Negative works. Cf. revelation of Bush's prior DUI less than a week before election 2000.
That's why it's there. And Kerry is... well...
Maybe this isn't the place. But I can't imagine somewhere better.
I'm a Republican. I remember this time, called the 90's, when a Democrat was president. I couldn't stand the guy - smarmy, looked like a used car salesman. He ran again in '96. And I still couldn't understand what in the world people found admirable about this guy. He got hummers from an intern, then lied about it to Congress. It made my blood boil - not because the President was cheating (I'm not that naive), but because he came out and lied to all 280 million of his bosses about it. Still, inexplicably, these people liked him.
Looking back now, it's sorta funny - he was busy enacting policies that everyone would have called Republican in 1992 - welfare reform, NAFTA - and ditched the issues that he spent that campaign talking about - gays in the military, health care reform - as soon as he realized they were losers. And he just didn't lose battles with Congress.
Fast forward to 2004. Now, there's a Republican in office that most Democrats feel a harsh, visceral hatred for. Let me give you a hint. Nominating a Senator is not a winning prospect - the last one to go straight from Senate to White House was Kennedy. In fact, since then (and often before, as well) the winning strategy is to be a popular vice president or a governor, preferably from the South or California. Nominating a nice guy Senator who totally deserves a chance to destroy Satan's minion at 1600 Pa Ave and of course totally will because he's everything that the minion isn't - virtuous, honest, charming. All you have to do is point out just how evil and lying he is and you'll certainly win.
Ahem. Helpful hint - the people who voted for this guy last time have already taken his faults into account . And what they see is that, even in the period before Sept. 11, 2001, he was actually extremely successful at getting his policies enacted. He wasn't (and isn't) a public speaker, but he's affable enough. He's willing to give up credit in order to get his policies through. And he doesn't lose battles with Congress.
-------------
So people are in his admin that, possibly, shouldn't be there. I'd wager some like that are in every administration. But people, frankly, just don't care. They don't care who he hires, they don't care who he's connected with. They don't give a damn about what he did in Vietnam (probably the best things Clinton accomplished as a candidate, rather than as a president). And they don't care about Kerry's remarkable investigative history. Stop a random person on the street - ask if they know who Ahmed Chalabi is, or what BCCI stands for. (No fair doing this in a newsroom or college class. Go ask the construction workers across the street.)
All they see is that Bush is the guy who kills terrorists. And that Kerry can't shut up about Vietnam. Why? He's a weak candidate. As I saw it mentioned somewhere else today, a really great race would have been Gephardt vs Bush - a real, substantive election. Dean vs Bush would have been a real, substantive election. Kerry is a milquetoast of a candidate - he can't manage his staff, he can't come up with coherent attack ads, he can't convey a real position on any issue to the people. Can you imagine Kerry broadcasting the modern-day equivalent of the LBJ "Daisy" commercial? Nope. Which is why, in the somewhat-less-than-50% likelihood that he wins, he'll be a lame duck from the beginning. He's an Anybody-But-Bush candidate. And that kind of support from the people doesn't last once the Bush is gone. (Hilary in '08 - well, I can't say I'll like her even as much as I did her husband, but I do honestly think that she'll believe in something that isn't simply the negative of what the guy in the R column thinks.)
Except, of course, media corporations, right? Or are you seriously advocating returns to the crazed "equal time" concept of the past, when equal time had to be granted to other viewpoints no matter how ridiculous?
That is the essential problem of campaign finance reform - the less that candidates and parties can spend on direct-to-consumer advertising, the greater the influence the media corporations play. Now, I can't imagine anyone - anywhere on the political spectrum - who considers themselves a believer in democracy thinks that having an unelected, unaccountable group determine what a candidate's message is could possibly be a good idea. What happens when the other side controls the media? At least if you can buy time and space for ads, you can talk directly to the people. Maybe you say something great (e.g., Morning in America). Maybe you don't (e.g., Willie Horton). Your choice.
