abortion, what we call after-birth abortion should be permissible.
In spite of the oxymoron in the expression, we propose to call this practice ‘after-birth abortion’, rather than ‘infanticide’, to emphasise that the moral status of the individual killed is comparable with that of a fetus (on which ‘abortions’ in the traditional sense are performed) rather than to that of a child. Therefore, we claim that killing a newborn could be ethically permissible in all the circumstances where abortion would be. Such circumstances include cases where the newborn has the potential to have an (at least) acceptable life, but the well-being of the family is at risk. (bold emphasis mine)
For those who don’t know, I am vehemently supportive of the rights of women to abort without exception or restriction. I regard so called “pro-life” people as egregiously anti-life in that, by attempting to force unwilling women to carry fetuses, they are in profound conflict with life and all the values which it requires (see Leonard Peikoff on this). With that as context, I regard this new “ethical” justification of infanticide as beyond the pale. An infant, once separated from its mother, is an independent human entity and needs to be treated as such.
This article illustrates well the reason why, though I abhor the “pro-life” movement, I often do not feel at home with other “pro-choice” people—because many in the pro-choice movement are following whims just as much as the pro-lifers are. Without a solid, objective philosophic foundation on the matter (see recent TOS article on this), both groups are just pissing in the wind.
[1] Alberto Giubilini and Francesca Minerva, “After-birth Abortion: Why Should the Baby Live?,” Journal of Medical Ethics (March 2, 2012), http://www.ncbi.nlm.nih.gov/pubmed/22361296.
Pathetic Pickup Artists
by: Ross
The xkcd comic from today was really awesome. Titled "Pickup Artist," the comic humorously calls attention to the pathetic tactics of pickup artists (sometimes abbreviated as PUAs). To my knowledge, this PUA stuff became popular with the publication of Neil Strauss's book The Game: Penetrating the Secret Society of Pickup Artists and increased in popularity with the 2007 Vh1 show The Pickup Artist. There are many websites and other books with focus on teaching men these techniques for meeting and seducing women. The comic deals particularly with the shameful tactic known as "negging," which basically involves obliquely and subtly insulting a woman with whom one is engaged in conversation, thereby undermining her self-esteem and making her more dependent on your attention to fulfill her now-exacerbated need for confidence. New initiates to the PUA life way (I have known quite a few) are typically obsessed with the effectiveness of this little tip--obsessed way past the point of realizing that this method essentially boils down to trying to make girls feel bad so they can get laid. We have a word for that where I come from--asshole.
I have long thought that the life of PUA is generally stupid, only appealing to men with serious self-esteem issues, and ineffective at meeting quality women. Especially since these books/shows have made all of this information as available for women as they have for men. But I have never been able to express any of these thoughts as eloquently and amusingly as this comic.
How I Was So Wrong About Sleep
by: Ross
Anyone who has been well acquainted with me for more than a few years probably knows that I long held a certain strong opinion about sleep. Basically, my view was that people give way too much attention to sleep. I was in the habit of sleeping between 5.5 and 6.5 hours per night all through high school and much of college, and I always felt fine. People would occasionally inform me that science dictates 8 hours of sleep per night, for which I had a canned response. An extra 1.5-2.5 hours of sleep per night, multiplied out over the 100+ years I intend to live, totals to between 6.5 and 10 years of extra sleeping--time I can't spend doing the things I love doing while I'm awake. My view was that the cost wasn't worth the (supposedly) negligible benefit of being less tired.
So what changed? Well, I was listening to back episodes of Robb Wolf's Paleo Solution Podcast on a trip down to Baltimore and I was listening to a question that was, if I remember correctly, posed by a listener who has been having difficulty losing fat. Among a number of suggestions from Robb Wolf was that the person probably needed to get his sleep in order (a suggestion at which I would usually scoff) and followed this with a phrase that, for some reason, really stuck with me-- "I wish I could sell going to bed earlier." I don't know if it was the fact that he connected his advice to business/capitalism (which I obviously love), or if I just found it funny, but I got to thinking more about sleep. It was really the only element of the Paleo lifestyle that I hadn't tried or adopted yet. If Robb Wolf thought he could become a wealthy man if he could monetize good sleep habits, maybe I ought to try it. So I did. I started dimming the lights and reading some fiction at 9:30 am, lights out by 10:00 am and sleeping with a back-up alarm set for 7:30 am, the goal being to wake up without an alarm. How did it go?
