LostLamb Posted August 11, 2009 Report Share Posted August 11, 2009 If any of you as physicians were called upon by the family member of your extremely high needs patient to help advocate for assistance (be it day programming, home care, respite care, specialized intensive therapy, or all of the above), what would your response be? Consider that the individual at hand has been your patient since childhood and is now in their late teens. The family member in your office is also your patient. I just need to clarify in my mind where people stand. Thanks in advance for your input. Link to comment Share on other sites More sharing options...
Dampy Posted August 11, 2009 Report Share Posted August 11, 2009 7:45 AM: Arrive to work, go out of your way to say hello to the new cute nurse 8:00 PM: Call up the cute nurse and sexually harass her. Only about 3 times I have spit up my water laughing while reading pm101 posts, this was the third. Good work Link to comment Share on other sites More sharing options...
AndrewB Posted August 11, 2009 Report Share Posted August 11, 2009 If any of you as physicians were called upon by the family member of your extremely high needs patient to help advocate for assistance (be it day programming, home care, respite care, specialized intensive therapy, or all of the above), what would your response be? Consider that the individual at hand has been your patient since childhood and is now in their late teens. The family member in your office is also your patient. I just need to clarify in my mind where people stand. Thanks in advance for your input. I would definitely advocate for them. That being said, I acknowledge the limitations of Medicare and that certain requests can and may be legitimately declined due to the strain they pose to our fragile socialist healthcare system. Link to comment Share on other sites More sharing options...
Rayven Posted August 12, 2009 Report Share Posted August 12, 2009 keep your mind on the topic, lol You're one to talk.. avenir does part time nursing, stay away from avenir or I will report you to the matron of nursing. who may sexually harass you, lol No fat chicks please. lol.. jk jk.. If any of you as physicians were called upon by the family member of your extremely high needs patient to help advocate for assistance (be it day programming, home care, respite care, specialized intensive therapy, or all of the above), what would your response be? Consider that the individual at hand has been your patient since childhood and is now in their late teens. The family member in your office is also your patient. I just need to clarify in my mind where people stand. Thanks in advance for your input. It would depend entirely on what the family's asking for. But in most cases if it was something reasonable then I'd most likely advocate for their requests. Even if I was ethically opposed to it (ie $300,000/year for one patient), I would not go setting precedents at the cost of my own patients. Although the family has history with me, I would hope it doesn't bias my decision. If I felt it did then I would probably consider referring them to another doctor. Link to comment Share on other sites More sharing options...
LostLamb Posted August 12, 2009 Report Share Posted August 12, 2009 Posted by AndrewB (sorry I don't know how to multiquote) I would definitely advocate for them. That being said, I acknowledge the limitations of Medicare and that certain requests can and may be legitimately declined due to the strain they pose to our fragile socialist healthcare system. It would depend entirely on what the family's asking for. But in most cases if it was something reasonable then I'd most likely advocate for their requests. Even if I was ethically opposed to it (ie $300,000/year for one patient), I would not go setting precedents at the cost of my own patients. Although the family has history with me, I would hope it doesn't bias my decision. If I felt it did then I would probably consider referring them to another doctor. The family is asking for support from a medical professional familiar with the individual in question to strengthen their case for receiving desperately needed care. Can either or both of you clarify what is 'reasonable' to ask for? Remember, the family member did not come to you asking for $300K of funding. They just need your help in accessing services. I am not clear on which way you are afraid you would be biased, Rayven. Also, do you think it would be fair to this patient to refer the patient/family member to another physician, unfamiliar with their history? Link to comment Share on other sites More sharing options...
AndrewB Posted August 12, 2009 Report Share Posted August 12, 2009 LostLamb, I should have made that more clear. I don't mean that I would be the one declining services. I would do everything to help them access the services they require. If the government declines my request, that's unfortunate. I would understand their argument from an economic perspective though if my request was going to cost a lot of money. Link to comment Share on other sites More sharing options...
