Just for anyone planning on using this, you only get the bonus of Nebula (which is what we're all after) if you get the "premium" (~4x the price £70) version of Curiosity Stream. EDIT: i may be a moron, i just had to activate nebula through the email. Hope this helps other morons :)
but is it also a deepfake? I can't bear watching actual human beings on youtube in my pasttime and the obviously computer-generated antics of this channel fit my sociophobic needs perfectly
4:50 "A doctor's main job is talking to their patients." This hit me since I go through a hyperthyroidism treatment in Germany and talked with couple of doctors. And they all asked me if I have further questions. And when I did, they were really invested in clarifying what's up. I intended to get operated in the city I grew up because I didn't want to be alone while recovering. But I met a surgeon who won my trust by explaining the operation really thoroughly. She received the same operation I am about to get, showed me at the end of our conversation her scar and said: "You'll get a much smaller scar because I'm better than the surgeon who operated me." It might sound arrogant but she said it so matter-of-factly and nonchalantly, I felt safe in her care. I'm generally a rather chilled person but my surgeon's confidence gave me even more reassurance:)
The fact she said it so nonchalantly would have absolutely made me feel better and more secure too. If it was a doctor who was clearly inflating/shielding their ego I would have been worried/panicking because you'd be left wondering what corners would they cut or risks would they take purely to protect their ego... I'm glad your surgery went well and I hope your quality of life has drastically improved and stayed that way :) All the best from the UK
On the placebo answer where you used paracetamol as a hypothetical, I've actually been faced with having to give placebo to my grandma instead of paracetamol. She kept taking it every time she "had a cold" when she was still relatively healthy. Eventually we noticed that those colds were just her feeling a bit down so we discouraged it. Then it all snowballed, the "feeling down" was actually alzheimer's, she was taking paracetamol way more frequently than she should, and got extremely aggressive if we refused to buy it for her. So I bought some starch tablets online, put them in empty pill bottles, got some stickers on them, and convinced her that the brand had changed their packaging (meds are usually individually foil packaged here, so I had to use my one bottled medication to prove that they could come in bottles too; unbeknownst to her, those were the exact same bottles I'm using for her "paracetamol"). She still takes them every time she is having a bad day and magically feels better once she does. All is good.
I'd give her a herbal pill so there's still something that can maybe calm her which is good with dementia. Try something like passionflower or lemon balm.
That's a tough one. I guess, for me, it's acceptable because your grandmother is not mentally capable of understanding why and how she's doing herself damage. Using deception to properly medicate young children or animals would fall under the same kind of umbrella. But that's a very different thing if the person doing it is a loved one who's taking responsibility for the person with diminished capacity, compared to a doctor. The relationship between doctor and patient vs. elder and caregiver has very different boundaries.
I gave harmless aqueous cream to an elderly patient who was convinced he had a rash and had been seriously overusing hydrocortisone cream. Worried like a charm.
Understanding the placebo affect thoroughly, i would consent to people giving me placebos without me knowing for things like pain, low mood, nausea and anxiety. ( Once it was clear that the placebos did help and no medicine could safely help more. ) The placebo effect is a wonderful switch in our brain and we should use it as much as we can.
You wouldn't believe the amount of comments I get from irate people (let's be honest, Americans) who are enraged by how I say "med-sin". So for this video I decided to try out saying "med-i-sin". I did not care for it.
well since English is, well English - _and_ they can't spell correctly - colour, flavour, ardour are among their lesser crimes (adding Ls, leaving off Es - mixing up R & E at the end of words ... the list goes on) I wouldn't worry about it. no matter how many times I change my setting to English (New Zealand) I get these frustrating red corrections on words spelled perfectly correct
I see 2 different specialists for 2 different health conditions, the medicine necessary to treat Condition A can cause Condition B to get worse, so I keep getting told by one doctor to take it, and by the other doctor to stop taking it. They spoke to each other about it and said they couldn't agree so I should talk about it with my GP and make my own decision. GP says because he isn't a specialist in either field he doesn't feel comfortable advising me, so I should decide for myself. 3 people who have been to medical school leaving this decision to someone who has a Brownie's First Aid Badge and has watched a few episodes of Casualty is insane, and makes me as the patient feel stressed not empowered.
I'm sorry it feels stressful to you. The thing is (and Rohin can correct this if he sees fit) it sounds to me like the effects of taking or not taking that medication are symptomatic. If either taking or not taking the medication would shorten your life or cause worsened disabilities, then the doctors need to tell you so. But apparently they haven't told you that, so I'm guessing it won't make a difference in those ways in the long run, at least AS FAR AS THEY KNOW. If that's right, then really it's a question of how badly the symptoms affect *your* life -- not the various doctors' lives, but yours. But it would be worth asking the two specialists whether taking or not taking that medication will shorten your life or make you more disabled in the long run. The question the doctors can't answer is: do you feel better and function better if a) you take the medication, and Condition A is better but Condition B is worse, or b) you don't take the medication, Condition A is untreated and therefore worse, but Condition B is better? If I were in your place, which of course I'm not, I'd try it both ways (with and without that medication) for several weeks each time and see which one goes better. That's actually a good question to ask your GP: how long a time does he think would be a reasonable trial? Also, it's helpful to write down how bad the symptoms get on each day of each test, if you do test it, so that you're not depending on your memory.
@@miashinbrot8388I specifically didn't mention the medical conditions and treatment involved, so I don't know why you've made so many assumptions about what my doctors have or haven't told me, whether the conditions are symptomatic, and what the potential outcomes are. In this my case, one of the conditions leads to blindness and the other is potentially fatal. One is detectable primarily through blood tests, the other is symptomatic once damage has already been done. I have found a treatment plan I am happy with, I wasn't asking for advice - I only commented about my situation as it is relevant to the topics that were raised in the video.
Re: turn it off and on again - I had a nerve injury from a bad blood draw and my nerve sensitivity lingered for a long long long time. I had to go in for an unrelated surgery, and being under general anesthesia for even 15 minutes erased a majority of that over sensitivity. Wild what turning it off and on again can achieve! I am now living a 99% normal life with only mild occasional reminders that I was injured (for now) EDIT: A surgeon saying "we knew all our patients inside and out," made me giggle more than I think I should have haha
I recently watched Hannah Fry's BBC documentary on cancer treatment and it raised some questions about informed consent in my head. In one clip we see a doctor discussing chemotherapy with a patient. She goes over possible outcomes, how likely the cancer is to recur with/without chemo, etc. The patient decides to proceed with chemo and when she is interviewed by Hannah Fry after the consultation she says "Well, the doctor said that the cancer is pretty much definitely going to come back if I don't have the chemo", which is not even close to what we had just heard the doctor tell her. Between the obviously emotional and stressful situation and the fact that some of these statistics are quite difficult to get your head around, she was making decisions based on very little understanding of the situation.
I definitely think giving leaflets or some other written info source you can take home can help because even when I'm level headed I still forget the exact information given to me by doctors. And taking someone else with me doesn't always help because their bias impacts what THEY remember and it just clouds my memory rather than make it stronger.
WRITTEN information helps some. But there used to be a saying that a doctor (with MEDICAL TRAINING) who treats him/herself has a fool for a patient ... no one has a cool head about their own outcome.
