domain:drmanhattan16.substack.com
Tophattingson
4hr ago
I think what broke a lot of people (myself included) was the disastrous and anti-scientific response to Covid, which every step of the way was blessed by the so-called experts.
To add to this, if "conspiracy theory" was used in a neutral way instead of only being used against right-wing beliefs, then supporters of the mainstream response to COVID are conspiracy theorists. After all, they believe, without evidence, that masks stop covid, in the same way that a tinfoil hat might block mind control. They believe, without evidence, that imprisoning the entire population in their own homes, for just two weeks, with a "real" lockdown, will make covid go away. And they believe that governments that don't do this, such as Florida under DeSantis, are conspiring to commit mass murder while covering up the true number of deaths. Similarly, they treat all opposition to policies they support as motivated by criminal conspiracy (by some combination of Trumpists, Russians, the religious, or far-right) rather than by differing opinions or priorities.
Pretty much every crank view on the right has an equivalent on the left, just couched in academic language and with institutional support. There's plenty on the left that believe in a "Trans Genocide" or that Israel is committing genocide in Gaza, to state the obvious equivalents to white genocide conspiracy theories. And as for broader conspiratorial worldviews like QAnon, critical theory is just that: a conspiracy theory. Just one that's popular enough in academia that it dodges the definition.
Throwaway05
4hr ago
My question is: just how crucial is it for someone already practicing as a doctor in a French or German hospital to do 3+ years of residency in US?
I've never met a foreign trained doctor who came to the U.S. with Medical School and Residency training in Western Europe. We might actually have reciprocity agreements for those countries, I don't know, I've never encountered one. Scott did his Medical School in Ireland IIRC, which is note quite the same. The vast majority of foreign doctors I've met are from Asia (mostly India) and do absolutely need retraining and will generally admit as such, however frustrating it is.
Every time this comes up I have to drag out a few facts.
-There is actually a surplus of residency spots. Yes you heard me.
-We do have something of a shortage of some specialties, but this can't adequately be solved by increasing spots without decreasing training quality.
-Nobody wants to go into primary care because it pays significantly less, is one of the harder jobs, and has been made less attractive by regulatory burden and other factors.
-Most jobs are in primary care anyway, aka most doctors work in primary care.
-Even within primary care we have more of an allocation problem than a shortage. Doctors train very hard and start their adult life late. They want to be in desirable locations so Iowa has a shortage but NYC does not.
-NPs and PAs were meant to fix this but make it worse - they still want to go into specialties (and can since they have no specialty training, they can just do what they want) and they still hang around the same urban areas.
-You could hypothetically fix this by importing a ton of foreign doctors but you'd have to enslave them and force them to work in the undesirable locations long term or they would just leave immediately when given the option.
-You can fix this using the resources we have by raising salaries to what incentivizes the behavior you want. Nobody wants to do this, they just want to continue giving doctors the pay cuts they've been getting for the last 20-30 years, even though doctors are not a high percentage of healthcare costs.
zeke5123a
4hr ago
I think the left adopts this view because their self image is that of being the experts (by which they mean credentialed). The replication crisis strikes at the heart of this view. So they pretend it (and all of the other mistakes by the experts) don’t exist.
magic9mushroom
If you're going to downvote me, and nobody's already voiced your objection, please reply and tell me
4hr ago
I'll offer that record as an example: very few right wingers happy to rail against TikTok at the time of the original comment are still upset over it, and even fewer will acknowledge out loud why they're no longer upset about it, and I doubt even a few will acknowledge the Gell-Mann amnesia implications of their favorite "heterodox" writers forgetting about TikTok once they paid off Trump.
I'll admit to being somewhat peeved about people here going "well, this particular accusation against TikTok is dubious, so banning the site is bad". But rightists aren't quite as monolithic as you think; there is a monolith behind Trump, certainly, but there are a bunch of others in the tent.
ActuallyATleilaxuGhola
Axolotl Tank Class of '21
5hr ago
If conservatives have been ‘pearl clutching’ about sexual morality for this long maybe it’s not performative
Because the majority of pearl clutchers get divorces, use contraception, get abortions, let their sons and daughters fornicate in high school and college, consume internet porn, watch gratuitously violent and sexual movies/tv series, etc etc.
I don't doubt that principled conservative exist when it comes to sexual mores -- I think I (and you?) would probably count, but we're now a very small minority. My conservative religious family members are all okay with gays now, 20 years ago they absolutely were not.
