# Something might have happened



## SuperMatt

Black Doctor Dies of Covid-19 After Complaining of Racist Treatment (Published 2020)
					

“He made me feel like a drug addict,” Dr. Susan Moore said, accusing a white doctor of downplaying her complaints of pain and suggesting she should be discharged.




					www.nytimes.com


----------



## Gutwrench

SuperMatt said:


> BTW, she was a doctor herself and yet those caring for her didn’t listen to her, obviously because of her skin color. [/URL]




Why is it obvious?


----------



## Mark

SuperMatt said:


> Racist doctors refuse to treat a black woman properly, leading to her death from COVID-19. BTW, she was a doctor herself and yet those caring for her didn’t listen to her, obviously because of her skin color. It’s not kneeling on a man’s neck, but it is a death directly attributable to racism nonetheless. And Trump made it MORE acceptable to be racist, not less.
> 
> 
> 
> 
> 
> 
> 
> 
> 
> Black Doctor Dies of Covid-19 After Complaining of Racist Treatment (Published 2020)
> 
> 
> “He made me feel like a drug addict,” Dr. Susan Moore said, accusing a white doctor of downplaying her complaints of pain and suggesting she should be discharged.
> 
> 
> 
> 
> www.nytimes.com




@SuperMatt thanks for the article.
it was a devastingly heartbreaking article to read.

systemic racism, and, in a lot of instances,* gender bias and socio-economic class prejudice*, within the health care delivery system.

quote
Dr. Moore tested positive for the coronavirus on Nov. 29 and was admitted to the hospital, according to her Facebook post, which she wrote on Dec. 4.
She wrote that she had to *beg the physician treating her to give her remdesivir, *an antiviral drug some doctors use to treat Covid-19.
Dr. Moore said she received a scan of her neck and lungs *after her doctor denied she was short of breath*, despite her telling him she was, and after he told her he could not justify giving her more narcotic painkillers. The scan detected problems — pulmonary infiltrates and new lymphadenopathy, she said — and so she began receiving more opioid pain medication. *But she said she was left in pain for hours before a nurse gave her the dose.*
“*This is how Black people get killed, when you send them home *and they don’t know how to fight for themselves,” Dr. Moore said.
Dr. Moore’s experience highlighted what many Black professionals said they regularly encountered. Education cannot protect them from mistreatment, they say, whether in a hospital or other settings.
Born in Jamaica, Dr. Moore grew up in Michigan. She studied engineering at Kettering University in Flint, Mich., according to her family, and earned her medical degree from the University of Michigan Medical School.
endquote

thanks for the article.
*we do our part to remember her here.*


----------



## Gutwrench

The Dunning Kruger Effect in action.


----------



## Gutwrench

SuperMatt said:


> Maybe if the article was a one-liner, you would have read it.




Maybe if you weren’t the focus you’d understand it.


----------



## User.45

Gutwrench said:


> The Dunning Kruger Effect in action.



Your laziness if painful to watch.


----------



## Renzatic

Yeah, I'm failing to see how Dunning Kruger applies to this thread, since no one here is claiming expertise on anything.


----------



## User.45

SuperMatt said:


> Racist doctors refuse to treat a black woman properly, leading to her death from COVID-19. BTW, she was a doctor herself and yet those caring for her didn’t listen to her, obviously because of her skin color. It’s not kneeling on a man’s neck, but it is a death directly attributable to racism nonetheless. And Trump made it MORE acceptable to be racist, not less.
> 
> 
> 
> 
> 
> 
> 
> 
> 
> Black Doctor Dies of Covid-19 After Complaining of Racist Treatment (Published 2020)
> 
> 
> “He made me feel like a drug addict,” Dr. Susan Moore said, accusing a white doctor of downplaying her complaints of pain and suggesting she should be discharged.
> 
> 
> 
> 
> www.nytimes.com



It's a tough one that is hard to interpret without access to the records.
Disparities in healthcare are a very well known issue. I think most of us do our best to fight it. First thing is to acknowledge its existence. Then to recognize it in real life, then to reassess what and how to do differently. What opens a can of worms here is that Blacks getting subpar treatment is usually considered a manifestation of socioeconomic status/power conflated with race. She was a family doc, so she's an outlier in this equation and that disturbs a lot of us a lot more than just the "usual Blacks get subpar care" problem.

