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Hey my friend. This is Darnell clock your industry leader in his career gang. Hey the answer man Hey, today’s topic is how to prep for a in person interview in today’s marketplace before I really get started I have something special for you I have a cheat sheet for interviewing is the interviewing cheat sheet is exactly what you need is perfect for anybody who really doesn’t have a good sense of what a interview is how you actually prep for I have a cheat sheet for you will love it. It is packed with information but you had stayed to the end to get it I promise you it is well worth so now how do you actually prep for an in person interview you know I have had opportunity to be on stages of conferences and workshops and seminars to thousands of people I have also done one on one consulting one on one contracting one on one clients that I have that I that I work with them one on one and

All the people that I have come across thousands of people on stage or workshops and seminars, hundreds of people want a little consulting and coaching. I have recognized that about 95% of people don’t really know how to prep for an interview. I asked people all the time, you know, are you ready for an interview as a yes. Well, how much and how long have you prep? Hey, I’ve only prefer to 1520 minutes or I didn’t prep at all. I’m just gonna go just talk off the cuff. Those type of people go to interviews. And don’t prep does not do well my friend so I’m not sure if you know me. See, I’m different than most career coaches. Most career coaches come from HR or recruiter cited off the side of the fence. Not me. I was the back in hiring authority working for IBM urging Yun Jie Coca Cola. I have a computer science degree and an MBA I was the back in hiring.

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These HR people will get with you. You have that discussion. You have to get through them before you get with me. But I was the backend hiring authority in my career. I have interview well over 300 people and I have personally hired over 250 people to work directly for me. I know what a good interview is. I know what a bad one is. I know exactly what I hire managers looking for.

Because I was one of all those many years. So now I’m going to tell you from the hiring managers perspective, what am I looking for? When I asked you certain questions, I’m going to give you the perspective of hiring authorities not HR, see if you can really think how a interview goes interview is really broken down in four stages. And if you can master those four stages, you will always be in a game for the interview those four stages is the stage number one is is is the introduction stage number two is the employer

Questions stays. Number three is the candidates questions and stays. Number four is the closing. And if you can understand those four stages and see what is expected of you, you will be able to have a high probability and high chance to be selected when you do an interview. So I’m going to break down the four stages and tell you exactly what it is how do you prep for it, and what do you need to do to master each stage stage one is in his introduction, the introduction is this is not the decision part where this this date is not where the employer or the interviewer will make a decision to hire you if that’s not that stage yet, but it is the stage if you patch it. If you blow this introduction stage. This is the stage where they will decide

Not to hire you is not the stage will they will they will decide to hire you but it is the stage will they decide not to hire you as a hiring authority I hired for two reasons to reason only one for likability and to fitness I will have to like you somewhere in this process of the interview, I would have to start liking you to see if I’m going to hire you.

I will never hire anybody I don’t like so that first introduction stage is all around into introducing yourself is the stage where the interview will ask you that question that freaks everybody out. Tell me about yourself, right? That’s the question that everybody starts with because we want to know a little bit about you. Now listen to me, my friend. When I asked you the question, tell me about yourself. I am not asking you where you from? What do you like to do? Do how many brothers and sisters you have are not efficient.

Interested in all that? I’m not. Also I’m not interested in hearing your 15 32nd

elevator pitch. You know the elevator pitch is a high level commercial or who you are a 15 2030

seconds high level general elevator pitch know when I asked you the question Tell me about yourself. I am looking for your value proposition. So what the heck is you have a value proposition in a nutshell your value proposition is a clear statement that explains how you will solve a company’s problem here, how you will improve their situation, what the liquid What do you deliver, what value and what strength Do you deliver to that organization as it connects to the job announcement and why should I hire you over someone else is specific. It is not general. Here’s the crust of it. When I asked you the question, why should I hire you?

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You I’m looking for who you are, what are you have your strength, your benefits as it connects to the actual job and mouse. That’s the key. The elevator pitch is general. It’s a general introduction of yourself. The value proposition is not gender specific of who you are, what do you bring to the table as the connects to the actual job? And now that’s the key. So if you have no idea how to craft your value proposition, when somebody asks you the question, tell me about yourself. Go below in the description field. I have created one of my first YouTube videos of how to address and handle Tell me about yourself. Question The title is, tell me, tell me about yourself. It is not a rendition of your resume. So here’s my tell you tell me about yourself that you have proposition. All right, Darnell, tell me about yourself. Hey, I am a lawyer.

Long learner, I take what I have learned in the past and I transition it to what I do now. I learned from my mistakes and my successes and I’m make sure that it I put it in play. So I can always learn from everything I do. I’m a high say, do I say what I do, and I do what I say. And that will make me a great asset to you and your organization. I’m dependable, reliable, and accountable for getting things done. I love to get to work to get things done. Because I believe in results. It is results and execution that I love so much. Most people say I get things done faster than most there’s no substitution for speed I call the speed of business results.

