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Why one should NOT do medicine?


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Hi,

 

My question is the opposite of: Should I do medicine?

My question is: Why should I NOT do medicine?

 

I am currently an engineer, 2 years experience, making 70K a year. If I work very very hard (harder than a doctor), I could make ~120-150 in 5 years. But if I change jobs that will drop to 70-100K.

 

My picture of a doctor is very tempting: (the PROS)

  • 150K average salary
  • job security
  • can move to other countries
  • can specialize and have own practice
  • can secure a loan and live decently while a student (even if supporting a family and then pay it off relatively easily within a few years)
  • possibility to help people directly and do humanitarian work

 

Now what are the CONS of doing medicine? What makes people who would qualify and do great in medicine not study it?

 

I have a relative and a close friend preaching med shcool to me every time we discuss career and life paths.

 

I'd appreciate if someone could tell me about the other side of the coin.

 

Thanks all for your sincere advice.

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Medicine demands a large time commitment...

not only as a student trying to learn and memorize the large amounts of information, but also as a resident, working the wee hours of the night and getting no sleep. Then, depending on your choice of a specialty, you could be spending more time with your patients and on call, than with your family.

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Hi,

 

I know two doctors who aren't too pleased with their careers, one of whom left a post at St. Mike's to pursue massage therapy. For one, it is the time commitment (including the lack of sleep when she's on call) and the monotony of her specialty that she doesn't enjoy, (she is trained in Obs/Gyn). For the other, he left medicine as he found the occupation to be too stressful and despite trying, he did not feel that he could extricate this stress from his extra-medical life. He feels much happier doing what he's doing now.

 

Although these are two examples of folks who are not happy, there are plenty of other people who are very happy with medicine. There are huge numbers of factors (both career and personal) that will contribute to happiness within a career.

 

Cheers,

Kirsteen

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On another thread, there was a link to a blog on which the blogger was a med student who aimed at enlightening his premed viewers on the negative aspects of medicine. I think he named them "reasons for not persuing medicine," or something like that. I forgot the link : ((

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Hi,

 

My question is the opposite of: Should I do medicine?

My question is: Why should I NOT do medicine?

 

I am currently an engineer, 2 years experience, making 70K a year. If I work very very hard (harder than a doctor), I could make ~120-150 in 5 years. But if I change jobs that will drop to 70-100K.

 

My picture of a doctor is very tempting: (the PROS)

  • 150K average salary
  • job security
  • can move to other countries
  • can specialize and have own practice
  • can secure a loan and live decently while a student (even if supporting a family and then pay it off relatively easily within a few years)
  • possibility to help people directly and do humanitarian work

 

Now what are the CONS of doing medicine? What makes people who would qualify and do great in medicine not study it?

 

I have a relative and a close friend preaching med shcool to me every time we discuss career and life paths.

 

I'd appreciate if someone could tell me about the other side of the coin.

 

Thanks all for your sincere advice.

 

Hey,

 

You've got a good handle on a lot of the pros. The money is decent, job security and mobility are unparalleled and docs can help people in a way that is unique to our profession.

 

I'm not a doc yet, but I trained as an engineer and worked in industry for a while before med school so let me chip in my $0.02. I think the two big cons to meds are time, and in your case, money. The work can be very rewarding but I'll try and highlight some of the downsides of it as well (caveat: I'm still in my preclinical years so I'm not really speaking from experience here).

 

 

TIME

 

At a residency talk at UWO last year, an internist (who reads and posts on this board, incidentally) put it this way: "Medicine is a jealous mistress". If you let it, a career in medicine will suck all of your time and leave you nothing for yourself. The schooling takes years, residency takes years and many practicing physicians put in ridiculous hours, day after day, month after month, year after year. Physicians have a higher rate of divorce, addiction and suicide than the general population. Although docs graduating these days put a lot more emphasis on work/life balance than do old-school doctors, most of them still work longer and harder than any other profession I can think of. Many of them have great home lives, raise families etc but it doesn't just fall into place. You have to work extra-hard at having a "normal" life outside medicine.