Rayven Posted August 12, 2009 Report Share Posted August 12, 2009 Posted by AndrewB (sorry I don't know how to multiquote) The family is asking for support from a medical professional familiar with the individual in question to strengthen their case for receiving desperately needed care. Can either or both of you clarify what is 'reasonable' to ask for? Remember, the family member did not come to you asking for $300K of funding. They just need your help in accessing services. I am not clear on which way you are afraid you would be biased, Rayven. Also, do you think it would be fair to this patient to refer the patient/family member to another physician, unfamiliar with their history? I guess what's reasonable is the million dollar question. Things I would consider first and foremost is if there's any real benefit that they'd derive from the requested services. This would be very much like any other patient coming into your office and asking about certain treatments. Kind of if like a patient came in with a simple cough and started to ask for oxycontin then I'd have decide if that's reasonable. I should clarify at this point (given our debate) that I'm not considering the cost of the services to taxpayers as a factor in my decision or any such notion while considering my patient's requests. But ultimately, I would fall back on what I said earlier and not set any precedents at the cost of my patients. If other patients with exact or similar conditions are receiving access to these services (even if I thought it was a waste of their time and of the health or SS budget) I would still advocate that my patient also receive access to these same services. The bias that I'm fearing is that I may in fact be too close to this hypothetical family that my decisions might be biased in favouring to give the patient services or treatment that I normally would deem pointless and would normally otherwise not advocate. I would know the patient best but sometimes being too close to the patient clouds our judgment (ie they'd probably never let you be the surgeon to operate on your spouse, boyfriend, or girlfriend). A history and medical record would accompany the referral so that the relevant facts are still available to the other doctor.. just not the emotions. But hey, I'm not a doctor. I can't say I really know if that's how things work. What about you, lamb? Link to comment Share on other sites More sharing options...
future_doc Posted August 13, 2009 Report Share Posted August 13, 2009 I think the great divide occurs when some want to re-allocate financial resources away from their patients and toward the great good. I understand the goal, but I question the means and do not know how a doctor can juggle his/her responsibility toward a patient and the greater good. On a theoretical level, I understand where people are coming from. On a practical level, on the basis that we are practicing physicians, I have problems with the ethical implications. That is why this discussion could be so much more meaningful if there were partcipants who are already MDs and have real experience. We need, I need, the benefit of the experience of others to test our views. For sure, we all want to have a compass to help steer our course as physicians. To the extent that any of us can begin to learn or begin to develop strategies of how to deal with real life situations involving ethics, futility, withdrawal or withholding of treatment, this thread could be of great benefit to us all. Are there any med students or new MDs reading this thread who can help us? So a question, why would you save the child over the elderly given that both have the same chance of surviving? What happened to your sanctity of life argument? Why wouldn't you? If you really don't understand the reasoning (and I cannot bring myself to believe that you don't understand, this gotta be another one of your jokes), then you won't understand my explanation. But try this, the child has 80 years to live, the elderly person has another 10 or 15 years. Basically what I'm saying (for the 10th time to you) is that as a doctor you should be a doctor when you're working. You see, we can agree on some things. But as a human being you're entitled to think. We continue to agree. Doctors are just as human as we are too. They're flawed just like we are. The MD designation really holds no water. You have some doctors who are vehemently opposed to abortion at any stage and then you'll have some who are for it or maybe only at certain terms. Yes Logically I would assume that if the given patient is capable that it is their decision to continue or stop treatment. If they're not capable then you'd find a substitute decision maker (ie family). I think it's rare that a physician would make the decision. And if it really came down to the doctor making the decision then I imagine there's quite a bit of paperwork to be done to avoid being legally sued and stripped of your license. But hey I'm probably wrong, that's just how I would imagine the system to work anyways. Yes, and.....? ps: 8:00 PM: Call up the cute nurse and sexually harass her. What happens at 8:15 PM? If any of you as physicians were called upon by the family member of your extremely high needs patient to help advocate for assistance (be it day programming, home care, respite care, specialized intensive therapy, or all of the above), what would your response be? Consider that the individual at hand has been your patient since childhood and is now in their late teens. The family member in your office is also your patient. The family is asking for support from a medical professional familiar with the individual in question to strengthen their case for receiving desperately needed care. Can either or both of you clarify what is 'reasonable' to ask for? Remember, the family member did not come to you asking for $300K of funding. They just need your help in accessing services. It would depend entirely on what the family's asking for. But in most cases if it was something reasonable then I'd most likely advocate for their requests. Even if I was ethically opposed to it (ie $300,000/year for one patient), I would not go setting precedents at the cost of my own patients. I guess what's reasonable is the million dollar question. Things I would consider first and foremost is if there's any real benefit that they'd derive from the requested services....I should clarify at this point (given our debate) that I'm not considering the cost of the services to taxpayers as a factor in my decision or any such notion while considering my patient's requests. But ultimately, I would fall back on what I said earlier and not set any precedents at the cost of my patients. If other patients with exact or similar conditions are receiving access to these services (even if I thought it was a waste of their time and of the health or SS budget) I would still advocate that my patient also receive access to these same services. Good for you, Rayven, I will even forgive your unnecessarily insensitive comments about fat chicks, who may be your future patients and daughters. Link to comment Share on other sites More sharing options...
