in rare cases, these fractures are found in neonates born after an uneventful pregnancy and non-traumatic delivery (vaginal or cesarean), so that they are defined as “spontaneous”.
Thursday 30 June 2016
SPONTANEOUS PING PONG FRACTURE, NO , JUST INCOMPLETE OSSIFICATION DEFECT
in rare cases, these fractures are found in neonates born after an uneventful pregnancy and non-traumatic delivery (vaginal or cesarean), so that they are defined as “spontaneous”.
Vegetable oils and fruits and nuts are healthier than butter, but on the other hand, low-fat turkey meat or a bagel or cornflakes or soda is worse for you than butter.”
Vegetable oils and fruits and nuts are healthier than butter, but on the other hand, low-fat turkey meat or a bagel or cornflakes or soda is worse for you than butter.”
“I don’t care how hard this is. I don’t care how disappointed I am. I’m not going to let this get the best of me. I’m moving on with my life.”
“I don’t care how hard this is. I don’t care how disappointed I am. I’m not going to let this get the best of me. I’m moving on with my life.”
I choose my response, and that changes everything.”
I choose my response, and that changes everything.”
ITNP=“It’s not personal (it’s really not), even though it feels personal.”
“It’s not personal (it’s really not), even though it feels personal.”
“It’s OK to make mistakes. That’s how you get wiser.”
“It’s OK to make mistakes. That’s how you get wiser.”
It’s not what you say to everyone else that determines your life – it’s what you whisper to yourself that has the greatest power.
It’s not what you say to everyone else that determines your life – it’s what you whisper to yourself that has the greatest power.
Motivation to bully is regulated by brain reward circuits
Motivation to bully is regulated by brain reward circuits
Individual differences in the motivation to engage in or to avoid aggressive social interaction (bullying) are mediated by the basal forebrain, lateral habenula circuit in the brain, according to a study
Individual differences in the motivation to engage in or to avoid aggressive social interaction (bullying) are mediated by the basal forebrain, lateral habenula circuit in the brain, according to a study
Wednesday 29 June 2016
the mind, or mindness state, is but one of several global functional states generated by the brain.
the mind, or
mindness state, is but one of several global functional states generated by
the brain.
mindness state, is but one of several global functional states generated by
the brain.
HUMN- lowest of angels rather than the highest of beasts
Charles Sherrington, in his Gifford Lectures at Edinburgh in 1937, entitled
Man on his Nature (1941, chapter 12), hinted at the possibility that
if human beings ever came face to face with their true natures that knowledge
might trigger the demise of human civilization. To him, evidently,
humans prefer to consider themselves the lowest of angels rather than the
highest of beasts. I am of the opinion that if we were to comprehend fully
the awesome nature of mindness, we would, in fact, respect and admire
each other all the more.
Man on his Nature (1941, chapter 12), hinted at the possibility that
if human beings ever came face to face with their true natures that knowledge
might trigger the demise of human civilization. To him, evidently,
humans prefer to consider themselves the lowest of angels rather than the
highest of beasts. I am of the opinion that if we were to comprehend fully
the awesome nature of mindness, we would, in fact, respect and admire
each other all the more.
MOL BIO
Single large neurons have physical dimensions observable at low optimal
magniªcation, that of a tenth of a millimeter. That is big enough to
be dissected by hand with pins, using a good magnifying glass (Deiters
1856). Moving just two orders of magnitude down to the micrometer
level, which requires a good microscope, one is at the scale of synaptic
transmission. One may observe synapses at the union between nerve and
muscle, for example. Two orders of magnitude further down, at tens of
nanometers, with the aid of electron microscopy, we ªnd the realm of single
ion channels and of signal transduction and molecular biology
magniªcation, that of a tenth of a millimeter. That is big enough to
be dissected by hand with pins, using a good magnifying glass (Deiters
1856). Moving just two orders of magnitude down to the micrometer
level, which requires a good microscope, one is at the scale of synaptic
transmission. One may observe synapses at the union between nerve and
muscle, for example. Two orders of magnitude further down, at tens of
nanometers, with the aid of electron microscopy, we ªnd the realm of single
ion channels and of signal transduction and molecular biology
BRAIN
At the heart of Llinás's theory is the concept of oscillation.