Ho-ly Crap.
I don't know what else to say. I was so wrong about sleep. Looking back now, I think it's entirely possible that I may have never been well-rested in the last 12 or 13 years of my life. While I never thought I was tired before, the improvement in feeling well-rested is marked. I also have leaned out a little (though it's hard to attribute that to the sleep), but my most conspicuous (and favorite) improvement has been in cognitive functioning. I am way, way smarter when I sleep well (and, for the record, I was really smart before). I learn things way faster and I remember more of what I learn. I solve problems way faster; my experiment designs have become a piece-of-cake in the lab. I've been able to read more non-fiction without getting tired or burned out. In a surprising turn of events, I'm actually not intellectually stimulated enough now by television shows I used to like, so I end up reading way more (this could be viewed as good or bad, but I love reading so I'm going to take it as good). This, combined with David Allen's Getting Things Done (also a recent addition to my lifestyle) has turned me into a superhuman compared with my previous self. I so love all the effects of sleeping more that I've actually started eschewing late night social events, even on weekends, because I don't want to sacrifice this treasure trove of increased functioning.
Some observations. Like I said, I go to bed at 10:00 every night and wake up without alarm. The regularity of my waking time is actually really surprising; I almost always wake up at 5:4x am. That means I still come in short of 8 hours, but I think I'm probably fine because I'm waking up without an alarm. Waking up is an incredible change. I was so used to grudgingly getting up because of an annoying alarm. Now I just open my eyes and think "It's probably time to get up," I check my watch--and it is time to get up! Another thing I've noticed is that I started sleeping on my back. This might not sound weird to anyone else, but I've never (as long as I can remember) been able to sleep on my back. I've always been a stomach sleeper, with the occasional foray into side sleeping. I can't even imagine what could have changed that has made me a back sleeper this late in the game, but I think it would be too much of a coincidence for it to be unrelated to my change in sleeping habits.
There are some additional changes I would like to try to see if I can't hone my sleep even more. Robb Wolf recommends sleeping in a totally blacked out room, but I haven't quite gone that far yet. My room is pretty dark, but some ambient light does come in around the blinds (I have a huge window in my room which is really difficult to black out). Nevertheless, the total black out is my next frontier in sleep.
So, in sum:
1. I was wrong
2. Sleep is awesome
Awesome Science T-Shirt
by: Ross
I just saw that Saturday Morning Breakfast Cereal (SMBC) has this awesome t-shirt which says "Science: Ruining Everything Since 1543" with prohibition symbols over depictions of (1) a model of the geocentric theory of the solar system; (2) Michelangelo's The Creation of Adam (clearly intended to represent theism); (3) a unicorn. I love this t-shirt! It would really be perfect for when I wake up in the morning and feel like expressing my inner smart-ass.
For those not-well-versed with the history of science, 1543 was the year in which Nicolaus Copernicus's On The Revolutions of the Celestial Spheres was published, marking the beginning of the Scientific Revolution.
