Saturday, February 17, 2018

Seth Abramson Twitter Thread


This series of images is self-explanatory...










Thursday, February 15, 2018

Post-Parkland Random Twitter Fragments

Michael Ian Black‏
@michaelianblack

Deeper even than the gun problem is this: boys are broken.
Until we fix men, we need to fix the gun problem.

The last 50 years redefined womanhood: women were taught they can be anything. No commensurate movement for men who are still generally locked into the same rigid, outdated model of masculinity and it’s killing us.

If you want to hurt a man, the first thing you do is attack his masculinity. Men don’t have the language to understand masculinity as anything other than some version of a caveman because no language exists.

The language of masculinity is hopelessly entwined with sexuality, and the language of sexuality in hopelessly entwined with power, agency, and self-worth.

So men (and boys before that) don’t have language for modes of expression that don’t readily conform to traditional standards. To step outside those norms is to take a risk most of us are afraid to take. As a result, a lot of guys spend their lives terrified.

We’re terrified of being viewed as something other than men. We know ourselves to be men, but don’t know how to be our whole selves. A lot of us (me included) either shut off or experience deep shame or rage. Or all three. Again: men are terrified.

Even talking about this topic invites ridicule because it’s so scary for most men (and women). Men are adrift and nobody is talking about it and nobody’s doing anything about it and it’s killing us.

Correct- can we get kids off their cell phones?? Lack of human interaction is causing kids to feel alone and left out. No one ever sits around laughing with their friends and says “i cant wait to come into school and harm you” Kids being isolated is a huge problem and guns.

I don't think you're entirely off base here, but Columbine was well before every kid had his nose buried in a phone all day. 24/7 connectivity is contributing to the feelings of isolation, but I don't think it's the source of them.

Springfield Oregon we barely had blackberries, the only messaging device. Video games were still pixelated Mario. This is deeper than the technical refuges young men run to now.

it was also speculated that violent video games lead to violence in everyday life but I believe its a far more complex issue and blaming gun violence on technology doesn't explain the gun violence that was happening prior to this era of technology.

Once again, NO OTHER COUNTRY IN THE WORLD HAS THIS KIND OF GUN VIOLENCE. We all have cellphones and iPads and screens. JUST NOT ALL THE GUNS.

I agree and to find out research about this concept I found a very informative article about Mass Shootings, with statistical data comparing the US to other industrialized countries Out of the 119 Mass Shootings from 1983 - 2013 66% were in the US

Thank you! I was looking for scientific based information.

Some of the date is from 2013 so some of it may need to be updated but its important also to check sources, this one does seem to written by a published valid source, I would not be surprised if the NRA will try to publish propaganda with in the next few weeks to regain support.

Correction, in Florida you can own an AR-15 at 18 and do not have to register it, crazy.

Crazy indeed ! How many more dead children do they need to add to the statistics b4 they come to the conclusion that the gun laws are insane OR perhaps it will become normal to send ur child to school in Kevlar vest and helmet - sorry I feel so angry

How long before we realize that more kids die each year due to drunk/impaired drivers and ban all personally owned vehicles and alcohol. Then we really enforce the drug laws in this country. Owning a fun is a right.....driving is a privilege.

How about we license each and every gun owner, register all guns, do background checks, and require insurance on each and every gun? You know, like we do cars? If you are caught drinking and carrying a gun, you lose your license and gun.

That’s def one of the cleverer things that could be done. At least a portion of shooting sprees could be, if not avoided entirely, at least made a bit less easy for would-be shooters.

Hey, bon courage, man! Quit binge drinking and smoking 17 years ago. Never looked back.

Mercury and aluminum.
Mercury and aluminum. 
Mercury and aluminum. 
Mercury and aluminum. 
Mercury and aluminum. 
Mercury and aluminum. 
Mercury and aluminum. 
If we think these kids are crazy it's because they are. We made them that way. Required it in fact. Mercury and aluminum.

