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Why do so many death certificates say the cause of death was cardiac arrest? Isn't death and cardiac arrest pretty much the same thing? How is saying that useful?
You are extremely insightful to ask such a question.“Cardiac arrest” often means that the person died and an autopsy was not performed. Typically we HAVE NO IDEA what the real cause of death was. Obviously, when people die, their heart stops, which is literally what “cardiac arrest” means.I will never forget the first death certificate I had to sign as a young doctor still in training. The patient was a man I had just seen in my clinic a couple of weeks prior, and he really was fine, normal check up. I do believe that he had some high blood pressure that was controlled on some medication. He also was a smoker. But he wasn’t that old, didn’t have anything else wrong.In any case, he was found dead in his home, still seated in his chair.I don’t know about you, but if my healthy family member just died while sitting watching TV, I would be very interested in finding out why. UNLESS I KILLED HIM. Just sayin’. Family did not want any autopsy.Poison causes “cardiac arrest,” too.So anyway, I recall asking my professor what I should do. He told me to write, “cardiac arrest.” And I did. The man officially died of cardiac arrest. Nothing to see here!Of course nobody will ever know why he passed, and his family was not curious. Had he died in the hospital, we would probably know why he died, and we would enter the real cause. But a death at home is a different thing.
As someone in the medical field, have you ever genuinely not cared if a patient lived or died?
There are some groups of people I don’t care if they live or die, because they made the choice themselves.Jehovahs Witnesses.Batshit Crazy People who believe in Christian Science.People who want to die.Jehovah Witnesses - these people are batshit crazy in my personal opinion. When faced with a choice of blood transfusion to live or die, they almost always choose death. The religion is crap - what sort of religion forces you to die instead of getting the medical treatment you need? In USA, treating someone who declined blood transfusion with blood transfusion opens a doctor to lawsuits. Get this right, you saved his life, and he sues you out of house and home.Christian Science - In some parts of USA, it is legal to have pastors go over to the house to pray and try to cure a patient. They can lawfully decline medical services. As expected, in most cases, the poor suffering patient dies after an agonising period of time. In the rare cases that the patient is sent to the hospital, it is often because they are unconscious, in very serious condition, and are dead or close to dying. This is nothing short of murder - by denying someone medical attention. Urgh.People who want to die - In USA, the medical cost is batshit crazy. So what happens to the poor who do not have medical insurance or limited medical insurance? They choose to die rather than to saddle their family with a large debt. They decline all medical services and medicine, and die very painfully.And the cost of medicine in USA is insane. Life-saving drugs are like $16,000 for a month’s supply. Who can afford that?Why didn’t the US have socialised healthcare so that people can be treated cheaply? And somehow, socialised healthcare is a dirty word for Republicans. Urgh!
What would you, as a physician, think of another physician writing "schizophrenia" for the cause of death on a death certificate?
Causes of death on a death certificate can be pretty tough. I have a colleague who on every death certificate he has ever signed, has listed “cardiopulmonary arrest” as the cause of death, because he was taught to do it that way. The person who taught me said that was useless, because as he said “find me a dead person with functioning heart and lungs”. The idea on a death certificate is to know why they died, not the fact that their heart stopped, which is actually fairly common in dead people.Schizophrenia is not a cause of death. The process that is ongoing in their brains does not kill them.However, death certificates also have an area for things which lead to the ultimate cause of death, as well as contributing factors. The person with lung cancer might have actually died from pneumonia, caused by their lung cancer, with a contributing factor of tobacco use.The schizophrenic patient who shoots himself died of a gunshot wound, but the schizophrenia can certainly be a contributing factor. The schizophrenic patient who has a stroke because he wouldn’t take his blood pressure medication probably has it as a contributing factor as well. But it probably shouldn’t be the prime cause of death.
As a doctor, what did you learn from your first patient death?
