Beri-beri is a Deficiency Disease caused by Lack of Vitamin B1 (thiamine)

Beri-beri is a nutritional human disorder in which affected individuals suffer from wasting of muscles, paralysis, mental confusion and sometimes heart failure. It occurs mainly in those countries where the staple diet is polished rice. There are two types of the disease: wet beriberi and dry beriberi. Wet beriberi affects the heart and circulatory system. Here is an accumulation of tissue fluid (oedema), In extreme cases, wet beriberi can cause heart failure. Dry beriberi causes nervous degeneration and can lead to a loss of muscle strength and eventually, muscle paralysis. Skin cyanosis is due to lack of oxygen. Beriberi can be life-threatening if it isn’t treated.

© (From the Author, “Biology for Medical Entrance”, S Chand Publishing, New Delhi)* Use this Book to get MBBS Seat in NEET, AIIMS or JIPMER *

What are some tricks used by waiters that most people never notice?

Andrew Rothman, former Waiter and Shift Manager at Restaurants

A man entered a restaurant and sat at the only open table. As he sat down, he knocked the spoon off the table with his elbow. A nearby waiter reached into his shirt pocket, pulled out a clean spoon, and set it on the table. The diner was impressed. "Do all the waiters here carry spoons in their pockets?"

The waiter replied, "Yes. Ever since an efficiency expert visited our restaurant. He determined that 17.8% of our diners knock the spoon off the table. By carrying clean spoons with us, we save trips to the kitchen."

The diner ate his meal. As he was paying the waiter, he commented, "Forgive the intrusion, but do you know that you have a string hanging from your fly?"

The waiter replied, "Yes, we all do. Seems that the same efficiency expert determined that we spend too much time washing our hands after using the men's room. So, the other end of that string is tied to my penis. When I need to go, I simply pull the string, do my thing, and then return to work. Having never touched myself, there really is no need to wash my hands. Saves a lot of time."

"Wait a minute," said the diner, "How do you get your penis back in your pants?"

"Well, I don't know about the other guys, but I use the spoon."

How do people develop stage 4 cancer without noticing until it’s too late?

By Clare Absher, R.N. | Family Caregiver | Founder of CarePathways.com

As a nurse for over thirty years I have reflected on this question with regard to certain patients who are suddenly faced with an unexpected diagnosis of stage 4 cancer. However, when my dear husband Jeff went undiagnosed with stage 4 prostate cancer for over a year, I now can sadly and humbly shed some light on this quandary.

First, understand that its highly unlikely that symptoms go unnoticed by a person with late stage cancer. Jeff was keenly aware that something was wrong when he suffered worsening lower back pain and severe urinary problems. Other folks with stage 4 cancer will have different symptoms depending on the nature of their cancer. However, I still expect that most persons with stage 4 cancer will notice something is seriously awry with their health.

I believe that more often than not my husband and others share similar causes attributing to their delayed diagnosis. While not a club you wish to belong, sharing even catastrophic experiences is invaluable. Jeff’s story is sad as so many others because lives could have been spared.

Aloof, skeptical, and even arrogant doctors were responsible for their share of mishaps on Jeff’s declining path. Jeff sought out care initially from three different urologists all of whom did not find significant findings suggestive of prostate cancer. His slightly elevated PSA blood results were attributed to inflammation and treated with antibiotics. If one of the first three urologists he went to see had performed a simple prostate biopsy he might be alive today.

When Jeff’s symptoms worsened, he surrendered to an extensive evaluation by countless physicians at Cleveland Clinic for a couple of months. This included poking and prodding by urologists, neurologists, gastroenterologists, and proctologists among others. In retrospect I recall that all the physicians seemed to be looking for some rare disease and not focused on the picture right in front of them. While maybe crystal clear now, at the time we were caught up in the onslaught of CT scans, MRIs, and invasive diagnostic tests.

Moreover, Jeff was accused by one physician of being a drug seeker. Another doctor suggested that his symptoms were psychosomatic or fabricated. Still another claimed that he had been seen by every department except OB/gyn and they simply had no more medical attention to offer him.

We left Cleveland Clinic with no more answers then we had come with except a remote possibility of Lymes disease. We saw an expert in this field and he confirmed that it was likely Lymes disease that was causing Jeff’s deteriorating health. Hope was lost however after an extensive course of oral and intramuscular injections showed no improvement. Perhaps if this doctor had not misdiagnosed Jeff precious time would not have been wasted.