So my point (perhaps poorly expressed) was that the media is engaging in a sort of cargo-cult appeal to Christian morality ("Can you BELIEVE he cheated on his wife/had sex with a student/posted raunchy comments on a forum/etc.??") to the ever-dwindling number of people who can muster anything more than lukewarm outrage to that stuff. There's a "smoke and mirrors" effect of the same type as a woke Twitter outrage mob. Some outlets repeat the story, Twitter addicts tweet incessantly and spam memes and shit up the victim's Twitter threads, and risk averse corporate/political consultants label the victim "high risk" and endorsements get withdrawn. The Kamala campaign astroturfed the heck out of the internet for weeks, we just saw a very pure example of this phenomenon.
More to the original point, they tried the same stuff with Trump. He's a philanderer, he has sex with expensive prostitutes, grab em by the pussy, pee tapes, etc. I'm pretty sure that (most) conservatives in the 90s would have been genuinely affronted by Trump's behavior, but (most) conservatives in the 2010s, while unhappy with his antics, apparently didn't find them disqualifying.
MadMonzer
Temporarily embarrassed liberal elite
5hr ago
The non-flying car in its current form only exists thanks to a collective irrationality about safety - people (both individually behind the wheel and collectively as voters) treat life as being an order of magnitude cheaper on the roads than it is in other contexts. There is no comparably dangerous activity except driving where it is socially acceptable to do it in a public place with only $50,000 of liability insurance. If someone proposed cars, driven by ordinary citizens, as a new transportation technology then we would ban it - and by the criteria we normally use to judge dangerous technology we would be right to do so. Car crashes are the largest cause of premature death in most rich countries.
Even with the current regulatory environment, general aviation is about 10x more dangerous than driving. (We tolerate this because private flying is seen as an expensive extreme hobby in the tradition of yachting or snowboarding. Also because the regulatory environment makes it very hard for a pilot to injure other people through ordinary non-culpable stupidity. And even so a pilot with less than a million dollars of liability insurance is going to get the stinkeye from airport and hangar operators.) Another way of putting it is that the mean time between fatal crashes (slightly over 100,000 hours) is only slightly longer than a career (80,000 hours). If a job was as dangerous as an average licensed pilot flying a plane maintained properly by average licensed mechanics, then most people doing that job would not survive to retirement. A plane flown by someone with the skill level of the average driver and maintained by the average motor mechanic would be dramatically more dangerous.
The sequel to Where's my Flying Car should be called The Texas Planesaw Massacre.
magic9mushroom
If you're going to downvote me, and nobody's already voiced your objection, please reply and tell me
5hr ago
The academy is the "high ground" in the sense that a defeated tribe can hide out in the mountains and wage guerilla war until a suitable opportunity arises (like Hilary wanting a way to attack Bernie from the left) - not in the sense that it is the key strategic terrain being fought over. That would be the government and corporate bureaucracies that actually implement cancellations.
I think we're largely in agreement. I called it the high ground because it's relatively hard to conquer, because as the legible-qualification-providing institution it can fairly-effectively gatekeep a large number of professions with power (i.e. bureaucrats, middle managers, executives, lawyers, and less-directly schoolteachers), and because as the legible-fact-providing institution it's hard to stop listening to it without getting stuck in a whirlpool of insane delusion and losing effectiveness. It is, indeed, not the prize being fought over... but it's a mountain directly overlooking it. Cf. Moldbug: "Ideas check out of the university, but they hardly ever check in."
FiveHourMarathon
Listen to Pierre
5hr ago
I'm just flattered you read it.
Since writing this I'll note that I've stopped using TikTok, not for any particular reason I just stopped using it and never came back. And the TikTok ban and argument more or less disappeared from exactly the moment Trump flipped on it as a result of influence from a single mega donor.
The ban was signed into law by Biden, over Trump's opposition, and the issue is winding its way through the courts, with TikTok still legal. Our errant substack writer, who doesn't post that much anyway, hasn't posted about TikTok since, though he continues to rail against the cathedral in a way so generic it feels a little chatgpt.
I'll offer that record as an example: very few right wingers happy to rail against TikTok at the time of the original comment are still upset over it, and even fewer will acknowledge out loud why they're no longer upset about it, and I doubt even a few will acknowledge the Gell-Mann amnesia implications of their favorite "heterodox" writers forgetting about TikTok once they paid off Trump.
Crowstep
5hr ago
fireinabottle.net has some really interesting posts about historical calorie consumption. One I remember was about consumption in New York. I don't know if it ever got to 5000 calories, but it was certainly a high number. And he's also written about body temperatures declining over time. He attributes it to increased PUFA consumption from vegetable oil.
