domain:drmanhattan16.substack.com
Mewis
13m ago
Not reading all this shit or watching some smug deboonker, but at a certain point, nonsense is too nonsensical to deboonk or deconstruct. You can't deboonk Timecube, for example.
Proving that 1*1=1 from first principles is very easy - natural-number mathematics defines 1 axiomatically as the multiplicative identity!
FCfromSSC
Nuclear levels of sour
19m ago
Ha! Relic and Reliquary were the only two of the series that I read, back in the day, and I loved 'em. Were the rest of the books good? And which Gould was this, now?
self_made_human
Kai su, teknon?
28m ago
In India, the few private hospitals that do hire NPs use them for one purpose only, they're usually trained to do procedures in the ICU, I'd say usually under doctor supervision, but I was a Medical Officer fresh out from an internship and my presence was superfluous. At least they never dared to take training opportunities away from actual CCM residents or registrars, if they wanted to do something, they got a crack at it.
If you think the US is bad about mid-level scope creep, wait till you hear about the UK.
There, NPs and PAs are both just about as useless as there, but have been bulldozed in by the government because they're far cheaper in the long run than an actual doctor, you know, the kind that expects career progression and also has the temerity to run away for greener pastures when fucked with.
They can't prescribe, nor order most investigations, and anything they do has to be be double checked by a harried doctor. Thankfully, the movement to curtail their expansion has been taking off hard, with doctors both working to rule (Oh, as a PA you report only to my consultant? Sorry, I'm snowed in, I can't sign off on a patient I haven't personally reviewed, please go badger the boss, they'll be very happy about it).
In fact, new guidance on the level of autonomy they possess, especially in GP, makes it so that they're effectively redundant in any practice, so the latter are now begrudgingly forced to accept that actual GPs are non-negotiable.
Add in scandals over them grossly overstepping their remit, and fucking up cases that would be obvious to any semi-competent doctor, such as dismissing obvious MIs with good old PPIs and a paracetamol..
It's all exacerbated by rotational training, with consultants unwilling to invest effort in mentoring and training their juniors who are going to fuck off to a new hospital, whereas they could at least teach the rote mechanical skills to a NP/PA who'll be working under them for their whole career.
What's doubly farcical is that they're paid more than FY1 and FY2 doctors, who are both more competent, and in the latter case, actually capable of ordering followup investigations for whatever they suspect is the case.
fishtwanger
36m ago
Open-borders libertarians, I think? They'd prefer lots of immigration, all legal by default. But as is, they're heavily sympathetic to people coming to America, any way they can, to make a better life through hard work and free enterprise. The first place I looked was "Reason", and their top article right now is "Trump's Mass Deportation Plan Is Anti-American", making the case largely on moral grounds:
But this conversation is about much more than monetary costs. It's about the government wielding force against largely peaceful, nonviolent residents who help create vibrant American communities. It's about whether deploying police officers, National Guard members, and the military to extract undocumented immigrants from their homes and workplaces in raids is consistent with American values. It's about the civil rights and due process violations that will inevitably occur if this plan comes to fruition.
2D3D
37m ago
The problem is that the 'blacks' progs want to lift up don't end up in prog circles to kiss the ring in thanks of prog generosity. The most black millionaires come from sports and rap industries, hardly fields progs find affinity or interest in. Progs want to raise a black girl out of the hood to be president and crowd down the normie whites that otherwise occupy that position, replacing white competitors with grateful black toadies.
Very interesting. However, I still am curious if 1 mile or 2 miles is a better reflection of the reality of my travel distance, since you said that 1x1=2 is looking at reality rather than avoiding it and retreating into theory.
You can't tell that from walking around a mere mile.
You sure can if you're walking uphill.
fishtwanger
49m ago
even if the new fad diet was based on unicorn farts
Oh, fasting, I've done that. :-)
sarker
Where are the Snowdens of yesteryear?
50m ago
It's not me claiming this, it's the source you provided that distinguishes the two.
pm_me_passion
אֲנָשִׁים נֹשְׂאֵי מָגֵן וְחֶרֶב וְדֹרְכֵי קֶשֶׁת וּלְמוּדֵי מִלְחָמָה
51m ago
Americans use traditional SMS messages to text each other, instead of Whatsapp like everyone else. When you text another iPhone from your iPhone, it actually uses a different app called iMessage that doesn’t cost money and the text appears in a blue bubble. If you text an Android user from an iPhone, the text appears in a green bubble and costs money (or consumes a bit of your plan, or whatever).
RandomRanger
Just build nuclear plants!
1hr ago
It's not doing so well against Bitcoin.
RandomRanger
Just build nuclear plants!
1hr ago
Zeihan thought that China was just about to collapse for the last 15-20 years.
Look at what he says here:
https://www.businessinsider.com/stratfor-predictions-for-the-next-decade-2010-1#iran-pacified-6
Iran pacified, China implodes, US ascendant. If you squint at it he gets some things right (India and Africa irrelevant, Russian movement towards Europe). Other things are dubious, Turkey as regional leader? Maybe, sort of? But the key trend of that decade was the continued growth of China in all domains. He was effectively all in on China shorts and should have lost all his reputational currency with that biggest and most failed investment.