Vaccines are used around the globe, and yet, this problem is uniquely American. Girls are required vaccines, yet this problem seems uniquely male. Your antivaxx paranoia is not the reason for the gun epidemic.

The amount of these elements in vaccines is less than that found in many things we regularly ingest. Vaccines are extremely helpful and not dangerous, but paranoia is.

Ingestion and injection are two completely different things. But it feels nice to feel smart by repeating pharma talking points right so give yourself a pat on the back.

Will do.

great endorsement of [xxx], Michael. If you can be open to the idea that masculinity is a good thing when properly taught and demonstrated instead of the idea that boys need to be feminized to be “fixed”, then I see a way forward

I did not advocate "feminizing" men. Instead, I advocate for men to be able to draw from the full breadth of human experience to inhabit their fully masculine selves, which may include some more traditionally feminine roles.

Here is the link from which these random thoughts were collected...

Tuesday, February 13, 2018

A Peek Behind the Curtain -- Financial Challenges of Being a Doctor

This note for future reference. 
The following post appeared at KevinMD.com

A physician volunteered for his hospital’s board. He was sued for millions.
PHYSICIAN ON FIRE, MD  FEBRUARY 13, 2018

The telephone rang. Why would he be calling? Must be a misdial, I figured. I hadn’t worked with him in several years, and we were never known to make social calls back when we did work together.

That call was no mistake. What he had to say made me simultaneously queasy, fearful, and angry. It felt like the first couple loops on a rollercoaster ride I didn’t sign up for. I had no idea at the time that I would be stuck on this coaster for years.

He had been sued. I had been sued. A few dozen other people whose names appeared in the hospital board minutes over the previous ten or so years had been sued. And we were being sued for tens of millions of dollars.

A few weeks later, I would receive the four-inch thick packet prepared by lawyers representing the trustee of the bankruptcy. A hospital that I had worked for had gone bankrupt two years earlier, and those who were owed money by the defunct hospital were looking to collect.

The hospital couldn’t possibly pay, so they went after the doctors and administrators who had served on the board. Each and every one of us was accused of breaching a fiduciary duty to keep the hospital afloat.

I volunteered for the hospital board


How did I end up in this position?

In 2007, I worked a long-term locum tenens job at a small community hospital close to my wife’s extended family. It was not exactly a thriving community, but there was a lot to like in this small town, and they were in need of a full-time anesthesiologist.

By the time my temporary stint was up, I had signed on to return as the chief of anesthesia and the only anesthesiologist in the county. In hindsight, I realize it was a naive thought, but I believed my rarity meant real job security.

I also believed the place was in great financial shape, just as I was told when I formally interviewed. It would only be a matter of time before they added a dialysis unit, they said, a great place for my wife to use her dietitian skills. A beautiful clinic had recently been added on to give the front of the hospital a modern all-glass look, and there was talk of adding an outpatient surgical center; I might even be given a chance to invest!

After a couple years and a virtual carousel of administrators, it became clear that my “permanent” job might not be. Facing increasing operating losses, the hospital had dropped obstetrics, debts were mounting, and I was one of the higher paid independent contractors in town.

The president-elect of our medical staff left for a more secure situation. I was asked to assume his role, which would be an appointed position in this situation.

Well, of course, I wanted to be next in line to be the president of the medical staff. I had plenty of experience volunteering on the quality committee and medical executive committee, and there’s no way they hospital would let the president-elect go no matter how dire the situation, right? More job security, I figured. I gladly signed on to a more prominent role.

My position included an observational, non-voting role on the hospital’s board of trustees. I was being groomed for the presidency, but I had to walk before I could run. With the fragile state of the hospital’s finances, the board was meeting more frequently and for longer periods of time.

I had a toddler and infant at home, and I was taking solo call every 3rd night and every 2nd or 3rd weekend with no post-call day off. I was burning the candle at both ends, but I knew it would all work out in the end. We had built our dream home, started a family, and were determined to see this through. We weren’t about to bail; we had made this town our new hometown.