Dr Moore's case isn't necessarily trivial, but there are parts that seem to be. Remdesivir overall doesn't seem to be very effective so there i feel like an argument whether to give nearly ineffective treatment or not. Some of the things she states, like a CT angiogram are kinda routine and let's say for someone who is hypoxic and tachycardic is a legitimate test to run to rule out pulmonary embolism that requires anticoagulation (and is a definite thing to consider in a hypercoagulable state such as COVID). So the question is whether she didn't mesh well with the treating team and she would have gotten all these or not.

Pain management is also an issue. There was a school of thought according which "pain was the 5th vital sign". In reality it's a very complex issue because you give stronger and stronger pain medications, sometimes unnecessarily and you DO hook people on narcotics (see opioid epidemic). Vitals.com provider ratings are largely a reflection as to which doctors refuse narcotics (if unnecessary). Now to complicate this, one of the side effect of opioids is inhibition of the respiratory circuit in the brainstem, so you can tank patients on narcotics who have compromised breathing, but you can also potentially help them if they are so short of breath that their work of breathing is exhausting their breathing muscles.... Not easy at all. However, good communication usually mitigates this.

Now what's more straightforward here is that AFAIR she died within 2 days of her discharge. In peacetimes what some colloquially call a "bounceback" is readmission within a few days (I think it's 1 week officially) and is penalized by medicare as it suggests an "unsafe" or premature discharge. We are talking about 2020 though, so the adequacy of this discharge really depends on the hospital's load and again only straight forwardly inappropriate on an individual level, but to judge it on a hospital level, we need to know how their bed situation and how their ER looks.

My impression here is they souped her up, had good numbers for a day, discharged her the moment they could. And again it's COVID. Things can take unpredictable turns.


----------



## User.45

SuperMatt said:


> Assume I’m an idiot. Explain to me what I’m missing. Spell it out in painstaking detail so a tiny mind like mine can comprehend it.



I don't think @Gutwrench is able to go beyond the "it's easy to be a couch expert, so stop criticizing others" comment. So if we bring Dunning-Kruger into this thing, as a card carrying expert I say it is meaningful to discuss the complexities and issues in the system.


----------



## User.45

Renzatic said:


> Yeah, I'm failing to see how Dunning Kruger applies to this thread, since no one here is claiming expertise on anything.



I am...to an extent.



SuperMatt said:


> Assume I’m an idiot. Explain to me what I’m missing. Spell it out in painstaking detail so a tiny mind like mine can comprehend it.



I don't think @Gutwrench is able to go beyond the "it's easy to be a couch expert, so stop criticizing others" comment. So if we bring Dunning-Kruger into this thing, as a card carrying expert I say it is meaningful to discuss the complexities and issues in the system.


----------



## Scepticalscribe

Is race (or ethnicity) the only issue - or the only possible explanation - here?

Or, could it be a case of a conflation of both race and gender?

Over the years, I've read a number of articles which have argued that the pain experienced by women visiting their doctors, or presenting to hospital seeking admission, was sometimes dismissed, disregarded (as though they were not sentient - or serious - or remotely credible human beings capable of describing or expressing what they felt, or, as though they were not deemed "valid" witnesses advocating in their own cause) and appropriate treatment - or diagnosis - or pain management was offered belatedly or not at all.