Annoyingly, the site seems to be down now, so I can't point to any actual posts.
All these articles about "cranks" to me are just wordgames. Radical/progressive/woke left believes in their own conspiracy theories, the main one is what I call as universal leftist conspiracy - courtesy of James Lindsay. It is really simple:
There are two groups of people: purple and beige. Purple people have access to some special attribute or property - let's call it purpleness. Purple people use this property to oppress beige group. Purpleness also helps purple group to create and reproduce system of purpleness, which reproduces oppression over to the next generation. Liberation from oppression and true equity will only happen if we dismantle the system of purpleness.
This is the most simple and primitive form of conspiracy theory which you can apply to mainstream ideas that for some reason are not considered as low status conspiracies. Some examples:
-
There are men and women. Men have access to male privilege which they use to oppress women. This system is called patriarchy and women will never be free unless we dismantle it.
-
There are heterosexual people and the rest such as queer people. The former group has ability to define what is normal, they have access to heteronormativity which they use to oppress nonheterosexual people. We will not have true liberation until we will not dismantle patriarchy.
-
There are white people and the rest, especially Black people. White people have access to whiteness to oppress other races. There can never be true equality until we will not dismantle white supremacy.
-
There are capitalists and workers. Capitalists have access to capital and they exclude workers from access to it, reproducing the system of *capitalism. There can never be true equality unless oppressed workers do not have access to means of production which is the first step to dismantle capitalism.
These are all the simplest and crudest forms of conspiracy theory which if applied to anything else would be identified as some uncouth theory only stupid people believe in. Except these conspiracies are high status so they are fine to utter even in a good society. This universal conspiracy can also be applied to many other popular leftist systematic conspiracies, just define new groups and systems of oppression be it handicapped people or fat people or tans people or many more. This type of "analysis" is in my opinion absolute farce, people who believe in these things can identify racism and sexism everywhere - from knitting to hiking. Which is the point - once you are woke to this systemic conspiracy thinking, then you will see sexism, racism and white supremacy even if you see somebody throwing a bugger from his car as he waits on a red light.
RenOS
the mountain passed, the sea in front
5hr ago
The mobile app is also decent. I've been playing it a bit with friends.
ControlsFreak
6hr ago
People have comically false beliefs about all sorts of stuff in the world. We have not discussed what the constraints on marketing would be; I think your comment assumes that there would be none, but I think that is unlikely. So far, we've only been talking about the total ban.
To quote the Wikipedia article on Blanchard's typology (which is generally sceptical of the concept, if not outright hostile to it):
Studying patients who had felt like women at all times for at least a year, Blanchard classified them according to whether they were attracted to men, women, both, or neither.[3]: 444 He then compared these four groups regarding how many in each group reported a history of sexual arousal together with cross-dressing. 73% of the gynephilic, asexual, and bisexual groups said they did experience such feelings, but only 15% of the androphilic group did.[8]: 10 He concluded that asexual, bisexual, and gynephilic transsexuals were motivated by erotic arousal to the thought or image of themself as a woman, and he coined the term autogynephilia to describe this.
From an interview with Blanchard himself in 2019:
When I looked at the relative numbers of autogynephilic and androphilic gender-dysphoric males back in 1987, the autogynephilic cases were already a majority, approaching 60 percent. The proportion had reached 75 percent by 2010, and it might be even higher now.
...
Examples I have collected include: sexual fantasies of menstruation and masturbatory rituals that simulate menstruation; giving oneself an enema, while imagining the anus is a vagina and the enema is a vaginal douche; helping the maid clean the house; sitting in a girls’ class at school; knitting in the company of other women; and riding a girls’ bicycle. These examples argue that autogynephilic sexual fantasies have a fetishistic flavor that makes them qualitatively different from any superficially similar ideation in natal females.
There is also the telling phenomenon of autogynephiles who are involuntarily aroused by cross-dressing or cross-gender ideation, and who complain about difficulties changing into women’s attire without triggering erection or ejaculation. It seems likely that few natal women would give the analogous reports that they wish that they could put on their clothes without triggering vaginal lubrication or orgasm.
