"Foreign doctors have all kinds of different forms of training. But many are united by one common factor that seems to be operative especially in the Commonwealth countries — a great emphasis on the bedside exam and on clinical skills. In part, [this approach] was driven by the lack of ready access to all the kinds of sophisticated testing that we have now. But I think that kind of clinical training still serves me very well. It’s almost embarrassing to see how little emphasis we put on that here where the most glaring finding, one that could have been discovered by either a good history or by a discerning exam, instead requires this $2,000 MRI and interpretation to discover something that was really there for everyone to see and recognize had they only learned how to do that."

Rose Mula writes: First I had to liberate corn from a plastic-coated box which had been glued together with an impenetrable industrial-strength adhesive strong enough to attach the wings onto a 747. I was supposed to stir the corn frequently and cover the pan if it started to pop. Of course, every time I uncovered the pan to stir, several kernels popped and escaped to the kitchen floor. When what was left of the corn in the pan was a bit charred, I added the other veggies — a poblano and tomato (after coring, deseeding and dicing) and scallion (chopped, of course) and some cilantro (also chopped) with a drizzle of olive oil and a liberal sprinkling of salt and pepper. Eventually, all the veggies were charred (which was supposed to be a good thing) and the chicken and potatoes were cooked. Finally! The dinner was ready to be plated — but I was so exhausted and traumatized that I no longer was hungry.

Brain scientists and pharmacologists don’t know how to measure if and to what extent marijuana causes impairment. Existing blood and urine tests can detect marijuana use, but, because traces of the drug stay in the human body for a long time, those tests can’t specify whether the use occurred earlier that day or that month. They also don’t indicate the level at which a driver would be considered “under the influence.” “It’s a really hard problem,” said Keith Humphreys, a psychiatry professor and drug policy expert at Stanford University. “We don’t really have good evidence — even if we know someone has been using — [to gauge] what their level of impairment is.”

Jo Freeman writes: While many have greatly lauded this great leap upward over the 112 women who were M.C.s during 115th Congress, few have noted that this gain was almost entirely among Democrats. Of the 36 women elected to the House for the first time, only one is a Republican. Of the 3 new Senators, only one is a Republican. Women are now 25 percent of both houses of Congress, but not of both parties. Women are over one-third of the Democratic Caucus in both houses (36% and 39%), 15 percent of Republicans in the Senate, and only 8 percent of Republicans in the House.

Beyond the general critique of careless interpretations of seemingly sexy study findings, the authors make a subtler point about clinical trials. They screened 92 potential participants for the study, but only 23 were eligible and willing to participate. The authors suggest that this resembles common practice in clinical trials, where a small fraction of the patients screened are included. They add that prior research shows participants who might stand to gain the most from the experimental treatment often are less likely to be included in clinical trials.

In a series of interviews with heroin users in Rhode Island in 2017, Brown University researchers reported that users “described fentanyl as unpleasant, potentially deadly, and to be avoided.” They concluded that demand for the deadly contaminant was low and that its presence in the drug supply was “generating user interest in effective risk mitigation strategies, including treatment.” But in San Francisco’s gritty Tenderloin district, where fentanyl was only rarely seen until last year, drug users tell a starkly different story. For many of them, fentanyl is a high-value drug that, if used carefully, can prevent dope sickness and deliver a strong high for a fraction of the price of heroin. Amber Sheldon, right, greets a frequent client at the harm reduction program at Glide in San Francisco. The program offers clean syringes, drug tes…

Sonya Zalubowski writes: One of the most thrilling moments was our visit to the Alcazar in Segovia, the castle with foundations that date to Roman times, where Isabella and Ferdinand reigned in the 15th century. We stood in the very throne room where Christopher Columbus once knelt before her. The people are surrounded by remnants of a succession of cultures ranging all the way back to prehistoric to Roman, Visigoth and Moorish, to the kings and queens whose rule dominated Europe as they sent out Portuguese and Spanish explorers, to 20th-century despots and finally present day governments