 

Q. What's the worst thing about one-in-two call?

A. You miss half the good cases...

 

 

MONEY

 

There's a huge opportunity cost to leaving a career and going back to school for meds. You will have three or four years of essentially zero income, followed by 2-5 or more years living on a resident's salary. For perspective, a PGY1 makes $46k a year, while an PGY5 makes $65k. That's more than most people earn, but if your career tracks the way you expect it to, it's a lot less than you will be making a decade from now. On the other hand, once you pass your boards you'll probably make more, maybe a lot more, than you ever would as an engineer. (I think $150k /year is on the low side for physician income.) I did a back-of-the-envelope calculation a long time ago, and figured I'd be over 50 years old before I broke even.

 

On the flip side the opportunity cost of not following your dream is incalculable, so it all comes down to what's important to you.

 

 

THE WORK

 

TV medicine is exciting. Real clinical medicine can be *incredibly* rewarding, but it's not all sexy people and gorgeous lighting.

 

It's paperwork. It's digital disimpaction of demented 90-year-olds. It's hospital politics. It's provincial politics. It's having patients die on you. It's that [expletive] pager going off at 4AM when all...you...want...to...do...is...sleep... It's **** and piss and blood and puke and the smell of gangrene and the two-pack-a-day obese patient who isn't compliant with his meds and that delerious kid burning up in room three whose parents are frantic with worry and you have no clue what's wrong with him and it's chasing down lab tests and it's trying to grab some food because you haven't eaten yet today and it's missing dinner with your wife again and it's too much bad coffee and it's a waiting room full of angry patients and it Never.

 

Ever.

 

Stops.

 

 

 

:eek:

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Hey,

 

I predict that ploughboy will be the next to respond to this thread!

 

Best of luck!

Timmy

 

 

I'm just an average guy with an average life

I work from nine to five, hey hell I pay the price

But I want is to be left alone in my average home

But why do I always feel like I'm in the Twilight Zone

 

CHORUS:

I always feel that somebody's watchin' me

And I have no privacy

I always feel that somebody's watchin' me

Is it just a dream?

 

When I come home at night

I bolt the door real tight

People call me on the phone I'm trying to avoid

Well, can the people on TV see me or am I just paranoid

 

CHORUS

 

When I'm in the shower, I'm afraid to wash my hair

I might open my eyes and find TMax standing there

People say I'm crazy, just a little touched

But maybe showers remind me of Psycho too much

That's why...

 

I always feel like somebody's watching me

Who's playing tricks on me

I always feel like somebody's watching me

Tell me it can't be

 

I don't know anymore

Are the neighbors watching me

Well is the mailman watching me

And I don't feel safe anymore, oh what a mess

I wonder who's watching me now?

Who?

The IRS?

 

I always feel like somebody's watching me

Who's playing tricks on me

I always feel like somebody's watching me

I can't enjoy my tea!

 

- Rockwell (featuring Michael Jackson)

 

...Yay for cheesy 80s songs...

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My picture of a doctor is very tempting: (the PROS)

  • 150K average salary
  • job security
  • can move to other countries
  • can specialize and have own practice
  • can secure a loan and live decently while a student (even if supporting a family and then pay it off relatively easily within a few years)
  • possibility to help people directly and do humanitarian work

 

 

Talking to people who are acctually in the field (as I'm still trying to get into medicine), this is what I've learned about the job. Not to make your pros look like cons, but there is always more than one side to the story. Now these are things I've been told by current physcians and surgons, they may NOT be 100% true, so ANYONE feel free to add additional details, or correct me if I make a mistake. I'm only human, and I cannot possibly know everything (although I do try :D) I'm just gonna comment on your points.