Many neurons possess electrical activity, manifested as
oscillating variations in the minute voltages across the cell
membrane. On the crests of these oscillations occur larger
electrical events that are the basis for neuron-to-neuron
communication. Like cicadas chirping in unison, a group of
neurons oscillating in phase can resonate with a distant group
of neurons. This simultaneity of neuronal activity is the
neurobiological root of cognition. Although the internal state
that we call the mind is guided by the senses, it is also
generated by the oscillations within the brain. Thus, in a certain
sense, one could say that reality is not all "out there," but is a
kind of virtual reality
Many neurons possess electrical activity, manifested as
oscillating variations in the minute voltages across the cell
membrane. On the crests of these oscillations occur larger
electrical events that are the basis for neuron-to-neuron
communication. Like cicadas chirping in unison, a group of
neurons oscillating in phase can resonate with a distant group
of neurons. This simultaneity of neuronal activity is the
neurobiological root of cognition. Although the internal state
that we call the mind is guided by the senses, it is also
generated by the oscillations within the brain. Thus, in a certain
sense, one could say that reality is not all "out there," but is a
kind of virtual reality
If your platelet count is increased, serum LDH will be artificially high and not reflective of the LDH actually present.
- If your platelet count is increased, serum LDH will be artificially high and not reflective of the LDH actually present.
The only person you are destined to become is the person you decide to be. ~ Ralph Waldo Emerson
The only person you are destined to become is the person you decide to be. ~ Ralph Waldo Emerson 
Tuesday 28 June 2016
Enterovirus infections, particularly enteroviral myocarditis and encephalitis, can cause significant morbidity and mortality.
Enterovirus infections, particularly enteroviral myocarditis and encephalitis, can cause significant morbidity and mortality.
SEND THE GUCKING CSF FOR VIROLOGY IF ILL PT ON PRESENTATION
CONSIDER ECHO THE YOUNG INFANT IF AFFECTED
SEND THE GUCKING CSF FOR VIROLOGY IF ILL PT ON PRESENTATION
CONSIDER ECHO THE YOUNG INFANT IF AFFECTED
Enterovirus infections, particularly enteroviral myocarditis and encephalitis, can cause significant morbidity and mortality.
Enterovirus infections, particularly enteroviral myocarditis and encephalitis, can cause significant morbidity and mortality.
SEND THE GUCKING CSF FOR VIROLOGY IF ILL PT ON PRESENTATION
CONSIDER ECHO THE YOUNG INFANT IF AFFECTED
SEND THE GUCKING CSF FOR VIROLOGY IF ILL PT ON PRESENTATION
CONSIDER ECHO THE YOUNG INFANT IF AFFECTED
robert-"If you don't think every day is a good day, just try missing one."
"If you don't think every day is a good day, just try missing one."
FREEDOM FROM GENES
scientific and I believe evolution is just crap. Evolution is just random chance and selfish DNA with the need to reproduce. Better living through chemistry and also technology has consistently proved that evolution is aimless, and only a proactive approach to ourselves can yield better results. Science has invented things that can cause the human brain to grow more brain cells. Science invented memory enhancers, wakefulness enhancers, a pill to diminish fear from traumatic memories, and also strength enhancers. Chemistry based science has increasingly allowed the human to reach higher levels of improveability(some improvements are temporary while others are more permanent). They even did an experiment where a single alteration of a mice gene has boosted intelligence while reducing fear by a significant amount. Neorats. Fearless hyperrational neohumans might become the new reality. One day, absolute freedom from genes will be achieved. It all doesn't matter objectively though as we all still die. Just like when a phone or computer dies. But it's all subjectively entertaining and would bring cool knowledge and utility.
Even without any obviously traumatic event, many of us find life painful. It can be painful to realize that life has no inherent, undisputed significance, that it is often hard, that it contains many disappointments, and always ends in death." --- Colin Feltham
Even without any obviously traumatic event, many of us find life painful. It can be painful to realize that life has no inherent, undisputed significance, that it is often hard, that it contains many disappointments, and always ends in death."