I truly love getting things done on time and within budget. I am a leader and I believe in delegation of authority because that drives individual accountability and at the bottom line, it grows people and make them be able to handle things at this

level and I’m truly excited by the opportunity that this position presents. You hear that? That’s my value proposition. Did you hear anything about my resume? Did you even hear the word resume? I say anything about my resume. I didn’t say anything about my accomplishments. I see say anything about where I worked at. When I asked you the question, tell me about yourself. I am not asking you for rendition of your resume. Because the very next question I will ask you right now, take me your resume. So that’s stage one. Stage one you must be able to address. Tell me about yourself. Why should I hire you? What’s your differentiation? What’s your strengths and your weaknesses and where you see yourself in five years? Right. Those are the introduction questions. Remember, I hire for two reasons likability and fitness. It’s an 8020 split. 20% of my questions is for likeability and then 80%

My question for fitness and then it transitioned from stage one to stage to stage two is employers questions? Yeah, that’s what I asked the question. All right. Not take me through your resume. Now, I need you to understand this. My friend, I need you to understand and know your resume called when I asked you to take me through your resume. The worst thing I can honestly say, that I see people do is that when I say, all right, take me through your resume. They open up their portfolio and they start reading their resume. I need you to script your resume. What the, what the heck does that mean? Yeah, script your resume. I need you to be able to script it you like as a person as an actor or a a, a actress, you know, so when in the movies or sitcoms, whatever they tell you their lives no different I need to script your resume. So how does it work? So

When I sat down to take me through your resume, I say while working for IBM from 2005 to 2017, you know, I was the program manager director. My responsibility was that because people always want to hear numbers and percentages, I was responsible for 25 people. And my budget was about $15 million our disposal for p&l to the organization and I was driving roughly about 100 million dollars to our to our services are from our products and services to our customers and our clients worldwide. Then my responsibilities XYZ, ABC, you see that and then when I finished with that, I say what my next position was, was what what Gee, I was working for GE from this time to this time for this position, my responsibility that I have 45 people reporting up to me, I had a budget of $65 million I responsible for my p&l to the business over 100 to $200 million to the business.

My responsibility was program project management I built a pm or office either Nana Nana, Nana and when I get finished with that I did this position that’s how you script it right? Do not spend a lot of time on your resume I want you to spend no more than two to five minutes maximum on your resume. So your resume got you in the door. The resume got UNIDO. Your resume was submitted for one reason. And one reason to get a call back for the interview. Your resume worked, your resume will not get you higher. The interview will get you high. So don’t spend a lot of time on your resume my friend to the five minutes get through it as fast as you can. If they want more information. They’ll ask their answer the question but get through it. By scripting your resume. Do not commit it to chance that you know what’s on your resume. I freaked people out and doing I was in interviews you know, I will have my friends.

resume it’ll be my portfolio but I would never pulled it out this. All right, Darnell, take me through your resume. And I just scripted and there’ll be looking at the resume while I’m talking. I hit our numbers and is exactly what they need. So stage two stars, where the question is, take me through your resume. Now most interviewers have a standard set questions that they want to ask. Remember, the second part of me, heart is fitness. I am trying to ascertain that you can do the job by because you have done it already. In today’s marketplace. We don’t hire people to train I know the millennials are having issues with that for sure. But I don’t have a budget to train so we don’t train what we want to do is hire you hit the ground running, learn it on a job so on the job training and hit the ground running when you hear that that means we are not training you whatsoever and only way you can hit the ground running because you have done it.

Before so so most employers are most most interview have standard interview questions they are trying to attach that whatever you have done before you have done it again now in these second stage there’s a two part interview process is your traditional interview questions and behavioral interview questions the majority of the marketplace now is going to majority of is going to behavior interview question if you don’t know what behavioral interview questions is all about. I crafted a four part series of how to handle behavioral interview questions go below in the description field and you’ll see a four stage process of handling How do you handle behavior interview question and when you handle behavior. Any question is all about behavior interview question is is a predictor is a predictor of what you did in the

Past is a predictor of what you have can can do in the present interviewer does not want to know what you think you can do the interviewer note wants to know what you actually have done and prove it and the way you do it by using the behavioral interview using the star method st AR s for situation to attach a for action are for results and throw one more in their lessons learned. So when they ask you a question and you will always know a behavior interview question when they started out like this. Tell me about a time when you did x y z show me a time when you did this. How did you did this? How did you handle that? So a one interview question is Tell me about a time when you had a conflict with a co worker at work. How did you handle it you will have to use the star method s you must tell the situation innocent party is it isn’t here to

tardy, tardy it’s Eric Can you say the word out right? You must tell the situation T for task you must tell the task that you had to do a for action what action that you had to do to handle that task and are for result what results came from your actions and what lessons did you learn for that whole thing a normal traditional interview question if you talk in longer than 3545 seconds you’re talking too long but a behavior interview answer could be anywhere from a minute to two minutes, the three minutes the more detail you are the better it is for behavior interview question down below. Go find out how to do because they will ask you the question you know those behavioral interview questions and if you cannot handle it, it would destroy that part. This stage is the stage that it that the interviewer will decide if you are the person

