text:
I don't know about you, but I've been having a hard time getting out of my usual post-holiday slump. New Year's Day found me on the couch, channel surfing as I could not bring myself to do much else. I decided to binge-watch a television show (I've been informed that this is what people do now – sitting down for hours at a time, watching multiple seasons of a TV show, so I decided to give it a try). I've had many friends recommend the show, Friday Night Lights, to me. So I gave it a try. For those not in the know, this TV show centers around a small Texas town and their high school football team. Four episodes in, I felt a slight connection to a few of the characters but could not wrap my mind around the importance being placed on the game of football. I remember high school football games and cross-town rivalries, but nothing like this. Businesses sponsoring the sports teams with obscene amounts of money, quarterbacks being idolized, parents hell-bent on seeing their kid make it to the big leagues at any cost. I just couldn't understand the appeal, so I stopped watching.
Then a few days later, I found myself getting caught up in the playoffs. It's easy to say I don't care, but when it comes down to the final month of football and both of my state's teams are in the running for the championship, I can't help but get a bit excited. So, I watch. And a huge part of me dies inside because I hate almost everything about it – the violent nature of the sport, the idolization of the players (in my case: on one team, an alleged rapist and on the other, a convicted dog-killer), the obscene amount of money from corporate sponsors, the huge salaries of the players, the sexist and misogynistic messaging and advertising – the list goes on and on. But something pulls me in, and I keep watching. And all the sudden I start seeing the connections. This is our culture (or at least the culture that media, corporations, and advertisers want us to buy into). This is what is important to us. This is what we choose to invest in. This is what it means to be a "real man". It starts early – all of the hoopla around high-school football (and pee-wee football, as seen in this preview [1] for a new show called Friday Night Tykes – appalling, to say the least) filters down from our society's idolization of sports teams, athletes, and support of "jock culture". And I'm conflicted. Sports aren't bad, but the way we put so much emphasis and importance on the game and the players is. One only need look at recent cases like those in Steubenville, at Florida State University, and Vanderbilt to see the connection between jock culture and rape culture. Dave Zirin points this out in an article [2] he wrote for The Nation following the Steubenville rape trial verdict:
"We need to ask whether there's something inherent in the men's sports of the twenty-first century, which so many lionize as a force for good, that can also create a rape culture of violent entitlement. I am not asking if playing sports propels young men to rape. I am asking if the central features of men's sports—hero worship, entitlement and machismo—make incidents like Steubenville more likely to be replicated."
So, there's a little gem to think about as we head into the final few weekends of playoffs, culminating in the all-important Super Bowl. Will you be watching the Super Bowl? I'm on the fence about attending a Super Bowl party. Perhaps I'll just go for the food. Maybe I'll stay home and watch a Downton Abbey marathon in protest. Care to share your thoughts? Feel free to comment below.
[1] http://tv.esquire.com/videos/70957-friday-night-tykes-sneak-peek
[2] http://www.thenation.com/blog/173387/verdict-steubenville-shows-bond-between-jock-culture-and-rape-culture
[3] http://www.nsvrc.org/blogs/preventionista
[4] http://www.nsvrc.org/blogs/preventionista/primary-prevention
[5] http://www.nsvrc.org/blogs/preventionista/promising-programs


text: Duo Adhesive is perfect for applying individual lashes, as it comes in a dropper bottle to eliminate mess and waste. This latex–free, long–lasting adhesive was created for individual lashes only. Lashes stay on for up to two weeks using this waterproof formula. Customize your look, from natural to glamorous, with the easy–to–use dropper bottle that eliminates any mess or clumps. To remove lashes, simply use baby oil and a Q–Tip to dissolve adhesive.

subset: commoncrawl


text:
Your touch of style shouldn't cost extra
From the countertops up to the ceiling and back down to the floor, Lennar homes include thousands of dollars in luxury features at a price that was previously unattainable in the home buying process. With Everything's Included, you no longer have to haggle, hope or compromise your dream home – because your dream features are already included.
I love that we moved in and did not have anything to worry about except unpacking and enjoying our new home. Everything you usually have to do when purchasing a new home is all done for you. I especially love my kitchen and all of the extras that are included.
Kelly Weinland
Regency, Denver, CO
The house has Energy Star appliances, which save us money in energy costs and provides us the ability to control each floor separately depending upon our needs.
Rob & Marilyn Pennello
Almond Glen, Charlotte, NC
I love my new Lennar Home. I love the tile floors and granite countertops. It's like a complete custom home at an affordable price.
Jenn Nokes
Stonefield, Austin, TX
I like my Lennar home because of all the features that are included: stainless steel kitchen appliances, energy efficient building structure, home automation, spacious rooms, tandem garage, etc. Love it.
Susan S.
Riverbend Ruskin, FL
I wouldn't trade my home for any other home or builder, and what I like best about Everything's Included is that it's such a wonderful deal. No extra money for granite, recessed lighting, hardwoods, etc. You simply receive just about everything with Lennar.
Gwen Maryland
Bryans Road, MD
One of our favorite features of our new home is the front door lock that allows us to enter a code to open the door without a key. We can even unlock our door remotely if a relative drops by when we're away.
Larry and Hoa Dershem
Terraza, San Marcos, CA
Your sense of security shouldn't be a nice‑to‑have
Even the perfect home isn't complete without some peace-of-mind. Imagine being able to control and monitor your home from anywhere in the world, directly from the palm of your hand. With Nexia Home Intelligence you can unlock doors, control the thermostat, turn off the lights, or watch the kids playing in the living room – all from your smartphone.
Explore how you can be home even if you're away, with Nexia™ Home Intelligence
Security and Sensors
Unlock a door for a guest when you're at the office or running an errand.
Use wireless cameras to see what's going on when you're away.
Lighting and Modules
Turn lights on and off—and other home electronics—to save even more.
Remotely adjust heating or cooling for your arrival home.
Use wireless cameras to see what's going on when you're away.
Remotely adjust heating or cooling for your arrival home.
Lighting and Modules
Turn lights on and off—and other home electronics—to save even more.
Security and Sensors
Unlock a door for a guest when you're at the office or running an errand.
Energy efficiency shouldn't be an upgrade
What saves you money can also help save the environment, so Lennar homes include a wealth of green features that add a lifetime of value with no additional cost to you. From Energy Star appliances, to WaterSense faucets, to Low-E glass windows, Lennar's cutting-edge green building features greatly enhance the quality of your home, while decreasing your monthly utility bills.
ENERGY STAR Qualified Appliances
The benefits of efficiency without sacrificing features, performance, style or convenience.
Moen Water Sense Faucets
Optimizing water flow means significant water conservation without sacrificing performance.
Nexia Home Intelligence
The latest in home automation enables you to manage your home from wherever you are—control lights, locks, thermostats, cameras, and more.
Low-E Glass Windows
Low-emittance glass reflects radiant heat waves, keeping your home cooler in the summer and warmer in the winter.
Mohawk GreenWorks Carpet
Mohawk is an industry leader in creating beautiful, durable carpet & flooring options that are eco-friendly and energy efficient.
Mohawk GreenWorks Flooring
Mohawk is an industry leader in creating beautiful, durable carpet & flooring options that are eco-friendly and energy efficient.
Energy Efficient Heating and Air
Stay warm in the winter and cool in the summer and enjoy great savings with a 14-SEER/90+% furnaces that boast optimal efficiency and performance.
High Energy-Factor Water Heaters
The higher the Energy Factor, the less energy wasted and the more money saved. Save money with energy factors of 90% and above on electric or .62 energy rating on gas heaters — both rated beyond standard requirements.
Gas Fireplace
A Heath & Home's Heatilator fireplace offers the traditional look of a wood-burning fireplace with the energy efficiency of gas.


text:
GLOUCESTER star Henry Trinder made his senior debut for England in the crushing 38-7 win for the national side over Super 15 side Crusaders in Christchurch, New Zealand on Tuesday.
Trinder and the remainder of the second string team were trying to impress head coach Stuart Lancaster ahead of the third and final Test against the All Blacks this weekend. The tourists have already lost the series, albeit narrowly, going down 28-27 in the second Test on Saturday.
Trinder started the Crusaders game in the centre and was bright in attack and dependable in defence during his 56 minutes on the pitch, but it was his Gloucester team-mate Matt Kvesic who caught Lancaster's eye with a man-of-the-match performance in the six-try victory.
Former Wootton Bassett player and Kingsholm regular Jonny May had a late second-half cameo.


text:
You won't be able to dismiss this by usual means (escape or click button), but you can close it programatically based on user choices or actions.
"I am so happy with my invitations. The quality of the paper is great...weighty and perfectly textured. The design is so elegant. The only thing I would say is that they are smaller than I expected but I was reading that's that is a good thing as it saves on postage! Service was also prompt and a pleasant experience."
"I love my invitations! This was a simple yet elegant way for me to invite my guests to our wedding. Our picture on the invitation came out beautiful. I love how I was able to print on the front and back of the reception card, making it easy for both myself and my guests. Highly recommended for a simple, chic, and elegant girl!!"
"Absolutely beautiful. It was really easy to customize the wedding invite. My designer did a great job of brining my ideas to life. I really wanted to be able to include our parents in the invite and the designer came up with a great solution and moved a few things around. The invite is exactly what we wanted. Thank you so much!"
"I ordered these for my wedding invitations, and they came our gorgeous! I loved the design and the color options they offered. I went with the square option, and used the cream colored background and solid color for the back design. I love that the paper is already shimmery, which also adds to the design. I did think the paper was a little thin, and maybe I should have ordered a thicker paper, but overall all I was very happy with my order and my invitations! My order also arrived earlier than expected."
"I am so happy with these invitations! They are simple, yet beautiful and classy. I wanted to put all the information (reception and all) on one card, and I needed to make a second set in another language. The designer followed my instructions perfectly and made great suggestions to fit the text on the page. They turned out even better than expected. The paper quality (I used the shimmer paper) was excellent. I would recommend the shimmer paper. I can't say enough about the service as well. The proofs were done so quickly, the people on the phone were amazing and friendly and the package was delivered days ahead of time. The only hiccup I had was that they were unable to tell me what the customs/duties would be so I had to just keep my fingers crossed. In the end, it wasn't so expensive (about $60 for Canada). I would recommend Wedding Paper Divas to any bride-to-be!"


