E. Walong

Doctors should be paid based on the health of their patients. Things would look a lot different.

Pakistán e India se odian, viven en guerra, tienen una carrera de arsenal nuclear. Sin embargo tienen la mejor ceremonia de apertura y cierre de frontera del mundo.

“If powerful states were rare in precolonial Africa, that was because Africans did not want to build them. Statelessness was a sign of success, not failure.”

The scariest finding in this paper: the subjects couldn't tell it was happening. UPenn ran this study on 48 healthy adults. One group slept 8 hours. Another slept 6. Another slept 4. For 14 straight days. They tested cognitive performance every 2 hours from 7:30am to 11:30pm. The 6-hour group's reaction times, working memory, and sustained attention deteriorated on a near-linear curve. By day 14 they were performing at the same level as someone who hadn't slept at all in 48 hours. The 4-hour group hit that threshold by day 6. Here's the part that should unsettle everyone who thinks they "do fine" on 6 hours: the subjects' self-reported sleepiness flatlined after the first few days. Their brains kept getting worse. Their perception of how impaired they were stopped updating. The cognitive decline was invisible to the person experiencing it. The researchers found a hard threshold. Any wakefulness beyond 15.84 hours in a day produces cumulative neurobiological cost. That cost compounds every single day you exceed it and does not reset with a weekend of sleeping in. About 35% of American adults sleep less than 7 hours a night. 40% of those get 6 hours or less. In 1942 that number was 11%. We built an entire professional culture around a sleep schedule that this paper says is functionally equivalent to pulling consecutive all-nighters. "I'm fine on 6 hours" is the most common response to sleep research. The first thing chronic sleep debt destroys is your ability to notice chronic sleep debt.

There’s a formula that a lot of med students follow haha: UFAPS (uworld = practice questions) (first aid = abbreviated content & reference book) (AnKing = a flashcard deck that can be downloaded for free, contains 30k+ flashcards that are the most essential factoids we need to know for med school) (Pathoma = video resource for pathology that also comes with a concise outline of the information) (Sketchy = memory palace visual mnemonic tool for memorizing hundreds of different drugs and micro-organisms that exist in this world) There are also other resources like Ninja Nerd on YouTube, a ton of anatomy resources where you can watch cadaver dissections on video, CT/MRI/ultrasound educational websites where you can do cases interactively, etc

Your kid's piano teacher was reshaping their brain. A Harvard-led team tracked children from age 6 to 9 and found that kids who practiced an instrument at least 2.5 hours a week grew the corpus callosum (the cable connecting the left and right halves of the brain) by about 25% in the region that handles movement planning. Kids who practiced less or quit showed zero growth there. USC ran a separate study starting in 2012 that followed children from low-income LA neighborhoods. One group learned violin through the LA Philharmonic's youth orchestra program. A second did soccer. A third had no structured after-school program. Two years in, only the music group showed brain changes: stronger white-matter connectivity, faster maturation of auditory processing, and greater activation in networks involved in decision-making and impulse control. The soccer and no-program groups looked the same on brain scans. A randomized trial at the University of Toronto tested 144 six-year-olds assigned to keyboard lessons, voice lessons, drama, or nothing for a full school year. The music kids gained about 7 IQ points on average. Drama and no-lessons kids gained 4-5. That roughly 3-point gap showed up across every subtest, including reading and math. Now the language side. Bilingual kids outperform monolingual kids on task-switching tests (jumping between different sets of rules quickly), and it holds regardless of which second language they speak. Brain scans of nearly 1,300 children and young adults from a 2021 Georgetown and University of Reading study showed that bilinguals kept more grey matter (the layer where the brain's processing cells live) as they grew up than kids who spoke one language. The long game is where this gets serious. A 2025 Monash University study of 10,893 Australians over 70 found that people who regularly played an instrument had 35% lower odds of developing dementia. Bilingualism shows an even sharper effect. Studies across India, Canada, and the US consistently find that bilingual adults develop dementia symptoms 4 to 5 years later than monolingual adults. A 2024 door-to-door survey of 1,234 people over 60 in Bengaluru, India, found dementia in 4.9% of monolinguals and just 0.4% of bilinguals. Both piano and a second language work through a similar mechanism. They force the brain to manage competing systems at once, left hand versus right hand, one language versus another. That constant switching strengthens the frontal regions responsible for planning, focus, and filtering distractions, building what neurologists call cognitive reserve: a buffer that lets the brain keep working even as age-related damage accumulates. Those parents running their kids between piano on Tuesdays and Mandarin on Thursdays were basically running a two-front neuroplasticity program without knowing it.