That they want to hire. The first stage gives them the ability to who you are. Now I’m starting to like you. The second stage, which is the second part is a fitness. I am now trying to ascertain that you can do the job because you show me how to do it. That’s the fitness part. Listen, there is a big difference between traditional interview questions and the behavioral interview questions every time you open your mouth to add to answer any question, you must connect what you have done in the past to what the job announcement is. So I asked you the question, my friend when you see a job announcement to you, like how long and how often do you read it? I need you now to understand it is the job announcement that connects to your resume that connects what you do that you what you have done that will get you the job you spend at least 25 to 32 hour on that job description when I look at

job description. I spend roughly about two or three hours I get my markers, I get my pins, I carve it out. I try to find the what the requirements and I tried to get those requirements as it connects to something in my resume accomplishments, the things that I have done in my resume like connect the dots you must connect the dots. As a hiring manager we are looking for somebody that can get the job done you my friend must be in a solving problem business you must be able to solve businesses solve problems I’m hiring you not just because I want to hire you I’m hiring you because I got some problem that needed to get done and you my friend in the interview stage to the interview the employers questions you must connect what you have done in the past to the actual job announcement. So I can see you have done it already. I can’t tell you how many millennials have issues with that because they want training they want mentorship and in the month

marketplace we just don’t do that right now. I’m sorry millennials but we just don’t do that right now. So you will have to understand that whatever you have done in the past is a predictor of what you can do in the future that is stage to employers questions, you must be able to connect what you have done in the past to the actual job announcement. I need you to spin Elisa hour on that job announcement so they can so you can connect the dots so you can see the job announcement and you can see how it connects to the actual job And now’s your resume connected you must connected that stage three tours in of all of the interview. The interviewer will always say, all right, Daniel, I have everything I need by I have everything I need. And so now

Do you have any questions for Me and I can tell you how many times I have interview people remember I have interview over 300 people. I can’t tell you how many times an interview interview will come in. I said, Do you have any questions for me? And they say, No, listen, my friend

at this stage, the interviewer is trying to ascertain what

how do you determine how much interest do you have for this position? See, if you really wanted that position, you will spend some time and craft some interview questions. So when they said do you have some interview questions for me? I want you to say yes, and I want you to pick your portfolio up just like this. I want you to open it

I want you to pull your questions out there looks just like this

right here on in here on my interview questions. I want you to make sure they have the text

is large enough so so they can see that you have crafted up, I want you to put it back on your portfolio. I want you to take your input. And I want you to now read that first question. And the first question is, what kind of person? Are you looking to fill this position? And what is your ideal candidate looks like get ready, my friend, get ready to write down because the interviewer is getting ready to tell you exactly what they are looking for. They might have said it sometime in the interview. They might not. But now they’re getting ready to tell you exactly what they are looking for. You write it down because this is the beginning of your clothes, right? And so always be able to add that is the first question you ask. And then some of the other questions you can ask is on here. And then this last question the second from last question, I want you to always ask this question this guy

licenses. Now that you had a chance to meet and interview me, what reservations would you have for putting me in this position? Yeah, Margaret, you put them on the spot. Yes. You have put them on the spot. Hey, I need you to conquer your fear. Don’t worry about it. See, number question number one. If they say Yeah, well, we’re looking for XYZ, ABC. And then you hear Hey, that’s me. I have either done that before. It is part of my strength package. Never go to an interview. When you know the position is in your weakness package. You only go to interviews that you know as part of your strengths. That’s why you need to know what your strengths are what your weaknesses are. Never ever ever ever go to a interview when you know it’s not part of your strength package. Never go to interview when you know as part of your weaknesses. No, no, no, no,

you can never perform at a high level.

Doing things that you’re not good at, because it’s part of your weaknesses. No, don’t do that. So the first question is, will, hey, we’re looking for this. We’re looking for that. Hey, then you got to hear that. Is that part of me? That’s part of my strength packet. I have done that before. When you hear that, that question,

let’s, you know, you let you think that you are a good fit, you are a good fit for the position that ate that. That’s that question before. The last question is that hey, what

said you had a chance to meet and interview me? What reservation do you have? And put me in this position? Yeah, you put them on the spot. Listen to that. Because if the interview start talking to negative, well, you don’t have this. You don’t have that you don’t have this, hey,

you are not in the game. Wrap that interview up as fast as you can, and get the heck out of there because you are not going to get that job. But if they say, well, Darnell, I don’t have any

any reservations? We’re looking for x, y. z. You had that? Would you describe it? Pretty good. We are still interviewing but I don’t have no reservations. Now you know that they think you are a good fit. Remember, the first question is positive, it lets you know that you are a good fit. Now, that second question lets you know they think you are a good fit, and if it’s a good fit, and if is the position that you will love to do then transition into the fourth stage, which is closing, you ask this last question of what’s the next step? What’s the next step in the timeline, they’ll ask, they’ll tell you the next step. And then if they if you like it, it’s a good fit. Then I want you to transition into the clothing by asking for the job. Yes, my friend.

