IM Doc: Naked Capitalism – Intense and independent thinking in the age of Covid
Author: IM Doc, a physician who practices medicine in Tianqiao
Yves asked me to write something for Commitment Week, and I am honored to do so. Sites like this are so rare in our words, I think we should do our best to maintain them. So please contribute in Tip Jar!
For more than ten years, I have been following this website devoutly every day. I never comment because I am not an expert in any field except internal medicine, medical history and ethics, and classical history and language. CalPERS’s mischief and corporate malfeasance are not in my cab. But over the years, I have read Links and Water Coolers and comments religiously.
What a magical and rare website this is. A rational dialogue between rational actors, mutual respect and admiration. In terms of arguments, this is a basic courtesy. I heard Joe Rogan describe social media perfectly on the podcast the other day. I can prove that he hit it in the park-“Twitter and Facebook are just a mental hospital, and prisoners throw shit at each other all day.” That’s correct. I know that the workload of managing this kind of website and ensuring that it is still valuable is overwhelming, and I can’t give Yves, Lambert, and Jerri-Lynn and all others too much credit for their hard work.So don’t forget Help through Tip Jar.
You can only imagine that the past two years have been very difficult for myself and every medical worker in the United States. What really bothered me in the early days was the complete lack of rational words and truth-telling in our media. But I saw it all here—and found a place where I could read links and comments and be forced to think—usually in a way that didn’t happen at all in the medical world. As it happens, I am indeed a well-trained professional in the field, and soon I started to comment.
I am not a reporter. Nor is it an investigative reporter. I am a doctor, and in this nightmare, I do my best to do my best for my patients. I also try my best to be a truth-teller. This is how I grew up. And what I see in real life and what is reported in the news are often completely different. What worries me more is the media and its constant immersion in drama and panic porn. I can see this result in the patient’s psychology and feel the need to do something about it.
The basic figure in internal medicine is a doctor in the early 1920sday The century is named after Sir William Osler. One of his pioneering works is to celebrate what he believes is the most important characteristic of any doctor-AEQUANIMITAS-that is, equanimity. It can remain stable even in the most terrible situations. When their world fell apart, it became the rock of Gibraltar. Over the years, I have instilled this basic concept into the brains of hundreds of students all my life. All the conversations I saw on TV with the doctors in charge and our federal health officials were absolutely the opposite.
Sir William Osler. Founder of internal medicine. The person who single-handedly put the Johns Hopkins School of Medicine on the map. One of the basic heroes in my life. In the past 18 months, I have spent a lot of time in very dark days, reminiscing about his achievements, his works and the evaluation of him by his peers. One of the sharpest statements I found was written by Harvey Cushing MD, the founder of the neurosurgery profession in the country. Upon hearing the news of Sir William’s death, Harvey Cushing wrote the following, which was reproduced from the book of Isaiah-which later became part of Cushing’s masterpiece-Conceio Medici ( Consecatio Medici). I quote:
That person will be like a shelter from the wind, a shelter from the wind; like a stream in a dry land, like a rock shadow in a weary land.
This is what Dr. Cushing thinks of his mentor Sir William Osler. It also outlines my views on medical mentors and how I know how they will respond to this COVID crisis.Nobel Prize winner, textbook writer, pioneering medical figure of the 20th centuryday They used to be for a century-somehow, I knew in my heart that they would be very disappointed with our development in the field of medicine today.
A short story about the first day of my internship many years ago. My first attending doctor was an infectious disease doctor. The night before, my team had just admitted 19 patients. We were hit. The resident had to read the morning report-and the attending physician looked at me and said, “IM Doc will take us to see simple patients first.” So we set off. At that time, the intern who stayed up all night stood by the bed, with the caregiver on his left. Remarks are not allowed. The complete introduction comes from memory. The first patient is a middle-aged Vietnamese veteran with chest pain. I introduced the complete details to the patient. The Infectious Diseases department looked at me—”IM Doc, please tell me how to diagnose this patient’s melioidosis.” “Well, sir—I never considered this patient’s melioidosis. I’m not sure what it is. .” He looked at the patient and announced: “I sincerely apologize for the intern’s complete incompetence today. Trust me, we will solve this problem-he and I will be back later today.”