The hospital let me go


The telephone rang. This was nearly three years prior to that other phone call, but it was a similar sock to the stomach. I was out of a job. Within a year, everyone else who worked there was out of a job, and the hospital was closed.

I would be paid for the next three months and expected to work the next two. I dutifully finished out those last eight weeks, attended my last two board meetings, and returned to the locums circuit.

We landed on our feet of course, and by the time I was notified of the lawsuit, we had moved twice and were getting settled into what I can now say is likely my final “permanent” anesthesia job.

I was sued for millions


I experienced some intense emotions in those initial weeks after I was notified of the lawsuit.

Anger. How could they do this to me? I didn’t even have a vote! I was never compensated with anything better than a sandwich. We wanted nothing more than to see the hospital to survive and to remain in place. How dare they!?!

Fear. Could I really lose millions? I don’t even have millions. What’s the next step? How soon ’til it’s over?

Regret. How did I fail to see the writing on the wall? Why did take a seat on the Board at the busiest time of my career while starting a family? Why did I give up so much of my time only to be paid back like this?

Hope. There’s no way I could actually be held liable. I was on the Board for under a year and never voted on a single thing. They’ll be reasonable and dismiss me when as soon as the extremely limited role I had on that board is better understood.

The neverending lawsuit


I made some phone calls and learned that a former board member with a similarly limited role had been dismissed. The president-elect who had served a longer term before I took over was not even named in the lawsuit. I contacted the lawyer who had helped a fellow board member in his successful quest for an early dismissal from the suit.

My new lawyer and I had a pleasant chat. Many of his family members were physicians, and this action by the trustee made him sick. He offered to write a letter on my behalf free of charge. Like me, he was hopeful that would be the end of it for me.

It wasn’t.

As a highly paid specialist, the trustee’s lawyer was not about to let me off the hook. Instead, he asked me to provide a detailed list of my assets. Twice. I declined both times.

Over the following months, there were conference calls among lawyers, frequent emails, and glimmers of hope always followed by a kick of the can down the road.

The lawsuit bounced back and forth between the bankruptcy court and federal district court. The trustee refused to accept that our directors and officers (D&O) insurance did not cover us in the event of a bankruptcy, which is what the bankruptcy court had ruled. Ultimately, I believe the trustee was most interested in an insurance settlement, but it was my name on the docket and my financial future at stake.

Months turned into years. My legal fees increased from three to four to five figures. Our stress level waxed and waned with each and every turn and loop-de-loop on the seemingly never-ending rollercoaster, but not a week went by that I wasn’t reminded that the ride had not yet come to a complete stop.

Redemption. At last.


In the fall of 2017, three and a half years after I was sued and more than six years since I had served on the board, I received glorious news. A judge had granted me dismissal without prejudice and barring an appeal; I would be free and clear of the lawsuit for good. My dismissal was not appealed.

I was ecstatic to step off that costly ride but saddened to hear that numerous friends remained on this nightmare of a ride for yet another pass. The lawsuit is still ongoing, and a number of my former colleagues are waiting for this unamusement park to close its doors.

Lessons learned after being sued for millions


As a physician who lived with the threat of losing my life’s savings for several years, spending enough on legal fees to buy a nice used RV, I have a better understanding of the phrase “no good deed goes unpunished.”

I used to be quick to say “yes” to medical staff appointments. I actually took on a similar title as chief of anesthesia & surgery with a spot on the medical executive committee in my next job. That was before the lawsuit. Now, I am quick to say “no.”

Asset protection is more important than I realized. If you have the letters “MD” behind your name, you have a target on your back. Know which assets of yours are protected and which can be confiscated, and do what you can to minimize the latter.

I’m not saying it’s imperative to create complex irrevocable trusts or shell companies to hide your assets, but simple steps like titling assets together with a spouse may be a good move. Asset protection varies by state, so be sure to consult someone with a working knowledge of your local laws.

