What would you, as a physician, think of another physician writing "schizophrenia" for the cause of death on a death certificate?
Causes of death on a death certificate can be pretty tough. I have a colleague who on every death certificate he has ever signed, has listed “cardiopulmonary arrest” as the cause of death, because he was taught to do it that way. The person who taught me said that was useless, because as he said “find me a dead person with functioning heart and lungs”. The idea on a death certificate is to know why they died, not the fact that their heart stopped, which is actually fairly common in dead people.Schizophrenia is not a cause of death. The process that is ongoing in their brains does not kill them.However, death certificates also have an area for things which lead to the ultimate cause of death, as well as contributing factors. The person with lung cancer might have actually died from pneumonia, caused by their lung cancer, with a contributing factor of tobacco use.The schizophrenic patient who shoots himself died of a gunshot wound, but the schizophrenia can certainly be a contributing factor. The schizophrenic patient who has a stroke because he wouldn’t take his blood pressure medication probably has it as a contributing factor as well. But it probably shouldn’t be the prime cause of death.
What was the most misogynistic thing you have seen or heard?
These aren’t the most misogynist things EVER, but they have happened to me. I’m a chemical engineer and have worked in the energy business my entire career.During college:My advisor telling me that I’m going to get a job, because quotas, but I will be taking away a man’s job. A man that has a family to support. That I will quit in a few years, after I have a child. That I won’t be allowed to work in refineries or chemical plants when I’m pregnant or breastfeeding (I never worked in those places, anyway). My thermodynamics professor asking me if my husband did my homework for me (I was married to a civil engineer student, who BTW flunked thermo his first try). Another professor asking me how my husband felt having a wife that was smarter than him (stereotype about different engineer disciplines). About how my husband felt about me going on school trips and being the only female. About how my husband felt about me wearing that black skirt with the slit on the side, and did I need to borrow his needle and thread?During college, when doing on-campus interviews with major companies:Did I know that summer jobs for engineering interns often required working outside in the plants, which were hot and dirty? ( My answer: I do my own oil changes and tune-ups). Did my husband mind me being away for the summer on an intern job? When did I plan to have children?My first job out of college, with Amoco Production (later purchased by BP, after I left), comments FROM MY SUPERVISOR:Don’t expect to be promoted very far, because (in the tech track), women aren’t as capable technically as men and don’t get the higher-up jobs. In the operations/engineering tracks, women are too emotional to make good supervisors.Women let their personal problems interfere with their work (while he was having an affair and a divorce, and was so grouchy and angry that we avoided him at all cost).All women are bitches and out to snag a man to take care of them.When I became pregnant but continued working, was not given any assignments that ended after my due date, because ‘no matter what you say, we know you won’t be coming back”. I started work again after 4 weeks, just because.From an HR manager: Hey, can you cross your legs so I can get a better look?I became friends with the local VP’s secretary, so learned other things about my five years with Amoco: whenever we had pre-employment or random drug tests, female engineers were also given pregnancy tests - without our knowledge or consent. There was a form that the district offices sent to the headquarters whenever an engineer, or in the case of a married male engineer- their wife - became pregnant. She told me that during exec staff meetings, they would comment that they liked the male engineers to be married, with kids and a mortgage, because it made them stable and tied them to the company, but they lived the female engineers single because married females would be less flexible about transfers and they never seemed to burden themselves with big mortgages.(And I’ve been told by MANY young women that I have no clue how bad it is for women)./
Have you ever seen a person die?
