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>Health and Nutrition>doughnut bacon sandwich
Queen of 3rd Place
I could use this right about now.
Ex runner
Cool Jump Suit
Maybe even just a bacon sandwich. Or heck, just bacon.....
So bittersweet,This tragedyWon't ask for absolution;This melody,Inside of me,Still searches for solution.A twist of faith,A change of heart Cures my infatuation.A broken heart, Provides the sparkFor my determination.
At "Sesame Burgers and Beers", they have the
"memphis - house made peanut butter, bacon & banana slices".
It was definitely the strangest burger I've ever had.
Rock n Roll Half finish
Gene's Sausages on Lincoln Ave. in Chicago has bacon maple sausages. All the major food groups :-)
2017 Races: 1/28/17 Lakefront Half Marathon, Chicago 2:25:56 | 4/2/17 --Shamrock Shuffle, Chicago 51:02
Memorial Day Weekend - Conquer the Capital Challenge, Madison 5/27/17 Twilight 10K 1:14:11 | 5/28/17 Madtown Half Marathon 2:57:33 | Rock & Roll Half Marathon. Chicago, July,2:31:26 | Chicago Half Marathon, September | Madison Half Marathon, November
The sausages are marinaded in beer?
I could use this right about now.
I had to look! I like donuts, I like bacon, but together, I'm not so sure.
I could use a nice bacon sammich though... 2 slices of Texas toast, some mayo, sliced tomato, cheddar cheese, and bacon (give or take the egg either way) would make my day!
"We do not become the people who this world needs simply by turning our backs on anyone we don't like, trust, or deem healthy enough to be in our presence. " ---- Shasta Nelson
Half Fanatic 12680
VooDoo Doughnuts in Portland, OR has bacon maple doughnuts. http://voodoodoughnut.com/
2017 goals: Don't embarrass myself at IM 70.3 World Championship (September, Chattanooga)
A Saucy Wench
The sausages are marinaded in beer?
I often cook my brats in beer, I see no reason the sausages couldnt be.
I have become Death, the destroyer of electronic gadgets
"When I got too tired to run anymore I just pretended I wasnt tired and kept running anyway" - dd, age 7
They also have bacon maple beer. It is horrendous. Possibly the worst thing I have ever tasted. Pour budweiser in a dirty ash tray and you've pretty much covered it
Looks yummy. I'm counting down the days!
An unfortunate oversight. However, which kind of beer should it have been marinated in?
Boy, what is this obsession with bacon? Friggin' bacon everything! How did Bacon, which is around for so many decades, suddenly become the topic of so many food shows, the sole main ingredient served in every single entree at several restaurants(including desserts), and the food mentioned in 59% of RunningAhead posts related to food?!
I can only say that I like Bacon. And I like Donuts. But to combine "Sweets and meats" for me is a no-no. 2 Great things separate sometimes make something terrible when put together. I mean I love Beignets(French/New Orleans style Do-Nuts)... and I love Brussels Sprouts too. But I have no plans to try to mix the two...
Main Point: Crossing certain foods is like crossing the streams of the plasma rays in Ghostbusters. Just don't do it....
The Plan '15 → /// "Run Hard, Live Easy." ∞
Princess Cancer Pants
I often cook my brats in beer, I see no reason the sausages couldnt be.
Brats when not pre-cooked in beer, onions, and Tabasco are not really brats. They are just boring sausage that flares up like hell on the grill and ends up burned on the outside and raw on the inside. I will judge people who don't boil their brats in beer. Generally these are the same people who don't cook anything that isn't bland (hello, West Michigan Dutch).
• Chemo
• Chemo-Radiation
• Surgery
• Return to kicking my own ass by 2018
She was not strong. She was valiant. Radiant. Brave and broken. The beauty she discovered in the aftermath was unparalleled to anything she had known before, because it had come at such a cost.
~ Unknown
Main Point: Crossing certain foods is like crossing the streams of the plasma rays in Ghostbusters. Just don't do it....
I'm not so sure. One morning a while back I looked in the fridge and saw a tube of those Pillsbury crescent cinnamon rolls (the ones that come with the Cinnabon icing) and a package of pre-cooked bacon. Inspiration hit. I opened and unrolled the rolls, inserted a strip of bacon, rerolled, and baked them as normal. The result was borderline genius. Crunchy, gooey, salty, sweet, all the breakfast food groups all together.
Now I'm hungry.
Sit on a potato pan, Otis.
Fight The Future
Main Point: Crossing certain foods is like crossing the streams of the plasma rays in Ghostbusters. Just don't do it....
Agree. Nonetheless, I would be willing to try a Cronut


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Illustrated Shrimp Poster
I'm a science and nature geek. I love research and learning. And I'm an artist so naturally I love this poster. I'm a big fan of illustrated nature posters. When I was little we had some that had fish of various regions. This is a cool one about shrimp. Who knew there were so many.
Hey! I see a sun fish! I love those guys.
Now here's one I must have. I like to collect interesting shells on the beach and I have no earthly clue what they are.
I could definitely spend some time learning more about squid. Like why do they taste so good fried in batter.
Crabs & lobsters, oh my! This is another one I'll put in the kitchen.
I love fish. I had no idea there were this many different kinds of tuna and mackerel. I think I'd hang this one in my kitchen.

subset: commoncrawl


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Pisillo Italian Panini is a Financial District deli we already know does huge, tasty sandwiches. Like the Cagliari, the Roma ($12.90 with sfilatino bread) is a monster sandwich that will leave the hungriest luncher satisfied.
Size aside, the Roma is a solid—if somewhat unbalanced—sandwich. The base is thinly-sliced porchetta, which tastes good enough, but is pretty mild. On any bite with pickled peppers, it gets totally lost. That would be a bigger problem if the peppers weren't so good—sweet and juicy, they're the real star of the show. You could ditch the porchetta entirely and still have a great sandwich. Generously sliced mozzarella and perfectly adequate arugula round everything out.
All in all, I'd call the Roma another win for Pisillo. After two great sandwiches, I can't wait to check out the rest of the menu.
About the author: Rabi Abonour is an editorial intern at Serious Eats. A Midwest native, he's taken up the challenge of exploring New York one bite at a time. You can find him on his blog, Twitter, and Instagram.


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Results 1 to 20 of 43
Ok, so someone in the UK explain to me what's going on with the BBC?
From the limited info i have from the outside, it seems like a totally media generated storm in a teacup. Yet we're getting resignations and people saying "the bbc must change or die".
Am i wrong in thinking that basically what's happened is that some bad stuff went down 30 years ago, a newsnight editor decided not to run a story mildly connected to that, and now a guy who told newsnight that he was abused by a guy (that they didn't name) has said that he had the wrong guy. Is that all?
To be saying that a world respected media outlet that's been making overall pretty great news reporting and investigative journalism (not to mention drama, comedy, etc..) for decades must change or die because of 2 vaguely (and i'm not even sure they were) bad reporting decisions on newsnight seems bizarre. To have people who just started working there resignig over them is even more bizarre.
Is it just a case of the usual media fishbowl and everybody piling on? Or did i miss the part where the modern BBC did something bad?
Apparently the deceased BBC star Jimmy Savile is suspected of molesting children, and a report on that was replaced with a report on how great he was. So now the BBC is accused of trying to cover it up, and whether or not that's true doesn't really matter any more, I think.
This is what I read on spiegel.de, which is a big and competent news outlet of one of the major German newspapers.
Edit: I doubt that the newsnight thing would have made a splash otherwise, mistakes can and will happen. Seen in the above context though, it just adds fuel to the fire.
Editedit: Also I can recommend this post http://botherer.org/2012/11/10/the-b...-is/#more-3125 on Mr. Walkers homepage.
Last edited by Labbes; 12-11-2012 at 02:08 PM.
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Well the Tories naturally want it gone, so that'd be part of the reason people are lining up to slate the BBC.
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The knives have been out for BBC for a long time. Rupert Murdoch hates the BBC, so he usually gets his cabal of tabloid papers to jump on any and all mistakes that the BBC make to try and weaken it. And because David Cameron and the Tories are basically in Murdoch's pocket, you'll find them sneering at the BBC from behind his back.
Edit: Just to add, there is one thing I hate about the BBC, and that's the fact they seem incapable of appointing a Director General with the backbone to tell Murdoch to fuck off, and the ability to deal with these problems. They shouldn't be appointed to stare at the floor and meekly apologise for everything. They should be able to fight the BBC's corner when it's needed and deal with serious issues when they happen.
As much as I detest the Tories and Rupert Murdoch, the BBC do themselves no favours by being so bloody inept sometimes.
Last edited by DiamondDog; 12-11-2012 at 03:07 PM.
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Piers Morgan and Rupert Murdoch attacking the BBC over journalistic standards. Depressing and hilarious.
As pedophilia/child rape is one of the worst crimes one can commit, even the accusation of one is enough to destroy one's entire career and life, especially when it is broadcasted by the BBC, one of the most trustworthy broadcasters in the world.
So a false accusation is a big mistake.
... Which is why I can understand that they replaced the earlier report. Don't know what the problem is with that one.
You'll likely find some better timelines out there, but this has been my reading of the situation...
Last Christmas, Newsnight (one of the BBC's flagship current/political affair shows) shelved a documentary on Jimmy Savile, alleging he was a child molester. Exactly why this was done is still unclear... either they didn't want to 'rock the boat', or it clashed with another BBC documentary about how saintly Savile was, or they didn't want to air allegations against a dead man.
Skip to 6 or so weeks ago, and the accusations against Savile hit pretty much ALL of the British media. Questions were asked of the BBC, not just about why they shelved the documentary about Savile, but about how a figurehead of the BBC could have gotten away with what he got away with for ~50 years without anyone cottoning on. It turns out they didn't... multiple times concerns about Savile were raised, and they were dismissed (note that the BBC were not alone in dismissing/ignoring these allegations, they were also raised with the Police, and it's a pretty safe bet that other news media would have caught wind of the allegations). Along with these Savile revelations, there were other stories about other BBC figures (Leonard Rossiter, John Peel for example) being involved in some unsavoury practices during their time with the BBC. A lot of British media took this as an opportunity to attack the BBC for having a 'culture of silence' that allowed these things to occur.