It was my first night duty of my internship, I was posted in surgery department and I went to have dinner before my shift started. I came to the hospital about 30 minutes early since I was enthusiastic and very curious about working as a doctor.I was given the job to prepare a patient posted for surgery, the investigations had been sent and reports were awaited before we could shift the patient to OT. I was about to go to the lab for the reports but for no reason I felt I should once check out the casualty, and as I entered I saw few of my colleagues were assessing a patient, he appeared extremely obese and sweaty also he had lost consciousness. Since all of us were new to these kind of situations, we had little clue about the gravity of his disease. I approached near the bed, tried to feel for pulse, it was very feeble and rapid, all his body was sweating and cold, breathing was shallow and rapid, we asked for brief history from the patients relatives while our nursing team stabilised everything, got the GRBS- 104mg/dL(which means he had enough sugar in blood) and the family of the patient said he was a known case of IHD and HTN(Ischemic heart disease and hypertension, a condition where the heart is not getting enough oxygen to work) and he was not taking his medicines regularly because someone told him that allopathy doesn't work and he took some alternative medicine.This is how his arteries that supply his heart must have been- representational image on IHD from wikipedia-Our casualty officer was busy in another case and we were already on this one so he arrived after few minutes and joined us.We wanted to take a quick ECG but suddenly the patient crashed, pulse was not recordable and BP was not recordable, we suspected massive myocardial infarction/heart attack, the attenders around were anxious and worried about him, I had never ever been in that situation and it was my first time I was dealing with it.I looked at the attenders, and the devastation, I was under extreme pressure, I took few breaths for myself and just recalled what was taught to me in a UG conference about Basic life support, I checked for the scene safety, responsiveness, carotid artery pulse, and I assessed that he needs CPR, I started the chest compressions, and asked for help, the nursing staff got the AMBU(a bag which is used for pushing some air) and we were following with the BLS protocol, I remember I had broken 2 ribs when I had started the chest compressions which means the CPR was good, all of this happening within not even 2 minutes of my entry into casualty, and my first night duty and first case of night duty, I was feeling a lot of pressure upon me, with every push into the chest I wanted him to get revived, after 6 cycles it was still no pulse, which means his heart was not pumping, I asked the nurse to give a shot of adrenaline and and we continued, I still remember the scene crystal clear, I can recall the sweat on my colleagues face and the sweat dropping from my chin, we had been doing the compressions for over 20 minutes. We continued the CPR for another 10 minutes, the resident doctor then asked that we can stop, we still did another cycle and checked for pulse and breathing, it was in vain.We were all exhausted, both physically and emotionally. Resident doctor confirmed death and broke the news to attenders, they were devastated• all of this happened in mere 35–40 minutes and I got a call from my senior asking where are the patient reports, he needs to be shifted to OT right now and without even wiping my face drenched in sweat I ran to the lab and got the reports, attached them to the file and shifted the patient at around 8.20pm.What did I learn?A lot of things!First- Trust your doctor! If he has given you medicines for a weak heart, as in this case IHD, follow his advice, he's not your enemy! Definitely he's the last person to wish bad for you. In this case I'm sure the situation would've been different had he been on meds regularly.Two- Life goes on! I had to get back to work immediately. Shakeebuddin Kashif
Have you ever had to deal with a ridiculous policy at a doctor's office?