23:17 I was talking to my dad, who is a GP, about cancer diagnosis. He said that he sees around 4-6 cancer cases per year of which half are "obvious" and half are "non-obvious". This was in regards to politicians saying that GPs are terrible at diagnosing cancer. Cancer is apparently everywhere and so people assume that it's at least weekly when it isn't even monthly and when it does come around it may be "non-obvious" and it may lead to a wrong diagnosis or a referral - he has admitted that he has given misdiagnosis but he always outlines the observed symptoms and recommends seeing him again if anything changes, so far he hasn't killed anyone (although someone has tried to sue him for a misdiagnosis that was dismissed because none of the symptoms present and the tests conducted suggested cancer and that she didn't see him again after symptoms changed). I just messaged my dad about patients searching their symptoms and he said that it is fantastic because they are informed about what things can be and they are thinking more objectively about their symptoms. He said that he does not take what the patient thinks as a diagnosis, easy job done, but it provides a better method of diagnosing as the patient is an active participent. Edit: after writing the massive block of text below I wondered what he thought about patients who came in asking for a medication rather than a possible diagnosis, as I expected that he dislikes it. He dislikes it because patients come in and when they leave they want to have got a certain medication and they may have been given a different one that does the job but in a better way or that they had skipped over getting an accurate preliminary diagnosis and looking at cures without finding out that they don't have the symptoms of the thing they want to treat. He also mentioned that his encyclopedic knowledge actually makes some patients trust what he says less because they cannot fathom that he knows everything about the mentioned drug and therefore he thinks they think he is making it up. (btw, having a doctor as a dad is amazing although I think I bore him asking him to inspect anything that looks even slightly dodgy. Anything past a spot or if I already know. But he says that it is better to be sure. I'm also fairly sure that he is part book which would make me part book too. He knows what every medication does, dosages, what other names it has, and side effects with rough chances, he knows every medication for a specific ailment too, so the reverse. I have never caught him out even when making up medication names that are similar to existing medications and asking if I meant another. His memory is insane. He is also able to profit free drug merch with it not affecting his judgement because he knows the medications and where this specific drug is compared to others, he just loves getting as much free stuff as he can, as a result I have lots of drug merch (I'm using a trustlocums notebook (not all are drugs) with benecol post-it notes and my trusty viagra pen). I mean, all doctors I know love something that is free, cheap bastards)
I wish my dad/doctor would know all about different medications, I'm on so many prescribed by different doctors and I have no idea if they know what they’re doing haha
I watch a lot of different people on youtube I can safely say you are the youtuber I would most want to have a drink down the pub with. Your ability to discuss interesting serious topics while throwing in a big dose of humour is great. People are sometimes funny and sometimes intresting it is great when people are both.
My doctor gave me the highest dose possible of an NSAID for chronic joint pain but didn’t really explain anything about it like any potential side effects. Granted, I’m perfectly capable of reading treatment guidelines on my own and researching about the medication on my own. But simply wish they took the time to explain it in the office.I always feel like they don’t have time for me when I’m there.
21:05 This part had me clapping my hands from laughter. Having one or two weirdos above you in the workplace hierarchy seems to be a universal phenomenon. (I can tell I am slowly becoming one of them. Send help.)
It's interesting how you mention injecting air into an artery as a big fear, and how the bubble will remain in the artery blocking flow. I'm a chemist and we work with high pressure pumps all the time and I've had multiple occasions where I've gotten air into the pump in one way or another, and it's become something I dread as well. Medicine practice and chemical practice seem to have so much in common.
Wanted to pop in and in and say thank you Doc! I'm in a really cruddy point in my life, I have laughed more watching this video then have in over a year. I really needed the laughs. Thank you!
Something for all of us to consider...people have great variations in their comprehension of vocabulary which worsens with specialized jargon, medicine being a good example. My mother was being questioned prior to surgery and was asked when she last micturated. I am a word lover but that was at the fringe of my knowledge. After a minute I was able to translate, "She means pee, Mom". Add anxiety and time pressures and it gets worse. Increasingly, in the USA, we are told to have a companion at medical appointments of any importance because so much is missed or misunderstood. Here's to 500,000 more subscribers, you deserve them (and they need you).
I wish there was a third option for resuscitation. Resuscitate me, and then if I'm severely disabled afterwards, euthanise me. It's crazy to me that there's so many DNRs, and it's all because our society won't acknowledge that people in these situations should also get to choose (including preemptively). Because that's the route I would choose. Resuscitate me. If it goes well yay! If it doesn't and there's no sign of recovery then just euthanise me. Yes I know there's still going to be in betweens, but my standard would be after being resuscitated and recovery, if I can make it clear I don't want to be euthanasied and can clearly understand that, then the euthanasia is off. Serious. I think we're leaving people with a hard decision and guilt because if they choose a DNR, then they have no idea what might have been. If euthanasia were legal and accepted, we could make a more complex decision.
I think the issue with that is that if the patient survives but is mentally disabled to the point that they can't express their desires, then they would have to be left alive since it would be impossible to tell if they have changed their mind.
I’ve always loved listening to medical stories. A friend of my brother works in a dementia and elderly people ward and he has stories that range from the hilarious, heartwarming all the way to quite sad. Adam Kay’s this is going to hurt is an amazing read for anyone who found those stories about the Colonel entrancing. I’ve always felt jokes and funny stories from the medical world are quite important. I’m all honesty I sometimes find myself afraid of doctors and have delayed getting myself checked because of it. Listening to Rohin reminds me that everyone there are just people doing their best as well.
Thank you for bringing up resuscitation and informed consent. I agree that the main thing we need to be more comfortable doing is expressing a clinical opinion based on our knowledge of our abilities, presenting pertinent information about clinical realities, without FORCING patients to go one way or another. It’s really hard and an important skill that gets looked over by our current training system. Signed, a palliative care doctor
on "informed consent", for many people, it turns into "how well do you trust an expert" & "how well do you think the doctor understands the state of current best practices and risks/rewards" (i.e. do you think this particular doctor is actually an expert)
And the doctor displays that via educating the patient, of the patient feels like they can somewhat understand and come to the same conclusion, then that's how one can gauge if doc knows what they're talking about. If you are the expert, explain it, if you cant explain as far as I know you dont know shit on this topic. And explain it simply, you cant explain it simply you dont understand it well enough to be advising the patient.
As someone who has a condition that almost every doctor I have ever met has referred to as a complicated case. I feel that in some situations shared decision making can be a viable option, after thirty years as far as my own condition goes I think I have earned the right and acquired the knowledge I need to help decide about any treatment plan etc. 💜 Edit.. I can confirm that being surrounded by neurosurgeons and entourage at ward round was intimidating, at first. Until I learned the joy of consultant baiting, then it became quite entertaining.
As a recently-graduated medical resident who is still frequently a member of such entourages, I am intrigued and curious what the condition is haha. Btw your dog is super cute
@@monkiram I had an astrocytoma inside the spinal cord that went from the base of my brain to my shoulder blades.. cue several operations, radiotherapy etc. This was in 1993 I was given a life expectancy of maximum 10 years but I am still alive and annoying consultants to this day 😃 not without my disabilities but in the circumstances I'll take it. Thanks she's called Neena, she's my 50 kg monster the biggest of our three rescues. Hope that is comprehensive enough, it's a long story to condense 💜 And congrats on graduating, I spent many nights with student and resident Doc's, I always had a reliable supply of chocolate and a willingness to be practiced on 🤣
Congrats on almost but not quite getting to 500k at the moment. (I'm trying to not say something about about premature celebration, it would just come off as being a double entendre, but it's hard, so very hard)
I just want to thank you for recommending the Nebula/Curiosity streaming feed. I have enjoyed it immensely, especially having access to your extended videos. Additionally, I was thrilled to see several other "evidence-based" creators whom I follow on YT posting their content as well. Bravo 👏👏👏
I loved the question about informed consent and making decisions together. It's a very important topic. In my experience doctors are so unwilling to get into any real discussions with their patients that they intentionally omit very important facts and seem to hope the patient never asks. The result is that any consent is as far from informed as possible. And sometimes they don't ask for consent at all, simply get nurses to inject medication into the IV fluid bag while the patient is hopefully looking the other way and apparently counting on the patient being too sick to stand up for themselves.
As a radiographer who regularly does coronary angiography and their work ups for cardiologists I agree with the tier list for arteries. Circumflex sucks but I also love the random natural variance of a ramus.
I really enjoyed your answer about placebos. I've become interested in open-label placebos, and have recently started experimenting (on myself) with using a placebo for some of my breakthrough chronic pain relief. All with my GP's knowledge and encouragement. Not going rogue, lol!