--- Colin Feltham
There is only one way to happiness and that is to cease worrying about things which are beyond the power of our will. ~ Epictetus
There is only one way to happiness and that is to cease worrying about things which are beyond the power of our will. ~ Epictetus 
Wanting to be someone else is a waste of who you are." -- Kurt Cobain
Wanting to be someone else is a waste of who you are."
-- Kurt Cobain
-- Kurt Cobain
PED NN INTUBN
Intubation tips
This great procedural talk was followed by Tim Horeczko on his top three tips for intubating infants. We know that critical procedures are rarely performed by paediatricians let alone general emergency physicians but by adding these three things to ones repertoire we should increase our chance of first pass success.
- Use the shoulder bump
- Use the jaw thrust
- Change your position and look high
CRIT ILL PT
‘FAST HUGS BID‘ by Vincent and Hatton:
- Feeding/fluids
- Analgesia
- Sedation
- Thromboprophylaxis
- Head up position
- Ulcer prophylaxis
- Glycemic control
- Spontaneous breathing trial
- Bowel care
- Indwelling catheter removal
- Deescalation of antibiotics
Vincent WR 3rd, Hatton KW. Critically ill patients need “FAST HUGS BID”
TOXICOLOGY-
- RESUS-RSI-DEAD mnemonic
- Resuscitation
- Airway
- Breathing
- Circulation
- Seizure control
- Correct hypoglycaemia
- Correct hyperthermia
- Resuscitation antidotes
- Risk assessment
- Supportive care and monitoring
- Investigations
- Screening (ECG, paracetamol)
- Specific
- Decontamination
- Enhanced elimination
- Antidotes
- Dispositio
NN RESUS=f you have attempted for 10mins or more with no heart rate recorded at any point, the guidance suggests this is an appropriate time to discontinue.
If you have attempted for 10mins or more with no heart rate recorded at any point, the guidance suggests this is an appropriate time to discontinue.
sepsis?
he NICE traffic light system and other early warning scores to predict sepsis. But really he gave us two key take home points to lock onto:-
- Be worried if there is a change of state – they are not the same as they were yesterday
- Be worried if this illness is like no other illness they have ever had
By using these two key questions in the history we might become more alert to the risk of potential deterioration and look for ways to validate our fears – order the extra blood tests, keep the child in for a period of further observation.
HANIGTON EPIPHANYAs with paediatric resuscitation we are going to give compressions if the heart rate remains LESS THAN60/min despite adequate ventilation.
As with paediatric resuscitation we are going to give compressions if the heart rate remains <60 adequate="" despite="" min="" span="" ventilation.="">
POST ROSC- BOCTG
- Target SBP >5th centile for age- BP
- Aim for normoxaemia-O2
- ?Aim for normocapnia-CO2
- Avoid hyperthermia (>37.5) (following the THAPCA trial) and severe hypothermia (<32 li="" nbsp="">
- Avoid hyper and hypoglycaemia but without rigid control-G
PED RESUS-Shockable rhythms are rare, even in hospital (3.8-19%) so CPR should be prioritised and established before searching for a defib.
Shockable rhythms are rare, even in hospital (3.8-19%) so CPR should be prioritised and established before searching for a defib.
Exercise is work to make you live longer; meditation is work to make you live better.“
Exercise is work to make you live longer; meditation is work to make you live better.“
PEWS
Ann Emerg Med. 2015 Jun;65(6):633-5. doi: 10.1016/j.annemergmed.2014.11.012. Epub 2014 Dec 20.
Sick kids look sick.
MCLUHAN="There are no passengers on spaceship earth. We are all crew."
"There are no passengers on spaceship earth. We are all crew."
Monday 27 June 2016
MOTIVATION= The Goldilocks Rule states that humans experience peak motivation when working on tasks that are right on the edge of their current abilities. Not too hard. Not too easy. Just right.