text:
Front-end operations is attracting more attention these days as a mechanism for getting Web applications built quicker and running faster. The concept is an emerging discipline in Web application development and engineering.
Front-end ops, the subject of Sauce Labs' first-ever Front End Ops Conf this week in San Francisco, is about application testing via any number of tools and weighs heavily in real-life situations such as Flickr's move from PHP code to Node.js code.
The main goal of front-end operations is speed, as in speed of websites and speed in developing applications, says Alex Sexton, an authority on the subject and a product engineer at payments SDK provider Stripe. The entire application stack is factored into front-end operations. "The key to becoming faster is measurement. Front-end operations is about measuring, so you know how to get faster," said Sexton, who has written about front-end operations.
Although not necessarily a new concept, front-end operations is taking on new meaning from the tools being developed to reinforce it. "The act of doing things that are in the front-end operations landscape has been around forever," Sexton said. "But the tooling around doing it is certainly becoming more popular as we build bigger applications on the client side, rather than applications on the server side."
Build tools such as Broccoli and the Grunt JavaScript task runner factor into front-end operations along with tools and techniques to compile JavaScript in different ways, Sexton said. Other tools leveraged in front-end operations include Sauce Labs' Appium test automation framework for mobile applications. Tasks such as unit testing, code coverage, and continuous integration are factored into the mix.
At Flickr, Bertrand Fan, principal engineer, sees similarities between front-end operations and what he is doing in the course of moving over to Node.js. "We've ported a few pages over, but we're working on moving the entire site over to [Node.js] over the course of many years." Flickr's migration processes incorporate a variety of technologies, including the Flicker API for fetching and writing data, dual server clusters, and an Apache traffic server.
This story, "Front-end ops gaining prominence in Web development," was originally published at InfoWorld.com. Get the first word on what the important tech news really means with the InfoWorld Tech Watch blog. For the latest developments in business technology news, follow InfoWorld.com on Twitter.


text:
A CHARITY will aim to provide services to Radcliffe residents of all ages after receiving a grant of nearly £22,000.
Redeeming Our Communities (ROC), a national charity which has a centre in Coronation Road, Radcliffe, will use the money to create a breakfast club for primary and high school pupils.
It will also open a new cafe for all ages called Roc 'n' Rolls Community Cafe as well as holding weekly IT classes and providing work experience opportunities for disabled people.
ROC, which was founded in 2004 and is based in Manchester, aims to improve community cohesion and reduce crime and social disorder.
The charity received the money from HealthSustain Community Interest Company (CIC), through the People's Health Trust.
Lawrence Bettany, national development manager of ROC, said: "We feel this project will create an increased sense of togetherness in the community.
"We want to see the community have a place that they can call their own.
"The community is at the heart of everything we do and we're really excited to see this pioneering project take shape.
"If this project is successful, it's something we hope to replicate across the UK."
It was one of two charities in the borough to receive funding after The Mosses Community Association was awarded £25,000 to hold bi-weekly activities for young people in East Bury.
John Hume, chief executive of People's Health Trust, added: "We are delighted to be investing in these local organisations with great ideas to make their communities even better places to grow, live, work and age."
ROC is hoping to launch this new project and open the Roc 'n' Rolls Community Cafe by the end of February.


text:
Countries ContainedTrivia brain teasers have some element of trivia in them, but they are not just pure trivia questions.
Which is the only country in the world to contain two whole countries within it?
AnswerItaly contains San Marino & Vatican City.
What Next?
See another brain teaser just like this one...
Or, just get a random brain teaser
If you become a registered user you can vote on this brain teaser, keep track of
which ones you have seen, and even make your own.
Back to Top


text:
Tag Archives: mommy wars
"Breastfeeding Failure" is an Oxymoron
Lately I've been wondering if "breastfeeding failure" is an oxymoron. I mean, to fail at something don't you need to have a predetermined understanding of what failure is and what success is? Must you not be able to assess and … Continue reading
Posted in Blog, Main Content, Support 360 Tagged bottle, emotions, failure, forgiveness, formula, guilt, judgment, mommy wars, success 40 Comments
Last revised on 11/03/2011
Last revised on 11/03/2011


text:
September 25, 2012
SANTA CLARITA, Calif. - Shea Richards scored both goals, including the game-winner in overtime, to lead The Master's College past Biola 2-1 in the GSAC opener for both squads Tuesday afternoon on Reese Field.
The victory not only got the 23rd-ranked Mustangs (6-1-2) off to a good start in conference play but also ran their winning streak to three games and kept them unbeaten over their past seven matches. They haven't lost since August 23.
Richards has been one of the primary reasons why the Mustangs are on a roll. The sophomore forward from Palmdale, California, entered the match as the GSAC's leading scorer (seven goals and two assists for 16 points) and added to those numbers with two more tallies.
The first of those came in the match's 17th minute (16:24) when she took a pass from Jasmine Benson (Corona, CA) and put it by Eagle goalie Marina Rodriguez for a 1-0 lead. Benson's assist was her team-best fourth of the year.
That margin lasted all of seven minutes because Eagle Amanda Lillicrop evened things up at the 23:52 mark, scoring in unassisted fashion against Mustang goalie Ilyssa Espiritu.
Neither team scored the rest of the half and the shots taken by each team mirrored the closeness of the match. The Mustangs outshot the Eagles 8-7 over the opening 45 minutes with Rodriguez notching three saves while Espiritu came up with one.
Both sides had fewer chances in the second half, evidenced by a 5-2 shot advantage by the Mustangs and the more obvious result of no scoring.
So, the Mustangs, for the third time in 2012 went to overtime, hoping for better results than two earlier, double-overtime ties. Richards made sure that would happen as she scored just 2:52 into the extra frame, tallying off an assist from Gia Loza and sending her teammates and fans into a frenzy.
After three days off, the Mustangs return to the pitch on Saturday in search of their fourth straight win when they play at Arizona Christian.


text:
Segments Sponsored by
Then and Now: Sunscreen
Editor's note: This is the edited version of an article that originally ran in the May 2013 issue of Skin Inc. magazine. All rights reserved.
Sun protection has come a long way since the Coppertone girl of the 1950s. Although sunburns then were no doubt as painful and unhealthy as they are today, sunscreen was definitely not viewed as a necessity. It was just a lotion every mom had in her beach bag and only used after her kids were already burned.
Well, times have certainly changed. Sun protection is now considered a daily-use item because it is well-known that UV rays cause premature aging, skin damage and even cancer. The stuff is no longer looked at as something you need use only during a day at the pool or the beach. Sunscreen can be found in everything from facial moisturizer to lip balm ... and is no longer relegated to the bottom of the bag.
Sunscreens may not have been a common household item decades ago, but the product does have a long history. The first sunscreen is thought to have been developed by chemist Franz Greiter in 1946. As the story goes, Greiter acquired a sunburn while climbing Piz Buin mountain in the Alps, which led him to create a sun-protection product, aptly named Gletscher Crème or Glacier Cream, which is believed to have had a sun protection factor (SPF) of 2. Consequently, Greiter also invented SPF—the standard of measuring sunscreen effectiveness—in 1962. His formula, sold under the brand name Piz Buin, is still on the market today.
Remember the little Coppertone girl with the puppy pulling on her bathing suit? This popular product started out as a gooey red substance called Red Vet Pet. Created by pharmacist Benjamin Green in 1944, Red Vet Pet stood for "red veterinary petroleum" and had a sticky, red petroleum jellylike consistency. Not exactly a poolside staple by today's standards, but sales of the formula took off when it was purchased by Coppertone, mixed with cocoa butter and coconut oil, and then marketed as Coppertone and Ban de Soleil.
Thank goodness we are not limited to the sticky redness or greasy whiteness of sunscreens from years gone by. Today's sun protection products are not only super effective at protecting against UV damage, but invisible and comfortable on the skin. Although variety may not be the issue, wild claims of safety and effectiveness have led to recent consumer confusion.
How much SPF is enough? Is a higher SPF better? What about UVA and UVB protection? These are only some of the questions consumers are asking. It is now known that UVB rays cause sunburns, but UVA rays are responsible for skin cancer and premature aging. So, it is important that both you and your brand become aware of which products provide this broad-spectrum protection.
Generations ago, the best known way to protect yourself from the sun was to wear long-sleeved clothes or a bonnet. The effects of the sun were clear when people ventured into the beaming light with no protection and ended up with bad visible burns. Now, the science and understanding of the sun's rays and the effect they have on skin has advanced to the point where only sunscreen needs to be applied to provide your body with the protection it needs. Throughout the years, sunscreens have taken a dramatic turn for the better when it comes to skin protection.
Although the SPF on a bottle of sunscreen is commonly referred to when shopping for sun protection, few clients actually know what the number system means. The SPF of a sunscreen tells you two things: how long you can stay in the sun and how well the formula filters the sun's rays. First, if you take the amount of minutes you can stay in the sun before turning pink and then multiply that number by the SPF rating, you get the amount of time you can spend in the sun using that sunscreen. For example, if you are normally able to stay in the sun for 10 minutes without burning and the SPF of your sunscreen formula is 20, and it is applied correctly, your sunscreen will protect you for 200 minutes before your skin starts to burn. How well the formula filters the suns rays goes as follows.
SPF 2 blocks about 50% of UVB rays.
SPF 10 blocks about 85% of UVB rays.
SPF 15 blocks about 95% of UVB rays.
SPF 30 blocks about 97% of UVB rays.
Above SPF 30, the increased percentage protection is minimal. Instead, there is a longer period of time before sunburn takes place. Regardless, experts do recommend you re-apply at least every two hours.
The marketing and labeling of sunscreen has created much consumer confusion over the years, and a proposal to clarify sunscreen marketing has been in the works by the U.S. Food and Drug Administration (FDA) for decades. And as of 2013, it has finally been implemented.