When i was a child i believed bandaids actually healed the wounds they covered. though not the fancy ones with cartoon pictures, i thought those were fake. just the boring Real, Serious ones that adults use.
3:10 "turning it off and on again" is how we describe the seizure I had a few years ago lol following a concussion I had regular brainweird episodes for... three years? Four years? where I'd get woozy, my vision would go spotty and dark, and I couldn't process what was going on around me or any words. One time I tried to type out what I was experiencing during one, because every time they happened I'd perceive one of like three scenarios but could never remember them afterward, and it was complete gibberish. Anyway I had like five in one day the day of the seizure, got scared, and went to the ER to try to figure out what was wrong and how to stabilize it right? Nurse decided I was a heroine junkie and sent me home, at which point I immediately had the seizure, face first into the litterbox (at least it wasn't the toilet or edge of the tub, I guess?) and woke up in an ambulance. Fun! The brainweird episodes haven't happened ever since, though, so we concluded my brain just needed to reboot.
not a doctor but the brainweird episodes might have been seizures too, just a different type - you can get absence seizures and stuff as well as the more obvious ones. Glad you're ok now though!
I AM SO ANNOYED BY THIS VIDEO My sister is about to become a doctor and is the funniest person I know (personally). It is extremely annoying to be around people who are naturally funny AND clever and I am having this yucky envious feeling again watching this video. How very dare you Sir!
The way I interpreted the question about the "preferred" way to let someone pass is more along the lines of "what's the least horrible way someone could die under the care of a cardiologist", or "if the patient's death is unavoidable, what way can they be let go that minimizes suffering?"
Sound-engineer here, hi! Although the mic setup looks rather nice pointed like that, condenser mics generally do not pick up sound from their end. Usually the side that has the brand's logo on needs to face the source. Fortunately this didn't affect too negatively in this video, but pointing it the right way would help with picking up the consonants.
Dude I would do Cardiology just to work with you for the rest of my life....because of your teaching style. I feel like all your trainees pass their exams first time.
I can confirm from personal experience, you do not want to experience an air embolism. I have founds myself in that unfortunate situation (as the patient). It was caused by a malfunction of an IJ central line that resulted in a huge volume of air being sucked into the line into my heart. I had a brief second of severe chest pain and that awful 'I'm gona die' feeling and then blacked out. I ended up with severe damage to my heart, temporarily neurological deficits which thankfully improved over time, and a load of psychological trauma. I was 19 years old at the time and 5 years have passed and I still have nightmares about it.
I had to pause the video to laugh about the Colonel. I had my appendix removed three weeks ago and laughing after having that done to me would have been a disaster. 🤣
As a mental health practitioner, let me say thank you for not answering the question about the best way to die. There are people who have only avoided attempting because they are afraid of surviving and living with consequences, and there are those who have attempted and hearing a discussion of means outside of the narrow scope of medically assisted death can be deeply triggering. So thank you for only talking about the gruesome side of things 😁
Also, as far as seeking a second opinion, it depends on the field. As soon as subjectivity comes into the picture, often assumptions can be made when making a diagnosis. I remember reading about a cardiologist who died of a cardiac arrest because of his own history of panic attacks. I've also seen studies where they give the same chart to doctors, but change the gender, sexuality or race, and the same medical tests, symptoms and history can lead to different diagnoses, which suggests bias.
32:36 that’s almost exactly what is going on with my medical team in Canada, my family doctor referred me to the specialist the specialist did the tests and interviews and made recommendations and now the family doctor is managing the case with occasional consultation with the specialist to make sure that everything is still going to plan. I feel like I’m in good hands with my current family doctor, I hope that she doesn’t move or retire or quit medicine after a few years like the last three doctors did.
My joke about milk is asking why don't they sell human milk in the grocery store? It's actually made for humans so it must be healthier than animal milk. Of course, both are a bad idea for anyone to drink unless they are the child of the mother.
Just finished a cardiology term in AUS, I just wanted you to know I have a 100% cardioversion success rate and I learned that infusion pumps can create artifact that looks almost exactly like a heterotropic heart transplant on the ECG
Doc I am 80. Single old man. I. Have a big slice of apple pie with whipped cream in the morning. I walk every day 2 miles. My heart is good. I will enjoy my remaining years. Plus salt and butter. Life is good.
I don't know about anyone else, but I am suddenly eager to hear you talk more about reperfusion injury. What is the deal? What things did you look at to mitigate the damage? What could hypothetically be done to make things better?
I am going to embarrass myself and argue that your example isn’t the placebo effect. I would also argue that the placebo effect always seems to reduce or even disappear the better run the study is. The idea behind placebo as that the patient is not aware they are getting the placebo (and ideally the people interacting with the patient, but that of course is often impractical). Giving the patient hope and giving them a positive personal experience sounds like a type of treatment to me :)
Indications seem to be that deception isn't even wholly necessary - placebo treatments seem to work even if the patient knows it's a placebo. repository.canterbury.ac.uk/download/854757a4e7efa9ea9c0b9845ef30ebd4bfa85d67207afee6f535129239c6f431/965140/17318_OpenLabel_placebo_final%20050117%20Clean.pdf
An auto-injector should be able to be easily engineered to determine if it's pushing air? I can think of so many ways to do it. From shining a laser through the medium. To having an ability to close the outputs and then have the motor attempt to compress the plunger. If it compresses easily and a lot then yeah that's air mate, if the motor doesn't turn and stalls, that's water or similar yo. This would only add maybe 1-2 seconds onto the processes before it actually starts pushing. Or it could just be done on putting a new syringe in. Other ways include: measuring the current flow across the output, etc. I mean this is just a few of the ways you could do this. I can think of several off the top of my head. Why on earth don't they have an interlock for this? This should be designed in. It should just stop immediately and require a manual override (ideally from another person in case person A is dumb or under the influence or something else.
Your comment about the magic wand which predicts 1, 3, and 5 year all-cause mortality is funny, but might be a touch more realistic than you think. Recent ‘epigenetic clock’ technology based on DNA methylation can somewhat measure your overall biological aging rate, and can be compared to your actual chronological age to get an idea of mortality risk. I recently saw a ‘clinical epigenetics’ meta analysis which stated that for every 5 years your epigenetic age increases, your all-cause mortality risk increases by ~10%. I’m a PhD student working in basic biology research so don’t have a great grasp on the translational medicine world, but I do think this tech will become important in the coming years - or at least epigenetic based diagnosis in general.
My late husband truly believed that resuscitation would lead to years more of pain. He signed a DNR (do not resuscitate) order. When he fell and hit his head, and died, I had to show the responding police officer the DNR before he would stop chest compressions. My word was not enough. My poor beloved deserved to be out of pain. I miss him, but how guilty would I have felt if he kept hurting so much?
I think the point of Fooqs question is what is the preferred method for a Cardiologist to administer MAID? It is well known that MAID is the number one prescribed treatment in Canada, The Netherlands, UK, and very popular elsewhere.
So, on the flip side of the people saying docs don't get enough nutrition training, a lot of people seem to assume that doctors are the best people for drawing your blood (like, if the phlebotomist/nurse can't get it, just get the doctor!). Well, I've got to say, being a phlebotomist myself (so a little biased), unless the physician in question is an anaesthesiologist (and even then, it's gonna depend), they likely have very little experience drawing blood lol. They do get to go after larger vessels like arteries or jugular veins for a central line, but those are radically more invasive then just calling the experienced phlebotomist or the stat nurse, whose literal job it is to get blood from a proverbial turnip, and have been doing just that for literally years on end lol. That's not to say all doctors can't draw blood (I know one doc at my hospital that used to draw all her own labs when she did outpatient stuff, so I imagine she probably got pretty good at it), but they're gonna be the exception, not the rule lol Edit: also, in terms of you not gaining any followers recently, I wonder if it has something to do with the TH-cam algorithm. I've been subscribed to you for a LONG time (with the little bell rung) and this is the first video I've been notified about from you in months, but it turns out you've been making far more videos than I've been notified about. So kinda a bittersweet revelation, as I realized I'd missed a lot of your content, but also realized that means I have a ton of stuff to watch during my next night shift lol
@@pattheplanter lol, it is a forgotten art amongst practicing medical professionals, yes. Bloodletting was once a respected field...now it's relegated to only those with very specific diseases. It's too bad, really, that doctors as a result lost their ability to draw blood as a result! (And in case it isn't obvious, this is all meant sarcastically/satirically, I'm not actually advocating for bringing back bloodletting as a standard medical panacea)
As someone who was previously a phlebotomist and is now a few weeks off becoming a doctor. The difference is that nurses and phlebotomists have to give up after 2 or so jabs or have other limitations in what they can do. The doctor tends to not obey these rules and as you mentioned, can go for those more invasive ones if the blood is desperately needed. For example, we had a patient who we really needed a urea and potassium off, no one could get vascular acces so we decided to go for capiliary blood, 20 min later we had enough for a full chem 20.