The Goldilocks Rule states that humans experience peak motivation when working on tasks that are right on the edge of their current abilities. Not too hard. Not too easy. Just right.
SEPSIS= SEE HEAR MEASUR OBS TEST DISCUSS ADMIT REFER =SHMOT DAR
The TPR paradox - how do I know if a child might have sepsis?
When I assess an ill child, I am primarily making a decision about whether the child has possible sepsis. To a certain extent, everything else is detail. The sepsis question determines which door the child leaves through. Just like in primary care, I send the vast majority of children presenting to the ED back out the way they came, whether they have pneumonia, urinary tract infection or just a cold. A small number of ill children are admitted, with the possibility of sepsis as the primary reason. The question is: How do I decide which door to send each child through? Once you answer that, I believe that you can begin to understand how to use the many guidelines and decision tools designed to help us make this choice.
In 1935, Einstein and two of his buddies published a paper detailing some problems with quantum physics theories. In effect they were saying that their own advances had explained a lot about how physics worked, but that there were some things that they could not explain. Specifically, when two particles went through two doors, one of them did something that didn't make sense. You could do something to one of the particles and the other reacted even though they are not connected. This is called the EPR paradox, after Einstein, Podolsky and Rosen.
I believe that we are in a similar place in medicine when it comes to recognising possible sepsis in children. Once again we have two doors and sending children through these is not as straightforward as it should be. We all do our best to send each child through the correct door. There is a big piece of the jigsaw missing though and that’s got us all scratching our heads. The missing bit is knowing how to go from considering possible sepsis to diagnosing probable sepsis without resorting to reading tea leafs or other substitutes for a valid test. Most of the time we do our best and accept that in the absence of a good test all we have is good judgement. The problem comes when a child dies of sepsis and that gap in the process comes under scrutiny. I'm all for completing the puzzle but I am suspicious that we are trying to put the wrong piece into the gap.
If I asked you to create a decision tool for clinicians to move from considering sepsis to a provisional diagnosis of sepsis, what would you choose as predictors? You could use the appearance of the child but that is difficult to quantify. What seems far more reliable is TPR (temperature, pulse and respiration) since these can be measured. The trouble is that the most measurable features of your assessment are the least reliable.
Before I get a rush of people saying that I think that you should ignore tachycardia and high temperature, please be clear that I don’t think that. It is just that I think that there is a much better category of evidence and that numbers are not as reliable as we want them to be.
There are plenty of reasons to mistrust numbers. For starters we have a lack of reliable reference ranges. There is a good reason why no-one has started making a lot of money out of selling centile charts of paediatric heart and respiratory rates. They don't exist. There is not enough evidence to produce such a thing. The variables are just too many. Is it age that determines heart rate or your weight? If it is weight then is it lean weight? What is the effect of anxiety on heart rate? How different is a normal heart rate in a resting child to that of a playing child or a screaming child?
What about those normal ranges that you have somewhere when you need to check? Aren't they evidence based? You could try to find out what their evidence base is but I could probably save you a lot of hassle by telling you that all the normal ranges that I know of are based on consensus, which is why they are all slightly different from each other. In the past few years, two large analyses have shown that some of the most commonly available reference ranges map poorly to population studies. Even then, these publications acknowledge that the populations studied are never truly normal. (1,2)
However, I think that this whole issue is much simpler than all of that, because the wrong question is being asked. The question is not, “Does this child have sepsis?” The question is, “Can I say with confidence that this child does not have sepsis?” When we use the rule out rather than rule in approach, everything starts to fall into place, including the value of numbers.
I said before that there is more reliable evidence than temperature and pulse. That evidence is something that you rely on every time you assess a child and it is the thing that makes sense of the numbers for you: activity. What we really want to know about the heart rate and capillary refill is not the absolute number but the effect that these are having. What we need to assess is oxygen and glucose delivery to the organs and there is no better measure of this in a child than what the child can do once these get there.
There is one more variable which complicates the TPR paradox, which is the up and down nature of the illness. You may see the child at their worst or possibly their best. In any viral illness the likelihood is that the child will have extremes of activity making nonsense of the assessment. Thankfully we have two saving graces here. The first is that we can hear about what has gone before. The second is that we are able to continue the assessment either by observing, referring or safety netting.
