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ritz: Trisha Greenhalgh #FBPE @trishgreenhalgh Doctor: Don't confuse your Google search with my 6y at medical school. Patient: Don't confuse the 1-hour lecture you had on my condition with my 20y of living with it. 5:30 AM May 26, 2018 7.4K Retweets 22.8K Likes val-ritz: dreaming-in-circles: magickinmundane: pr0dr0me: licensetomurse: meanwhileonwednesday: As a medical professional and a medically complicated human this is very important to me That’s not wrong. These are both true Both are very very true. These are both true, but more importantly, not mutually exclusive! Say a patient comes in with chest pain. First time they’ve ever had chest pain. They say they googled it, and clearly they have cancer now! …no. That’s the first example. But say a patient has chest pain, they’ve had chest pain for 10 years, every previous doctor has checked for all the obvious causes, and nothing changes. That’s a completely different scenario. In the first example, the patient doesn’t know what they’re talking about. The condition is new, their knowledge is limited. That’s why we have doctors. But in the second example, the patient is the expert, and the doctor is the one who’s new to the situation. The patient has done all this before, and is very familiar with the pain (condition, etc.) that they have. The doctor is not the one with 10 years of experience. They need to listen, because the patient actually has something they don’t know to add to the conversation. These two things are not mutually exclusive, they are not the same scenario, and both doctors and patients (but mostly doctors) need to learn to tell the difference and know when to talk, and when to listen. This is also *highly* relevant to anti-vaxers. There is a reason that the entire section on dysthymia in my psychology textbooks is basically “this person has been living with this for years longer than you will ever have researched it. help them facilitate their own coping strategies.”
 ritz: Trisha Greenhalgh #FBPE
 @trishgreenhalgh
 Doctor: Don't confuse your Google
 search with my 6y at medical school.
 Patient: Don't confuse the 1-hour
 lecture you had on my condition with
 my 20y of living with it.
 5:30 AM May 26, 2018
 7.4K Retweets
 22.8K Likes
val-ritz:

dreaming-in-circles:

magickinmundane:

pr0dr0me:


licensetomurse:


meanwhileonwednesday:
As a medical professional and a medically complicated human this is very important to me
That’s not wrong. 


These are both true


Both are very very true.


These are both true, but more importantly, not mutually exclusive! 
Say a patient comes in with chest pain. First time they’ve ever had chest pain. They say they googled it, and clearly they have cancer now!
…no. That’s the first example. 
But say a patient has chest pain, they’ve had chest pain for 10 years, every previous doctor has checked for all the obvious causes, and nothing changes. 
That’s a completely different scenario. In the first example, the patient doesn’t know what they’re talking about. The condition is new, their knowledge is limited. That’s why we have doctors. But in the second example, the patient is the expert, and the doctor is the one who’s new to the situation. The patient has done all this before, and is very familiar with the pain (condition, etc.) that they have. The doctor is not the one with 10 years of experience. They need to listen, because the patient actually has something they don’t know to add to the conversation. 
These two things are not mutually exclusive, they are not the same scenario, and both doctors and patients (but mostly doctors) need to learn to tell the difference and know when to talk, and when to listen. 
This is also *highly* relevant to anti-vaxers. 

There is a reason that the entire section on dysthymia in my psychology textbooks is basically “this person has been living with this for years longer than you will ever have researched it. help them facilitate their own coping strategies.”

val-ritz: dreaming-in-circles: magickinmundane: pr0dr0me: licensetomurse: meanwhileonwednesday: As a medical professional and a me...

ritz: bastard angel idiot hungry chaotic soft angels-dining-at-the-ritz: Upon further thought, I decided to expand on this alignment chart. For your consideration:
 ritz: bastard angel
 idiot
 hungry
 chaotic
 soft
angels-dining-at-the-ritz:

