On the subject of earwax and unsupported medical arguments

There are a limited number of residency slots allotted by the government each year so if you don't get one it's a whole year before you can apply again. It's certainly an archaic system, and the incentive by the medical lobby to expand residency programs is low presumably to protect wages. Even if you do jump through all the hoops, life as a doctor is a grind. Hospitals are businesses and your job is to see as many patients as possible. This is all coming from him and other family members who went through the whole ordeal.

In general:

If you want a nice balanced life, you should aim to open a private practice. However private practices are a dying breed due to cost for renovating/acquiring an office (150k at the very least for renovating yourself here in LA), shitty payouts by insurance (and getting worse), I saw a pay stub just today for $37 for a specialist visit (cash visit would be around $250 so Drs really hate taking even PPO insurance these days), etc. Few specialties can pull off a private practice such as: Plastic/Aesthetic, ophthalmology (doing LASIK and cataract surgery), and some others but usually these two have it the best. It's even harder if not in a very populous area, but then competition is rife, should be ready to shell out for marketing. The majority of physicians work in groups or hospitals. There is a lot of stress and responsibility if you are a surgeon, you should know that this kind of life is what you want.

In the end it depends on his goals, these days and evermoreso going forward physicians are just cogs in the system. You can get away by opening a private practice but there are plenty of challenges there. Getting into a nice residency program is mostly luck and medical school is rough. Not to mention the costs if you aren't well off.

If anyone wants to ask anything I'd be happy to answer in a bit more detail when I get time.

How can anyone rely on reputation in a world where there's no accountability when people systematically and mercilessly destroy someone's reputation?

Even most people who oppose copyright and patents still seem to understand that trademarks serve a singularly critical role in permitting a free market to operation. But the existence of trademarks necessarily require the ability to sue those who violate them. The same is true of reputation--reputation has no meaningful substance if the law does not provide a means for people to defend it. Without legally (i.e. community) enforceable accountability, a person's reputation is whatever the most powerful person or group says it is. That's literally a world where might is right; where free market is synonymous to law of the jungle.

Which is exactly why we don't, and essentially no one is advocating for it. But different domains of life need different risk tolerances. Some amount of greater caution, to say the least, is warranted when you're dealing with people's health.

Or you can let them grow out and scare old ladies and young children.

1) Preference/Social - This is primarily smell and appearance-based. For example, you won't see medical problems from irregular bathing (as long as you keep wounds/orifices clean), not cutting your hair, or not wearing deodorant, society just politely asks that you do those things.

2) Modern-life Adaptions- This is things like tooth brushing. We need to do it more because of our modern diets than anything else.

3) Comfort - This is things like cutting your finder nails so you don't scratch yourself.

Using this framework, you realize you can get away with not doing a lot: pretty much everything except 2 is medically optional (especially after you let your body get back to homeostasis) - but keep in mind just because you and those close to you can't smell you, that does not mean strangers can't smell you.

Ear cleaning, FWIW falls mostly in 3, but maybe in extreme cases it becomes 1; if you're swimming a lot maybe it's a 2, but rarely is that true.

But also, given the above, please be considerate of others and do as much 1 as you're capable of.

I swim a lot too and get a blockage at least once or twice a year. I used peroxide on it to varying results, sometimes it would work, sometimes not. Then I read that hot water flushing after the peroxide is the key part, and that works consistently for me now. I do it by getting in the shower and aiming a stream of hot water into the ear for a minute or so.

https://www.bbc.com/travel/article/20181029-in-china-chengdu...

As someone who has suffered barotrauma ear perforation, I find it hard to believe you would persist in using a squeeze bulb at that pressure as the pain is excruciating. When you get a perforated drum it's not a volume problem, sounds are actually muted, the cilia will be fine.

If you use plain tap water, make sure it is boiled in a kettle or on the stove first to kill any microbes. Hot tap water is not hot enough to kill microbes.

Not much pain. I significantly lost hearing in that ear immediately. There was not really any way to treat it apart from waiting for it to heal itself, which it did after about 4 weeks. Hard to tell whether it's truly as good as new though.