@@MegaRetardist the funny thing is, capillary samples are absolutely something we do for stuff like that. If you gave me a really tough patient and told me the two things I want are a potassium and a urea, I'd look first to see if it really is a tough venous stick, and if it is, yeah, those two tests need like 40 MICROliters of plasma total lol, so around 80 microliters of whole blood. So a capillary draw is a totally reasonable way to go for it, just slap a heel warmer around the finger, give it a few minutes, and viola, blood. I'd likely aim for closer to .4 mL just to make sure they could do the full chemistry like you said, but it's an option that a lot of new people forget. Arteries are a whole different animal though, as often a standard phlebotomy license won't allow you to intentionally draw from them, due to theoretically higher risk involved. We can draw from feet though, just need a physician to document the approval! And I've done it before (once on a labor and delivery patient that was numb from the waist down from the epidural and HAITED needles, so the anaesthesiologist that was in the room turned to me and was like, can you get blood from her foot? And I was like yeah, no problem, just throw a note in the computer and I'll get it done. 5 minutes later I had a blood sample and we had a very happy patient lol. I've also done it countless times in ED patients with no veins at all, even saw a more experienced colleague get blood from a thigh once in a VERY tough stick patient). The default for the ED docs though seems to just be a femoral artery stick, which is both extremely easy to do and significantly riskier than almost every other method lol (even a brachial artery is less risky, but for whatever reason the ED docs always seem to go for the femoral. I guess it beats carrotid at least lol)
@@MegaRetardist Last time I saw a phlebotomist, they struggled to get a sample from my right arm, probably because I had a sample taken from that same location a couple of weeks earlier or something. After three or four jabs, I just told him that he should probably try my left arm instead, and he got a sample from there first time. On a related note, during the whole thing I had the song "We drink your blood" playing in my head because I'm a total metalhead.
Pharma profit margins are pretty tame when compared to finance and petroleum industries and are comparable to software profit margins. The societal benefit is that pharmaceuticals go generic, which you can't say for any of the others.
As someone whos had a liver transplant due to OTC deficiency i have definitely researched my condition because sometimes i teach my doctors about it. My geneticist however is the man that has kept me alive. Urea cycle disorders are brutal.
As someone with O negative blood, I was told it was "baby blood" because it could be used in an emergency situation upon delivery before there was a chance to type the baby. But from now on, I'm going to say I have "Flying Squad Blood"!
I really hate that 'doctors only get 1 hour of nutrition training' thing, it smelt like bullshit when I first saw it. You see it a lot with people trying to promote particular diets, for differing reasons. It annoys me because, as someone who is vegan, I care about reducing animal suffering, so as much as I'd like to see other people go vegan, I wouldn't want them to go vegan via overhyped health benefits and distrust in doctors. Though at the same time, as Rohin said, doctors aren't dieticians so they aren't always the gospel truth of a nutrition.
I Made a similar point to some “but… but” head over on a doctor’s page on Facebook. «whah whah whah» “but doctors only have __ number hours of training in nutrition … “ «blah blah blah» Or some other such sub-subject that was not the primary focus of that specialty. I asked them if they knew for sure that it was “only ___ hours” and even so, was the only so many hours like hours on a clock? Or was it “credit hours”. Meaning, for example, I have (iirc) 4 credit hours of Abstract Algebra on my transcript. Now, that’s not 4 hours as in the time between noon and 4:00 PM … but rather, that I was in that class for an hour a day, 4 days a week for about 12 weeks.
It is estimated that an average 75kg human contains 716000000 Joules of energy. Is this why you need a really good jolt of lightning to reanimate a corpse?
I found channel through suggested content, like the humor of the video, loved the wittiness, heard of the plateau in subscriber, immediately subscribed.
Watch Part 2 of this Q&A exclusively on Nebula! go.nebula.tv/medlifecrisis
Just for anyone planning on using this, you only get the bonus of Nebula (which is what we're all after) if you get the "premium" (~4x the price £70) version of Curiosity Stream.
EDIT: i may be a moron, i just had to activate nebula through the email. Hope this helps other morons :)
but is it also a deepfake? I can't bear watching actual human beings on youtube in my pasttime and the obviously computer-generated antics of this channel fit my sociophobic needs perfectly
Only a intp would say i am an intp btw mbti is astrology
@@benemenhall4215 This comment actually helped me. Almost got the premium, thanks :)
Really good QnA, what I liked the most was the part about reperfusion injury; I did not know you were an actual Doctor!
4:50 "A doctor's main job is talking to their patients."
This hit me since I go through a hyperthyroidism treatment in Germany and talked with couple of doctors.
And they all asked me if I have further questions.
And when I did, they were really invested in clarifying what's up.
I intended to get operated in the city I grew up because I didn't want to be alone while recovering.
But I met a surgeon who won my trust by explaining the operation really thoroughly.
She received the same operation I am about to get, showed me at the end of our conversation her scar and said:
"You'll get a much smaller scar because I'm better than the surgeon who operated me."
It might sound arrogant but she said it so matter-of-factly and nonchalantly, I felt safe in her care.
I'm generally a rather chilled person but my surgeon's confidence gave me even more reassurance:)
The fact she said it so nonchalantly would have absolutely made me feel better and more secure too.
If it was a doctor who was clearly inflating/shielding their ego I would have been worried/panicking because you'd be left wondering what corners would they cut or risks would they take purely to protect their ego...
I'm glad your surgery went well and I hope your quality of life has drastically improved and stayed that way :)
All the best from the UK
My wife’s surgeon won me over pretty much the exact same way. Its pretty easy when someone knows something vs when they believe it.
What a gigachad!
On the placebo answer where you used paracetamol as a hypothetical, I've actually been faced with having to give placebo to my grandma instead of paracetamol.
She kept taking it every time she "had a cold" when she was still relatively healthy. Eventually we noticed that those colds were just her feeling a bit down so we discouraged it. Then it all snowballed, the "feeling down" was actually alzheimer's, she was taking paracetamol way more frequently than she should, and got extremely aggressive if we refused to buy it for her.
So I bought some starch tablets online, put them in empty pill bottles, got some stickers on them, and convinced her that the brand had changed their packaging (meds are usually individually foil packaged here, so I had to use my one bottled medication to prove that they could come in bottles too; unbeknownst to her, those were the exact same bottles I'm using for her "paracetamol").
She still takes them every time she is having a bad day and magically feels better once she does. All is good.
Her liver is probably thanking you very much
I'd give her a herbal pill so there's still something that can maybe calm her which is good with dementia. Try something like passionflower or lemon balm.
That's a tough one. I guess, for me, it's acceptable because your grandmother is not mentally capable of understanding why and how she's doing herself damage. Using deception to properly medicate young children or animals would fall under the same kind of umbrella. But that's a very different thing if the person doing it is a loved one who's taking responsibility for the person with diminished capacity, compared to a doctor. The relationship between doctor and patient vs. elder and caregiver has very different boundaries.
I gave harmless aqueous cream to an elderly patient who was convinced he had a rash and had been seriously overusing hydrocortisone cream. Worried like a charm.