----------



## JayMysteri0

Scepticalscribe said:


> Is race (or ethnicity) the only issue - or the only possible explanation - here?
> 
> Or, could it be a case of a conflation of both race and gender?
> 
> Over the years, I've read a number of articles which have argued that the pain experienced by women presenting to hospital admissions was sometimes dismissed, disregarded (as though they were not sentient - or serious - or remotely credible human beings capable of describing or expressing what they felt, or, as though they were not deemed "valid" witnesses advocating in their own cause) and appropriate treatment - or diagnosis - or pain management offered belatedly or not at all.



I thought that it ties into two other things.  The myth about Black people & pain & the greater number of Black women dying during childbirth/pregnancy compared to others.


----------



## Gutwrench

Gutwrench said:


> Why is it obvious?





PearsonX said:


> Your laziness if painful to watch.




Still waiting.


----------



## Gutwrench

Renzatic said:


> Yeah, I'm failing to see how Dunning Kruger applies to this thread, since no one here is claiming expertise on anything.




Dunning Kruger encompasses ignorance not merely expertise.

People’s ignorance is invisible to them.
Erroneous beliefs, insufficient background knowledge, confirmation bias feeds their continued ignorance. And they’re lack of awareness is the point. 

The conclusion in the op is an example.
There is no support to the claim it’s ”obviously because of her skin color.”

An article is a single perspective from the plaintiff. Yet the incompetent thinkers are accepting and making further claims based on it. It demonstrates how the enlightened are deficient in critical thinking.


----------



## SuperMatt

Health Equity
					

What CDC is doing to promote fair access to health.




					www.cdc.gov
				












						Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care - PubMed
					

Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the...




					pubmed.ncbi.nlm.nih.gov


----------



## Renzatic

Gutwrench said:


> The conclusion in the op is an example.
> There is no support to the claim it’s ”obviously because of her skin color.”




In general, I try to avoid most conversations about race and racism on the internet, since they tend to boil down to arguments between people who will go out of their way to point out the racism allegedly inherent in every seemingly innocent thing, vs. people who will refuse to acknowledge racism even when it's slapping them in the face with a klan hood. It's a topic worthy of discussion, but any attempt at such online rarely ever amount to anything more than static and noise.

As far as this story goes, I have no reason to believe that this woman is playing the race card for sympathy or attention. Now it's possible she could be misattributing the actions of someone who's merely rude and dismissive as being racist, but given that she's a doctor herself, well aware of the usual standards and procedures she was denied, and there are documented issues of black people being treated unfairly by medical professionals, I see no reason to dismiss her story outright.

I take everything with a grain of salt, but won't doubt something for the simple sake of doubt.


----------



## User.45

Gutwrench said:


> Still waiting.



You can find my detailed assessment above. I'm still waiting for a meaningful contribution from you.



Gutwrench said:


> Dunning Kruger encompasses ignorance not merely expertise.
> 
> People’s ignorance is invisible to them.
> Erroneous beliefs, insufficient background knowledge, confirmation bias feeds their continued ignorance. And they’re lack of awareness is the point.
> 
> The conclusion in the op is an example.
> There is no support to the claim it’s ”obviously because of her skin color.”
> 
> An article is a single perspective from the plaintiff. Yet the incompetent thinkers are accepting and making further claims based on it. It demonstrates how the enlightened are deficient in critical thinking.



...and no, it's not obvious. The systemic issue however is. Also, I, as someone who spent 3+ years doing purely inpatient medicine can be considered an expert according to that Dunning Kruger curve. It's also ironic that you assume most of us are unfamiliar with their work...I've read the paper and some of its iterations too. I can tell you that you've contributed NOTHING to our conversation by bringing it in. You are just building on my impression about you that your words are hollow and you are either lazy to back them up, or you just unable to do so. Neither of these reflect on your critical thinking skills to support your positioning yourself to criticize others'.

Don't worry, I expect nothing more substantial in response than what https://perchance.org/cliche generates.


----------



## Gutwrench

SuperMatt said:


> A legend in your own mind.



No answer is noted.


----------



## Gutwrench

PearsonX said:


> ..and no, it's not obvious.




Precisely.

More-so it’s merely a one sided claim.