Two days before my wedding and honeymoon (our flight was a few hours after the wedding), I showed up at least 10 minutes early, let’s say 12 minutes and got into an unusually long line at the check-in window. No problem, I have plenty of patience, The nerves in my hip and leg don’t, but I was close enough to lean on a chair after about 5 minutes.While I’m waiting, I observe that the patients checking out are now checking out at the check-in windows for some reason, are being given priority, thus making the check-in process even slower. Not only that, but I can hear clearly, despite HIPAA, all of the patients• information as both windows were calling other offices to make appointments for specialty services.Half an hour later, they gave the man standing in front of me, who had to be pushing 90 years old, grief for how late he was at 13 minutes, and how he better call next time. I got told I was 19 minutes late where 15 minutes was the deadline, I had to pay a $50 missed appointment fee (which is double my co-pay), and they had another appointment in 10 days, when I would be on my honeymoon. She was usually very nice, but today she was a disciple of Lucifer himself. I explained that I had been there for over a half hour, and even started my wait in line DIRECTLY UNDER A SURVEILLANCE CAMERA that they should check, that the only reason I didn’t make it to the window was because they were not only doing check-outs, but prioritizing them, when I was, in fact, at least 10 minutes early. There was no way I was flying back from my honeymoon just for a doctor’s appointment that I didn’t miss, and that my medication would not last me through my vacation.Finally, she told me why all this was happening (the letting go of the other employees) and told me to wait. The nurse then came out around 20 minutes later with prescriptions that would last me one week, but gave me an altered appointment for the day after I get back clearly showing that the girl at the window told her what my return date was. When I told her the medications would cut me short by 6 days, she then tells me I can take it or get nothing. I mean, nerve damage and pain that can get so severe I could lose my ability to walk isn’t all that important, nor the withdrawals from the drugs they’ve had me on for so long…When I got home from my honeymoon we were obviously exhausted and one of the things we didn’t do was read the giant pile of mail on the table, All our bills were on auto-pay anyway. The next day I went to my doctor’s appointment 45 minutes early just to be told they can’t find my appointment in the system. Then they tell me they can’t find ME in the system. The doctor asked me if I got his letter, to which I had not yet gone through the bushels of mail at home, and reprinted the letter before slamming the door. He then went to the window, as if he needed protection, and told me I was to leave immediately or the police would be called. I wasn’t even given enough time to read the two-page letter where the doctor stated that I was unacceptably late, rude, disruptive to the other doctors and patients, and a drug seeker, and they would not be prescribing medication for me anymore.
How can I obtain Japanese citizenship?
Great answers by Dick Karp and David LaSpina.I can only add my two cents of knowledge to their insights.The first thing: citizenship and naturalization are two different matters.You can only get citizenship if you were born from Japanese parents, AND being registered within 3 months with your local Japanese consulate.AND when you reach 20 years old, it's mandatory you choose whether lose your local citizenship or your Japanese citizenship.Should you not make a move, you lose your Japanese one by default.On the other hand, you might be naturalised Japanese (i.e.: become a non-born Japanese with a permanent visa) if all these criteria are met:- you're living for at least 5 years in Japan- you're at least 20 years old- you can read, write and speak Japanese fluently- you are willing to go through writing exams and interview processes- you have professional skills and $ to support yourselfEvery case is examined and weighed individually. Say, if one of your parents is Japanese (Japanese-born), the Ministry of Justice may wave the age and residence requirements. But again: it is a case-by-case process.Sources:Japanese nationality lawI want to become a Japanese nationalMany angles to acquiring Japanese citizenship | The Japan TimesAlso, I went myself to my local Japan consulate and talked with them.
What was the most misogynistic thing you have seen or heard?
These aren’t the most misogynist things EVER, but they have happened to me. I’m a chemical engineer and have worked in the energy business my entire career.During college:My advisor telling me that I’m going to get a job, because quotas, but I will be taking away a man’s job. A man that has a family to support. That I will quit in a few years, after I have a child. That I won’t be allowed to work in refineries or chemical plants when I’m pregnant or breastfeeding (I never worked in those places, anyway). My thermodynamics professor asking me if my husband did my homework for me (I was married to a civil engineer student, who BTW flunked thermo his first try). Another professor asking me how my husband felt having a wife that was smarter than him (stereotype about different engineer disciplines). About how my husband felt about me going on school trips and being the only female. About how my husband felt about me wearing that black skirt with the slit on the side, and did I need to borrow his needle and thread?During college, when doing on-campus interviews with major companies:Did I know that summer jobs for engineering interns often required working outside in the plants, which were hot and dirty? ( My answer: I do my own oil changes and tune-ups). Did my husband mind me being away for the summer on an intern job? When did I plan to have children?My first job out of college, with Amoco Production (later purchased by BP, after I left), comments FROM MY SUPERVISOR:Don’t expect to be promoted very far, because (in the tech track), women aren’t as capable technically as men and don’t get the higher-up jobs. In the operations/engineering tracks, women are too emotional to make good supervisors.Women let their personal problems interfere with their work (while he was having an affair and a divorce, and was so grouchy and angry that we avoided him at all cost).All women are bitches and out to snag a man to take care of them.When I became pregnant but continued working, was not given any assignments that ended after my due date, because ‘no matter what you say, we know you won’t be coming back”. I started work again after 4 weeks, just because.From an HR manager: Hey, can you cross your legs so I can get a better look?I became friends with the local VP’s secretary, so learned other things about my five years with Amoco: whenever we had pre-employment or random drug tests, female engineers were also given pregnancy tests - without our knowledge or consent. There was a form that the district offices sent to the headquarters whenever an engineer, or in the case of a married male engineer- their wife - became pregnant. She told me that during exec staff meetings, they would comment that they liked the male engineers to be married, with kids and a mortgage, because it made them stable and tied them to the company, but they lived the female engineers single because married females would be less flexible about transfers and they never seemed to burden themselves with big mortgages.(And I’ve been told by MANY young women that I have no clue how bad it is for women)./
What do employers absolutely not want to see on a résumé?