You know, I could put up with just about any of McCain's ideas - they're probably closer, on average, to mine than Bush's are - but he did support that godawful "campaign finance reform" law.
The only CFR I want to see is "how much money did you get, and who gave it to you, and no you can't hide behind shadowy groups to disguise who's paying." After that, who cares how much any one person gives, or what they spend it on?
Oh come on. They're not horrible hellholes, they're places that people move to because they are intentionally boring. Night life sucks, but you're a lot less likely to get stabbed - that, and a lot more space for the same money, is why parents move there.
That said, I'd rather live in Bladerunner - but I have to say I'd need to be in one of the huge full-floor penthouse jobbies, as opposed to Bruce Willis' place in The Fifth Element.
Those empty areas are full of roads traveling between the populated places. There's no use in something that you can't listen to outside the cities.
A similar logic dictates one of the reasons GSM was so slow in the US - it takes a lot of towers to cover even the major highways, let alone the minor ones.
I'm well aware of the way agricultural interests (*cough* ADM *cough* - the anticorp folks on/. are always aiming at the wrong corporations) have a stranglehold on the govt, but the point still stands - there is vastly less veggie oil than petroleum. Even if the entire world's supply of vegetable oil were used, it's a drop in the bucket compared to petroleum fuels. Even if you neglect the fact that a significant amount of petroleum is used to produce the vegetable oil in the first place (those crops aren't harvested by hand, and the fertilizer takes a lot of energy to make), vegetable oil just doesn't exist in sufficient quantities to replace our need for diesel.
It will never exist in quantities necessary to sustain a modern lifestyle. It takes energy, and a whole lot of it, to sustain our existence. This is the unfortunate economic point on which all the reduced-consumption schemes falter - there aren't more than a tiny handful of people who are actually willing to return to ca. 1900 levels of energy consumption. You've got a great idea, and maybe it's worth it (ethanol, for instance, is not, in that more energy is used to make it than is gotten out of it - the lower price vs. gasoline existing only because it's not taxed like gasoline, and hey, there's ADM again!), but it still doesn't solve the problem.
You missed the point here. The supply of veggie oil is vastly smaller and more expensive than that of petroleum (if you don't believe me, try getting any oil for the same cost-per-gallon as pre-tax gasoline or diesel). The fact that kitchens want to get rid of it is irrelevant. As long as they're equally good fuels, the total amount of veggie oil out there will be bid up in price until such point as nobody can make a decent profit off it - in other words, restaurants will be paid just enough to make it worth the refiners' while to clean the stuff up. If they're getting paid less than that, some enterprising young refiner will come along and offer to pay them, say, 2c/gallon more. And thus the restaurants manage to maximize their use of the oil, essentially paying depreciation on it for the right to use it for frying.
In short: if it's cheaper, the supply would run out almost instantly if it became mainstream practice to use it. As long as it's a minor, niche thing, with restaurants throwing away oil (no recycling infrastructure), they're happy to give it for free. But as soon as they can get paid for providing it, it'll bid up in price. And if, say, 1/2 the cars on the road used it, it would be wiped out at any price lower than that of petrodiesel (because if they're equivalent, who cares which you use? You'll go for cheap!)
I actually met a guy online once who claimed to bike-commute in New Orleans. He said his company was great, had showers onsite and he just changed into his suit when he got there. I still think he was insane.
Having looked at the company website (the relevant diagram is the PDF here),
this thing has an inflow directly from the LV at the apex and implants into the ascending aorta proximal to the brachiocephalic trunk. Looks like in diastole you'd still get a bump in pressure - after the aortic valve closes, there's still pumpable blood in these guys with dilated CMP's. So this little puppy empties that before the next contraction.
Besides, they'll all be on a beta blocker anyway. Myocardial oxygen demand should be pretty minimal.
Pulse ox will work fine. You get sats even if you don't get a rate - try it sometime, if you jiggle it enough you'll find the machine locks on to the sat before it locks onto a rate.