I did. I will never be able to unsee it.It happened on the 27th of July, 2021. I was at the train station, waiting for my train to arrive, it was quite a small station where there are approx. 4 trains every hour. I was there at 08:05 AM and my train was scheduled to arrive at 08:15 AM. I decided to have a cigarette while waiting, so i went where the ashtray is on the platform. I remember seeing a lady, she was dressed quite normally, she had black jeans, a pink shirt (i will never forget that color) and a black leather jacket (it was hot as hell so i thought that was strange), she had a suitcase and a purse. This lady was acting a bit strangely, she was walking back and forth on the platform and kept looking if the train was coming, she wasn't really close to her suitcase, like 10 meters or something. I was looking at her, she looked worried, but since she had a suitcase i thought she was going somewhere and was late, or simply in a rush. Two minutes before 08:15 AM her legs started shaking, like..really really shaking and she was looking for the train like every 10 seconds. She was super close to the tracks but she was still on the plaform. At this poing i was closer to her suitcase than she was, to help you picture it, the suitcase was in the middle, between me and the lady. I was at 5 meters from it and she was at 15 or more, so approx. 20 meters from me. She then began coming closer to me so she was at 10 meters from me and 5 from the suitcase.From here on, it all went so fast, but so slowly at the same time. I heard the speaker saying "train 000 to …. arriving on platform 4, please step back". It was a long train, so it arrives kind of fast then stops while at the station. I'm trying to remember exactly how things went but I still have a few blackouts here and there. I remember for sure the train arriving, the lady quickly looked around, i saw her eyes… never, ever in my life have I seen such a look, i can't describe it to this day. In a matter of seconds she JUMPED right in front of the train, I saw the WHOLE THING, there was blood… there was a lot of it. There were some remains that… you could not tell if it was a person or an animal.Now, every person reacts differently to shock, some people scream, some faint, some will start throwing up and some go completely crazy, but there are also some people who just stay there, paralized, in shock. That's exactly what I did, I stayed there, looking without blinking, I didn't fell anything, I had literally no feelings, no words.People around me were screaming but I was just...there. 2 minutes later, which felt like hours to me, a guy with a bright orange vest came to me and took me away, they asked me if I needed an ambulance and at that time I still was not talking, but I "said" no with my head. They asked who they could call, I took my phone and called my mom. At that moment, it hit me. I was not able to speak but I was crying histerically, my mom kept asking me what had happened, if I was hurt, if something happened to me.. I just gave the phone to the guy with the vest and he talked to her. My mom arrived in 10 minutes, and took me to the doctor. My story goes on obv. but this is out of topic so I will end it here.I am sorry for the mistakes, english is not my mother Language, it happened close to Paris Gare-de-Lyon.thank you for reading.
Have you ever had an illness that made you interesting to doctors?
In 1988, I flew despite having a head cold. Three days after my return, I took a nice hot shower and felt a searing pain in my ear, followed by a “pop.” I turned on the TV and all theme music (and commercials) sounded like it was played underwater and horrendously out of tune. I got up to call my HMO clinic, and nearly keeled over—the floor seemed to undulate like a ship in very choppy water. I knew instantly I had not only a punctured eardrum (not merely a garden-variety otitis media) but likely an inner-ear infection (vestibulitis) as well. Friend drove me to the HMO, where the “gatekeeper” GP on duty was an older Englishman who’d come out of retirement to be the doc-of-the-day. He looked into my ear, and immediately called every resident, PA and med student in the clinic into the exam room to take a look.Turns out my eardrum looked like cobblestones! (His word). He said he had seen that only once before in his career, when he was a young resident in London. He put me on meclizine (Antivert, the prescription strength of Bonine) for the vertigo, and because there was definitely pus (and I’m penicillin-allergic), 10 days of a tetracycline. It took a couple of days for me to “get my sea legs” and a couple more before I could bear to listen to music (and I’m a performing songwriter). Of course, I finished the full 10 days of the abx.One day in 2021. after returning from a plane trip with a very mild cold, I once again awoke to find all music on the TV sounded like watery crap—and the singers & instrumentalists seemed to be singing in different keys. All my high-end acoustic guitars sounded like unplugged Wal-Mart Strat copies. I heard pitches 1/4 tone lower in my L ear than my R. (“Diplacusis”). How I got