text:
Print this issue
The Massachusetts Bar Association will hold its 2013 Annual
Dinner on Thursday, May 9 at the Westin Boston Waterfront, 425
Summer St., Boston.
Consider attending this annual event as a sponsor. Sponsorship
opportunities include:
here to register for the MBA's 2013 Annual Dinner online. For a
printable PDF outlining the above sponsorship opportunities and
table reservation information, click here. For additional information call
(617) 338-0543.


text:
I don't like the white display and the black background in nano and vi. so , how can i use the color display on them.
wating online, 3Q for your help.
3q ..........
On top of that, most people have no idea what 3Q means. I certainly didn't, and had to look it up.
Very Sorry,
I was used to use "3Q" in chinese forum. Because "3Q" pronunciation is the same as "Thank You" in chinese.
Very Sorry, Next time will be not.
By the way, Your signature is very interesting. I like it.


text:
Boot Barn Item #: 2005542
Easy Returns In Stores and Online
All Boots Ship Free (more...)
All Boots Ship Free (more...)
Color: Click a button belowcolor
size: Click a button below Size Chartsize
width: Click a button belowwidth
- Handcrafted in the USA
- Oklahoma State University logo on front of shaft
- Full-grain leather and vintage cow
- 11" shaft height
- Square toe
- Cushion insole
- Leather outsole with rubber heel grip
Show school spirit with these Oklahoma State University College Boots by Nocona. Handcrafted in the USA, these boots were made with full-grain leather and vintage cow, a leather outsole, and a classic square toe—perfect for any cowgirl college student wanting to show their pride in western culture and their school. With a rubber heel grip on the outsole, these boots were made to be long lasting, wear them to your first tail gate game, then wear them for graduation four years later.
Style(s): LDOSU22
Toe Type: Square
Outsole: Leather
Lifestyle: Western
Country Of Origin: USA
Heel Type: Cowboy
Upper Material: Leather
Shaft: 11"
Material: Leather
Color: Tan/Black
Product Weight: 6 lbs
Closure: Pull-On
Print After "Daddy Joe" died in 1918, other members of the family wanted to move the business to Fort Worth. Miss Enid felt so strongly that "Daddy Joe" wanted the company in Nocona, she stayed. In 1925, her brothers packed up the equipment and moved to Fort Worth. Miss Enid had made her decision. She borrowed $5,000 to keep seven employees in her small shop and founded the Nocona Boot Company. During those first years, Miss Enid turned her home into a boarding house, worked as a sales clerk, shipping clerk, stenographer and credit manager. At first, some men had trouble doing business with a lady bootmaker, but they soon discovered the quality was just as good as her late father's. The discovery of oil near Nocona brought many new customer's to Miss Enid's young company. They made a 16 inch "lace-up" boot that was tough enough to survive the oil fields and the wildcatters kept coming back for more. Accompanied by her sister, Miss Enid made her first sales trip into West Texas in 1926. "The roads looked like cattle trails in those day's" she said. "And for good reason, they were cattle trails. Our old Model T took a pretty good beating on that first trip. In fact, we lost a back wheel once, it came loose and jumped over a fence. Despite the hazards of the road, the trip was successful. We came back with a book full of orders and a new market for boots." On the way to the company's national reputation as a quality bootmaker, Miss Enid sponsored a Pony Express race from Nocona to San Francisco. Fourteen cowboys and one cowgirl took off at 9 AM on March 1,1939, from Nocona and the first rider reached San Francisco at 2 PM on March 24th. In 1981, the Nocona Boot Company merged with Justin Industries, parent company of the Justin Boot Company, bringing the bootmaking histories of the two family companies full circle.