Self-identified autogynephiliac trans woman Anne Lawrence, who has medically transitioned, wrote a book about autogynephilia called Men Trapped in Men's Bodies, in which she solicited the perspectives of autogynephiliac males and affirmed Blanchard's typology:
"I would simply like to state for the record that, based on my clinical experience and my reading of the scientific literature, I am firmly convinced that the overwhelming majority — probably 98% or more — of cases of severe gender dysphoria in men arise in connection with either effeminate homosexuality or autogynephilia; most of the rare exceptions probably arise in connection with conditions such as schizophrenia and certain personality disorders. The idea that substantial numbers of MtF transsexuals belong to a putative “third type” that is neither homosexual nor autogynephilic is inconsistent with my clinical experience and is, in my opinion, inconsistent with the best available empirical evidence..."
Scott's survey of his users found significantly higher rates of autogynephilia among trans women than among other groups. When asked the question "Picture a very beautiful woman. How sexually arousing would you find it to imagine being her [on a scale of 1-5]?", the mean response among self-identified trans woman was 3.2.
The highest rates of autogenderphilia were found in bi cis men (autoandrophilia), gay cis men (autoandrophilia), bi trans women (autogynephilia), and lesbian trans women (autogynephilia).
(Scott goes on at length about what it would mean to be a male person who is sexually excited by the thought of oneself as an exceedingly handsome male person, or vice versa. I will freely admit I still have no idea what this entails in practice.)
SubstantialFrivolity
I'm not even supposed to be here today
6hr ago
I'm reading Breakfast With Seneca by David Fideler. Basically the author takes several themes touched on by Seneca, and writes a chapter on each one with his own thoughts (and corroborating quotes from other Stoic writers). It's enjoyable, although not earth shattering since I have previously read Seneca's letters. But still, it's nice to spend more time reflecting on Stoic ideas, and think of new ways I can try to apply them better in my own life.
Have also just started The Confessions of Lady Nijō. It is pretty much what it says on the tin - Lady Nijō was one of the concubines of one of the emperors of Japan in the thirteenth century, and this is her writing about her life. Not sure I'll enjoy this one very much to be honest, but meh - it's a library book so I haven't lost anything if I don't wind up liking it.
He could easily have made the case against any of the specific policies without that element.
I don't think you truly understand what his case was if you think this is true. He could have made a different case, one that is more compatible with the ideology of his opponents. He couldn't have made his case.
it would seem less than conducive to a healthy working environment to know that your colleagues consider you naturally predisposed to neurotic behaviour, by virtue of being a woman.
The very notion of such a standard is a indictment of the CRA in itself. That a "healthy working environment" demands suspending basic human cognition is insane.
I can understand demands that this may not be talked about in a specific context (hell I can understand banning all politics at work) but once you're asked to voice views on a particular issue connected to biology, as Damore was, the idea that certain views are simply illegal to voice because of their inherent content is clear political censorship, and unjust insofar at is has not been explicitly declared as such and only affects certain views.
This is in effect no different from similar standards that allow people to use racial epithets and rethoric at work, but only against certain races.
You can argue that one ought to know better than to criticize people who hold such a power. You can't argue that it is just that they must.
RenOS
the mountain passed, the sea in front
6hr ago
Noah claims that progressives were in favor of immigration primarily, if not only, because Trump was against it, and that the right in general is against immigration on racial grounds. It's hard to take someone seriously after this kind of statement; The left has been very strongly in favor of immigration in general since the 90s, and this has been the case worldwide. The backlash to immigration has likewise happened worldwide, and for near-identical reasons: The number of immigrants were much higher than expected, the strain on the welfare systems, increased crime, etc.
Maybe it's because I'm in academia, but all the extremely woke people here haven't actually changed their opinion, and they haven't actually lost their positions, either. If I read the university newsletter, it's still full of "how to appreciate our diverse gender presentations" and very thin on hard science. If I walk around the campus, it's full of "critical orientation week" advertisements, which is exactly the kind of "critical" you'd expect. The university provides rooms for this week, which ostensibly is against the university, completely free of charge, of course. It's not even very long ago that the university kicked out a right-leaning moderate because "university is not political" and that the university should not "provide resources to political groups".
And this is the core problem imo: If there is a conflict and the right-leaning side is losing, the left will often successfully take away positions up to and including booting them out entirely. If the left loses, they just keep everything they try again after a while. Universities are still de-facto purging themselves of even moderately right-leaning people and promoting quite frankly completely insane people, so long as they are sufficiently far left. Unless we start kicking out far-left cranks the same way we do for the right, I don't see the general trajectory changing much. Sure this or that particular DEI statement gets discontinued, but the next thing is already being implemented.