----------



## Gutwrench

Renzatic said:


> As far as this story goes, I have no reason to believe that this woman is playing the race card for sympathy or attention.




I have no judgement on the merits of her claim. I asked the op what was so obvious.


----------



## Gutwrench

SuperMatt said:


> To summarize this in a one-liner:
> 
> OP is ignorant, and everybody who replied to this thread except @Gutwrench is an incompetent thinker.
> 
> Got that about right? Why waste your time talking to a bunch of idiots? Surely you can find people with IQs of 200 like yourself instead of the proletariat here.



Still waiting.


----------



## Renzatic

Gutwrench said:


> I have no judgement on the merits of her claim. I asked the op what was so obvious.




Yeah, you seem to be more hung up on the absolute tone Supermatt took rather than anything that's been said in the article. I'm just addressing the thread in general here, both you and everyone else.


----------



## Gutwrench

Renzatic said:


> Yeah, you seem to be more hung up on the absolute tone Supermatt took rather than anything that's been said in the article. I'm just addressing the thread in general here, both you and everyone else.




Its not tone, it’s what he said and basis he had to say it.

It’s a one sided perspective of her treatment which if true is tragic. @SuperMatt is convinced something happened that was “obviously” due to the color of her skin. I asked what that was. The reason he can’t answer is my point.

Nothing pains people more than having to think.


----------



## Scepticalscribe

Donning mod hat here:

@SuperMatt & @PearsonX: How about discussing the topic - addressing the thread in general terms to quote @Renzatic - and foregoing personal insult? 

There is a strong case to be made for why health (plus societal, economic, legal, political and other) outcomes can be - and, often are - an awful lot worse for people from some groups (as determined by ethnic, and/or gender, and/or social class status, or membership) than for others.   Please make that case, rather than insulting those who question blanket statements.


----------



## User.45

Gutwrench said:


> Precisely.
> 
> More-so it’s merely a one sided claim.



Patient unhappy with care? No news.
Doctor being a difficult patient? Story of my life.
Patient dying within 2 days of discharge? Giant fucking red flag with hospital risk management all over the case.

There's a chance she would have died even if she remained hospitalized, but again cardiopulmonary failure septic shock is best treated inside a hospital, not en route to one and there's a reason readmissions are tracked and penalized (you can learn about it here: https://www.cms.gov/Medicare/Medica...teInpatientPPS/Readmissions-Reduction-Program).

In this case the patient didn't only raise her concerns publicly, but to also managed to prove her point...by dying. 
I don't agree with calling this flat out racism, or even with publicly shaming the treating physician (see my opinion about ratings on vitals.com), but it is a case that shines a light on a systemic issue, and deserves an investigation. I can guarantee you that the hospital is running a root-cause analysis the very moment if not finished it already.

Now please, make an attempt to either engage in meaningful discussion, or just leave this thread.


----------



## thekev

Scepticalscribe said:


> Is race (or ethnicity) the only issue - or the only possible explanation - here?
> 
> Or, could it be a case of a conflation of both race and gender?
> 
> Over the years, I've read a number of articles which have argued that the pain experienced by women visiting their doctors, or presenting to hospital seeking admission, was sometimes dismissed, disregarded (as though they were not sentient - or serious - or remotely credible human beings capable of describing or expressing what they felt, or, as though they were not deemed "valid" witnesses advocating in their own cause) and appropriate treatment - or diagnosis - or pain management was offered belatedly or not at all.




It can also be neither. It could just be bad care. This tells you one person's experience. It doesn't tell you the experience of other women, other Black people, or other doctors admitted as patients. I imagine it may not that difficult to mistake incompetence for racism.


----------



## Scepticalscribe

thekev said:


> It can also be neither. It could just be bad care. This tells you one person's experience. It doesn't tell you the experience of other women, other Black people, or other doctors admitted as patients. I imagine it may not that difficult to mistake incompetence for racism.




Agreed.

It could.

