Throwaway05
7d ago
In other countries prison is bad because the guards are bad and don't care about the prisoners.
In the U.S. the prisons are bad because they are filled with American prisoners. Somehow this is often worse. Additionally in the U.S. guards are frequently prevented from "managing" the prison which can cause unnecessary problems.
Throwaway05
8d ago
Despite online feminist complaints the biggest users of "females" to describe women (well outside of scientific literature anyway) is the American Black community.
Keep this in mind when people complain about use of "female" and accuse nerdy white males of doing it.
Throwaway05
10d ago
Sometimes I look at this stuff and wonder if this what it was like to be pro Civil-Rights back in the day. Just watching all of these pillars of society being told "don't be racist" and hearing "no" in response while much of the influential nod their heads along like it's a good thing.
It is a chilling feeling.
Throwaway05
11d ago
Parts of the show are intentionally cringe, as they are satirizing corporate America's choices, abuses, and aesthetic.
Part of the show is enjoying the severed characters rolling with corporate bullshit because they don't know any better and then later going...wait...this is so stupid.
Throwaway05
14d ago
calibrated do this a lot in general and VERY STRONGLY not his particular topic.
calibrated do this a lot in general and VERY STRONGLY not (on t)his particular topic.
aka covid broke people's brains + me making typos
Throwaway05
14d ago
Probably stems from purchasing like baked goods?
Throwaway05
14d ago
I mean I'm sure not everyone did this but my cohort of family and professional contacts which is typically smart, educated, but not particularly politically informed or calibrated do this a lot in general and VERY STRONGLY not his particular topic.
Throwaway05
15d ago
I very much do not believe it's a left or right thing. Some people blow with the wind.
Oh yeah for sure, not saying one side has a monopoly on this. The leftist-doublethink seems to magnify though. "No not literally defund the police" "wait yes literally" "no that's ridiculous."
Throwaway05
15d ago
Your story about "Daily Kos grandmas" who literally don't remember what they used to believe in is of course nonsense (just like all those Never Trumpers who are now MAGAs do, in fact, remember what they used to believe in). People remember, they just rationalize it or else they develop coping mechanisms for the cognitive dissonance.
I'm not sure this is the case. The one that sticks out to me the most is the initial response to COVID. So many people don't remember the early days where believing in COVID was racist and bad. They just swapped back and if you try and remind them now you'll get a lot of "holy shit I forgot about that" or "no way!!!!!!"
Throwaway05
17d ago
The Great Books program is specifically supposed to be a replacement for a traditional college curriculum in which you learn things from primary sources in and see Western Civilization being shown off.
Much of what you ask for is contra to the mission - if you made the changes you are suggesting it would be something else.
It's like getting annoyed at Western Canon lists for not having Eastern material.
Throwaway05
22d ago
Rideshare apps completely slaughtered traditional cabs and cabbies, especially the racket of medallions. Sucks to be some poor cabbie who saved up for years to get his own medallion only to have his entire investment torpedoed.
It's worth noting that one of the main reasons for this transition is the sheer depth of poor quality service and outright fraud associated with the old yellow cab model. It truly was unbelievably brazen and hard to convey if you didn't live through it.
Now back to my regularly scheduled defense of doctorhood.
- We don't have a MD stranglehold in the US anymore.
There's a range, everything from pretty much parity (MD, DO, MBBS) to obviously inferior but often not in a way that patients notice (NP, PA, Psychology Prescribing), to actually quite dangerous (Chiropractors, Naturopaths, Alternative Medicine providers - some of these have full or mostly full rights in some settings/states).
You see all kinds of tensions associated with these options and I know plenty of doctors who have lost out on jobs to one of the others, but in terms of improving care well... we have evidence it makes it worse, and we have evidence that it saves no money or even costs money (example: unnecessary testing).
Many of physician job responsibilities extend outside of direct clinical work and you can't replace them adequately with the others (they make better administrators, managers, and executives). Others also can't fulfill the educator roles or research roles.