Then, last Friday (2nd of November) NewsNight aired a documentary accusing a 'senior Tory figure' of being responsible for abuse of children at care homes in North Wales throughout the 1970s. The figure was NOT identified by name on the show (but the accuser/victim did confirm to the shows producers who the figure was, off screen) but it could be argued it was a case of Jigsaw identification... enough information was given for the accused individual to be identified, if the pieces were all put together. Within a few minutes of the show airing, several names were flying around on Twitter and other parts of the net. The most prominent of these names was Lord McAlpine, and the accuser and Newsnight have since confirmed that he WAS the individual they were referring to in the show.
Cut to Friday just been (9th November)... It started with the Guardian breaking a story that Lord McAlpine may have been ID'd mistakenly (that a different member of the McAlpine family who lived locally to North Wales may have been mistaken for Lord McAlpine), and that he had been exonerated of the same accusations twice before. Along with this, a Channel 4 reporter showed that, with the merest of actual journalism, the accusations against Lord McAlpine would have been shown to be false. Also at this time, Lord McAlpine took the decision to release a statement declaring his innocence, and threatening libel against those who identified him as a child molester. That afternoon, the accuser came forward to say that Lord McAlpine was NOT the individual responsible for the abuse... that he had originally been shown a photo of his abuser, by Police, and the Police ID'd the person in the photo as Lord McAlpine.
Several other things came to light from the ensuing shit storm. Firstly, the standards of journalism around the show were appalling. No one thought to check the accusers story, perhaps by showing him a photo of Lord McAlpine (when he was shown one he immediately said "that's not the guy"). In addition, very few of the reporters, police, lawyers etc. involved in the original enquiries were approached (if they had been, the spurious rumour about Lord McAlpine would have been shot down as well). Secondly, McAlpine was given no right to reply. Thirdly, George Entwhistle was unaware of the contents of the show, until after it had aired, and generally there was little in the way of editorial oversight.
BBC shelved documentary about a (almost definite) child molester. BBC aired a documentary impugning an innocent man, using 15 year old rumours which had already been proven false. Some feel the 2nd documentary was rushed/pushed through to 'save face' over the previous failings.
I have to run off to teach a class just now, so I might have missed some things. Here's a decent run down of the situation, but focussing on something called the Bureau of Investigative Journalism, who were the ones ultimately responsible for the documentary, and who were founded/funded by a Labour donor.
is newsworthy in this day and age.
Anyway, this kinda sounds like the Penn State case, except entirely situated on the whistleblowers rather than the culprit (or both).
I'd like to point out that despite the Tories being more inclined to aim at the BBC other politicians are just as quick to attack if they need to cover their own backs. Although this set of stories particularly the shoddy journalism evident in the second (there's still not enough info on the reasons for shelving the Savile Newsnight for me to feel like I have an informed opinion on) are damaging they don't on the face of it seem as bad a time for the BBC as the whitewash of the Hutton report when the Labour government went on the offensive to try and quell the problems of the "sexed-up" Iraq dossier and suicide of David Kelly. Although I guess on that occasion despite the forced resignations and damning criticisms there wasn't such a backlash from the media, with even the usually vehemently anti-BBC Daily Mail seeing the enquiry as flawed.
It is, though, as the initial poster points out, a bit of a media storm in a teacup. Like the majority of gamers reading about "Doritos-gate" they'll think "oh that's not so good is it" and promptly forget about it with their trust/lack of trust in the BBC barely changed.
Have to say I always find it hilarious watching the BBC attempt to report on itself. It's a cringey, awkward exercise for everyone involved made more so by the fact they are painfully aware of just how awkward it is. Though I can't help but feel this whole barrage of reporting deflects somewhat from what really matters; namely ensuring that any victims of abuse feel like they can come forward, talk to the police and hopefully at least see the people who have committed these horrible crimes brought to justice.
To quote the key bits: "Copies of a shelved report into abuse at north Wales care homes in the 1970s and 80s have been found in local council archives."
"...report was not published because council insurers felt it could lead to the authority being sued, and after taking legal advice it was considered the report was not suitable for publication."
EDIT: rereading I see the report was only in 1994 so questionable if it could have prevented any abuse but still, their reason for not publishing is awful
Really?! REALLY!? They didn't think they should publish a report about numerous serious crimes being committed because they might get sued?
While I can understand the twisted thought process behind it, its a poor reflection on the depressing state of humanity.
In terms of the whole BBC thing being a storm in a teacup I'm inclined to agree, is it also just me or does this seem like a depressing extension of the blame culture that has always been present in this country but in recent years seems to have become that much more vitriolic and bloodthirsty. I guess social media has had an impact - and is accentuated by politicians and journalists desire to comment on it to seem 'in touch' - but all too often you see people instantly claiming such and such should be fired and that person should have their title revoked or their pension slashed or benefits withdrawn after (sometimes pretty forgivable) mistakes which are often only evident retrospectively?
Off topic but since I'm writing about things that depress me I was glad someone pointed out this travesty of a daily mail article, mentioning how it was so offensive the Daily Mail had to print numerous pictures and a video just so you could be suitably outraged
Last edited by Timofee; 12-11-2012 at 07:32 PM.
(Some of) Those on the Left, will claim the BBC is a right-leaning, fascist, elitist institution, a propaganda outlet for the 'old boys network' and the 'Establishment' etc.
So, yeah... I think that means they're just doing a good job, most of the time.
Last edited by Unaco; 12-11-2012 at 07:42 PM.
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It really is. Ask Mr Jefferies how it feels to have eight different newspapers writing 40 articles of bullshit about you. Tabloids have to be taken to court to be held accountable. And the Sun wants to talk about slurs? It's pure hypocrisy. I don't even think it's a lack of self awareness, they just couldn't give a fuck.
All the while a serious issue, which should involve more questions being asked of the BBC, is being used in another round of point scoring.
Yup. Hypocrisy.
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As for the current furore, just another example of journalists trying to make the news rather than report it.
Last edited by NathanH; 12-11-2012 at 08:03 PM.Irrelevant on further examination of the rest of the thread.
A much more entertaining and less disturbing article that I always like to point out when pointing out how ridiculous Mail Online is is this 'un (the article on the website appears to no longer work so via Tabloid Watch) - http://tabloid-watch.blogspot.co.uk/...ailonline.html
Last edited by Lambchops; 12-11-2012 at 08:22 PM. Reason: Closing a pesky bracket
Here's pretty decent, if brief, summary, from the BBC itself. that's just come out. It's the summary of the McQuarrie report, that the head of BBC Scotland has prepared over the weekend, and as such it's bereft of any comment, opinion, etc., it is 'just the facts'. Also, the background should include the whole Jimmy Savile clusterf*ck
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Surprised, with this talk of how detestable the Daily Mail is, that no-one's posted this yet. However bad you think the Mail is, it's probably worse.[RIGHT]
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As for the false accusation, it happens, it should be dealt with, the BBC should settle with the person concerned and move on. No need to dismantle the entire BBC.


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THE jury in the trial of a former Blackburn police inspector accused of raping two women has been discharged.
Judge Heather Lloyd, sitting at Preston Crown Court, told the 12 jurors yesterday that the case could no longer continue because of legal issues.
Mustaq Patala, 37, had been charged with 14 counts of rape, three counts of sexual assault and another of perverting the course of justice.
He was facing trial alongside Arif Patala, 35, and Nighat Anwar, 34, both of Blackburn, who were accused of perverting the course of justice. All three denied all allegations.
The trial had been in progress for around five weeks.
Judge Lloyd told the jury there had been problems because information had not been disclosed by the prosecution in advance to the defence.
She said: "The prosecution accept that there have been some failings in the disclosure process.
"This is not a decision I take lightly. I am well aware that this will mean witnesses will have to give evidence once more.
"I am well aware it causes anxiety in each of the defendants. I am also well aware that each of the defendants must have a fair trial."
It is expected a new trial will begin later in the year.


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Round Table Coin GameLogic puzzles require you to think. You will have to be logical in your reasoning.
You die and the devil says he'll let you go to heaven if you beat him in a game. The devil sits you down at a perfectly round table. He gives himself and you an infinite pile of quarters. He says, "OK, we'll take turns putting one quarter down, no overlapping allowed, and the quarters must rest flat on the table surface. The first guy who can't put a quarter down loses." You guys are about to start playing, and the devil says that he'll go first. However, at this point you immediately interject, and ask if you can go first instead. You make this interjection because you are very smart and can place quarters perfectly, and you know that if you go first, you can guarantee victory. Explain how you can guarantee victory.
AnswerYou place a quarter right in the center of the table. After that, whenever the devil places a quarter on the table, mimic his placement on the opposite side of the table. If he has a place to place a quarter, so will you. The devil will run out of places to put a quarter before you do.
What Next?
See another brain teaser just like this one...
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which ones you have seen, and even make your own.
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AC/DC 1000 Piece Puzzle: AC/DC jigsaw puzzle offers all the memorable moments in this hard rock band's career. This 1000-piece puzzle measures 27" x 20" when complete. For ages 14 and up. UPC: 184709652217


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Card Suit Cutters by Lindy Smith
If you have a gambling guy, Vegas visitors or Alice in Wonderland fan that you bake for these card suit cutters are a must have. They lend themselves wonderfully to decorating cakes (when used to cut fondant shapes) or making cookies (I think cookie jam sandwiches in card suits would be perfect for a tea party). If you want a peak, take a look at the other picture that in this recommendation.


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Great video there, Steve. I totally enjoyed that!!!
Hey Steve, Have a blast with Tyler!! I'm certain you will and I can't wait to see the photos! All is well here with both Gary and I. Glad you are back riding again. It's soooo much fun to see your posts!