While it is certainly admirable to pay off your mortgage before you retire, our experience is that retirees and pre-retirees over-estimate the impact. In today’s world of low mortgage rates, paying off the last $100,000 of your mortgage, may free up cash flow, but isn’t saving you much in interest cost. You are still left with paying insurance, and property taxes, which will continue to go up. If you consider the fact that the IRS allows for a building to depreciate over 27.5 years, it stands to reason that you may need to almost completely replace your home over 25-40 years. And if you are banking on your home to pay long-term care costs or for a move to a more elderly friendly environment, you might be disappointed in what you get.

Editor's Note: Two points about this lawsuit are it doesn't force an injunction and doesn't protect private contractors. "Our members put their lives on the line to keep our country safe,” said J. David Cox Sr., national president, American Federation of Government Employees, “requiring them to work without pay is nothing short of inhumane. Positions that are considered ‘essential’ during a government shutdown are some of the most dangerous jobs in the federal government. They are frontline public safety positions, including many in law enforcement, among other critical roles. A substantial number of those working without pay are military veterans."

New York City's Metropolitan Museum of Art exhibition (Floor 2, Gallery 999, Iris and B. Gerald Cantor Exhibition Hall) opens with a dramatic installation that emphasizes the universality of jewelry — precious objects made for the body, a singular and glorious setting for the display of art. Great jewelry from around the world will be presented in a radiant display that groups these ornaments according to the part of the body they adorn: head and hair; nose, lips, and ears; neck and chest; arms and hands; and waist, ankles, and feet.

Julia Sneden wrote: It's embarrassing to think back over the sheer volume of presents I've received over the years. A few stand out: a beautiful, winter-white skirt of soft wool embroidered with pale blue and silver snowflakes that I longed for but knew we couldn't afford, that turned up miraculously anyway ... an opal ring that my great aunt had promised me when I was sixteen ... from my husband, a pair of books by Carmen Bernos de Gasthold, the first Christmas we were married ... a present my eldest son selected all by himself for me when he was about eight, blue ornament earrings paid for from his allowance ... the Double Crostic books another son gives me yearly ... a copy of Babar the King brought me by my adult middle son ... photos of my grandchildren taken and compiled into a little book by my clever daughter-in-law.

During the holidays, many in the press write stories aiming to help readers cope with the blues and other seasonal conditions. But some journalists inadvertently support a myth about the holidays and suicide, or quote well-intentioned sources who should know better. Despite the fact that the holiday season has some of the lowest average daily suicide rates, some journalists continue to perpetuate the holiday-suicide myth. In the 2017-18 holiday season, two-thirds of the print news and feature stories that mentioned both the holidays and suicide drew a false connection between them, according to the latest analysis by the Annenberg Public Policy Center of the University of Pennsylvania.   

"Similarly, I believe we must be resolute and unambiguous in our approach to those countries whose strategic interests are increasingly in tension with ours. It is clear that China and Russia, for example, want to shape a world consistent with their authoritarian model – gaining veto authority over other nations’ economic, diplomatic, and security decisions – to promote their own interests at the expense of their neighbors, America and our allies. ... We must do everything possible to advance an international order that is most conducive to our security, prosperity and values, and we are strengthened in this effort by the solidarity of our alliances."  

Compelled by personal financial difficulties, Dickens wrote A Christmas Carol in only six weeks, during a period of intense creativity in fall 1843. The original manuscript of A Christmas Carol reveals Dickens's method of composition, allowing us to see the author at work. The pace of writing and revision, apparently contiguous, is urgent, rapid, and boldly confident. And, if you want to make a full weekend of Dickens' story and have an Amazon Prime membership among others, view The Man Who Invented Christmas. Dickens is portrayed by Dan Stevens, of Downton Abbey fame. The program is also available for a minimum fee if you don't have one of the memberships.