So let’s bring all of this together. There are two simple elements to recognising serious infection in children. The first is a hierarchy of evidence. The second is a rule-in/ rule-out approach.
The hierarchy of evidence is logical. If I see a child in a playground climbing up to go on the slide and their parent mentions that they have had a temperature, I don’t worry that they may be septic. I do imagine that they have a significant tachycardia but this will be a result of their activity and possibly their temperature. I see with my eyes both the activity and the vigour with which it is undertaken. I don't need to ask any questions or measure any physiological parameters because I have all the evidence that I need.
If I was giving telephone advice and I hear that a child is sat playing on a tablet I now have some very useful information about the adequacy of their brain’s perfusion and oxygen/glucose supply. It's not as good as what I see because I can't scrutinise what I am being told with my own experienced eye.
Finally if I measure a child’s heart rate and capillary refill, I have information but it needs to be put into context. Was it cold outside? Have they just been upset by something? So the numbers are important but I need what I see and hear to make sense of them.
In any acute assessment of an unwell child this hierarchy can be combined with a rule-in/ rule-out approach to answer the question, “Am I certain that this child does not have sepsis?”
If what you see, hear and measure is all reassuring then the answer is yes, they do not have sepsis. If what you see, hear and measure are all concerning then the answer should be no, they could well have sepsis. If what you see, hear and measure give a mixed message then the question remains open and there are various ways to answer it. Using the hierarchy of evidence above, I feel confident to give paracetamol and wait when a child looks well and behaves well even if they are febrile and tachycardic. The options are always the same: discharge with safety netting advice, observe, discuss or refer.
Just like the scientists of 1935, none of us has all the answers. None of the decision tools available is even close to perfect and all of them rely on someone at some point taking responsibility for making a decision about which door the child will go through. Thankfully the majority of children answer the question for you.
Just like the scientists of 1935, none of us has all the answers. None of the decision tools available is even close to perfect and all of them rely on someone at some point taking responsibility for making a decision about which door the child will go through. Thankfully the majority of children answer the question for you.
Edward Snelson
@sailordoctor
If you liked this you might also like:
If you liked this you might also like:
In Praise of Doing Nothing (Easter Egg – good safety-netting and saving lives)
Or How special is your patient? - (Neonates and other patients who don't follow the rules)
References:
(1) Fleming S et al, (2011). Normal ranges of heart rate and respiratory rate in children from birth to 18 years of age: a systematic review of observational studies. The Lancet, Vol 377, no 9770, 1011-1018.
(2) O'Leary F et al (2015) Defining normal ranges and centiles for heart and respiratory rates in infants and children: a cross-sectional study of patients attending an Australian tertiary hospital paediatric emergency department, Arch Dis Child, 100, 733-737
(2) O'Leary F et al (2015) Defining normal ranges and centiles for heart and respiratory rates in infants and children: a cross-sectional study of patients attending an Australian tertiary hospital paediatric emergency department, Arch Dis Child, 100, 733-737
Erythromycin reduces residual gastric volume in patients undergoing emergency surgery under general anaesthesia with an acceptable side effect profile
- Erythromycin reduces residual gastric volume in patients undergoing emergency surgery under general anaesthesia with an acceptable side effect profile
JONES-"Bravery is being the only one who knows you're afraid."
"Bravery is being the only one who knows you're afraid."
CIORAN-"What would be left of our tragedies if an insect were to present us his?"
"What would be left of our tragedies if an insect were to present us his?"
Sunday 26 June 2016
IGNORANCE-MODESTO
FIVE KINDS OF “IGNORANCE” WE OUGHT NOT TO “IGNORE”
It is customary to employ the word “ignorance” as if it were a simple and singular idea, but actually the word has at least five distinct meanings, probably more. It is helpful to differentiate them.
First, there is Innocent Ignorance. This is the innocent of children and of the simple-minded who have had limited experience of life and exposure to general knowledge of the world. We tend to look at such ignorance as quaint, naive and charming.
