simplyfantast

I'm curious about your experiences.

I'm an inpatient physician. Once you are dying of cancer, we almost dump opioids on you where I practice. Especially if you elect hospice or comfort care. If you don't, then it becomes somewhat more difficult because escalating opioid therapy is just assuming risk of causing hypotension or respiratory depression.

We definitely undertreat acute pain. But in my circle, I'm pretty frank with patients that we generally won't use opioids for chronic pain outside of cancer-pain. It's not because of regulatory issues, it's more because the vast majority of people with chronic pain that I see don't have an obvious organic cause. Yes, it means the few that do have a good indication for chronic opioid therapy will suffer.

Also, acute and chronic pain behave differently. People with acute pain have a certain appearance that is easily recognizable. People with chronic pain will be sitting there looking comfortable, normal HR, eating and walking and watching movies comfortably on their iPads. It feels so weird prescribing opioids to those people. All the while telling you they "10/10" pain.

We need better studies on who qualifies for chronic opioid therapy and how it should be managed. Drug-monitoring databases have certainly helped, but a lot more needs to be done.

Some awkward yuppie guy gets friend-zoned by his Chinese kinda-internet-celebrity crush and exaggerates what he did to keep the platonic relationship going.

Not sure how the parent would respond, but early on, while discussing Rosalind Franklin's DNA diffraction findings, he makes an unnecessary comment about the Nobel prize going to "the two white men." It seemed out of place compared to the rest of his talk.

I didn't feel like the talk gave off an overtly political tone.

The New England Journal of Medicine on the other hand...cancelled my subscription due to how political it has become. Still has very good review articles, though.

I've been a physician for about 16 years. I won't defend the guy, it's just that I routinely see things that I would consider worse: doctors drunk at work, doctors who sleep with medical students in exchange for good evaluations, rampant cheating in medical school, rampant stimulant abuse, and the list goes on and on...

It's unethical for sure, but I guess my gut reaction is that it's not necessarily an offense that demands termination.