A few thoughts about the end of life for the survivors who make it to the end of their lives (the elderly, yes, they are the survivors of life).

When I do nursing home visits, very often, people have come to the end of their lives. They have come to the end of what medicine can do for them. Medicine can't fix ageing hearts, or kidneys, or brains. There is no cure for old age (yet, watch this space over next decades).
When it's very clear to us that the medicines don't work anymore, we have a very frank discussion about changing our goals from trying to cure things that can't be cured, to prioritising comfort and dignity above all else. Treating symptoms now matters more than cure.
(We never, ever, give up, or stop, or pull out. We do not use the word futile, nothing is futile because there is always something we can do. Whether it's medicine or surgery, morphine or ice cream, there's always something we can do. We are there to lives completion).
These decisions to switch from trying to cure, to reducing symptoms and prioritising comfort and dignity aren't made in a prescriptive way. They are done over multiple discussions with our patients and families, and their carers and us. No god complexes here.
But every now and then, even though we know things are failing, and we can offer the medicines to make someone feel better - the thought of taking that step, accepting that this time, they're not going to get through, is just too much.
They want to go to hospital to have it all investigated, and to have people around them 24/7. And to feel safe and cared for, because dying alone in a nursing home, or their own home is terrifying. Even though they hate hospital and never wanted to go, they do now.
It doesn't happen very often, most of the time we can do a good job managing that fear in the community, but sometimes it's just too much, they elect to go to hospital where they will be safe. And you know what?

That is perfectly okay.
If you survive to lifes completion, medicine should not, and will not abandon you at the final step, whatever that step means and looks like to you. Thankyou for listening.

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“We don’t negotiate salaries” is a negotiation tactic.

Always. No, your company is not an exception.

A tactic I don’t appreciate at all because of how unfairly it penalizes low-leverage, junior employees, and those loyal enough not to question it, but that’s negotiation for you after all. Weaponized information asymmetry.

Listen to Aditya


And by the way, you should never be worried that an offer would be withdrawn if you politely negotiate.

I have seen this happen *extremely* rarely, mostly to women, and anyway is a giant red flag. It suggests you probably didn’t want to work there.

You wish there was no negotiating so it would all be more fair? I feel you, but it’s not happening.

Instead, negotiate hard, use your privilege, and then go and share numbers with your underrepresented and underpaid colleagues. […]

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