text:
When Harm in the Hospital Follows You Home
It's estimated that more than a million people per year suffer infections, medical mistakes and other harm in the hospital. But even if patients are lucky enough to physically recover, their lives may never be the same.
"How is it possible to move past medical harm when every single aspect of life is impacted by it – when absolutely everything a person believed about doctors, lawyers, oversight agencies, insurance companies is turned upside down and inside out?" – Robin Karr, patient harm survivor
A slip of the scalpel, an invisible microbe, a minute miscalculation. It's estimated that something goes wrong for more than one million people per year during a visit to the hospital. Some patients experience a full physical recovery. Some are never fully healed.
But even if patients are lucky enough to physically heal, their lives may never be the same. Sleep becomes elusive, relationships break apart, and a wall of silence appears between patients and the doctors they trusted.
What follows is a conversation of sorts between some of the 1,550 members of our ProPublica Patient Harm Facebook community and Dr. Gerald Monk, a professor at San Diego State University who specializes in dealing with the aftermath of patient harm for both patients and providers. We asked group members to share their questions and thoughts about the aftermath of patient harm, and then got Monk's response. What emerges is a portrait of the long journey that begins after the unthinkable happens.
Monk's comments are not a substitute for treatment by a mental health professional. They have been edited for clarity and length. Each quote in italics comes from a member of ProPublica's Patient Harm Facebook group.
PP: What symptoms can survivors of patient harm expect?
"I find I think about what happened day and night." – KariAnn Syna
"Survivors have "very real PTSD symptoms, including avoidance, difficulty sleeping, etc." – Debra Van Putten
"I experience 'flashbacks.'" – Georjean Parrish
Dr. Monk: The psychological symptoms are similar to those people suffer when exposed to physical, sexual and psychological violence. What all these things have in common is that they take place in settings where we reasonably anticipate that we will be safe and secure. We tend to believe the maxim that the doctor will do no harm.
The symptoms can be physical, such as headaches and sleeplessness; or psychological, like depression, anger, guilt and being vulnerable to drug abuse. Patients can even blame themselves. A survivor of harm surely knows others that have had the same medical procedure without suffering harm, and so they can feel they somehow contributed to the error because they were at the wrong place at the wrong time with the wrong health care provider.
PP: Many group members expressed feelings of betrayal by the health professionals and authorities they thought were there to protect them. What phenomenon are they experiencing?
"A patient who is denied validation for their medical injury is betrayed by the medical system they have learned to trust as an official authority. It is a shocking experience to realize that everyone one has thought about trusting this authority is suddenly wrong." – Garrick Sitongia
Dr. Monk: Patients can feel especially violated in the context of health care. Not only do patients anticipate being safe and secure, they expect to be healed. Following an adverse medical event, a patient may experience a lifetime of heartbreaking anguish and suffering.
PP: Group members describe a related problem. Others are reluctant to hear their new understanding of the health care system and dismiss them as crazy or tell them "it's all in your mind."
Dr. Monk: Doctors are trained to be perfectionists. They are expected to answer difficult heath care problems and to know how to heal. Sometimes doctors are also pressured to gain legitimacy by exuding a sense of confidence and certainty when they don't actually know how to make a patient well.
As we know, the reality is that health care is far from perfect. Medicine is inexact yet doctors face the expectation that they will fully understand the human condition and know all of the complexities about what ails us.
This is an onerous responsibility, and this territory can be ripe for misunderstanding between health care providers and the patient and family members. Doctors may feel that patients haven't communicated all of their symptoms or followed through on their instructions, and this can leave patients and their families feeling blamed.
PP: Many patients say they encounter a 'wall of silence,' where providers are unwilling to discuss what happened and which hinders the healing process.
"There can be a "refusal of anyone to talk about the emotional impact or an error on both the provider, care team, patient, and their family ... it feels like a systems error ends up being an individual problem and no one wins." – Sherry Reynolds
Dr. Monk: The health care environment is still dominated by the culture of "deny and defend." Most physicians have been trained not to apologize when things go wrong and warned by their mentors that it can lead to a lawsuit. Actually, the opposite is true. Harmed patients who do not receive an apology and an open and transparent investigation about what went wrong are often left with a strong desire for justice. These feelings of injustice drive them toward a lawsuit.
But legal action can make things worse for the patient. It seldom produces any sense of justice and healing and often leads to even more trauma. In contrast, an open and heartfelt acknowledgment of an actual or perceived medical error could lead to psychological healing.
Another distressing part of this "deny and defend" culture is that many doctors and nurses actually want to apologize when things have gone wrong. Many providers went into medicine because they want to be healers and bring good to people's lives. When things go wrong, it can have catastrophic consequences for providers. They often suffer what is called 'second survivor' syndrome. They are traumatized by causing the patient harm and they are isolated and trapped with secret knowledge about what really happened.
Providers are often called the "second victim" in cases of patient harm, and struggle to handle deep feelings of guilt and remorse.
Fortunately, a growing trend is changing the culture of deny and defend. For example, large health care systems within California, Illinois, Maryland, Missouri, Massachusetts, and Virginia are trying to overcome the barriers in the health care environment to open, honest disclosures and encourage apologies when things go wrong. Some doctors are doing the same: disclosing medical errors and making heartfelt apologies. These conversations can be restorative for providers, patients and their families.
PP: Survivors of harm also describe themselves as isolated from their families just when they need them the most. Sometimes loved ones have trouble coping with the damage, other times they don't understand why the victim of harm can't 'just move on.'
"My husband never doubted me, but the challenges financially, physically and emotionally after suffering irreparable damage by my former dentist … destroyed our happiness ... He and I separated." – Tina Gomes
"I have no family now due to what was done to me ... This has proven to be too traumatic for my family to endure so I find myself with no family and no support. It's as if I'm dead." – Robin Karr
Dr. Monk: The harmed patient can become frozen with unprocessed emotional trauma following the harm they suffered. They can become stuck in emotional distress and psychological fragility. Loved ones and friends may become exhausted by the victim's ongoing anguish. They may start to recoil from hearing any more about this ugly situation.
Significant others can feel powerless to do anything other than encourage the harmed party to go to court or stay with a legal process. That can take more than five years, cause significant financial strain, and many cases are decided in favor of the health care professional. This contributes to the paralysis for the family and the harmed patient. These powerful stressors often lead to separation, divorce and alienation of family members.
PP: The feelings of isolation or abandonment are not necessarily limited to friends and family. Many social relationships can be strained, and survivors can feel shunned.
"We went from being the perfect family to being seen as the Addams family. When you have a child die from 100 percent medical error you become every mother's worst nightmare ... It is a grief and pain most people, fortunately, can never understand and are afraid to come near." - Lenore Alexander
Dr. Monk: There are no societal rituals about how to grieve the losses that come from serious medical error in a socially acceptable way.
While people can be kind and compassionate in their efforts to help, eventually there may be a growing sense that 'enough is enough' and survivors need to put this behind them and move on with their lives.
When family and friends tell the survivor of patient harm to move on, or suggest they are psychologically unwell, this can add feelings of shame and guilt to the grief they already feel, which may actually make the healing process longer.
PP: In addition to emotional trauma, there may also be lasting health effects that drag on for years or even permanently.
"How do you ever move on, when you live in a damaged body that reminds you every minute of every day what you lived through?" - Georjean Parrish
"I try to cover up my now ugly body with nice clothes...my body looks deformed." - KariAnn Syna
Dr. Monk: For a few people there is a form of loss and grief caused by a grievous physical injury that seems to take over a person's whole being. Physical prowess and attractiveness can be an important part of how people define themselves. Day-to-day physical injuries and impairments caused by a medical error remind victims of what they no longer have in strength, mobility, being pain free and physical appearance.
Some survivors know their body has been harmed forever but they still can't believe it. Time is moving along but they are not. Yearning for the life they had before the trauma, thoughts and images of the person they once were frequently fill their mind.
PP: Some survivors find the struggle to find acceptance or forgiveness an impediment to moving on with their lives.
"It took until I was finally diagnosed and two surgeries later to even begin to be able to 'let go' and 'forgive.' After I got Medicare and could go to doctors ... who listened and understood, I could begin to be grateful and that's when healing starts." - Anna Gardiner
"A big problem is one of acceptance." How do harmed patients separate accepting their damaged selves from feeling like they are saying that what happened to them was acceptable?" - Jeri Tresler
Dr. Monk: The desire for revenge can be a common reaction among patients who have survived a terrible medical error or for families who have had a loved one die because of a medical mistake. This is compounded when the expected legal punishment falls far short of expectations.
Survivors of serious medical error can feel shocked and horrified by the intensity of their own vengeful impulses when they have recovered sufficiently to have those feelings. They may even withdraw from community support because they feel ashamed of wanting revenge.
In many Western cultures, the desire for vengeance is taboo, and society instead pressures victims of harm to 'turn the other cheek' and forgive the perpetrator. But misplaced efforts to encourage forgiveness before the victim is ready can just cause more shame and distress.
Victims of an error need somebody who can acknowledge, accept and support them around intense displays of emotion and not withdraw from them but rather step toward them. Harmed patients at this time can benefit from working with a counselor who is not frightened by powerful feelings of rage, and revenge.
Counselors trained in dealing with trauma can help survivors speak openly about their experiences without being brushed aside or have the topic changed. This helps a harmed patient begin their own emotional repair. An overarching desire for many harmed patients is to want to move beyond the terrible emotional scars that may accompany the physical ones. Physical injuries may never be healed. Thankfully, with qualified help, emotional injuries can be.
Illustrations by Marina Luz
Exploring Patient Harm: Have you been affected by patient harm? Join our Patient Harm Community on Facebook to share your experience with patients, family members and others affected, or tell our reporters your story by completing our patient safety survey.
29 comments
One enormous problem is that when a doctor makes a mistake, he not only fails to admit it and inform the patient and family, but a complaint to the supervisors results in usually muted or non-existent reproaches or disciplinary action. Doctors do not like to criticize another, resulting in a failure of the offending MD to ever learn anything, even if the patient and family criticize him directly. Arrogance and a feeling that they know best govern most MD behavior.
This is what so-called tort reform got us: a medical industry wherein no one who causes serious harm is held accountable, and the lives of the victims receive no assistance or compensation.
I donated a kidney in January, 2006 at Beth Israel Deaconess Hospital in Boston. A day after the surgery I felt intensely nauseous and like I was blowing up like a balloon. My complaints were met with a couple doses of Mylanta, which only caused me to feel even more nauseous. I could not eat, started vomiting, no stool, etc. They sent me home 4 days after the surgery, still feeleing terrible. Felt terrible for a couple more weeks, the wound through which the kidney had been taken started running like a faucet. When I had my first post op appointment with the surgeon, he took the bandage off, and his mouth fell open. He took a couple swabs around the wound and sent them for testing and sent me back home to Vermont. Next morning he calls my home, tells me to get to the hospital immediately. I arrive back in Boston in the early evening, after waiting for my son to return home from school so I can settle him in with someone to look after him while I'm gone. I was admitted, prepped, and put under sometime by 8:30 that night.
Next morning when I awoke, I saw I had an enormous bandage stuck to my abdomen and a wound-vac slurping away under my bed. The surgeon came in, told me that my small intestine had been snagged in the sutures of the kidney removal opening, a hole had developed, and become infected, luckily leaking out through the wound instead of into my abdominal cavity. A 49 centimeter (about a foot and a half) of small intestine had to be removed and the intestine resected. The doctor told me that if I had waited one more day, I may not have survived.
In the end, I ended up with a month in the hospital, 3 months of intensive recovery, most of it with a portable wound-vac attached, and a year of weakness and pain, during which I was cautioned against lifting more than 5 pounds. I was always in pain, and often exhausted. I was unable to exercise, which was particularly bad for me since I row a shell on the Connecticut River about 6 months a year, ski, and maintain a rural homestead that requires a considerable amount of physical labor. Not to mention that my job as an attorney was difficult, since sitting was tremendously uncomfortable during that time. Then, for about 3 years after that I had to contend with an abominal/intestinal hernia, along with continued fatigue and pain.
When I tried to obtain some sort of compensation, I contacted 8 different attorneys. No one would take the case. I was informed that although I would prevail in a medical malpractice suit, the damages weren't severe enough to make it worth an attorney's time to bring suit. This was because I was not dead or dismembered. Short of those characteristics, a med-mal case is not worth bringing any more. Huge changes in quality of life, damage to one's career, disruption of the family, foreclosure, and so on, are not enough for a useful suit. So the behavior that causes injury such as mine goes unaccounted for and continues.
I don't just blame the doctor, and in fact he may only be a minor part of the problem. I do fault the hospital and the hospital industry though. I learned that the day I made the kidney donation was the busiest day Beth Israel Deaconess ever had in the transplant department. I suspect that the surgeon was under so much pressure to process patients that he was scrubbing up for the next vict…errr…patient while an intern was sewing me up. On top of it all, kidney donors are warehoused in BIDMC with liver patients. Every roommate I had was stricken with liver cancer, a much more serious issue that a donation if things go even moderately alright for the donor. But the care at BIDMC was poor, and the place was pretty dirty - example, I threw up in the lavatory and the remnants remained there for over 24 hours.
These issues are not just about how the doctors and nurses behave, it is also, and primarily, about how the hospital administration behaves toward patients: Patients are merely commodities from which the hospital derives revenues. If as a patient I had mattered to the hospital, my surgeon would have monitored me closely, he and the nurses would have paid attention when I complained about nausea, the place would have been clean, I would have stayed in a room tailored to the needs of a kidney donor, and so on. These issues are determined by the hospital administration, and this is where most hospitals fail. Hospitals will never be healthy places as long as administration is business first, patients last enterprises.
What is missing from the article that Physicians are cautioned not to admit anything out of fear of malpractice suits.
There is no maxim that physicians can cause no harm, only that they will avoid causing harm. Expecting perfection from anybody is a recipe for disappointment.
"The health care environment is still dominated by the culture of "deny and defend." Most physicians have been trained not to apologize when things go wrong and warned by their mentors that it can lead to a lawsuit. Actually, the opposite is true."
I'm not sure I agree with this statement. As a pharmacist, I've been trained to NOT hide errors, report them immediately, to be empathetic and apologize for any mistakes. And then go about trying to fix the system that led to the error in order to try to prevent it from happening again.
You are not a hospital administrator. That is why you do not hide errors. You are responsible for the work you do, and you are at a close remove from those you provide service to. Administrators are not. They tend to stay away from patients, and never develop an understanding of "patient-hood". And every patient is just a means to obtain revenue. You on the other hand, are aware that a mistake on your part can injure someone or worse, so at the very least, you try to be as professional as possible and do your job well. None of this is true for the people that actually run the hospital industry.
I have dealt with hospitals my whole life because of various family members' professions as lab techs and my own job as a medical device designer. I can attest to the philosophical - psychological - differences between the health care providing people, and the business people. The administrators are the ones making health care expensive, and are the ones who create the conditions that increase the likelihood of injury in the hospital.
Often medical errors and faulty treatments go undetected because the frequency of competent autopsies is so low, as I believe Pro-Publica's previous investigation in cooperation with PBS showed, though the emphasis then was that low frequency's consequence on crime investigations rather than medical error and accountability. Autopsies and its pathology reports are an essential mechanism in the practice of evidence-based medicine.
The problem is that a large portion of the people working in the medical industry are mentally challenged. This has occurred because the AMA has limited the number of doctors in order to keep the price up. Due to the shortage, we are forced to keep incompetent doctors and other personnel working. I went into the hospital after drinking too much water following a doctor's advice. They left me hooked up to an IV to drain the water for 3 weeks. At 5'10" I went from 187 pounds down to 130 and looked like a concentration camp surviver. While in the3 hospital, I told everyone that I could find that this was not healthy. They wante4d to give me Bio-plasms and ran every test that the hospital offered. Finally, they told me that I had some kind of virus and they didn't know what it was but they didn't want5 me in their hospital so, they sent me home. Doctors and hospitals are the number 1 cause of death in the USA. They kill twice as many people as smoki8ng so, don't assume that yours knows what he/she is doing.
My father contracted MRSA pneumonia in his tiny Maine Hospital in 2008, and he never recovered. After weeks of suffering and decline, he died in January 2009. This happened in his hometown, and mine. Some of his caregivers were old friends, co workers, neighbors, even distant relatives. It was where I started my nursing career. That made this personal tragedy even more painful. Dad was old and he had a good long life, but that does not excuse that he was the 3rd of 3, who within a month's time, contracted nosocomial MRSA in that hospital and died. The elderly are not a disposable patient population. One very disturbing statement that his doctor made to me when he disclosed Dad's hospital acquired infection was . "Well, these things happen, and there isn't really very much we can do about it". That claim of helplessness enraged me. It was a bold faced lie. MUCH can be done about it, but they just hoped the problem would go away. My poor old Dad suffered terribly, and my family has grieved, and that can't be changed, but the arrogant attitude and resistance to effective infection prevention in Hospitals can and must be changed. YES, they can do a LOT about it!
We can do better..
Hospitals should run like the Mayo Clinic or Cleveland. Everyone should be on salary not fee for service.
All persons working in hospital: janitors, kitchen staff,lab techs should be eligible for sick days even if they are not hospital employees and work for third-party contractors or agency. Hospitals should be graded on ratio of employees/ temps they have on a all shift basis. Everyone needs to have both written and auditory English comprehension.
My son had a severe brain injury at 17 and due to his age I was allowed to stay with him for the first three months of his hospitalization. It was a nightmare of potential life-threatening events.
My doctor (gynecologist) and hospital didn't make a "mistake." They intentionally harmed me to train gynecology residents how to remove sex organs. I was de-sexed for a benign ovarian cyst. Sadly, I discovered that this is all too common (even when not training residents) so it was impossible to get justice. The medical board determined that my doctor did nothing wrong despite my surgeon going against the recommendation of the oncologist to whom he referred me. But that's not surprising especially knowing that a medical malpractice defense attorney sits on my state's medical board.
Hi Jason,
I'm the community manager for healthcare here at ProPublica. Myself and our health care reporters would love to hear more of your perspective from the pharmacy side. Would you consider joining our provider network? You just have to fill out this short form. If our reporters have more questions, they'll be in touch: http://www.propublica.org/getinvolved/item/providers-tell-us-what-you-know-about-patient-safety
Hi Ernie,
Thank you for taking the time to share your story; I'm so sorry you had to go through that ordeal. There are several people in our patient harm Facebook group who have had similar experiences; you may find some support and resources there: https://www.facebook.com/groups/patientharm/
If you have a moment, we'd also love for you to fill out our patient harm questionnaire. Our reporters are working on a major investigation into patient harm, and that form is the best way to help inform our reporting. Thanks, and let me know if you have any questions! http://www.propublica.org/getinvolved/item/have-you-been-harmed-in-a-medical-facility-share-your-story
blair.hickman AT propublica.org
Many hospitals use their 'risk management' thugs to further threaten and harm people victimized by their doctors. particularly if the offending action was not neglect but intent to cause harm. Thete is active effort to discredit and harm further. There is alot of research money that is dispersed to medical 'care professionals' from big pharma looking to 'test' vaccines if that's what there calling them. and even bigger money from organ harvesting that occurs after 'mistakes' turn lethal. Fetal material being the harvest target of choice.
I maintain that the problem is that we (or, more properly, the AMA) wants to keep doctors up on pedestals as demigods, rather than accept the fact that they're human.
As Emmett points out, they keep a strict limit on the number of doctors. I don't believe the result is incompetence (since kids graduate every year with medical degrees), but it certainly does result in the fact that every doctor you'll ever meet hasn't slept more than an hour in the last thirty-six, because there aren't enough pairs of hands to care for everybody. (That is why it costs so much, though. That, and drug companies that "deserve" to be paid for their efforts.)
You'd think an organization of doctors would understand and acknowledge that sleep-deprived workers are less effective and more prone to error, but no, let's not fix the problem but (as Ernie's plight makes clear) rather blame the patients as money-grubbers.
Even failing that, I'm a fan of the aviation industry, in this sense. They keep planes in the air with checklists. No mechanic touches a plane without following the checklist, no pilot makes it off the ground without one. When there's a failure, the NTSB's priority is to find something to add to the checklist to detect that failure in the future.
Because of that, no matter how exhausted the mechanic or pilot, you fear the TSA groper more than the flight.
Again, you'd think that a group of doctors (who are literally trained as scientists) would see the value of systemic treatment, but no, we can't do that. That would demean the profession, by holding the hands of the doctors. Much better, obviously, to treat the doctor as an artisan who needs to keep the entirety of the sciences in his head to accomplish anything.
At the rate the AMA's going, I'm surprised they don't start making doctors forge their own scalpels from metal ore. I mean, really, mass-market tools? For a doctor? That's so gauchely awkward!