Upon further thought, I decided to expand on this alignment chart. For your consideration:

angels-dining-at-the-ritz: Upon further thought, I decided to expand on this alignment chart. For your consideration:

ritz: Secret Confessions of the Working Class OTARGET I don't know how true it is for the other stores but at my Target the door alarm is always going off for various reasons (most of the time when we are pushing carts in), and we've come to ignore it and dont even look if it goes off BED BATH& BEYOND Bed Bath and Beyond accepts expired coupons don't throw them away. They also accept competitor coupons for specific items. And you can return ANYTHING without a receipt even if you did not buy it from a BBEB. (You'll only get a store credit.) DS If you ship something that has to be delivered at a certain time of day (for instance, next day air usually needs to be there by 10:30) check the delivery time. If it gets delivered 10 minutes late or later, you get your money back. So a 10:45 delivery is considered refundable Abercrombie & Fitch While some Abercrombie locations are equipped with spritzers of Fierce (the brand's signature cologne) built into the walls, many locations aren't, and the employees are required to walk around at hour intervals and liberally spray every product and surface with the stuff. I happened to be in a location that got the best of both worlds, as we bath had the spritzers and were encouraged to go on spray-runs throughout the day, lest everyone's nostrils not be assaulted with the odor within a five-store radius. I worked for the Ritz Carlton for a few years. In my orientation, the HR rep told everyone that each employee has a special allowance of $1,500 to make sure they can help the guests feel like their stay would be memorable. There was a story about a guest who last his Rolex and asked the front desk if they had seen it or one of the maids took it and complained a lot. When the guest finally left, the guy from the front desk went out and purchased the guest a new Rolex and was reimbursed fully by the Ritz. The guest was extra happy and is now returning to the same property every year You don't need to have a Sam's Club membership to buy the liquor. Just tell the door person you are there to buy booze and they won't need to see your membership card. You can also grab a few of the free food samples as you walk through the store if your conscience allows it. FedEx The people who actually handle your packages are more or less slave laborers. NO ONE cares if you packages says fragile or has special instructions. Most of the time the workers hate their jobs so much they throw your box on purpose or stomp on it to make it fit in the trailer. UNITED STATES POSTAL SERVICE As a mail carrier for USPS, I know that all of the clerks and carriers in my office handle packages marked as fragile very carefully because we are so concerned about keeping customers. Plus they pay us well enough that we actually do care about our jobs and tanera Everything at Panera Bread is microwaved. All soups and pastas come in frozen bags reheated for the customer. Pastries and breads come in "half-baked, bakers just slap on some frosting/fruit, and heat it up. It's all fast-food quality food, but with a good ear ee World Overnight cast member here. Please leave your cremated loved ones at home. Stop dumping them in Haunted Mansion. They just get vacuumed up and disposed of srsfunny: Some Confessions Of The Working Class
