Throwaway05
1d ago
Amadan's reply said most of what I was going to say far better than I would say it, but I want to emphasize this.
It makes sense to me that reading these words, knowing that people have these thoughts would upset you. I get it. Rage in the existence of such a thing is not a productive emotion and at the same time it is an understandable one. That rage lies to you though. It might tell you that such and such belief is widespread, or "real" - I imagine the most of the sayers are keyboard warriors who would wilt at the thought of actual implementation for instance.
Channel that pain somewhere productive - know that every time someone says something brutal and mean about Republicans or Whites or Men (and even about Democrats and Women!) that a similar pain is produced.
Don't contribute to that pain in others, yell at people who generate that pain - do unto others etc.
Throwaway05
2d ago
Though I would be lying if I said there wasn't a tiny part of me that is sad that I'm not as "normal" as I once believed.
I wrote something long and deleted it.
Your instinct to avoid fad diagnosis is in all likelihood spot on. People have an intense variety, you may have some things that you enjoy and are good at it and some that you do not.
Putting a label on it and embracing a diagnosis that may not be appropriate is poison. Enjoy your life and don't do that!
Throwaway05
2d ago
Like many diseases states BPD is thought to essentially be a "two hit" problem - genetics loads the gun by giving you a predisposition to emotional lability in response to stresses and some life event fires it. Usually this is little t trauma or big T trauma. For more complications on this, see the discussion about C-PTSD.
Anti-Social PD and true sociopathy seem to be somewhat similar,* and for a hilarious and more medical example you can see "cigarette smoking pulmonologist" phenomena (lung cancer is a genetic phenomena and you can't fire the gun if it's not loaded).
Childhood sexual trauma is about as big T Trauma as you can get.
Once impacted by the disorder BPD individuals are more likely to continue to receive and deliver IPV for all the usual reasons including poor choices in partners, ongoing poor coping skills, the presence of mental illness (often with morbidity) and substance use.
With respect to Human's comment on DBT - in many ways BPD is one of the better diseases to have. With appropriate life course and engagement in therapy you can smother the disease state and it goes away. Period (compare with say Bipolar). Historically the more maverick individuals would prescribe a dick (with appropriate male partner) and if the dick puts up with the BPD long enough it dies on its own. This is....old fashioned, but a kernel of the wisdom remains, the natural progression of cluster-b personality disorders (aka persistent teenage brain) is to eventually develop an adult brain, you just need enough of your life to be remaining by the time you get there.
Modern social trends have....presented some problems, but the increase in prevalence in therapy is a counter balance.
Individuals in medicine usually think BPD is worse than it is in aggregate because we spot it media/celebrities when it's quite severe, and when it's noticeable in patient populations its usually severe (especially if your only major experience is IP and you only see the worst of the worst).
If you work enough non-psychiatry outpatient clinic and look closely you'll see a variety of personality disorders with a variety level of function just going about their business getting general medical care and living their lives.
Not every patient is belligerent, suicidal, and homicidal.
*Bad outcomes in development is a problem for all sorts of shit. TBH I'm very annoyed at your preceptors not talking ACE and the impact on development at some point in Psychiatry or Pediatrics.
Throwaway05
2d ago
That is 100% a problem - female doctors are increasingly more common, work shorter careers, and work less hours during them. Many of them do switch to pure teaching or admin roles for lower hours, more consistency, and safety.
That said it is an oddity because a doctor with 20 years experience and one fresh out of residency make mostly the same in most situations.
With respect to specialty choice (which is responsible for most of the variation in pay) women are more likely to go into more mission focused fields that pay less (like pediatrics and infectious disease) and men are more likely to go into money machine go brrr fields like radiology and ortho.
Throwaway05
2d ago
Well shit. My B.
I need a vacation.
Throwaway05
3d ago
In brief - Cluster-B personality disorders are ones in which basic human defense mechanism (immature ones) run roughshod over function. People may effectively end up acting permanently as a teenager. Everyone has these defense mechanism however, and sufficiently bad circumstances can bring them out. And not everyone who has the disorder acts like a total crazy bitch. Plenty of politicians are functional narcissists, anti-socials work in Wall Street. If you know where to look you'll see more, or if your bubble gets stressed in some way you'll see more.
Ideally these people do well enough that most of the people around don't know that involved a ton of therapy or whatever to get there.
Modern woke feminism etc provides a good scaffolding for these peoples worst impulses to explode everywhere and cause a horrendous mess and for it to be called a good thing - which may explain certain over representations.
Throwaway05
3d ago
Furthermore, if you don't want to live in a HCOL then being a doctor is an amazing deal.
In the US this is not true, doctors get paid less in HCOL areas (not universally because California is a bit different). Want to live in NY? Boston? Chicago? Take a 25-35% pay cut.