I first read it here on/., I believe. No links, sorry. Try the Goog yourself. IIRC everything is in RAM. No HD's at all are involved in the actual search process. How else to get Google-like response times, as vs. ca. 1995 Lycos (when it was still at CMU; if you don't remember the bad old days, don't worry - they sucked)?
I think you're missing the total point. Psychological components of addiction - those produced by the high - are much more difficult to treat than physiological components.
I can, for example, legally (in many states) provide methadone to heroin users. Physiological addiction solved, and all they have to do is show up once every 2-3 days for an oral dose. It's quite cheap, and (not so) coincidentally legal. If they're wanting to get off the needle, it lets them do so without spending a few days with sweating, vomiting, and diarrhea (see Trainspotting). But it doesn't give them the high like heroin does.
You're absolutely incorrect about morphine and cocaine being developed to reduce addictive potential; they're both natural products. In an ironic twist, heroin was developed as a method to get people off morphine.
I don't think you understand what I mean by physiologic addiction - I'm talking about the components that aren't associated with the reward systems in the brain. There's no incentive to OD, because it doesn't make you feel good.
Drug-seeking behavior: the expenditure of considerable amounts of time and effort to obtain one's preferred intoxicant. Includes both time spent actually locating a dealer and time spent obtaining the money to afford the drugs. And yes, I've seen alcoholics. I've detoxed about half a dozen. Takes about a week to dry them out, and no more physiologic dependence on EtOH. Of course, I can't do a damned thing about their preference for drunkenness over sobriety, so once they leave, they'll probably go back on the bottle. The addiction of the body is easily treated. The addiction of the mind is not. That was the essence of my entire post. If you could, somehow, erase the addiction of the mind from the equation, addiction of the body is not a problem.
until they take to much and OD or they finish the prescription and can't get it anymore, what are they going to do then?
As I mentioned before, why OD on something that doesn't make you feel good? And I suppose, like the rest of us, when their prescriptions run out they'll refill them. These people already exist, using massive doses of narcotic analgesics. They can't function any other way. But if we could remove the threat of psychological dependence - if we could take out the reward - I could give those out to lots and lots of people who are currently undertreated for their pain because their docs just don't trust them. (And there are lots of people that we don't trust - e.g., if you're an alcoholic with severe arthritis, you're pretty much going to have to live with the pain because you've shown you will abuse.)
Charcot-Marie-Tooth is the first disease you're looking for. I'm not terribly familiar with it. The second disease I've not heard of, and can't Google it. I'm a fourth-year med student, not officially an MD yet, and obviously don't know the details of your situation, so I won't make a long commentary. However, for CMT, you might try here or here.
Of course, another stop for any health-related concern should be MedLine Plus, which offers information both for health providers and for patients, along with links to current research. It's a fabulous resource, and you can pursue just about anything to any level of detail you like. Good luck.
Incidentally, though it doesn't cover very rare diseases, Family Practice Notebook is a website geared to family docs who just need a quick refresher on a disease in the middle of the day. It's often one of the clearest sources of quick summary info on diseases; I've used it innumerable times to read up on patients' diseases when short on time.
He claimed to be allergic to all the prescription NSAIDs too. In fact, that was what his allergy sheet said: NSAIDs. Besides, it's usually pretty easy to spot drug-seekers.
And we don't treat pain well enough because we're always scared that the DEA is going to swoop down and take away our license to prescribe that stuff. It's a nasty state of affairs.
I've come across people who claim to be in severe pain but also claim to have allergies to aspirin, Tylenol, every single NSAID (Advil, Aleve, etc., etc., for the non-medical), Ultram, codeine, Vicodin (and every other hydrocodone product)... yep, he needed Dilaudid. Sure he did...
I didn't realize there was a problem with Duragesics sticking - I happen to be quite a fan of them in the outpatient setting because they make me feel a lot more confident they won't be abused. I'm terribly sorry for your condition - RA is a hellish, evil disease.
One nitpicky thing I would take issue with is your characterization of ketamine - while it is occasionally used for pediatric anesthesia, the side effects of hallucination and nightmares essentially preclude its use in adults. Out of the hundred or so surgeries I watched in med school, the only time I saw ketamine used was in an eight-year-old with a broken leg who was having it set in the ER - not the OR.