 ritz: Secret Confessions of the
 Working Class
 OTARGET
 I don't know how true it is for the
 other stores but at my Target the
 door alarm is always going off for
 various reasons (most of the time
 when we are pushing carts in), and
 we've come to ignore it and dont
 even look if it goes off
 BED BATH&
 BEYOND
 Bed Bath and Beyond accepts expired
 coupons don't throw them away. They
 also accept competitor coupons for
 specific items. And you can return
 ANYTHING without a receipt even if you
 did not buy it from a BBEB. (You'll only
 get a store credit.)
 DS
 If you ship something that has to be
 delivered at a certain time of day (for
 instance, next day air usually needs to
 be there by 10:30) check the delivery
 time. If it gets delivered 10 minutes
 late or later, you get your money
 back. So a 10:45 delivery is
 considered refundable
 Abercrombie
 & Fitch
 While some Abercrombie locations are equipped with
 spritzers of Fierce (the brand's signature cologne)
 built into the walls, many locations aren't, and the
 employees are required to walk around at hour
 intervals and liberally spray every
 product and
 surface with the stuff. I happened to be in a location
 that got the best of both worlds, as we bath had the
 spritzers and were encouraged to go on spray-runs
 throughout the day, lest everyone's nostrils not be
 assaulted with the odor within a five-store radius.
 I worked for the Ritz Carlton for a few years. In my
 orientation, the HR rep told everyone that each
 employee has a special allowance of $1,500 to make
 sure they can help the guests feel like their stay
 would be memorable. There was a story about a guest
 who last his Rolex and asked the front desk if they
 had seen it or one of the maids took it and
 complained a lot. When the guest finally left, the guy
 from the front desk went out and purchased the guest
 a new Rolex and was reimbursed fully by the Ritz. The
 guest was extra happy and is now returning to the
 same property every year
 You don't need to have a Sam's Club
 membership to buy the liquor. Just tell the
 door person you are there to buy booze and
 they won't need to see your membership
 card. You can also grab a few of the free
 food samples as you walk through the store
 if your conscience allows it.
 FedEx
 The people who actually handle your packages are
 more or less slave laborers. NO ONE cares if you
 packages says fragile or has special instructions.
 Most of the time the workers hate their jobs so
 much they throw your box on purpose or stomp on
 it to make it fit in the trailer.
 UNITED STATES
 POSTAL SERVICE
 As a mail carrier for USPS, I know that all of
 the clerks and carriers in my office handle
 packages marked as fragile very carefully
 because we are so concerned about keeping
 customers. Plus they pay us well enough
 that we actually do care about our jobs and
 tanera
 Everything at Panera Bread is microwaved. All
 soups and pastas come in frozen bags
 reheated for the customer. Pastries and
 breads come in "half-baked, bakers just slap
 on some frosting/fruit, and heat it up. It's all
 fast-food quality food, but with a good
 ear ee World
 Overnight cast member here. Please
 leave your cremated loved ones at
 home. Stop dumping them in Haunted
 Mansion. They just get vacuumed up
 and disposed of
srsfunny:

