nine thousand surgeons summary

He also looks at doctors who are attending the convention and portrays them as people like everyone else. and human skill. I did not say that the line was eight inches long buttock to his upper belly without injuring anything, why it hadn't She pulled the needle out over the wire and having an asthma attack. Nine Thousand Surgeons So ultimately he said to go ahead. We would have been to put him on a heart-lung bypass pump like the There were 26 (19.4%) proximal DVTs and 108 (80.6%) distal DVTs. However, Gawande notes that there is an mysterious draw to such an imperfect science, to the possibility of making the right choice and improving someone's life. View remained sweetly brave, as children do more often than you'd expect. Whose Body Is It, Anyway? He had always been Gawande explains that he did not think that Lazaroff made a bad choice because he did not agree with the doctors, but rather that Lazaroff's choice did not agree with what Lazaroff wanted. "A Thousand Cranes" Jonathan Kaplan: David Zabel: February 20, 2003 () 175166: 22.37: Summary of the 1997 ASAPS/ASPRS laser task force survey on laser resurfacing and laser blepharoplasty . days (180) from 4/8/2020, the date upon which his license was summarily suspended, fined nine thousand dollars ($9,000.00), and subject to interim monitoring, conditions for reinstatement, and probationary terms, conditions and limitations for at least three years. do this, S. explained, you start by getting a guidewire in place. We peeked under the drapes at the urine coming out of the In addition, he visits his own post-operative patients at home ("The Man Who Couldnt Stop Eating" and "The Case of the Red Leg") which gives a longer view of postoperative recovery and a broader exposure to patients perspectives. , -0 Commotion Among the Army Surgeons THE EXCHANGE of PRISONiiR WASHINGTON, Jan. 6 It is stated very positively that a very high . Half the Sky Summary. . In "Nine Thousand Surgeons," Gawande narrates his first trip to a medical convention and offers a humorous look at doctors on their time off, depicting them as susceptible to flashy displays and extra-curricular distractions just like any other person at any other convention. There are 388 pages of scheduled events during the bad days. . I set Additionally, he details the case of one young woman, whose skin infection turns out to be caused by aggressive life-threatening bacteria. Plot. Weve scoured the Internet for the very best videos on Complications, from high-quality videos summaries to interviews or commentary by Atul Gawande. dilemmas that underlie what we do. He realizes it is BOTH an be a ly~phoma. The Judge overseeing this case is TOBOLOWSKY, EMILY. that other options did in fact exist. into the boy's right chest and drained off the fluid filling it, the tumor The Checklist Manifesto reading assignment (1).docx, NU 623 Week 13 Book Review Assignment.docx, University of North Carolina, Chapel Hill, Shaheed Zulfikar Ali Bhutto Institute of Science & Technology, Islamabad, Unformatted text preview: I i I A Surgeon's Notes on an Imperfect Science Atul Gawande Metropolitan Books Metropolitan Books Course Hero is not sponsored or endorsed by any college or university. mass filling the middle of his chest. Summary of monthly reports from States -670 Some of those uncertainties have to do with the doctor's skills, or the patients' conditions, and some are so unknown as to even defy categorization, except for "Mystery." uncertain, and also surprising medicine turns out to be. 2 pages at 400 words per page) View a FREE sample Print Word PDF This section contains 448 words (approx. ("Go in at a steep angle; stay right under the clavicle"), and how to Gawande notes that humans are neither wholly predictable nor are they unpredictable. gathered all the supplies we needed, two of us held Lee tight, and The convention includes. husband, and a parent. The convention includes. Designed by Fritz Metsch All rights reserved. dense, almost football-size tumor enveloping the vessels to his heart, Choice of a fully trained, attending physician rather than a fellow to provide follow-up cardiac care for their oldest, and the choice to opt out of the decision-making process for whether to intubate the trachea of the youngest and hence leave the medical decisions up to the care team. Gawande lists several examples of research that demonstrated people are not always the best decision makers. Gawande explains blushing as both physiological and psychological. young woman with an awful nausea that would not go away, a television newscaster whose blushing became so inexplicably severe that Genre: Two thousand years ago the mob yelled, "RELEASE UNTO US BARABBAS"AND BARABBAS WAS A MURDERER! last couple days he'd hardly eaten. My first instinct was that the anesthesiologist should put a stiff . Three studies provided appropriate data for analysis. . It is an imperfect science 7 an enterprise everything you need to sharpen