Bostoniangirl writes: I find the practice of giving anesthetized women pelvic exams without their informed consent horrifying - and horrifyingly widespread.

Particularly viscerally terrifying to me was the story of the woman who was given phenergan to calm her nerves and awoke to find herself with a speculum inside her.

Physicians rely on the idea that there is implicit consent when a woman consents to certain surgeries. I vaguely recall that there was case law on a similar concept where surgeons who noticed serious issues that weren't the precise focus of a particular surgery went ahead and addressed them with a patient without having explicitly discussed them first. Certainly, if I was otherwise going to die on the table, I would want a surgeon to perform a procedure. Anyone willing to make the best case for when it might be acceptable and how best to improve the situation?

Heebie's take: (I haven't read the link b/c of the NYT paywall, so maybe they address this but) it seems like the fix for this is so easy that it's bizarre to me that it's not undertaken: when you explain to the patient about the procedure, you give a disclaimer that it's standard practice to do these ancillary pelvic exams for [X, Y, and Z] reason.

So what I'm inferring is that there must be occasions when there's no justifiable reason whatsoever?

Here's my best guess for the reasoning in those cases: "As long as we've got the car up on the lift, we'd be fools not to check all the obvious entry points for any unrelated issues." It's definitely a dehumanizing perspective, but maybe it just needs to be re-marketed?

(Am I being an ass? I have that vague sensation.)

Did he crash and burn last night? Did anyone watch? I'm super annoyed that he timed his ascent so well. Even my mom is musing about his electability and it made me irate. Yggles says that Bloomberg tanked last night. I hope so.

There's a person whose bad takes I sometimes see on twitter because people I follow mock it in replies or retweets-with-commentary, and whenever she pops up, I think, "ah, [so-and-so]—undoubtedly the worst person I ever slept with".

I will be the first to acknowledge that this is an odd way to react off the bat to seeing someone's visage and name, but I confess this to you all because it seemed marginally interesting that I was immediately confident in the identification. Do YOU, varied readers, think that you could identify a single worst person with whom you've ever slept? (Why, one might ask, would one even bother with this exercise? I don't know. It might prove diverting. It might prove traumatic! Don't do it if you think it might be more traumatic than diverting, is my advice.)

1. I enjoyed these notes from a forensic psychiatry conference:

- Forensic psychiatrists have become very effective at determining which criminals who plead insanity are "faking it". They usually rely on patterns of mental disease which psychiatrists know but criminals don't. For example, they'll start by asking "Do you hear voices?", and most fakers, anxious to please, say they do. Then the psychiatrist will ask questions like "Which side of your head do the voices come from?" and "Do you ever have smells associated with the voices?" Still eager to please, the fakers will choose a side of the head for their voices to be on, and make up smells that happen at the same time as their voices. But real schizophrenics don't generally hear their voices to one side or hallucinate smells, so this decreases the likelihood that they're telling the truth. Some of these questions are very tricky - for example, one psychiatrist asks both "Do you ever hear secret messages for you from the TV or radio?" and "Do cats and dogs ever give you secret messages?". The first is very common in mental illness; the second practically never happens. Unless you're a psychiatrist yourself, you're not going to know these things and you'll end up claiming symptoms that make no sense.

These were taken by a regular psychiatrist, not a forensic one. (Also, the blogger is probably problematic and uses "eugenics" as a punchline in a way that might irk.) But as a standalone collection of observations, it's entertaining (and short).

- Another fragment of a story: "The night before his execution, murderer Troy Gregg sawed through the bars of his cell, donned a homemade prison guard uniform, and accomplished the first death row breakout in Georgia history. He was beaten to death in a bar fight later that night."

2. Ugh, I knew I sort of recognized the blogger from (1), and so I did a google site search and found that we're chronically annoyed by Star Slate Codex. Oops. Sorry. (I had stumbled upon his risks of Adderall post the other day.)

3. Anyway, my other link is just reviving a very old debate here, about the ending to the saying "If you think [X], you've got.... ":

In summary: Another think coming is the older of the two, dating in use to the mid-19th century, and originated in British English. Another thing coming appears to have come about in American English several decades later, probably as a result of confusion regarding the original phrase. Another thing is the more recent turn of phrase and now is more common, though it is frequently criticized.

I'm counting that as me being right.

Stop Blaming Democrats For Republican Intransigence :

As Josh Marshall wrote, "there's always a strong tendency to take consistent and insistent misbehavior as a baseline." So because Republicans have now become the party of intransigence, that is the new norm and gets a pass when it comes to accountability. The burden is placed on Democrats to conjure up some magic trick to stop Republicans from employing a strategy that has worked marvelously for them--partly because the media fails to identify the source of the problem.

This is exactly right.

Left-leaning activists have to focus on what Democrats can do, because to spend the mental bandwidth on Republican intransigence isn't going to get anything done. The problem is when journalists fail to do their job. If journalists wear their lefty-ish-hats, or think about their lefty-ish audience, then they describe national politics as if Democrats are the only players with choices in front of them, and Republican intrasigence is just the summertime humidity that we all must endure. It's complete bullshit.

(It is ironic that I'm blaming the media more specifically than the actual Republicans, in a post complaining about how the actual Republicans never get held responsible for being the source of all feces spewn.)

It's just insanely boring to recount the fact that Republicans are still relentlessly greedy, destructive shitheads, and always premise everything with that underlying fact.