There was a very interesting article in the March 4 TIME Magazine on health care in the U.S. It was the first time that the magazine allowed just a single subject to be discussed. The article was over 35 pages and was very enlightening about our health care and why it's costing us (and the U.S. government) so much money and keeps going up and up. I recommend everyone try to locate a copy and read it….as I said, it was eye opening to say the least. I passed a copy on to my own doctor; and he, in turn, passed it on to other doctors in his group. His comment was that there were things in the article that he, as a doctor, didn't even realize were occurring in our hospitals. Even he wasn't aware of how much unnecessary tests, etc. were costing patients. Had he known or had any idea of the actual costs that hospitals charge for ridiculous things, he said he would have been more careful as to what he ordered; i.e., daily blood tests (not necessary), CT scans (generally not necessary in ALL head traumas), etc. Anyway, again, I would ask that people try to find this and read it…I found it extremely interesting and extremely telling as to what hospitals are up to.
The article Didi's talking about is available here to TIME subscribers: http://www.time.com/time/magazine/article/0,9171,2136864,00.html
After this article came out, ProPublica also hosted the author, Steven Brill, for a talk about the story and how he reported it. SO for those who don't subscribe to TIME, our podcast includes the article's important nuggets! Listen here: http://www.propublica.org/podcast/item/podcast-steve-brill-on-healthcare-and-the-media-in-america/
I cannot use my real name because of a pending legal suit—- if I can actually get any help that is, but I would like my comments to be posted.
Now I know why I have had so many of these thoughts and feelings.
I was transported by ambulance from a party that was 40 miles from my home. Symptoms were extreme bloated sensation, vomiting, and I just had to lay down. It was hard to remain conscious. I was brought to the nearest hospital, MidState Medical Center in Meriden, CT.
I explained symptoms to ER personnel along with medical history of haveing had coronary bypass surgery, and the presence of an aortic aneurism of at least 4.5 cm. discovered two years earlier.
That was on a Sunday evening. I was given a CT Scan on Monday morning and surgery was performed at about 1:00PM to put a stent into the aneurism. I did not meet the surgeon until two days later.
I stayed in the ICU post op. I was moved to a regualar room by Wed.
The surgeon came into my room late on Wed. to excoriate me that I had not eaten much if anything and needed to walk. He was prepared to discharge me that everning by 5:30 PM.
There are two types of people I term the most dangerous walking the earth: 1. those that know all the answers and not longer know how to ask questions. 2. those who will never get an ulcer but they are carriers.
This doctor was a combination of both! Without knowing or asking my medical history he lit into me for a host of sins in my personal life he presumed by what he found during the operation. He fought with me and my wife on whether I should stay an additional day as I was clearly not ready to be discharged. Even his PA and nurses advised that something else was going on with me they just did not know what. He, after more argument, allowed me to stay until no later than noon the following day, Thurs.
That altercation ended about 6 PM.
At about 7:30 PM, while talking with the PA and nurses I vomited blood.
By 8:30 I was headed for another CT scan. At 9:45 PM I was informed that I would need to have a second, now emergency, surgery as it was discovered that my original and real problem was an intestinal loop. Part of my small bowel had gotten twisted on itself, cutting circulation, and was now dead and could go sceptic.
I was operated on by another surgeon at about 10:30 PM who removed about 3 feet of gangrenous bowell form me and resected the intestine.
In total I spent 10 days in the hospital, 7 days in the ICU. My blood pressure, which had always been rock solid at 120/80, now became out of control (an still is). Recovery took better than 6 months due to getting the beta blockers correct. The first surgery resulted on a large bulge that had to be spirated. That incision failed to close for over 3 months. Other complications occured in the hospital as well that would take to long to describe.
It was the second surgeon as well as a consuling cardiologist, who should have been called in from the start, to get me under control. The second surgeon made a poignant apology to me on behalf of himself and everyone in the hospital on what I had to go through there. That absolutely floored be speechless. I also prevented me from taking any action against them on the long road to recovery.
I followed up with my own local vascular surgeon who cautorized the first incision by the first surgeon to close it. He kept making excuses on why the MidState Drs. had not caught the intestinal loop in the first CT scan. I had the distinct feeling that someone had gotten to him on this whole issue. I also felt the "white wall of silence" going up.
I do have flash backs every year at about the second week of October. Some have been vivid including sights, sounds, and SMELLS, and then they all go away.
I went into that hospital at 175 lbs and came out at 150 lbs., and I lost another 10 lbs. at home withing 60 days as the blood pressure medications robbed me of taste and smell so I had great difficulty eating for about 4-5 months until my own cardiologist put me on a BP medication that actually worked.
I, to this day, have trouble trying to excersize, have little energy, fight some modicum of depression, and cannot eat a reasonable amount of food at meals. I have not gotten above 160 lbs since. Oh, I am 5'11" tall.
The whole thing is burned into my memory. Bypass surgery was a breeze compared to this. Oh, I also have been treated for non-Hodgkins lyphoma to boot two years before the bypass surgery.
Tough decade. I am little gunshy around Drs.
gunste - I absolutely agree with you.
Eric, Diane, and anyone who has suffered harm - I am so sorry for what happened to you.
Some doctors are negligent because they feel above reproach and do not have personal ethics. Making a mistake is different than being negligent. I had a surgeon who committed medical battery, which is criminally negligent. I am permanently disabled from it and in excruciating pain far beyond what I ever could have imagined possible. The surgeon brutally assaulted my body by performing operations I didn't need or ask for - without cause, and against any good medical judgment.
This senseless surgery effectively ended any quality of life as well as my ability to support myself. I can't sit, walk, move, or do anything normally. The searing, burning pain is mind-blowing.
In California it seems impossible to get a Medical Malpractice lawyer because they say that "these cases" are costly, and doctors have a good 'ol boy network, and often refuse to testify against one another. A few months ago I had a lawyer who was going to help, but his 'go to' surgical expert knew the surgeon that did this to me, so there was a conflict.
It's easier to sue if you die, but if you are alive in excruciating pain and disability, then you are out of luck if you don't have a lot of money. There is no legal aid for malpractice.
I spoke to yet another lawyer today and I wrote down what he said as he said it. I quote: "The legal system stinks for medical malpractice cases. There are a lot of laws that protect doctors that people aren't even aware of."
I can never work again and I do not want to end up on the street. I also believe that the surgeon needs to be held accountable. The surgeon who did this to me, has at least four other patients who have called him 'the worst, most dismissive doctor ever- on the vitals.com site, yet still… there is not any oversight, because it is so hard to rightfully sue a surgeon.
The surgeon operates out of his own private SurgiCenter (for which he is listed as the President of), and in California, these private SurgiCenters are not licensed, they are only certified. There is little oversight to what surgeons are doing in the bubble of their private SurgiCenters. Since the legal system often does not pick up the ball once someone's body and life is decimated, surgeons get away with literally butchering people.
I believe that every level of our dysfunctional 'health care', 'regulatory' and 'legal' systems contributed to this wrong.
I appreciate this article, although I do disagree with one point. Saying that emotional healing is possible with 'qualified' help is not always possible.
It feels like my body is on fire every moment of every day. I will die from complications of surgery, I am in searing, burning pain, the surgeon turns and looks the other way, I'm afraid of ending up on the street without money in this pain, I don't have any quality of life left, I just wonder how much more pain and ill health I will be in before I die… and the article implies that I can go get counseling for this and emotionally it will all be okay? From my experience, that sort of statement only adds to the suffering of someone who has been butchered. Not everything can be healed.
I would like to know who sits on the board of my state's medical board. I will try to find out that information now.
As a patient who has suffered with the Iatrogenic injury (physician caused injury) for almost 5 years I can assure you that no one knows what this is like, unless they have gone through it. And with that, I will make my comments:
1) Revenge? Of all the words in the English language to pick, Dr. Monk wants to pull that one out of his . . . lexicon?!?
Revenge?!?!? Even the quotes used don't sound like anyone is talking Revenge. Why this word?
Does my seeking justice for the damage I sustained equate to revenge? The way this is written it sounds like an injured patient is just about to go "postal". We want justce, we want to be treated fairly for the injuries we sustained, we want to be respected, we want to stop being marginalized by healthcare professionals, we want to stop being marginalized by the insurance "defense" industry. We want our injuries—that we didn't cause to ourselves—acknowledged in a dignified, civil manner. We are tired of the "deny and defend" mantra that the ABA and AMA have set in place as the norm to deal with PATIENTS who have been injured.
2) "Physical injuries may never be healed. Thankfully, with qualified help, emotional injuries can be." . . .
Seriously? First, define "qualified help" I had an M.D. practicing psychiatry at Providence Medical Center in Portland Ore. Was she not well qualified?!? All she did was perscribe more and more and more anti-psychotics, anti-anxiety, sleeping pills—in combination with the Oxycondone and Oxycontin the Orthopedic who caused my Iatrogenic injuries perscribed.
For over 18 months I was medically ZONED OUT by TWO well quailified M.D.'s . . . who probably didn't even talk to each other about ther mutual patient . . . ME . . . but it was perfectly fine to drug me up for 18 months, while me entire life was spiraling down. Thanks "well qualified" help.
The premise that emotional injuries can heal, but with qualified help—even though the physical injuries may never, is ludicrous. My physical injuries never healed—'cause my leg got butchered. What was supposed to be the outcome of my surgery was not the reality. And my leg will never be what it was supposed to. So how is it even posssible to get over the emotional injuries when the scars and physical pain are still there?
Teach YOURSELF how to heal . . . do not rely on "qualified" help. Understand how the game is played, distance yourself as best you can from the medical world altogether, and move on.
The minute you trust and rely on an outside source, you give up your strength and open yourself up to what they think you ought to be feeling. Screw that. Yeah, now patients who have been harmed by an Iatrogenic injury are out for revenge . . . see how it's played!
Love many, trust few . . . always paddle your own canoe!
It's YOUR peace of mind, and getting over trauma. Join support groups with people who have been through an Iatrogenic injury and how know how physical AND emotional go hand-in-hand.
3) And how can a patient seek "well qualified" help / counseling for an Iatrongenic injury when . . . the medical / legal community has already circled ther wagons and is denying it all (Deny and Defend) "Ah, there's nothing wrong. The doctor didn't do anything wrong . . ."
Who is truly helping patients and the TRUE second victims . . . the families and friends and caregivers of the harmed patients?
I suffer from chronic fatigue/fibromyalgia, brain fog/cognitive impairment. I had one doc just 'disappear' from the clinic. His replacement was the ONLY doc to come to my house and see me in situ and he declared he would support my disability claim. He was then replaced by another who said "The clinic does NOT support disability claims period". I asked for objective testing and was refused. I have been through a myriad of drugs that push me to suicidal thoughts(SSRIs) on over 3 ocaissions with NO notation in my file. This last doc even told me "I won't lie for you" when I asked for objective testing yet he lied and fabricated medical records regarding tests never ordered nor performed. I am wasting away, losing weight and they are more concerned about cutting pain meds and their liability than with my health issues so I am also labelled 'depressed'. At 50 y/o I look forward to death as an end to the pain rather than continual subjection to disbelief and humiliation and pending homelessness. We ONLY have 'health marketing' with liability being the main driving factor NOT health or insurance issues. And with government entering the field we will be worse off than Canada/UK/Russia healthcare.
I have been butchered by a surgon with a 'Hellers Myotomy" for what is a diverticulum problem. I've lost forty five pounds and was never over weight to start with. Was put on coumaden (rat poison) by another so called doctor. That ate my bones up so much I'm ashamed of my arms and legs.
I told him that I was getting off all my prescription meds and going with natural vitamins. He didn't like that. I told him that I would rather be in a casket then a wheel chair and he didn't like that either. But since I did, I feel the best I have in years. He the same as told me he was me that he wasn't getting his kick back from the drug companies.
I told my wife that when I die, I want the the cause of death listed in the obituary as "medical incomptence."
Carla - yes, I agree completely that the word revenge is off the mark.
And as for 'qualified help', I agree - most doctors have hurt me WAY more than they have helped. I found out that most doctors don't listen to the patient's experience about their body. Just because a person can pass through medical school, does not mean that they have the interpersonal skills to practice medicine.
Aside from being butchered because the surgeon had his own agenda when operating on me for a needed structural surgery, I had 20 pain/SSRI medications thrown at me by doctors who didn't even do a medical exam or look at my injured body after the surgery. You can't force someone's butchered body to feel okay by throwing pain medication, SSRI's or nerve mediations at it, and I don't understand why the doctors didn't listen to me when I begged them to stop. They made me suffer tremors, splitting headaches, gut wrenching stomach pain and nausea, hives, swelling, and so on… on top of the excruciating pain I'm already suffering.
I told them clearly that the medications just made me feel more sick and could not help, but those doctors didn't like being told that they were wrong, and they were angry that they couldn't help. Not in a humane way, in an egotistical way. I told them that sometimes not making things worse IS the way to help. Not to heal, not to fix, but not to cause any more harm.
I had to fight to finally get to a good doctor. He took one look at me and saw that I was butchered and made an invalid. He said so right there and then. He said, 'Well, there's no reason to take medication that only makes you feel worse.' This doctor is a real human being who listened to me, looked at me, saw me as a person, and not just as a bother and a paycheck.
My body was so incredibly damaged that any potential 'cure' makes me worse. Natural cures that used to help cannot help me now either:
Before my surgery, throughout my life I had very healthy habits. I ate a very healthy diet, went hiking, running, (on trails, not on concrete!), did weight lifting, yoga, meditation, had good sleep hygiene, took healthy supplements (within reason), received massage, acupuncture and so on, in order to stay healthy and feeling great.
I am now in such intensive pain, I can't do any of that. I can barely sit or walk. I can't even sleep without medication (that's the only medication I will take now). I can't meditate. Acupuncture would only be like sticking needles into me and causing more pain - it wouldn't be able to help me now.
Ted, being subjugated to disbelief and humiliation on top of physical pain, and worrying about homelessness should never happen to anyone. I am in that situation as well, and I am so sorry for what is happening to you.
Larry, I have tried to think of some way that I can let the police know that my eventual death will be from complications of this surgery. I don't want them writing 'heart attack' or something else on the death certificate because I fell it should be known that Dr. ______ killed me. And no, that is not 'revenge', it is the right thing to do. If others who vehemently complained about this surgeon on vitals.com had brought about a lawsuit, he would not have had a license in order to injure me. He's still probably injuring other people now. I am trying to get my voice heard, but how can I do so when lawyers say, "Medical Malpractice stinks for the patient. There are so many laws to protect the doctor."... and then they don't help!
I have asked a friend of mine if she will hold on to a letter that I write to mail to the police citing surgical battery as the cause of my death. She said that she would. Oh, I realize that they won't care, and I realize the futility of even asking, but as a human being my mind goes there. As human beings, we want to be seen and heard. It's not an affliction. It's normal and natural—-
Surgeons who butcher us put us into that horrible position of defining our lives in terms of their medical incompetence instead of in terms of who we were before we were harmed. We we are at our essence. And then to protect themselves, they ignore and humiliate us even more.
Then the legal system doesn't help, and we some of us actually worry about being homeless. What is the best case scenario: being in some awful group home?
This has got to be changed NOW. It shouldn't be so hard. I am so sorry for anyone who is feeling this sort of pain. Surgeons who cause this much pain because of negligence ought to be help accountable. Not for revenge, but because it's the right thing to do.
I have been an RN, BSN for almost 14 yrs. I too have so much I want to say, but I am currently in the middle of a lawsuit against a doctor. First, I want to say I'm so sorry for all of you have suffered with life changing medical errors. I too have been through hell the last 3 years, which changed my quality of living. The healthcare system is so bad, I no longer want to practice nursing. I have now experienced both sides as an RN and patient. Something has to be done to held doctors accountable!! I feel bad for my patients always wondering when the doctor will be in to see them. It's a joke…the healthcare system is all about the money and cutting cost. There is not a shortage of nurses…they just don't want to pay…they will cut staff at the expense of patient care and safety…and then the people at the top get bonuses. This healthcare system is not in alignment with my values, morals, belief, etc…I feel like I need to find a way to make a difference in the healthcare system to protect the patients and hold doctors accountable!
Well, Jesus had a good answer for this problem - FORGIVE - and move on.
For a detailed description of how pockets of blatant corruption in the medical industry, involving multiple medical providers, ended the life of a great lady named Glenda, with cover-ups by government bureaucrats, go to http://www.defraudingamerica.com/glenda.
I approached this article with good will hoping to find it supportive of those who have suffered iatrogenic injuries. I was quite surprised and disappointed by what I read. For instance, in referring to physicians as having 'second survivor' syndrome, Dr. Monk wrote:
"They (doctors/health care providers) are traumatized by causing the patient harm and they are isolated and trapped with secret knowledge about what really happened".
There is a solution for any of the doctors or nurses that are holding onto 'secret knowledge' about what really happened in regards to medical harm: Step up, tell the truth; you have a moral and ethical obligation to do so. Remaining silent in order to avoid a lawsuit, while an injured patient languishes in pain and financial ruin because they can't work anymore is unconscionable.
If you want to talk about catastrophic consequences, look no further than to the patient who has been physically harmed. Severe physical injury takes over a person's whole being. Social, occupational, and other levels of function are significantly impaired, or completely devastated.
What society defines as 'qualified help' often refers to those doctors who feel the most entitled. Entitlement can be a dangerous commodity. Plenty of surgeons who 'look good on paper' (i.e. have gone to a well-known medical schools, have decades of experience, and belong to several prominent associations) cause irreparable harm every day… Negligent malpractice is often not simply the 'slip of a scalpel', but often caused by arrogant, entitled, neglectful behavior. Even the best medical schools, and all of the associations a doctor can buy their way into, cannot instill the ethics and/or the ability to communicate with patients in the way the profession demands. Many doctors don't listen or pay attention to what a patient says rather than the other way around.
Holding someone legally accountability through legal action is not to be confused with justice; once your body has been harmed, and the quality of your life ended, there is no true justice. Social Security Disability doesn't pay enough to pay for a roof over your head in a place with any dignity, so for some people, legal action isn't a choice, but the only option. Many patients don't need simply a verbal apology; they need their mortgage paid.
Bringing the polarizing words/concepts of either revenge and/or forgiveness into this conversation pulls the focus off of the real issues of physical well-being and survival, which is what accountability in the form of lawsuits are often based on.
One would hope that successful med mal lawsuits might prevent the offending doctor or surgeon from harming anyone else, however, because our medical/legal systems are unreasonably skewed in favor of doctor's rights over patient safety, sadly that isn't likely, but that doesn't mean that we ever have the luxury of giving up. Doctors with track record of harmful negligence, continue to practice because medical malpractice suits are so hard to get to court (or the biased Medical Boards) at all, let alone with more the sort of action that would take an unsavory doctor out of practice.
Rodney, It is a tragedy what happened to Glenda. I hope that everyone looks at your website.
I feel kinda silly after reading some of the tragedies reported here. Nonetheless, whether it is neglect, mishap, malpractice, bad luck or whatever you want to call it, it happened, and it causes serious problems. I had a cardiac oblation (first one was 2 years prior). Felt terrible, was discharged the next day even though I felt poorly, and then on the drive home (60 miles) my heart went into acute diastolic cardiac failure half way to our destination. I still freak out just typing this! They had pumped too much fluid into me during the ablation. Something about the heart pumping water and not blood that doesn't work so well - sarcasm intended.
The response from the doctors/hospital - nothing. Have not heard a word from them.
I don't sleep, I am on anxiety medication that turns me into a whacky doodle, I blame my wife for everything wrong in the world and then I feel guilty for the things just mentioned. I know, I need to get over it.
I don't know who's telling you that you need to 'get over it' as though the fault is yours. The fault was not yours. Physical maladies affect the whole system.
Yes, medical harm spreads a wide web, and it's difficult (by proxy) for the people that are around those who were harmed, but not as painful as being harmed directly.
Giving medication that makes someone feel worse doesn't make sense to me, and in my opinion is a large part of the whole problem with the medical field.
I'm sorry for what they did to you at the hospital. There's no good reason for the doctors not to be held accountable. How dare they not respond to you - do they think that you pumped fluid into your own heart! I don't know about you, but my sarcasm comes out because people around me don't want to allow me to get justifiably angry. If they allow you your anger, they have to acknowledge what they did.
You are not at fault, Jay. I am sure that you are doing your best.
Commenting on this story is closed.
Patient Safety: Exploring Quality of Care in the U.S.
More than 1 million patients suffer harm each year while being treated in the U.S. health care system. Even more receive substandard care or costly overtreatment.
The Story So Far
Too many patients suffer harm instead of healing in U.S. medicine. That's why ProPublica's reporters have investigated everything from deadly dialysis centers and dangerous hospitals to the failure of state boards to discipline incompetent nurses.
This page allows patients, providers and readers to join the patient safety conversation. Our goal is to find out why so many patients are suffering harm and highlight the best ways to solve the problem. Here you'll find regular updates, and places to share your stories, views or expertise.
Read all of our posts on patient safety, and find out how to get involved.
Contact Us
Marshall Allen, Reporter
Olga Pierce, Reporter
Got a tip? Fill out our form.
Share Your Story
Your input can help ProPublica's reporting.
Have you worked in health care? Tell us what you've observed about patient safety.
Have you or a loved one been harmed? Tell us about it.
Join the Discussion
Join the over 3,300 members of ProPublica's Patient Harm Group to learn, share your story and connect with others.
Icon graphics courtesy of the Noun Project.
Latest Stories in this Project
- Doctor Confesses: I Lied to Protect Colleague in Malpractice Suit
- New Report: Problem Care Harms Almost One-Third of Rehab Hospital Patients
- Study Urges CDC to Revise Count of Deaths from Medical Error
- When a Brain Surgeon Becomes a Malpractice Lawyer
- How Denmark Dumped Medical Malpractice and Improved Patient Safety


