Brain waste, funny taste

An article I came across in the JAMA on health worker migration alludes to what they call " Brain waste"- skilled migrant workers are unable to find work in their area of expertise and end up working in unrelated low-paying jobs.

Exotic sounding word.No neurons being tossed into the bin.But compelling on the idea of why people mix up career and life.People have very quaint ideas when they make the switch.

While I must admit at forth that I am no sage on this, I have heard mixed views.
For people like DRK, working in resource poor areas was a brain waste.That its no use working for excellence when you are fighting with red tape and cost cutting all the time. It is funny, none of my teachers have given me negative feedback on that.Not Dilip Mathai, not DRK, not Kaka.
Hardik was honest to admit that its all about money.
One friend of mine, now an intern in MI told me that he came here with romantic notions that what he saw in western movies about a open country and 'promiscuous' lifestyle was true.
"Tab life mein aish karne ka aise lagta tha"

There's a whole bunch in KEM and BJ who think the Mah government is going crazy on bond issues, trying to bulldoze its way through on its supposedly moral high ground, and count it as wise investment to rather spend time and money in making it to elsewhere.

Abhijit said he wants to learn interventional pulmono skills.Charudutt said the same thing when he first came.Learning skills.Lot of things have changed since.

Lifestyle is a major draw.But I presume that means cleaner roads, more taxes, being distanced from near and dear ones,loneliness, nice big cars,safety, subtle racism. It is a mixed bag, really.It is about making choices based on priorities.As Dhiraj says," i would rather be a first class citizen in a second class country than be a second class citizen in a first class country."
No one person is right or wrong here.Just that 'results might vary based on experience.'

Many medical students seem to do so because it is a fashionable thing to do.All the batch toppers are doing it.It catches on as a trend in places like MAMC or AIIMS, where Ramadoss has to address the convocation thus:" don't go away. And if you do, please come back."In my MD batch I am the only one who chose to give my USMLE. In the batch after mine, half the batch is already interviewing.

Renita gave me a totally new perspective: of parents of unmarried girls equating getting married to someone in the US and going there as being an indicator of success in life. I got registered on shaadi.com, just to test the waters and am already put off and shall be deleting my profile.


These are individual anecdotal experiences, a bit colorful,but unsupported by sexy stats.For a more detailed discussion read the WHO fact sheet on this. But I gather, at least from the Pinoy experience, everything starts with an individual experience, an anecdote, a word of mouth, which people tend to trust.Then when things get big, people become numbers, more reliable.

If anyone does read my blog, your experiences are welcome.

Yeah...Mukesh Ambani is the richest man on the earth......so?

Territory size shows the proportion of all people living on US$10 purchasing power parity or less a day worldwide, that live there.

And the Sensex touched a sexy 20,000.So?
More such maps and great stuff at worldmapper.

To give you a sized perspective of things>>>>

Watch the video here....amazing stuff!!!

http://www.micro.magnet.fsu.edu/primer/java/scienceopticsu/powersof10/

LoveER

Believe me or not. If you plan to work in Emergency Medicine, there is a high chance that romance will strike you sometime or the other, more so if you are tall, muscular, with chiseled features and had suffered personal tragedy in the past.

Brendan Kelly from Department of Adult Psychiatry, University College Dublin does a study where she studied 20 randomly selected medical romance novels. And published her results in................... the Lancet !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!( Lim-> 1/0)

Lance my conservative heart, you blokes. Holy whatchamacallit!!

And the conclusion:
These novels draw attention to the romantic possibilities of primary care settings and the apparent inevitability of uncontrolled passions in the context of emergency medicine, especially as practised on aeroplanes. These novels suggest that there is an urgent need to include instruction in the arts of romance in training programmes for doctors and nurses who intend working in these settings.

Get me some beer please.

The new Harry....expectations

We all have grown up on this book figuratively, and literally speaking- ventured through the 14th while looking up to seniors who read the 12th and 13th, snacked on titbits from the 15th( the most extensive edition to date) ravaged the 16th with pencil underlinings and dogs ears and sticky notes, sweaty forearms and contemptuous doodles...and finally here comes the 17th. Waited a long time for this!!

The 16th was probably the one with the most mistakes- 'non caseating granulomas in TB', holy mackerel!!- as also the most monoclonal antibodies. It was a colorful cousin come visiting, but we hoped for short time.The editing left a lot to be desired - GI and immunology had a lot of unnecessary chapters, the cover was unimaginative and the colors looked as if they were splashed all over with childish glee, the mistakes were atrocious, and I still like to have an atlas- it is what makes OTM a pleasure to read when line after line of text get to your rods' nerves.

The 17th will be out March 2008. Priced $199 on Amazon. From what I can see it seems it is packaged as one book.I hope I am wrong, carrying it along will be a pain. And the middle chapters will be a pain to read with print going down into the central gutter.We want to hypertrophy the gyri, not the brachii.