Australian police forcefully chase away Muslims who occupied a street in Sydney to pray to Allah. The streets are not personal mosques.

It was the worst month of my life!! September 2001, I was a surgical intern at the University of Texas Medical Branch in Galveston, Texas and I was doing a rotation at the Shriner Pediatric Burn Hospital. Now remember this was back in the day before they passed laws limiting how many hours you were allowed to work and historically surgical residency has often been fairly abusive. Long hours, little sleep and consistently being berated was a pretty typical experience for many residents, more so with the surgical ones. My size, being 6’5” and 280 lbs, coupled with the fact that I pretended to be slightly unstable kept my beratement to a minimum. Size has its advantages! Anyway, the burn hospital had the reputation among the residents as a pretty hellish experience and I was right in the middle of it. When you saw another colleague around the hospital and they asked you what rotation were you doing and you said Shriner’s, it was alway met with an “ouch, hang in there” or something similar. As an intern, even though you just finished medical school, you are basically at the level of an idiot, when it comes to managing patients. And the Shriner Burn hospital was filled with critically burned little kids in the intensive care unit where you were assigned. Now as I was just at the beginning of my journey I had not yet become used to the constant fatigue that I would learn to embrace over the next 5 years of my orthopedic residency. After 4 years of college, 4 more years of medical school I was about 60% of the way through my education, but the light at the end of the tunnel was still a long way off. Residents in general, were largely just cheap labor for the hospitals as our salaries were way less than minimum wage given the number of hours we were expected to work and quitting was never a good option. Orthopedic surgical spots were extremely competitive and highly coveted among medical students and if you were not in the top 10% of your medical school class good luck getting in. Fortunately, I was a very good medical student, good grades, good at standardized testing and a hard worker. I got my spot and wasn’t going to let being tired or anything else deter me from finishing. As I mentioned sleep was a luxury during residency, some months better than others. Over the years I can remember being so exhausted that I would be falling asleep while standing up assisting in surgery. It was a common trick to clamp non penetrating towel clips to our arms, chests or even nipples in order that the pain would keep us awake during surgery. I remember many times I avoided sitting down in the clinic because the second I sat down I would immediately fall asleep. The burn hospital was the worse place for not being able to sleep. We were on what is known as Q2 call, which means every other night you would be staying at the hospital on call to take care of the sick kids and often would be up all night. This coupled with the typical daily schedule which started at around 4 am and often lasted to 10 pm meant that you basically worked 40 hrs straight, went home for 7-8 hours and then did another 40 hours over and over again for the whole month. 120-130 hours per week was the average for the month rotation and that aspect really beat you up. Now, the guy who ran the hospital, was a world renowned burn surgeon named David Herndon, who I think might still be the chief of staff there. Anyway the rumor was that he was a little bit crazy and the staff and burn fellows were terrified of him. He was loud, yelled a lot and had no problem letting someone know that they were an idiot in front of the entire staff. Morning rounds with him was a stressful event. Each intern, residents, and fellow would be responsible for 2-3 of the ICU kids and we’d walk around the ICU going from bed to bed presenting our patients when it was our turn. It was always a dog and pony show with about 20 people following Dr

This is unacceptable on multiple levels. Yes, national security matters, but indiscriminately delaying visa renewals for physicians who have already been living and practicing in the U.S. for years makes no sense. Blocking new physicians from these 39 countries only deepens the damage. This is not just an immigration issue, it is a direct hit to patient care in America. Many of these doctors serve in medically underserved areas, where wait times are already long and access is fragile. When they are suddenly pulled out of the system, it is U.S. citizens who pay the price with delayed care, missed diagnoses, and worsening outcomes. I have lived this reality. I went through prolonged administrative processing twice. During my absence, my patients in North Dakota were the ones who suffered. We cannot claim to address a physician shortage while simultaneously sidelining the very doctors keeping the system afloat. There must be a clear, immediate exception for physicians already serving in the U.S. This needs to end.

Wait, you guys are getting rescued?