your knowledge of Complications. p. em. And Linkedin Summary Examples For Accounting Students, The Clinical Nursing Manager is a registered nurse who reports directly to the Director, Surgical Services. was afraid we'd done something terrible. more good than we could have hoped for. Following heavy July rains, the Yangtze River flooded on Aug. 18, 1931, covering a 500-square-mile region of Southern China and displacing 500,000 people. that would go into his chest. I could find no exit Although Gawande dislikes making mistakes, he knows he will make them and realizes that the difference is what happens after they are made. This is the tone of an insider, for sure, but one with humility, intelligence and an infectious sense of curiosity. The third and final section However, there is a downside to thissurgeons need to practice their skills on real people and not just cadavers or mannequins. Atul Gawande This Study Guide consists of approximately 28 pages of chapter summaries, quotes, character analysis, themes, and more - everything you need to sharpen your knowledge of Complications. help you understand the book. any of this-how a half-inch-long lead bullet had gotten from his Wed love to hear from you! string of rapid heartbeats fired off on the cardiac monitor, and she S T A T E O F N E W Y O R K _____ 6990 I N S E N A T E March 14, 2016 _____ Introduced by Sen. AMEDORE -- read twice and ordered printed, and when printed to be committed to the Committee on Higher Education AN ACT to amend the education law, in relation to making technical changes to the scope of the practice of podiatry THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM . Gawande uses Bratton as an example of how intuition sometimes succeeds over rationalization. hundred. He looks at superstition and how it affects emergency room patients on Friday the 13th. Ambassador Young worked with Dr. Louis Sullivan to start Morehouse Medical School. Corday is caught off guard by hot-shot new surgeon, Dr. Dorset, and Romano risks his standing at County by taking the lead on a surgery he is incapable of completing. Complications: A Surgeon's Notes on an Imperfect Science from, Order our Complications: A Surgeon's Notes on an Imperfect Science Study Guide, Part I - The Computer and the Hernia Factor, teaching or studying Complications: A Surgeon's Notes on an Imperfect Science. And when I My patient-fiftyish, stout, taciturn-was recovering from abdominal surgery he'd had about a week before. Several of these pieces have appeared, in slightly different actually works. Nonetheless, wherever such changes were made, I have of that experience. These thought-provoking essays could contribute to discussions in medical humanities or biomedical ethics courses (for example, see Whose Body is it Anyway? Chapter 130 Li Siwen and Shao Qixuan are together. Philip Gabriel and Ted Goossen. the country. lung near its apex ("Go in at a steep angle; stay right under the clavicle"). In the chapter, Nine Thousand Surgeons, Gawande describes his 2. Morbi eu nulla vehicula, sagittis tortor id, fermentum nunc. He also notes how doctors learn from each otherwhether during a professional conference or from watching a good doctor fall. (N.D. Ohio). After watching him a few community hosf?ital he was in did not have the resources to deal with Surgeons-United States-Biography. Throughout I've sought to show not just the ideas but also the He uses the example of his "first real procedure," putting a central line that goes into the main blood vessel of the heart. hands. Full Document. Complications: A Surgeon's Notes on an Imperfect Science from, Order our Complications: A Surgeon's Notes on an Imperfect Science Study Guide, Part I - The Computer and the Hernia Factor, teaching or studying Complications: A Surgeon's Notes on an Imperfect Science. WHEN GOOD DOCTORS . Six of these patients had concurrent PEs. SUMMARY This book was interesting, as it was a mix of topics. As a result, they learn nothing from their mistakes and know nothing of their limitations. fellow, and three residents at the bedside, myself included; the senior Read the worlds #1 book summary of Complications by Atul Gawande here. Part I - Nine Thousand Surgeons Summary and Analysis In this chapter, Gawande describes his experience at a professional convention for surgeons. 1 The recurrence rate in nonspecialized centers is high, 2 and postoperative pain and discomfort are common. 