You ask for the job you have. Not because you ask not what shoot man what a job you do this So you asked what the next step. So you say, all right, Mr. Clark, I got the next step. I appreciate the opportunity this interview, right? I think I did a great job. I wait patiently for the next step. Because you say, in the next couple of weeks, you’ll have an answer. So now let me leave you with this. In closing, this is your clothes. Let me leave you with this.

Yeah, I am very interested what I have learned here today and the opportunity that this position present right I believe I will love working with working here and learning from you as well. Is there anything else you need to know about my background to determine that I go to the next step in the interview process? Because I want this job that strive you just ask for the job. Some people like okay as what a job I’m scared. Listen, I need you to conquer your fear. I need you to to feel the fear and do it. Anyway, conquer your fear. conquer your fear.

And if you conquer your fear, you’ll be the captain of your ship and a master your destiny. conquer your fear and ask that question and ask for the job. You ask for the job. Listen, listen. Listen. Listen. Listen. Listen.If you don’t hear me, listen now.

I have interviewed over 300 people and only one person at all those people ever asked for the job. And he’s the only one I hired on the spot. Those other over 250 people I hired I still took him through the whole process in made him an offer, but he’s the only one I interview and he asked for the job. He’s the only one I hired on the spot. I can’t tell you how many times I have used that since he did it to me. He did it to me early in my career. So cool. I start in doing it myself. Now. I told you on one side of the fence. I was a higher authority working

for IBM at Ernst young a GE and Coca Cola hire people but early in my career I got my computer science degree in an MBA and all these it certification and I became a perpetual job hopper I noticed right now the marketplace doesn’t mind that you job haha we have become a nation of job hoppers from the Bureau of Labor Statistics says for the first time in our nation’s history more people have quit their jobs thing got laid off. The average life cycle of a job is only five years every three to five years. My friend you’re going to be looking for we can be looking for a job but we are nation the job I don’t call them job hoppers. I call it free agent we are a free agent nation unbounded, untethered to one organization taken our talents to the whole marketplace instead of one boss in one one company. That’s what we do now. Right? But I was doing it before this was cool. I was going from job to job every 24 months every 18 to 24 months I would job hopping because I was trying to go get that K.

Every job opportunity came up to get more money. I left one company and went to another why I was in a job search mode.

Other side of the fence I submitted over 5000 resumes. What a dark, you know, up to 5000 resume because I keep track of everything I know who I submitted it to when I submitted to what information I got from it. What company I submitted you I know everything from those 5000 resume. I have had over 200 interviews. Yeah. Does that mean every interview possible that you know that it had a Skype interview in person interview a phone interview interview with HR interview as a group interview as a panel, I have interview all of it and mastered all of them. And early in my career. I recognize the ability to ask for the job. I can’t tell you how many times I’ve used it.

And it worked for me. You know, as a director, senior director over the past 1015 years in the marketplace, I was always interviewing when I go to an interview the person was interviewing me was either general managers, vice presidents, CIOs, CEOs, or see in a minute medium or small medium companies. They were big baller shot callers and I have used the each and every time Excuse me,

I can’t tell you how many people stopped and say, Wow, Darnell, you just asked me for the job. Outstanding Young man. I’m a man a vice president. She was so impressed that I asked for a job. She hired me on the spot. Yes, yes. Yes, sir. So I always use it. Now when you ask somebody for the job. One or two things are going to happen either they can like wow, I’m so impressed. That’s what a job or you’re going to have somebody like man is do just as before the job How dare he have enough.

goon is encouraged as for the job now I’m not giving you for a job when you come across those people who are put up because you asked for the job listen you don’t want to work for those type of people anyway they’re scared you have enough courage and fortitude to ask for what you want and they’re scared to hire you because you think you’re going to take their job you got all right I’m gonna take your job if you think that I’m going to be scared to not ask for the job and you’re not going to give it to cuz cuz you got scared that I’ve had enough fortitude and confident as for you better believe I’m going to ask I’m going to take your position Oh buster, it Hey, but don’t worry about it. So you ask for the job. And then I want you to give them your personal guarantee. Listen, my friend, I can’t tell you how many people scared to put them cell phone line. You give me a personal guarantee. And you say after you say I want this job. Listen, Mr. Clark.

