A long time ago when I first started out in ICU, docs could not believe I was a pharmacist. "you're too smart to be a pharmacist" "What a waste..here I will help you get into med school if you want. I know the dean"
But they cannot give you the credit for care to patients or other docs. Years ago we had a youngish patient with organizing type pneumonia from similar to that of Covid. I suggested a 24-48hr trial of steroids. The patient turned around fast and was extubated in 48hrs. They were all congratulating themselves. One resident said it must have been the steroids I prescribed. I reminded him who was the one with the idea. Oh yeah he said and shrugged his shoulders.
Even 30yrs later my resident came up with the cause of a young womans cyclical vomitting on her 3rd admission in 3 weeks. A history showed she used a lot of marijuana so likely hyperemesis cannabinoid syndrome. The attending physician disagreed IN THE CHART where we had written out a plan. Discharged the patient, then called the family doc and told them what to do for this syndrome.
They often cannot help themselves. They are taught they're the most intelligent, they are leaders, and more importantly, they have the responsibility for the health outcomes (even if you saved their behinds).
Many docs came to me in private and said I was the best thing that happened to the unit/hospital/program but WILL NOT say that to management, or other physician groups. I don't get it.
Our vaxxed vs. unvaxxed study (Paul Thomas' practice data) was retracted due to unsubstantiated HUB - they use it when it suits them. I then published this finding that the unvaccinated made their well-child visits with a greater fidelity than the vaccinated! https://popularrationalism.substack.com/p/new-study-from-ipak-results-shows Facts don't matter to clowns.
Matt. I’d like to add to this, the narcissistic patient is also a phenomenon. I hit so much frustration in my family with members who felt their doctors are “The Best”. TOP doctors of NYC and they are the smartest and therefore what I had to offer as grave concerns about the vaccines where nothing next to these brilliant doctors. I was being silly. I think I was actually told, “you really think you’re smarter than doctor blah blah?” There is no room to challenge these MDs or their groupies. I’m still waiting for family members to come back to me with any indication of how wrong they were to take those brilliant doctors advice. I managed to avoid the shots myself and save my daughter from them. But my son, old enough to make his own decision, I couldn’t convince and my husband lied to cut the line to get a shot. I took a tremendous amount of heat because this stupid doctors were so ignorantly sure and my family blindly BLINDLY went with it. I also challenged retired doctors in the friend sphere as they were participating in the email chains with the older generations. It got ugly but I felt they needed to be more careful with their general statements “the vaccines are safe, move along”. Their “friends” were listening as tho they have the inside track being friends with a DOCTOR. Or how Rhee doctors felt they were the authority to make these ignorant statements! Maddening how the doctor was so stubborn. Maddening how my family treated me like I wore a tin foil hat. Maddening that friends treated me like I had kooties furthering the vaccine lies. Yes. I’m still not over it. But people, and their willingness to elevate an MD to godlike status, is a real problem too. Great piece. I continue to work to tear down the walls of modern medicine (figuratively) in hopes to achieve some honesty and most important, REAL HEALTH in our society. My kids now realize I’m not so crazy after all.
Mar 28, 2023·edited Mar 28, 2023Liked by Mathew Crawford
I agree with you analysis, and having been assigned to teach medical students applied maths, and computing a couple of times during my university lecturer days, I saw how spoon fed with rote learning they were, and at the same time were drilled with a superiority complex putting them above all non-medical students [with the exception being Law students, who they saw as on a par, maybe]. From my perspective of today, having learned about childhood trauma, I definitely see that certain career choices have become self-selecting of specific trauma survival styles, and medical is an arch example of this https://garysharpe.substack.com/p/connections-between-career-choices
ps I find your observation that it is difficult to distinguish talking to a doctor from a chat-bot interesting and telling... :-)
There were two people who provided decent medical info during the lockdown:
Seheult and Campbell.
Seheult had videos banned for reasonable discussions of Hydroxychloroquine and other as forbidden topics and he just shrugged it off. He buried his head in the sand.
Campbell followed the evidence as the facts emerged and realized he and all us were being lied to, and spoke up. Campbell has gone from being well respected to being demonized.
Sadly most of the industry and the world follows the ostrich path.
One of my best supervisor/mentor/professors frequently made the statement that residency was not to teach us everything we needed to know, but to make us students for the rest of our lives. Not knowing what one doesn’t know, challenging one’s assumptions, and engaging in critical thinking is essential to be an effective physician.