He doesn't deserve any more reputational capital.
ulyssessword
1hr ago
Last I heard, it was because black women chose black obstetricians, and being in a situation where you give birth with a doctor other than your first choice indicated some sort of problem (usually, complications that required a non-racially-filtered specialist).
It's also why home births are so safe in some studies: if they become dangerous, they become hospital births.
SteveKirk
1hr ago
Thank you, I spent hours trying to come up with a "new soviet man was the noble savage all along" joke.
functor
1hr ago
Russia chose to go to war with America.
Glad we are admiting that Ukraine is just a proxy state for America. So the US can bomb, invade and occupy countries left and right and have proxy states right on Russia's border and there are no sanctions. However, other countries have no real legal protection and are left to the wims of American for whether their dollars are worth something or not.
There is a reason why this system isn't going to be stable.
No_one
1hr ago
Using Minutemen ICBM for Urban renewal is very bold but rather too expensive.
No_one
1hr ago
Can't get rid of the dollar..until you can.
For your information,Iphones are kind of rare elsewhere. ..and..green text? Wut?
Iphone is just incredibly bad value. I
FD4280
1hr ago
No, from a hard major perspective, a B+ average sounds like severe grade inflation rather than the reverse.
The TV show "The Wire" had two black kids in what one black parent referred to as the "pediatric neurosurgeon phase", where a young black kid, who hadn't been ground down yet, picked as a role model one of the most intelligent and successful black men in the area. Apparently this was a real thing, at least in Baltimore, and it was due to Ben Carson being the director of pediatric neurosurgery at the Johns Hopkins Children's Center (in Baltimore).
nfhs82nsa12
1hr ago
In your ideal America, the US should have remained a white supremacist state with blacks as second class citizens. Black people should have sat around until desegregation was convenient for you. Fortunately that did not happen.
Whites left because they were being beaten, robbed, raped and murdered at an appalling rate
How do you quantify "appalling"? I see some anecdotes about old white people, but very little in the way of actual evidence. Violence is largely interracial and white people were, and continue to, commit plenty of violence against other whites.
Interestingly, violence and intimidation of whites against blacks is completely absent from your narrative. This is what that looked like. The vast majority of black families who moved were decent law-abiding people and the white people who moved out were primarily motivated by racism. White families accosted and assaulted small black children. Perhaps you believe they were doing the right thing.
NullHypothesis
1hr ago
I don't think I'd be here if brevity was something really important to me lol.
The way I see it, if it's good and the more there is to consume, the better.
No_one
1hr ago
I was never too fond of the genre, though I did enjoy the mystery/thriller Agent Pendergast series a bit too much despite it being slightly Reddit.
But it had a character clearly inspired by the despicable Communist Gould turn into a sewer mutant cult leader. You love to see that.
Bit of a guilty pleasure.
RandomRanger
Just build nuclear plants!
1hr ago
Encouraging economic policies that were good for cotton plantations but not for your wheat crop?
I recall that during this period, US tariff policies meant that much of government spending was funded by Southerners importing foreign luxury goods at a mark-up. This money would then be spent on many things, including developing railways in the North. Northern industries were shielded from foreign competition while the South had to compete in world markets. This made the South quite angry, causing one of the many pre-war crises. There was a long struggle with different parties raising and lowering tariffs, Lincoln's Republican Party was elected on a platform of raising tariffs significantly.
https://en.wikipedia.org/wiki/Tariff_of_Abominations
https://en.wikipedia.org/wiki/Nullification_crisis
This is not to say that slavery was not a primary contributor to the war but there were a range of issues causing division.
fishtwanger
1hr ago
I agree, although I think "refuse to identify" is too strong - there seems to be a "there but for the grace of God go I" attitude, from what I've heard. But yes, from what I can tell, a lot of racial disparities seem to be mediated by class rather than coming directly from race.
Anyway, looking back at the original quote, those with four American DOS grandparents make up 33%, so there's 66% who have at least one grandparent who is from Africa or the West Indies, or who is non-black. Put that way, the numbers make a lot more sense. It could easily be the long-hoped-for cultural assimilation at work, where once people make it into the upper-middle-class (this being Harvard), they identify more and more with their class peers, regardless of geographical background and sometimes regardless of skin color. And so their children and grandchildren still count as "black" in America's racial classification, but they aren't the sort of "black" that intelligent progressives want to focus on.
NullHypothesis
1hr ago
Goes to show that being right doesn't make you likable and that delivery matters as much as the message.
I admire your incredible ideological consistency. Modern society is so massively skewed in the other direction.
And as obscure historical note Van Buren is the outlier president in that he is not a descendant of Irish or anglos. He is the only president not descended from or closely related to King John of England. Including Obama through his mother. Van Buren is the only German outlier bucking the trend.
On the other hand my grandparents are almost caricatures of "all American" people. They happen to be the descendants of Irish immigrants, like many almost-caricature examples of Americanness. But being an American transcends the national origin of your ancestors according to common understanding.
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