Understanding the placebo affect thoroughly, i would consent to people giving me placebos without me knowing for things like pain, low mood, nausea and anxiety. ( Once it was clear that the placebos did help and no medicine could safely help more. ) The placebo effect is a wonderful switch in our brain and we should use it as much as we can.
You wouldn't believe the amount of comments I get from irate people (let's be honest, Americans) who are enraged by how I say "med-sin". So for this video I decided to try out saying "med-i-sin". I did not care for it.
Med-errrR son 🍻
like Americans cared so much about pronouncing stuff the way its intended, lol.
Ask them why they insist on rhyming squirrel with whirl. It's just weird
well since English is, well English - _and_ they can't spell correctly - colour, flavour, ardour are among their lesser crimes (adding Ls, leaving off Es - mixing up R & E at the end of words ... the list goes on) I wouldn't worry about it. no matter how many times I change my setting to English (New Zealand) I get these frustrating red corrections on words spelled perfectly correct
@@juliaconnell Aluminium is the one that gets me. It's literally one of the building blocks of our whole shizznit. Spell it correctly.
I see 2 different specialists for 2 different health conditions, the medicine necessary to treat Condition A can cause Condition B to get worse, so I keep getting told by one doctor to take it, and by the other doctor to stop taking it. They spoke to each other about it and said they couldn't agree so I should talk about it with my GP and make my own decision. GP says because he isn't a specialist in either field he doesn't feel comfortable advising me, so I should decide for myself. 3 people who have been to medical school leaving this decision to someone who has a Brownie's First Aid Badge and has watched a few episodes of Casualty is insane, and makes me as the patient feel stressed not empowered.
Thanks for sharing that perfect illustration of how unsatisfactory this can all be. Very frustrating for you.
Yeah doctors need to collaborate better so they can better advise you so you can make a decision and feel confident in it.
It's your desicion, hopefully they explained to you the consequences of either choice. But they can't make the decision for you.
I'm sorry it feels stressful to you. The thing is (and Rohin can correct this if he sees fit) it sounds to me like the effects of taking or not taking that medication are symptomatic. If either taking or not taking the medication would shorten your life or cause worsened disabilities, then the doctors need to tell you so. But apparently they haven't told you that, so I'm guessing it won't make a difference in those ways in the long run, at least AS FAR AS THEY KNOW. If that's right, then really it's a question of how badly the symptoms affect *your* life -- not the various doctors' lives, but yours. But it would be worth asking the two specialists whether taking or not taking that medication will shorten your life or make you more disabled in the long run.
The question the doctors can't answer is: do you feel better and function better if
a) you take the medication, and Condition A is better but Condition B is worse, or
b) you don't take the medication, Condition A is untreated and therefore worse, but Condition B is better?
If I were in your place, which of course I'm not, I'd try it both ways (with and without that medication) for several weeks each time and see which one goes better. That's actually a good question to ask your GP: how long a time does he think would be a reasonable trial? Also, it's helpful to write down how bad the symptoms get on each day of each test, if you do test it, so that you're not depending on your memory.
@@miashinbrot8388I specifically didn't mention the medical conditions and treatment involved, so I don't know why you've made so many assumptions about what my doctors have or haven't told me, whether the conditions are symptomatic, and what the potential outcomes are. In this my case, one of the conditions leads to blindness and the other is potentially fatal. One is detectable primarily through blood tests, the other is symptomatic once damage has already been done. I have found a treatment plan I am happy with, I wasn't asking for advice - I only commented about my situation as it is relevant to the topics that were raised in the video.
Congratulations on the 500k subscribers! I hope you reach it one day!
ಠ_ಠ
@@MedlifeCrisis Well, The Guardian is at 96 views now, which makes you wrong again in the most self-referential way possible.
"I'm a bit late, but I have a question: What does it takes to be successful on TH-cam?
Asking because I need an outsider's opinion."
20 Sept. 2022: 498k! Oh, nearly!
Side note: 'great' idea, removing exact sub numbers, Sue W. >_>
@@someguycalledcerberus9805
Why is your comment in quotes? Who're you quoting?
This video is so dripping in sarcasm it's basically marinated.
😂
i'm convinced he's made up some of these stories
Some might even say it’s dripping in it
I've missed these.
Dr. Francis is British, and like all British people we are steeped in sarcasm just like tea is steeped in hot water.
Re: turn it off and on again - I had a nerve injury from a bad blood draw and my nerve sensitivity lingered for a long long long time. I had to go in for an unrelated surgery, and being under general anesthesia for even 15 minutes erased a majority of that over sensitivity. Wild what turning it off and on again can achieve! I am now living a 99% normal life with only mild occasional reminders that I was injured (for now)
EDIT: A surgeon saying "we knew all our patients inside and out," made me giggle more than I think I should have haha
I recently watched Hannah Fry's BBC documentary on cancer treatment and it raised some questions about informed consent in my head. In one clip we see a doctor discussing chemotherapy with a patient. She goes over possible outcomes, how likely the cancer is to recur with/without chemo, etc. The patient decides to proceed with chemo and when she is interviewed by Hannah Fry after the consultation she says "Well, the doctor said that the cancer is pretty much definitely going to come back if I don't have the chemo", which is not even close to what we had just heard the doctor tell her. Between the obviously emotional and stressful situation and the fact that some of these statistics are quite difficult to get your head around, she was making decisions based on very little understanding of the situation.
I definitely think giving leaflets or some other written info source you can take home can help because even when I'm level headed I still forget the exact information given to me by doctors. And taking someone else with me doesn't always help because their bias impacts what THEY remember and it just clouds my memory rather than make it stronger.
WRITTEN information helps some. But there used to be a saying that a doctor (with MEDICAL TRAINING) who treats him/herself has a fool for a patient ... no one has a cool head about their own outcome.
23:17 I was talking to my dad, who is a GP, about cancer diagnosis. He said that he sees around 4-6 cancer cases per year of which half are "obvious" and half are "non-obvious". This was in regards to politicians saying that GPs are terrible at diagnosing cancer. Cancer is apparently everywhere and so people assume that it's at least weekly when it isn't even monthly and when it does come around it may be "non-obvious" and it may lead to a wrong diagnosis or a referral - he has admitted that he has given misdiagnosis but he always outlines the observed symptoms and recommends seeing him again if anything changes, so far he hasn't killed anyone (although someone has tried to sue him for a misdiagnosis that was dismissed because none of the symptoms present and the tests conducted suggested cancer and that she didn't see him again after symptoms changed).
I just messaged my dad about patients searching their symptoms and he said that it is fantastic because they are informed about what things can be and they are thinking more objectively about their symptoms. He said that he does not take what the patient thinks as a diagnosis, easy job done, but it provides a better method of diagnosing as the patient is an active participent.
Edit: after writing the massive block of text below I wondered what he thought about patients who came in asking for a medication rather than a possible diagnosis, as I expected that he dislikes it. He dislikes it because patients come in and when they leave they want to have got a certain medication and they may have been given a different one that does the job but in a better way or that they had skipped over getting an accurate preliminary diagnosis and looking at cures without finding out that they don't have the symptoms of the thing they want to treat. He also mentioned that his encyclopedic knowledge actually makes some patients trust what he says less because they cannot fathom that he knows everything about the mentioned drug and therefore he thinks they think he is making it up.
(btw, having a doctor as a dad is amazing although I think I bore him asking him to inspect anything that looks even slightly dodgy. Anything past a spot or if I already know. But he says that it is better to be sure.
I'm also fairly sure that he is part book which would make me part book too. He knows what every medication does, dosages, what other names it has, and side effects with rough chances, he knows every medication for a specific ailment too, so the reverse. I have never caught him out even when making up medication names that are similar to existing medications and asking if I meant another. His memory is insane. He is also able to profit free drug merch with it not affecting his judgement because he knows the medications and where this specific drug is compared to others, he just loves getting as much free stuff as he can, as a result I have lots of drug merch (I'm using a trustlocums notebook (not all are drugs) with benecol post-it notes and my trusty viagra pen). I mean, all doctors I know love something that is free, cheap bastards)
You dad sounds awesome!
