Doctors warn of codeine dangers after occurrence of acute confusion in daughter, 14

Lack of efficacy and risk of poisoning and craving suggest use of over-the-counter codeine narcotics may be unwarranted, says report

Doctors have issued a warning about the use of over-the-counter medications containing codeine following what is believed to be the first published lawsuit of acute disarray in a 14 -year-old girl.

The dangers associated with codeine in cough remedies, both prescribes and otherwise, are highly unnecessary because of the lack of evidence that they actually work, the experts said.

Many mothers still dedicate codeine products to their children, despite regulators fears. This may be because of what they perceive as its strength, and its analgesic impacts, medical professionals from Ireland say in an article in the publication BMJ Case Reports.

The girl was assured at a hospital A& E department after five days of fluctuating confusion and amnesia, according to the report. She had been sleeping up to 20 hours a day, had a decreased attention span and suffered from intermittent headaches.

She had falsely reported having completed tasks, such as having showered, her mothers told physicians, and she also switched speeches while doing her homework. The girl had flu-like symptoms over 15 days, during which she missed school, and had been taking two to three spoonfuls a day of oral codeine phosphate over this time.

Although the girl had not exceeded the recommended daily dosage of three to six spoonfuls, she had outstripped the maximum recommended duration of three days. In all, she was thought to have devoured 450 -6 75 mg of codeine, instead of the maximum of 270 mg over any course of treatment.

The symptoms abated five days after the girl was admitted to hospital. There was also no codeine in her urine. A clinical review 2 week after she was discharged proved she was well and free of symptoms.

Confusion is a relatively unusual complaint in codeine intoxication, say the doctors, highlighting the necessity of thorough investigations. Codeine does however often affect the central nervous system and breathing and can cause severe rub of the scalp and flushes.

In April, the European Medicines Agency warned physicians against giving codeine to children and adolescents. It reviewed international data relating to coughs and other respiratory infections, including four demises, arising from codeine poisoning in children aged between 17 days and six years.

For coughings and colds in under-1 2s, it should only be used in special circumstances, relevant agencies said. Older children and adolescents with breathing problems should also not use codeine , nor should patients of any age who were known to convert codeine into morphine at a faster rate than normal.

The authors of the BMJ article say that although there was no evidence of codeine craving in this case, other studies had raised questions over codeine dependence in adolescents and vulnerable adults.

The combination of lack of efficacy, danger of acute intoxication and dependency, suggests the use of over-the-counter codeine preparations may be unwarranted, they said.

The UKs Medicines and Healthcare Products Regulatory Agency said: Codeine is a strong medication authorised for pain relief. It is not recommended for use in children or adolescents for the symptoms of coughing and cold as it is associated with a risk of respiratory side-effects.

If anyone has any questions, they should speak to their GP or pharmacist who can best advise on alternative treatments.

Professor Nigel Mathers, honorary secretary of the Royal College of General Practitioners, said: GPs are aware of the risks links with prescribing codeine and, in line with current guidelines, as a general rule we would not recommend medications containing codeine for children unless other alternatives have been explored and only when it is really necessary.

We would certainly not recommend these drugs for patients who have other conditions, such as asthma. But codeine is an effective cough suppressant and widely accessible without a prescription, so if patients do choose to take medications that contain codeine, we would urge them to read the label carefully and stick to the recommended dose.

Neal Patel, a pharmacist and the head of corporate communications at the Royal Pharmaceutical Society, said: The UK Commission on Human Medicines advises that over-the-counter liquid medications that contain codeine should not be used for coughing suppression in people under 18.

There is only limited evidence that codeine is effective for treating cough and cold symptoms in children. The hazards outweigh the benefits for treating the symptoms of cough in this age group.

Codeine-containing medications are unsuitable for treating pain or coughing in children under the age of 12 due to the potential seriousnes of side-effects.

Pharmacists advise that, when used, codeine-containing medications should only be taken for three days and only at the recommended dosage, as it can cause addiction. People with coughings that last for more than two weeks should seek advice about the cause from a pharmacist or GP.