Most doctors do some form of teaching and research and essentially all of them have done both at some points in their career.
That kinda stuff doesn't track well on research into these matters but is important. Likewise physicians pick up the slack in the way the the others (especially nurses) do not.
We've been running a natural experiment for awhile now and having growing evidence of that gap.
- Again, physicians do more than you think. Carpal tunnel doctor actually needs to be able to know the physiology medications, and so on. Emergency overnight staff like a surgeon or surgical resident need to be able to cover part of the work of others otherwise you'll need full time overnight staff that you might not otherwise....a million things like this means the training is relevant and necessary.
You also have to consider that if you box someone into say total knees from the beginning then they have to do that 100% of the time they can't switch to another specialty to avoid burnout or other things like that. It's very common for surgeons to switch around and extend the longevity of their careers by doing that sort of stuff.
Throwaway05
22d ago
I think this is easy to say in principle but if you look at how successful identity politics were at taking over such a large part of the public discourse and intellectual framework...well we don't need to speculate what happens in practice, which is that some people figure it out (cough cough looks around) but most don't and it isn't enough.
Moral panics and crowd hysteria and Hersey have always been part of human culture. Expecting that to not be the case is foolhardy, even if we can feel comfortable tossing out labels about lack of ethics or whatever.
Throwaway05
22d ago
I think the flip side of this is important to hold onto when it comes to why so many people hate medicine.
For most people, the most important things that happen in their lives (aka life and death and the prevention of the latter) involve interaction with medicine.
When it goes poorly, that sticks and it hurts. If your mother passed away as a complication from a clot treatment (assuming ischemic stroke) you'd hate that intervention, and maybe even your doctor and healthcare. Maybe you have the wherewithal to know that's an emotional response - but it would still hurt and feel that way.
One invalidating interaction, one missed diagnosis or bad outcome...and suddenly the emotional connection to the idea that the system is useless and needs to be burned down is established. It's really hard to avoid and generates a lot of the ill feeling.
The opposite happens too! But you only have to get it wrong once and that's not avoidable.
Throwaway05
22d ago
EDIT: It's true that Trump also genuinely has a habit of saying stuff he doesn't mean seriously, like locking up Hillary Clinton.
I suspect you was serious about that but that he actually listened when people tossed out the arguments against it (like "we dont do that so they don't do it to you").
Now it seems like they defected anyway... but I do believe in his original intent on that one.
Throwaway05
22d ago
I think the decline of Musk illustrates what makes Trump so impressive.
It is is nearly impossible to function at a high level if everyone fucking hates you, even if you have unlimited money. Musk is not handling it well, the fact that Trump has done so well for so long is amazing!
Throwaway05
22d ago
Absolutely, a lot of businesses are just waiting for someone who isn't a corrupt asshole to show up. Uber so massively trounced cabbies because cabbies absolutely fucking sucked.
General trade and contracting work, lots of things to do with cars.... you could make a killing by getting into these things and not being corrupt assholes.
Throwaway05
22d ago
On a related note (in case you didn't know), the Pulse Nightclub shooter was not motivated by targeting homosexuals - that was by accident. This kinda misattribution is common.
Throwaway05
22d ago
On a practical level I think that sort of thinking is gone from almost all modern education - we don't really focus on critical thinking any more and much of the university experience in America is essentially just a fancy trade school.
In medicine in particular you have to get phenomenally good at box checking and thinking too much is going to get you in serious trouble and unable to advance. This is magnified by downstream pressures - people who are republican or unable to hide being republican don't get admitted to medical school, people who aren't willing to engage in games about social signaling don't end up at good programs for residency, teachers who don't engage with wokeness either get fired or pushed into non-teaching roles and so on.
Outside of medicine most disciplines in school don't really select for or allow much in terms flexibility on this front.
Some people do still have those chops but you have to be very good at turning them off and not saying shit to succeed.