Jeff passed away almost 8 years ago on May 16, 2011. It still infuriates me to recount the blunders made by trusted professionals for over a year. I believe many of whom to this day had a hand in Jeff’s avoidable and painful death. His delayed diagnosis was a result of mishaps, indifference, insensitivity, and even skepticism on the part of our medical system. It was ultimately our trust in the medical community that caused Jeff’s beautiful life to be ended abruptly and in a most agonizing way.

What is the best advice a medical doctor can give to a medical student?

By Patrick James Boland, studied at St. Olaf College

Keep a routine. If you don't have a routine, make one. If you don't like having a routine, LEARN TO LIKE A ROUTINE. You won't have any time to do anything. As a friend of mine told me before med school: sleep, family, friends, school, exercise - choose any three. It's true - you won't have time for anything. The way to have time in medical school is EFFICIENCY - efficiency in every single thing you do. If you can create a routine where you're dressed, showered, clean-pressed, and well-fed in the morning in just 35 minutes, you are ready to be a medical student.

Sweatpants are for college. Appearance matters. A lot of medical students will dress casually for lecture. They'll throw on a T-shirt, a pair of sweatpants, and lounge in front of their iMacs with glazed eyes. BE BETTER THAN THEM. The professors of your classes might later have you in clinic. They might even be the ones who write you a recommendation. Medicine is a small world - people talk. I once had the head of the general surgery department tell me, "You're always clean and well-dressed. I like that." And like most surgeons he walked away and never spoke to me again for the rest of the rotation. He later offered to write me a recommendation, without my asking. Appearances MATTER.

Sleep when you can, but it's overrated. I'll sleep when I'm buried in a coffin six feet under. I do sleep in, but it's a luxury. There's a reason humanity invented the depth charge, or whatever they call it at your local coffee shop - a mix of espresso and drip coffee. Caffeine is amazing. Coffee also has health benefits (which I wrote about in a blog post, but let's be real, it's Quora, you DON'T CARE). Get sleep. Love sleep. Relish sleep. But don't sleep. It's for later.

Learn what matters and cut out the rest. Be ruthless. Do grades really matter? Does your Step 1 score really matter? Does doing research matter? Do your hobbies matter? When thinking about priorities, DON'T think about a particular school or a particular residency in the future. Instead, imagine: in fifteen years, what do you want your life to look like? What kind of person do you want to be? What kind of relationship do you want to have or not have? What kind of house or apartment do you want to live in - urban, suburban, rural? Now, to have that dream life, think: what do you NEED to do now? When you've identified that, take everything else and cut it out. Perhaps you decide that you'll just pass most of your medical school classes with a few rare honors, but to balance it you'll get a 265 on Boards because that's what you NEED. In med school, don't try to do and be everything. You'll fail, you'll look worse than the people who focused, and you WON'T be the doctor you always dreamed of being. One of my best friends, a brilliant pediatric ENT surgeon who trained in the Ivy League schools for years, once told me he realized part of the way through residency that he HATED doing research. So he didn't do it anymore. Now he's happy, successful, and doing the things he always loved to do. BE RUTHLESS with what you love.

Ask for help. This is the single hardest thing for medical students to do, but one of the most important. In medical school, you will struggle with at LEAST one thing. I say 'at least one' because I know what you're thinking, you, like every other doctor, are completely infallible. Just like we all say when we're 40 and a doctor that we were born a surgeon or an internist, and were NEVER a med student (or so the attending will tell you - it's kind of a classic joke). The point is we are human. We are vulnerable. There will be a class that is hard, or a rotation where the attending does not like you, or a day you did not sleep enough. It is completely ok to admit the truth. It's ok to say you just ended things with your boyfriend or girlfriend and thus, you might sound a bit incoherent in your case presentation (this happened to me - and it ended up one of my best days in clinic). Be real. Tell the truth. Ask for help when you struggle. When all is said and done, no one will put in your recommendation that your grandma passed away, but you forgot to take a social history and had to go back to the room and ask again. Just be real, and you'll be a fantastic, incredible medical student.

Eat well and PLAN. I cook most of my meals Sunday night. I also have a morning smoothie with Greek yogurt + hemp seeds (for protein), almonds + chia seeds (for healthy fats), fresh berries + banana (for healthy carbs + antioxidants), and spinach or kale (for the fiber and green goodness), every single day. This is not me bragging (yeah, that smoothie sounds super pretentious...). There is no substitute for giving your brain the energy it needs to learn. There is no substitute for the time saved by planning your meals ahead of time. Do it. Learn it. Even study it - we know you're good at that.