Hi Steve, it's been too long. I was just thinking of something you said about flying missels and had to smile and let you know about ours. They are about as smart but bigger. A friend and I were riding on a big gravel road in south east Oregon doing 55mph or so and a deer jumped right in front of me out of thin air. It came from the left and I hit it in it's mid section. The bike went right and I went down and slid and slid. All my gear did the job very well. One tear in the pant knee and helmet trashed .Jacket near unhurt. My injury was broken left little finger and bad sprain left ankle. Could have been much worse. Finger is fixed with 4 screws and therapy ongoing to ankle. Bike is another story. I'm still looking for a front fender but most other things are repairable.
So, just a line to let you know we're ok here.
Ride safe.
Norm Rickey
HAPPY HAPPY BIRTHDAY to you Steve !!
Family fun - woo hoo !!
I thought about you guys when I was out on the bike on Sunday , particularly whe I was visiting Chipping Campden , I just know you would love that place - so much history , fine architecture and hidden nooks to investigate .
Looking forward to some more of your ride reports and photos real soon ,
Take care both ,
Thanks Steve...a very Merry Christmas to you and yours as well!! We are quite content having returned to CA. My sons will both be with us as well and one daughter in law and two grandboys!! A lovely family holiday!
Happy New Year too and I hope this coming year will shower fortune on us all!!
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text:
Without Autopsies, Hospitals Bury Their Mistakes
Hospital autopsies have become a rarity. As a result, experts say, diagnostic errors are missed, opportunities to improve medical treatment are lost, and health-care statistics are skewed.
When Renee Royak-Schaler unexpectedly collapsed and died on May 22, no one ordered an autopsy.
Not the doctors at Howard County General Hospital in Columbia, Md., where the 64-year-old professor and cancer researcher was pronounced dead.
Not the Maryland Office of the Chief Medical Examiner, which passed on the case because no foul play was involved.
And not Royak-Schaler's physicians at Johns Hopkins University School of Medicine who had diagnosed cancer in her hip two days beforehand but acknowledged they didn't know what had caused her unforeseen death.
A half-century ago, an autopsy would have been routine. Autopsies, sometimes called the ultimate medical audit, were an integral part of American health care, performed on roughly half of all patients who died in hospitals. Today, data from the Centers for Disease Control and Prevention show, they are conducted on about 5 percent of such patients.
As Royak-Schaler's husband, Jeffrey Schaler, discovered, even sudden unexpected deaths do not trigger postmortem reviews. Hospitals are not required to offer or perform autopsies. Insurers don't pay for them. Some facilities and doctors shy away from them, fearing they may reveal malpractice. The downward trend is well-known — it's been studied for years.
What has not been appreciated, pathologists and public health officials say, are the far-reaching consequences for U.S. health care of minuscule autopsy rates.
Diagnostic errors, which studies show are common, go undiscovered, allowing physicians to practice on other patients with a false sense of security. Opportunities are lost to learn about the effectiveness of medical treatments and the progression of diseases. Inaccurate information winds up on death certificates, undermining the reliability of crucial health statistics.
It was only because of Royak-Schaler's connections that her case ended differently. Her colleagues at the University of Maryland School of Medicine urged her husband to authorize an autopsy and volunteered to conduct it for free.
In her case, as in so many, the autopsy revealed a surprise: Royak-Schaler, the renowned cancer researcher, had cancer ravaging her body — in her lungs, kidneys, abdomen and the marrow of her bones. A blood clot, likely related to the tumors, caused her sudden death.
Jeffrey Schaler has wrestled with anger that his wife wasn't diagnosed sooner but said knowing how she died was better than not.
"There's a sense of peace that accompanies that knowledge," he said.
For the last year, ProPublica, PBS "Frontline" and NPR have probed America's deeply flawed system of death investigation, focusing primarily on forensic autopsies, which are conducted by coroners' offices and medical examiners when there is suspicion of an unnatural death. State laws vary, but the preponderance of deaths that occur in hospitals are considered natural. When deaths are unexplained, unobserved or within 24 hours of admission, hospitals may be required to report them to local coroners or medical examiners, but such agencies rarely take hospital cases.
Hospital physicians, with consent from patients' next of kin, may order a clinical autopsy to explore the disease process in the body and determine the cause of death. That was the norm 50 years ago, when the value of the autopsy was considered self-evident.
"Much of what we know about medicine comes from the autopsy," said Dr. Stephen Cina, chairman of the forensic pathology committee for the College of American Pathologists. "You really can't say for sure what went on or didn't go on without the autopsy as a quality assurance tool."
Yet, autopsy rates at teaching hospitals, which are typically run on a nonprofit basis and have an educational mission, hover around 20 percent today. At private and community hospitals, which constitute 80 percent of facilities nationwide, rates can be close to zero.
"I know new hospitals are being built these days without a place to do an autopsy," said Dr. Dean Havlik, the Mesa County, Colo., coroner, who estimated that the overall hospital autopsy rate in his area is less than 1 percent.
Hospitals have powerful financial incentives to avoid autopsies. An autopsy costs about $1,275, according to a survey of hospitals in eight states. But Medicare and private insurers don't pay for them directly, typically limiting reimbursement to procedures used to diagnose and treat the living. Medicare bundles payments for autopsies into overall payments to hospitals for quality assurance, increasing the incentive to skip them, said Dr. John Sinard, director of autopsy service for the Yale University School of Medicine.
"The hospital is going to get the money whether they do the autopsy or not, so the autopsy just becomes an expense," Sinard said.
Since a 1971 decision by The Joint Commission, which accredits health-care facilities, hospitals haven't had to conduct autopsies to remain in good standing. The commission had mandated autopsy rates of 20 percent for community hospitals and 25 percent for teaching facilities, but dropped the requirement. Many hospitals were performing autopsies "simply to meet the numbers" and not to improve quality, said Dr. Paul Schyve, the commission's senior adviser of health-care improvement.
Doctors, too, have gravitated away from autopsies because of growing confidence in modern diagnostic tools such as CT scans and MRIs, which can identify ailments while patients are still alive.
Still, in study after study, autopsies have revealed that doctors make a high rate of diagnostic errors even with increasingly sophisticated imaging equipment.
A 2002 review of academic studies by the federal Agency for Healthcare Research and Quality found that when patients were autopsied, major errors related to the principle diagnosis or underlying cause of death were found in one of four cases. In one of 10 cases, the error appeared severe enough to have led to the patient's death.
"Clinicians have compelling reasons to request autopsies far more often than currently occurs," the agency concluded.
Schyve called the findings of such studies flawed because cases in which autopsies are performed are typically the most complex, making diagnostic errors more likely. The overall error rate is far lower, he said.
But Sinard said so few autopsies are being conducted — one survey found that 63 percent of hospitals in Louisiana performed none in a given year — that doctors and hospitals can't say for certain how patients are dying. "They've never checked," the Yale pathologist said.
Pathologists interviewed by ProPublica said they often find diagnostic errors. "We often identify things that the imaging study could not," said Dr. Debra Kearney, director of autopsy pathology at Texas Children's Hospital.
Autopsies can also be a crucial tool for evaluating and improving medical care.
Dr. Elizabeth Burton, deputy director of the pathology department at Johns Hopkins University School of Medicine, said performing autopsies on patients who have died of hospital-acquired infections helps save others. Infection clusters "go in waves" in hospitals, she said. Physicians have used her findings to change antibiotic regimens, snuffing out the bacterium.
Dr. Renu Virmani, president and medical director of the nonprofit CVPath Institute, has used postmortem examinations to help reform the treatment of heart disease. Virmani and her team have collected about 250 specimens of metal stents removed at autopsy from patients who had procedures to clear blockages from their arteries.
Their work showed that, in certain patients, a type of stent designed to reduce the risk of blood clots was causing delayed healing, inflammation and reactions that could be fatal. As a result, patients who receive these stents are now required to take blood-thinning medication for a year after the procedure.
Sitting in her lab in Gaithersburg, Md., Virmani peers through a microscope at a specimen slide taken from a 61-year-old man who died suddenly in 2004, about four months after receiving a clot-resistant stent. She points out signs of inflammation in the cross-section of his stented artery, describing the swirls and grains, stained pink and purple so they stand out on the slide. The autopsy showed that the stent had led to the patient's fatal blood clot.
Autopsies should be used to evaluate the effectiveness of other therapies, Virmani said, from chemotherapy to heart-valve replacements. "The only way to learn is through autopsies."
Hospital autopsies are even rarer when patients older than 60 die in hospitals, representing a lost opportunity to learn about age-related diseases, Burton said. More than 684,000 such patients died in hospitals in 2008 — more than one-quarter of the total deaths in the country — and just 2.3 percent were autopsied, CDC data show.
Without autopsies to confirm patients' precise causes of death, public health officials say, the health-care system overall suffers. Erroneous information sometimes ends up on death certificates. Broad categories of disease such as cancer are probably accurate, but specifics such as the type of cancer may not be, said Robert Anderson, chief of the mortality statistics branch of the CDC's National Center for Health Statistics.
"These data are used to set public health priorities, to develop public health programs and allocate resources," Anderson said. "We do the best that we can given the information we have, but if you put bad information into the system, you're going to get bad information out."
In 1999, the Medicare Payment Advisory Commission, or MedPAC, which advises Congress about Medicare, issued a report stating that increasing the rate of clinical autopsies could improve health care and reduce errors.
The report recommended paying pathologists directly for autopsies and giving hospitals bonuses or penalties for hitting or missing target autopsy rates. The advisory group also suggested that Medicare change its hospital regulations to encourage more autopsies and use them as a standard of performance.
But Medicare has not acted upon these recommendations. An official from the Centers for Medicare & Medicaid Services declined ProPublica's request for an interview, saying the use of autopsies in hospitals "is not within [Medicare's] bailiwick at all."
Other organizations that advocate for better medicine, such as the Institute for Healthcare Improvement, National Quality Forum and The Joint Commission, have not pushed for higher levels of autopsies, either, despite the widely held belief that this could produce improved care.
Raising the rate "is not one of our priorities by any means," The Joint Commission's Schyve said.
Dr. George Lundberg, a pathologist and one of the country's most vocal advocates for increasing the autopsy rate, shakes his head when discussing the medical industry's apathy about low autopsy rates. Lundberg, the editor of the journal MedPage Today, said The Joint Commission should re-establish mandatory autopsy rates "like they used to have back in the good old days of quality when we weren't running away from trying to find the truth [about] our sickest patients."