In an individual case, yes, agreed, as it may be argued that it could indeed come down individual (poor, or bad, or incompetent, or indifferent) care (on the part of an individual doctor, or care team and an individual patient).

However, if a pattern of incompetence, indifference or negligence or lesser care is seen to occur over a period of time, where the incompetence (or indifference, or lesser care) of the care tendered is more marked, and more pronounced, and more obvious (when measured re outcomes, for example) when caring for certain groups (in the context of this particular discussion, I would argue that ethnicity, - given that this has occurred is the US - and perhaps gender may both be of some considerable relevance), then the issue is no longer lamentable lack of care of an individual patient but a story of systemic discrimination, of difference of care dependig on one's race (and/or gender).


----------



## Scepticalscribe

SuperMatt said:


> It is possible to discuss a topic without the following:




It is also possible to discuss the topic without the following:



SuperMatt said:


> Maybe if the article was a one-liner, you would have read it.






PearsonX said:


> Your laziness if painful to watch.






SuperMatt said:


> A legend in your own mind.






SuperMatt said:


> To summarize this in a one-liner:
> 
> OP is ignorant, and everybody who replied to this thread except @Gutwrench is an incompetent thinker.
> 
> Got that about right? Why waste your time talking to a bunch of idiots? Surely you can find people with IQs of 200 like yourself instead of the proletariat here.




Robust debate is one thing, - and to be encouraged - but let's, pease, keep it civil. 

That means debate the topic, not the person, please.



SuperMatt said:


> I find it quite obvious that this woman was treated differently because of the color of her skin. I based this on my reading of the article. Somebody else might not see that; fine. No need to insult my intelligence, and that of everybody who disagrees with you.




From a debating - rhetorical - perspective, it is far easier to make a case for something when words such as "obvious" are avoided, unless you have incontrovertible proof to support that statement.

"There is a strong case that", "It seems very likely that..." "you can argue that.." that this women was treated differently because......are forms of words that I would have used - as a writer, or debater, or poster - in such a context.


----------



## User.45

Scepticalscribe said:


> Donning mod hat here:
> 
> @SuperMatt & @PearsonX: How about discussing the topic - addressing the thread in general terms to quote @Renzatic - and foregoing personal insult?



I think I've contributed enough to this topic to expect certain critics to hit the bare minimum standard of a discussion. So yes, I will call someone out if the person expects a certain quality of posts that he himself isn't invested in producing.




Scepticalscribe said:


> Is race (or ethnicity) the only issue - or the only possible explanation - here?
> 
> Or, could it be a case of a conflation of both race and gender?
> 
> Over the years, I've read a number of articles which have argued that the pain experienced by women visiting their doctors, or presenting to hospital seeking admission, was sometimes dismissed, disregarded (as though they were not sentient - or serious - or remotely credible human beings capable of describing or expressing what they felt, or, as though they were not deemed "valid" witnesses advocating in their own cause) and appropriate treatment - or diagnosis - or pain management was offered belatedly or not at all.



It's more complex of an issue than that because 70% of people with chronic pain are females. Chronic pain causes depression and depression causes altered pain perception and lowered pain threshold. It is difficult to actually help patients and put them on a track to treat their souls (depression) and not their pain solely. Pain and pain medications are also mainly studied in male test animals, etc, so we again have to be honest and humble about our knowledge deficits. I started my career in a small rust belt hospital and I can tell you that pumping people full of the pain meds of their request will make things worse, not better. But Dr. Moore's case isn't about pain per se (who knows). It's about her claim of having to request a CT to prove mediastinal lymphadenopathy (potentially painful swelling of the lymph nodes in the chest), to justify getting stronger pain meds. That's her grievance.

What is objectively bad is going into (what is described as septic) shock within 12 hours of discharge. That looks really bad. So even at the best case scenario this was a coincidence of a set of unfortunate events and miscommunication...


----------



## Gutwrench

PearsonX said:


> Now please, make an attempt to either engage in meaningful discussion, or just leave this thread.