I wish my dad/doctor would know all about different medications, I'm on so many prescribed by different doctors and I have no idea if they know what they’re doing haha
It is psychologically impossible for bribes and gifts to not twist his judgement, but he sounds like a lovely doctor.
@@RobinTheBot He's autistic. We're immune from being pursuaded to prefer something that isn't actually better
I watch a lot of different people on youtube I can safely say you are the youtuber I would most want to have a drink down the pub with. Your ability to discuss interesting serious topics while throwing in a big dose of humour is great. People are sometimes funny and sometimes intresting it is great when people are both.
plus he actually has a well-paid and stable job, so he could pay for drinks
@@cobaltno51 He _could_ pay for drinks, yes. But would he?
I don’t trust the beard. Lol.
My doctor gave me the highest dose possible of an NSAID for chronic joint pain but didn’t really explain anything about it like any potential side effects. Granted, I’m perfectly capable of reading treatment guidelines on my own and researching about the medication on my own. But simply wish they took the time to explain it in the office.I always feel like they don’t have time for me when I’m there.
It's usually the pharmacist's job to provide this information to the patient.
21:05 This part had me clapping my hands from laughter. Having one or two weirdos above you in the workplace hierarchy seems to be a universal phenomenon. (I can tell I am slowly becoming one of them. Send help.)
54 minutes went by so fast! I literally laughed out loud many times, I loved this one.
It's interesting how you mention injecting air into an artery as a big fear, and how the bubble will remain in the artery blocking flow. I'm a chemist and we work with high pressure pumps all the time and I've had multiple occasions where I've gotten air into the pump in one way or another, and it's become something I dread as well. Medicine practice and chemical practice seem to have so much in common.
Units, molarity, and dimensional analysis *are* important parts of each.
Wanted to pop in and in and say thank you Doc! I'm in a really cruddy point in my life, I have laughed more watching this video then have in over a year. I really needed the laughs. Thank you!
More story time please. As a nurse, dark humor appreciated 🙂
The most I've ever dipped into the medical world is an expired Wilderness First Responder cert.... The Colonel stories absolutely killed me....
As 40 year retired family doc, your You Tube site is refreshing, and right on with my experience.
Something for all of us to consider...people have great variations in their comprehension of vocabulary which worsens with specialized jargon, medicine being a good example. My mother was being questioned prior to surgery and was asked when she last micturated. I am a word lover but that was at the fringe of my knowledge. After a minute I was able to translate, "She means pee, Mom". Add anxiety and time pressures and it gets worse. Increasingly, in the USA, we are told to have a companion at medical appointments of any importance because so much is missed or misunderstood.
Here's to 500,000 more subscribers, you deserve them (and they need you).
I wish there was a third option for resuscitation. Resuscitate me, and then if I'm severely disabled afterwards, euthanise me. It's crazy to me that there's so many DNRs, and it's all because our society won't acknowledge that people in these situations should also get to choose (including preemptively).
Because that's the route I would choose. Resuscitate me. If it goes well yay! If it doesn't and there's no sign of recovery then just euthanise me. Yes I know there's still going to be in betweens, but my standard would be after being resuscitated and recovery, if I can make it clear I don't want to be euthanasied and can clearly understand that, then the euthanasia is off.
Serious. I think we're leaving people with a hard decision and guilt because if they choose a DNR, then they have no idea what might have been. If euthanasia were legal and accepted, we could make a more complex decision.
I think the issue with that is that if the patient survives but is mentally disabled to the point that they can't express their desires, then they would have to be left alive since it would be impossible to tell if they have changed their mind.
I’ve always loved listening to medical stories. A friend of my brother works in a dementia and elderly people ward and he has stories that range from the hilarious, heartwarming all the way to quite sad.
Adam Kay’s this is going to hurt is an amazing read for anyone who found those stories about the Colonel entrancing.
I’ve always felt jokes and funny stories from the medical world are quite important. I’m all honesty I sometimes find myself afraid of doctors and have delayed getting myself checked because of it. Listening to Rohin reminds me that everyone there are just people doing their best as well.
Thank you for bringing up resuscitation and informed consent. I agree that the main thing we need to be more comfortable doing is expressing a clinical opinion based on our knowledge of our abilities, presenting pertinent information about clinical realities, without FORCING patients to go one way or another. It’s really hard and an important skill that gets looked over by our current training system. Signed, a palliative care doctor
on "informed consent", for many people, it turns into "how well do you trust an expert" & "how well do you think the doctor understands the state of current best practices and risks/rewards" (i.e. do you think this particular doctor is actually an expert)
And the doctor displays that via educating the patient, of the patient feels like they can somewhat understand and come to the same conclusion, then that's how one can gauge if doc knows what they're talking about. If you are the expert, explain it, if you cant explain as far as I know you dont know shit on this topic. And explain it simply, you cant explain it simply you dont understand it well enough to be advising the patient.
As someone who has a condition that almost every doctor I have ever met has referred to as a complicated case. I feel that in some situations shared decision making can be a viable option, after thirty years as far as my own condition goes I think I have earned the right and acquired the knowledge I need to help decide about any treatment plan etc. 💜
Edit.. I can confirm that being surrounded by neurosurgeons and entourage at ward round was intimidating, at first. Until I learned the joy of consultant baiting, then it became quite entertaining.
Wdym by consultant baiting?
@@v0id_d3m0n just using a bit of humour and piss taking...
When you're in a life threatening situation you find any reason to laugh 💜
As a recently-graduated medical resident who is still frequently a member of such entourages, I am intrigued and curious what the condition is haha. Btw your dog is super cute
@@monkiram I had an astrocytoma inside the spinal cord that went from the base of my brain to my shoulder blades.. cue several operations, radiotherapy etc. This was in 1993 I was given a life expectancy of maximum 10 years but I am still alive and annoying consultants to this day 😃 not without my disabilities but in the circumstances I'll take it.
Thanks she's called Neena, she's my 50 kg monster the biggest of our three rescues.
Hope that is comprehensive enough, it's a long story to condense 💜
And congrats on graduating, I spent many nights with student and resident Doc's, I always had a reliable supply of chocolate and a willingness to be practiced on 🤣
Congrats on almost but not quite getting to 500k at the moment. (I'm trying to not say something about about premature celebration, it would just come off as being a double entendre, but it's hard, so very hard)
thank you, very unhelpful!
(on a serious note, congratulations :) )
I legit queue up all your q&as and listen to them nonstop. So glad I discovered you! Thank you for being you and educating all of us!
I just want to thank you for recommending the Nebula/Curiosity streaming feed. I have enjoyed it immensely, especially having access to your extended videos. Additionally, I was thrilled to see several other "evidence-based" creators whom I follow on YT posting their content as well. Bravo 👏👏👏
I loved the question about informed consent and making decisions together. It's a very important topic. In my experience doctors are so unwilling to get into any real discussions with their patients that they intentionally omit very important facts and seem to hope the patient never asks. The result is that any consent is as far from informed as possible. And sometimes they don't ask for consent at all, simply get nurses to inject medication into the IV fluid bag while the patient is hopefully looking the other way and apparently counting on the patient being too sick to stand up for themselves.
Congrats on your vlog channel getting half a million subs! xx
Not yet lol
As a radiographer who regularly does coronary angiography and their work ups for cardiologists I agree with the tier list for arteries. Circumflex sucks but I also love the random natural variance of a ramus.
I really enjoyed your answer about placebos. I've become interested in open-label placebos, and have recently started experimenting (on myself) with using a placebo for some of my breakthrough chronic pain relief. All with my GP's knowledge and encouragement. Not going rogue, lol!
The "somewhere" at 7:08 is lovely.
I use the placebo effect on my kids all the time. A hug and an otter pop are sometimes the best medicine.
As a non antive english speaker you got me curious, what's an "otter pop"?