Study hard, but remember the end game. There is no substitute for studying hard and studying a lot. You need to know this material. Patients and your attendings depend on it. Just know that you WILL learn it. Medical school wasn't designed to fail you - it was designed to teach you. All I will say as a counterpoint is that you will eventually work with patients at the end of their life regularly during third and fourth year. And when you do... you'll see a lot, a lot of regret. A lot of people realizing they'd never travelled, they'd never written that book, they'd never challenged a system of routine and comfort and truly LIVED. Don't be that person. If you leave the library everyday drained and unhappy in undergrad, consider the fact that you'll feel that way everyday in medical school. There's always the chance, as unfortunately happened to a recent brilliant neurosurgery resident, that you'll die of a rare cancer in the midst of your residency (ps, read his book, it's incredible and poignant for all of us). That could very well happen to me.   It could very well happen for you.  So yes, there's ultimately no substitute for studying. But there's also no substitute for your life if you don't live it now. I backpacked Europe alone for a month-and-a-half between first and second year. Recently, I went to Mexico for vacation for a week and hiked to a hidden beach along the coast. I don't regret a thing. In fact, when I come back, I study all the harder for it. And guess what - when the patient walks in that door, the first thing they see is me smiling.

Smile. You'll do just fine.

Do doctors not always give stages for cancer? My friend says her doctor didnt?

By David Chan, MD from UCLA, Stanford Oncology Fellowship Via Quora

Stage is only a description of cancer location to guide treatment. It’s not a prediction of life expectancy and stages don’t translate across different cancers. Cancer stage is not is a grading system of cancer survival.

I can cure most stage 4 lymphomas. I can’t cure a stage 1 GBM of the brain. I also can’t cure a stage 4 breast cancer but that patient will generally outlive a stage 3 pancreatic cancer or any stage GBM by many years unless her breast cancer is triple negative. Some stage 4 prostate cancer patients can survive a decade without needing treatment or very minimal treatment depending on Gleason grade.

Some stage 4 colon cancer patients with limited metastasis to the liver can be cured with directed therapy to the liver and chemotherapy. Some stage 4 lung cancers with EGFR mutation survive many years while others have shorter life expectancy (EFGR, ALK, ROS1, NTRK fusion mutation and PD-L1 negative).

I often don't give a stage for cancer unless asked because it doesn't add much to the patient’s understanding of prognosis and treatment options. I will if asked and some patients on learning that they have stage 4 ER positive or HER2 positive breast cancer gasp thinking that they have about 6 months when they more likely have 5–10 plus years of life expectancy with modern therapy.

It’s complicated. The other thing I don’t like about staging is that patient often will google their survival without understanding that most survival numbers are based on data from 10–15 years ago don’t include many of the new treatments in many cancers.

Doctors: How do surgeons hold out on surgeries more than 6 hours long? Do they rest during the operation?

By Murat Dayangac, Certified liver transplant surgeon since 2010

I am a liver transplant surgeon. On days of living donor liver transplantation, which takes at least 8 hours, from skin-to-skin, I have to keep operating all the time. But after 15 years of intense training, I have my muscle memory in place. Plus, there is a high level of adrenaline flow during the first 2–3 hours of surgery, which keeps you awake until the end of the operation!

In addition, when the new liver is reperfused, the rest of the operation, which involves arterial and biliary anastomoses, are performed under microscope. This means that you take a short break (for rehydration only, you’re not supposed to eat while the patient is asleep and the rest of the team is waiting! Also, you are not advised to continue with full stomach!), get rid of your surgical loupes, put your daily goggles back, and perform microsurgery. This opens a new chapter in your work.

The good thing is that, a recent study from the Maastricht University has shown that, standing for long periods during work has health benefits which are different than those of daily exercise.

Lastly, a few things to remember: change your scrub nurse and your first assistant frequently, because they are not expected to have the same stamina as yours; and don’t forget to put on your anti-thrombotic socks at all times!

The guidelines on acute calculous cholecystitis (ACC) in the elderly were released on March 4, 2019, by the World Society of Emergency Surgery (WSES) and the Italian Society of Geriatric Surgery (SICG).