If you hire me I give you my personal guarantee that if you select me

You will not be sorry or disappointed. You hired me. So when you go in the back and you start talking to your team, and you decide who is the best person for the job. Think of me. Mr. Clark. When you go on your team and say, who can hit the ground running because they’ve done it before, and they don’t need little to no supervision. Think of me. Best o’clock. Hi, my name is the clock because I want this job. That’s right. And you shut up and let them talk. Listen, my friend, that is your differentiation.

That right there will put you over the top with anybody. I’m telling you right here right now. My friend. nobody’s doing this. No one is going to be asking for the job because they told freaking scared but not you. You raise up your courage and boldness and you come before us for the job. I want that job if you hire me, Mr. Clark. I guarantee you won’t be sorry or unhappy that you hired me I promise you so there you go for it.

So let me recap. let me recap. There’s four stages of interview. The first day is introduction. This is where you must be able to answer the question. Tell me about yourself. Stage Two is the employers questions. Employers question will give you traditional interview questions and behavioral interview question you must be able to handle both. And stage three is the candidates question.

You always come with questions and you always ask the question what they’re looking for and you capture it. You always ask the question now you had a chance to interview me what reservation we have put me in this position. You always ask that question. And then the final question you always ask for next steps. And then you transition right into the closing by asking for the job which is days for my friend. So then you go, I told you in the beginning, I have something special for you. I have an interview cheat sheet. The interviewing cheat sheet is everything I talked about here. Plus

Much much more it tells you how you supposed to dress in today’s marketplace before in a bit and back in the day it was always suit and tie knot in more my friend you must understand the culture of the organization would tell you how you dress for interview it tells you about how to address and handle the question to tell me about yourself. It talks about the the ability to handle behavior interview questions, it gives you the top 20 most common asked questions in an interview and it gives you the answers to it gives you everything right. It also gives you the ability to understand that your salary it tells you how to find your salary. Never, ever ever go to an interview and you don’t know what the salary is for this position. Down below my friend. I made a video of how to address salary question is down there too. Now lastly,

I can’t tell you how. How many people that I know go to an interview it doesn’t go well any questions them this in my friend, you are not responsible to go to the interview to make somebody like you know what they’re going to do you don’t know why they’re going to hire you.

Why not you are not responsible to find out if they like you are not you are not responsible if they give you the job offer not your responsibility is my friend is to come to the interview and deliver the package What the heck is the package everything I taught you how to prep how to prep and prepare for an interview.

That’s the package your responsibility is to prep and practice everything I showed you here come to the interview and the liver what you practice that’s it you’re not responsible for if they like you. You’re not responsible for if they made your offer. That’s not what you’re supposed to do. Your responsibility is to get to that to the interview.

delivered a package if you get the offer great if you don’t so what is not your responsibility listen no man can open a door to anything any door closes and no man could close any door God opens in that position is for you is for you and there’s nothing they could do about it it will be for you my friend. So if you don’t get it, learn from it, go to another interview and keep learning and you keep doing it until you get hired my friend so there you go.

So if you like this video, click on the like button I truly love when you click on the like button and share with four or five friends I need you to share this with five friends this is how I get my content out I I do it. The way I get my content out is when you share it with five friends so I asking you to share with all five friends and more but minimum five friends in in the comment field. Give me a comment or your feedback or any questions you have.

Have because I’m Darnell clock the answer man there’s no question that you can ask me that I will not have an answer for and I answer every comment every feedback and every question down there I personally answer it and as always if you haven’t subscribed to my YouTube channel subscribe to my channel on the side is that bill click on that bail my friend so you can be notified every time I come out with fresh new content so there you go my friend this is how you prep for in person interview you spend hours so if the interview is four or five days out I want you to spend one hour a day prepping it will serve you well when you get into that interview. So this is Darnell Clark you your your your industry leader, your career coach say hey there’s one thing I recognized for sure that is whatever you want in life. You got to go get it now go get that interview because I showed you how to do it. I see you later. Today we’ve cooked up a video where we teach you know less than 50 wicked football skills and while you might have seen a few of them before you can still use the video as your personal skills Bible that you can pull out before training or match so sit back dealer number one the fake classical facing the defendant you saw him in by pushing the ball forward then you know quick scooping motion dragon away from it’s a bit like the elastic only done with inside of your step

number two the street running with speed you get ready to take on the defendant. And just before reaching in you slow down only to explode away. Again. Lowering the pace for a moment is key because the defendant will sleep the same

Number three, the fake shot. This is what you would call all school move probably the most effective dribble and football set yourself up for a shot and slide to all you have to do now is to not follow through all around the defense.

Step number four is the stop and go running down the line with the defender in your back. You stop the ball with the outside of your foot. Then do a quick body thing and drag the ball with you in the opposite direction. Great, simple and effective move.