Some Confessions Of The Working Class

srsfunny: Some Confessions Of The Working Class

ritz: Recently obtained image from Moscow Ritz-Carlton security camera: Donald Trump coerces two Russian prostitutes to enact sexual fetishes on hotel mattress (Nov. 8, 2013)
 ritz: Recently obtained image from Moscow Ritz-Carlton security camera: Donald Trump coerces two Russian prostitutes to enact sexual fetishes on hotel mattress (Nov. 8, 2013)

Recently obtained image from Moscow Ritz-Carlton security camera: Donald Trump coerces two Russian prostitutes to enact sexual fetishes o...

ritz: THE RITZ-CARLTON I BELIEVE IN MY SON. I GOT YOU @yungtyreik DAZ ON MY MOTHER! 🙏🏾 takecareofyachirren richgang ritzcarlton 💯💪🏾
 ritz: THE RITZ-CARLTON
I BELIEVE IN MY SON. I GOT YOU @yungtyreik DAZ ON MY MOTHER! 🙏🏾 takecareofyachirren richgang ritzcarlton 💯💪🏾

I BELIEVE IN MY SON. I GOT YOU @yungtyreik DAZ ON MY MOTHER! 🙏🏾 takecareofyachirren richgang ritzcarlton 💯💪🏾

ritz: In case you're having a rough day DrSmashlove Bruh. Why every hotel and resort - even nice ones - give u that lil ass bar of dry ass soap, and the lotion that don't even moisturize u? Shit feel good for 11 seconds, then u dry again. It's like catfish lotion - just when u think u nice and creamy it's like "nah bish, YOU THOUGHT. Squeeze another lil ass bottle of lotion on u, see if that'll do it ☺️." See, hell nah. If I ran a hotel, everybody get a big ass bar of Dove extra moisturizing soap, and a tub of cocoa butter. Not a bottle, a tub. Crack the seal on dat bish, dip your hand in it, and slather yourself silly. Or for $20 extra, a Filipino maid (who's not ugly but she's not cute either like she's 51 years old and u can see she use to be cute but the stress of having four kids and 11 grandkids done wore on her) will pop up and slather u down with cocoa butter skrate down to betwixt the butt cheeks and then enrobe u in a silk bathrobe so u feel soft, sexy and special AF. And then u just like "Thank you Analyn, that non-sexual lotion rub-down was incredible. I know this service at Chateau du Smash costs 20 bucks but here's 50. Or as y'all say in the Philippines, 'Pippty' ☺️." RITZ CARLTON I'M COMING FOR YALL - KEEP FUCKING AROUND AND NOT MAKING ME FEEL SOFT AND SENSUAL AND IMMA OPEN MY OWN HOTEL CHAIN. I ALREADY NAMED IT. YA CLOCK IS TICKING. FIX DIS SHIT. 😂😂😂 [Editor's Note: A Filipino follower (justifiably) asked if I have something against Filipinos. Let me say this 💯 percent straight up: I love Filipinos with all my heart. I grew up with some Filipinos homies and feel like they blood. I honestly try to keep it light hearted but I could see how it might look like I'm singling them out. Please forgive me! I love all people and I will make sure to portray Filipinos in a more positive light in the future. Bless up! ❤]
 ritz: In case you're having a rough day
 DrSmashlove
Bruh. Why every hotel and resort - even nice ones - give u that lil ass bar of dry ass soap, and the lotion that don't even moisturize u? Shit feel good for 11 seconds, then u dry again. It's like catfish lotion - just when u think u nice and creamy it's like "nah bish, YOU THOUGHT. Squeeze another lil ass bottle of lotion on u, see if that'll do it ☺️." See, hell nah. If I ran a hotel, everybody get a big ass bar of Dove extra moisturizing soap, and a tub of cocoa butter. Not a bottle, a tub. Crack the seal on dat bish, dip your hand in it, and slather yourself silly. Or for $20 extra, a Filipino maid (who's not ugly but she's not cute either like she's 51 years old and u can see she use to be cute but the stress of having four kids and 11 grandkids done wore on her) will pop up and slather u down with cocoa butter skrate down to betwixt the butt cheeks and then enrobe u in a silk bathrobe so u feel soft, sexy and special AF. And then u just like "Thank you Analyn, that non-sexual lotion rub-down was incredible. I know this service at Chateau du Smash costs 20 bucks but here's 50. Or as y'all say in the Philippines, 'Pippty' ☺️." RITZ CARLTON I'M COMING FOR YALL - KEEP FUCKING AROUND AND NOT MAKING ME FEEL SOFT AND SENSUAL AND IMMA OPEN MY OWN HOTEL CHAIN. I ALREADY NAMED IT. YA CLOCK IS TICKING. FIX DIS SHIT. 😂😂😂 [Editor's Note: A Filipino follower (justifiably) asked if I have something against Filipinos. Let me say this 💯 percent straight up: I love Filipinos with all my heart. I grew up with some Filipinos homies and feel like they blood. I honestly try to keep it light hearted but I could see how it might look like I'm singling them out. Please forgive me! I love all people and I will make sure to portray Filipinos in a more positive light in the future. Bless up! ❤]

Bruh. Why every hotel and resort - even nice ones - give u that lil ass bar of dry ass soap, and the lotion that don't even moisturize u?...