One way to shake the complacency, various experts told ProPublica, would be for insurance companies and the government to pay for autopsies. But an official from UnitedHealth Group, the largest health-insurance company in the country, said the autopsy is not reimbursed because it "isn't a procedure that would prevent or treat a sickness or injury" in a patient.
Virmani called this shortsighted. The cost of an autopsy is small relative to the money spent on drugs, treatment and diagnostic imaging, she said, and the payoff could save lives and money.
"We are letting go of something which we could really use tomorrow to improve the health care of patients," she said.
30 comments
When I was an Internal Medicine resident in the early 1980's, we were routinely expected to ask families for autopsies, especially in situations of sudden death. The trickiness was determining when to get the medical examiner involved.
As mentioned, cause of death would be verified, improving public health records. But incidental findings (for example, unrecognized cancer) could be important for family history.
If the rate is 20% in academic institutions now, I would be very interested to know how these rates have declined in the last few decades.
For families who are concerned that their loved one's care was compromised, this is deeply disturbing. It is not in the hospital's best interests to recommend an autopsy. I hope that there are no out-of-pocket costs for an autopsy.
ProPublica's "Dollars for Docs" shows the willingness of doctors to unnecessarily prescribe medications that kill or injure more than a million Americans annually. If those injuries and deaths were treated as criminal assaults, I expect the number of homicides to skyrocket in the US.
Unfortunately, local, state and federal law enforcement are as reluctant as the reckless docs who accept pharmaceutical kickbacks. If Hezbollah and al Qaeda injured and killed this many Americans each year, the President and Congress would declare war. Unfortunately, companies like GlaxoSmithKline and Ely Lilly fund many of their political campaigns.
Clark Baker, OMSJ
LAPD (ret)
Why would hospitals encourage autopsies when so many might reveal malpractice (failure to diagnosis and treat), overtreatment or hospital acquired infections as the cause of death?
As Mr. Baker points out, with so much political campaign funding coming from the medical community big guns (pharmaceutical, insurance and professional organizations like AMA), why would our elected officials even broach the subject?
The documentary "Hot Coffee" aptly describes how widely even our judicial system is being compromised by these same influences.
As a U.S. citizen who became disabled unnecessarily due to medical error with no money to pursue recourse for actual damages or suffering, I no longer believe we have any consumer protections.
As I see it, there are Three good reasons why we don't perform more autopsies: The first reason was mentioned in the story; that since 1971 hospitals no longer are reguired to maintain a 20% autopsy rate to keep their accreditation. The second reason, also mentioned in the story, is that insurance companies do not pay for the procedure. The third reason, which was not mentioned, is that autopsy results may cost hospitals and doctors(and their malpractice insurance carriers) big bucks if the results provide evidence of medical errors.
In the immortal words of Deep Throat,"Follow the Money."
The situation in the US is alarming, because causes of death are a scientific information very useful to drug manufacturers; M.D.'s and hospital ( "is Dr.X more often than Dr.Y mentioned in causes of death from a similar pathology"?)
What about the situation in EUROPE?
At our medical center, and on our medical service, we actively seek ways to detect unsafe conditions and errors, so that we can improve care. When we find errors, we discuss them in open forums, so that what we learn about improving the quality of care can be spread to all parts of our service, and our hospital.
When a patient dies and we are able to obtain an autopsy, we always learn something that can improve the care of the next patient. We regularly urge our residents and staff physicians to seek autopsies, and they do seek them frequently; too often they are refused by next of kin. Increasing the frequency of autopsies will require that we change public attitudes about them, and make it clear that what we learn from autopsies helps improve patient care.
How are you possibly going to maintain the fiction that you're "the best medical system in the world" - and so worth every penny of the highest medical costs in the world - if you go around letting people accumulate autopsy evidence that disputes it?
There is something about that phrase "autopsy results" that adds a certain emphasis to a statement disputing that fiction, I might add.
Malpractice issues may not be as important as is generally supposed. In general, medicine is practiced at a high level and actual malpractice judgements based on autopsy information are exceedingly unusual. The opposite situation may pertain: juries may decide against a physician whose patient has died on the assumption that "he/she buried the mistakes" by not having an autopsy performed.
There are other significant reasons for the decline in the utilization of this highly valuable, always instructive, inexpensive method for studying death and, equally important, for studying the pathophysiology of disease and the efficacy and effects of treatments and procedures:
1. Physicians have placed so much trust in modern, highly expensive, not completely reliable imaging methods such as MRI that they no longer recognize the possibility of significant diagnostic discrepancies which still occur in as many as 10-20% of people who die in hospitals.
2. The discipline of Pathology has been significantly de-emphasized in medical education and many medical students and young physicians have never even witnessed an autopsy.
3. In today's highly specialized medical practice world there may not be a physician with whom the patient's family can identify as "the" physician, and they may not be comfortable with a relatively impersonal request for permission to perform an autopsy.
4. Department leaders at academic centers, particularly those in internal medicine as well as pathology, who are engaged in administrative or research activities, have little or no interest in the autopsy. In our own institution neither the chair of the medicine department nor the chair of the pathology department have attended autopsy conferences.
5. Most pathologists have little interest in the autopsy. It is a time-consuming, intellectually demanding, sometimes physically difficult activity that is not remunerated and not appreciated. The busy pathologist must tend to other demanding activities such as surgical pathology, cytopathology and clinical laboratory testing where he/she handles a large volume of cases. Many hospitals in the United States no longer have a facility in which to perform autopsies.
6. Public education about the usefulness of the autopsy, including the considerable value to surviving family and friends in terms of their healing through knowledge of the actual events of illness and death, is almost nonexistent. Autopsy is not a topic discussed on talk shows. The major pathology organizations have not committed significant money or effort to public education. Hence survivors are concerned about possible mutilation to the body (which does not occur), possible delays in burial (which are not necessary) and possible expense (which does not pertain in teaching hospitals). The physician with whom the survivor interacts is generally uninformed about these matters.
7. Perhaps most alarming is the fact that most young pathologists do not know how to perform an autopsy well. Their teachers are usually not interested and may themselves be inexperienced and, without the benefit of something like a regional autopsy center, they have almost no experience.
One of the solutions, mentioned in the article, is to establish regional autopsy centers where pathologists interested in the autopsy as a scientific discipline can practice and continue to learn, where autopsy can appropriately function as a distinct specialty in and of itself with opportunities for ongoing research, and where costs to the health system can be minimized.
Emily O'Rourke, M.D.
Stephen A. Geller, M.D.
Department of Pathology and Laboratory Medicine
Cedars-Sinai Medical Center
Los Angeles
Wow…very pedagogic way to poo-poo not just autopsies but pathologists and their current practices.
Guess they'll have to throw out all murder convictions based in part or entirely upon pathology reports.
Continuing to perpetrate the many fictions associated with the autopsy and its supposed value is of no use to anyone. If there was anyplace that evidence based medicine is lacking it is the autopsy. Cutting up the dead to reveal their secrets has been romanticized by television, film, journalists and salaried academic pathologist alike. I've had to listen to Dr. George Lundberg pining for "the good old days" for 25 years. Enough already!
Drs. O'Rourke and Geller continue this nonsense.
1. Can the autopsy be an "inexpensive method for studying death" and simultaneously "a time-consuming, intellectually demanding, sometimes physically difficult activity". Really? The truth is that they are an EXPENSIVE, time-consuming, intellectually demanding, sometimes physically difficult activity.
2. There is a reason "Department leaders at academic centers, particularly those in internal medicine as well as pathology, who are engaged in administrative or research activities, have little or no interest in the autopsy." Show me the significant medical advances from the last 50 years that derived their data principally from autopsy based studies. It's slim pickings. Autopsy studies, even the best ones are virtually all retrospective studies and subject to all the problem and biases of retrospective studies in other areas of medicine. If you are serious about the autopsy and not just blowing wind, show me your rejected grant application for a prospective autopsy study. $100 bucks says you can't.
3. The abuse of patient families at a time of great emotional vulnerability that occurred prior to 1971 is conveniently overlooked. A hospital chaplain who routinely brought chaplaincy trainees to the morgue at a 900 bed training hospital told me that a substantial amount of his time in the pre 1971 era was spent counseling families who regretted giving consent to an autopsy because they though they "had to".
3. The idea that physicians are hiding malpractice is just foolish nonsense. In over 500 autopsies over 20 years as a community pathologist and medical examiner I can confidently say the number of cases of previously undocumented medical malpractice is vanishingly small. Exculpatory evidence is far more often the case. Unexpected significant medical finding are also rare and close reading of most autopsy studies bears this out.
4. Oh and by the way Mr. Allen, only a medical examiner can "order an autopsy", and then only under the specified statutory guidelines. The clinical doctors at Howard County General Hospital might have requested an autopsy consultation from their pathologist. When journalists and clinicians by their language treat pathologist as peons rather than professionals, its hardly a surprise that "most pathologists have little interest in the autopsy".
I could go on and on, but I'm on my dime.
I agree in part with Dr. Krzymowski that autopsies are not necessarily effective in identifying the cause of death. For instance, my mom had cancer but the autopsy my sister insisted upon said she died of kidney failure.
Another friend went to the hospital ER and shortly thereafter ended up in a coma. The cause of death on the autopsy: She stopped breathing. I'm not kidding.
Having trained as a clinical chaplain, I see a few things lacking in the article and in the comments:
1) How does an autopsy interact with a family's grieving process?
2) How do changing views of death, soul, body, and spirituality in the US interact with a family's choice of whether to do an autopsy?
2) Relatedly, how does the decline of autopsies correspond to the increased emphasis within those same decades on the rights of patients and their families to ask for the care they want and decline the care they don't want? (This gets into the question of public education on the usefulness of autopsies that Drs. Geller and O'Rourke raised.)