I am of the thought asking why a mere claim makes anything obvious is most meaningful.

Perhaps you’re unfamiliar with the teachings about being tough or soft minded.  If so, let me know.

Tough mindedness is to judge critically and objectively; to discern truth from falseness.

The tough minded examines facts before reaching conclusions in short they postjudge.

The soft minded reaches conclusions before examining the facts. In short they prejudge.

“Soft mindedness is one of the basic causes of racial prejudice.”

I further agree in the belief that the state of the world -whether it’s the 1960’s or the 2020’s- does not allow us the luxury of soft mindedness.



SuperMatt said:


> It is possible to discuss a topic without the following:
> 
> 
> 
> 
> 
> 
> 
> 
> 
> I find it quite obvious that this woman was treated differently because of the color of her skin.




See above.


----------



## User.45

Gutwrench said:


> I am of the thought asking why a mere claim makes anything obvious is most meaningful.
> 
> Perhaps you’re unfamiliar with the teachings about being tough or soft minded.  If so, let me know.
> 
> Tough mindedness is to judge critically and objectively; to discern truth from falseness.
> 
> The tough minded examines facts before reaching conclusions in short they postjudge.
> 
> The soft minded reaches conclusions before examining the facts. In short they prejudge.
> 
> Soft mindedness is one of the basic causes of racial prejudice.
> 
> I further agree in the belief that the state of the world -whether it’s the 1960’s or the 2020’s- does not allow us the luxury of soft mindedness.
> 
> 
> 
> See above.



And did you think about that maybe it takes some "soft skills" to express your "tough-minded" attitude without  miscommunications happening? Like the one this post was made about? (perhaps you're unfamiliar with bayesian statistics, but this is my criticism of your false dichotomy). The reported facts are the following here:
1. She complained about not getting adequate care
2. She was readmitted to the hospital within 12 hours for a process that takes more than 12 hours to develop.

It is taught very early on in medical school and it has been the most valuable lesson to me to date:
you don't have to be the best doctor, as long as you're communicating well, patients will be a lot less likely to sue you.


----------



## Gutwrench

PearsonX said:


> And did you think about that maybe it takes some "soft skills" to express your "tough-minded" attitude without  miscommunications happening?




This sentence is a prime example why I write short replies. 

My first contribution to this thread was asking the op to explain something. Nothing ambiguous or vague.

A claim is not a statement of fact. Yet its being treated as one. Without facts, inflammatory statements, disseminating distortions and half truths sows abnormal fears and confusion.


----------



## Gutwrench

SuperMatt said:


> Perhaps we can start a separate thread on tough-mindedness.
> 
> Meanwhile, people of color are dying due to disparities in our health system, as evidenced from studies I linked already in thread (which were linked within the initial article anyway). Perhaps this case was just a coincidence and had nothing to due with these racial disparities in our health system. The problem is, there are many, many more “coincidences” involving healthcare and people of color. The studies mentioned above, and more, show that the healthcare system is not treating minorities well.



See post 2.


----------



## User.45

Gutwrench said:


> This sentence is a prime example why I write short replies.
> 
> My first contribution to this thread was asking the op to explain something. Nothing ambiguous or vague.
> 
> A claim is not a statement of fact. Yet its being treated as one. Without facts, inflammatory statements, disseminating distortions and half truths sows abnormal fears and confusion.



This comment would stand only if you didn't have a track record. You do.


----------



## Renzatic

This thread is proof positive that none of you people drank enough egg nog this Christmas.


----------



## Gutwrench

PearsonX said:


> This comment would stand only if you didn't have a track record. You do.




It doesn’t need your permission. I’ve been completely consistent.