Second, there is Willful Ignorance. This is the ignorance that stubbornly and deliberately persists even in the face of many opportunities to attain new knowledge and experience. This ignorance prefers to cocoon in an ideological ghetto or cultural enclave that is closed off to outside information and ideas rather than risk exposing its mind to what Emerson called “the wide-wide world.” It is the kind of ignorance that choosed to “ignore” rather than question, explore, investigate and engage what is going on in the larger natural, intellectual, cultural and social environment beyond its own immediate survival, safety and security needs.
Third, there is Arrogant Ignorance. This is the ignorance that confuses partial knowledge with total knowledge, and presumes to know all things. It is the pretentious “know-it-all” who looks down contemptuously upon others who do not know what he knows, or thinks he knows, and who is arrogantly ignorant of what he does not truly know and understand but assumes he knows.
Fourth, there is Domain Ignorance. This is the ignorance that is specialized in nature. There are persons who are knowledgable in one or more domains of knowledge but are ignorant of many others. It is tempting to assume that because we may have worked hard to attain a broad knowledge and deep understanding of particular domains of knowledge that we must automatically possess a broad and deep comprehension of other domains that we have investigated to nearly the same degree of inquiry as we have given to our intellectual specialties. Others may also falsely assume that because we have knowledge of one domain that we must possess an equally in-depth and refined knowledge of other domains of which we remain largely ignorance or merely rudimentary in our understanding.
Fifth, there is Enlightened Ignorance. This is the kind of ignorance that we may become aware that we possess after a lifetime of intensive and extensive study and reflection, whether of a particular domain of knowledge and dimension of experience, or of all of them together. This is what we mean by Socratic Ignorance. It is a knowledge humbled of what we do not know, and perhaps of what we cannot know in our finitude and limitations as fallible human beings. The idea has resonances Nicolas of Cusa’s idea of Learned Ignorance , of Keat’s idea of Negative Capability and of Rilke’s advice to a young poet to “live the questions.” Enlightened Ignorance brings us “full circle” to the Sense of Wonder that launched us upon our journey in the first place.
A knowledge of our ignorance, and of the different kinds of ignorance, is the beginning of wisdom.
Nature is painting for us, day after day, pictures of infinite beauty if only we have the eyes to see them. ~ John Ruskin
Nature is painting for us, day after day, pictures of infinite beauty if only we have the eyes to see them. ~ John Ruskin 
GSW
Warning signs of internal bleeding include:
- Decreasing alertness
- Nausea/vomiting
- Weak pulse
- Lowering blood pressure, or faster and faster pulse
GSW H/N -THINK AIRWAY
DP- NO TOURNIQUETS AROUND NECK
PREVENT BLOOD FROM CHOKING- RECOVERY POSITION
DP IF CAROTID ARTERY NICKED
/////////////////////
GSW CHEST
Think about: air sucking, spine injury.
SUCKING CHEST WOUND- OCCLUSIVE DRESSING-OD
SPINAL IMMOBILISN TILL CLEARED
HEART/LUNGS/SPINE/BLOOD VSSL- CALL SURGEONS TO STOP HGE
///////////////////////////////
GSW ABDOMEN
THINK ORGAN PROTECTION
STERILE DRESSING ON WOUND WILL PREVENT INF
CALL SURGEONS
SPF-NGT
///////////////////////////////
GSW LIMBS
THINK BONE PROTECTION
DP, ELEVATE LIMB, PRESSURE BANDAGE =DP/EL/PB
TOURNIQUET, SPLINT
Saturday 25 June 2016
SELF
even though our basic traits come from a combination of genetics and early life experiences, later environmental and societal circumstances continually provide individuals with opportunities for changing their character throughout their lifetimes.
BAGINNI
You and I are what our bodies and brains do. There is no pearl sitting at the center of our selves, we are rather bundles of psychosomatic activity, albeit highly organized and remarkably stable ones.