AndrewB Posted August 13, 2009 Report Share Posted August 13, 2009 Why wouldn't you? If you really don't understand the reasoning (and I cannot bring myself to believe that you don't understand, this gotta be another one of your jokes), then you won't understand my explanation. But try this, the child has 80 years to live, the elderly person has another 10 or 15 years. The point of that scenario was to provide a basic example of when a physician would have to choose between possible life and death among their own patients. It was just to show that your argument about saving every life all the time is too simplistic and unrealistic in practice. Consider this now, what if the 9-year old was the mentally disabled patient that the OP originally posted about? Is age the only consideration you would use? Should severe mental retardation be used to determine who gets priority? These are hard questions and I don't really know the answer to them. But just pretend it happened. What does your gut say? Link to comment Share on other sites More sharing options...
future_doc Posted August 13, 2009 Report Share Posted August 13, 2009 The point of that scenario was to provide a basic example of when a physician would have to choose between possible life and death among their own patients. It was just to show that your argument about saving every life all the time is too simplistic and unrealistic in practice. Consider this now, what if the 9-year old was the mentally disabled patient that the OP originally posted about? Is age the only consideration you would use? Should severe mental retardation be used to determine who gets priority? These are hard questions and I don't really know the answer to them. But just pretend it happened. What does your gut say? Alastriss also raises a valuable perspective. Having read both posts, my gut tells me to go with the 9 year old, he is so young, medicine and technology is advancing so quickly in so many ways,it is entirely possible this youngster will have possibilities that don't exist today and I would not cut off his possibility for life based upon age n/w/s the fact that the elderly patient has a wide range of people and probably contributes more to society. You pose a most interesting dilemma for us all. Three years ago a woman confined to a wheelchair and without movement or ability to communicate had her brain literally connected to a computer and now she herself can communicate with the world, turn on her favourite piece of music, etc. And there is another paralized man on a ventilator who was unable to communicate in any manner and now with elctrodes placed on his head with a removeable cap, he is able to write his thoughts for others to see, merely by thinking the letters that appear o n a computer. So, he are already living in the future and I would not curtail this kid's future based upon strictly present day considerations. Link to comment Share on other sites More sharing options...