Basically blame the framework for brain washing people, not the people who got brainwashed.
If your job requires you to not notice - at every level, for years, with tremendous pressure to do so....it's hard to keep noticing.
And while the impacts of not noticing from medicine are higher, I'm not sure we should be held to a higher standard than anyone else - all the other disciplines are having this problem and medical professionals are already held to a higher standard in so many different ways that put much of the community on the knife's edge of burnout, suicide, substance abuse, and exit. Don't add more.
Throwaway05
22d ago
Black physicians deal with healthier babies including healthier black babies. The sick black babies go to white physicians. Therefore black physicians have better outcomes for black babies than white physicians do.
They focused specifically on what happened to black babies for the paper.
Throwaway05
22d ago
I'm sorry you still aren't being clear.
Throwaway05
23d ago
I'm not sure what you mean.
Throwaway05
23d ago
I really don't think that is true. People in medicine are there because they are willing to suffer to help people. They are getting it wrong because of propaganda efforts by the university administrations and journalist classes.
They are just as fooled as everyone else, even the bad actors in this case think they are helping and doing the right thing because "these things are true, if the data doesn't match we must have done something wrong!" after years of being brainwashed.
Throwaway05
23d ago
but I am glad to know you can see it now too
Nah this problem is why I first started posting way back in the days where some of our most reasonable contributors didn't see that the news and "science" was biased. I think pretty much everyone still here gets that at this point, so I've spent more time arguing about overreaction lately, but my views haven't changed.
This is a particularly good example for everyone to toss into their brain for later though.
Throwaway05
23d ago
Yeah the Meddit thread goes into some of this and that's a very sympathetic audience going.....oh my.
You'd be surprised how common this is in the U.S. actually.
Background: I spent some time working clinically in corrections.
A number of things need to go wrong for someone to engage in egregiously violent behavior (this is most studied when it comes to serial killers but applies all the way down). Society is filled with people who have things like intellectual reserve, good impulse control, social resources, appropriate time preference, and so on but have the underlying psychiatric and psychological temperament to do really bad shit. These people usaully end up run of the mill shitty people or things like your classic corporate raider sociopath.
In the U.S. (and many other countries with a significant amount of the criminal element) you see people who are missing one or more of the protective factors sliding into the criminal class, getting into trouble early, and so on. This knocks off a lot of people who would be doing what you describe and puts them in another bucket early.
The number of people who have had thoughts about killing others for little reason is shocking, but most are somewhat repressed by social pressure, fear of consequence, and adequate impulse control... but they still have those thoughts. Again the U.S. has mechanisms like the criminal underclass which lets people with interest get it out and get in trouble etc, but fundamentally a lot of people are walking around with "what if I stabbed people" and absent opportunity to misbehave they don't unless something else goes wrong.
In the U.S. usually this is things like said criminal stuff, substance problems, medical/psychiatric issues or sufficient life stressors. I imagine Japan is similar.
Salarymen wonders his whole life what killing people would be like, but likes the "deal" society gives him enough to maintain his other psychological needs so he doesn't do it. Then he gets fired....and well why not?
Now Japanese police have their issues so it is certainly possible that is what is going on here, but my suspicion is that modern Japanese society keeps these people buttoned up more adequately than the U.S. and sometimes you run into the rare thing that causes them to snap and check out what they've always thought about.
About 3% of the male population has antisocial personality disorder (ASPD). Most of these people would kill if the right situation came up, but it doesn't...most of the time.
Plenty of people don't really care about others adequately. Some of this is clearly pathology (think stereotype of a gangbanger - that's gotta be ASPD). Some of it is in-group outgroup bias type stuff. Some of it is things like woke advocates whose virtual signaling overtakes actual virtue. This is a spectrum that applies to a lotttttt of people in some way or another. Get far enough down the spectrum and have anything that makes you ask certain questions, and you have random killer in the making waiting for the "right" change in their life or stressor.
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