Read more: www.theguardian.com

Cutting-edge theatre: world’s first virtual reality operation runs live

Dr Shafi Ahmed will carry out surgery live-streamed in virtual reality, a move experts hope will build healthcare more equitable and help medical training

This Thursday afternoon, Shafi Ahmed will lean over a patient and begin a delicate operation to remove cancerous tissue from a male patients bowel. He has performed such procedures many times before. But this time it wont be only his surgical squad who are in the room with him the world will be there too.

Showing from 1pm the approximately two-hour long procedure at the Royal London Hospital is the worlds first operation to be streamed live in 360 -degree video, allowing medical students, trainee surgeons and curious members of the public to immerse themselves in the medical event in real time.

A cancer surgeon at Barts Health NHS Trust, Ahmed believes the approach could attain healthcare more equitable, improving the training of surgeons the world over. With internet connections becoming better, smartphones get ever cheaper and merely a pair of lenses and some cardboard needed to make a virtual reality headset the costs, he says, pale in comparison to the expenditure of students travelling abroad to train. It is actually quite cost effective, he said.

Shot use two 360 -degree cameras and a number of lenses arranged around the theater, the operation can be viewed through the VR in OR app, utilizing a virtual reality headset that is likely to be paired with a smartphone. Those who do not have a headset can watch the video live online.

While videos showcasing surgical procedures have been around for years, Ahmed believes the new approach is more than a mere gimmick. The technology, he argues, brings a valuable new feature to education, letting viewers to focus not just on what the surgeon is doing, but also on what other members of the team are up to. There is likely to be noise, there will be the immersive factor so that will add different layers of educational value, he added.

George Hanna, professor of surgical sciences at Imperial College, London is cautiously optimistic about the benefits of the approach. If this technology allows the transfer of knowledge and abilities[ over] a wider range and in an easier route that would be very beneficial.

But he is quick to add that, compared with existing approaches for sharing scenes from the operating theatre, the new technology offers more of an upgrade than a revolution. It is a good video and broad broadcast with interactive[ possibilities ], he told, stressing that the operation itself is real rather than virtual.

It is not the first time that Ahmed has led the style in embracing modern technology in healthcare. As co-founder of the healthcare company Medical Realities( which will be streaming the operation in collaboration Barts Health and 360 -degree video experts Mativision ), he believes virtual reality, augmented reality and games all play a role in training medical students: two years ago he streamed a live operation using the augmented reality system, Google Glass, permitting viewers to ensure the procedure from a surgeons point of view.

But the new 360 -degree video, says Ahmed, offers a new, immersive approach, allowing users to assure beyond what the surgeon is looking at. Among the developments he envisages, Ahmed is keen to add graphics to the raw footage to provide additional information during the operation, as well as taking questions from those viewing the procedure.

[ During an operation] I am teaching people, talking to them, there is communication going on so itll be just an extension of that, he told. Whats more, in three to five years haptic devices could boost the experience further, he added. Companies are genuinely working on various gloves or bodysuits and devices so that it can replicate touch and feel, he told.

Such technologies, said Ahmed could be a boon to health care. But he added, the role of patients in agreeing to take part should not be forgotten. Ultimately, it is about the operation, about[ the patient ], about his cancer care and that has to be the priority for everyone, he said. The fact that patients have agreed to do this before with the Google Glass and again, it is quite reassuring and quite humbling.

Read more: www.theguardian.com

VIP syndrome: why do the doctors to the stars build fatal mistakes?

Medical professionals who treat celebrities such as Prince and Michael Jackson are as susceptible to star power as the rest of us, and the results can be deadly

Anthony Mobasser, a Beverly Hills dentist, virtually swooned where reference is responded to a medical emergency and detected the patient was the screen legend Elizabeth Taylor.

It was an amazing experience. You have to act cool but youre sweating inside. I merely feigned that she was any other patient and I calmed down.

That was in 1980. Since then Mobasser has treated many Hollywood superstars and still, to this day, can feel a frisson.

