In revenge and in love, a woman is more barbaric than man is.

- Friedrich Nietzsche

When you see absent P-waves, you must check whether the rhythm is regular or irregular based on the QRS complex:-

- Irregular and normal QRS: most likely to be atrial fibrillation.

- Regular: if the QRS < 120 ms (narrow), then it's likely to be paroxysmal SVT.
If the QRS > 120 ms (wide) then it's probably VT.

JUST TO BE CLEAR: This is an oversimplification with a lot of buts and ifs.
For example, some paroxysmal SVTs can present with wide QRS if they're associated with pre-existing LBBB.

In AF, the P-wave is either absent or it's replaced by rapid, variable, irregular and low-amplitude oscillating fibrillatory waves.

Also, the diagnosis of VT is defined as: tachycardia (>100-120 bpm), and the rhythm originates below the bundle of His (in the ventricles, therefore it is a ventricular rhythm).

Usually, you can tell if the rhythm is sinus or ventricular by observing the P-wave & the QRS complex. If QRS is wide and P-waves are absent or dissociated from the QRS (not every P-wave is followed by QRS) then it's most likely to be ventricular rhythm.

A wide QRS happens in VT because the rhythm originates in the ventricles and this makes the depolarization of the ventricles slower and takes a longer time (indicated by wide QRS > 120 ms)

“I do not fear death. I had been dead for billions and billions of years before I was born, and had not suffered the slightest inconvenience from it.”

- Mark Twain

Death cannot touch us because while we exist death is not present, and when death is present we no longer exist.

- Epicurus

أيا سافِرًا ورداءُ الخجل
مُقيمٌ بوَجنَتِهِ لم يَزَل

بِعَيشِكَ، رُدَّ عليكَ اللثامَ
أخافُ عليك جِراحَ المُقَل

فما حَقُّ حُسنِكَ أنْ يُجتَلى
ولا حَقُّ وجهِكَ أنْ يُبتَذَل

أمِنتُ عليكَ صروفَ الزمان
كما قد أمِنتَ عليَّ المَلَل

- أبو فراس الحمداني

An idea is not the same thing as a fact. A fact is something that is dead, in and of itself. It has no consciousness, no will to power, no motivation, no action. There are billions of dead facts. The internet is a graveyard of dead facts. But an idea that grips a person is alive. It wants to express itself, to live in the world. It is for this reason that the depth psychologists—Freud and Jung paramount among them—insisted that the human psyche was a battleground for ideas. An idea has an aim. It wants something. It posits a value structure. An idea believes that what it is aiming for is better than what it has now. It reduces the world to those things that aid or impede its realization, and it reduces everything else to irrelevance. An idea defines figure against ground. An idea is a personality, not a fact. When it manifests itself within a person, it has a strong proclivity to make of that person its avatar: to impel that person to act it out. Sometimes, that impulsion (possession is another word) can be so strong that the person will die, rather than allowing the idea to perish. This is, generally speaking, a bad decision, given that it is often the case that only the idea need die, and that the person with the idea can stop being its avatar, change his or her ways, and continue.

- Jordan Peterson

The bro code🍻

إنّ في الإنسانِ شوقًا إلى أن يكون خرافيًا، إنّ الحقيقةَ وحدها كئيبة، غبية، دميمة.

- عبد الله القصيمي

"Sunlight And Shadow" by Albert Beirstadt

“Hannibal with Chopin”

“You teach students to memorize lots of facts,” he told me. “You say: ‘Look at this patient. Look at how he’s standing. Look at his facial features. That particular pattern represents one disease, and this pattern represents another.’ We teach those patterns so that the next time the doctor comes across it, he or she comes up with a diagnosis.” What’s missing, says Braverman, is how to think when an oddity appears. That requires careful and detailed observation. After years of teaching he still wasn’t certain he’d found the best way to communicate that complex set of skills.
In 1998 Braverman came up with a way to teach this skill. What if he taught these young medical students how to observe in a context where they wouldn’t need any specialized knowledge and so could focus on skills that couldn’t be learned from a book, where the teaching would force students to focus on process, not content? He realized that he had a perfect classroom right in his own backyard, in Yale’s Center for British Art. The course, now part of the curriculum, requires first-year medical students to hone their powers of observation on paintings rather than patients.

- Irwin Braverman, Every patient tells a story

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