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Number five the rollback. Roll the ball back to the side of your body and wait for the defendant to come rushing in. When the timing is right, quickly drag the fall back again and accelerate the way

number six is the outside touch receiving a pass with a defendant chasing you down. This is the perfect skill to send him for a hot dog. Just before touching the ball. There was more money fame tap the ball with the outside of your first in the opposite direction and seventh place is the stop and shop running with the defender on your side.

Do this step on the ball with one foot into a chop with your other it’s a great way to buy yourself some time number eight the zigzag if you’ve got some speeding you This move is even better. T

ake on the defendant and take a shop touch to one side. Now run a bit past the pool so you can top it again outside of your foot in the opposite direction. Thank You for reading
This past August, her exuberance, emotion and enthusiasm had already made Fu Yuanhui the most famous Chinese athlete at the Olympics. After winning a bronze medal in the women’s 100-meter backstroke with a personal best, she nearly exploded with excitement: “I was so fast! I’m really pleased! I’ve already… expended my primordial powers!” Her interview went viral with millions of hits worldwide.

Then she said something truly shocking: she was having her period. Noticing that the swimmer was grimacing after her relay team narrowly missed medaling, an interviewer asked if she had a stomachache. Yuanhui answered “It’s because I just got my period yesterday, so I’m still a bit weak and really tired. But this isn’t an excuse for not swimming well.”

When the New York Times, NPR and other media outlets covered the story of the Chinese swimmer who dared to mention that she was having her period as if it were the perfectly natural thing that it is, they focused on the fact that she’d violated a cultural taboo — indeed, it is virtually unheard of for women in China to publicly mention menstruation. But, they also missed an opportunity to counter the common misconception that menstruation impairs athletic performance or that it’s unsafe or inappropriate to swim while having your period.
Menstruation and athletics

I recall classmates in high school sitting out basketball practice because they had their periods. I assumed it was just because they weren’t feeling well. In fact, many girls have been told they are more likely to be injured, less likely to perform well, and that the best way to handle menses is to take it easy. Maybe. But the evidence for each of these is weak.

Much has been made about the apparent increased incidence of significant injuries — ankle sprains, anterior cruciate ligament (ACL) tears and others — in female athletes compared with their male counterparts. Blaming it on “hormones” is common. A 1989 study interviewed 84 female soccer players and found more reports of injuries during the premenstrual period and menstrual period, especially among those with premenstrual symptoms (such as irritability or breast discomfort). A 2007 study found that ACL injuries tended to occur more often during the first half of the menstrual cycle (in the week or two after the period). A 2009 study found that among eight healthy volunteers, hamstring flexibility increased at the mid-point of the menstrual cycle. That’s the point in the cycle that estrogen levels are rising or at their highest.

So it’s possible that variations in female hormones through the menstrual cycle change the function of bones, joints, tendons, or ligaments, and that these changes could have an impact on performance or likelihood of injury. Then again, these studies are simply observations of certain patterns — they don’t prove a connection between phases of the menstrual cycle and injury. In fact, we don’t know for sure whether the phase of the menstrual cycle truly has an important effect on tendency for injury. And if there is an effect, it’s not clear what to do about it.
Athletic performance

Studies find inconsistent effects on the impact of menstrual periods on athletic performance. For example:

    a group of swimmers were found to have poorer performance just before their periods started, and improved times during menstruation
    cross-country skiers were best just after their periods and after ovulation (which occurs midway between periods)

in yet another study, strength of handgrip and standing long jump distance were best during menstrual periods compared with other parts of the menstrual cycle.

A 1994 analysis reviewing the available research concluded that when it comes to having your period, “…for most women there is no significant effect… medals have been won and world records set in any phase of the menstrual cycle.”

Even so, many women don’t feel well just before or during their periods and it seems reasonable that this could affect athletic performance. Anyone who is in pain, tired, or just not as sharp as usual may not perform at their highest potential. And in elite athletics (such as Olympic events) in which the difference between a gold medal and last place may be fractions of a second, surely feeling poorly could make a big difference. A 2009 study concluded that taking an anti-inflammatory medication (called diclofenac, a drug that’s similar to ibuprofen) led to reduced menstrual cramps and improved exercise performance. In fact, some athletes try to avoid the issue altogether: they take oral contraceptive pills or other hormones to avoid having their periods during important athletic events.
The bottom line

There is much we don’t understand about the relationship between the menstrual cycle and athletic injuries or athletic performance in women. It’s probably true that individual factors, including overall health, type of exercise, degree of conditioning, and nutritional status matter more than the phase of the menstrual cycle.

Clearly, women with premenstrual or menstrual symptoms may not feel like exercising. But there is no compelling evidence that exercise or athletic activities should be avoided or altered based only on what part of the menstrual cycle you’re in. Good training may reduce the risks of injury and enhance performance much more than trying to time exercise around one’s periods.