Rayven Posted August 13, 2009 Report Share Posted August 13, 2009 Why wouldn't you? If you really don't understand the reasoning (and I cannot bring myself to believe that you don't understand, this gotta be another one of your jokes), then you won't understand my explanation. But try this, the child has 80 years to live, the elderly person has another 10 or 15 years. Ah. But I thought you made it pretty clear from the beginning that you didn't care about functionality or how much a patient could contribute to society. Under your "sanctity of life" argument (which you reiterated only about a billion times or so), both lives would be equal. Basically what I'm saying (for the 10th time to you) is that as a doctor you should be a doctor when you're working. You see, we can agree on some things. ...no, we don't. Because I've had to tell you 10 times already of the difference. You don't understand that a doctor needs to be a doctor while he or she is working but they're still allowed to hold opinions, think, and have feelings. Otherwise you wouldn't have said, "I understand the goal, but I question the means and do not know how a doctor can juggle his/her responsibility toward a patient and the greater good." But as a human being you're entitled to think. We continue to agree. lol..? See above. Doctors are just as human as we are too. They're flawed just like we are. The MD designation really holds no water. You have some doctors who are vehemently opposed to abortion at any stage and then you'll have some who are for it or maybe only at certain terms. Yes Yes what? You were just saying you need a MD with experience to tell you and us how to think. I disagreed with you. Are you now agreeing with me? Logically I would assume that if the given patient is capable that it is their decision to continue or stop treatment. If they're not capable then you'd find a substitute decision maker (ie family). I think it's rare that a physician would make the decision. And if it really came down to the doctor making the decision then I imagine there's quite a bit of paperwork to be done to avoid being legally sued and stripped of your license. But hey I'm probably wrong, that's just how I would imagine the system to work anyways. Yes, and.....? Anddd I was addressing one of the questions you asked regarding withdrawing or not withdrawing treatment. ps: What happens at 8:15 PM? You and I have the best angry sex ever. Good for you, Rayven, I will even forgive your unnecessarily insensitive comments about fat chicks, who may be your future patients and daughters. I was kidding... as implied when I said "jk jk". edit: Btw... did you just delete your post from 2 days ago and just repost it? Because I see myself quoting you (like I usually do) but that original post is gone. Any reason why..? Link to comment Share on other sites More sharing options...
AndrewB Posted August 13, 2009 Report Share Posted August 13, 2009 You and I have the best angry sex ever. Ahahahahahahahahahahahahaha! Link to comment Share on other sites More sharing options...
future_doc Posted August 13, 2009 Report Share Posted August 13, 2009 Ah. But I thought you made it pretty clear from the beginning that you didn't care about functionality or how much a patient could contribute to society. Under your "sanctity of life" argument (which you reiterated only about a billion times or so), both lives would be equal. There you go putting words in my mouth. Under sanctity of life, one life must be saved and so, I can and will make the hard choices when I must. ...no, we don't. Because I've had to tell you 10 times already of the difference. You don't understand that a doctor needs to be a doctor while he or she is working but they're still allowed to hold opinions, think, and have feelings. Otherwise you wouldn't have said, And these feeling must not interfere with the responsibilities of being a physician. "I understand the goal, but I question the means and do not know how a doctor can juggle his/her responsibility toward a patient and the greater good." lol..? See above. There is nothing now above. Yes what? You were just saying you need a MD with experience to tell you and us how to think. I disagreed with you. Are you now agreeing with me? Yes:) , we are both reasonable people and why can we not agree at times? Anddd I was addressing one of the questions you asked regarding withdrawing or not withdrawing treatment. I cannot now see that you are quoting so the reply will be delayed. You and I have the best angry sex ever. I will not bother to quote to you from the Criminal Code and explain how 'angry sex' can result in not being able to get into med school and/or practice mediicine, but that is for another thread. I was kidding... as implied when I said "jk jk". I understood you were joking and left out "jk jk" Still insensitive. edit:Btw... did you just delete your post from 2 days ago and just repost it? Because I see myself quoting you (like I usually do) but that original post is gone. Any reason why..? of course:p and there were 2 reasons. Firstly, I did not want to interupt the flow with lambiepie's discussion, so I kept posting my edits that you taught me to do in the above post (the one I switched to the bottom). Secondly, I knew that in makin g it the last post, it would gain your immediate attention and you would not be able to resist to reply and so the post would heat up again, and I was right. I had waited a decent interval so as to give other posters the opportunity to reply to the lambiepie discussion and when there were no more posters, I felt that I was not intervening in a worthwhile discussion. And btw, did you receive her permission to call her 'lamb' and not even 'lambie'? You don't need to answer, I figured it out for myself:p , b/c I do have a brain you know. Link to comment Share on other sites More sharing options...
future_doc Posted August 13, 2009 Report Share Posted August 13, 2009 Ahahahahahahahahahahahahaha! Bring avenir into the discussion. Link to comment Share on other sites More sharing options...