This R-Word Thing
by: Ross
I've been noticing a few people posting about a campaign to end the "r-word" (i.e., mental retardation, retarded, etc.). I've checked out the website and, I have to admit, I'm a little puzzled. Mainly, I'm puzzled by a lack of clarity in the actual aims of the movement--in particular whether the movement is directed at discouraging pejorative use of so-called r-words, or if it is directed at ending all usage of the terminology all together, including in psychiatric or educational contexts. To be sure, the pledge which they promote says "I pledge and support the elimination of the derogatory use of the r-word from everyday speech and promote the acceptance and inclusion of people with intellectual disabilities" (emphasis mine), which indicates that they recognize a distinction between derogatory usage of this term and legitimate medical usage of the term. Yet, there are elements of the campaign which seem to contradict this. The slogan is "Spread the Word to End the Word" which suggests they want to end usage of the word per se. A facebook meme created by and sponsored by the movement depicts a little girl with accompanying text which says, among other things, that "calling her retarded is hate speech" (quote may be slightly paraphrased as I'm remembering it, not looking directly at it as I write) which, overlooking the fact that I think the whole idea of "hate speech" is nonsense, is certainly a strong denunciation of the term as such, with no exceptions provided for legitimate, non-derogatory contexts. Moreover, the content of the webpage praises physicians who elect to substitute the term "intellectual disabilities" for "mental retardation" in the course of their professional workand likewise praises and supports legislation which requires that federal health-related documents use the same substitution, all of which further suggests that the movement is aimed at eliminating all usage of the word.
My reason for drawing this distinction is that, while I'm sympathetic with a general policy of discouraging derogatory usage of "mental retardation," it is clear that there are clinical contexts in which this term is used to refer to a real, specific set of disabilities. I think that there are some important issues to consider in relation to this.
"Intellectual Disabilities"
If this movement wants, as it appears to, for physicians to adopt "intellectual disabilities" as a replacement term for "mental retardation," it should be recognized that this is actually a de facto erasure of the term altogether. The reason is that intellectual disabilities is already a general category of disabilities which affect intellectual or cognitive functioning, of which mental retardation is a sub-category. For example, a person with a specific learning disability (e.g., in reading) has an intellectual disability, but does not have mental retardation, which is a type of intellectual disability which indicates more broad intellectual and cognitive limitations when compared to normally developing peers. Substituting "intellectual disabilities" for "mental retardation" is about as useful as asking people to substitute "sandwich" for "hamburger"--it sounds fine and good in theory, but what do I do when I legitimately need to distinguish between a general type of sandwich and a hamburger? Physicians, educators, etc. require a refined, specific terminology which can account for subtle variations in disorder--"intellectual disabilities" is not, in my opinion, good enough.
The Euphemism Treadmill
Even if a suitable, new terminology could be developed which refers to the group of disabilities currently designated as "mental retardation," I have serious doubts whether it should be done, especially considering the reasons cited by this campaign. The reason is that, whatever term is chosen, it will soon become adopted by the jerks of the world as a new derogatory term to throw around at others. As soon as "intellectual disabilities" would undergo widespread adoption as a clinical term, there will be kids on playgrounds taunting others by calling them "I.D." or some such variant. If you doubt this, consider the history of the term "mental retardation." "Mental retardation" was introduced as a medical term for the exact same reasons that are being cited for introducing "intellectual disabilities"--the previously accepted medical terms were regarded as having acquired derogatory meaning. The terms which were widely in use before mental retardation came into vogue were "idiot," "imbecile," and "moron," each of which was a clinical term which denoted a specific sub-normal IQ level. Since they were relinquished by the medical establishment, in favor of "mental retardation" as a blanket term, they have lost all legitimate meaning and are now purely used and understood as insults. Yet this is not yet true of "mental retardation." Patients, and parents of patients, are easily able to understand the contextual difference between using "mental retardation" as diagnostic language and taunts from jerks. In my judgment, retiring this word from clinical parlance would simply add one more taunt to the verbal arsenal of the mean-spirited without having any lasting beneficial effects.
Conclusions
Perhaps I'm wrong about this movement's goals and I just wasted a bunch of time writing about this. I certainly didn't have time to read every word on the website, so I went on some representative passages. If you think I'm wrong in my interpretation of the message of this campaign, let me know in a comment. Feel free also to present your case if you disagree with my analysis.