ritz: Secret Confessions of the Working Class OTARGET I don't know how true it is for the other stores but at my Target the door alarm is always going off for various reasons (most of the time when we are pushing carts in), and we've come to ignore it and dont even look if it goes off BED BATH& BEYOND Bed Bath and Beyond accepts expired coupons don't throw them away. They also accept competitor coupons for specific items. And you can return ANYTHING without a receipt even if you did not buy it from a BBEB. (You'll only get a store credit.) DS If you ship something that has to be delivered at a certain time of day (for instance, next day air usually needs to be there by 10:30) check the delivery time. If it gets delivered 10 minutes late or later, you get your money back. So a 10:45 delivery is considered refundable Abercrombie & Fitch While some Abercrombie locations are equipped with spritzers of Fierce (the brand's signature cologne) built into the walls, many locations aren't, and the employees are required to walk around at hour intervals and liberally spray every product and surface with the stuff. I happened to be in a location that got the best of both worlds, as we bath had the spritzers and were encouraged to go on spray-runs throughout the day, lest everyone's nostrils not be assaulted with the odor within a five-store radius. I worked for the Ritz Carlton for a few years. In my orientation, the HR rep told everyone that each employee has a special allowance of $1,500 to make sure they can help the guests feel like their stay would be memorable. There was a story about a guest who last his Rolex and asked the front desk if they had seen it or one of the maids took it and complained a lot. When the guest finally left, the guy from the front desk went out and purchased the guest a new Rolex and was reimbursed fully by the Ritz. The guest was extra happy and is now returning to the same property every year You don't need to have a Sam's Club membership to buy the liquor. Just tell the door person you are there to buy booze and they won't need to see your membership card. You can also grab a few of the free food samples as you walk through the store if your conscience allows it. FedEx The people who actually handle your packages are more or less slave laborers. NO ONE cares if you packages says fragile or has special instructions. Most of the time the workers hate their jobs so much they throw your box on purpose or stomp on it to make it fit in the trailer. UNITED STATES POSTAL SERVICE As a mail carrier for USPS, I know that all of the clerks and carriers in my office handle packages marked as fragile very carefully because we are so concerned about keeping customers. Plus they pay us well enough that we actually do care about our jobs and tanera Everything at Panera Bread is microwaved. All soups and pastas come in frozen bags reheated for the customer. Pastries and breads come in "half-baked, bakers just slap on some frosting/fruit, and heat it up. It's all fast-food quality food, but with a good ear ee World Overnight cast member here. Please leave your cremated loved ones at home. Stop dumping them in Haunted Mansion. They just get vacuumed up and disposed of <p>Some Confessions Of The Working Class.</p>
 ritz: Secret Confessions of the
 Working Class
 OTARGET
 I don't know how true it is for the
 other stores but at my Target the
 door alarm is always going off for
 various reasons (most of the time
 when we are pushing carts in), and
 we've come to ignore it and dont
 even look if it goes off
 BED BATH&
 BEYOND
 Bed Bath and Beyond accepts expired
 coupons don't throw them away. They
 also accept competitor coupons for
 specific items. And you can return
 ANYTHING without a receipt even if you
 did not buy it from a BBEB. (You'll only
 get a store credit.)
 DS
 If you ship something that has to be
 delivered at a certain time of day (for
 instance, next day air usually needs to
 be there by 10:30) check the delivery
 time. If it gets delivered 10 minutes
 late or later, you get your money
 back. So a 10:45 delivery is
 considered refundable
 Abercrombie
 & Fitch
 While some Abercrombie locations are equipped with
 spritzers of Fierce (the brand's signature cologne)
 built into the walls, many locations aren't, and the
 employees are required to walk around at hour
 intervals and liberally spray every
 product and
 surface with the stuff. I happened to be in a location
 that got the best of both worlds, as we bath had the
 spritzers and were encouraged to go on spray-runs
 throughout the day, lest everyone's nostrils not be
 assaulted with the odor within a five-store radius.
 I worked for the Ritz Carlton for a few years. In my
 orientation, the HR rep told everyone that each
 employee has a special allowance of $1,500 to make
 sure they can help the guests feel like their stay
 would be memorable. There was a story about a guest
 who last his Rolex and asked the front desk if they
 had seen it or one of the maids took it and
 complained a lot. When the guest finally left, the guy
 from the front desk went out and purchased the guest
 a new Rolex and was reimbursed fully by the Ritz. The
 guest was extra happy and is now returning to the
 same property every year
 You don't need to have a Sam's Club
 membership to buy the liquor. Just tell the
 door person you are there to buy booze and
 they won't need to see your membership
 card. You can also grab a few of the free
 food samples as you walk through the store
 if your conscience allows it.
 FedEx
 The people who actually handle your packages are
 more or less slave laborers. NO ONE cares if you
 packages says fragile or has special instructions.
 Most of the time the workers hate their jobs so
 much they throw your box on purpose or stomp on
 it to make it fit in the trailer.
 UNITED STATES
 POSTAL SERVICE
 As a mail carrier for USPS, I know that all of
 the clerks and carriers in my office handle
 packages marked as fragile very carefully
 because we are so concerned about keeping
 customers. Plus they pay us well enough
 that we actually do care about our jobs and
 tanera
 Everything at Panera Bread is microwaved. All
 soups and pastas come in frozen bags
 reheated for the customer. Pastries and
 breads come in "half-baked, bakers just slap
 on some frosting/fruit, and heat it up. It's all
 fast-food quality food, but with a good
 ear ee World
 Overnight cast member here. Please
 leave your cremated loved ones at
 home. Stop dumping them in Haunted
 Mansion. They just get vacuumed up
 and disposed of
<p>Some Confessions Of The Working Class.</p>

