The human brain is a wonderfully complex organ that has evaded understanding since the dawn of time … at least, until now. John Cleese, English actor and comedian, presents an in-depth yet succinct overview of how the brain works. Even more amazing is his ability to distill all this information into a 2-minute videocast, “All About The Brain”.
For an Einsteinian few, these ideas appear elegantly logical and simple. As for the majority of us, including myself, they represent concepts far too esoteric and advanced for mere minds to comprehend. If you feel Cleese’s words were like gobbledygook, then you belong in the latter group. It may have helped if I stayed awake more during neuroscience classes in medical school.
Coincident with the prestigious Nobel Prizes awarded each year are their parody counterparts: the Ig Nobel Prizes (a play on the words “ignoble” and “Nobel”). The honors are bestowed to individuals who demonstrate notable achievements that “first make people laugh, and then make them think.” The awards ceremonies take place each October at the Sanders Theater of Harvard University and include genuine Nobel Laureates presenting the awards.
This year’s Ig Nobel Prize in Medicine goes to Donald L. Unger of Thousand Oaks, California, for investigating whether knuckle cracking causes arthritis. The premise of his research, published in Arthritis & Rheumatism, was to test the validity of admonitions from “renowned authorities” (i.e., his mother, several aunts, and mother-in-law) that cracking his knuckles would lead to arthritis. Over the course of 50 years, Unger cracked the knuckles of his left hand at least twice daily, while sparing his right hand to serve as a control. At the end of the 50-year observation period, Unger did not detect any difference between both hands. He concluded that “there is no apparent relationship between knuckle cracking and the subsequent development of arthritis of the fingers.”
In light of the present evidence, Unger now questions whether other “parental beliefs”, such as the importance of eating spinach, are similarly flawed.
I am not familiar with Mitchell and Webb, but a brief Bing search reveals that they are British comedians known for starring in several popular comedy sketches and sitcoms. In one of their shows, The Mitchell and Webb Look, they satirize homeopathy and its impotence in treating serious diseases.
“A&E” stands for “Accident & Emergency” and is more commonly used in the Commonwealth countries. It is analogous to the “ED” (Emergency Department) or “ER” (Emergency Room) acronym used in the United States.
Scientific research has so far not found any superiority in homeopathy above placebo, but it is a brand of therapy more readily accepted in some countries. Several European health services will reimburse the use of certain homeopathic remedies. In India, homeopathy is an officially recognized form of medicine.
One could argue that if homeopathy were not doing any harm, why bother? There can nevertheless be great potential for harm when homeopaths counsel against the use of conventional treatments (see article in Telegraph with follow-up in BBC). Having obtained degrees in biochemistry, molecular biology, and medicine, I know I’m biased, but that is why we have double-blinded randomized control trials.
Mr. Jones is a 65 year-old gentleman with a past medical history significant for hypertension (HTN), diabetes mellitus (DM), chronic obstructive pulmonary disease (COPD), and coronary artery disease (CAD), who presents from OSH with … who-knows-what?
OSH denotes an “outside hospital” from where a patient was transferred. These hospitals are generally smaller medical centers that do not have the advanced specialists, equipment, or support facilities to manage the evolving complexity of a patient’s disease. Consequently, they request from a higher-level care center (i.e., tertiary hospital, major academic institution) to have the patient transferred there. In rare instances where patients carry cryptic or immensely challenging clinical diagnoses, a tertiary center may even refer the patient to another hospital where supposed “world experts” of a particular field may practice.
A common complaint at tertiary centers receiving transferred patients is that they arrive with poor supporting documentation. That is, what had been done for the patient while at the other hospital? What happened whereby the patient now requires higher level care? Discharge summaries sometimes appear as if they were drafted on the fly; at other times, they are replaced by randomly copied chart notes or nothing altogether. In worse scenarios, patients may arrive with such dearth of information that the admitting physician is left dumbfounded about the real reasons for admission.
In response, a group of medicine residents from the University of Pennsylvania created the following video to critique–with gross exaggeration, of course–the infamous OSH.
Disclaimer: the video is intended to be a comedic satire and does not reflect the standard of care at OSH. Training programs, practicing medical professionals, and health care organizations are closely monitored by an army of acronyms, such as the ACGME (Accreditation Council for Graduate Medical Education), ABIM (American Board of Internal Medicine), JCAHO (Joint Commission on Accreditation of Healthcare Organizations), etc.
