This is incorrect. You just can’t switch manufacturers easily if you’re stable on one. But that’s not a brand vs generic thing, that’s an any manufacturer to any-other manufacturer thing. Same with warfarin, narrow-therapeutic index antiepileptics, etc.

No idea unfortunately, but definitely not to release pressure. You don’t get air in your brain, it’s all fluid. Outside of the hospital, all the drains drain to somewhere internal, usually the abdominal cavity

Am doctor. Outside of very rare and specific causes of headache, no this wouldn’t fix anything, just put you at risk for infections.

Am a doctor, this wasn’t actually a migraine and is not how migraines happen. Shunts are placed for elevated intracranial pressure, which can occur for a number of reasons, and do cause headaches. But it’s a very uncommon cause of headaches and a shunt will not fix your actual migraines or tension headaches.

Cellular insulin resistance is the definition of Type II diabetes

Body-bag ice cooling has actually been pretty common practice across emergency medicine for some time. Legit body bags (clean ones obviously) are purpose built to be watertight and hold an adult human, and they’re easily accessible to hospitals. It’s a very effective and affordable method for controlling hyperthermia

Not OP but loss of the Pi results in loss of network connectivity. A headache if you’re home and never doing anything time-critical on the network. A disaster if you or anyone else is dependent on the network for anything time-sensitive (virtual doctors appointment, work call, etc), or you’re away from home and unable to directly VPN to your router to reconfigure DNS settings.

I go back and forth on this. I feel like I’m enabling these choices by pulling punches. But it feels excessively anti-fun to just kill them and be like “sorry lol be better”. I don’t think I have the heart to just murder characters all the time.

That’s why I came to the community. I feel like I’m a reasonable and half-way experienced DM at this point. The player is aware cantrips are unlimited use. The player is a very intelligent individual. I’ve had the conversations about spell use. At its core, I genuinely think the player is attracted to the “cool factor” and “aesthetic” of playing a caster but doesn’t actually want to engage with any of the mechanics. I can remind the player about spells and that reminder will last for a combat, sometimes less. I feel like I’ve done everything I know to do aside from straight banning the player from playing full casters or queuing them to cast spells every-other turn, I’m at a loss.

All of my encounters with individuals who feel liberal arts are useless and STEM is the way seem to, at their core, feel that way because of earning potential, and I’ve never heard one of them bash Econ/finance/investment as a career path. But 🤷‍♂️

Then no, I don’t agree with this specific implementation of the system, at least the second half. I do think more productive/effective workers should be compensated more. But being a good engineer does not make you a good manager, and the issues associated with promoting an excelling worker into management (a job requiring a substantially different skill set) are so common there’s a name for their inevitable failure, The Peter Principle

I didn’t say it did, but I am a citizen of the USA and the vast majority of my cultural experience and knowledge, and therefore what I can intelligently comment on, are centered on the US.

Well you need to clarify further then. Are you saying we should make the best scientist the president, or the person with the most aptitude for politics and rule to be president? I don’t see how this is functionally different than what I said.

If I was guessing, in general, I think people who advocate for a pure meritocracy in the USA feel the world should be evaluated in more black and white, objective terms. The financial impact and analytic nature of STEM and finance make it much easier to stratify practitioners “objectively” in comparison to finding, for instance, the “best” photographer. I think there is also a subset of US culture that thinks that STEM is the only “real” academic group of fields worth pursuing, and knowledge in liberal arts is pointless -> not contributing to society -> not a meaningful part of the meritocracy. But I’m no expert.

As a general rule, yes. People who are able to better perform a task should be preferentially allocated towards those tasks. That being said, I think this should be a guiding rule, not a law upon which a society is built.

For one, there should be some accounting for personal preference. No one should be forced to do something by society just because they’re adept at something. I think there is also space within the acceptable performance level of a society for initiatives to relax a meritocracy to some degree to help account for/make up for socioeconomic influences and historical/ongoing systemic discrimination. Meritocracy’s also have to make sure they avoid the application of standardized evaluations at a young age completely determining an individual’s future career prospects. Lastly, and I think this is one of common meritocracy retorhic’s biggest flaws, a person’s intrinsic value and overall value to society is not determined by their contributions to STEM fields and finance, which is where I think a lot of people who advocate for a more meritocracy-based society stand.