USMLE Study Tool: The Memorization Sheet
By: Joe
Memorization Sheet Word Document
When studying for a test like the USMLE Step 1 (the first of three standardized exams required for medical licensure in the United States) it is important to find a method to separate high yield facts that must be memorized from conceptual ideas that must be studied and thought about. The following document is one I made during my Step 1 studying to do just that. It can be used with a study plan of your choice or with my complete study plan.
Knowing this material alone could probably get you 15-20% of the answers. I recommend printing two of these (attached above as a Microsoft Word Document) and, as you go through First Aid and other review sources, fill in answers on one of the two copies. This will be your answer sheet to reference throughout your board studying period (I wish I could just publish my answer sheet, but that material is the intellectual property of First Aid and other review sources).
Every other day you should go through the blank "Memorization sheet" and write your answers on another blank sheet of paper. Afterwards, check these answers with your answer sheet and re-emphasize the facts you got wrong. Alternatively, you could do half of the sheet every day.
This takes about 30 minutes, but it is incredibly valuable.
Bactericidal antibiotics
Bacteriostatic antibiotics
Drugs that induce P450
Drugs that inhibit P450
Drugs that cause Lupus
Disulfiram rxn drugs
X linked diseases
Hormones that signal via cAMP
Hormones that signal via IP3
Causes of Acute Pancreatitis
Causes of DIC
Features of SLE
Criteria for Schizophrenia
Manic Episode
Suicide risk factors
Panic Disorder
Causes of Anion Gap Metabolic Acidosis
Regulation of Enzymes
Lysosomal Storage Diseases (FA full page - write page number in answer sheet)
Electrolyte Abnormalities (FA full page - write page number in answer sheet)
Draw: Virus Classification, Brachial Plexus, Basal Ganglia, Lung Volumes Chart, Embryonic Heart
Book: The Help by Kathryn Stockett
by: Ross
Grade: A+
Last weekend I was dying for a novel to read. I've been reading a ton of non-fiction (mostly history and philosophy at home and journal articles in the lab) and my brain was completely burnt out on it. I was actually so burnt out from reading non-fiction that I couldn't even bring myself to look hard for a good novel to read next. My fiancee had The Help on Kindle and it was near the top of the list so I just jumped right in when I saw it.
First thoughts--this book is awesome. I was immediately taken with it and I could hardly put it down. The story is told in a first-person, present-tense with alternating perspective from three characters: Eugenia "Skeeter" Phelan, a young white writer; Aibileen Clark, a black maid who specializes in raising white children; and Minny Jackson, also a black maid who is known for her cooking and her attitude. The story is set in Jackson, Mississippi 1962-1964 and deals with the struggles of the characters in the Jim Crow period in the South. The basic premise of the novel is that Skeeter decides to write covertly a book of real stories from the perspective of black maids in Jackson. I don't want to get too much more into the story because I'm extremely anti-spoiler.
In reading the book, the thing that I most felt was overwhelming repugnance at the racism of so many of the characters. In my life, I haven't run into that many racists. I think racism is properly ostracized so most racists don't come right out with it anymore (at least not in Pennsylvania, where I live). Notwithstanding my disgust for the racist characters, the main theme of the book is the triumphant effort of the main characters to try to do something about it.
I also watched the film of the book this weekend, and I thought it was very good. As expected, some of the elements of the story were changed to better accommodate film as the medium of story-telling, but it was mostly the same and the acting was great.
On a somewhat separate note, I was pretty bothered by this fake movie poster which I first saw on Facebook. It imagines the title of the film to be "White People Solve Racism" with the tagline "You're Welcome, Black People." I don't think an honest person could come away from this film, and certainly not the book, with this impression. The book has one white person who is deeply conflicted about the complex relationships between the black maids and the white children whom they raise and, in this context, decides to try to do something about it by enlisting the help of 13 black maids. Further, the story is 2/3 from the perspective of black maids and the book presents them as heroic characters who are taking great risks to achieve their values. Even so, the character of Eugenia Phelan (and anyone who may have acted in similar manner in real life in that time period) deserves moral credit for what she did. She by no means solved racism, but she exhibited profound courage in standing up for what is right in her disturbingly backward social system.