I was in private practice as a pathologist for 14 years. A major reason autopsies are not done in the private sector is: they are a loss leader. As alluded to above, no one wants to pay the pathologist for his or her professional time. Autopsies are difficult to perform, physically demanding (especially if the patient is obese), and time consuming. And if the patient is HIV + or has hepatitis, they are not without risk to the pathologist. Small wonder most pathologists would rather be in their offices signing out cases which provide remuneration. When families request an autopsy, the pathologist additionally fears litigation—not necessarily being sued personally, but being subpoened, dealing with depositions, time in court—all in an era when hospital pathology departments, like every place else, are down-sizing. Time away from the lab means either more work for the partners, or late nights after a day or two in court. Who can blame the pathologists for not wanting to spend time in the mogue any more? It is sad, because, as Dr Lundberg correctly notes, much can still be learned in the morgue. Clinical diagnoses are sometimes wrong—not because of malpractice, but because there is still much doctors do not know, in spite of advanced imaging technologies. Radiologists are not quite ready to replace pathologists completely.
I completely agree with George Lundberg and Renu Vermani (both mentors of mine in the now increasingly distant past…). Unfortunately, as with government, the American public gets the health care system it wants to pay for, or maybe it deserves. If insurance companies heard from enough of their clients that autopsies should be a covered benefit, they might reconsider. If the Joint Commission thought it was important, things might change. If our Congressmen thought it was important, things might change. Few of them even know what pathologists do, let alone have interest in the ins and out of autopsy pathology. But until there is a collective societal agreement that this is important, nothing will happen, alas.
Strong agreement with Drs. O'Rourke and Geller and their reasons for why autopsies are not performed.
In my geriatric practice, I invariably requested autopsies on my patients, giving the reason to families that "There is one more important thing that your mother/father can give to us and help us by. Nearly always he/she has something more to reveal than what we diagnosed in life. And finding and knowing that keeps us humble." I rarely had a refusal.
But when I attended my last autopsy of one of my patients, who had been under care of the medical residents, I asked the lone pathologist, "Where are the residents?" They wait for the images, I was told (of pictures on a screen in a comfortable conference room).
This parallels what Verghese wrote about in the NEJM, of the preference for teaching and therefore learning to be conducted away from the patient, alive (or dead!).
cf. that marvellous image of the Bologna medical school autopsy (the physicians being pressured by the law faculty to perform them). The professor is far away from the body; a menial does the crude dissection while physicians maintain a 'no-contact' observation. And read Charles Singer's comment!
So, after decades of involvement, I see us as being undone by our confidence in images and abstractions, away from the flesh. And don't blame the (quite marvellous) technology for this regression in the manner of our observing. Medicine has always preferred a practice of some distancing, shall we say, in its conduct towards the sick. Rare have been the Pares and Vesaliuses.
And not by the way, conducting autopsies as fault-finding (except for forensic reasons) is not the principal reason.
people have to die. why does data?
The comments make disheartening reading; they describe a medical community evolving away from being "hands on" physicians and into self-distancing technicians. That doesn't bode well for patient care - whether you're alive, or dead.
And it certainly hasn't shown any efficacy at controlling costs.
"plus ça change, plus c'est la même chose" (The more things change the more they stay the same). - Jean Baptiste Alphonse Karr - 1808 - 1890.
At the end of WWII I attended a lecture on statistics in London by a world renowned epidemiologist. One of the things he told us was: "If you can't find anything wrong with a patient - dead or alive - and learn from it then you haven't looked long or hard enough."
There is no honesty in medicine anymore. It's all above covering up the truth and ordering the most profitable treatments and drugs while patients are alive so why would they want an autopsy. Even pathologists have been trained to be willfully ignorant. It's the paradigm of the medical industrial complex that is the problem. We don't want to know that mercury poisoning kills, pesticides kill, that GMOs kill, that gadolinium based contrasting agents kill and that radiation kills. The results of autopsies don't tell us anything. This one died of cancer so what, what caused the cancer in the first place? Those are questions we need answers to but they are not forthcoming. And I blame the doctors for not being honest and bringing attention to what are the true causes of illness and death.
Can any of the doctors that posted here tell us why we don't yet know what causes autism, RA, MS, Lupus, CFIDS, FM, scleroderma or cancer? I think it's because someone is liable for these diseases and rather than admit the truth or look for the likely culprit you stick your head in the sand and spew meaningless academic explanations about nothing. In my opinion you are a useless profession. The country would be better off if we didn't have doctors at all for all the good you do today. There are a few good ones left and but even they have been silenced.
I agree with Dr. Branton, that you get what you pay for. The pathologists in my hospital are happy to perform an autopsy… as long as they are paid in full up front. Billing the patient is of course problematic. This naturally, is where any further discussion from the interested party ceases. Behind the indignation here at "pro publica" is the implication that this information should be "pro bono".
You're wrong Sud, my indignation comes from being poisoned by doctors and PhRMA but by all means keep blaming the victims of the medical industrial complex and stay safe in your little bubble. This model/bubble is unsustainable and is the next bubble to burst whether you think it will or not.
This conversation reflects the epitome of what is going on with U.S. healthcare. I speak as one who became unnecessarily disabled at the height of my career at age 50 (several years ago) due an undiagnosed intestinal blockage. I had the necessary surgery this past October thanks to Medicare. Had I not had this surgery, perhaps the problem would have been discovered during an autopsy, but I think not.
What I learned from years of investigating the U.S. medical system in order to get the care I needed was that there are excellent physicians out there with the knowledge and will to help who find a way to get paid within the system. They are as scarce as hen's teeth. The way it is now is that Medicare is left picking up the tab on private industry's failures for those astute and stubborn enough to find that elusive physician.
When my close relative passed away few years back, biggest hurdle and reluctance to grant permission to do autopsy was from immediate family members as they didn't want to see the mutilated body of our relative during Wake Ceremony.
The fact is that after even after autopsy the body can be sewn back to almost perfect state without any visible mark of dissects.
I am impressed by Dr. Virmani and her staff for pioneering the effort for doing autopsies in hospitals. As a practicing NP, I do suggest the grieving families for autopsy of their lost relative in order to predict and diagnose their disease.
I would like a sticker I can put on my license next to my organ donor sticker stating that upon my death I insist on being autopsied, no matter how I died.
I think you picked a bad example to try to make your point. With condolences to Dr. Schaler on the loss of his wife, I find it a little hard to believe that, having found a bone metastasis, her Hopkins doctors wouldn't have known that she had cancer in other areas of her body. The first test ordered after such a finding would be a head-to-toe CT scan or PET/CT scan which would have revealed the same findings as the autopsy. Sudden death in such a patient is almost always due to pulmonary embolism—again a piece of knowledge that doesn't require an autopsy. Unfortunately, knowing these facts wouldn't likely change the treatment, or the poor prognosis of such a patient.
I'm sure that Sharon is frustrated at the slow pace of medical discovery in some areas. However, it is unfair to point out only conditions wherein the causes are not yet known and to indict the entire medical/scientific profession for lack of trying (not to mention greed). Rigorous medical science and discovery take time. One can point to many conditions where causes have been discovered. For example, scientists very quickly found that HIV is the cause of AIDS. Finding the viruses causing measles, mumps, rubella, and polio and the bacteria underlying diphtheria, meningitis, and other diseases has led to effective vaccines. Discovering the intricacies of bacterial metabolism has led to effective antibiotics. The cholesterol hypothesis of heart disease has resulted in drugs that can help prevent coronary artery disease. The underlying mechanisms leading to various cancers has made some of them treatable (eg., HER2-positive breast cancer, chronic myelogenous leukemia) or even curable (eg, Hodgkin disease). Epidemiological and metabolic studies have revealed lifestyle as a major factor in disease prevention. I suggest Sharon give adequate acknowledgment to what has already been accomplished and that with adequate funding and continuing education of clinicians and scientists that such progress and more will occur in the future.
I counsel for a reasonable balance ...
As a pathologist, having to do an autopsy on an HIV/Hep. C infected patient to give the family no new information about why the patient died and, realistically, not change anything in clinical practice represents a waste of time, a waste of resources, and an unfair risk of myself contracting a devastating disease
I look at autopsies as a test. With any test, we evaluate sensitivity and specificity with regard to its result. We don't just order medical tests at whim because we want to utilize resources (e.g. time, money, man-power) effectively. If the utility of a test overall does not outweigh its cost, then we don't perform it. The lay-public wants every test ordered, and they feel cheated if everything hasn't been ordered.
But that's not how medicine is supposed to work. So, autopsies on patients with HIV/Hep. C? Autopsies on patients with clear clinical evidence of an myocardial infarction? Autopsies on patients with clear clinical evidence of metastatic cancer? What's the point? We have already learned about these processes, and I encourage anyone to pick up a pathology textbook as proof.
The only autopsies that are worth doing are:
— Surgical or other iatrogenic mortality
— Sudden cause of death in an otherwise healthy person (especially child)
— Reason to suspect a genetic disorder which may affect family members
Even in these instances, autopsies should be restricted in what organs are examined (rather than cutting out all the organs and the brain when the chances of finding anything RELEVANT are remote).
We don't (at least shouldn't) CT scan everyone when they are alive. Why should we do the physical equivalent in someone who is dead?
I counsel for a reasonable balance ...
As a pathologist, having to do an autopsy on an HIV/Hep. C infected patient to give the family no new information about why the patient died and, realistically, not change anything in clinical practice represents a waste of time, a waste of resources, and an unfair risk of myself contracting a devastating disease
I look at autopsies as a test. With any test, we evaluate sensitivity and specificity with regard to its result. We don't just order medical tests at whim because we want to utilize resources (e.g. time, money, man-power) effectively. If the utility of a test overall is not clinically indicated or does not outweigh its cost, then we don't perform it. The lay-public wants every test ordered, and they feel cheated if everything hasn't been ordered.
But that's not how medicine is supposed to work. So, autopsies on patients with HIV/Hep. C? Autopsies on patients with clear clinical evidence of an myocardial infarction? Autopsies on patients with clear clinical evidence of metastatic cancer? What's the point? We have already learned about these processes, and I encourage anyone to pick up a pathology textbook as proof.