It has saddened me over the years watching the practice of various fields of medicine be turned into checklist diagnosis & “consensus guidelines” treatment. Thinking is removed. Technology has certainly contributed to this, as docs rely more on sophisticated (and expensive!) tests & imaging technologies, and less on LISTENING TO THE PATIENT! The best teaching docs were like Sherlock Holmes: they would ask observe, ask questions, and listen. In teaching rounds they would discuss the nuances of their brief exam and most of the time correctly diagnose the patient BEFORE the confirmatory labs were performed.
As an aside, we had an entire course in biostatistics - I assumed everyone did! As an engineer I loved seeing medicine through the lens of mathematics, but never lost sight that I was dealing with an individual. Turns out I am an anomaly!
When I went to medical school here in the U.K. 35 years ago I was unusually allowed in with A levels in Maths, Further Maths, Physics and Chemistry but not Biology. I noticed that my fellow classmates were hopeless at maths and hated anything that vaguely resembled it ( which bizarrely was pharmacology). I would never be allowed in these days - but perhaps more non biologists should ( after all Biology is just vast quantities of learning which I hated which is why I didn’t do it!).
Mar 28, 2023·edited Mar 28, 2023Liked by Mathew Crawford
Perhaps you've stumbled upon the true significance of medical school and college debt. How much more docile the serfs when saddled with the responsibility of student loans and the threat of financial ruin. Certainly impetus to 'tow the line' until you have dependents and then door is closed for another 30 years...
Even when holding up a mirror, he will never see his true self. This is the curse of a true narcissist. I vividly remember my rotation in med school in psychiatry and discussing how you could not convince certain patients that they weren’t Napoleon or Jesus by logical arguments( a psychotic disorder).I truly believe narcissists are on that spectrum and gravitate to some occupations ( politics? ) more than others( head of NIH?).
Hmmm.. as a long time nurse... many doctors I worked with were all about believing what they’re told. They’re to blame for the oxy endemic... they’ll go with the majority on anything
It's their training I think.
A long time ago when I first started out in ICU, docs could not believe I was a pharmacist. "you're too smart to be a pharmacist" "What a waste..here I will help you get into med school if you want. I know the dean"
But they cannot give you the credit for care to patients or other docs. Years ago we had a youngish patient with organizing type pneumonia from similar to that of Covid. I suggested a 24-48hr trial of steroids. The patient turned around fast and was extubated in 48hrs. They were all congratulating themselves. One resident said it must have been the steroids I prescribed. I reminded him who was the one with the idea. Oh yeah he said and shrugged his shoulders.
Even 30yrs later my resident came up with the cause of a young womans cyclical vomitting on her 3rd admission in 3 weeks. A history showed she used a lot of marijuana so likely hyperemesis cannabinoid syndrome. The attending physician disagreed IN THE CHART where we had written out a plan. Discharged the patient, then called the family doc and told them what to do for this syndrome.
They often cannot help themselves. They are taught they're the most intelligent, they are leaders, and more importantly, they have the responsibility for the health outcomes (even if you saved their behinds).
Many docs came to me in private and said I was the best thing that happened to the unit/hospital/program but WILL NOT say that to management, or other physician groups. I don't get it.
Our vaxxed vs. unvaxxed study (Paul Thomas' practice data) was retracted due to unsubstantiated HUB - they use it when it suits them. I then published this finding that the unvaccinated made their well-child visits with a greater fidelity than the vaccinated! https://popularrationalism.substack.com/p/new-study-from-ipak-results-shows Facts don't matter to clowns.
Matt. I’d like to add to this, the narcissistic patient is also a phenomenon. I hit so much frustration in my family with members who felt their doctors are “The Best”. TOP doctors of NYC and they are the smartest and therefore what I had to offer as grave concerns about the vaccines where nothing next to these brilliant doctors. I was being silly. I think I was actually told, “you really think you’re smarter than doctor blah blah?” There is no room to challenge these MDs or their groupies. I’m still waiting for family members to come back to me with any indication of how wrong they were to take those brilliant doctors advice. I managed to avoid the shots myself and save my daughter from them. But my son, old enough to make his own decision, I couldn’t convince and my husband lied to cut the line to get a shot. I took a tremendous amount of heat because this stupid doctors were so ignorantly sure and my family blindly BLINDLY went with it. I also challenged retired doctors in the friend sphere as they were participating in the email chains with the older generations. It got ugly but I felt they needed to be more careful with their general statements “the vaccines are safe, move along”. Their “friends” were listening as tho they have the inside track being friends with a DOCTOR. Or how Rhee doctors felt they were the authority to make these ignorant statements! Maddening how the doctor was so stubborn. Maddening how my family treated me like I wore a tin foil hat. Maddening that friends treated me like I had kooties furthering the vaccine lies. Yes. I’m still not over it. But people, and their willingness to elevate an MD to godlike status, is a real problem too. Great piece. I continue to work to tear down the walls of modern medicine (figuratively) in hopes to achieve some honesty and most important, REAL HEALTH in our society. My kids now realize I’m not so crazy after all.