SELX EGO TRICK
. This is the “narrative” function performed by the left cerebral hemisphere, where human language capacity is hard-wired
SELF
as consisting in a memory criterion, or a continuous-body criterion, or a more traditional selfhood criterion – each captures part of the truth, and each helps to constitute the whole truth.
SELF-STUFF
Whatever stuff you are made from,” he writes, “is the same kind of stuff that everything else is made of.”
BAGINNI
The topic of personal identity is strictly speaking nonexistent. It’s important to recognize that we are not the kind of things that simply popped into existence at birth, continue to exist, the same thing, then die off the cliff edge or go into another realm. We are these very remarkably ordered collections of things. It is because we’re so ordered that we are able to think of ourselves as being singular persons. But there is no singular person there, that means we’re forever changing.” ~ Julian Baggini
RD BK EGO TRICK
In reality, our essence oscillates between a set of hard-wired patterns and a fluid spectrum of tendencies that shift over time and in reaction to circumstances.
DEGRASPING
What Buddhism is interested in is degrasping, it’s a letting
go, it’s a releasing of this tight clutch on to things which actually is life denying.’
Blackmore. ‘I certainly think of Adam, whom I love deeply, as a
biological machine. He’s a sixty-something-year-old man, somewhat overweight with high blood
pressure, he could die at any moment. I do actively remind myself that that could happen. I mustn’t
assume he’s going to be around with me for the next twenty to thirty years. I would love him to be, so
if he dies I will be devastated, I will cope. None of that changes.’
go, it’s a releasing of this tight clutch on to things which actually is life denying.’
Blackmore. ‘I certainly think of Adam, whom I love deeply, as a
biological machine. He’s a sixty-something-year-old man, somewhat overweight with high blood
pressure, he could die at any moment. I do actively remind myself that that could happen. I mustn’t
assume he’s going to be around with me for the next twenty to thirty years. I would love him to be, so
if he dies I will be devastated, I will cope. None of that changes.’
SELF MEETS DTH
People may say they believe that death is
the end and there is no God, but when oblivion is staring them in the face, they’ll hang on to whatever
hope they can, and pray to whoever might be listening.
the end and there is no God, but when oblivion is staring them in the face, they’ll hang on to whatever
hope they can, and pray to whoever might be listening.
BUNDLE THEORY X SELF
Hofstadter is another kind of bundle theorist, who thinks we are ‘strange loops’, not things,
but patterns of information that feed back on themselves to create higher, more complex networks of
abstraction. ‘It ain’t the meat, it’s the motion,’ he colourfully says of the brain’s role in identity
but patterns of information that feed back on themselves to create higher, more complex networks of
abstraction. ‘It ain’t the meat, it’s the motion,’ he colourfully says of the brain’s role in identity
BLACKMORE X FREE WILL
She will make a decision. Let the process go on. Don’t interfere. Let the
thinking go on: thinking about these issues, thinking about carbon footprints and the poor Colorado
river, thinking about the pleasure of giving a lecture to all those people. Just let it go on because a
decision will emerge.”
thinking go on: thinking about these issues, thinking about carbon footprints and the poor Colorado
river, thinking about the pleasure of giving a lecture to all those people. Just let it go on because a
decision will emerge.”
SELF
least accepted that whatever you are, you function because your brain and body function and there’s
no other extra thing that is you, sitting inside handling the controls
no other extra thing that is you, sitting inside handling the controls
PERSONHOOD
So far, the vast majority of thinking about what we are as persons has been an attempt at
description. I think we now have a fairly comprehensive understanding of what we are. You and I are
what our bodies and brains do. There is no pearl sitting at the core of our selves, we are rather
bundles of psychosomatic activity, albeit highly organised and remarkably stable ones. We are not
illusions but we are not what we most obviously appear to be either. The picture may not be entirely
complete and some questions remain, but more than two millennia of philosophy, a century of modern
psychology and fifty years of neuroscience have given us a clear enough picture of what it means to
be a person.
description. I think we now have a fairly comprehensive understanding of what we are. You and I are
what our bodies and brains do. There is no pearl sitting at the core of our selves, we are rather
bundles of psychosomatic activity, albeit highly organised and remarkably stable ones. We are not
illusions but we are not what we most obviously appear to be either. The picture may not be entirely
complete and some questions remain, but more than two millennia of philosophy, a century of modern
psychology and fifty years of neuroscience have given us a clear enough picture of what it means to
be a person.