Rayven Posted August 13, 2009 Report Share Posted August 13, 2009 There you go putting words in my mouth. Under sanctity of life, one life must be saved and so, I can and will make the hard choices when I must. What words did I put into your mouth? Be specific. Because from what I gathered, and I believe many others, is that your argument, as irrelevant as they were, has always been the same. Preaching the sanctity of life and that all lives are equal despite what they can contribute to society etc. So are you now saying that a younger person's life is worth more? And these feeling must not interfere with the responsibilities of being a physician. "I understand the goal, but I question the means and do not know how a doctor can juggle his/her responsibility toward a patient and the greater good." You're the one that seems so lost and confused about this... I've only told you now like 11 or 12 times that when you're working then you're expected to do your job. You might fantasize about how you could change the world for the better while you're working but you're still expected to do your job and not have your opinions get in the way of you doing your job. I thought this was pretty obvious but apparently 10 pages later it is not. There is nothing now above. Actually yes, there is. >.> Yes , we are both reasonable people and why can we not agree at times? I have no problem with agreeing but what I find actually borderline repulsive is that you're almost suggesting that you've always been agreeing with me or I with you.. which really hasn't been the case. I cannot now see that you are quoting so the reply will be delayed. Well... it doesn't help that you deleted and reposted your post from which I quoted just to get more attention. I will not bother to quote to you from the Criminal Code and explain how 'angry sex' can result in not being able to get into med school and/or practice mediicine, but that is for another thread. I had no idea that depending on my mood during sex that it could be illegal and have me banned from being accepted into med school. So I'm taking that as a no..? I understood you were joking and left out "jk jk" Still insensitive. Okay so I'm a jerk. I used a semi-popular saying like "fail". What now? of course:p and there were 2 reasons. Firstly, I did not want to interupt the flow with lambiepie's discussion, so I kept posting my edits that you taught me to do in the above post (the one I switched to the bottom). Secondly, I knew that in makin g it the last post, it would gain your immediate attention and you would not be able to resist to reply and so the post would heat up again, and I was right. I had waited a decent interval so as to give other posters the opportunity to reply to the lambiepie discussion and when there were no more posters, I felt that I was not intervening in a worthwhile discussion. The thing is, I've already replied to your original post. The only reason I replied to this new one was because you had editted it and replied to bits and pieces of mine. If anything, by deleting and reposting your post you screwed up the continuity and flow. Btw, if you really did learn anything about what I said in regards to editting then you wouldn't have double posted just now... =_= And btw, did you receive her permission to call her 'lamb' and not even 'lambie'? You don't need to answer, I figured it out for myself:p , b/c I do have a brain you know. Did you get written consent from avenir123-whatever to call her avenir?? Seriously, if you have time to nit-pick trivial stuff like this then I wish you'd go back to address all the replies to you (from me and others) that you somehow missed. P.S. So you're sure about the angry sex...?? Link to comment Share on other sites More sharing options...
future_doc Posted August 13, 2009 Report Share Posted August 13, 2009 You might fantasize about I have no problem with agreeing but what I find actually borderline repulsive is that you're almost suggesting that you've always been agreeing with me or I with you.. which really hasn't been the case. Well... it doesn't help that you deleted and reposted your post from which I quoted just to get more attention. I had no idea that depending on my mood during sex that it could be illegal and have me banned from being accepted into med school. Okay so I'm a jerk The thing is, I've already replied to your original post. The only reason I replied to this new one was because you had editted it and replied to bits and pieces of mine. If anything, by deleting and reposting your post you screwed up the continuity and flow. Seriously, if you have time to nit-pick trivial stuff like this then I wish you'd go back to address all the replies to you (from me and others) that you somehow missed. P.S. So you're sure about the angry sex...?? Hey Rayven, I don't fantasize, you do, cute nurses, sexual harassment, fat chicks, angry sex - your words, not mine, lol and for the record, angry sex can lead to rough sex which can lead to police report, criminal record and ergo, no med school, just tellin' you for your own good:o , after all I do want to protect you and to fight with you professionally as physicians, although not in FP, lol, for obvious reasons. And the sole purpose of the repost was to hook you in to your reply, I knew you would not be able to resist and I was 100% correct, those are the facts. You alone have probably created audience appeal to this thread the readership of which increased dramatically since you returned from your posting vacation. I have no time for tihs as I am preparing for MCAT tomorrow. Luckily this is my best form of preparation I can now think of for today, lol. On a very serious vein, I know you will do well tomorrow and in part this is b/c I will not be marking your essays and judging your arguments, lol jk. Do well, be well, this may be the last statement I make upon which we shall agree. PS Please please give me a list of med schools you will be applying too, not too long though, so I can apply to the others, lol. And btw, you called yourself a jerk, I never directly or indirectly inferred or stated that and I don't t hink you are a jerk regardless of what you think of yourself. You need to improve your self-image, you already have humility. PEACE, SHALOM. Link to comment Share on other sites More sharing options...