The only autopsies that are worth doing are:
— Surgical or other iatrogenic mortality
— Sudden cause of death in an otherwise healthy person (especially child)
— Reason to suspect a genetic disorder which may affect family members
Even in these instances, autopsies should be restricted in what organs are examined (rather than cutting out all the organs and the brain when the chances of finding anything RELEVANT are remote).
We don't (at least shouldn't) CT scan everyone when they are alive. Why should we do the physical equivalent in someone who is dead?
I am a board-certified pathologist with a combined 30 years practice experience. Apologias for autopsies have cropped up again and again over my career. What I have never seen, though, is any evidence that the autopsy really is the "gold standard" in medical diagnosis. It is clearly very good for making some diagnoses (bullet wound to the heart, pulmonary thromboembolism) but next to worthless for making others (death by poisoning, arrhythmias, early myocardial infarcts, hemodynamics disturbances [such as shock], and sepsis, to name a few). The fact that the autopsy has enjoyed such an exalted status has provided undue license to autopsy pathologists, especially forensic pathologists, to elevate their wild speculation on cause of death to ultimate finality. In the era of excellent medical imaging and clinical laboratory tests, we need to relegate the autopsy to the level of that of one of many diagnostic tools that can be used or misused, depending on the skill of the physician who uses it.
Excellent job at not letting actual facts get in the way of a good narrative, Marshall.
As a now disabled (thus forcibly retired) RN, BSN, clinical MSW, & MAT-educated teacher, I am SO GRATEFUL for your work! You keep focusing on topics that other media will NOT investigate, such as the amount of deaths being caused by indifferent, incompetent, unethical, irresponsible health care systems, groups, & individuals, across the USA!
In my 25+ years practicing as a clinical RN, BSN, the amount of malpractice I personally witnessed, let alone saw documented in one patient chart after another, HORRIFIED ME! I had no way of knowing, that the same disastrous health care system (which has run amok in Oregon, since the late 1980's), would lead to me becoming severely & permanently disabled, myself six years ago.
There are several MAJOR changes that MUST be made to the USA's current health care system, IMHO, if ANYONE here is to consistently receive quality health care. The first involves regular (at least every 5 years) ongoing re-licensure testing (theoretical & "hands-on"), for all licensed/certified health care providers (of ANY type).
It's MUCH too easy, for currently licensed health care providers to ignored, overlook, and/or pay minimal attention to issues of lifelong continuing education. I'm capable of & have been actively engaging in "medical (MD) continuing education" opportunities. It's such a laughably simple process, it makes me NAUSEOUS!
Most of their "continuing education articles" require them to only answer TWO questions, after skimming through the article. They are free to answer those TWO questions, as many times as they wish, UNTIL they answer 70% or higher on the "test questions"! All this, while they're, simultaneously, allowed to re-read the same article, over & over, until they get the TWO questions CORRECT!
In my professional experience, most elementary students could pass any "test" like THAT! Yet we wonder why our nation's health care system costs SO MUCH & gives such poor results. Instating mandatory complete autopsies would so enlighten the general public, (as to all of the health care issues that MDs are ignoring/ignorant of), I believe the outcry to Washington, D.C. would be deafening!
Right now, nearly the entire focus within our health care system, is on people at the top getting as wealthy as they can, as quickly as they can. The Scrooge-like attitudes toward patients & the general public, are so blatant (at least here in Oregon!), that RNs have been leaving the profession in DROVES.
Patients are now treated as "disposable goods", rather than as soul-filled beings. The health care workers on the "front-lines" (particularly the RNs, PTs, OTs, S/LPs. RTs, CNAs), are expected to pick up ever-enlarging numbers of patients to care for, during the same periods of time, for less money/benefits, & with minimal educational help from their mega-wealthy employers!
I made LESS money, at the end of my RN career, than I did newly out of nursing school in 1984. My experience is the NORM, within the world of nursing, but most people choose to forget that RNs even exist. If you doubt this, think back to the hours of 9/11 media coverage that occurred, in 2001.
Did you witness a SINGLE RN being interviewed by anyone? No one, typically, recalls EVER seeing RNs anywhere, during that terrible time in our nation's history. Yet, I know that RNs are STILL taking care of the survivors of those plane crashes, to this day! That's what WE DO. At the same time, most people do not know that RNs are #2, in the USA, in terms of "on the job" injuries. We're so easily ignored/forgotten.
It's time for licensed professionals to be held responsible for maintaining their CLINICAL credentials. Otherwise, they need to "retire" their licenses, IMHO. Clinical credentials need to be repeatedly demonstrated, at least every five years (we have to undergo CPR training, every 1 - 2 years).
Though the very same "managers" will, undoubtedly, squack LOUDLY about the "costs" involved, I would feel comfortable any time, showing them the "costs" involved, in NOT requiring such ongoing standards! They have been piling up, all over my home, ever since my 72 year old surgeon butchered me so badly, during a "minor" procedure to remove a kidney stone, that I am now partially paralyzed on my left trunk, have a large "flank bulge" hanging off my left side, am on the brink of requiring kidney dialysis, am in severe/chronic pain, & experiencing other complications.
Thank you for doing your part to bring these major issues to light, Propublica!
Commenting on this story is closed.
Post Mortem: Death Investigation in America
A year-long investigation into the nation's 2,300 coroner and medical examiner offices uncovered a deeply dysfunctional system that quite literally buries its mistakes.
The Story So Far
In TV crime dramas and detective novels, every suspicious death is investigated by a highly trained medical professional, equipped with sophisticated 21st century technology.
The reality in America's morgues is quite different. ProPublica, in collaboration with PBS "Frontline" and NPR, took an in-depth look at the nation's 2,300 coroner and medical examiner offices and found a deeply dysfunctional system that quite literally buries its mistakes.


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Any form of news or commentary coming from any media organization owned by Rupert Murdock. The sensationalistic and invasive mindset of the Murdock media empire invites slanted, propagandist material released as solid news. What goes into the media empire as valid fact comes out the other end as Rupe Poop.
On Fox News last night, more Rupe Poop from O'Reily-he said President Obama was gay. He said Obama's visit to an Aids clinic proved that.
by dannyb July 18, 2011
The Urban Dictionary Mug
One side has the word, one side has the definition. Microwave and dishwasher safe. Lotsa space for your liquids.Buy the mug


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About this blog
Posters and Election Propaganda
A blog dedicated to the examination of communications in election campaigns, with a focus on posters
Tagged as "McGovern"
Wednesday, August 20, 2008
In 1972, some of the posters for Democratic presidential candidate George McGovern's campaign were intended to be inspirational and appeal particularly to younger voters. N. Schneider designed a series of posters for the McGovern for President Committee, all of which were colorful, exuberant, and stylized: one was dominated by a drawing of a leafy tree, accompanied by the phrase "A time to grow in a world of permanent change."
In 2008, artists are also working to create imagery that symbolizes the themes of Barack Obama. One, Scott Hansen, also used a stylized tree in a poster for this year's Democratic candidate for president. The tree grows out of the Obama logo, with people joining hands around it. As in McGovern's campaign, "change" is a key word, along with "hope" and "progress."


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|Course Requests Requiring Only Chair/Dean Approval
|Change in repeatability
|Change in lab designation
|Valid grades allowed
|Writing intensive designation
|Reactivating a course that has been inactive longer than one year
|Change in graduate assistantship
|Topics course addition (new suffix only)
|Adding/Changing a course cross reference
|Course Requests Requiring Board of Regents Approval
|Course addition
|New topics course number addition (not just adding a suffix)
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The Graduate College coordinates the editing and printing of the Graduate Catalog. Contact their office for additional information. Degree plans are not included in the Graduate Catalog. Graduate degree audits are located in DARS and are updated by contacting the Graduate College.
Curriculum Services coordinates the editing and printing of the Undergraduate Catalog. The course additions, changes, and deletions will be added to the catalog edit before it is sent to each College. At that time, faculty and/or staff will edit the degree plans for correct inclusion of courses. The degree audits in DARS are updated by Supervising Advisors at the undergraduate level.
The department is required to submit a course inventory change form. The form should include in the description, the change in prerequisites or corequisites and the justification for the change.
Repeatable for credit means that this course can be repeated by the student for credit in his degree. If the student takes this course a second time, both letter grades will count in the student's GPA and in the hours calculated towards a degree. If this option is not indicated on a course form and a student takes a course for the second time, the second grade will replace the first in the student's GPA and on the transcript.
1) All letter grades: A, B, C, D, F, I, W are all valid for entry by the faculty.
2) Credit/Non-credit grades: CR, PR, F, I, W are all valid for entry by the faculty.
Use the same CIP code as the header record. Curriculum Services will verify the code upon submission.
Use the CIP code that most closely relates to the course description. You can find CIP code information on the THECB website at http://www.txhighereddata.org/Interactive/CIP/. The CIP code is unnecessary for a course deletion proposal and most course change proposals.
The Curriculum Services office will review CIP codes submitted on course proposals for verification that our University is authorized to teach under this code.
The student transcript allows for 18 character course titles.
The general rule is that if 50% or more of the course description and course content are changing, you create a new course. This requires a course addition form and supplemental form. If the old course will no longer be offered, you must also submit a course deletion proposal.
If the course description and content are changing, but less than 50% of the content and description changing, then you should submit a course change form with the updated course description. This will also require an updated supplemental form.
Cross-referenced and cross-listed courses are courses that have been determined by the faculty to be equivalents with at least 50% of the same course content. Cross-referenced and cross-listed courses count as repeats of each other in grade point calculations and degree audits. Cross-referenced courses can be inactive or active courses, whereas cross-listed courses are typically active courses. Cross-referenced and cross-listed courses can be established across multiple academic administrative units or in a single unit. If course additions are proposed as replacements for deleted courses, then the course addition proposal should include the deleted course as a cross-reference.
Yes. Because this course was never taught, the department may submit a course change proposal (P.P.S. 2.01, Attachment B), along with the supplemental form (P.P.S. 2.01, Attachment C). The form requires Chair and Dean approval. It can then be submitted to the Curriculum Services office in JCK 1040.