Many have commended Fu Yuanhui for being so forthright about having her period even though it violated a longstanding taboo, but she could also be commended for avoiding the temptation to blame her period for a disappointing performance. “It’s a definite that you’re all going to screw up, but it’s not a definite that any of you will learn from that,” declared one of our medical school instructors, years ago. “Cultivate the attitude that allows you to own your mistakes, and then, not repeat them.”
How common are medical errors?

Medical errors are, frankly, rampant. A recent study used data analysis and extrapolation to estimate that “communication breakdowns, diagnostic errors, poor judgment, and inadequate skill” as well as systems failures in clinical care result in between 200,000 to 400,00 lives lost per year. What this means is that if medical error was a disease, it would be the third leading cause of death in the United States.

The article is specifically about fatalities secondary to medical errors, and how these are vastly underreported. They point out many reasons for this, the first being that cause of death on a certificate is usually listed as the physiologic cause of death. For example, “myocardial infarction” may be listed as cause of death for a patient who was sent home from the emergency room with chest pain and a diagnosis of acid reflux. We have no direct way of knowing that their fatal heart attack was due to misdiagnosis.

In the course of my training over a decade ago I saw many errors, such as a punctured lung during central intravenous line placement in the intensive care unit, postoperative morphine overdose requiring emergency intervention, cancer seen on an emergency room CT scan and never reported to the patient… I could go on. What was most common then was a culture of silence: there was not consistent nor complete disclosure to the patient. People would whisper about mistakes, never directly addressing the issue for fear of litigation, or even retaliation by the involved physician.
Preventing medical errors—and learning from the ones that do occur

As the BMJ article authors point out, we can’t develop safer healthcare without identifying and analyzing medical errors when they happen. They call for a national database of medical errors, so that the information can be compiled for quality improvement and prevention research.

Thankfully, I now work at an institution that recognizes this, and openly embraces errors reporting. We even have an easy-to-use online safety reporting system which my colleagues and I have used many times, for everything from blood test tubes being sent to the lab without labels, to the wrong vaccine being administered, to falls suffered by our patients while in the hospital.

Worried that these types of reports reflect more mistakes being made than normal? Think again: as the data supports, the vast majority of medical mistakes simply go unreported. The true number of medical errors, both fatal and non-fatal, is unknown. What we do know is that healthcare delivery cannot improve if these are not examined.

How does this work? I can pull an example easily from among my own recent mistakes:

A lovely patient of mine* in her late forties complained of fatigue, depression, and body aches, which I attributed to perimenopause and arthritis. She did have slightly elevated calcium levels, but I didn’t think much of it. I blamed it on her calcium supplements.

After more than a year, we finally discussed checking her calcium level OFF of supplements, and lo and behold, it was still high. We discovered that she had hyperparathyroidism, an overactive parathyroid gland that causes calcium to leach out of the bones. Indeed, hyperparathyroidism and high blood calcium levels can cause fatigue, depression, and body aches, among other things that she had, such as osteopenia (weak bones).

She asked for a referral to a surgeon and had her overactive parathyroid gland surgically removed. Her complaints resolved within a day after surgery.

I apologized for my error which had resulted in a delay of diagnosis of about two years, during which time she had not only felt awful, but also developed weakened bones. I offered to facilitate her transfer to a new primary care doctor. She declined, and said that she was appreciative of my honesty in discussing the error, and hoped it could serve as a valuable lesson.

I shared this error with my colleagues and in the system. I, for one, will never let any slight elevation in calcium go uninvestigated, and my colleagues have learned from my example.

My med school instructor was right: if we don’t own our errors, we are destined to repeat them. In medicine, honesty is truly the best policy.The 2016 summer Olympics had its share of exciting performances, upsets, and photo finishes. But for days after Michael Phelps’s first appearance at the games, it seemed all anyone could talk about was “cupping.” It’s an ancient therapy that left multiple circular discolorations on his skin. During “dry cupping,” suction is applied to the skin for several minutes; sometimes it is combined with massage, acupuncture, or other alternative therapies. (“Wet cupping” is similar except that blood is removed by making small cuts in the skin.)

Cupping is supposed to draw fluid into the area; the discoloration is due to broken blood vessels just beneath the skin, much like a bruise. Cupping has been popular in Egyptian, Chinese, and Middle Eastern cultures going back thousands of years, but increasing numbers of people worldwide have been adopting it. Celebrities and athletes have popularized it in the U.S. in recent years.
What is cupping supposed to do?

According to its advocates, cupping is supposed to promote healing and has been used extensively for sore muscles. But that’s only the beginning. Cupping has also been used for

    back and neck pain
    skin diseases such as acne and hives
    lowering cholesterol
    knee arthritis
    improving immune function.