Diagnostic Testing
In elderly patients, no single investigation is capable of establishing or excluding ACC without further testing. A combination of symptoms, signs, and laboratory tests results may have better diagnostic accuracy.

Abdominal ultrasonography (US) is the preferred initial imaging technique for elderly patients clinically suspected of having acute cholecystitis.

Data on the diagnostic accuracy of computed tomography (CT) are scarce. The accuracy of magnetic resonance imaging (MRI) may be comparable to that of abdominal US, but the data are insufficient to support this view. Hepatobiliary iminodiacetic acid (HIDA) scanning has the highest sensitivity and specificity, but scarce availability, long execution time, and radiation exposure limit its use.

Combining clinical, laboratory, and imaging investigations should be recommended, though the best combination is not yet known.

No high-quality studies on specific diagnostic findings of ACC in the elderly are available.

Pros vs Cons of Surgical Treatment
Old age (>65 years), by itself, is not a contraindication for cholecystectomy to treat ACC.

Cholecystectomy is the preferred treatment for ACC even in elderly patients.

Evaluation of risk for elderly ACC patients should include the following:

Mortality for conservative and surgical therapeutic options

Rate of gallstone-related disease relapse and time to relapse

Age-related life expectancy

Patient frailty; consider use of frailty scores for assessment

Specific risk (for individual patient or particular procedure); consider use of surgical clinical scores

Optimal Timing and Choice of Surgical Technique
A laparoscopic approach should always be attempted first, except in the case of absolute anesthetic contraindications or septic shock.

Laparoscopic cholecystectomy is safe and feasible in elderly patients, associated with a low complication rate and a shorter hospital stay.

Laparoscopic or open subtotal cholecystectomy is a valid option for advanced inflammation, gangrenous gallbladder, and "difficult gallbladder."

Conversion to open surgery may be predicted by fever, leukocytosis, elevated serum bilirubin, and extensive upper abdominal surgery. It should be considered in the setting of local severe inflammation, adhesions, bleeding in the Calot triangle, or suspected bile duct injury.

Laparoscopic cholecystectomy should be performed as soon as possible but can be performed up to 10 days after the onset of symptoms.

Percutaneous Cholecystostomy in Patients Unsuitable for Surgery
Percutaneous cholecystostomy can be considered in the treatment of ACC patients deemed unfit for surgery (>65 years, American Society of Anesthesiologists [ASA] class 3 or 4, performance status 3 to 4, septic shock).

When medical therapy has failed, percutaneous cholecystostomy should be considered as a bridge to cholecystectomy in acutely ill (high-risk) elderly patients deemed unfit for surgery to render them more suitable for surgery.

Percutaneous transhepatic cholecystostomy is the preferred method of performing percutaneous cholecystostomy.

The percutaneous cholecystostomy catheter should be removed 4-6 weeks after placement if a cholangiogram performed 2-3 weeks after cholecystostomy demonstrated biliary tree patency.

Management of Associated Biliary Tree Stones
Elevation of liver biochemical enzymes and/or bilirubin levels is not sufficient to identify patients with choledocholithiasis; further diagnostic tests are needed.

Visualization of common bile duct (CBD) stones on abdominal US is a very strong predictor of choledocholithiasis. Indirect signs of stone presence (eg, increased CBD diameter) are not sufficient to identify patients with choledocholithiasis; further diagnostic tests are needed.

Liver biochemical tests and abdominal US should be performed in all patients to assess the risk for CBD stones. CBD stone risk should be stratified according to a classification modified from American Society of Gastrointestinal Endoscopy (ASGE) and Society of American Gastrointestinal Endoscopic Surgeons (SAGES) guidelines.

Elderly patients at moderate risk for choledocholithiasis should be evaluated with preoperative magnetic resonance cholangiopancreatography (MRCP), endoscopic US, intraoperative cholangiography, or laparoscopic US, depending on local expertise and availability.

Elderly patients at high risk for choledocholithiasis should undergo preoperative endoscopic retrograde cholangiopancreatography (ERCP), intraoperative cholangiography, or laparoscopic US, depending on local expertise and availability.

CBD stones may be removed preoperatively, intraoperatively, or postoperatively in accordance with local expertise and availability.

Choice of Antibiotic Regimen
Elderly patients with uncomplicated cholecystitis can be treated without postoperative antibiotics when the focus of infection is controlled by cholecystectomy.