text:
LAKE FOREST – A group of residents has sued the Saddleback Valley Unified School District to stop the construction of a stadium at El Toro High School.
The lawsuit, filed last month in Orange County Superior Court by resident Richard Stein and a group of unnamed residents calling itself Responsible Use of Land at El Toro, seeks to stop the project and forbid the use of any taxpayer money for a stadium on the high school campus.
The SVUSD board approved the stadium Nov. 13. Plans include bleacher seating for 4,000 people, 70- and 80-foot tall lighting poles, a concession building and a new scoreboard. The stadium is expected to cost $5 million to $6 million, according to district officials, paid for with redevelopment funds.
At the November meeting, some residents complained their property values and quality of life would decline if the school added bleachers and lights to its main sports field, allowing teams to use it for nighttime practice and competitions.
In the lawsuit, Stein and other residents argue funds from a local bond measure were promised for a stadium off campus.
"I voted for the passage of Measure B, in part, because it established and provided funding for an offsite stadium for El Toro High School, thereby eliminating the community impacts associated with an onsite stadium," Stein wrote in the lawsuit.
Measure B is a $180 million bond measure passed by district voters in 2004. According to Noemi Avila-Zamudio, district facilities, planning and construction coordinator, $163.4 million has been spent. The remaining $16.6 million is earmarked for schools that are going to become eligible for modernization in the near future, she said.
The stadium was among a number of projects not completed as planned because of factors such as rising construction and labor costs, according to the district.
In the lawsuit, Stein asserts the district has "misappropriated" Measure B funds by using them for modernization rather than an off-site stadium.
The lawsuit also alleges that the district violated the California Environmental Quality Act by not properly analyzing the environmental impacts of such a project, such as its effects on traffic, noise and air quality.
He asks the court to compel the district to rescind its approval of the project and to pay all attorneys' fees and litigation costs related to the lawsuit.
District spokeswoman Tammy Blakely said the district has thoroughly studied the potential environmental impacts of the stadium.
"The district believes that it will be vindicated in court and expects this matter will be resolved in its favor," she said.
Contact the writer: 949-454-7307 or firstname.lastname@example.com