Microbiodude Posted August 13, 2009 Report Share Posted August 13, 2009 Alastriss also raises a valuable perspective. Having read both posts, my gut tells me to go with the 9 year old, he is so young, medicine and technology is advancing so quickly in so many ways,it is entirely possible this youngster will have possibilities that don't exist today and I would not cut off his possibility for life based upon age n/w/s the fact that the elderly patient has a wide range of people and probably contributes more to society. You pose a most interesting dilemma for us all. Three years ago a woman confined to a wheelchair and without movement or ability to communicate had her brain literally connected to a computer and now she herself can communicate with the world, turn on her favourite piece of music, etc. And there is another paralized man on a ventilator who was unable to communicate in any manner and now with elctrodes placed on his head with a removeable cap, he is able to write his thoughts for others to see, merely by thinking the letters that appear o n a computer. So, he are already living in the future and I would not curtail this kid's future based upon strictly present day considerations. Noted, but I don't think I'd make a decision based on potential long-term future technologies for the boy. That technology may come out after the lifespan of that boy, in which case as a Physician you may not have preserved the greatest value of life. I think when it comes to this kind of decision every decision maker uses the same formula: Quality of Life * Quantity of Life = Value of Life Quality of Life = Cognitive Function Score + Physical Function Score I think the difference of opinion lies in how much we score each individual. For example I may score the mentally challenged boy a 1.2/5 in cognition while you would give him a 2.7/5. Of course by introducing the quantity of life parameter we also introduce age discrimination. Also, the quality of life score is based on current technologies/ what may appear in the VERY near future (i.e. guaranteed to be available next year). Link to comment Share on other sites More sharing options...
avenir001 Posted August 13, 2009 Report Share Posted August 13, 2009 What happens at 8:15 PM? You and I have the best angry sex ever. is it getting hot in here or what Link to comment Share on other sites More sharing options...
future_doc Posted August 13, 2009 Report Share Posted August 13, 2009 is it getting hot in here or what He tried angry sex:eek: and she reported him and she consulted a lawyer;) . Now you understand why he remained quiet on that one. Link to comment Share on other sites More sharing options...
