Throwaway05
16d ago
Consider:
- Condemn the shooting because it is the wrong thing to do.
Or.
- Condemn the shooting because actually I'm for shooting those people. Wait this is America and the right has more guns. Umm. Don't shoot me? But I'd still be okay if you shot them.
Given for instance, Hasan's interests and platforms he seems entirely pro political shooting if the victim is "zionist" enough for him, but obviously he would not like to be on someone else's list.
Depending on if it is 1 or 2 you may get different private statements, different behaviors going forward, and different policy decisions about what to do on this.
I want people to condemn the shooting because political violence is bad, not because they could be the next victim.
Throwaway05
16d ago
I am a physician, I have beliefs that are mainstream in this country that would result in me being removed from promotion consideration, teaching, and could lose me my license.
Fired? Maybe, maybe not - certainly put under a microscope and given zero slack.
I didn't vote for Trump this last time in spite of interest in doing so because I was afraid that I'd be tired one day, lose my poker face and reveal who I voted for.
It's possible I am being histrionic, but I truly believe this - and I know lots of other physicians and working professionals in big name companies who believe the same thing.
In 2Way Morning Meeting yesterday some guy from a big four firm nearly broke down telling the same kind of story. Blue regions are littered with people like us and we are just about done.
Throwaway05
16d ago
You see a lot of people on the left (and right, moderates, whatever) who are personally terrified right now - they have a fear they are next. See: Hasan.
I think this greatly obscures how much they actually care or condemn.
Throwaway05
16d ago
Obama might be the only thing close?
Throwaway05
17d ago
Now who knows how politicized this is (or if recent data has changed) but when I was in Med School this was one of those facts that all med students were supposed to know for exams.
It's probably true in the sense that the average person with Serious Mental Illness is mostly harmless - the presence of significant outliers does not change the overall stats.
Throwaway05
18d ago
The problem is that outside of the big names they really don't have much security. The capital baseball shooting only dodged more death because one of the guys there happened to have actually security (I think it was Scalise?).
Most of these people are only defended by norms.
Throwaway05
18d ago
Politicians may have lower value than children, but politicians getting killed is probably more destabilizing for society and has the potential to lead to more death.
Throwaway05
18d ago
Yeah later finding out that the closest hospital was a level 2.... + looking again it looks like he may have been internally decapitated by the shot.
Throwaway05
18d ago
The people who usually commit violence in society don't have the interest and skillset to engage in organized political violence.
Anti-socials are violent and impulsive but tend refocus to the next person who frustrates them or someone who has wronged them in a personal (and petty way).
Traditional serious mental illness (like schizophrenia) usually involves too much functional decline and disorganization.
Delusional disorder patients (like erotomanic) tend to focus on political causes or more general fears (like paranoia about their neighbors or the FBI).
Malignant narcissists for the last few decades have been focused on school shootings, but they are starting to shift to politics (bad).
General criminals wants to avoid the eyes of the government.
So what really needs to happen for substantive political violence is for more or less normal people to find it necessary. The rhetoric is starting to hit that point.
Once it starts the social contagion will likely lead to some snowballing....
Throwaway05
18d ago
The number of things we can turn from dead to not dead is shocking but this was unlikely to be one of them.
I wander how many units (of blood) they used on him.
I hope they gave it a try.
Throwaway05
18d ago
Oh, yeah, that recent attack on ICE Agents that many have already probably forgotten.
I was talking to my father earlier today (right leaning big business Republican) and he said "you know if this rhetoric keeps up someone is going to take a shot at ICE."
For. Fuck. Sake.
I think there has been at least three?
Something has to be done about the complete failure of the media to keep people informed.
Throwaway05
18d ago
It's not impossible- https://en.wikipedia.org/wiki/Clint_Malarchuk#Neck_injury
But huge difference in the type of damage from a skate and a rifle round.
We have shocking ability to help with blood loss and at this point most hospitals have updated their mass transfusion protocol and all that but again a rifle round has a lot of energy (and may have also shattered his spine).
Throwaway05
18d ago
The injury looked like it caused significant damage to surrounding structures- so you have general exsanguination issues, and the clock on cerebral perfusion but the bigger problem is that repairing the anatomy would be a nightmare, some approximation of tourniqueting a neck wound is already a sign you've hit catastrophe but something this big and scrambled? Unlikely.
Even if everything goes right somehow he's probably had too much down time for any neurological recovery.
It's grim.
With the exception of weird stuff like a brain tumor, run of the mill crazy people violence usually tapers off by 50. People die, calm down, or experience too much cognitive decline to do something like this.
This guy might be crazy as in politically motivated or driven to violence by politics and the media, but he's unlikely to be schizophrenic or something like that.
EDIT: Updates suggest the shooter wasn't the old man.
Throwaway05
18d ago
Haven't seen any update yet, but given the political situation they'll probably keep coding him for a long time before giving up and declaring him dead, but from a practical perspective he was dead with the shot (in the sense that repairing the damage would be nearly impossible).
His vascular structures looked torched from the video, supposedly it was a rifle round.
I have no idea how fast the response was/how close he was to a trauma center though, if the wagon had a shit ton of blood and they had advanced trauma options available it's maybe possible he makes it with severe deficits, but that's the kind of wound I wouldn't want to treat if the person was shot in the theater with Anesthesia and like fucking ECMO already standing by.