Recognize that participation on the board of a non-profit can open you up to substantial liability. I may be paranoid, but when I was asked to serve on the board of our local curling club, I swiftly declined. What’s my liability when someone is overserved at the club’s bar, slips on the ice, and cracks a skull? Probably zero, but why take that chance?

If you do serve on a board, be sure you have adequate directors & officers insurance. I know very little about D&O policies, but I now know that insurance that doesn’t cover you in the event of the non-profit filing for bankruptcy is woefully inadequate. Bankruptcy is exactly the sort of event that could be most likely to result in a lawsuit against the Board.

Carry umbrella insurance. I don’t believe it would have helped protect me in this particular case, but the target on a wealthy individual’s back is ever-present, and umbrella insurance can protect from lawsuits related to your home or auto. When I had this lawsuit cloud over my head, my home and auto carrier wouldn’t consider covering me. After my dismissal, I was able to secure $3 million in coverage at a cost of under $200 a year. It’s a small price to pay for peace of mind.

This is a story I’ve been wanting to tell for some time, but I was unable to discuss it while still party to the lawsuit. It was a rotten experience that has left me rather jaded, and the ordeal is no doubt a contributing factor to my willingness to walk away from the medical profession at an age where I could continue practicing for another twenty years or more.

Additionally, the lawsuit has been the number one reason I haven’t wanted to publicly associate my name and face with Physician on FIRE. When the lawyer suing you for millions of dollars keeps asking for a list of your assets, having that list show up in a blog post with a simple Google search of your name is less than desirable. I’m not saying you’ll be seeing my smiling mug in the sidebar tomorrow, but now that this ridiculous lawsuit is behind me, I find I’m smiling a whole lot more.

“Physician on FIRE” is an anesthesiologist and can be reached at his self-titled site, Physician On FIRE, on Facebook, and on Twitter @physicianonfire.

To which I left the following comment:

For me, a layman, the most interesting part of this post was that link to "locum tenens job." I never heard of this before so I had to look it up. At a glance it seems like a good way to make additional income if your schedule and lifestyle allows, something like the gig economy -- signing with Uber/Lyft or listing your second home with Airbnb. But "locums work" (another descriptor new to me) isn't just multi-level marketing on the side. It's more like expert speaking or coaching in return for honorariums.

At that link (which mentioned "...following your IPS, and life is good. But you want a Tesla. Or to erase your school debts. Maybe build one of those amazing treehouses Pete Nelson tosses up on TV) I ran into yet another new link, IPS (Investor Policy Statement), apparently commonplace in investment circles. There, in turn, I came across an unexplained acronym, DAF, which I had to search.
["I plan to superfund the DAF in my final years before retirement.] DAF means Donor-Advised Funds. "Donor-advised funds (DAF) have grown in popularity in recent years. A DAF is a charitable giving vehicle that is sponsored by a public charity that allows an immediate tax deduction in the year the money is contributed to the DAF, even though the funds may not be paid out to the charity until a future date."

Having spent my working life as a lowly cafeteria manager, I thought I had a pretty good working business vocabulary. I knew about balance sheets, P&L statements, the difference between operational profits and reportable profits, EBITDA, Chapters 11 and 13 bankruptcy paths, depreciation, capitalization, amortization, journal entry bookkeeping, accounts receivable, etc. I was also informed about elegant techniques of boosting compensation such as stock options (exercised to optimize returns but timed just right for tax purposes) and risks and rewards of converting a company from private to public ownership, tweaking the asking price of the IPO, etc. [That movie "The Post" is excellent, btw.] Then there's a way to fund future liabilities, such as golden parachutes or other perks by purchasing life insurance policies for employees, unbeknownst to them, listing the beneficiary as ("insert name here") when they die, which they all will -- eventually. I could go on, but the limits of my background are not the point.