Throwaway05
3d ago
Pay is pretty flat - once you are an attending that's the salary, if anything it goes down with seniority because more senior people will take on less optional work/call and will take on non-clinical duties that pay less because clinical work is brutal.
Exception is if you go into private practice which is dying in the U.S.
Usually pay differences are more by specialty, some just don't pay well, but also you have working in academia (pay is ass) or working in a big city (pay is ass).
Opposite of most of life, in medicine more prestige and higher cost of living = lower salary.
Throwaway05
3d ago
Ah, correction noted!
Throwaway05
3d ago
Yeah medicare and medicaid can often pay below cost, sometimes to a ridiculous extent. I think I saw someone saying California Medicaid was paying under 40 an hour at one point on Meddit - with costs like front desk staff and MAs that is just grossly unsustainable.
Throwaway05
3d ago
I strongly require a citation for this.
According to the Google the top 1% of of income earners in the U.S. make between 650-800 per year. According to the most recent salary data I've seen exactly zero specalities have an average salary in that range. Neurosurgery is not shown on this data and probably reaches 1% thresholds, however.
The bulk specialties (what most doctors are) all have average salaries which are less than half of the 1% threshold except for EM which is a tad over half of that threshold.
Throwaway05
4d ago
Of course, the real retaliation for Soleimani was likely Iran greenlighting the Oct 7 attacks.
So your argument for Israel being the aggressor is that the US and Israel killed the king of terrorists and assassins via assassination? And that this action makes the abduction, rape, torture and murder of over 1000 civilians a legitimate act of warfare and retaliation?
That is certainly a choice.
Any argument that Israel is the aggressor has to deal with 10/7 and the arm of the Iranian military that functionally exists to murder Israeli civilians (the proxies).
Throwaway05
5d ago
Has Israel perhaps done something directly prior to these missile attacks?
Yes yes Iran has always been at war with Israel since the formation of the modern Iranian state, you can always point to some earlier insult in the back and forth. Structurally I think arming, funding, and directing terrorist groups with the primary goal of destroying Israel is a good place to stop with respect to determining initial cause of conflict - but fine, they've always been at war.
hot war
You don't get to decide when someone has enough of you punching them in the face and decides to punch back.
Throwaway05
5d ago
But I do have different standards. First, the US and Israel are clearly the aggressors here.
Iran has been launching missiles at Israel, engaged in near constant terrorism against Israel, and is engaged in a variety of forms of cyberwarfare with the US and Israel.
You can trace back decades in an attempt to figure out who started it "first" but a fight has been going on for a long time.
Iran just mad because they've been punching people in the face without ramifications and Israel and the US said "one more time and I'm going to shoot you in the knee" and then they did.
They are not the aggressors.
Throwaway05
6d ago
Anybody have a recommendation for a coffee maker you can load in advance and set to brew at a predetermined time?
Throwaway05
6d ago
In all honesty I'm not sure if this criticism is being aimed at me or pro-Iran posters who are confusing me.
If it's aimed at me - it does seem that seem people are formally anti-intervention (which makes sense) or anti-jew (which makes no sense to me but it is hate and hate doesn't always make sense), some of the other posters I cannot establish a theory of mind for, like the people who are mad at the US for being authoritarian and want to support Iran in response (or move to China as a hegemon).
Throwaway05
6d ago
If the US had military intelligence so great that they could avoid blunders, GWB would have invaded neither Iraq or Afghanistan.
This ignores (at least in the case of Afghanistan) the necessity of invasion.
Which is likely what happened here. To me it seems likely if not obvious that some of the governmental claims are correct in a way that makes invasion necessary and appropriate.
Many people disagree. That's fine.
What bothers me is the posters who don't seem to have any idea what the claims and circumstances are, either out of genuine ignorance or for need of rhetorical flourish. This is the first time in years I've felt mainstream media reporting is more reliable and informative than this forum and it's gross.
Throwaway05
6d ago
Alienating his base and attacking his own supporters, and then starting a insane war for what seems like no particularly good reason.
Comments like this confuse me.
It's not like Trump is some unknown man in a smoky room, he talks all the time. His administration has stated the reasons why. You can believe them or not but they are out there. You can even go beyond the public statements and make some inferences.
If you don't know what the stated reasons are.....try and address that first? It's not hard.
Furthermore it's pretty much impossible to know if the stated reasons are true/accurate or not without access to classified intelligence.
It's entirely possible that 100/100 presidents would have done this. It's entirely possible that 1/100 would have done this.
If this is the guy I am thinking of then the rumor is that the situation is completely understood it is just being withheld for family privacy reasons. Aka the guy wandered off and died from early dementia, killed himself or something similar.
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