Urm, who cares if they're addicted for pain control? They're not the ones knocking over convenience stores to get the money. Addiction is not the problem - it is, in fact, possible to function fairly normally while utterly addicted to methadone. The problem is the drug-seeking behavior. People who were physiologically addicted to a medication that they're going to take daily for pain control anyway aren't a problem.
USA policy is essentially the same. At least some state health departments (mine included) have adopted daily observed therapy for TB, outreach programs for syphilis outbreaks (going directly to the community instead of waiting for people to show up), etc. Vaccinations are optional but strongly encouraged and, I'm happy to say, we've been quite lucky here in keeping our rates near the top of the national list. It's really a problem in certain upper-middle-class communities where huge percentages of the kids aren't immunized.
I'm not certain about the schools; presumably they do have to take you, although private universities might not (unknown - this is pure speculation). I was required to receive Hep B vaccination for admission to medical school. MRSA/VISA is met with high-grade isolation and 6 wks of antibiotics (most of which time it's done through home health nurses), but unfortunately that's really just rearguard action - I'm quite certain that 90+% of hospital personnel are colonized with MRSA.
I'm in med school, so I know how awful the authentication via user/pass is (really the only terrible thing about the VA system, if you ever worked in one of those).
If it were my institution, we've already got transponder-on-the-ID-card-based authentication for entry to ER, ICU, OR, etc. I'd just extend that system out to provide authentication. Define a logout key, and you're done.
If you're in a smaller environment, that would be a new expense, and maybe a hard sell to the admin. But it's totally HIPAA-trackable and is linked to the badge you're carrying anyway. See if a vendor has a system that works with your existing patient tracker.
For those outside the medical field, a few points that make some systems less than optimal:
1. Proximity isn't always reliable - most ERs are quite crowded, especially in the computer areas, and striking a balance between close-enough-to-activate and not-so-close-as-to-allow-crosstalk is nigh impossible. Unless you're talking about very-short-distance RFID, the proximity sensor isn't going to work well.
2. No PINs, please. The whole idea is to avoid having to login and give you a 1-2 second delay MAX before being able to enter info. While most doctors' notes are of sufficient length that user/pass is OK (if annoying), the nurses' notes are often very brief - entering vital signs, or saying "patient vomited", and they're going to be dropping those notes off a lot more often. Keeping the system up to date with their info is essential for the doctors to be able to use the system effectively. Delayed entry of nursing info onto charts is a hideous problem in medicine if you're in a hurry.
3. Multiple security levels is a non-starter, because nobody wants to do multiple swipes or have to type in a PIN in order to go from observation to data entry. These systems are generally pretty well-protected from public access (usually by being located behind a nurses' station). The important thing is to ensure that you have a convenient system that provides sufficient security to be auditable.
Where do you live? I pay $28 a month for a dialtone. I know that not everyone lives on a student budget - but considering it's more expensive than the VOIP line, it's hardly a minuscule cost.
You do remember that the original Quake actually had a text-only server mode, right? Idea was that you could use a 486 to be the server so that nobody got the I'm-playing-directly-on-the-server advantage.
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That's why it's there. And Kerry is... well...
Maybe this isn't the place. But I can't imagine somewhere better.
I'm a Republican. I remember this time, called the 90's, when a Democrat was president. I couldn't stand the guy - smarmy, looked like a used car salesman. He ran again in '96. And I still couldn't understand what in the world people found admirable about this guy. He got hummers from an intern, then lied about it to Congress. It made my blood boil - not because the President was cheating (I'm not that naive), but because he came out and lied to all 280 million of his bosses about it. Still, inexplicably, these people liked him.
Looking back now, it's sorta funny - he was busy enacting policies that everyone would have called Republican in 1992 - welfare reform, NAFTA - and ditched the issues that he spent that campaign talking about - gays in the military, health care reform - as soon as he realized they were losers. And he just didn't lose battles with Congress.