If there is a header record in the course inventory, the Curriculum Services office can add a topics course as soon as they receive a topics course proposal, with the required signatures (Chair, Dean, and Graduate Dean if applicable) and the required supplemental form. We will email you with confirmation of entry and you can immediately schedule the course.
A header record course is a permanent course and is used for reporting purposes at the THECB. This course must be processed through the annual course cycle; just as all other permanent courses are processed.
The department will submit a header record course proposal along with two possible topics courses. For example, MKT 5397 is submitted as the header record course and MKT 5397A and MKT 5397B are submitted as the two potential topics.
No. This course is used for reporting purposes only and is not intended to be taught.
The two potential topics courses you submit are just that, potential topics. The submission of two potential topics demonstrates to the review bodies (CCC, UCC, BOR, etc.) that the department has seriously considered this option and that the department has ideas that could be of interest to their students. It is not required that these actual topics be scheduled and taught.


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From Uncyclopedia, the content-free encyclopedia
I know it probably isn't suitable for an article here, but I just wanted to let people know about this Zimmer thing. I find it funny and perhaps others might also. It consists of George Zimmer introducing himself, telling a very dirty story about his adventures with his insatiable lidibo and enormous male genital, and then saying "I guarantee it." Oh, and it's in all caps for some reason. This apparently started on an Ashlee Simpson messageboard in the wake of her lip sync scandal and has been going on for awhile. I only recently learned about it.
Here's a link to more information on this.
If you're looking for more, search for "George Zimmer" and "I guarantee it" on google. You'll find a bunch of them. They're easy to find, just look for the all caps. I had a pretty good link to them but it's not available to me now. I'll add it later. Here it is: link
Have fun, or if this isn't your sort of thing, just ignore. Keep in mind however that this may be our generation's version of "the aristocrats." If you like the idea, maybe you can try writing a few new ones and put them here. I wrote one already, the Wheel of Fortune one (currently at the bottom of the page).
Hrodulf 21:43, 31 May 2007 (UTC)
- /b/tard... -- TKFUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUCK 21:46, 31 May 2007 (UTC)
- It's actually from an ashlee simpson message board, and did not originate on /b/, but who cares where it's from? It's funny. And fyi, I learned about this meme from MajinVegeta, not from /b/. Just because a joke is popular on /b/ doesn't mean it's bad and just because someone brings a joke that was popular on /b/ up doesn't mean they're a /b/tard. I'm more of an /uncyc/tard, since I'm not even sure exactly what/where /b/ is . . .--Hrodulf 21:49, 31 May 2007 (UTC)
- /b/tard... -- TKFUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUCK 21:46, 31 May 2007 (UTC)
- Hmm. I think The Aristocrats is our generation's version of The Aristocrats. I've seen this or something like it on just about every sketch comedy show starring men. No offense, guys. :-) -- Whhhy?Whut?How? *Back from the dead* 23:26, 31 May 2007 (UTC)
- No, the Aristocrats is really old. Probably was around before WWII. "The Aristocrats (also known as The Debonaires or The Sophisticates in some tellings) is an exceptionally transgressive dirty joke that has been told by numerous stand-up comedians since the vaudeville era." (from wikipedia) Hrodulf 23:29, 31 May 2007 (UTC)


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NVIDIA GeForce GTX 680M: Kepler GK104 Goes Mobileby Jarred Walton on 6/4/2012 9:12 PM EST
46 Comments
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Iketh - Monday, June 04, 2012 - linkI wish Intel would deliver their chips with the same chip packaging as Nvidia... Reply
Casper42 - Monday, June 04, 2012 - linkHuh?
You mean the 2nd picture above with the 2 square chips?
Thats a BGA package and is only used when you plan to surface mount a chip to a board, ie; NON REMOVABLE.
GPUs in laptops are either integrated into the Mainboard or are delivered in a form factor called MXM that uses an edge connector. Reply
Iketh - Wednesday, June 06, 2012 - linkmaybe i mispoke, but im talking about the exposed die with the supportive padding instead of an IHS Reply
RaistlinZ - Monday, June 04, 2012 - linkI bet it will cost like $300.00 more than the 7970m too. Reply
Spunjji - Tuesday, June 05, 2012 - linkBased on the last generation, $200 wouldn't be surprising. I hope to be wrong! Reply
raghu78 - Tuesday, June 05, 2012 - linkGTX 680M costs USD 286 more than HD 7970M. close to 300 bucks
You can check using the origin pc laptop configurator
HD 7970m was found to be close to 50% faster than 675m by notebookcheck.net
My guess is GTX 680M will beat the HD 7970M by 10%. But the price is nowhere in relation to perf. so advantage AMD. Reply
Alexvrb - Wednesday, June 06, 2012 - linkYeah unless money is no object. Nvidia's high-end mobile chips always did carry one heck of a premium, but ouch! Reply
marc1000 - Monday, June 04, 2012 - linkI'm waiting for a 28nm 150W desktop card from Nvidia, to choose betwen it and the AMD cards. If they take too long to launch it, they will loose a customer. Reply
thunderising - Tuesday, June 05, 2012 - linkWhat do you think the GTX670 is? A 300W card? Reply
puppies - Tuesday, June 05, 2012 - linkI think what he means is he wants a mid range card with a mid range price tag, of course just saying that would have been a lot simpler and the chance of it happening when 670s and 680s are in short supply and still selling out is somewhere between 0% and 0%. Reply
marc1000 - Tuesday, June 05, 2012 - linkEspecially, midrange PRICE. no way on earth I, would spend more than 300 $ on any video card. I mentioned the tdp because last-gen nvidia cards are too power-hungry in my opinion, so i wont buy one. This makes Amd the only option. Reply
iwod - Tuesday, June 05, 2012 - linkIt looks like Kelper is superior then AMD offering this time around. Something that cant be said for the past 2 - 3 years.
But the GTX660M Mid Range Mobile GPU is too far away from the High End Range GTX 680M.
I would love to get the GTX 680M on the coming Macbook Pro and iMac, but i am guessing lower end will be stuck with GTX660M again, there is a Staggering 2.5x EXTRA CUDA Cores difference between them.
BTW, why are there no the TDP of GTX680M? Reply
JarredWalton - Tuesday, June 05, 2012 - linkNVIDIA doesn't typically disclose TDPs for mobile GPUs, but the standards are something like 30W, 45W, 60W, and 100W (give or take) -- that's for the entire MXM module. AMD basically targets the same power usages, as many OEMs like to support either AMD or NVIDIA. Reply
ExarKun333 - Tuesday, June 05, 2012 - linkI was thinking the same. After more thought, the issue might be the memory bandwidth. If they go 2x 660M cores (~768) I suspect they would need to go the route of the 256-bit memory bus, because 128 would just not feed it enough. That probably means more TDP and a more expensive chip. That would be the 'sweet spot' though IMHO; 'enough' cores with sufficient memory bandwidth would make it a great laptop GPU, without breaking the bank or power consumption. It would also be just slower (likely) than the current 580M with much better power efficiency. I guess time will tell if NV decides to release such a chip. Reply
Spunjji - Tuesday, June 05, 2012 - linkEven with memory bandwidth limitations, that would still be a nice chip. Those limitations would play into their hands too and keep it away from the 680M. Unfortunately they can't release such a chip this generation because the marketing bastards have plugged that gap with Fermi. Of course, nVidia don't usually shy away from releasing a totally different card with the same name, so maybe we will see a genuine 670M! Reply
iwod - Tuesday, June 05, 2012 - linkYes, 768 sounds good to me, a perfect balance of Performance and Power on Laptops. Last week i asked and discovered Intel are no longer binning their CPU and instead pretty much produce the chips as spec with little disabled parts. This actually sits right in line with what Nvidia has been complaining about wafer cost. Disabled Parts will just be too expensive and possible no longer provides any financial incentive.
SO we wont be getting a Disabled GK104, and GK107 dont offer any real performance, we are pretty much stuck in the middle of no where.
Sounds like a gap of opportunity AMD may want to explore. Reply
Spunjji - Tuesday, June 05, 2012 - linkThis gap has happened for the line-ups of both companies and it's very frustrating. They've decided to force people who like the mid-range cards to pony up more cash than usual or suffer with lower-mid-range performance. :/ Reply
bobburn - Tuesday, June 05, 2012 - link"Superior" if you like paying double the money for something that bests the equivalent AMD branded card in maybe 1/3 of the games that people usually play, ties in another 1/3, and is downright trounced in another 1/3. Reply
JarredWalton - Tuesday, June 05, 2012 - linkFUD much? What are the 1/3 of games where the GTX 680M is actually trounced by the HD 7970M? Can you even name two? If someone has actually tested the two GPUs in a notebook (e.g. not simulated with desktop hardware) and done a thorough comparison, I'd love to see it. We're still trying to get hardware, and I think the same is true of every other site. Reply
Riek - Tuesday, June 05, 2012 - linkthe question can also be: can somebody name 2 games where the 680M will trounce the 7970M. Because at this point that cannot be found either.
All we know at this point imo is:
7970M is smaller than 680M
680M has the layout of the 670 while the 7970M has the layout of the 7870. So basically we can assume the 680M will have higher performance. Altough the article talks about 680M having a 50% higher performance than the 675M... the same is true for the 7970M... and that was tested by 3rd parties. Reply
MrSpadge - Tuesday, June 05, 2012 - linkI don't think the G610M is worth it for Ultrabooks. Bypassing the 17 W TDP limit for the CPU this way may sound nice - but the GPU will also consume power. I'd rather have an Ultrabook which lets me up the CPU to 25 W TDP - the cooling system would need to be able to handle this anyway, if it supports a 17 W CPU and a G610M.
Thereby I could occasionally get higher pure CPU performance (higher Turbo modes) and HD4000 should be significantly faster than G610M anyway, even with a hit due to TDP-constrained lower clocks. Reply
JarredWalton - Tuesday, June 05, 2012 - linkThe GPU only consumes power when in use, thanks to Optimus, and presumably it will be on a separate cooling apparatus. I do however agree that in general, if you're at the point where you're looking to add a discrete GPU, you should consider laptops that are a bit larger with SV CPUs. Reply
bennyg - Thursday, June 14, 2012 - linkDon't buy something tagged "ultrabook" then, instead look at the almost-an-ultrabook group of notebooks. Clevo 11" comes to mind if you want performance.