When were treating celebrities we have to go beyond our consolation zone. Celebrities demand much more than the average person and rightly so because they are in front of cameras and on the red carpet. But you have to know your restrictions. If you mess up, you have a problem.

In extreme cases, a dead celebrity problem. Elvis Presley, Michael Jackson and Joan Rivers are among cases where fame appeared to pressure, astonish or distract physicians into bad medicine. The phenomenon has a name: VIP syndrome.

It is not new. Walter Weintraub, a doctor who coined the expres in 1964 , noted venerable instances. The well-known cases of such historical figures as King George III of England and King Ludwig II of Bavaria clearly demonstrate that the treatment of an influential man can be extremely hazardous for both patient and doctor.

With investigators probing the possible role of Los Angeles and Minneapolis-based physicians in Princes opioid overdose, comments and observations remains valid. Doctors who bend the rules to provide special care to special patients can end up killing them.

There are physicians who give things that build no sense, for example growth hormones to construct person seem younger, said David Agus, a cancer specialist who treated Steve Jobs. It stimulates the field look bad.

Before his death in 2011 the Apple co-founder bombarded Agus with quack redress. Agus, a prof of medication and engineering at the University of Southern California, said he repudiated them.

The challenge is to stand up to people. My medical practise is about tough love. Its very data driven. Steve fired me a hundred times and hed call me back an hour later.

Cancer
Cancer expert David Agus said some of Steve Jobss doctors strayed from solid medical science. Photo: Bloomberg/ Bloomberg via Getty Images

In addition to requesting unwise therapy, some celebrities have been known to pressure doctors to forgo invasive tests, or to not share information with colleagues to protect their privacy.

Theres no question that people who are rich and powerful are treated differently than those who are not, said John Connolly, president and CEO of Castle Connolly , which ranks physicians. Physicians can be star-struck and swayed by powerful patients in directions that may not be the best.

It can be hard saying no to a high-profile patient who in addition to lucrative business can bestow prestige and glamour. The Hollywood Reporter utilizes Castle Connolly data to publish an annual list of Hollywoods top doctors in which superstars single out dentists, oncologists, pediatricians, obstetricians and other experts for kudo.

One article features Charlie Sheen posing alongside orthopedic surgeon, Bal Rajagopalan( aka Dr Raj ), who boasts about a miraculous stem cell cocktail which supplies tools to regenerate bone cartilage and turn back time.

Unexpected celebrity demises have illuminated the darker side of medical relationships.

The midwest medical examiner cited Princes cause of death as self-administered fentanyl, a powerful opioid. Investigators are probing the musicians suspected prescription drug addiction.

Michael Todd Schulenberg, a doctor in Minnesota, prescribed drug. Days before Prince died Howard Kornfeld, a California addiction specialist, sent his son Andrew, to gratify Prince. Kornfeld has defended his treatment of Prince on social media.

Doctors
Doctors were reportedly star-struck by Joan Rivers, even photographing her on the operating table. Photo: Karen Robinson for the Observer

Fame appeared to be a factor in Joan Rivers death in August 2014 during a routine procedure. Physicians were reportedly so star-struck and nervous they contravened protocols. One took a photograph of the comedian on the operating table before she went into cardiac arrest. The clinic and doctors accepted responsibility for her death in a malpractice lawsuit.

Michael Jacksons physician, Conrad Murray, facilitated the singers request for propofol, a powerful surgical anesthetic, to help him sleep. A jury convicted Murrayof involuntary manslaughter on the grounds the drug played a key role in Jacksons death in 2009.

Doctors largely escaped public blamed in the case of Jobs. The Apple chief refused to let them remove a pancreatic tumor and instead tried to treat it with a vegan diet, herbal remedies and acupuncture. When he afterwards agreed to surgery the tumor had spread uncontrollably.

For many high-profile patients who get a disease its the first time theyre not in control and its hard for them to get are applied to that, said Agus, who started treating Jobs after the cancer had advanced.

A lot of the time you have a high-profile person and they want, say, a herb from China, and theyll search out someone who can provide that. Steve would send me literally dozens of things, asking about special mushrooms, or a therapy in Germany.