----------



## thekev

Scepticalscribe said:


> Agreed.
> 
> It could.
> 
> In an individual case, yes, agreed, as it may be argued that it could indeed come down individual (poor, or bad, or incompetent, or indifferent) care (on the part of an individual doctor, or care team and an individual patient).
> 
> However, if a pattern of incompetence, indifference or negligence or lesser care is seen to occur over a period of time, where the incompetence (or indifference, or lesser care) of the care tendered is more marked, and more pronounced, and more obvious (when measured re outcomes, for example) when caring for certain groups (in the context of this particular discussion, I would argue that ethnicity, - given that this has occurred is the US - and perhaps gender may both be of some considerable relevance), then the issue is no longer lamentable lack of care of an individual patient but a story of systemic discrimination, of difference of care dependig on one's race (and/or gender).




I don't actually disagree with you here. I mention the other stuff, because causal analysis is difficult. You need to control for other points of variance. I'm not in any sense suggesting they did well here. Discharging someone only to have them readmitted hours later is complete garbage. It's just race and sex alone don't provide enough information.

Side note: I usually refer to sex rather than gender here since we're referring to healthcare, and transgender individuals may not have identical health risks or concerns when compared to others. I suspect we'll see more studies on this in the coming decade.



Renzatic said:


> This thread is proof positive that none of you people drank enough egg nog this Christmas.




I don't seem to drink at all these days, and yet, drunk people still laugh at my jokes.


----------



## User.45

Gutwrench said:


> It doesn’t need your permission. I’ve been completely consistent.



The opposite of neither was claimed, but I certainly value my time more than this. 
I hope you drew satisfaction from our interactions. Cheers.


----------



## Gutwrench

SuperMatt said:


> In reply to post 2:
> 
> Why isn’t it obvious?




Because you’ve not answered. And I understand why.


----------



## Gutwrench

PearsonX said:


> The opposite of neither was claimed, but I certainly value my time more than this.




Cheers.


----------



## Renzatic

I just learned that someone makes soy egg nog.

...this disturbs me.


----------



## Mark

@SuperMatt @PearsonX
i had never heard of Dunning-Kruger theory.
the wiki says it is highly disputed.
and that people who fall into the category of not understanding their true ability are said to be, colloquially, on (quoting from from the wiki mind you...) *Mount Stupid*
lets not feed trolls. trolls often self-project in an offensive way.


----------



## User.45

Mark said:


> @SuperMatt @PearsonX
> i had never heard of Dunning-Kruger theory.
> the wiki says it is highly disputed.
> and that people who fall into the category of not understanding their true ability are said to be, colloquially, on (quoting from from the wiki mind you...) *Mount Stupid*
> lets not feed trolls.



It's a very American phenomenon:
​


> Studies of the Dunning–Kruger effect usually have been of North Americans, but studies of Japanese people suggest that cultural forces have a role in the occurrence of the effect.[7] The study "Divergent Consequences of Success and Failure in Japan and North America: An Investigation of Self-improving Motivations and Malleable Selves"[8] indicated that Japanese people tended to underestimate their abilities and to see underachievement (failure) as an opportunity to improve their abilities at a given task, thereby increasing their value to the social group.


----------



## Gutwrench




----------



## Gutwrench

Mark said:


> @SuperMatt @PearsonX
> i had never heard of Dunning-Kruger theory.
> the wiki says it is highly disputed.
> and that people who fall into the category of not understanding their true ability are said to be, colloquially, on (quoting from from the wiki mind you...) *Mount Stupid*
> lets not feed trolls. trolls often self-project in an offensive way.




Have you heard of the Dilbert Principle?


----------



## Scepticalscribe

SuperMatt said:


> The sky is blue; this is obvious. None need ask “why is it obvious the sky is blue?” Kind of the definition of obvious: self-evident: it needn’t be explained.




I do.

In my part of the world, the sky is usually grey, because of cloud cover.   Not blue.

And, when you approach high altitude, - at the edge of the measured atmosphere - the "sky" becoes midnight navy in perceived colour, and then, stark black.

So, no, such matters are not "obvious" at all, let alone "self-evident".  

Actually, I spent an embarrassing amount of my childhood asking "why"?