LONGRVITY X BOREDOM
At any given moment, if a person has the opportunity to keep on
living healthily, why wouldn’t anyone take it?
One answer is boredom. The late Bernard Williams wrote a now famous paper based on The
Makropulos Case, a play by Karel Čapek, later adapted into an opera by Janáček. The central
character is known as E.M., having had several names over her lifetime with those initials. In the
sixteenth century, her father, a court physician, tried out an elixir of life on her. Now aged 342, ‘her
unending life has come to a state of boredom, indifference and coldness’. She eventually refuses to
keep taking the elixir and dies, miserable, showing that it is possible to die too late, as well as too
soon. If he lived too long, Williams concludes his paper, ‘I would eventually have had altogether too
much of myself.
living healthily, why wouldn’t anyone take it?
One answer is boredom. The late Bernard Williams wrote a now famous paper based on The
Makropulos Case, a play by Karel Čapek, later adapted into an opera by Janáček. The central
character is known as E.M., having had several names over her lifetime with those initials. In the
sixteenth century, her father, a court physician, tried out an elixir of life on her. Now aged 342, ‘her
unending life has come to a state of boredom, indifference and coldness’. She eventually refuses to
keep taking the elixir and dies, miserable, showing that it is possible to die too late, as well as too
soon. If he lived too long, Williams concludes his paper, ‘I would eventually have had altogether too
much of myself.
ESKIMO SELF
‘Eskimo
emotional states appear to be much more socially dependent than ours. Isolated Eskimos, in so far as
they can be observed, seem to be stolid, neither cheerful nor depressed. But once they become part of
a community (a family, say) they quickly take on the emotional tone of the community, whether they
are intimately bound up with its concerns or not.’
emotional states appear to be much more socially dependent than ours. Isolated Eskimos, in so far as
they can be observed, seem to be stolid, neither cheerful nor depressed. But once they become part of
a community (a family, say) they quickly take on the emotional tone of the community, whether they
are intimately bound up with its concerns or not.’
A FRACTURED MIND
The castle and all its inhabitants were contained within the head of one man: Robert B. Oxnam.
Oxnam was diagnosed with Dissociative Identity Disorder (DID), more commonly, but
anachronistically, known as Multiple Personality Disorder
Oxnam was diagnosed with Dissociative Identity Disorder (DID), more commonly, but
anachronistically, known as Multiple Personality Disorder
Friday 24 June 2016
New research uncovers why an increase in probability feels riskier than a decrease
New research uncovers why an increase in probability feels riskier than a decrease
When there is a hill to climb, don't think that waiting will make it smaller." -- Author Unknown
When there is a hill to climb, don't think that waiting will make it smaller."
-- Author Unknown
-- Author Unknown
Maintaining a stable weight, avoiding long dieting periods, eating more protein and getting more sleep can help optimize ghrelin levels.
Maintaining a stable weight, avoiding long dieting periods, eating more protein and getting more sleep can help optimize ghrelin levels.
Ghrelin levels can rise during a diet, increasing hunger and making it harder to lose weight
Ghrelin levels can rise during a diet, increasing hunger and making it harder to lose weight
Uncertainty is the only certainty there is, and knowing how to live with insecurity is the only security.” ~John Allen Paulos
Uncertainty is the only certainty there is, and knowing how to live with insecurity is the only security.” ~John Allen Paulos
“It is only in solitude that I ever find my own core.” ~Anne Morrow Lindbergh
“It is only in solitude that I ever find my own core.” ~Anne Morrow Lindbergh
Grief, when it comes, is nothing like we expect it to be.” ~Joan Didion
Grief, when it comes, is nothing like we expect it to be.” ~Joan Didion
CA SURVVR-There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle.” ~Albert Einstein
There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle.” ~Albert Einstein
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