Sunday, January 26, 2020

Prestige in Medicine

Prestige is a human construct, not natural consequence. As with most human construct, prestige has always involved elements of myth, partial fact, and make-believe. This is especially so in medicine. The defining features of prestige in medicine, as in most human pursuit, has historically been quite malleable with the times. What was prestigious in medicine at the time of the Aesciplia in ancient Greece, much different than prestige in medicine today. This despite the use by historians and physicians of altering historical facts in order to create the illusion of a single arc of noble intent and progress through the ages of medical endeavor in attempts at painting a prettier picture and to enhance contemporary prestige.

The bulk of prestige in medicine today is to be found in the halls of academia, or so the academics would have you believe. But academic prestige today is not based in the selfless caring for the in-firmed or in devotion to prolonging quality life and reducing suffering. Prestige in medicine today results almost entirely from pedigree, publication, and funding. Pedigree takes credit for historical accomplishment where credit is not due  - William Osler did most of the heavy lifting resulting in prestige for Johns Hopkins University early on, that those that graduate from now lay claim to. Upon graduation and embarking on their academic careers, publication and research funding will be the yard sticks by which they are judged and promoted, not by how good of a clinician they are. I personally take pedigrees from Hopkins, Harvard, and the ‘good’ places as warning concerning clinical skill. In my experience no one cared how good my care of patients was in assessing my appropriateness for promotion. It was the number and quality of my publications and the amount of research funding I brought to the university that mattered, not how well I cared for your relative.

Of the two department of medicine chairs I have known, both had excellent pedigrees, publication and grant portfolios, but both were mediocre clinicians, and that is being generous. The problem? Mediocrity in medical care, kills. 

Wednesday, January 15, 2020

Let the Univerese Be Our Guide

Imagine a single clan of human on earth, no nations, its social fabric woven from the beauty, perspective, and humility, the understanding of our objective reality can afford. To see earth as it is, a fragile globe 90 million miles from a nuclear fireball a million times our size reveals our collective fragility and interdependence, resulting in a greater compassion and tolerance for all of life. A glimpse at the nearly incomprehensible beauty of a single oak leaf - from shade, coolness, and green verdant beauty as part of a whole - the tree - to the incredible complexity of photosynthesis at its molecular level, to the unimaginable in its quantum world. A miracle of complexity and beauty turning sunlight into an oak tree. One simple leaf.

Now imagine cutting down its tree for toilet paper. 

Knowledge and perspective of our objective reality can change everything.

So much of who we are, how we think, our desires, our aspirations and wishes are based in ignorance and human invention - made up constructs that are not real, and fail us, have failed us at the cost of so much human suffering, murder, and now the destruction of our environment. Money, myth, gods, nations, corporations. None of these are real, and as our technology grows will lead us to our destruction. 

The cost of our salvation? We must abandon so much of who we think we are and evolve or we will perish. We must look outwards to our objective reality and abandon our inter-subjective constructs. If enough people abandon the concept of nation, it will cease to exist - because it is real only in terms of the subjective consciousness of the many. The same can be true of religion, money, success, power, corporation.

Low Information Voter

Donald Trump as president is proof that America's public school system is failing. 

Wednesday, January 8, 2020

Live, Die - Most of the Rest is Made Up

Somewhere out there is a just universe.
It's just not this one.

Iranians Are Human

Remember that evangelicals are ok with billions of innocent children dying horrible painful deaths at the rapture. In fact it’s a wonderful affirmation of their superiority and a big time joyous payback. Rapture an odd word for murder don’t you think? Then remember both our Vice President and our Secretary of State are evangelicals.

To our evangelical brothern. Iranians are humans. Are you?

Rapture With a Twist

Mike Pence and Mike Pompeo are both evangelical christians. Both beat the drum for war with Iran. Both wealthy enough to have built ‘rapture shelters’ - underground harden shelters designed to save themselves in comfort while the world fries.

But don't worry, its not cheating, god told them to do it. 

Sunday, January 5, 2020

Victims and Thought Police

Monty Python’s Terry Gilliam recent remarks about the metoo movement caused millennials by the hundreds to literally crawl all over themselves trying to destroy him - despite most not having read what he actually said. Terry likes to provoke with laughter, and to shake people out of their comfort zones. What better targets than modern day victim’s movements.

Ironic then that he was blasting piling on, rigid intolerance to others, viciousness, and the victim mentality in general. White man’s past power and abuse was part of an unjust societal fabric centuries in the making. We have since begun to evolve away from that in all areas but forgiveness.

Imagine going through life the victim. Imagine trying to twist victimhood into power. People’s energy would be better spent forgiving and then evolving together to better times rather than using victimhood as excuse for mind control, judgmentalism, and viciousness.