Rayven Posted August 13, 2009 Report Share Posted August 13, 2009 Hey Rayven, I don't fantasize, you do, cute nurses, sexual harassment, fat chicks, angry sex - your words, not mine, lol and for the record, angry sex can lead to rough sex which can lead to police report, criminal record and ergo, no med school, just tellin' you for your own good:o , after all I do want to protect you and to fight with you professionally as physicians, although not in FP, lol, for obvious reasons. To be honest, I'm no expert at sex since I'm kind of old fashioned and saving myself... >_> But angry sex to me is more about the heat of the passion... and not... literally.. angry, straddling you, while punching you in the face. =.= With your kind of logic, I shouldn't leave the house because it could lead to me accidentally bumping into someone, who then falls down an open manhole, police report, charged with manslaughter, criminal record, and ergo, no med school. And the sole purpose of the repost was to hook you in to your reply, I knew you would not be able to resist and I was 100% correct, those are the facts. You alone have probably created audience appeal to this thread the readership of which increased dramatically since you returned from your posting vacation. LOL! Omg man. I was replying to your post because you REPLIED TO MINE. You make it sound like you trapped me with some elaborate plan... lol?? Hmm.. if what you're really saying is true then that's neat. Maybe I should go into writing. I hear adult romance books are all the rage now.. you just have to make them for the teen demography and throw in vampires and werewolves. But I do digress, I am nothing without you... in this thread, at least.. you are the moon that gives rise to the waves in my ocean. The stars that light my blackened night skies. :3 I have no time for tihs as I am preparing for MCAT tomorrow. Luckily this is my best form of preparation I can now think of for today, lol. On a very serious vein, I know you will do well tomorrow and in part this is b/c I will not be marking your essays and judging your arguments, lol jk. Do well, be well, this may be the last statement I make upon which we shall agree. You've been posting all today and apparently yesterday.. =.= But yeshhh, good luck to you too. PS Please please give me a list of med schools you will be applying too, not too long though, so I can apply to the others, lol. And btw, you called yourself a jerk, I never directly or indirectly inferred or stated that and I don't t hink you are a jerk regardless of what you think of yourself. You need to improve your self-image, you already have humility. PEACE, SHALOM. Usually being called insensitive implies I'm a jerk... So what do you think of me then..? Link to comment Share on other sites More sharing options...
avenir001 Posted August 13, 2009 Report Share Posted August 13, 2009 To be honest, I'm no expert at sex since I'm kind of old fashioned and saving myself... >_> So what do you think of me then..? awww i bet she's madly in love with you now Link to comment Share on other sites More sharing options...
future_doc Posted August 13, 2009 Report Share Posted August 13, 2009 To be honest, I'm no expert at sex since I'm kind of old fashioned Two peas in a pod. With your kind of logic, I shouldn't leave the house because it could lead to me accidentally ..... The thin skull theory, i.e., he who has a thin skull is going to suffer significantly more damage than somebody who has a thick skull - if both receive a hard bump to the skull. LOL! Omg man. I was replying to your post because you REPLIED TO MINE. You make it sound like you trapped me with some elaborate plan... lol?? No trap, just logic. If it was put in front of your eyes, you had to reply and could not stop yourself (even though you had seen it before). This is called "marekting" which we all understand. Actually, marketing affects our lives in so many ways, e.g., how we present ourselves on OMSAS applicatons, in essays, in person and on this froum, etc. Hmm.. if what you're really saying is true then that's neat. Maybe I should go into writing. I hear adult romance books are all the rage now.. you just have to make them for the teen demography and throw in vampires and werewolves. Seriously, its true, just look at the numbers in the audience, how it has climbed since tou returned, it ain't accidental. But I do digress, I am nothing without you... in this thread, at least.. you are the moon that gives rise to the waves in my ocean. The stars that light my blackened night skies. :3 This is what you should have been saying at 8 PM, lol. You've been posting all today and apparently yesterday.. =.= Yep, best form of relaxation at this stage. If I am not prepared by now, I deserve what I will get and will rewrite (which I am prepared for mentally and emotionally). Tomorrow is another practice test - for real. But yeshhh, good luck to you too. ditto Usually being called insensitive implies I'm a jerk... So what do you think of me then..? We all become insensitive at times w/o even realizing it. You are definitely not a jerk. And you would definitely be a good lawyer (and phyisican). SHALOM Link to comment Share on other sites More sharing options...
future_doc Posted August 13, 2009 Report Share Posted August 13, 2009 awww i bet she's madly in love with you now avenir, my crush on you continues. I don't know if I have room for two in my life. And how did you know what you secretly said was true? Did I let you know, sh! please..... We all know that opposites attract. Link to comment Share on other sites More sharing options...
AndrewB Posted August 13, 2009 Report Share Posted August 13, 2009 To be honest, I'm no expert at sex since I'm kind of old fashioned I'm an expert. Just throwing that out there. Link to comment Share on other sites More sharing options...
Cnussey Posted August 13, 2009 Report Share Posted August 13, 2009 I'm an expert. Just throwing that out there. I've been avoiding responding to this thread...but I love this reply--I actually "loled". Link to comment Share on other sites More sharing options...
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