 

150K average salary, then you have taxes and clinic costs (assuming you are talking about a family physcian) but that's once you're done school and all your residency, during residency you work long hours, and get paid pretty poorly. All in all, for the amount of work and schooling you do, compared to other careers, medicine (at least in canada) is not a carrer that will make you rich. (Dentistry, Chiropractic, business, law) all require 'less' time in school, some of them also are alot less competitive, and have very high earning potential. Depending on where you practice, even things like physiotherapy will take home more money after taxes and expences at the end of the day than a FP. But IMO a FP's work would be more fun :) It's also IMO that money can be made anywhere, you just have to let your money work for you, instead of you working for your money. I know some people with pretty crappy jobs (in terms of salary) but with making their money work for them, they can live really really good lives without going into debt.

 

Job security, yes and no, it depends on your location. IF you are in the middle of no where in a small remote town, and you set up practice there, and you only get a few paitents, you will starve. I think of having a clinic is sorta like a business, location, location location, although it's quite a bit easier, as physcians are in demand.

 

Can move to other countries, yes and no. It's like any job, if your degree/skills are reconized in another country, you can, but if it's not, you cannot. So say you get your MD, then you want to live in europe, say they don't reconize the MD you have, because they feel it's not up to their standards, you will not be practicing medicine there. (Ie look at all the european/east asian MDs that are here, that cannot practice medicine)

 

Yes you can specalize, but (to my knowledge) only certain specalities can have (or maybe it's should have) their own practice, the rest will work in a hospital. Psychiatry, Family Practice, Dermatology, Sports Medicine, etc. To my knowledge, although you get an 'unlimited' license to practice medicine by the provience/state or whatever, you are restricted to the specality you choose (unless if you go back for further training)

 

Loans, are all about your credit. Sure your schooling helps, but if you have bad credit, you will not get a nice huge loan. And you should not depend on loans to live while in school, because even in medicine depending on where you live, it could take a LONG time to pay it off.

 

Note some of these may be extreme, but you always gotta understand there no such thing as a 100% guarntee :)

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Well,

 

Here's the trouble. By the time that you figure out that medicine is not right for you, you've potentially sacrificed many years of your life and tens of thousands of dollars of debt.

 

There are a fair number of medical students who become very cynical while in medical school, and this attitude is fairly prevalent during residency as well. The trouble is that while you may have entered medical school as a very idealistic and humanistic person who will "never be like that jerk doctor who treated me or a family member/friend like a disease and not a person", medical school has a way of dehumanizing you.

 

An endless string of 30 hour shifts, chronic sleep deprivation, confrontations with nurses or other physicians, the incredible amount of social work (phone calls, forms to fill out, non-compliant patients, a medical system that seemingly makes it difficult to accomplish your goals for your patients [ie. waitlists for CT scans, surgeries, restricted medications, inabililty to get patients into specialist's offices, etc], and spending time with other disgruntled med students/residents/attendings can be enough to turn the most kind-hearted individual into a cynic.

 

Add to that an ever increasing pressure to see as many patients as possible to maintain your lifestyle, and doing medicine really can be tedious. There are a number of physicians out there who would not repeat the process if given the opportunity.

 

On the flip side, I think most physicians would love to practise medicine if they were able to take their time with each patient, and didn't have the lifestyle problems of always being on call and at mercy to his/her pager.

 

Unfortunately, when you are pressured to crank out patients factory-style, the joy of medicine gets replaced by the tedium of medicine. It's simply not possible to get to know your patients as well as you'd like to, nor is there enough time in the day to address your patient's questions as much as they'd like.

 

By the time you realize that medicine may not be a good fit for you, you might be halfway through third year of med school, or worse yet, a resident or attending, and by that time, you're trapped. It's very hard to reverse and change courses/careers at that time because of the time and money you've already invested.

 

The time investment has already been addressed, and is considerable. By the time you've completed a Bachelors +/- grad degree, 4 years of med school, and anywhere from 2-5 years of residency, most people are pushing 30 years of age.

 

That's an awful lot of time to sacrifice towards your career, particularly since the average physician still puts in 50-60 hours a week as an attending. It's not like life gets considerably easier after you finish residency.

 

I also wanted to address a few statements by the last poster.