Throwaway05
19d ago
but compared to almost every other country there is still some strange probability, of maybe 20%, that you eat something that tastes perfectly average and leaves you feeling diffusely sick for the next day like someone force-fed you a liter of gutter oil.
If this is happening to you the issue is likely something along the lines of too much fat or too much salt for your digestive system.
It's relatively common in America for Americans to have that problem with salt in Americanized Chinese food for instance.
Throwaway05
23d ago
Someone probably already told you this or you put it together yourself, but just in case -
Physician notes are usually organized in the "SOAP" fashion (subjective, objective, assessment, plan) for most purposes the A/P is all that matters so you can usually scroll down to the A/P (and some EMRs will directly facilitate this). Anything materially valuable should be recapped in that spot "...given patient's reports of acute pain, profound anorexia and reported history of diverticular disease as well as supra pubic tenderness suspect episode of diverticulitis..."
Lots of EMRs will also let you filter out the copy forward /auto filler to make things easier to read and identify any S/O that actually has value.
Unfortunately the EMR help won't help if you are getting PDF print outs.
I also support the movement to reformat the notes to APSO format to shove the useless shit to the bottom. Some places do that by default.
If you are getting a complete record I hope they aren't sending you all the bullshit nursing notes.
Throwaway05
23d ago
I look at a lot of medical records for work
Hmmm, any comments on what I could be doing in my documentation but probably don't.
Throwaway05
23d ago
I mean soccer aka football.
Always useful to have something you can talk to patients about. It can distract them, calm them down, normalize you, establish empathy, whatever.
It can be hard to be a normal person in medicine.
Throwaway05
23d ago
What Dak did has always been permissible under the rules, and, again, doesn’t really seem that bad or out of the ordinary. He literally just spit on the ground in the general direction of Jalen Carter;
So same stuff happens, Carter doesn't respond, a ref catches it... you don't think Dak gets flagged this game?
I absolutely think they'd throw a flag for spitting at Carter while shit talking.
We'd probably be talking about it being an overreaction, but still.
Throwaway05
23d ago
I think their is a kernel of an interesting conversation in discussing the union of impulse control, testosterone, substances of abuse (as are likely present) and how some of this may in fact be beneficial given the sport...but I don't know where to take that so I'll toss it inside.
Instead let's consider the game and metagame of this. Given that we can't take anything either of them say at face value (I assume Big Dom's hand is shoved firmly up Carter's ass and Dak is a pro at this point).
The game - I "believe" Dak probably was trying to instigate given the shit eating grin and the fact that both teams clearly came to play and were chippy as hell. But I think a reasonable person could believe Dak was doing it on purpose, and a different reasonable person could believe it wasn't deliberate.
So the metagame then - if you throw the book at Carter and let Dak "get away with it" it's going to make players feel that being a dick on the field is incredibly useful, as long as they don't get caught. That's a complete failure of the point of emphasis.
Do I think players are going to walk away believing that? Unsure. Certainly Eagles fans and anti-Cowboys fans will mostly think that.
Sidebar-
For the Eagles haters out there, this might be better for the Eagles in the long run, since it might decrease how much of a cap hit Carter causes when his big contract rolls in.
Throwaway05
23d ago
Football is a different beast than most sports and has a shocking degree of complexity for a bunch of large men ramming into each... - don't worry you don't have to pretend to pay attention.
Although picking up the other football will likely have professional benefits for you given your practice location.
Throwaway05
23d ago
It's clear from the footage that Dak directly spat at Carter with specific intent to taunt and enrage him. Likely also with some verbal content between the two of them we can't tell from the footage. We can tell Dak knew exactly what he was doing.
In a non football context doing that could easily start a fight. That doesn't suggest that the fight is justified, or a response in kind or with escalation (spitting on instead of at) is justified.
But it's still aggressive and offensive.
If you are going to flag someone for flexing (Nolan Smith I believe?) then spitting at a player is absolutely worthy of punishment regardless of Carter overreaction.
Throwaway05
23d ago
Dak
While one is worse than the other and they are always going to get the second guy...... you can't throw the book at Carter and let Dak get away with instigating that. It's bad looks all around.
Saints
My suspicion with them is that they do not have an NFL QB and the vet talent they've been riding on for so long will have the wheels fall off.
CMC
I think he's effectively done, he may be able to still perform at a high level but not for a full season and at the expense of post-football quality of life. Man needs to hang it up. Without him though? IDK they've worked magic before.
NFCE
Agree with you, but I also think they are in for a sophomore slump. Could easily see the Cowboys or Giants somehow winning the division, especially with the tough schedule the Eagles have. Felt more comfortable with that before the Parsons trade though. Giants will be high variance.
NFCN
I feel like the Packers and Vikings are both well positioned to be the top team in the NFC...or not. Lions have to regress, right? Bears will probably be a good team but underperform in W/L because of their schedule.
Chargers Fan
I'm so sorry.
I saw Cenk's response which I thought was shockingly good. I don't really follow his community but I think he got in trouble with the left recently anyway for standard insufficient purity problems.
I heard something about Hasan being scheduled to debate Charlie soon which probably really really made it real in his mind.
He's a LARPer, realizing what he is saying is real life will shatter a lot of ego defenses.
More options
Context Copy link