This sojourn into the private lives of doctors is enlightening for sure. I gather from the secondary links that these considerations apply for many high-income individuals, but are not generally discussed in everyday company. After drilling into these links my sympathy when I first scanned this post lifted. I leave this comment with good wishes and hope for the best. Your post serves as a caveat not only to doctors, but to all who "volunteer" for any position involving "compensation." The contradiction between those terms is clear to me, but what do I know?

Saturday, February 10, 2018

Refreshing Twitter Message

The images on this tweet are too small to read but too delightful to skip.
I am enshrining them here for future reference.
Hannah Thornton‏ @hannah_shef@hannah_shefThis time last week I got the train to my Grandma's and shared part of my journey with 2 lovely men. They'd never met before but instantly hit it off and laughed like they'd been best friends for years. I scribbled a note to them as I got off the train...and I got a reply!!



So Hannah got to meet these two new friends for the first time.

Tuesday, January 23, 2018

Noah Smith on Immigration


1/Immigration is the big issue in 2018. I've been writing about it for a while. 
So here's a thread of articles, facts, and graphs that you can use in the immigration debate.

2/First: Why immigration at all? Why do we need to bring newcomers into our country? Economic reasons: 1. They pay for the retirements of the native-born. 2. They are highly entrepreneurial. 3. They help keep America the center of the world economy.

3/Immigrants also help save declining towns, counties, and states. Immigration is the best hope for the Midwest and Northeast.

4/Finally, Americans just LIKE immigrants. The "nation of immigrants" thing isn't just elite propaganda. It's reflected in all the polls. https://www.bloomberg.com/view/articles/2017-12-18/anti-immigration-fervor-is-different-this-time …

5/Now, let's address the arguments AGAINST immigration.

6/The first argument against immigration is economic. "Immigrants take jobs away from the native-born!" "Immigrants lower native-born wages!" Are these true? Probably not.

7/You may have heard that George Borjas of Harvard says immigration hurts native workers. He does. But he's in the distinct minority. And the research methods he uses are often suspect. The vast weight of evidence is against Borjas.

8/The second argument against immigration is legal. "We just want to enforce the law! We like LEGAL immigration, just not ILLEGAL!" Well, guess what: The number of illegal immigrants living in America has actually FALLEN, not risen, over the last decade.

9/Furthermore, Americans favor a path to citizenship over deportation. Enforcing the law is good, but most Americans agree it's not worth turning our society into a police state just to kick out people who live here.

10/The third argument against immigration is fiscal. "Immigrants are a drain on government resources!" As it turns out, all but the least educated immigrants are a net POSITIVE for government budgets. https://www.bloomberg.com/view/articles/2017-09-22/immigrants-are-a-fiscal-boon-not-a-burden …

11/The fourth argument against immigration is cultural. "Immigrants don't assimilate!" Well, yes they do.

12/Today's immigrants learn English just as fast (or faster than) previous waves. https://www.washingtonpost.com/news/wonk/wp/2013/01/28/hispanic-immigrants-are-assimilating-just-as-quickly-as-earlier-groups/ … What's more, today's immigrants intermarry at very high rates - a sure sign that they're integrating into America.

13/What's more, immigrants' political attitudes are similar to Americans' attitudes. https://object.cato.org/sites/cato.org/files/pubs/pdf/edb_27.pdf … Immigrants are not importing foreign values that are going to displace traditional American values.

14/The fifth argument against immigration is racist. "Immigrants come from shithole countries, so they'll make America a shithole too!" Guess what: Immigrants from poor countries in Africa and elsewhere do really well in America.

15/There are also some arguments I haven't written about. For example, the idea that immigrants bring crime into the U.S. (False! It's the opposite: https://www.nytimes.com/2017/01/26/us/trump-illegal-immigrants-crime.html …)

16/To sum up: There are many good reasons to keep letting immigrants into the U.S., and to let in even more than we currently do. There are few good reasons to tighten restrictions. Happy debating!