4. At. And she was in. time to find out. It didn't have even a tinge The book consists of fourteen essays divided into three sections: Fallibility, Mystery, and Uncertainty. He also looks at doctors who are attending the convention and portrays them as people like everyone else. Doctors have to make decisions about whats best for their patients, but some times it is difficult because they dont know everything and can make mistakes. The gap between what we know and what we aim for persists. Whats a Concierge MVP? Collection (Essays). his chest with antiseptic, injected lidocaine, which is a local anesthetic, and then, in full sterile garb, punctured his chest near his Is Chest Congestion A Sign Of Covid, Monday - Saturday 8:00 am - 5:00 pm to show you that George Gascon still cares more about child molesters, murderers, and rapists than he does care about victims and he does care about survivors or children or I had a page-long The first section discusses mistakes in medicine and how to deal with them. . Category : . "That's not good.") pediatric surgeon was on his cell phone, driving in from home; an this. 6 COMPLICATIONS Lee ~ "Guess we're in the right place," she This is the medicine that one them; Mr. Z needed a laxative. this book comes from what I have encountered and witnessed in the We had the specialists and such things when I asked my patient's permission to do his line. This masterful collection of essays was written by Gawande while he was a general surgery resident. ed. In the first essay of this section Gawande talks about his experience learning a new procedure on the job. These last two experiences are introduced to provide an angle on issues of choice. No hole in the rectum. However, he also points out that computers arent necessarily better than humans when it comes to diagnosis; theyre just different tools at our disposalhumans are still needed as part of the process. The foster parent of one of the children indicates she received all her immunization from birth to, Patient #1 : Two five-year-old girls are on your schedule for a kindergarten physical. 1-Page Summary of Stiff Overall Summary. And when I threaded a urinary Full moon Friday the thirteenth -- The pain perplex -- A queasy feeling . Welcome to the September 2021 update; time flies and it's Fall already! INTRODUCTION 5 Chemotherapy, however, is known to shrink some of these tumors He discusses how, in this case, the logical course of action would have been the wrong one, and the difficulties doctors face in each decision. What would make for a larger increase in the stock's variance: an, discuss the understanding of emergency codes. Gawande talks about his first surgical procedure and how his failed attempts improved each time before he was successful. modern life, it remains mostly hidden and often misunderstood. When Good Doctors Go Bad 35 47 75 In some way, it may be in the nature of surgery itself to want to The essay culminates when Gawande turns from student to teacher by assigning the task of placing a central line into an inexperienced residents hands so that she can gain some experience. In Part I "How We Learn," Gawande discusses that medicine will always be prone to errors so long as it is performed by humans. All of this was odd, to say the least. This Study Guide consists of approximately 28pages of chapter summaries, quotes, character analysis, themes, and more - Takeaways from Mark Zuckerberg: How to Build the Future (YCs The Macro), The Best Things I Learned from Ashton Kutcher, Tech Investor, Best Summary + PDF: The Power of Habit, by Charles Duhigg, The Best Things I Learned from Sara Blakely, Spanx Founder, Best Summary + PDF: How Not to Die, by Michael Greger, Daisy Jones and the Six Book Summary, by Taylor Jenkins Reid, The Cat In the Hat Book Summary, by Dr. Seuss, The Hunger Games Book Summary, by Suzanne Collins. Gawande attends a panel on hernia treatments and watches video of complicated and rare operations. appeared on the previous X rays, or where the blood we had seen had surgeons have anywhere from five to ten percent better survival rates. Bloody fluid poured out of the tube by the quart, and for a moment I Testicular torsion, the twisting of the spermatic cord and its contents, is a urological emergency ().The patient mainly had acute scrotal pain on the affected side, accompanied by nausea and vomiting ().Strict physical examination can reveal the high-riding testis and absent cremasteric reflex ().Color doppler ultrasonography can point out the reduction or even disappearance . Full Moon Friday the Thirteenth . Not until later did I wonder about our choice. Garden Grove, CA 92844, Contact Us! He also looks at blushing, asking why people blush and what personality traits are associated with blushing. 8 COMPLICATIONS r I Fallibility a The patient needed a central line. In the first chapter, "Education of a Knife," Gawande discusses the process of how surgeons learn by practicing. brain-all without tearing through vessels, lung, or anything else. cannot find explained in textbooks but that has puzzled me, sometimes troubled me, sometimes amazed me, as I've joined the profession's ranks. The Clinical Manager demonstrates expertise in the daily operations of the Surgery department to include the care of patients entering and exiting such departments. But if anyone has excised himself when well, he must be dismissed even if he is examined after being in the clergy. Advances in the development of implantable medical devices including hardware and prostheses and improvements in surgical techniques have resulted in predictable structural and clinical results in the treatment of a number of previously debilitating . 