 

150K average salary, then you have taxes and clinic costs (assuming you are talking about a family physcian) but that's once you're done school and all your residency, during residency you work long hours, and get paid pretty poorly.
Note that most full-time family physicians in Canada are probably more around the 200k annual salary. Many specialists can make considerably more, comfortably into the 300-400k range.

 

Job security, yes and no, it depends on your location. IF you are in the middle of no where in a small remote town, and you set up practice there, and you only get a few paitents, you will starve.
Generally, it is those small towns that are most desperate for physicians. What is more a problem is whether that small community can support your specialty. As an example, there are probably very few small Canadian towns that are as well staffed with family physicians as they would like. For this reason, we fill these positions by recruiting international physicians to work in these areas in exchange for Canadian licensure, or give inducements to Canadian med students in the form of debt forgiveness or rural incentives to settle and practise in these areas.

 

However, that same small community does not have the population base to support a neurosurgeon, or an interventional radiologist, because there simply aren't enough neurosurgical cases or interventional procedures to justify retaining such a specialist. If you are a neurosurgeon, you need a minimum city/catchment population in order to justify your existence in that location.

 

Yes you can specalize, but (to my knowledge) only certain specalities can have (or maybe it's should have) their own practice, the rest will work in a hospital.
Actually, there are very few to no specialties that confine you to a hospital. The closest you might come to that would be an emergency medicine physician, and even they typically can work in urgent care/walk-in clinics. For those EM docs who were family medicine physicians first, they can obviously revert to family medicine if desired.

 

Even the traditional hospital-based specialties like Anesthesiology, Pathology, and Radiology have multiple mechanisms to get out of the hospital if need be. While surgeons operate at the hospital for 1-2 days of the week, and see their surgical patients in the hospital post-surgery, the rest of the time they are in their private offices seeing patients to generate more potential surgical cases.

 

Loans, are all about your credit. Sure your schooling helps, but if you have bad credit, you will not get a nice huge loan. And you should not depend on loans to live while in school, because even in medicine depending on where you live, it could take a LONG time to pay it off.
Most people in med school do exactly this, if they don't happen to have funds from family/spouse or a previous career. For the average med student, it is physically impossible to maintain enough of a job in medical school to pay for all living expenses and tuition without seriously compromising your studies.

 

Your very acceptance into med school opens up huge lines-of-credit from multiple banks, all of whom will be more than happy to lend you upwards of $150,000 for the four years of medical school. The reason they do this is because they realize that a full-time physician in Canada should be capable of generating over $200,000 per year of gross billings (and potentially much more), and therefore from a risk-perspective, you are a very low-risk candidate for defaulting on this loan.

 

Despite the huge debt, and rather daunting mental anchor of realizing that a bank has $150,000 of hooks into your body, if you get into med school and go on to practice medicine, you will be able to pay off this debt. That's why banks are willing to lend you the money.

 

Ian

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On the flip side, I think most physicians would love to practise medicine if they were able to take their time with each patient...

 

Question for those in the know about different Family Medicine practice environments:

 

Do any of you have any insight as to whether working as part of a FHN (Family Health Network -- this might be solely an Ontario thing, though I'm sure other provinces have similar setups) or in a CHC (Community Health Centre) allows for this???

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Thanks to everyone for the interesting replies and to the original poster for the question.

 

What about the politics of medicine? I was reading about the headache of trying to get appropriate OR time if you're a surgeon or an anesthesiologist. I don't know what are the politics for the other specialties. Does anyone have insight into this? (I'm just a measly little o'le premed so I don't know much)

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Thanks to everyone for their objective comments. A lot of food for thought.

 

I am at another cross-road in my life where I need to walk one way and turn my back to the others.

 

A few comments to the people who kindly replied:

 

Regarding family and life balance:

Indeed, it is a challenge. They should add "Proof of Family Support" to the requirements of Med School.

 

Regarding the hours:

30 hour shifts are extreme indeed. I knew Msc and PhD students in computer science (my field) who had to work pretty much that hard to get their papers published. Crazy hours are everywhere in this competitve age, what differs is what you get out of them.

