Not having terrible takes about China gets sooooo much easier when you drill it into your head that China and the US are two capitalist authoritative systems that are competing for global market domination by any means.
Like, that’s all there is to it. The US will say shit about China that’s inaccurate and fearmongering, but when we address that misinformation we should acknowledge that China is not some underdog we should be rooting for, it’s a massive state that’s genuinely terrible in other, accurate ways because it is a capitalist authoritative system.
There are differences, of course. Like the US tries to uphold a vague pretense of democracy and human rights and is a little more restrained about putting minorities in concentration camps (but still doing some of it), while China has been less aggressive about starting wars in other countries and drone bombing countries it claims not to be at war with. But it would be ridiculous to look at that and decide that one of these is a Good Guy. They are states. They are not on our side. Not ever.
China and the US are two capitalist authoritative systems that are competing for global market domination. When the chips come down, both of them would probably work together if they thought it was necessary to keep oppressing the working class, because in terms of class interests they are on the same side. Not our side.
Image transcript of tweet chain on the 16th of September 2020 from Sayed Tabatabai, MD @TheRealDoctorT [Begin transcript: “Why do you want to be a doctor?” I answer without hesitation, “I want to help people.” “There are many ways to help people.” “I want to save lives.” “There are many ways to do that too. So I’ll ask you again, why do you want to be a doctor?” “Because I believe in it” 1 of
I think about that exchange now and then, some times more than others. Why do we do the things we do? What do we really believe in? My next clinic patient is one I’ve known for many years. He is visiting me today via Zoom. I always look forward to talking to him. 2 of
As soon as the visit begins, I notice that his camera is angled off-center so I can’t get a clear look at his face. I ask if he can adjust it, but he says he’s having technical issues. No problem. I can adapt. It isn’t just the camera though. Something feels off today. 3 of
Almost immediately I can tell that he sounds subdued. He isn’t cracking his usual jokes. I’m comfortable with silence, even in the heart of a busy clinic day. Silence is often where the healing happens. After asking how he’s doing, I let the silence between us grow. 4 of
The question, when he asks it, is one I don’t expect. “Doc, which kills you faster? Blood pressure you don’t control, or blood sugar you don’t control?” The surprise on my face must register, because he explains further. “I just can’t afford all these medications anymore.” 5 of
He continues. “The way I see it, doc, I only need to stick around 4 or 5 more years. That’s how long my pet dog has left, then I ain’t got no more family and it’s me all on my own. So I figure maybe take the diabetes ones and skip the blood pressure? Or every other day?” 6 of
As I review his meds and start discussing our options with him, he adds one last remark. “And I’m real sorry doc. I know we go back a ways, but I can’t afford my co-pay. I’ll pay you later. Promise.” And just like that, I understand why his camera is angled. 7 of
And just like that, I’m again struck by the cruel illusion of what I do. The system I’m part of. This patient did everything right; got insurance, paid his taxes. And he still has to barter years of his life. And he can’t bring himself to look me in the eyes as he does so. 8 of
Our healthcare system is too often unethical, immoral, unsustainable. The insurance paradigm is focused on revenue generation. It strips the basic human dignity from patients, to the point where they can’t even make eye contact anymore. I know that I’m part of this system. 9 of
He’s old enough to be my father. Some part of me imagines that he is my father. Tears threaten my vision, as a hot anger floods me. Now I wish I could angle my camera away. I ask him if I can write about him. Because people need to know. His response lingers with me. 10 of
“Sure you can doc. But people already know. Lots of people deal with this. It ain’t that people don’t know. It’s just that nobody cares. Nobody gives enough of a damn to change anything. Nobody… cares.” The visit ends. My Zoom window closes. His window closes too. 11 of
I feel it. There’s something insidious here. A casual cruelty we’re all complicit in. “I can’t go to rehab, insurance won’t cover it.” “Insurance won’t pay for that medication.” “I can’t afford any of this.” “I’m uninsured.” This isn’t right. None of this is right. 12 of
Twenty years ago, I gave a medical school interview. I wore my best suit. I sat up straight. I said I believed in medicine. I meant it. Some part of me once burned brightly, but that fire is down to flickering embers. Our lives mean more than this. More than this.