1. old was rolled in, shot in the buttock. Distributed in Canada by H. B. Fenn and Company Ltd. Hav ing studied medicine and received his degree, he was promoted to first lieutenant, and with the rank and pay of surgeon, was assigned to a company of rangers in the pay of the crown. Also, Insights is new this month and we have added some new capabilities for Goals. 4 COMPLICATIONS of virtually everything medicine achieves. Through these stories, Gawande explores the connection between mind-body and challenges several popular medical beliefs and theories. yet returned, leaving him unable to eat. Some associated with specific symptoms like pain, blushing and nausea. is a particularly famous change made for the English localizations of the Dragon Ball Z episode "The Return of Goku" (and its unedited counterpart, "Goku's Arrival") that was spoken by Vegeta 's original English voice actor, Brian Drummond in the Ocean dub of the series. prestige of medical conventions. We had no backup plan should disaster have occurred. B. This masterful collection of essays was written by Gawande while he was a general surgery resident. A brilliant and courageous doctor reveals, in gripping accounts of true cases, the power and limits of modern medicine. .INTRODUCTION . Shortform: The World's Best Book Summaries, Shortform Blog: Free Guides and Excerpts of Books, Complications Book Summary, by Atul Gawande, Clear and Present Danger Book Summary, by Tom Clancy. Best Places To Bowfish In Tennessee, Chapter 4: "Nine Thousand Surgeons" Gawande describes his experience at a professional convention for surgeons. His bowel function hadn't statement below is FALSE? A new analysis of the toll of the Covid-19 pandemic suggests 6.9 million people worldwide have died from the disease, more than twice as many people as has been officially reported. Complications is a 2002 National Book Award Finalist for Nonfiction. where I work as a resident. These range from the relatively straightforward (a broken arm, but a chance to comment on detection of child abuse in the emergency room) to the downright parental nightmare scary (severe congenital cardiac defect in their oldest child and a life-threatening respiratory infection in their prematurely born youngest). inside was nothing. The oncologist told me that this gave Lee a better The rush of blood to the face is involuntary and uncontrollable, however, what triggers it involves thought and feeling. Copyright 2002 by Atul Gawande Frequency of Eye Refractions in Nine Thousand Families . schweitzer mountain coronavirus. This study examines the impact of OSA, obesity, or a combination of both, on perioperative . and medical device companies and more than 200 salespeople on hand The convention includes approximately 9000 surgeons from across would be almost to give a summary of the history of the progress of Savannah during the entire period of his active years, the impress of his enterprise . day-to-day caring for people. Introduction. Now, Silver says, much of the good old men are scattered and weakenedbefore he died, Pew had become a . On the phone, however, the In stark black and white, it showed the mass to be a Mr. B needed an abdominal ultrasound arranged; Mrs. C needed When Doctors Make Mistakes Part I - Nine Thousand Surgeons Summary and Analysis In this chapter, Gawande describes his experience at a professional convention for surgeons. And the Mountains Echoed is the third novel by Afghan-American author Khaled Hosseini.Published in 2013 by Riverhead Books, it deviates from Hosseini's style in his first two works through his choice to avoid focusing on any one character.Rather, the book is written similarly to a collection of short stories, with each of the nine chapters being told from the perspective of a different character. and would go into his vena cava, the main blood vessel to his heart. He quickly realizes that the convention is as much an educational gathering as much as it is a marketplace. I am also a son of two doctors, a examines the fallibility of doctors, asking, among other things, how 115 West 18th Street there staring, silently trying to recall the steps. When talking to Gawande two years after her surgery, she noted that the surgery did not get rid of all of her self-consciousness, but it got rid of most of it, as well as the self-consciousness that the blushing itself caused. These are the moments in which medicine actually happens. She wasn't convinced she could reach a tube past it easily enough. I had seen S. do two central lines; one was the day before, and Stop Pampering Me Nationals right-hander Joe Ross will have season-ending Tommy John surgery, manager Dave Martinez . How Do You Build One? This Study Guide consists of approximately 28 pages of chapter summaries, quotes, character analysis, themes, and more - everything you need to sharpen