367 karma · joined February 11, 2023
There’s a difference between doing an unsavory job to the best of one’s abilities and calling women’s mental health issues "hysterics" and invoking psychosomatics to avoid paying out after someone was badly injured horseback riding and are bedridden due to debilitating neurological disorders following her injuries.
There’s a decidedly difference between being strict, maybe even excessively so, whilst doing a controversial job and systematically being misleading, manipulative and untruthful when confronted with established standards of care.
I fully get having to yield to the way the world works, and i sincerely feel for your view. My parents have basically disowned me and trying to sustain myself through medical school is taking a fat toll on me.
But I’m sorry, but "savying" away any sort of criticism of the conduct of our profession on the basis of "that’s not of the real world works" has it’s limits. Maybe you haven’t been at the receiving end of this sort of ordeal, but i can attest you first hand that this group of physicians, at least here, has issues way beyond having to sustain themselves. Maybe our generation will be different, but the ease of your dismissal is kind of troubling to me.
A few months ago i came across an interview with a physician who worked for one of the online pill mills that sprung up after the US loosened the rules for RXing scheduled substance via telemedicine. He pretty much approved Benzos and Adderall all day. He invoked pretty much the very same argument you have, and I’m sure his situation was everything but easy. The pressures of becoming a US physician are very alien to me, so maybe i just don’t get it. But "well, that’s how the world keeps spinning, grow up kiddo" isn’t a carte blanche for being oblivious to the damage you’re doing. You have sworn or will swear an oath. Being a mercenary liar, misrepresenting medicine for monetary gain is not quite what was implied there. If you don’t see a glaring issue with behaving this way, maybe you should look into an alternative career path.
As you probably know, the severity of OSA is quantified in something called the apnea-hypopnea index. For every SINGLE point of BMI reduction (5-8lbs depending on height), you achieve an AHI reduction of 6.7%. That’s absolutely massive. [2]
It’s still multifactorial, one’s anatomy can be varyingly predisposed for OSA, sometimes to the point of causing problems without obesity. But in general, that’s one hell of a bet.
!! I’m a medical student. I have not yet achieved the status of approbated physician. Please adjust your trust accordingly. I don’t think i have to spell out the difference between informed medical advice and comments on HN, my comment is already patronizing enough as is, but regardless.
[1]Resta, O., et al. "Sleep-related breathing disorders, loud snoring and excessive daytime sleepiness in obese subjects." International journal of obesity 25.5 (2001): 669-675.
[2] Fattal D, Hester S, Wendt L. Body weight and obstructive sleep apnea: a mathematical relationship between body mass index and apnea-hypopnea index in veterans. J Clin Sleep Med. 2022 Dec 1;18(12):2723-2729. doi: 10.5664/jcsm.10190. PMID: 35929587; PMCID: PMC9713905.
Turkey, Iran and Syria can and have caused horrible water shortages in Iraq.
But, as it seems, i vastly underestimated the effort needed to cause my theorized catastrophe. I’m entirely open to admit being wrong about that, always good to learn.
Also, correct me if I’m wrong, but afaik, the viability of nuclear plants as strategic targets has been vastly overblown. I’ll go read up on it, but i don’t think it’s that big of a risk.
[1]: https://www.ispsw.com/wp-content/uploads/2020/09/718_Lin.pdf
"In this case, the Three Gorges Dam may become a military target. But if this happens, it would be devastating to China as 400 million people live downstream, as well as the majority of the PLA's reserve forces that are located midstream and downstream of the Yangtze River."
none of those claims are anything but proven, historical facts by the way.
Wanna lose your appetite? The leadership in charge of the described operations in Vietnam gleefully talked about their management genius. They implemented kīll quotas.
this list also is everything but exhaustive.
I just don’t think it’s very likely for just about any leader putting themselves into the position you are describing. This is a reoccurring narrative in western media, and I’m not here to defend dictators, but i feel like reality is less black and white than that.
Many of the "crazed leaders" we are told are acting irrational, often do not. It’s just a very, very different perspective, often bad ones, but regardless.
Let me try to explain what I mean: during the Iraq war, Saddam Hussein was painted as this sort of crazed leader, irrationally deciding to invade Kuwait. But that’s not the entire truth. Hussein may have been an evil man, but the way the borders of Iraq were re-drawn, Iraq was completely cut off from any sources of fresh water. As expected, their neighbors cut off their already wonky water supplies and famine followed. One can still think it’s not justified to invade Kuwait over this, but there’s a clear gain to be had from this "irrational" act. Again, not a statement of personal opinion, just that there IS something to be had. I’m not trying to say that i am certain that Hussein had the prosperity of his people at heart, but i do think that it isn’t entirely irrational to acknowledge that every country in human history is 3 missed meals away from revolution. That’s not good, even if you are their benevolent god and dictator for lifetime(tm).
Russia "irrationally" invading the Ukraine may seem that way to us, but let’s see. Russias economy is just about entirely dependent on their petrochem industry. Without, their are broke. The reason why they still can compete in this market is their asset of soviet infrastructure and industry. A good majority of USSR pipelines run through the Ukraine. I’m not saying it’s okay for them to invade, but i can see what they seek to gain and why exactly they fear NATO expansion all that much.
I personally don’t see a similar gain to be had from China invading Taiwan, at least right now. They have lots to lose and little to gain. Taiwans semiconductor industry is useless without western IP, lithography equipment and customers. There are even emergency plans to destroy taiwans fabs in case of invasion. And that’s beside the damage done to mainland China itself.
But as i stated, this may very well change when they get more desperate. Hussein fully knew the consequences of screwing with the wests oil supply, but the desperation was too acute.
I just don’t buy irrationality, there’s always something to be had or something to lose. It may be entirely different from our view, but there’s gotta be something.
You’re not wrong, maybe all the scaremongering in the west about China overtaking us got them delusional enough in a Japanese nationalist type way for them to behave this irrational, but i highly doubt it. But that can also change pretty quick if they feel like their back is against the wall, you’re not wrong in that regard
edit: one also should keep in mind that the Chinese real estate market is entirely different in its importance to its populations wealth. "Buying" real estate is pretty much the only sanctioned market to invest your earnings. They still pretend to be communist after all.