And there are many others. If cupping does help with these problems, it’s worth asking: how? From a biological perspective, it’s not clear how the application of suction and drawing blood into an area under the skin would provide all these benefits. A recent review of the treatment describes cupping as a treatment that can strengthen the body’s resistance, restore balance between positive and negative forces, remove disease-causing factors, and promote blood circulation. But exactly how is unclear.
Does cupping work?

A number of studies have examined this question, but unfortunately don’t seem to have  convincingly answered it. In fact, a 2015 review of the evidence found that cupping might provide some relief for chronic neck or back pain, but that the quality of the evidence was too limited to draw firm conclusions.

One problem is that it’s tough to perform a high-quality study on cupping. The best studies are “blinded placebo-controlled trials” in which neither the patient nor the researcher knows which treatment (real or placebo) has been given to a study subject. When medications are studied, coming up with a placebo pill is not difficult; it can be much more difficult to create a convincing placebo comparator for cupping. In addition, pain can be a difficult thing to measure and the placebo effect — improvement related to an expectation of benefit — can be quite powerful.

Still, there have been studies comparing actual acupuncture with convincing but fake (or “sham”) acupuncture.  Similar studies of cupping could be possible. And if cupping truly helped, you may not care if it’s due to the placebo effect.
Are there risks involved with cupping?

Most experts agree that cupping is safe. As long as those treated don’t mind the circular discolorations (which fade over a number of days or weeks), side effects tend to be limited to the pinch experienced during skin suction. It’s quite unusual that cupping causes any serious problems (though, rarely, skin infections have been reported).
So, what’s next?

If you want convincing evidence of effectiveness before trying a treatment, you may want to pass on cupping for now. But if you’d like to try something that’s safe and might help with certain aches and pains (and possibly other ailments), the main downsides seem to be the temporary skin discoloration and the cost — I found estimates online of $30 to $80 per treatment. Some people have it only “as needed” but others may have it monthly or even more often. Future research could prove that cupping is as good as the claims say it is — but we’ll have to wait for the results of high-quality studies to know if it’s true. Men have to accept many changes as they age — less hair, less muscle — but less sex doesn’t have to be one of them. In fact, 54% of men over age 70 are still sexually active, according to research in the January 2016 issue of Archives of Sexual Behavior.

What many men do need to change, however, is their mindset about this next phase of their sex lives. “Many continue to focus only on the physical aspect, so when issues like erectile dysfunction or unpredictable sex drives arise, it can trigger guilt, anxiety, and frustration,” says Dr. Sharon Bober, director of the Sexual Health Program at Harvard-affiliated Dana-Farber Cancer Center.

One way to overcome this barrier is to think less about intercourse and more about “outercourse.” This means to direct your attention and energy more on foreplay and manual stimulation with your partner. “The emphasis is on intimacy and closeness rather than performance,” says Dr. Bober. “This allows men to become less stressed and more engaged in connecting with their partner.”
What you can do

Here are some ways to better embrace outercourse:

Recreate date night. Make an effort to go out on a scheduled basis and experience something new together. It could be a hobby or an event you both have always wanted to check out, or even a quick day or overnight trip. “Doing something different can offer a sense of excitement that can bring you and your partner closer together,” says Dr. Bober. “Couples need to have romance and novelty to be emotionally, mentally, and physically stimulated.”

Focus on the nonsexual. When was the last time you and your partner just hugged, kissed, and explored each other’s bodies without the goal of sex? “Couples may say they don’t do that anymore because they are married, but do not underestimate the excitement of re-exploring the early rituals of courtship,” she says.

Mix up your sex routine. “Give each other a massage as part of foreplay, or try a different setting or time of day, like having sex in the morning when you both may be well rested,” says Dr. Bober. “Just having a conversation about how to change up the regular routine can be fun and exciting.”
Changes in desire

Men can lose interest in sex at times, but that is normal, says Dr. Bober. It often occurs because the sexual connection between your mind and body is out of sync. During these periods, it can be helpful to engage more in the mental side of sex, such as erotic thoughts, fantasy, and memories, says Dr. Bober. “This kind of mental engagement can be quite pleasurable for men without needing physical stimulation, and eventually it can help the mind and body reconnect.”

Desire also can wane if you are not involved with anyone. But again, do not feel under pressure to fill that part of your life. “You need to ask yourself if it bothers you,” says Dr. Bober. “If it is not something on your radar right now, no need to worry about it. You will know when you are ready for affection.”

Do not forget to take care of yourself so you can continue to enjoy your sex life. Many medical conditions can affect sexual drive and performance, such as obesity, diabetes, heart disease, high blood pressure, and high cholesterol. “If you want to be active, you have to stay active, and that means focusing on your exercise routine and being diligent about a proper diet and medical check-ups,” says Dr. Bober.

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