Agus, an writer and health guru who treats Silicon Valley billionaires, said some of Jobss doctors strayed from solid medical science. He had some well known physicians telling him to do things that induced no sense based on the data.

Rick Friedman, an ear specialist prominent in the Hollywood Reporters list of top LA physicians, said famous clients could warp medical judgment. Physician are very human. Ive no doubt that some who are star-struck can have clouded judgment.

As the brother of a film studio executive, Friedman said he felt largely inoculated from celebrity adore but still felt a tingle with certain patients, such as a pop star who had lost hearing in one ear. I try to keep my aplomb. I tell them I respect the performance of their duties and get on with my job. I recollect citing the Hippocratic oath at my graduation. I take it very seriously.

Mobasser, the dentist, recalled his exhilaration when Mel Tillis, the country and western star, summoned him at 2am to repair a broken front tooth on the eve of an important Tv appearance. Of course you get intimidated. But I got it done. You rely on your training and get fantastic outcomes. He mentioned me on Johnny Carson and wanted to give me a pony as a present.

Mobasser said he had turned away some famous patients. Many times Ive said no to a celebrity if I think theyre coming for the drugs. You have to do your duty. Unfortunately I do know colleagues who say yes. That is when morality comes into play when you want to keep a celebrity just for the sake of having that patient. Ive watched colleagues who do it and in the long run they have regrets.

Elvis
Elvis Presley is examined by an army doctor during his pre-induction physical in 1958. Photo: Don Cravens/ Time& Life Pictures/ Getty Image

Elvis Presleys demise in 1977 from heart problems linked to prescription drugs is perhaps the most famous example of VIP syndrome.

Criticism rained on his physician, George Constantine Nichopoulos, also known as Dr Nick, who succumbed earlier this year. He blamed Presleys addiction on the vocalists west coast physician, Leon Cole, who died a few months before Presley.

He publicly blamed my dad for everything, claiming he was the bad guy, and that he, Dr Nick, was always having to clean up the mess and keep Elvis healthy, said David Cole, Leons son. Most people didnt buy that hooey, but Dr Nick outlived my dad by quite a few years, so his version is the one are set forth in volumes.

Cole said he knew from his late mom that his father routinely furnished morphine and quaaludes to Presley. Dr Nick was supplying too, on a more daily basis, but my papa made a good fall guy, especially after he died and couldnt fight back.

Leon Coles own demise bolstered the contention that treating an influential human can be hazardous for both patient and physician. He took velocity to run a near-2 4 schedule, said his son. He had become so blas about doling out drugs to celebrities, he believed himself immune to the effects, but the amphetamines wore out his heart.

Read more: www.theguardian.com

We need clinical trials but we must remain vigilant against their abuse | Ranjana Srivastava

Startling new research has revealed that three-quarters of healthy participants in clinical trials conceal some health information to avoid exclusion. This could have wide-reaching outcomes for all of us

Someone I know has been left disabled after participation in a clinical trial of an experimental drug. Advised that no conventional therapy existed for his rare multisystem disease, he deliberated before dipping his toe into the world of clinical trials.

After receiving one dosage of the experimental medication, he told the principal researcher of new and troubling symptoms. The second dose greatly exaggerated his troubles. The medication was stopped but not before leaving him with profound nerve damage, chronic pain, and worse of all, the inability to use his dominant hand.

The patient alleges that the principal researcher did not take his objections severely, that there was a lack of good communication and that in the eagerness to enrol the patient, the process of informed consent was lax. An intelligent professional, he laments that had the rare but serious toxicities been explained better he would never have consented to the trial.

Having watched him caught between doing nothing and participating in an experiment, I feel very sorry that his choice led to an extreme outcome where his decline is now marred by depression and self-blame about having made a bad condition worse.

I have also come to admire his grace through an unimaginably difficult period. It would be fair to say that he is disillusioned and his trust in the clinical trials process has been fractured.

Recently, a prominent Australian trial was retracted by the Journal of the American Medical Association, a full two years after publication, when it emerged that the principal researcher had concocted patients and fabricated data covering a common blood pressure drug and an influence on strolling time in patients with peripheral vascular illnes.