I can tell from my experience what I absolutely do not like in a resume. Please keep in mind my experience is only with technology jobs and I am primarily recruiting for similar kinds of individuals all my life. A recruiter for example will have a very wide array of experience.This is what I don’t expect to see in resumes:Chronological description of everything you have ever done. Especially if you have a 10+ year professional experience. I do not care what project you did in 1994.Keep in mind we are checking your LinkedIn. So don’t just tell the exact same story on your resume as is on your LinkedIn. Give us something more.I don’t need to know your exact address, if you are married, have kids etc. Those are not relevant and in fact can create unconscious bias.If you have 10+ years experience or even 5+ years, your exact grades at college and school are not super critical. If you say I have a bachelors in X from Y college that should be sufficient. I don’t need to know you passed with 66.67% this year.I really like resumes geared towards specific roles. Eg. If you are applying for a role to be a manager, create a category in your resume highlighting everything you have done as a manager/leader in the past, going back to college. Think of your resume as having a number of your avatars represented. Some may be as a manager, some as a developer, some as testers etc.Don’t just list what you have done, but also include an abstract explanation of why we should hire you. What do you bring to the table which makes you great for this particular role?Keep your resume short and relevant. I often see resumes listing 30, 40, 50 + technologies listed in them. YOU CANNOT BE AN EXPERT IN ALL THESE TECHNOLOGIES. We need to know your 3 expertise. Highlight them. When I see a vast array of technologies listed my immediate thought is it’s because you are not an expert in any one of them.Please don’t put things like you know Oracle, mysql, mongoDB, postgres sql. It’s confusing because we don’t know what you are saying - are you a database expert, SQL expert, noSQL expert, have just used them or not an expert in any of them.Keep your LinkedIn profile updated. It’s not optional anymore.Try to capture any non job related stuff you have done. No, I don’t mean we need to know if you are an awesome singer, rather if you contribute to open source projects, speak at conferences, write blogs/whitepapers etc.Tell a story and don’t treat your resume like Listverse.
How do I get my father’s death certificate? The original copy is lost.
Apply for death certificate here → Death CertificateSteps involved in obtaining Death CertificateDOCUMENTS AND QUESTIONNAIREA checklist of documents and a questionnaire will be provided to record your details.DRAFTINGUpon receiving filled questionnaire, we will draft an Affidavit, Authority letter and Application form and share the soft copies for your signatures.NOTARIZATION OF AFFIDAVITYou are required to take a print out of the Affidavit and get it notarized from a local notary.DISPATCHING DOCUMENTSYou are required to send in the documents to us through courier.SUBMISSION OF APPLICATIONThe application along with all documents will be submitted at the office of Registrar of Deaths.COLLECTING AND DISPATCHING DEATH CERTIFICATEAfter issuance of death certificate, which could take 2-3 weeks after submission of application, we will collect and dispatch the same to you through courier.Required DocumentsProof of Birth of the deceased (photocopy of any one of the following • birth certificate, matriculation certificate, aadhar card, PAN card, driving license, voter id card)Affidavit specifying the date and time of deathIdentity Proof of the deceased person (photocopy of any one of the following documents will suffice: aadhar card, passport, voter ID card, PAN card, driving license)Proof of Death (photocopy of any of the following • crematorium receipt, hospital letter etc.)Passport size photo of the deceasedSigned authority letterCall at +91–9811782573Mail at support@myadvo.in
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