Fast forward to 2004. Now, there's a Republican in office that most Democrats feel a harsh, visceral hatred for. Let me give you a hint. Nominating a Senator is not a winning prospect - the last one to go straight from Senate to White House was Kennedy. In fact, since then (and often before, as well) the winning strategy is to be a popular vice president or a governor, preferably from the South or California. Nominating a nice guy Senator who totally deserves a chance to destroy Satan's minion at 1600 Pa Ave and of course totally will because he's everything that the minion isn't - virtuous, honest, charming. All you have to do is point out just how evil and lying he is and you'll certainly win.
Ahem. Helpful hint - the people who voted for this guy last time have already taken his faults into account . And what they see is that, even in the period before Sept. 11, 2001, he was actually extremely successful at getting his policies enacted. He wasn't (and isn't) a public speaker, but he's affable enough. He's willing to give up credit in order to get his policies through. And he doesn't lose battles with Congress.
-------------
So people are in his admin that, possibly, shouldn't be there. I'd wager some like that are in every administration. But people, frankly, just don't care. They don't care who he hires, they don't care who he's connected with. They don't give a damn about what he did in Vietnam (probably the best things Clinton accomplished as a candidate, rather than as a president). And they don't care about Kerry's remarkable investigative history. Stop a random person on the street - ask if they know who Ahmed Chalabi is, or what BCCI stands for. (No fair doing this in a newsroom or college class. Go ask the construction workers across the street.)
All they see is that Bush is the guy who kills terrorists. And that Kerry can't shut up about Vietnam. Why? He's a weak candidate. As I saw it mentioned somewhere else today, a really great race would have been Gephardt vs Bush - a real, substantive election. Dean vs Bush would have been a real, substantive election. Kerry is a milquetoast of a candidate - he can't manage his staff, he can't come up with coherent attack ads, he can't convey a real position on any issue to the people. Can you imagine Kerry broadcasting the modern-day equivalent of the LBJ "Daisy" commercial? Nope. Which is why, in the somewhat-less-than-50% likelihood that he wins, he'll be a lame duck from the beginning. He's an Anybody-But-Bush candidate. And that kind of support from the people doesn't last once the Bush is gone. (Hilary in '08 - well, I can't say I'll like her even as much as I did her husband, but I do honestly think that she'll believe in something that isn't simply the negative of what the guy in the R column thinks.)
That is the essential problem of campaign finance reform - the less that candidates and parties can spend on direct-to-consumer advertising, the greater the influence the media corporations play. Now, I can't imagine anyone - anywhere on the political spectrum - who considers themselves a believer in democracy thinks that having an unelected, unaccountable group determine what a candidate's message is could possibly be a good idea. What happens when the other side controls the media? At least if you can buy time and space for ads, you can talk directly to the people. Maybe you say something great (e.g., Morning in America). Maybe you don't (e.g., Willie Horton). Your choice.
The only CFR I want to see is "how much money did you get, and who gave it to you, and no you can't hide behind shadowy groups to disguise who's paying." After that, who cares how much any one person gives, or what they spend it on?
And? How does the fact that you can pick up a WiFi signal mean that you have permission to transmit via my connection?
That said, I'd rather live in Bladerunner - but I have to say I'd need to be in one of the huge full-floor penthouse jobbies, as opposed to Bruce Willis' place in The Fifth Element.
Those empty areas are full of roads traveling between the populated places. There's no use in something that you can't listen to outside the cities.
A similar logic dictates one of the reasons GSM was so slow in the US - it takes a lot of towers to cover even the major highways, let alone the minor ones.
It will never exist in quantities necessary to sustain a modern lifestyle. It takes energy, and a whole lot of it, to sustain our existence. This is the unfortunate economic point on which all the reduced-consumption schemes falter - there aren't more than a tiny handful of people who are actually willing to return to ca. 1900 levels of energy consumption. You've got a great idea, and maybe it's worth it (ethanol, for instance, is not, in that more energy is used to make it than is gotten out of it - the lower price vs. gasoline existing only because it's not taxed like gasoline, and hey, there's ADM again!), but it still doesn't solve the problem.