Given the high prevalence of cardiovascular disease, the impact of a positive analyze in a prestigious publication is substantial and wide-reaching. The finding was quoted more than 30 periods. Many physicians may have read the original c. conclusions and modified their practice but failed to see the retraction, including one published more recently in the New England Journal of Medicine.

The fraudulent actions of a lone researcher also left an entire organization shame-faced in its wake. For some, such accounts will cement their cynicism over clinical trials in medicine, often driven by big pharma and run by unscrupulous researchers who chase publishing fame over patient security. More reasonable people will rightly bristle at this broad generalisation and point out the greater good from well-conducted trials which advance the cause of all patients.

We are by now very well known the worldwide crunch in healthcare research funding even as we clamour for smart innovations and new discoveries. Publishing original research in top academic periodicals is a time-honoured style of gaining medical afterlife, and in turn attracting better fund. Therefore, we should nearly expect that despite ticking the boxes on research integrity and ethics there will be a subset of researchers who will try to outsmart the system. Many will be caught but regrettably, some will escape detection and censure.

The hallowed mission of improved patient care sabotaged by arrogant and dishonest researchers is by now a familiar tale, one that has institutions in knots over how to strengthen their monitoring systems. This is why I scarcely took notice of the words research and hiding in a periodical I was reading lately. But I am glad I read on because the study glisten light on an important but invisible aspect of clinical trials: deception by research participants.

The research referred specifically to healthy volunteers who are paid to compensate them for their period and inconvenience.( In trials involving real patients, there is typically no payment but travel costs and meals may be provided .)

The researchers examined 100 patients who had participated in at least two analyses in the past year or at least four in the last three years. An astonishing three-quarters of subjects reported disguising some health datum from researchers to avoid exclusion from enrolment in a study. One-third disguised health problems and use of prescription drugs and 20% recreational drug use. A one-quarter exaggerated their symptoms in order to qualify and perhaps more worryingly, 14% simply pretended to have a health condition in order to join the trial.

These high figures were startling. Why did these participants lie? Was it the financial incentive, shame about disclosing private datum or something else? Was a trial their only style of attempting medical help or was there a distorted altruistic instinct at play? Would their CV be embellished by the mention of being a healthy volunteer in the cause to banish a disease? The researchers observed that the frequency and context of the behaviour were unclear. This analyze was small but there have been longstanding ethical very concerned about paying people to take part in clinical trials.

An essay in the New England Journal of Medicine highlightings an even more troubling side to the tale. The novelists observe that by falsifying their account, participants undermine the integrity of the entire analyse by biasing the data.

Whether a trial is analyse the efficacy of a test or the toxicity of a drug, participants who report their experience with anything less than total honesty can substantially alter findings, leading to the discontinuation of a valuable trial or conversely, continuation of an unsafe one.

Serious toxicity can be attributed to the experimental drug when the culprit is an illicit medication or a drug interaction. Alternatively, a drug trial that mistakenly includes patients suffering from a given condition instead of healthy volunteers may be biased in favour of the medication.

The authors recall the dramatic but cautionary narrative of workshop participants who arrested and died during a sleep examine due to an electrolyte imbalance thought to be related to the prescribed lithium when in fact it was caused by anorexia and self-induced vomiting. Had the patient disclosed her anorexia, the researchers would have omitted her from the study but directed her towards the help she needed.

Progress in medicine comes from standing on the shoulders of volunteers and patients who are by and large altruistic participants in research. But since less than 5% of the population participates in clinical trials, even a small number of dishonest individuals can sway outcomes in significant ways to affect our health at its own population level. And yet, proof is our best friend when it comes to selecting the most appropriate antibiotic, the safest antipsychotic or the best surgical technique.

Doctors must pause to think if the evidence-based therapy we think we are practising has been acquired from research conducted with total integrity. For researchers and ethics committees, this entails intensive vigilance of institutional ethics. For clinicians, it means applying a continuously wondering mind to the reams of data thrust upon us everyday and not being afraid to acknowledge that in many regions of medication, there is no one right answer.