through a weekend of gigs (including a folk festival and recording session), I’ll never know. On top of that, my right hip seemed to keep painfully popping out of place.The young, green-as-grass ENT I saw shrugged and said there was a little clear fluid behind my eardrums, but it was allergy season and I have hay fever. I asked about the pitch and timbre disturbance and he shrugged “must be something with your cochlea.” (Ya think)? He told me to take Sudafed and ride it out. (Oddly, no nausea or vertigo this time).Went to the orthopedist, who (in front of a gaggle of med students) put my X-ray up on the light-box and gasped “holy shit!” (Two words you don’t want to hear from your doctor). There on the film was my R iliac crest (in lay terms, a hipbone), with a sharp chunk of it broken off and floating above it and off to the side. Because I was too young for osteoporosis to have caused it, he ordered a nuclear bone scan to look for signs of bone cancer.Next day, went to a neurotologist recommended by a musician friend who’d gone through the same hearing disturbance. (My friend’s own neurotologist in Seattle referred me to a colleague here who was also a musician…but he had died suddenly the week before and the guy I saw was his partner, a non-musician). When I mentioned the hip problem and the bone scan, he frowned and ordered an MRI to check for abnormalities. I asked if it might be bone mets from a brain tumor or vice versa, he shrugged and said “let’s wait & see.” He had his audiologist test my hearing, and said my acuity was very good for someone my age, especially someone who as a bassist had spent a couple of years standing next to a drummer every weekend.That weekend, awaiting results of both tests, was the scariest of my life—scarier than my breast cancer diagnosis and its aftermath a decade later. Then the ortho called, saying all he saw on the bone scan was some inflammation at the site of the fracture. “Say, didn’t my partner harvest bone from your hip a few years ago for a bone graft for a tibial plateau repair?” he asked. When I said yes, he said that maybe the partner had dug a bit too deeply, but better to take too much bone than too little. “We can go in now and remove the chip, or see if it resorbs.” I opted for the latter, and my pain went away in about two weeks.Then the neurotologist called and said my MRI was utterly normal. I asked why my hearing disturbance, especially the diplacusis. He replied “You’re a musician—you’re just too picky about pitch.” (!!!!) He said I had Meniere’s, which is a diagnosis of exclusion (i.e., when everything else is ruled out). When I told him I wasn’t dizzy or nauseated, he replied, “Well, atypical Meniere’s, then. Cut out sugar, salt, caffeine, alcohol, any brown drinks.”I asked him for a Rx, as I had done some reading and found in The Lancet that a regimen of prednisone, vinpocetine, alpha-lipoic acid, vit. E and manganese could reverse or at least mitigate sudden sensorineural hearing disturbance, so long as it was given w/in 7–21 days of onset. It was already day 20. He grumbled, but phoned in a Medrol Dosepak scrip, which I started (along with the supplements) immediately. By day 24, my hearing was back to normal. (I did later go to a musician-specific audiolgist, because the neuro’s audiologist said I should get fitted for custom musicians’ earplugs—and he found that my acuity started falling off at 12kHz, regular audiologists test middle-aged people only up to 8kHz. In other words, I had the hearing acuity of a live rock concert soundperson my age).
How can I fill out Google's intern host matching form to optimize my chances of receiving a match?
I was selected for a summer internship 2016.I tried to be very open while filling the preference form: I choose many products as my favorite products and I said I'm open about the team I want to join.I even was very open in the location and start date to get host matching interviews (I negotiated the start date in the interview until both me and my host were happy.) You could ask your recruiter to review your form (there are very cool and could help you a lot since they have a bigger experience).Do a search on the potential team.Before the interviews, try to find smart question that you are going to ask for the potential host (do a search on the team to find nice and deep questions to impress your host). Prepare well your resume.You are very likely not going to get algorithm/data structure questions like in the first round. It's going to be just some friendly chat if you are lucky. If your potential team is working on something like machine learning, expect that they are going to ask you questions about machine learning, courses related to machine learning you have and relevant experience (projects, internship). Of course you have to study that before the interview. Take as long time as you need if you feel rusty. It takes some time to get ready for the host matching (it's less than the technical interview) but it's worth it of course.
When a transgender person dies, does the coroner fill out the death certificate under their natal sex or gender identity?