In elderly patients with complicated acute cholecystitis, broad-spectrum antibiotic regimens are recommended; adequate empiric therapy significantly affects outcomes in critical elderly patients.

Microbiologic analysis is helpful for designing targeted therapeutic strategies for individual patients.

Most people who die of natural causes do not seek medical help

Fact checked by Jasmin Collier

Researchers have found that 70 percent of adults who died from natural causes had not seen a healthcare provider in the 30 days before their death.

A new study tries to make sense of premature death.

Scientists at the University of Texas Health Science Center at Houston and the Harris County Institute of Forensic Sciences (IFS) in Texas have uncovered some of the key factors related to premature deaths among adults.

They have now published their results in the journal PLOS One.

A 2016 report that the Centers for Disease Control and Prevention (CDC) compiled found that more than 2 million people in the United States die every year.

The leading causes of death in the U.S. are heart disease and cancer, with around 635,000 deaths and 600,000 deaths per year, respectively.

Before getting into the details of the study, it is important to understand what constitutes a natural cause of death: A natural cause of death rules out the involvement of external causes such as an accident, a murder, or a drug overdose.

Identifying modifiable factors

The team wanted to identify modifiable characteristics that could help healthcare providers prevent deaths from natural causes. To do this, the scientists focused on the 1,282 adults who died in Harris County, TX, in 2013. They analyzed autopsy reports and legal death investigation records.

One study, from 2015, found a significant increase in all-cause mortality of non-Hispanic Americans in the 21st century.

This increase seems to be due to rising death rates from drug and alcohol poisonings, suicide, and chronic liver disease.

10 minutes of leisurely activity per week may lower death risk

A recent study found that even a short amount of physical activity each week may lower the risk of death.

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"I had noticed younger people dying when I worked at the IFS, so I set out to identify the causes in Harris County," says lead study author Stacy Drake, Ph.D., an assistant professor at the University of Texas Health Science Center.

The team identified common modifiable characteristics within two categories that are growing in prevalence: deaths from natural causes and drugs. "We need to dive into what is going on with these folks and find out where we can break the chain of events leading to their deaths," says Drake.

Links to poverty and healthcare access

The researchers discovered that 912 deaths were due to natural causes and 370 were due to drug overdoses.

Study co-author Dr. Dwayne A. Wolf, Ph.D. — Harris County IFS deputy chief medical examiner — collaborated with Drake's team.

"As medical examiners, we perform autopsies and present findings in court. As physicians, we appreciate the opportunity to translate our findings into improvements in healthcare, in injury prevention, or even in preventing deaths."

Dr. Dwayne A. Wolf, Ph.D.

Deaths to natural causes included alcohol use, tobacco use, substance use, and documented past medical history. The top causes of death were linked to the circulatory system, digestive system, and endocrine and metabolic conditions.

The data also revealed that more than half of these people did not have a healthcare provider.

"They had symptoms and knew they were getting worse," explains Drake. "Yet, they didn't seek the attention of a healthcare provider. We need to conduct further research to answer the question of 'why?'"

In particular, the team focused on three areas where the number of premature deaths was higher: North Central (Trinity Gardens), South (Sunnyside), and East (Baytown). Here, education, income, and employment are comparatively low, and there is a lack of access to healthcare services.

"Overall, they're dying of diseases that we treat every day," Drake concludes.

Of the 370 drug-related deaths, most of them were accidental and a very small number were down to suicide.

The researchers found cocaine, opioids, antidepressants, and alcohol in toxicology tests. They also showed that white people, compared with black people, were more than twice as likely to die from drug-related deaths.

The authors hope that "these findings may influence the initiation of interventions for medically underserved and impoverished communities

How Do Space Suits Even Work?

People have been going into space for some time now and we’ve seen astronauts sporting all sorts of outfits to do so, but how do those space suits actually work? And how have they evolved over time to accommodate our ever-expanding explorations further from our home planet?

We’re talking space suit fashion, or well, more accurately, space suit innovation (although, if I’m being honest, they are becoming quite stylish these days

These suits essentially act as personal space crafts, and they have one very important job: to keep humans alive. A tall order in places quite different from the atmosphere here on earth.

Let’s begin with a little overview from WIRED that brings us from the first space suits that were designed by NASA, to the latest and greatest (and very chic) innovation that’ll be making its debut in space in the next couple years: the Boeing Blue.