<p>Some Confessions Of The Working Class.</p>

ritz: AA BallerAlert - spotted - ShereeWhitfield at the Melanie D Jewelry launch at the Ritz Carlton in Atlanta (📷 @atlpics)
 ritz: AA
BallerAlert - spotted - ShereeWhitfield at the Melanie D Jewelry launch at the Ritz Carlton in Atlanta (📷 @atlpics)

BallerAlert - spotted - ShereeWhitfield at the Melanie D Jewelry launch at the Ritz Carlton in Atlanta (📷 @atlpics)

ritz: <p>The Ritz Carlton Bangkok.</p>
 ritz: <p>The Ritz Carlton Bangkok.</p>

<p>The Ritz Carlton Bangkok.</p>

ritz: Russians Claim To Have Dirt On Trump, Say He Paid Prostitutes To Perform Golden Showers @balleralert Russians Claim To Have Dirt On Trump; Say He Paid Prostitutes To Perform Golden Showers - blogged by: @eleven8 ⠀⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀⠀⠀⠀⠀⠀ Last week, classified documents were presented to PresidentObama and President-elect Trump that claimed Russian operatives had damaging personal and financial information about the future President. The documents were presented in a synopsis that Buzzfeed has allegedly gotten their hands on. Needless to say the tea is boiling hot! ⠀⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀⠀⠀⠀⠀⠀ In the document, the Russian regime admits to assisting Trump for at least 5 years. They also say that Trump hasn’t always held up his end of the bargain, but it’s cool because they have tapes of him performing “perverted sexual acts” ready for blackmail. ⠀⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀⠀⠀⠀⠀⠀ “According to Source D, where s-he had been present, TRUMP’s (perverted) conduct in Moscow included hiring the presidential suite at the Ritz Carlton Hotel, where he knew President and Mrs. OBAMA (whom he hated) had stated on one of their official trips to Russia, and defiling the bed where they had slept by employing a number of prostitutes to perform a golden shower (urination) show in front of him. The hotel was known to be under FSB control with microphones and concealed cameras in all the main rooms to record anything they wanted to.” ⠀⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀⠀⠀⠀⠀⠀ Of course a ton of other things were listed, and Buzzfeed says that these allegations are currently “unverified”, but you can read it all HERE .....to read the rest log on to BallerAlert.com (clickable link on profile) clickthelink readmore
 ritz: Russians Claim To Have Dirt On
 Trump, Say He Paid Prostitutes To
 Perform Golden Showers
 @balleralert
Russians Claim To Have Dirt On Trump; Say He Paid Prostitutes To Perform Golden Showers - blogged by: @eleven8 ⠀⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀⠀⠀⠀⠀⠀ Last week, classified documents were presented to PresidentObama and President-elect Trump that claimed Russian operatives had damaging personal and financial information about the future President. The documents were presented in a synopsis that Buzzfeed has allegedly gotten their hands on. Needless to say the tea is boiling hot! ⠀⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀⠀⠀⠀⠀⠀ In the document, the Russian regime admits to assisting Trump for at least 5 years. They also say that Trump hasn’t always held up his end of the bargain, but it’s cool because they have tapes of him performing “perverted sexual acts” ready for blackmail. ⠀⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀⠀⠀⠀⠀⠀ “According to Source D, where s-he had been present, TRUMP’s (perverted) conduct in Moscow included hiring the presidential suite at the Ritz Carlton Hotel, where he knew President and Mrs. OBAMA (whom he hated) had stated on one of their official trips to Russia, and defiling the bed where they had slept by employing a number of prostitutes to perform a golden shower (urination) show in front of him. The hotel was known to be under FSB control with microphones and concealed cameras in all the main rooms to record anything they wanted to.” ⠀⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀⠀⠀⠀⠀⠀ Of course a ton of other things were listed, and Buzzfeed says that these allegations are currently “unverified”, but you can read it all HERE .....to read the rest log on to BallerAlert.com (clickable link on profile) clickthelink readmore

Russians Claim To Have Dirt On Trump; Say He Paid Prostitutes To Perform Golden Showers - blogged by: @eleven8 ⠀⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀⠀⠀⠀⠀⠀ Last w...