In Spain, there has generally been a push to simplify the process of legally changing your government identified gender. It no longer requires that you have medical surgery to “change” your biological gender appearance. You generally need a psychologist or psychiatrist to make a statement that you have gender dysphoria, that this condition has existed for a while and is not going away. The process has also been opened up to minors. As part of the process to get your official documents changed, you can get a legal name change including last name if I recall correctly. This process of name changing is generally otherwise next to impossible to legally do in Spain.Once the process is complete, you are identified by that gender across all your government documents. You have a full legal entitlement to be referred to as that gender, and you can lodge complaints with the government about discrimination should you be intentionally misgendered. I’ve looked around for specific documents referring to death certificates issued in Spain, and issues for trangeneros and transexuales. I just cannot find anything in any BOE that specifically addresses this narrow point. The best I can find are anti-discrimination laws related to health that says you cannot be discriminated against for any health services you request, and you’re legally entitled to all health services for your gender. (This is on top of other services that are often offered on the local government level specifically for trangenero and transexual individuals in assistance with transitioning.)Death certificates in Spain can be requested for the purposes of rectifying the sex of a deceased individual. In requesting a death certificate, gender is not a field. (And they have both mother/proginator 1, father/proginator 2 on their for the deceased person’s parents. Gender neutral and gendered for the parents.) The 2021 law that I found about sex on death certificates says the wording was changed to sex at birth, where it was originally just sex. (But this sex at birth is changed if you go through the legal process to change your registered gender is my recall.)The issue is it is unclear how many people have taken advantage of this and how many have not. An ein 2021 put the number of people going through the process at around 3,000 but that many more were likely to have gender dysphoria but have taken no steps to address this through channels. There were 800 people in Madrid in 2021 who took advantage of the law to seek to get their gender changed on their government ID. Spanish sources appear to indicate that around only a third of transgender individuals are out. Many fear getting the legal name and gender change and perceived finality of the decision as it relates to transphobia and legality of being your identified gender: there is no backing out at that point.This gray zone area is not adequately addressed to explain fully the legal consequence for the gender on a death certificate of someone who has not started going through the transition process for whatever reason. I am under the cultural impression that the death certificate holds less cultural and legal significance in Spain than in a place like USA, which may explain the lack of info.
Is a cyber cafe business in India still profitable?
It is most profitable business in current situation. Normal people will think Cyber cafe has only PC, Internet and print out. If you prfollowing services then you can earn more than 1.5 lakhs only in direct profit.(personal experience from Chennai).Fund transfer and micro atms. People need immediate transfer and if your cafe is open from 9 am to 10 pm you can cross 800 to 1500rs per day. Bank Holidays higher profits.Train ticket agent. Avoid personal login booking. Non bailable offense.Seat seller Agent(red bus).Flight ticket, Tour planner and hotel booking.Visa Services and passport.Pan card and DSC.IT returns and GST filings. Tie up with local Tax people or learn yourself. IT return filing for Salaried people is much easier.EB payment, postpaid, rechargesCredit card payment.Movie ticketsCollege and school fees paymentsExam fees(state and Central)Online form filling for exams from Neet to UPSC.Certificates from caste, Employment, Life, birth and death.Corrections in Aadhar, PAN any online documents.Life insurance renewals and royalty if you are LIC agent.bike and car insurance, road tax etcCurrency exchangeXerox , Plastic card , Color print out & Lamination For cropping, resizing additional cost.PF update and withdrawal.International and local Courier if you have space.Ola collections, Paytm KYC etcTTD, Sabarimala, Shirdi darshans.Typing in local languages & EnglishLand EC checking, Online tax paying like water, property etcIn some states there are different online schemes to get enrolled, renewals and withdrawals.CIBIL Score certificateCredit card swiping(2 to 3% commission)Moreover with digital India, people are looking for local knowledge nearby.All payments are becoming digital and cyber cafes with good reputation will give you best returns. Make sure your cafe never closes on any day even for lunch break. Trust, reliability, friendliness will yield positive feedback from customers.No matter how many Smartphones, Paytm, TEZ services comes, People looks for specific Knowledge locally. You can be creative and make changes as per consumer needs and requirements in future.Your cafe should be one stop solution for all. Use credit cards to make online payments which gives you back rewards points in most cases.Reward points alone provides more than 1 Lakh if you use continuously(indirect profit) and specific bank cards only provides 4x to 10x benefits while using online.Make sure you use Credit card after statement date so that the money will be in rotation for 50 days. My Statement generates on 10th January and due date is 30th January. I will start using from 11th January and Next due date is on February End or March 1st week. That gives me 45 to 49 days.Have 3 to 5 or more credit cards and be calculative on when, where and how to use. Minimum use if emergency arise.CAFE should be at center point or near to bank area for visibility. Even top geek will have to set foot once to avail one of the services above. Trust is one thing that make business popular. It takes more months to avail.Google, Digital God.