Dr Loscalzo joins the editorial board. That had to be, given that so many of Harrison's authors are from BWH :-)
The promotional video says there's a 40% increase in content. This valuable new collection includes even more great depictions of pathophysiological processes, decision-speeding algorithms,( we never needed an overdose of that guys, least of all for something like osteoarthritis, probably the worst flow chart in the 16th. And the emergency medicine section had hardly any!!There's always Fred Ferri for flowcharts guys. Butt I have to hand it to you on this, endo flowcharts rock!!) clinical photographs, essential radiology images, an atlas of EKG tracings ( thats a great addition), and full color depictions of key pathological specimens( again, I hope this doesn't get too extensive)

There's 40 new chapters- including Health Disparities," "Quality and Safety in Patient Care," "Hospital Neurology," "Electrophysiology in Neurological Diagnosis," "Clinical Management of Obesity," and "Approach to Heart Murmurs" . All good additions I would agree.

There's a new section called regenerative medicine ( fancy name!!) which includes Stem Cell therapy, tissue engineering and the works. This had to come I guess. So they take some tonnage out of the outlandishly heavy on content Genetics chapters.

There are three great additions I feel:
1)Paul Farmer makes his debut in a chapter called Global considerations in medicine. All chapters will have a Global Considerations icon, which identifies important epidemiological, diagnostic, and therapeutic distinctions between global regions to aid in the diagnosis and management of specific diseases. This will help Harry shed the America specific image it is perceived to have, and enter the league of OTM. A big round of applause for this one.

2) The classic Introduction to Clinical Medicine section features new e-chapters addressing Patient Safety and Quality, Ethics in Medicine, and The Economics of Medicine; Health Disparities, and more.

3) Bonus content in a DVD, as eChapters. This includes 37 chapters spanning some 300 pages , 90 videos and include content such as an atlas of CTs and a chapter on radiography of the chest,atlases of renal pathology and urianalysis, neurology, vasculitides among others.

Harry also has taken a leaning to putting factual information into procedural approach with the 'approach to the patient' boxes since the 16th.They push the pedal on this one with extra additions in form of symptom management. I do not know the details, but this is again a welcome addition form an internist's POV.

Fact is Harrison is the most popular medical textbook all over.It is a humongous task for the editors to even attempt to cater to all their reader base. But this edition seems to be a great first step.I look forward to March 2008.

Gandhi the UnNoble

I found this engrossing piece on Gandhi on the nobelprize.org website. Ovyvind Tonneson, the editor of the official site from 1998 to 2000 writes, quoting from personal diaries of the members of the Norwegian Nobel Peace Prize Committee. Nominated 5 times in 1937,38,39 and 1947 and 1948, each time the Nobel Peace Prize Committee shot down for reasons as varied as Chauri Chaura, partition, the rioting that followed, and also the fact- in 1948, when he strongest candidate -that the Nobel Prize had never been awarded to anyone posthumously till then.In fact in 1948 the Nobel prize for peace was not awarded to anyone, the official statement from the Committee being that there was 'no suitable living candidate'

The earlier committee( 1936) had harsh words about Gandhi, Jakob Worm Muller, an advisory to the Committee had these words to say:
"He is a freedom fighter and a dictator, an idealist and a nationalist. He is frequently a Christ, but then, suddenly, an ordinary politician." There are many hate sites which say Gandhi's fight in South Africa was restricted in that he took up cause for the Indians but not the blacks.

Muller probably misinterred on Gandhi's philosophy including his message of shunning cowardice for violence as being inconsistent on his principle of non violence.It is important to remember that Gandhi was a soul keeper who chose to be truthful to himself more than a politician. When confronted with making a choice between being truthful and being practical, he would choose the former, thus infuriating many of his colleagues, who chose to play the politics game upfront.He was the writer, thinker, Nehru was the orator. Many of the things good or bad that are ascribed to him are actually the INC's decisions.Besides Gandhi himself accepts that he made mistakes. He accepted to be a part of the British Empire initially.

The exact reasons, deliberations of the Committee are not cited. These are Tonneson's conclusions. Statute 8 of the Nobel Foundation states, "the deliberations, opinions and proposals of the Nobel Committee with the award of prizes may NOT be made public or otherwise revealed."

The irony is that eminent personalities, who based their own actions on the pattern of Gandhi's teachings, were themselves awarded the Nobel Prize in later years — Albert Luthuli in 1960, Martin Luther King, Jr. in 1964, Mother Teresa in 1979, the Dalai Lama in 1989 and Nelson Mandela in 1993.The irony is that Yasser Arafat and Henry Kissinger can be awarded the Nobel prize for peace by the same people who prefered to be holier than thou with Gandhi!!!

Visual acuity six by sex

This is an uproariously funny Snellen's chart for testing your acuity of vision!!LOL.No one will be 6/6 on this I guess!!