text:
The Wharton School recently asked what a social media "like" was worth. The response, derived from a recent survey of 2,000 social media users that "liked" something, was found to have a value of $174.17. Sound like a lot? Not your experience? Here's why that won't be the social media result for everyone.
Read the full blog post at Adobe Digital Marketing Blog


text:
A MAN savagely attacked by three men in his home was last night fighting for his life.
An attempted murder investigation has been launched after the late-night attack in Coleridge Street, Bank Top, Blackburn.
The 41-year-old was taken to Royal Blackburn Hospital after suffering a fractured skull and a bleed on the brain in the attack around 1am yesterday.
Last night he was in an induced coma and his condition was described as critical.
Police said the victim was at home when three men burst in and attacked him.
Detectives think the motive could be a row over money.
People living nearby said they were shocked and upset to hear what had happened on their doorstep.
One 93-year-old woman said: "I can't believe this has happened just a few doors away from my home.
"This estate has changed a lot in the 60 years I have lived here. It used to be much nicer."
Another neighbour said: "To have this happen in your street is terrifying. I have children and to think these people did this just yards away is horrible.
"I have been on to the council about this area. It's getting really bad, something more needs to be done."
Terrance Hayes, 61, who lives one street away in Hardman Street, said: "I can't say I am surprised. Something like this has been brewing for a long time.
"I just hope he is OK."
A police cordon was in place all day yesterday preventing motorists from driving to Montrose Street via Coleridge Street.
Extra patrols were set up and officers carried out house-to-house inquiries.
One neighbour said: "To see so many police officers on a Sunday morning was really unnerving.
"I am shocked something so nasty has happened.
"The guy who lived there just keeps himself to himself."
Another neighbour said: "This is the exact reason why I am moving out today. I just don't feel safe.
"I really hope the police catch whoever did this."
Crime scene investigators dressed in white suits were examining a smashed front downstairs window at the scene.
A police spokesman said: "We are still at a very early stage of this investigation and we are currently trying to establish exactly what has gone on.
"We are treating the investigation at this stage as attempted murder.
"I appeal to anyone who saw anything suspiciously in or around Coleridge Street around 1am on Sunday to come forward.
"I also urge anyone who saw three men entering Coleridge Street or running away from the address around the same time in the direction of Stancliffe Street to contact police as they could hold key information."
Witnesses should call police on 101.