My (Atheist) Wedding Ceremony
By: Ross
I’m really blogging this off-the-cuff so bear with me if I ramble a little bit.
The Problem (A Moderately Long Story)
I’m getting married in July so my fiancée, Jennie, and I have obviously had to give a bit of thought to how we want our wedding ceremony to go. This has not been a particularly straight-forward issue, since, though we are both atheists, we were also both raised in (at least ostensibly) religious families and almost all of the wedding ceremonies we have been to or participated in have been religious in nature and were presided over by a religious leader. So right off, there’s the issue of not having any exposure to any non-religious weddings. We were, of course, familiar with the fact that you can receive a non-religious wedding in a courthouse, but that isn’t really the vibe we want. Essentially, we want to have what, in all respects, looks like your typical wedding with all your friends/family assembled and a person leading the ceremony. We just don’t want the ceremony to be religious.
The Commonwealth of Pennsylvania doesn’t make this particularly easy. You probably need a law degree just to sort it all out, but my brief perusal of the pertinent laws suggests to me that only clergy, mayors, judges, justices of the peace, etc. can legally preside over a wedding that isn’t taking place in a courthouse or city hall. Another part of the issue is that Jennie and I want to know and value the person who is marrying us. I don’t happen to be friends with any mayors, judges, justices of the peace, etc. In this context, it has occurred to me that there is a certain state discrimination against the non-religious in this regard. Religious people who go to church (temple, mosque, etc.) are likely to know and feel close with their clergy-person, whom they are likely to get to marry them. For non-religious folks, the state basically says “Too bad—if you want someone you know to marry you, join a church!”
In the beginning, Jennie and I considered having the minister at her parents’ church do our wedding ceremony, providing she was willing to do a non-religious ceremony. Jennie emailed her and asked her about it, and she said that she would have to meet with us first and talk about it before she could decide whether she would be willing to officiate a non-religious ceremony, something she had never done before. One of the questions she wanted us to be able to answer was “Why get married at all if not for religious reasons?”
We couldn’t set up the meeting for a while because of schedule constraints, so we had a lot of time to think about it. Ultimately, we decided to go another direction, and I’m really happy with the decision that we made.
Our decision was motivated by a pretty basic desire: we want to be married by someone who is overwhelmingly excited about our wedding/marriage and who wouldn’t hesitate when asked to officiate. We, further, think that almost no religious official would fit that bill, because the religious view is that love comes from God. For my part, I was exceedingly uncomfortable with religion having any part in the wedding ceremony, even as the ostensible source of the officiant’s legal authority, because religion has no role in my life. I was also concerned that having a religious official presiding may be taken by my guests as my implicit endorsement of religion (e.g., “he’s atheist but he still thinks religion is ok”), and the fact is that I generally disapprove of religion insofar as I disapprove of all forms of unreason.
The Solution
It’s a funny thing that Jennie and I were looking for people who are excited to participate in our wedding, whom we value greatly, and who share, or at least understand, many of our core values and we couldn’t seem to find them anywhere. It turns out that they were right under our noses, as they likely are for anyone who is getting married—those are the exact qualifications for a best man or maid-of-honor. So our ultimate solution was to enlist my brother, Joe (co-author of this blog), and Jennie’s sister, Sarah, to co-officiate our wedding ceremony as well as being best man and maid of honor. [As a side note, we’re really grateful to both of them for being willing to do this]. We’ll either get married in a courthouse the day before the wedding to make it legal, or we’ll get married under Joe’s authority as an atheist minister (go figure) of the Universal Life Church, an online site that will ordain pretty much anyone to perform marriages in approximately 2 minutes. Jennie and I will be writing all of the content of our wedding ceremony so that it fully reflects our values and only our values. I’m super-pumped!
Next up: Wedding Cakes!