Cool, right? But how do these contraptions actually work…

We sought out seeker for a historical overview of how exactly space suits have been able to protect our fragile human bodies from the vacuum of space; from that first suit used in the first spacecraft mission to the latest designs that we’ve just seen!

So, what does it feel like to be inside some of these suits?

Loren Grush from The Verge wanted to know what it was like to wear one, and was able to try on the suit that’s used to walk on the moon as well as the one being developed to protect astronauts on Mars!

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Sour Thoughts: It Only Takes 5 Steps to Ruin Your Day

The strength your thoughts possess to steer the course of your life is often grossly underestimated. It is for that reason you must take stock in your thinking process on a regular basis, whether good or bad. Not every thought that drops into the space between your ears is worth being allowed to plant itself as a seed and grow. Nor is every thought true or rational.

It’s precisely why there is a significant difference between having a thought (which is involuntary) and thinking about a thought (which is voluntary). And it’s for that reason that I’m blowing the cover on what I affectionately refer to as “sour thoughts”—destructive thoughts that seek to sabotage your pursuit of building the best version of “you” possible.

Shuffle the Hits

What was the first negative thought you had today? Be honest. How about when you walked into work and your supervisor walked right past you without even looking your way? How about when your spouse hurriedly walked out of the house without saying goodbye? How about when you sent an important text to a close friend and never received a response?

I’ll wait for a moment while that emotion resurfaces. What was your reaction? I’d bet some serious coin that it was to the tune of…

What did I do wrong now?
What a jerk.
Maybe it’s true that I’m not valuable after all.
She looked at me like that yesterday. I’m probably in trouble.
You’d think he would value our relationship enough to text me back soon.
After all I do for her, the least she could do is acknowledge me.
And my favorite: Who do you think you are?

Pucker up, lemon lips. You’re sinking.

5 Steps to Ruin Your Day

Taking it a step further, assuming you let the thought move from your conscious mind into your subconscious mind like a bird’s nest in a gutter, let’s play this out and explore the five snowballing steps that will surely ruin your day:

1. Entertain a negative thought.

2. Think twice about the same negative thought.

3. Second-guess the stupidity of the thought and consider its possibility of reality.

4. Allow the negative thought to take root into your belief system.

5. Behave through the filter of the thought as if it were actually true.

What’s the result? Enter the feeling of the cold, unforgiving blanket of apathy wrapping itself around your soul as the weight of disdain presses unflinchingly atop your eyelids while laying out the welcome mat for a headache, irritability and exhaustion. And just like that, you’ve created a huge, totally irrational story. It’s cleverly stupid, isn’t it? But even though you may be down, you’re not out. Thankfully, there are three surefire strategies to ripping destructive thoughts out of your mind before they take root and do their damage.

1. H.A.L.T.

Recently, I learned an acronym known as H.A.L.T. Regarding stinking thinking, the principle holds true. Any time negative thoughts enter your mind, quickly ask yourself:

Am I hungry?
Am I angry?
Am I lonely?
Am I tired?

Making slipshod, irrational, impulsive decisions in any of these conditions will lead you away from focused living that yields negative, regressive results. Supporting this thought, a trusted leader in my life once said, “I have to manage my soul and nourish my body. I have to realize that my soul and body get exhausted before my spirit does.”

2. The umpire strikes back.

A really wise man said, “Let soul harmony act as umpire continually in your hearts, deciding and settling with finality all questions that arise in your minds.” In baseball, the umpires decide whether or not the ball is in or out of play. Concerning your thought life, shouldn’t you employ the same strategy? You see, if you don’t manage your inner world, it’ll eventually manage you and undermine your destiny. You need to question “reality” and learn to set your mind and keep it set on that which is true.

3. Don’t let one thought go unchecked.

This is especially important when you’re hurting. There are so many times you have a reason to think and believe something, but it doesn’t mean you should. You don’t have to actively think about every thought that drops in your head. Deal with it before it settles into your subconscious mind.

In life, the barrage of random thoughts that enter your headspace won’t completely end. But you can put an end to allowing “sour thoughts” to manage you. Earlier, I suggested that you’ve probably asked yourself, Who do you think you are? Well, the voice of identity and the voice of shame ask the same question. One is an invitation to discover significance and purpose. The other is a blatant taunt fueled by fear and condemnation. Make the regular choice to develop a mind that agrees with the truth about the core of your identity and purpose. So I ask…

Who do you think you are?