The real points why you'd bother with a low power dGPU that's barely faster than the HD4000 Reply
colonelclaw - Tuesday, June 05, 2012 - linkWhat would the equivalent desktop GPU be to the 680M when it comes to FPS? I know there's a lot of architectural differences between laptops and desktops, but I'd be interested to know which GPUs have the same real-world performance. Reply
JarredWalton - Tuesday, June 05, 2012 - linkRight now, the closest you can get is the GTX 670, which is clocked at 915MHz stock on the core and has 6GHz GDDR5. So the mobile variant is clocked 32% lower on the core and 40% lower on the RAM. Reply
Riek - Tuesday, June 05, 2012 - linkAssuming turboboost is similar on both models ofcourse. Reply
colonelclaw - Thursday, June 07, 2012 - linkThanks for the reply Jarred Reply
Batmeat - Tuesday, June 05, 2012 - linkSo can I swap my 570m our of my MSI gaming notebook and swap in a 680M? Reply
JarredWalton - Tuesday, June 05, 2012 - linkPossibly. Reply
bobburn - Tuesday, June 05, 2012 - linkIs pure hogwash from the reviews I've seen from the 7970. For Crysis 2, Diablo III, Arkham Asylum, Skyrim, and a plethora of other titles, the 7970 either beats the 680m (by as much as 18%) or is the same, and at worst was just 10% slower in the worst case. Yes, in some games the 680m beats the 7970, however, it certainly isn't worth paying more than double what you'd pay for the 7970. Reply
JarredWalton - Tuesday, June 05, 2012 - linkLink please? And are you talking about the 7970M or the 7970?
Diablo III is an NVIDIA supported title, so I'd be surprised if it's actually slower on their hardware, but stranger things have happened (e.g. DiRT 2 and Civ5 are "ATI" titles where NVIDIA held an advantage for a long time). Arkham Asylum is so old and undemanding that you'd be looking at 300 FPS vs. 290 FPS and very likely CPU limited; perhaps you meant Arkham City? If that's what you're talking about, it looks like the latest Batman with high-end hardware is hitting other bottlenecks on most GPUs (http://www.anandtech.com/show/5818/9). Skyrim also favors NVIDIA quite a lot on desktop GPUs, and Civ5 is basically a toss up.
Where are your "plethora of titles" They're not even there on the desktop GPUs! Switch to mobile GPUs and you're looking at a Pitcairn card that has 1280 cores clocked at 850MHz (a 15% drop from the desktop HD 7870 1GHz) and memory still clocked at 4800MHz. In most titles, particularly at 1080p laptop resolutions, I expect we're basically shader/core limited and the extra memory bandwidth will only help in select titles.
But hey, let's do a reasonable estimate. Take the 1900x1200 results here (http://www.anandtech.com/bench/Product/548?vs=598) and subtract 15% from HD 7870 and 32% from GTX 670 as a rough estimate. Do you know what you get? Downclocked 7870 on average would be 10% slower than downclocked GTX 670. The titles where AMD leads out of the list (only looking at actual games) are Crysis: Warhead (6%), Metro 2033 (2%), and Civilization V (15%) -- so really, two ties and only one clear lead. The titles where NVIDIA leads are DiRT 3 (5%), Total War: Shogun 2 (6%), Batman: Arkham City (28%), Portal 2 (14%), Battlefield 3 (30%), StarCraft II (25%).
Given we're only estimating performance, it does appear relatively close and AMD will certainly lead in some of their traditionally strong titles, but "pure hogwash" is a stretch. You're also not "paying double", unless you can manage to just by the MXM separate from everything else. You're looking at a $2000 notebook with HD 7970M (and relatively spartan components for storage), or a $2300 notebook with GTX 680M. The GTX 680M will also come with Optimus, so battery life at least won't suck when you're not gaming. For a 15% increase in total notebook cost, that's pretty darn reasonable: 10% better performance, likely double the battery life, and only 15% more money. Reply
TokamakH3 - Tuesday, June 05, 2012 - linkComparing an estimated total system cost to downplay the massive price difference in these GPUs is very disingenuous. And you even overestimate the system price. A P150EM with 7970m can be had for ~$1600-1700. Face it, AMD owns the price/performance mobility crown this time around, just like last generation. Reply
bhima - Tuesday, June 05, 2012 - linkThough that is true, I wish it were true that there were a lot of options to get an AMD mobile GPU. VERY few vendors are using them right now and the only one worth it IMO is the Sager with the 7970m. I'd like to see some Sagers/ASUS machines with the more midrange 7870m to compete with the 660m.
So while AMD may be winning the price/performance war in mobile, they aren't winning the distribution war. Reply
TokamakH3 - Wednesday, June 06, 2012 - linkYeah, the 660m wins midrange for sure.
On the high end, there are a whole lot more 7970ms available than 680ms. Reply
whatthehey - Tuesday, June 05, 2012 - linkWhatever. AMD owns shit right now. They've got decent GPUs, but their drivers are garbage, ESPECIALLY on laptops. If you're stupid enough to buy a laptop with AMD graphics, either you don't care at all about battery life, or you don't care about drivers. Even at the same price, I'd take the slower GTX 675M over the HD 7970M in a laptop. On desktops, AMD GPUs are better, but they still have driver issues. Reply
kyuu - Wednesday, June 06, 2012 - linkBullcrap. They do need a better iGPU/dGPU switching mechanism to compete with Optimus, but otherwise all this crap about their drivers is FUD. Yeah, their early drivers for 7xxx had issues, but Nvidia had some problems with early Kepler drivers. Driver issues happen with both companies. Reply
whatthehey - Wednesday, June 06, 2012 - linkGotta luv the AMD fanboys. Have you even used a laptop with AMD graphics lately? The drivers are a major problem; hell, they're a problem on desktops as well! For one, the user interface is complete garbage that any software developer with have a brain would throw out. You don't use .Net for drivers unless you're lazy and want your product to feel sluggish. On a fast PC, after first boot it will take several seconds for the Catalyst Control Center to appear; on a slower PC or a laptop? 10+ seconds isn't unusual.
But getting back to laptops, if you don't think drivers are a problem for AMD laptops, you haven't purchased a laptop with an AMD GPU lately, at least not from a big OEM. Sony and HP are two of the biggest PC manufacturers and you can't update drivers for shit on their laptops with AMD graphics. If they're discrete only graphics, you can at least try to get someone else to download the drivers for you, but if they're switchable graphics you're screwed. Hard!
It's not all AMD's fault, but it's at least partly their fault. If nVidia can get Sony and HP to allow driver updates on Optimus laptops, AMD should be able to do the same. Why haven't they? Because they just don't give a damn about you once you've purchased their product. Acer is better about driver updates, but they build horrible plastic shit to sell for bottom dollar at retailers.
The only decent laptops with AMD graphics right now are the MacBook Pros, and you'll have to pay homage to the lifeless shell of Steve Jobs by spending more money and running the oh-so-lovely OS X if you go that route. And what do you get? Gaming performance under OS X that's worse than HD 6470M under Windows. So you install Boot Camp and run Windows, right? But than why the hell did you pay $1700 for a Mac that will have lousy battery life under Windows (and you're still up a creek when it comes to getting the latest drivers for Windows)?
Yup, AMD has the best drivers and support for laptops ever! The only laptops with AMD graphics that are worth buying are the ones with Llano and now Trinity. But guess what? You get POS laptops there as well, with their awesome 15.6" 1366x768 displays that look washed out as hell! At least you can get driver updates for those (usually). Reply
Meaker10 - Wednesday, June 06, 2012 - linkDon't buy sony or HP then lol.
I can think of plenty of machines with AMD graphics that look good.
You have the 17.3" samsung with 3d display, Alienware M17X and M18X. Also now that clevo sorted out their issue their 15.6" and 17.3" machines look good too.
But hey, haters gonna hate. Reply
katana111 - Friday, June 08, 2012 - linkYou are out of your mind if you assume NVIDIA has stable drivers and AMD does not. Has it ever dawned on you that amd products do not need patch after update to get them running properly.
After having bought various nvidia products in the past and being burned, not a chance in hell am I touching that stuff again.
I've still got products running on AMD and they work fine. Whereas, anything with nvidia in it that is a few years old might as well be thrown away and are typically just collecting dust.
Second mistake is attacking the macbooks, which are excellent machine.
Speaking of quality AMD cards render video like streaming tv on WMC significantly better than nvidia cards. Reply
CeriseCogburn - Thursday, July 12, 2012 - linkThank you for telling it like it is.
Amd fans blabber price and fps (even as they lose miserably and then moan price again) a million times as their lips bleed, and they all lie about drivers "being the same", and are often completely clueless and totally ignorant by choice and by default, blissfully ignorant, incapable of admitting a single fact, and utterly foobar and totally broken, but they now love Winzip.
lol - yes they love Winzip Reply
TokamakH3 - Wednesday, June 06, 2012 - link*citation needed. Reply
bobburn - Monday, June 11, 2012 - linkGoogle 7970m review. Reply
TokamakH3 - Monday, June 11, 2012 - linkI see a lot of graphs showing the 7970m is the fastest card currently on the market. Reply
CeriseCogburn - Thursday, July 12, 2012 - linkNo more time for the amd fanboy to pretend with tricky worded lies
- amd lost again... L OOOOOOO ser
http://www.notebookcheck.net/AMD-Radeon-HD-7970M.7... Reply
MadMorph - Friday, June 08, 2012 - linkI'll be looking into a desktop replacement at the end of the year and an i7 tf book with this gpu would probably do it for me. some sites say it will be in ultra books but others say no chance Reply
nocturnal2048 - Saturday, January 05, 2013 - linkI have (2) GTX670m video cards in SLI in my M-tech laptop, I also have a third generation intel I7 2.4GHz CPU do I really need a gtx680m? Is the performance going to be better than 2 GTX670m's I just don't see it. Reply