EMS communication over unencrypted channels is limited by HIPAA, patient information must be kept vague to protect patient privacy. In the event that, say, an individuals name needs to be given to the receiving facility to facilitate review of records prior to arrival by the ER physician, some other method of communication has to be used.

As I said previously, the process needed to get insurance under these programs can be too complicated for individuals with low literacy or for whom English is a second language, limiting their access to these resources. And believe it or not, there are individuals for whom $15 a month is still not affordable for something they may or may not use that month, like medical insurance.

I’m aware that those costs do not magically disappear and are absorbed into other billing/passed on to society. However that is not why healthcare is so ludicrously expensive in the United States. It is the substantial and unnecessary administrative costs, predominantly driven by for-profit insurance companies, for-profit hospital systems, and pharmacy benefits managers. The continued exploitation of the ill for shareholder benefit is a uniquely American take on health care, and coupled with our incredibly individualistic tendencies bring about a huge fraction of the poor health outcomes we have in comparison to other developed nations, despite spending generally more than double per person.

Some of this is certainly driven by system inefficiencies such as forcing people into a situation where they have to use the ER for primary care. Or where they cannot afford their blood pressure or cholesterol medicine, and instead of our society helping provide these very affordable interventions, we pass the buck. So when those individuals inevitably have a heart attack, we then pay many times more for care that they may not have needed had they simply gotten good preventative care.

I will happily stand up and bash the current US healthcare system. I despise its insistence that human lives and suffering are secondary to wealth-extraction. But as much as I hate it I can’t change it, and while I will advocate for policy to change things, for now all I can do is continue to provide care to the patients presenting as a symptom of an ill society.

I hope others can see that these patients presenting to the ER are simply doing the best they can to take care of themselves and their families, and that the real blame and consternation should be placed on the government, hospital, insurance, and pharmaceutical officials and lobbyists who continue to exploit their illness for profits.

Let’s see if I can add something to this conversation. I’m a fourth year medical student in the United States, who in a few short months will hopefully begin training to be an emergency medicine physician. You are absolutely correct, that the government subsidizes health insurance, and that in a decent number of cases, individuals without insurance or the means to pay for healthcare are eligible for Medicaid. You are also correct that the ideal use of the emergency room is to evaluate for medical emergencies, I say this as someone soon to be an emergency room doctor. Lastly, there are certainly physician groups which are capable of providing cash pay based care.

However, the process to apply for Medicaid can be quite complicated, particularly amongst those with low medical or even just general literacy levels. This disproportionately impacts individuals for whom English is a second language. As I said above, in a perfect world, the emergency department is only for true medical emergencies. However, patients as a whole are notoriously bad at knowing if their symptoms are from an actual emergency or not. Secondarily, in many communities, the emergency department is the only reliable access some individuals have to the health system due to difficult difficulties with transportation and scheduling. With regards to your last point, while there are certainly clinics that can provide cash based care, the majority of individuals who cannot afford insurance are also likely the patient who cannot afford a cash pay clinic.

The fact is also that a large number of uninsured patients will simply have their ER bills written off by the hospital, and/or social workers within the ED will help sign the patients up for Medicaid if they qualify so they become insured can then have the visit billed for, as opposed to the individuals giving fake names.

Unfortunately, the current state of the US Healthcare system is that for many disadvantaged populations, the ER is their primary care physician. This is not ideal, but I will not admonish my patients for doing what they can to seek care in a system that otherwise leaves them abandoned and uncared for

Pharmacist and 4th year medical student here. Fun fact is TPN (total parenteral nutrition, i.e. IV food) is usually somewhere around 2L of volume daily, and the limiting factor preventing us from concentrating it more is the protein component. We can make some really concentrated sugar solutions, fat is so calorie dense it doesn’t take up much space either, but protein isn’t particularly calorie dense and can’t be concentrated very high before it starts to crystallize.