text:
The keys to Oracle…
I sadly have to say Tom that the Oracle forums are some of the most unhelpful I have ever read. They often have rude people, with big egos, giving rude responses and even after 13 years of experience I would be wary about asking a question in there. I would like to see them more closely managed and I would never recommend them as a first point of call, only as a 'you many turn something up in a search on there'. I think it's a dreadful shame that a bad culture in them exists because there are a lot of very supportive and experienced people ready to offer support if you can cut through the sarcasm.
Good recommendations, however the key to becoming a recognized expert is the willingness to work 80-90 hours a week for years to acquire in-depth knowledge and skills. Most are not willing to put in that type of commitment. Everyone is looking for the secret sauce but the secret sauce has never changed, it's commitment and hard work.
In Oracle, expert of today is the beginner of tomorrow. May be within few months another version of Oracle database will appear packed with new features and the experts of 11g will start deprecating some of the things and start adopting new ones.
Change is the keyword here.
But again the more the things change, the more they remain same. Spend time in understanding Oracle RDBMS architecture, and when you know it like back of your hand, then you should feel bit comfortable that you are ready for the trenches, come what may. All these fancy and indeed great technologies like RAC, Exadata etc are built on top of that foundation.
So get the foundation solid, and you are good to go. During that journey, share the knowledge, but before sharing test it yourself.
Excellent suggestions, Tom.
I only wish to add an invitation to check the PL/SQL Challenge at plsqlchallenge.com.
Complement "passive" education (reading doc and books, checking out forums) with a more active approach: test your knowledge with quizzes on PL/SQL, SQL and APEX.
Over 500 Oracle technologists take the daily PL/SQL quiz and many rave about how it has strengthened their grasp of the language.
Cheers, SF
I totally agree with Kelloggs Ville. The Oracle forums is not something I would recommend anyone to visit, ever. They need moderation. Most people post just for the sake of getting their point score up.
I still remember when I had taken a PL/SQL challenge at Mr. Feuerstein's website. It was years ago and I do not even clearly remember the problem. It was something to do with how to find out the input parameters to a stored procedure. I remember working hard on it. My solution was among the ones accepted as correct. It was a very good experience. Initially I thought the problem did not have a solution but it did.
Anonymous, I hope you come on back to the PL/SQL Challenge and take more quizzes!
We've also started up a new Roundtable discussion, which is currently focused on naming conventions for PL/SQL code - with a surprising and unusual proposal from one of our players.
This is also a great resource offered by Oracle
Fahd Mirza rightly said "In Oracle, expert of today is the beginner of tomorrow." Database features aren't as faddish as most software. Yet our "castles of sand on the seashores of technology change" offer the ongoing challenge of renewal and obsolescence.
Regarding forums, I've found http://dba.stackexchange.com/ with the familiar and superb stack exchange layout to be very helpful although it would be even more helpful if it had even more participants.
Best mix to start for me was : Oracle Server Concepts Guide + Administrator's Guide
Hello Tom:
This post applies to beginners and experts. I feel we move from beginner to expert many times in a cycle. There is so much to learn in Oracle stack.
Is it possible to keep this post always visible in your blog entry page? Just as the images of books are appearing always. A link on the right frame will do. Will help new comers to the site and also regular visitors.
Your blog posts have become boring these days, unlike the posts you blogged over 2 years ago. What happened ? Are you no longer interested ?
-- Botham
I don't think the count(hours)/weeks is the important thing. it takes 10,000 hours of purposeful practice to become a master of something. Purposeful means with the intention of getting better. Many DBA's put in 10,000 hours on the job with no intention of learning anything more than what they need at the time, and don't try to retain it when the need passes.
If you approach knowing Oracle with purpose, like Tom, and Jonathan Lewis, and Cary Milsap, and Kerry Osborne, and Doug Burns, and Tanel Poder, you can become an expert too... 10,000 hours from now.
The perfect time for you to have started learning would have been 10 years ago. The second best time to start is today.
Super post! Just like your blog professionalism! Keep up the good work.
While all of this is going on - you should also be communicating - a lot. Constantly. Get on the forums -http://otn.oracle.com/forums, start writing - start asking questions (after reading the guidelines!!), start participating. It is the way I learned much of what I know now myself. But communicate - a lot. You won't be able to progress forward in a vacuum. Share everything you have in your head - and find others that will share back with you. You'll find you not only get to learn (and to teach eventually) from people all over the world - but you may end up calling some of them your really good friends.
Hi tom,
It's been a long time I wanted to write a comment here to thank you for the post, not that I needed to give it a ton of thought, I just procrastinated...I kept waiting for a better time that really never arrived!
As you mentioned communicating constantly, starting to write, asking questions, reading, participating and in short communicating a lot with people who are also willing to share back is a key factor which applies to Oracle and most things we want to be good at.
Communicating with like minded people and to bounce back and forth thoughts and ideas and questions and answers, is invaluable not only in online forums and communities, but also in platforms like open world, user group conferences, events, trainings and seminars. In addition to the content that would be presented in those events, a lot of value is in networking and meeting with right people.
Thanks again for your posts and have a very happy Christmas and a great 2013 :)
Keys to blogging: DO it more often before you lose your following!
To all those who find Oracle forums need moderation in answering questions:
You set the stage with your question. Communication - and respect - goes both ways, that is: questions that show both lack of basic knowledge and lack of any effort to look up or read up on BASICS before asking - these questions should be screened out because they don't respect other participants. What do you expect if you pose a question with ZERO homework done beforehand - and then follow up with a second such question? - Yes, I have seen those questions, as has everybody else.
Forums are not courses, and not books. So read some documentation first, and show some respect, if you want to get respect.
I'm just 6 months within the job and yes, I feel that I am still a beginner in what I do, there's so much to learn or do about Oracle. :)
Nice article Tom, keep the good work!
I have although a question maybe to be answered by the more experienced people here.
I'm an application engineer that handles apps built on top of the Oracle DB.
Because i want to enrich also my DBA and DB design skills i started to learn more about Oracle. I'm know finishing the Oracle Server Concepts book and i think i'll go to 2 Day DBA as you also suggested.
I want to practice, installing an Oracle db and start working on it. The problem is that i don't know how can I simulate a real environment, or at least get one as real as a simulated could be.
I don't have an app to run on-top so i was thinking to biuld a schema and write some plsql procedures takes make different actions on that schema at repetead times, to be able to perform analysis, to get into trouble with disk space etc.
Does anyone has a better idea, a tool that can stress my DB or something?
Thank you !
you can go to apex.oracle.com and download some of their applications from there - install them - and use them a bit
rather than writing your own.
Sir, I agree with your view.
We obviously can't use anything until we know its there. Once we know whats there we can proceed with when to use that followed by how to use (commands/syntax) it.
1. What
2. Why/When
3. How
Once we are aware of the basics, we can move to Oracle forums to actively participate in the discussions.
Nice post....
Nice one..!!!


text:
The Dawn of a New Era for Rogue
Rogue Films, 1 day, 17 hours
Is This the Ultimate Beer Shed?
lbbonline.com, 1 week, 5 days
Tent City Finds a Permanent Home With Launch of Street-Life View via Clemenger BBDO, Sydney
Clemenger BBDO, 5 hours, 1 minute
20 Things You Should be Asking the APA About
Advertising Producers Association, 15 hours, 14 minutes
Fortnight Lingerie | 'Super Sexy CPR'
Rooster, 2 years, 2 months
Angel Soft's "Just Dad"
Humble + Postal, 4 months, 1 week
NFL-Handoff Across America
Bullitt, 9 hours, 19 minutes
Fall 2017 Cutters Studios Montage
Cutters Studios, 11 hours, 38 minutes
The Loeries Awards
The Loeries
Durban, South Africa
Edinburgh International Television Festival
Edinburgh, UK
The Industry School - Print Production Workshop
The Industry School
London, UK
The Industry School - Project Management
Build your own personal news stream. Discover the latest work created that interests you, share your favourite stories and follow your favourite people and companies
Big Chop, 2 years, 4 months ago
Matthew Felstead
Sports and leisure,
Theme parks
BRONZE £500 per annum (you upload your news to the)
SILVER £1000 per annum (we manage page for you)
You can find full details on our packages in our media kit.


text:
- Join/Renew
- About KBA
- Attorney Resources
- Public Resources
- Casemaker
- Foundation
|Community Calendar
|Upcoming Past Month View
Here you can find out about upcoming events and view photo galleries of past events. Some events may allow for online registration and the ticket purchase. Click the event name to view more details.
7/14/2017KBF opens IOLTA grant proposal process
7/19/2017KLS Seeks Attorney in Hays
7/19/2017KLS Seeks Attorney in Pittsburg
7/19/2017KLS seeks Dodge City Attorney