I agree with you analysis, and having been assigned to teach medical students applied maths, and computing a couple of times during my university lecturer days, I saw how spoon fed with rote learning they were, and at the same time were drilled with a superiority complex putting them above all non-medical students [with the exception being Law students, who they saw as on a par, maybe]. From my perspective of today, having learned about childhood trauma, I definitely see that certain career choices have become self-selecting of specific trauma survival styles, and medical is an arch example of this https://garysharpe.substack.com/p/connections-between-career-choices
ps I find your observation that it is difficult to distinguish talking to a doctor from a chat-bot interesting and telling... :-)
There were two people who provided decent medical info during the lockdown:
Seheult and Campbell.
Seheult had videos banned for reasonable discussions of Hydroxychloroquine and other as forbidden topics and he just shrugged it off. He buried his head in the sand.
Campbell followed the evidence as the facts emerged and realized he and all us were being lied to, and spoke up. Campbell has gone from being well respected to being demonized.
Sadly most of the industry and the world follows the ostrich path.
These doctors can stay at “ the peak of mount stupid” only because there is no shortage of equally stupid ( and trusting) patients.
One of my best supervisor/mentor/professors frequently made the statement that residency was not to teach us everything we needed to know, but to make us students for the rest of our lives. Not knowing what one doesn’t know, challenging one’s assumptions, and engaging in critical thinking is essential to be an effective physician.
It has saddened me over the years watching the practice of various fields of medicine be turned into checklist diagnosis & “consensus guidelines” treatment. Thinking is removed. Technology has certainly contributed to this, as docs rely more on sophisticated (and expensive!) tests & imaging technologies, and less on LISTENING TO THE PATIENT! The best teaching docs were like Sherlock Holmes: they would ask observe, ask questions, and listen. In teaching rounds they would discuss the nuances of their brief exam and most of the time correctly diagnose the patient BEFORE the confirmatory labs were performed.
As an aside, we had an entire course in biostatistics - I assumed everyone did! As an engineer I loved seeing medicine through the lens of mathematics, but never lost sight that I was dealing with an individual. Turns out I am an anomaly!
Imo we need to de stigmatize being wrong to advance our civilization. Or just to advance scientific understanding. Wrong is informative.
TV docs... deep down all they want is the spot light.
When I went to medical school here in the U.K. 35 years ago I was unusually allowed in with A levels in Maths, Further Maths, Physics and Chemistry but not Biology. I noticed that my fellow classmates were hopeless at maths and hated anything that vaguely resembled it ( which bizarrely was pharmacology). I would never be allowed in these days - but perhaps more non biologists should ( after all Biology is just vast quantities of learning which I hated which is why I didn’t do it!).
This reminds me of "medsplaining" , instead of mansplaining - how women are dismissed by certain MDs for women's issues (it's all in your head)
https://romanshapoval.substack.com/p/hysteria
Perhaps you've stumbled upon the true significance of medical school and college debt. How much more docile the serfs when saddled with the responsibility of student loans and the threat of financial ruin. Certainly impetus to 'tow the line' until you have dependents and then door is closed for another 30 years...
Another example Matthew of why I am a paying member! You’re worth every penny!😇👏👏👏🥰
Even when holding up a mirror, he will never see his true self. This is the curse of a true narcissist. I vividly remember my rotation in med school in psychiatry and discussing how you could not convince certain patients that they weren’t Napoleon or Jesus by logical arguments( a psychotic disorder).I truly believe narcissists are on that spectrum and gravitate to some occupations ( politics? ) more than others( head of NIH?).
He should Cram it!
Hmmm.. as a long time nurse... many doctors I worked with were all about believing what they’re told. They’re to blame for the oxy endemic... they’ll go with the majority on anything