My first patient as an intern. I just want to go back to the farm. But the participation in this meeting did not give up. He taught me to be strong under pressure. To be confident, the most important thing is to tell the truth and admit what you do and don’t know. This is intense. This is a fierce trial and bullying by the Brotherhood. But his treatment and similar treatments throughout the year made me who I am today. He and I became good friends for the rest of his life. He is my mentor in every respect.
We will not let medical students bear this kind of intensity today. Not far. Anyone who does this will be immediately labeled a villain and kicked out of the city. But this is what it has done for generations-I am worried that something has been lost.
I am seeing the results of this incident every day. Just a generation ago, we were taught to be fierce and independent thinkers. To question everything. Realizing that the answer is a pursuit, and authority is often the wrong place to seek help. We take the scientific method and apply it to every patient’s decision. We are taught to be comprehensive and unrelenting in advocating for our patients and their best results. We are taught to always treat our patients with the most careful and ethical behavior.
Somehow, my career lost its way. We have given autonomy to companies and hedge funds. We completely decentralized the care received by patients. Usually no one is “responsible”. We are like sheep acquiescing to suggestions from our better people, no matter how stupid they are. Doctors come and go from practice, as if staying for more than two years is a deadly sin. Most of us are now employees, no matter how important they are, they are completely powerless.
Many people are now talking about moral harm among health care workers, and this couldn’t be more correct. I keep hearing, I mean, constantly, my colleagues across the country are condemning how the overall COVID situation is declining. But they watched the debt—whether it came from school loans or their million-dollar home—and couldn’t afford to question or cause waves. I am absolutely sure that my career is being liquidated and it hasn’t come fast enough.
However, I don’t think all this is stuck.Due to the website and source, such as Naked capitalism, I realized a long time ago that personal debt is a major sin in the American way. I realized a long time ago that our current neoliberalism and corporate culture are driven by motives that are completely opposite to ethical behavior in almost every aspect. I planned my life accordingly.
I am in a position where I can speak, even if I am anonymous, I feel that I have a moral obligation to do so. I feel it is absolutely necessary to speak for people in the medical world, just like the mentor I have left. I will always thank Yves and Lambert for allowing me to speak freely. Several times this year, what I reported to them was completely different from what the CDC said. Even I began to doubt my sanity. But they never wrote it down. They redouble their efforts to obtain accurate information. As a member of the COVID think tank, I can tell you-how many crazy they screen every day. They have my eternal respect.
Mrs. IM Doc cares about me recently. In the past 18 months, I have been a few years old. This whole incident caused huge personal losses to me and all of my colleagues. I now understand the mental and spiritual loss that can be caused by questioning authority orders. I saw this in attendees during the AIDS crisis-now it’s my turn. One of their important lessons-don’t deviate from the facts-when you are wrong, admit it immediately.
As is happening across the country, in my community, two primary care doctors have announced their early retirement in the past few weeks alone. Thousands of their patients must now be taken care of. It just doesn’t have enough capacity. I learned from conversations with other people that similar problems are happening everywhere. This problem has existed in my profession for many years. It took a crisis to push it to the forefront. I am very concerned about our near future.
One thing is certain-we will not hear from our media and its blind loyalty to large pharmaceutical companies, large hospitals and large insurance companies the true extent of the medical problems of our culture. It will need sites like Naked Capitalism to fill in the gaps-I urge everyone to support this site in any way possible. If you can give, give generously, Tip Jar tell you how.
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Speaking of reviewers, I am most grateful to all the reviewers who endured me and corrected me and told me when I was full of nonsense. The best commentator in the universe.