In short: if it's cheaper, the supply would run out almost instantly if it became mainstream practice to use it. As long as it's a minor, niche thing, with restaurants throwing away oil (no recycling infrastructure), they're happy to give it for free. But as soon as they can get paid for providing it, it'll bid up in price. And if, say, 1/2 the cars on the road used it, it would be wiped out at any price lower than that of petrodiesel (because if they're equivalent, who cares which you use? You'll go for cheap!)
I actually met a guy online once who claimed to bike-commute in New Orleans. He said his company was great, had showers onsite and he just changed into his suit when he got there. I still think he was insane.
You don't live in the Southeast, do you? Because you'd be a pool of sweat from May to October, if you did.
Having looked at the company website (the relevant diagram is the PDF here), this thing has an inflow directly from the LV at the apex and implants into the ascending aorta proximal to the brachiocephalic trunk. Looks like in diastole you'd still get a bump in pressure - after the aortic valve closes, there's still pumpable blood in these guys with dilated CMP's. So this little puppy empties that before the next contraction.
Besides, they'll all be on a beta blocker anyway. Myocardial oxygen demand should be pretty minimal.
Pulse ox will work fine. You get sats even if you don't get a rate - try it sometime, if you jiggle it enough you'll find the machine locks on to the sat before it locks onto a rate.
You forgot to mention The Red Badge of Courage.
I first read it here on /., I believe. No links, sorry. Try the Goog yourself. IIRC everything is in RAM. No HD's at all are involved in the actual search process. How else to get Google-like response times, as vs. ca. 1995 Lycos (when it was still at CMU; if you don't remember the bad old days, don't worry - they sucked)?
Google's machines use RAM drives. If we stored everything in RAM, our filesystems would be a lot faster too.
I can, for example, legally (in many states) provide methadone to heroin users. Physiological addiction solved, and all they have to do is show up once every 2-3 days for an oral dose. It's quite cheap, and (not so) coincidentally legal. If they're wanting to get off the needle, it lets them do so without spending a few days with sweating, vomiting, and diarrhea (see Trainspotting). But it doesn't give them the high like heroin does.
You're absolutely incorrect about morphine and cocaine being developed to reduce addictive potential; they're both natural products. In an ironic twist, heroin was developed as a method to get people off morphine.
I don't think you understand what I mean by physiologic addiction - I'm talking about the components that aren't associated with the reward systems in the brain. There's no incentive to OD, because it doesn't make you feel good.
Drug-seeking behavior: the expenditure of considerable amounts of time and effort to obtain one's preferred intoxicant. Includes both time spent actually locating a dealer and time spent obtaining the money to afford the drugs. And yes, I've seen alcoholics. I've detoxed about half a dozen. Takes about a week to dry them out, and no more physiologic dependence on EtOH. Of course, I can't do a damned thing about their preference for drunkenness over sobriety, so once they leave, they'll probably go back on the bottle. The addiction of the body is easily treated. The addiction of the mind is not. That was the essence of my entire post. If you could, somehow, erase the addiction of the mind from the equation, addiction of the body is not a problem.
until they take to much and OD or they finish the prescription and can't get it anymore, what are they going to do then?
As I mentioned before, why OD on something that doesn't make you feel good? And I suppose, like the rest of us, when their prescriptions run out they'll refill them. These people already exist, using massive doses of narcotic analgesics. They can't function any other way. But if we could remove the threat of psychological dependence - if we could take out the reward - I could give those out to lots and lots of people who are currently undertreated for their pain because their docs just don't trust them. (And there are lots of people that we don't trust - e.g., if you're an alcoholic with severe arthritis, you're pretty much going to have to live with the pain because you've shown you will abuse.)
Of course, another stop for any health-related concern should be MedLine Plus, which offers information both for health providers and for patients, along with links to current research. It's a fabulous resource, and you can pursue just about anything to any level of detail you like. Good luck.