When i was a child i believed bandaids actually healed the wounds they covered. though not the fancy ones with cartoon pictures, i thought those were fake. just the boring Real, Serious ones that adults use.
3:10 "turning it off and on again" is how we describe the seizure I had a few years ago lol following a concussion I had regular brainweird episodes for... three years? Four years? where I'd get woozy, my vision would go spotty and dark, and I couldn't process what was going on around me or any words. One time I tried to type out what I was experiencing during one, because every time they happened I'd perceive one of like three scenarios but could never remember them afterward, and it was complete gibberish. Anyway I had like five in one day the day of the seizure, got scared, and went to the ER to try to figure out what was wrong and how to stabilize it right? Nurse decided I was a heroine junkie and sent me home, at which point I immediately had the seizure, face first into the litterbox (at least it wasn't the toilet or edge of the tub, I guess?) and woke up in an ambulance. Fun! The brainweird episodes haven't happened ever since, though, so we concluded my brain just needed to reboot.
not a doctor but the brainweird episodes might have been seizures too, just a different type - you can get absence seizures and stuff as well as the more obvious ones. Glad you're ok now though!
I AM SO ANNOYED BY THIS VIDEO
My sister is about to become a doctor and is the funniest person I know (personally). It is extremely annoying to be around people who are naturally funny AND clever and I am having this yucky envious feeling again watching this video. How very dare you Sir!
I felt i almost choked on my tea at "Off with her head!"
The way I interpreted the question about the "preferred" way to let someone pass is more along the lines of "what's the least horrible way someone could die under the care of a cardiologist", or "if the patient's death is unavoidable, what way can they be let go that minimizes suffering?"
Congratulations!
497k subscribers! What a milestone!
Congratulations on your 500k subs, Rohin. Live long and prosper.
“Off with her head!” Hahahaha, this one really tickled me
Those stories about the Colonel did my an injury. You're a good story teller, impressive impressions.
I’m cleaning out my cellar and this 54min miracle couldn’t have come at a better time 😁
congrats on getting 500k subscribers (almost)
Sound-engineer here, hi!
Although the mic setup looks rather nice pointed like that, condenser mics generally do not pick up sound from their end. Usually the side that has the brand's logo on needs to face the source.
Fortunately this didn't affect too negatively in this video, but pointing it the right way would help with picking up the consonants.
Dude I would do Cardiology just to work with you for the rest of my life....because of your teaching style. I feel like all your trainees pass their exams first time.
Been watching since the beginning! So happy for you to hit the milestone you deserve it!
I can confirm from personal experience, you do not want to experience an air embolism. I have founds myself in that unfortunate situation (as the patient). It was caused by a malfunction of an IJ central line that resulted in a huge volume of air being sucked into the line into my heart. I had a brief second of severe chest pain and that awful 'I'm gona die' feeling and then blacked out. I ended up with severe damage to my heart, temporarily neurological deficits which thankfully improved over time, and a load of psychological trauma. I was 19 years old at the time and 5 years have passed and I still have nightmares about it.
I had to pause the video to laugh about the Colonel. I had my appendix removed three weeks ago and laughing after having that done to me would have been a disaster. 🤣
As a mental health practitioner, let me say thank you for not answering the question about the best way to die. There are people who have only avoided attempting because they are afraid of surviving and living with consequences, and there are those who have attempted and hearing a discussion of means outside of the narrow scope of medically assisted death can be deeply triggering.
So thank you for only talking about the gruesome side of things 😁
Also, as far as seeking a second opinion, it depends on the field. As soon as subjectivity comes into the picture, often assumptions can be made when making a diagnosis. I remember reading about a cardiologist who died of a cardiac arrest because of his own history of panic attacks. I've also seen studies where they give the same chart to doctors, but change the gender, sexuality or race, and the same medical tests, symptoms and history can lead to different diagnoses, which suggests bias.
32:36 that’s almost exactly what is going on with my medical team in Canada, my family doctor referred me to the specialist the specialist did the tests and interviews and made recommendations and now the family doctor is managing the case with occasional consultation with the specialist to make sure that everything is still going to plan. I feel like I’m in good hands with my current family doctor, I hope that she doesn’t move or retire or quit medicine after a few years like the last three doctors did.
Here is to the sweet engagement and good luck for the next 3k subs
My joke about milk is asking why don't they sell human milk in the grocery store? It's actually made for humans so it must be healthier than animal milk. Of course, both are a bad idea for anyone to drink unless they are the child of the mother.
Yup. You wouldn't want a blood transfusion from a cow, would you? Same difference.
"I've got one upstairs actually. Don't ask why." is coincidentally my favourite phrase. Works great on first dates, especially in pubs or on buses.
Just finished a cardiology term in AUS, I just wanted you to know I have a 100% cardioversion success rate and I learned that infusion pumps can create artifact that looks almost exactly like a heterotropic heart transplant on the ECG
"They will fast-forward you... somewhere"
I died
you love to see a fellow frasier fan succeed
They should design blood to be more rigid, that way it can just punch through blockages.
Doc I am 80. Single old man. I. Have a big slice of apple pie with whipped cream in the morning. I walk every day 2 miles. My heart is good. I will enjoy my remaining years. Plus salt and butter. Life is good.
I don't know about anyone else, but I am suddenly eager to hear you talk more about reperfusion injury. What is the deal? What things did you look at to mitigate the damage? What could hypothetically be done to make things better?
Reperfuse slower? Has that been tried?
So many nuggets of gold in this Rohin 🤣🤣
I am going to embarrass myself and argue that your example isn’t the placebo effect. I would also argue that the placebo effect always seems to reduce or even disappear the better run the study is.
The idea behind placebo as that the patient is not aware they are getting the placebo (and ideally the people interacting with the patient, but that of course is often impractical).
Giving the patient hope and giving them a positive personal experience sounds like a type of treatment to me :)
Indications seem to be that deception isn't even wholly necessary - placebo treatments seem to work even if the patient knows it's a placebo. repository.canterbury.ac.uk/download/854757a4e7efa9ea9c0b9845ef30ebd4bfa85d67207afee6f535129239c6f431/965140/17318_OpenLabel_placebo_final%20050117%20Clean.pdf
Astonishingly informative, kudos sir.
An auto-injector should be able to be easily engineered to determine if it's pushing air? I can think of so many ways to do it. From shining a laser through the medium. To having an ability to close the outputs and then have the motor attempt to compress the plunger. If it compresses easily and a lot then yeah that's air mate, if the motor doesn't turn and stalls, that's water or similar yo. This would only add maybe 1-2 seconds onto the processes before it actually starts pushing. Or it could just be done on putting a new syringe in.
Other ways include: measuring the current flow across the output, etc.
I mean this is just a few of the ways you could do this. I can think of several off the top of my head.
Why on earth don't they have an interlock for this? This should be designed in. It should just stop immediately and require a manual override (ideally from another person in case person A is dumb or under the influence or something else.
Under-rated comment. Some billionaire should offer a prize for the simplest/ most cost-effective device to prevent air embolism…
Your comment about the magic wand which predicts 1, 3, and 5 year all-cause mortality is funny, but might be a touch more realistic than you think. Recent ‘epigenetic clock’ technology based on DNA methylation can somewhat measure your overall biological aging rate, and can be compared to your actual chronological age to get an idea of mortality risk. I recently saw a ‘clinical epigenetics’ meta analysis which stated that for every 5 years your epigenetic age increases, your all-cause mortality risk increases by ~10%.
I’m a PhD student working in basic biology research so don’t have a great grasp on the translational medicine world, but I do think this tech will become important in the coming years - or at least epigenetic based diagnosis in general.
My late husband truly believed that resuscitation would lead to years more of pain. He signed a DNR (do not resuscitate) order. When he fell and hit his head, and died, I had to show the responding police officer the DNR before he would stop chest compressions. My word was not enough. My poor beloved deserved to be out of pain. I miss him, but how guilty would I have felt if he kept hurting so much?
Can we have more Colonel related content please I haven't laughed like that in a long time!