 

Cost/Money/Opportunity Cost

In my case this is the tricky one. I am getting a decent salary with possibility of growth. The last analysis I did showed that it would take me almost 15 years to break even if I quit today and go for Med School. I will need to recalculate that. I have a feeling that it will be more. But just the fact that there is a break even point is financially an argument in favor of quitting. Also the loan and the residency salary help you maintain a minimum comfort for your family. In addition to that, it is a pretty much garanteed investment.

 

Thanks again for all the input you gave me. I will read them again in the future.

 

The Super Not So Immune Hero - I got a cold.

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Thanks Super Immune Hero and everyone for making this thread, I find it very helpful and eye opening...

 

I have a question (however ignorant) - what pressures you to see patients the way you would want to? Is it essentially debt, or your supervisors, etc?

 

And what to people do to preserve their humanity?

 

Thanks!

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Hey,

 

I can definitely attribute to the politics side of medicine. See today, while I was working in the ER, this nice old lady came in complaining of dizzyness. She had no other symptoms other than a heart rate of 40 (later found to be in AFib via ECG) and a bit of nausea but no chest pain or anything else concerning- she was otherwise healthy. The only thing that had changed recently was that she had just started a new heart medication (ie: yesterday), as prescribed by the cardiologist she sees through a certain clinic for her recurrent Afib. I found out the name of the cardiologist (we'll call him Dr. Z) and decided to give him a shout, since there wasn't much we were going to be doing for this lady in ER, other than consulting cardiology, which you think could be circumvented by just calling up the prescribing physician and finding out what he wanted done. Well, needless to say, I got an earful from Dr. Z, who had no idea who I was talking about to begin with, denied ever having seen her (yet she gave me his name and no one else's) in the first place and had no intention of seeing this patient who he had recently prescribed drugs to. He tried to sell me on the fact that clinically, since there was nothing wrong with this patient (other than being in some pretty severe iatrogenically-induced heart block), we should just do nothing and that there were a ton of people walking around London with heart rates of 40 (which I seriously doubt). A few choice words for me later, he hung up the phone.

A bit stunned (and mentally plotting Dr. Z's untimely death), I went back to the patient and explained to her that her (soon to be ex-) cardiologist didn't want anything to do with her and had refused to see her. The story actually has a happy ending since the patient blamed Dr. Z and not me for her plight, but you get the picture.

One thing that sucks about medicine is that unless you are a consultant, you get yelled at and/or $hat on for ringing up another consultant, regardless of how in the right you are. The least one can do as a physician is actually see the patients that you have (recently) prescribed to if they are having a problem. Medicine is great for passing the buck and nobody doing any work, if they can avoid it by fast-talking their way out of it or through sheer intimidation. I had an OB/GYN consultant refuse to do a quick pelvic U/S to rule in an intrauterine pregnancy because he said "Oh, we're not qualified to rule out ectopics", as he walked by my patient's room and me, pushing the ultrasound machine after undoubtedly ruling in an intrauterine pregnancy on another patient I had consulted him for. Thanks for nothing, jerk!

Remind me to refuse all consults from other services from now on, especially those coming from the ER- they're just there to waste everyone's time anyway, right? Oh wait, since I'm anaesthesia, it's probably safe to assume that any consult I get from the ER is because they can't intubate/ventilate/both a patient. If I refuse to see the patient, then they probably die! That wouldn't be very professional of me now, wouldn't it? I wish that I had the luxury of refusing to see patients when consulted!

Dammit, should have gone into derm! Or general surgery...

 

Best of luck!

Timmy

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Tmax, at least you're not the final dumping ground for anything that walks through the hospital door like the internal medicine service...

 

 

 

As a note about this thread, a physician near and dear to my heart (my father) told me if you can be happy doing anything other than medicine, do it. If you have the brains to get into medicine, you have the brains to make a pile in business, do some really interesting research in the field of your choice, get involved in politics or policy or social services and make a difference that way. But if at the end of an exhaustive analysis, you want the challenge, the hours, the non-compliant patients, the cranky attending physicians on all sides of a "social admission" at 3 am...