“It started with a joke about pansexuals. Something about defending your kitchen from pansexuals. Then one of my classmates accused me of belittling them. Which turned into a bigger conversation about homophobia and racism. People began sharing their own experiences with discrimination, and honestly, a lot of it seemed overblown. It’s like: C’mon. You live on the wealthy side of town. What you’re describing sounds like an everyday disagreement between two humans, but you’re bumping it up to discrimination. That’s when people started accusing me of discrimination. I pointed out that I was Jewish. But they said my trauma was generational and not first-hand, so it didn’t count. All of it just seemed like some sort of competition. A twisted game where the more discrimination you could claim, the more social points you won. It ended up with everyone ganging up on me and calling me racist. And that started me on a journey of watching alt-right videos. It just felt good to hear people say: ‘It’s not you, it’s them. Those blue haired people, with their thirteen pronouns, they act like they’re morally superior. But it’s all about power. They want to shame you into silence.’ The videos always used the word ‘they.’ ‘They’ are ruining this country. ‘They’ want to take away your rights. No matter how many types of people were being described, it was always ‘they.’ It made it easy for me to dismiss discrimination whenever it was claimed, by anyone. I’d think: ‘There they go again.’ I’m out of that phase now. If anything I’m politically active on the other side. I’m thankful it happened to me when I was fourteen, and still growing. Because if I’d been older, working some dead-end job, not meeting people, it would have been harder. Because one thing that really helped me was one-on-one conversations. My more moderate classmates started talking to me again. A few of them even apologized for how it all went down. They didn’t speak as a member of a group. It was just: ‘This is who I am. This is how I experienced discrimination.’ It wasn’t hostile. I didn’t feel ganged up on. And I was able to hear them. I’ve learned that for a lot of people, it’s not a game. It’s their lives.”
Never gonna know them, but shoutout to the healthcare workers who are breaking the law to help their patients get life-saving care. I’ll never see an article about you because knowing you would risk everything including jail time. Nurses who lie on medical records so their patients can get abortions. Doctors making up shit so their patients can have HRT.
Wherever you are, you are keeping your promise to help your patient.
not to oversimplify an extremely complex discipline but if i had to pick one tip to give people on how to have more productive interactions with children, especially in an instructive sense, its that teaching a kid well is a lot more like improv than it is like error correction and you should always work on minimizing the amount of ‘no, wrong’ and maximizing the amount of ‘yes, and?’
for example: we have a species of fish at the aquarium that looks a lot like a tiny pufferfish. children are constantly either asking us if that’s what they are, or confidently telling us that’s what they are. if you rush to correct them, you risk completely severing their interest in the situation, because 1. kids don’t like to engage with adults who make them feel bad and 2. they were excited because pufferfish are interesting, and you have not given them any reason to be invested in non-pufferfish. Instead, if you say something like “It looks a LOT like a tiny pufferfish, you’re right. But these guys are even funnier. Wanna know what they’re called?” you have primed them perfectly for the delightful truth of the Pacific Spiny Lumpsucker
I was in martial arts for years, and in particular I kinda specialized in working with the younger kids.
The two Big Rules when instructing younger students was- 1. Compliment before Critique 2. Don’t say ‘but’, say ‘now’
Praise kids on what they get right first, especially if they are struggling. Like OP said, kids don’t like to engage with people who make them feel bad. They need encouragement when learning new things.
Number two boils down to this. If you tell a kid a compliment, then say “but you need to fix this”, that ‘but’ completely negates your compliment. It’s gone. It was canceled out like adding a negative to a positive. Using “hey, that punch is looking great, now let’s focus on your stance” doesn’t verbally cancel out the progress they’ve made. It’s like they’ve checked off something on their list of stuff to work on.
Wording can absolutely make or break a child’s motivation and interest.
Rebloggling as it’s relevant in a Medical Education context
Honestly I use all of these to teach vet students too. I think people in general respond better to positivity in teaching. Not coddling, but acknowledging when a student got part way to the right answer, or had a good thought process, is something I’ve found keeps students engaged and builds confidence, which encourages them to keep going instead of shutting down and just “getting through” a lab or a rotation