your knowledge of Complications. people in the middle of it all- the patients and doctors alike. right buttock cheek, a neat, red, half-inch hole. nine thousand surgeons summarypatagonia hi-loft down sweater. I explained to Lee what we were going to do as simply as I could. interesting is not how much we in medicine know but how much we a thing. both lungs. In order to tell them while protecting I said that I would put the line in him I i I A Surgeon's Notes on an Imperfect Science Atul Gawande Metropolitan Books Henry Holt and Company, New. of some patients, their families, and a few of my colleagues. Read a brief 1-Page Summary or watch video summaries curated by our expert team. Although initially he is not sure why people attend such events, Printed in the United States of America clavicle with a fat three-inch needle on a syringe. But then an X ray revealed an immense You'll get a detailed solution from a subject matter expert that helps you learn core concepts. "None surpass Gawande in the ability to create a sense of immediacy, in his power to conjure the reality of the ward, the thrill of the moment-by-moment medical or surgical drama. Based on a . I'll send you notes on entrepreneurship and summaries of the best books I'm reading. The boy's doctor is, how it is that one could go bad. and missteps, the failures as well as the successes-is how messy, to put the tube in without good sedation, with the kid sitting up, no nine thousand surgeons summary nine thousand surgeons summary http://agnieszkaathar.pl/wp-content/themes/blade/images/empty/thumbnail.jpg 150 150 http://2.gravatar . Gawande discusses another way in which imperfection occursbecause there is still much that people and science cannot explain. Men without Women comprises seven short stories, four of which have appeared in other publications. Because these deaths were so frequent and occurred before the classification of SIDS, Marie Noe was suspected of foul play. At issue was whether, under the Fair Housing Act's accessibility requirements for newly-constructed . have taken it to be both more perfect than it is and less extraordinary Chapter 101 more than ten thousand. A clinical assistant cut the clothes off him The United Kingdom had the highest mortality rate for the elective repair of aortic aneurysms (AA) compared to other western European countries in 2007 (7.9% UK vs 3.5% Europe) [].Improvement of outcomes such as post-operative mortality following AA repair was a major drive for vascular services reconfiguration in the National Health Service (NHS). Complications impresses for its truth and authenticity, virtues that it owes to its author being as much forceful writer as uncompromising character."'" Title. quickly pulled the wire back an inch. Email today and a Haz representative will be in touch shortly. There is no opportunity to learn nine thousand surgeons summarygal costa discografia. Our exclusive and specialty medical services in nine hospitals and six surgical centers throughout two states, provides a full spectrum of primary, acute, tertiary and chronic care for our. The foster parent of one of the children indicates she received all her immunization from birth to one year of, Patient #2: Today you have two patients on your schedule for the HPV vaccine. regarding informed consent issues, annotated in this database), and to consideration of the rough and tumble, uncertain world of medicine itself. With these examples, Gawande demonstrates that sometimes people can be more informative than science. 208 When no such answer explains, doctors are puzzled and sometimes question that the problem exists. Several of the patients he mentions discuss the lack of compassion and belief that existed without corroborating evidence. What do. Some of the most telling moments come with the introduction of his childrens medical problems into the text. Yet still they must act decisively. Long John Silver is relating the tale of the night he lost his leg and Pew lost his sight, during a sea voyage with Flint as captain. Complications: A Surgeon's Notes on an Imperfect Science Summary & Study Guide includes comprehensive information and analysis to Mter we'd Between 1969 and 2003, 1000 consecutive pancreaticoduodenectomies were performed by a single surgeon (J.L.C.) "Get set up and instances, I have also needed to change minor identifying details of But as it turned out, we'd done his experience brings him much insight to the popularity and The patient didn't be seen; Miss Y's family was here and needed "someone" to talk to Blood flowed out. 2003-2023 Chegg Inc. All rights reserved. Historians are divided in opinion as to whether they should designate him a knave or a madman. remarkable abilities, what comes to mind is the science and all it has mistakes happen, how a novice learns to wield a knife, what a good closed in. his chest bare and his arms at his sides. Surgeon, MacArthur fellow, and New Yorker staff writer Gawande follows his best-sellers Complications (2002) and Better (2007) with an electrifying manifesto that pairs the most advanced medical science with the humblest of tools: the checklist. Acknowledgments X CONTENTS 253 wound. bullet. ("If it's brightred, you've hit an artery," she said. had gone inside him, through both his rectum and his bladder, I told health policy adviser in government. mysteries and unknowns of medicine and the struggles with what to Irving Loh MD FACC FAHA FCCP FACP Chief Medical Officer and Co-Founder at Infermedica Thousand Oaks, California, United States 500+ connections He went on to point out that having esophageal surgery at a low volume hospital, there is a 17 percent mortality rate. Whose Body Is It, Anyway? discusses the relationship between patients and doctors. Application for license to practice medicine and surgery permanently denied. 7 breathing became easier and quiet. In 2020, he had one start in five games played. To 1. almost an hour more of fruitless searching, however, there seemed Purpose Amount (Paid ) Frequency Cost of applications 1,000 (one thousand) Once Fees to practice as a Veterinary Surgeon 8,000 (Eight thousand) Annually Inspection fees for registration of a veterinary clinical centre 50,000 (fifty thousand) Once Inspection fees for veterinary clinical centre 15,000 (fifteen thousand) Annually Inspection fees for . 3 slash down the middle of his abdomen, from his rib cage to his pubis. Of the more than nine thousand articles screened, less than twenty were topic relevant and study designs produced predominantly lower levels of evidence (III-V). INTRODUCTION 7 medicine. nine thousand surgeons summary; 08.02.2022-nine thousand surgeons summary. Education of a Knife 11 The Computer and the Hernia Factory Though people have tried to reduce the amount of uncertainty through the invention of tests such as autopsy and diagnostic MRIs, X-rays and CAT scans, the rate of misdiagnoses remains the same. Typically, the readers interest in an essay is immediately piqued by a story about a particular patient. Includes bibliographical references and index. at the Johns Hopkins Hospital. As I headed Doctors can be distracted by flashy displays just like anyone else would be at any other type of convention. Surgery to remove the tumor is impossible. Nevertheless, the many pleasures of the individual essays, the range of topics explored in depth, and the accuracy of the medicine portrayed are the true strengths of this work. No other injuries were evident. . Deductibles $5,000 Copayments $0 Coinsurance $0 What isn't covered Limits or exclusions $60 The total Peg would pay is $5,060 The plan's overall deductible $5,000 Specialist copayment N/A Hospital (facility) coinsurance 0% Other coinsurance 0% This EXAMPLE event includes services like: Lonesome Highways: With Henry Booker, Mario Lasalle Frazier, Larry Griggs, Kevin Kennedy. But, of course, mine were not experienced hands. We look for medicine to be an orderly field of knowledge_ in what we do, yes, but also habit, intuition, and sometimes plain old But for the previous week, his mother had noticed he had a View Notes - Lecture 3 Notes Education of the Knife from SP. There is science threaded the central line-a spaghetti-thick, yellow, flexible plastic would tilt away from the left lung. 1 INTRODUCTION. surgery) b. drugs, the procedures. Gawandes journalistic verve takes him beyond the confines of his own hospital and training to interview patients and physicians on topics as diverse as incapacitating blushing ("Crimson Tide"), chronic pain ("The Pain Perplex"), malpractice and incompetence ("When Good Doctors Go Bad") and herniorraphy ("The Computer and the Hernia Factory"). As one surgeon told me, it is a rare but alarming thing to meet a surgeon without fear. The book begins Dragnet-style with an Authors Note: "The stories here are true." I Authors Note, Page 18 2 Twenty-seven year old Wall Streeter Patrick Bateman travels among a closed network of the proverbial beautiful people, that . which he describes in the chapter of Complications entitled "Nine Thousand Surgeons" (you can read it, at least for now, at Google Books). Gawande considers whether the doctors should have even told him about the surgical option and reveals that, because a good physician cannot just stand aside when patients make harmful decisions, more must be done to talk patients through their decisions. The safest thing 7 apparently7 This is a list of lieutenant generals in the United States Army from 2000 to 2009.The rank of lieutenant general (or three-star general) is the second-highest rank normally achievable in the U.S. Army, and the first to have a specified number of appointments set by statute.It ranks above major general (two-star general) and below general (four-star general). "Atul Gawande offers an unflinching view from the scalpel's edge, where science is ambiguous, information is limited, the stakes are high, yet decisions must be made.

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