Incidentally, though it doesn't cover very rare diseases, Family Practice Notebook is a website geared to family docs who just need a quick refresher on a disease in the middle of the day. It's often one of the clearest sources of quick summary info on diseases; I've used it innumerable times to read up on patients' diseases when short on time.
He claimed to be allergic to all the prescription NSAIDs too. In fact, that was what his allergy sheet said: NSAIDs. Besides, it's usually pretty easy to spot drug-seekers.
I've come across people who claim to be in severe pain but also claim to have allergies to aspirin, Tylenol, every single NSAID (Advil, Aleve, etc., etc., for the non-medical), Ultram, codeine, Vicodin (and every other hydrocodone product)... yep, he needed Dilaudid. Sure he did...
I didn't realize there was a problem with Duragesics sticking - I happen to be quite a fan of them in the outpatient setting because they make me feel a lot more confident they won't be abused. I'm terribly sorry for your condition - RA is a hellish, evil disease.
One nitpicky thing I would take issue with is your characterization of ketamine - while it is occasionally used for pediatric anesthesia, the side effects of hallucination and nightmares essentially preclude its use in adults. Out of the hundred or so surgeries I watched in med school, the only time I saw ketamine used was in an eight-year-old with a broken leg who was having it set in the ER - not the OR.
Urm, who cares if they're addicted for pain control? They're not the ones knocking over convenience stores to get the money. Addiction is not the problem - it is, in fact, possible to function fairly normally while utterly addicted to methadone. The problem is the drug-seeking behavior. People who were physiologically addicted to a medication that they're going to take daily for pain control anyway aren't a problem.
Unfortunately, neurosurgical approaches for pain control are of extremely limited effectiveness. Think of phantom limb pain in amputees as an example.
I'm not certain about the schools; presumably they do have to take you, although private universities might not (unknown - this is pure speculation). I was required to receive Hep B vaccination for admission to medical school. MRSA/VISA is met with high-grade isolation and 6 wks of antibiotics (most of which time it's done through home health nurses), but unfortunately that's really just rearguard action - I'm quite certain that 90+% of hospital personnel are colonized with MRSA.
If it were my institution, we've already got transponder-on-the-ID-card-based authentication for entry to ER, ICU, OR, etc. I'd just extend that system out to provide authentication. Define a logout key, and you're done.
If you're in a smaller environment, that would be a new expense, and maybe a hard sell to the admin. But it's totally HIPAA-trackable and is linked to the badge you're carrying anyway. See if a vendor has a system that works with your existing patient tracker.
For those outside the medical field, a few points that make some systems less than optimal:
1. Proximity isn't always reliable - most ERs are quite crowded, especially in the computer areas, and striking a balance between close-enough-to-activate and not-so-close-as-to-allow-crosstalk is nigh impossible. Unless you're talking about very-short-distance RFID, the proximity sensor isn't going to work well.
2. No PINs, please. The whole idea is to avoid having to login and give you a 1-2 second delay MAX before being able to enter info. While most doctors' notes are of sufficient length that user/pass is OK (if annoying), the nurses' notes are often very brief - entering vital signs, or saying "patient vomited", and they're going to be dropping those notes off a lot more often. Keeping the system up to date with their info is essential for the doctors to be able to use the system effectively. Delayed entry of nursing info onto charts is a hideous problem in medicine if you're in a hurry.
3. Multiple security levels is a non-starter, because nobody wants to do multiple swipes or have to type in a PIN in order to go from observation to data entry. These systems are generally pretty well-protected from public access (usually by being located behind a nurses' station). The important thing is to ensure that you have a convenient system that provides sufficient security to be auditable.
Where do you live? I pay $28 a month for a dialtone. I know that not everyone lives on a student budget - but considering it's more expensive than the VOIP line, it's hardly a minuscule cost.
You do remember that the original Quake actually had a text-only server mode, right? Idea was that you could use a 486 to be the server so that nobody got the I'm-playing-directly-on-the-server advantage.