And importantly, for patients, it means being unafraid of asking questions and having a curious intellect about the strength of evidence a doctors advice is based on. With the power imbalance between the physicians and patients this isnt easy but more than ever, its necessary, and I think we have to enable our patients to do it.

The patient I describe is dismayed at his experience of researcher misconduct and I hope he procures some succour in an apology. Meanwhile, all of us, living with common conditions from blood pressure to depression, should be wise to the potential of healthy volunteer participants in clinical trials to impact the decisions made about our own health. For all our sakes, researchers and participants must strive for better.

Read more: www.theguardian.com

A startup wants to make doctor home calls as easy as ordering an Uber

Heal wants to be your primary care physician .
Image: Luis Llerena/ stocksnap

Concierge medicine isn’t just for the rich anymore, and the app Heal has raised $26.9 million to prove it.

The startup, which appears to remove wasted period and fund in healthcare through on-demand, at-home doctor’s visits, announces that it first major fund round on Tuesday.

Heal says its platform is a long-term solution to problems in healthcare not alternative solutions when the doctor’s office is closed.

“We want to be your family doctor, ” Heal CEO Nick Desai told Mashable . “This is not something simply to use on weekends.”

Heal connects patients to primary care physicians through an app and website. Patients can request a doctor for that day for sickness and traumata, a regular physical, flu shoots or other needs.

Heal accepts insurance and charges a typical co-pay for customers with Blue Shield, Anthem, Cigna, Aetna and United Healthcare. Other customers pay a $99 flat fee. The company expects to accept Medicare by November.

Booking an appointment in the Heal app.

Image: heal

The round was led by Tull Investment Group with participation from Breyer Capital, Slow Ventures, HashtagOne and David Ellison. Earlier investors included Pritzker Group Venture Capital and Lionel Richie.

Heal is able to bring down the traditionally exorbitant costs of concierge medication since the platform doesn’t have the overhead of a traditional doctor’s office. In that style, the company is the next example of the gig economy, as applied to healthcare.

But the doctors who show up on patients’ doorsteps when requested through the Heal app are chiefly staff members of the company’s medical firm, although some are long-term contractors. Their specialized skill is one reason Heal, unlike tech companies that use contractors without a similar skill level, has been encouraged to provide full-time employment and benefits.

The company said that most Heal physicians are three to seven years into their practise and attracted to Heal for its flexible in hours or less hectic approach to primary care. They work principally with Heal , not with another practise, and can choose their hours from 8 a. m. to 8 p. m ., seven days a week.

Heal launched in California a year ago, and in that time has hired 60 doctors and completed 11,500 patient visits. The company is still limited to California, but looking to launching in six to eight new marketplaces this year, Desai said.

Heal’s approach to medicine has helped attract a diverse group of investors who have contributed $40 million in total to the company since its seed round.

“It’s the kind of product everyone wants to work. Everyone needs to go to the doctor’s office and everyone detests going to the doctor’s office, ” Desai said. “It’s an intuitive appeal in that sense.”

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Doctors would all support Obamacare if they ensure the vast inequality that I do | Celine Gounder

Data proves physicians in different disciplines election differently. The ones who dont take Medicaid seem to skew more Republican than the individuals who do

When Americans head to the polls in November, theyll be choosing the fate of the Affordable Care Act, what Barack Obama has called the most important healthcare legislation enacted in the United States since the process of developing Medicare and Medicaid in 1965. Over the past decade, healthcare providers have observed the rollout of Obamacare and its net-positive impact on their patients and their practice of medicine.

But how will they vote? Data reported by the New York Times last week suggests that different kinds of doctors tend to have very different political views. My experiences result me to believe that this empathy gap can be traced to the mix of patients that clinicians care for. The more physicians get out of their privilege bubble, the more likely they are to support maintaining, and strengthening, the ACA.