 

because several times a day, a complete stranger will say to you, "thanks, Doc" and mean it...

 

 

then by all means give it a try.

 

And good luck.

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Hey,

 

Tmax, at least you're not the final dumping ground for anything that walks through the hospital door like the internal medicine service...

 

Yeah, true enough- I'd hate to be one of those suckers...

 

I'm going to go now before I get myself cyber-b!tch-slapped!

 

Best of luck!

Timmy

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The problem getting consultants to see their patients is primarily a teaching-hopital phenomenon. In community hospitals, they will gladly see these consults because they get paid for each one. Heck, I saw a cardiologist's note in emerg once that said simply: "Not a cardiac issue. (Signed)" and they billed for it (hope they never get audited). Similarly for social admissions: takes all of 5 minutes to round and write notes on them, and you bill for each day they are admitted. You do need a good social worker though to be able to handle them easily.

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  • 1 month later...

Well then...what if you decide the cons of medicine outweigh the pros in terms of time and lack of work/life balance, but you'd like a career with as many of the "medicine" pros (especially mobility, humanitarianism etc.) as possible. What do you do? Has anyone considered other things they might do, or careers that are almost as versatile as medicine and that will let you live anywhere in the world (perhaps more easily than medicine because MD qualifications aren't always transferable...)?

Any thoughts?

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Hi,

 

My question is the opposite of: Should I do medicine?

My question is: Why should I NOT do medicine?

 

I am currently an engineer, 2 years experience, making 70K a year. If I work very very hard (harder than a doctor), I could make ~120-150 in 5 years. But if I change jobs that will drop to 70-100K.

 

My picture of a doctor is very tempting: (the PROS)

  • 150K average salary
  • job security
  • can move to other countries
  • can specialize and have own practice
  • can secure a loan and live decently while a student (even if supporting a family and then pay it off relatively easily within a few years)
  • possibility to help people directly and do humanitarian work

 

Now what are the CONS of doing medicine? What makes people who would qualify and do great in medicine not study it?

 

I have a relative and a close friend preaching med shcool to me every time we discuss career and life paths.

 

I'd appreciate if someone could tell me about the other side of the coin.

 

Thanks all for your sincere advice.

SuperImmuneHero:

 

I did engineering and spent the better part of two years at big name companies. When I decided to switch gears-- I had a master's project lined-up for working on jet engines with an industry partner.

 

*Salary: It depends on what you do. Some doctors make obscene amounts of money.

*Job security: It is hard to beat... but a nutty patient can sue you and threaten your livelihood without foundation. That can be unsettling.

*Move to other countries: Personally, I think engineering is better for that. I worked overseas a couple of times... and the opportunities (in engineering) I think are better than in Canada. I know someone that went overseas... got himself an engineering job--where he works less and makes more than he did in Canada. If money is your thing... Canada is second only to the US. Doctors everywhere else make less... so moving isn't going to improve things there. Also, language is a much bigger barrier in medicine than it is in engineering. I think global mobility is a CON... moving within the country is a PRO (you can work anywhere in the country-- where there are people there are sick people).

*Can have your own practise: Depends on what you do. Family medicine-- yes. In other areas you're dependent in some way on other people/ hospital admins.

*Can live decently while a student: It is alright... but you work like a slave. It isn't unusual that surgery resident work 80-90 hours/week. I've heard a surgery resident tell me they once worked over 110 hours in a week.

*Possibility to help people directly and do humanitarian work: This is where medicine wins hands down. That said, there is 'engineers without borders'... and you're likely to have a bigger impact if, as a civil engineer, you go fix a town's water supply... as opposed to recurrently treating the parasitic infections that arise 'cause of the drinking water is laden with feces.

 

Personally, I like the warm fuzzy feeling of working in an environment where you help people... as opposed to say building a better jet engine so some dictator can bomb innocent people OR some nut-job president can more easily bomb a country back into the stone age OR some device that polutes our environment and makes people sick.

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