I think the point of Fooqs question is what is the preferred method for a Cardiologist to administer MAID? It is well known that MAID is the number one prescribed treatment in Canada, The Netherlands, UK, and very popular elsewhere.
So, on the flip side of the people saying docs don't get enough nutrition training, a lot of people seem to assume that doctors are the best people for drawing your blood (like, if the phlebotomist/nurse can't get it, just get the doctor!). Well, I've got to say, being a phlebotomist myself (so a little biased), unless the physician in question is an anaesthesiologist (and even then, it's gonna depend), they likely have very little experience drawing blood lol. They do get to go after larger vessels like arteries or jugular veins for a central line, but those are radically more invasive then just calling the experienced phlebotomist or the stat nurse, whose literal job it is to get blood from a proverbial turnip, and have been doing just that for literally years on end lol. That's not to say all doctors can't draw blood (I know one doc at my hospital that used to draw all her own labs when she did outpatient stuff, so I imagine she probably got pretty good at it), but they're gonna be the exception, not the rule lol
Edit: also, in terms of you not gaining any followers recently, I wonder if it has something to do with the TH-cam algorithm. I've been subscribed to you for a LONG time (with the little bell rung) and this is the first video I've been notified about from you in months, but it turns out you've been making far more videos than I've been notified about. So kinda a bittersweet revelation, as I realized I'd missed a lot of your content, but also realized that means I have a ton of stuff to watch during my next night shift lol
Leechcraft is not what it used to be.
@@pattheplanter lol, it is a forgotten art amongst practicing medical professionals, yes. Bloodletting was once a respected field...now it's relegated to only those with very specific diseases. It's too bad, really, that doctors as a result lost their ability to draw blood as a result!
(And in case it isn't obvious, this is all meant sarcastically/satirically, I'm not actually advocating for bringing back bloodletting as a standard medical panacea)
As someone who was previously a phlebotomist and is now a few weeks off becoming a doctor. The difference is that nurses and phlebotomists have to give up after 2 or so jabs or have other limitations in what they can do. The doctor tends to not obey these rules and as you mentioned, can go for those more invasive ones if the blood is desperately needed. For example, we had a patient who we really needed a urea and potassium off, no one could get vascular acces so we decided to go for capiliary blood, 20 min later we had enough for a full chem 20.
@@MegaRetardist the funny thing is, capillary samples are absolutely something we do for stuff like that. If you gave me a really tough patient and told me the two things I want are a potassium and a urea, I'd look first to see if it really is a tough venous stick, and if it is, yeah, those two tests need like 40 MICROliters of plasma total lol, so around 80 microliters of whole blood. So a capillary draw is a totally reasonable way to go for it, just slap a heel warmer around the finger, give it a few minutes, and viola, blood. I'd likely aim for closer to .4 mL just to make sure they could do the full chemistry like you said, but it's an option that a lot of new people forget.
Arteries are a whole different animal though, as often a standard phlebotomy license won't allow you to intentionally draw from them, due to theoretically higher risk involved. We can draw from feet though, just need a physician to document the approval! And I've done it before (once on a labor and delivery patient that was numb from the waist down from the epidural and HAITED needles, so the anaesthesiologist that was in the room turned to me and was like, can you get blood from her foot? And I was like yeah, no problem, just throw a note in the computer and I'll get it done. 5 minutes later I had a blood sample and we had a very happy patient lol. I've also done it countless times in ED patients with no veins at all, even saw a more experienced colleague get blood from a thigh once in a VERY tough stick patient). The default for the ED docs though seems to just be a femoral artery stick, which is both extremely easy to do and significantly riskier than almost every other method lol (even a brachial artery is less risky, but for whatever reason the ED docs always seem to go for the femoral. I guess it beats carrotid at least lol)
@@MegaRetardist Last time I saw a phlebotomist, they struggled to get a sample from my right arm, probably because I had a sample taken from that same location a couple of weeks earlier or something. After three or four jabs, I just told him that he should probably try my left arm instead, and he got a sample from there first time.
On a related note, during the whole thing I had the song "We drink your blood" playing in my head because I'm a total metalhead.
Lucky for you, we're not just heading towards one dystopian future, but several at the same time! Isn't this an exciting time to be alive?
The Colonel sounds like James Robinson Justice in the Doctor films. Love it.
Sorry Robertson.....
The Colonel sounds like a right laugh, need more people like this in the world!
follow up to the air in the system question, how do you bleed the air out the system?
7:05
"I guarantee they will fast track you... somewhere."
Bloody comedic genius!
All I took from this is that you had only 4 weeks of cardiology!
I absolutely need to hear more of those funny workplace stories, I love them
Pharma profit margins are pretty tame when compared to finance and petroleum industries and are comparable to software profit margins. The societal benefit is that pharmaceuticals go generic, which you can't say for any of the others.
As someone whos had a liver transplant due to OTC deficiency i have definitely researched my condition because sometimes i teach my doctors about it. My geneticist however is the man that has kept me alive. Urea cycle disorders are brutal.
Those two clinician stories were hilarious, thanks :)
You are a good TH-camr in the best possible way. Engaging peronality, and giving out good intel.
It’s 530k right now. Don’t complain, there there past you. Come on Doc, this Deloreon ain’t gonna drive itself!
22:07 love it. Burn sicker than most of his patients.
As someone with O negative blood, I was told it was "baby blood" because it could be used in an emergency situation upon delivery before there was a chance to type the baby. But from now on, I'm going to say I have "Flying Squad Blood"!
33:30 I definitely think the OBD on cars has improved a lot more in the last several years than the OBD of human bodies.
Bluetooth connectivity is still shoddy in both cases
@@phitsf5475 There are indeed some times I could swear someone was trying to tooth my body.
I love your videos sooo much. I look forward to seeing content from you always. Please put out more videos ❤️
Cool dude, and I'm the 2nd viewer:D hahaha
“They will fast track you… somewhere.”
Classic.
With all the updates and shorts update making a difference on subs. Still congrats on any.
Congratulation on almost 500k subscribers
I really hate that 'doctors only get 1 hour of nutrition training' thing, it smelt like bullshit when I first saw it. You see it a lot with people trying to promote particular diets, for differing reasons. It annoys me because, as someone who is vegan, I care about reducing animal suffering, so as much as I'd like to see other people go vegan, I wouldn't want them to go vegan via overhyped health benefits and distrust in doctors. Though at the same time, as Rohin said, doctors aren't dieticians so they aren't always the gospel truth of a nutrition.
Same
I Made a similar point to some “but… but” head over on a doctor’s page on Facebook.
«whah whah whah» “but doctors only have __ number hours of training in nutrition … “ «blah blah blah»
Or some other such sub-subject that was not the primary focus of that specialty.
I asked them if they knew for sure that it was “only ___ hours” and even so, was the only so many hours like hours on a clock? Or was it “credit hours”. Meaning, for example, I have (iirc) 4 credit hours of Abstract Algebra on my transcript. Now, that’s not 4 hours as in the time between noon and 4:00 PM … but rather, that I was in that class for an hour a day, 4 days a week for about 12 weeks.
The "just die in the next 5" bit was gloriously British
Why did the Reiki practitioner work in the fromagerie?
They were good at aligning cheese!
I love how u know all these random facts about drug names 😂 was also wondering if u ever thought about doing vlogs? I’d love to see that :)
Showing 500K today. Congratulations! 🥳🥳
Thanks for answering my question! 12:56.
It is estimated that an average 75kg human contains 716000000 Joules of energy. Is this why you need a really good jolt of lightning to reanimate a corpse?
Subscriber growth ground to a halt as you started doing TH-cam shorts, coincidence or do you think there's a connection?
I don't know if making two shorts can be counted as "started doing TH-cam shorts" 🙃
although i am very much not a medical student nor is it something within my eventual expertise i certainly enjoy this channel and it's vids. so cheers
I unsubbed just to mess with ya. Thanks Rohin.
I found channel through suggested content, like the humor of the video, loved the wittiness, heard of the plateau in subscriber, immediately subscribed.