All physicians bear witness to the lives of others. But whom we meet depends in part on what insurance we accept. Medical experts including cardiologists and orthopedic surgeons and are less likely to take patients on Medicaid than are primary care doctors, pediatricians and infectious-disease docs.

Poverty, discrimination and other social factors also increase health risks of certain cancers such as HIV, hepatitis, childhood asthma, obesity, high blood pressure and depression. So certain medical specialists, like me, watch a higher proportion of patients from backgrounds vastly different from our own. Call it empathy boot camp.

One of my patients has been to the hospital six periods in as many months because her asthma flares up every time she smokes crack cocaine. She lives with her elderly mother and cant move, and its hard for her to discontinue when most of her neighbors smoke crack too. Another of my patients had PCP, a severe pneumonia related to HIV/ Aids, which required treatment with multiple medications. She left the hospital against our advice because she doesnt feel comfortable asking family, friends or neighbors to look after her children.

I have another patient who ricochets around from hospital to hospital looking for safety from her abusive partner. Another patient with advanced Aids refused to go to a nursing home where he would have gotten assist taking his dozens of drugs, three square meals a day, substance abuse therapy services and physical therapy. He was afraid of losing the apartment he shared with his HIV-uninfected girlfriend, leaving her homeless. He died. This is just a sample of patients I assured in one month.

My patients have shown me its nearly impossible to get person healthy when they dont have stable housing. Ive learned that if my aim is to help people get better, Ive got to be pragmatic. Ive realized that most people with an opioid craving will never be opioid-free. But with medication-assisted treatment( using substances like methadone, buprenorphine and naloxone ), they can become functioning members of society, return to work and resume their roles as caregivers of children or ageing mothers.

Ive even come to believe in safe injection sites, where people can use heroin and cocaine under the supervision of healthcare workers. Not only are they less likely to overdose, but theyre also channelled into testing and therapy. I used to think it was unfair for transgender females to want their breast implant covered by insurance when equally flat-chested cisgender women have to pay for their own cosmetic surgery. But then I ensure the damage that comes from injecting industrial grade silicone.

As physicians, we have the privilege of crossing social divides when most others dont. With that comes a responsibility to our patients and our country that goes beyond our vote. We know all too well whats at stake.

Read more: www.theguardian.com

5 Things You Unavoidably Learn When You Date A Med Student

1. Medical students are a rare breed.

I gratified my boyfriend at a strange time in my life when I was debating going to medical school. After listening to hours upon hours of medical jargon, factoids, and anomalies, lets just say Ill run the Ph.D. road. Most medical students examine somewhere around 30 -4 0 hours per week, excluding lecturings and all the other school-related things they do. Sometimes I regret my decision, but a late-night text about ovarian follicles or scalp flaps quickly erases those doubts.

2. He/ She will know your body better than you do.

His or her knowledge about the human body is simply astonishing. I often wondered how he managed to squeeze all of that info in his head and remember it in minute detail on command. While having your personal WebMD may sound fun at first, where reference is or she discusses the particularities of your ENTIRE menstrual cycle with you, things get uncomfortable fast.

3. Medicine is his or her first love.

When you get in a relationship with a medical student, you have to quickly come to terms with the fact that you will always be the side bae. This is not meant to undermine his or her commitment or impressions towards you, but to represent his or her passion and dedication to his or her soon-to-be profession. While watching him or her no more than once a week( or sometimes once a month) can be frustrating at times, his or her diligence and devotion are inspiring. Not seeing your significant other every day attains you truly appreciate the time you do get to spend together, while still permitting both of you to maintain a certain degree of independence.

4. Every day is a learning opportunity.

As I mentioned before, medical students spend the majority of their time analyzing and when theyre not examining, theyre talking about what theyre studying. This means that you will basically get a second-hand education from them. And, if youre like me, youll be trying to figure out what theyre talking about the entire period so Wikipedia will become your best friend. Youll never watch Greys Anatomy the same way again.

5. Its worth it.

Despite ensure him or her infrequently and medical gags that get lost in translation, your relationship with a medical student might just be your most meaningful one yet. Medical school entails hard work and dedication, both of which will carry through into your relationship.

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