MadMonzer
Temporarily embarrassed liberal elite
6hr ago
holds the high ground of the academy
The academy is the "high ground" in the sense that a defeated tribe can hide out in the mountains and wage guerilla war until a suitable opportunity arises (like Hilary wanting a way to attack Bernie from the left) - not in the sense that it is the key strategic terrain being fought over. That would be the government and corporate bureaucracies that actually implement cancellations.
A bunch of stupid nominally left-wing politics was defeated in the late 1970's, hid out in the academy for a decade, came out again as 1990's political correctness, lost again, hid out again, and came back as wokestupid in the 2010's. But wokestupid doesn't come out of academia - it comes out of tumblr - the changes from PC to wokestupid are very obviously driven by the need for social media virality. Academia was just a place where a parasite could be kept on life support until a new host turned up. If wokestupid is retreating into academia, it has been defeated (but not destroyed).
IGI-111
God was a dream of good government.
6hr ago
I don't find the proposition that the argument in favor of the the weak is self justifying convincing at all.
There have been plenty of successful societies throughout history that considered such a principle to actually be evil. And I don't see their arguments as any less self serving.
Why should we acquiesce to ressentiment? Why ought the weak be protected from the strong.
Divine command maybe the only argument I can actually contenance for this position, and even then God (the one of Abraham) is weary of weakness as an animating principle and gives not a command to submit all ressources and efforts towards it but demands the weak be shepherded by the strong. Establishing a specific subsidiary position where the weak's concern may not jeopardize the operation of all of society.
Southkraut
A tale Told by an idiot, full of sound and fury, Signifying nothing.
6hr ago
· Edited 6hr ago
Please let me know if you find out something useful about this topic.
FWIW, I also eat like a combine harvester, pace a lot, don't gain weight, and my skin ages poorly.
Not sure if there is anything to it all; maybe we're just reading too much into a bunch of coincidences.
hooser
7hr ago
VA had a hiring spree last year, in large part because of the expanding benefits from the PACT Act.
Your impression of a hiring freeze remains partly correct, because VA has budget shortfalls and plans to lay off staff:
More recently, though, the VA told Congress it now expects to have about 5,000 more employees in VHA next year compared to this year. That's created a new problem, as the VA is warning it is facing a multibillion-dollar budget shortfall.
I suspect that VA tends to paint a bleak picture to Congress as a standard operating procedure, in hopes of getting more funding. Though my nephew assures me from his VA experience that more funding would not go amiss.
So back to my off-the-cuff idea of importing doctors: my point is that any VA hospital that finds it challenging to attract a decent US doctor ought to be able to do what the private sector does. Right now, the VA follows AMA's standards, which require any non-US-trained doctor to do 3+ years of residency (plus other things) before they can practice medicine in US. Residency slots are, apparently, the bottleneck for US doctor supply in the first place.
My question is: just how crucial is it for someone already practicing as a doctor in a French or German hospital to do 3+ years of residency in US?
ArjinFerman
Tinfoil Gigachad
7hr ago
Only in America.
It's why cases where people see what works in American society and try and replicate it in their own makes me wince more than anything.
Hopefully this doesn't come off as too pedantic, but doesn't that imply it's not only in America? I'm probably just as disturbed by their cultural hegemony as you are, but in my experience it's so great that trying to draw a distinction between, say, American and European woke causes is rather futile. Maybe there is more of a distinction between the broader West and the rest of the world.
clo
7hr ago
Actually, what bothers me about them is the odd double standard where they demand recognition from our society, yet refuse to play by any of its standards
Only in America. Be all you can be and all that, tear down every fence and shatter every glass ceiling. If you're not who you could be, it's your fault, in the land of opportunity.
Oh, and you don't owe your fellow man anything. Why would you?
I share your disgust, but the targets are more broad. It's why cases where people see what works in American society and try and replicate it in their own makes me wince more than anything. The world has internalized their hegemony so hard that it genuinely believes the lies, often with awful results.
orthoxerox
If you can read this, you're using a custom theme
8hr ago
There's an image by https://x.com/patrickjfl that shows there's been a realignment between 1996 and 2024, but it has no dataset attached. To summarize (summarizing a tweet, lol), the parties have switched places: the GOP is now relatively more popular with the plebs, while the Dems have become the party of choice for the PMC.
There's another chart in comments by Kyle Saunders, with even less hard data on it, that shows that the cleavage line on the good old political compass has been rotating since 1960: it used to separate socialists from capitalists, but now it separates progressives from conservatives, with the GOP/Trump side becoming slightly more pro-redistribution that the Dems.
"Why would you shoot a man before throwing him out of an airplane?".
It makes no sense.
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