One has to ask why, both in matters considered the domain of science and those supposedly confined to the domain, or study of, society.   Nothing is "self-evident".   

And, usually, those who reach for the "self-evident" argument are conservatives who wish the world to remain as it is, with the values and attitudes and actions which support it, automatically accepted and unexamined and unquestioned.


----------



## User.45

Scepticalscribe said:


> I do.
> 
> In my part of the world, the sky is usually grey, because of cloud cover.   Not blue.
> 
> And, when you approach high altitude, - at the edge of the measured atmosphere - the "sky" becoes midnight navy in perceived colour, and then, stark black.
> 
> So, no, such matters are not "obvious" at all, let alone "self-evident".
> 
> Actually, I spent an embarrassing amount of my childhood asking "why"?
> 
> One has to ask why, both in matters considered the domain of science and those supposedly confined to the domain, or study of, society.   Nothing is "self-evident".
> 
> And, usually, those who reach for the "self-evident" argument are conservatives who wish the world to remain as it is, with the values and attitudes and actions which support it, automatically accepted and unexamined and unquestioned.



It’s not self-evident, but again for a lot of us who see and try to fight disparities  (and many of my colleagues who study it) it hits home because she didn’t fit the profile of someone who is “usually the victim of the system”.
I don’t remember if the New York Times story covered that, but she switched providers prior to her discharge, so her premature discharge is not attributable to the person she was primarily complaining about. Based on what I recall she was pretty symptomatic (damn dictation system) even the day before, and the discharge sounds premature, however it all depends on bed availability, and pressure to admit new patients based on the ER load.


----------



## Scepticalscribe

SuperMatt said:


> America’s Declaration of Independence begins with truths the founders of the country felt were obvious:
> 
> ”We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.”
> 
> Perhaps nothing is obvious to everyone, but anything can be obvious to someone.




@SuperMatt: 

1: I am not American.   

This means that appeals (by quoting the Founding Fathers - some of whom - Benjamin Franklin comes to mind, he is wonderfully witty, sceptical, ironical, creative, intelligent, and respectful of liberal philosophy and the English language - I actually admire) mean little to me, as they will not work on my heart-strings, stir my loyalty, or define my political preferences, or lay claim to my allegiance.   Bear in mind, I'm from Europe.  

In fact, you might as well quote the Soviet Constitution of 1924 (based on the Treaty of the creation of the USSR in 1922 - in an earlier life, I taught Russian history, and indeed, for that matter, I have also taught US politics) at me.

2: While I think that it would be difficult to argue that race (ethnicity) does not have an influence on economic, legal, policy and political (and health) outcomes, I think that @Gutwrench's point is that you have not conclusively proven (and no, it is not "obvious", just very likely) that race/ethnicity influenced the outcome in the case under discussion in this thread.  

3: "Obvious" - in rhetorical terms, is, a very high - actually, an insanely high - standard (in debate, argument, rhetoric, law) to meet.

Personally, for what it is worth, I think it - "obvious" - a silly hill to choose (rhetorically) to die on.  Because, nothing is "obvious", not until proven, or one's interlocutors persuaded that this is, indeed, "obvious".

I've worked as an academic, a political analyst, an international election observer, a diplomat: A heads-up: I never, ever, ever, ever, sought refuge in "obvious".  Let us put it this way: It is a philosophical, and rhetorical, cul-de-sac, one that is almost impossible to defend.


----------



## User.45

Scepticalscribe said:


> 2: While I think that it would be difficult to argue that race (ethnicity) does not have an influence on economic, legal, policy and political (and health) outcomes, I think that @Gutwrench's point is that you have not conclusively proven (and no, it is not "obvious", just very likely) that race/ethnicity influenced the outcome in the case under discussion in this thread.



And that could have been an interesting discussion if there were interest in making it one. But let me flick this back because there's a double standard here. The person who made the claim was a practicing physician with a degree from a top medical school, so if we are so pro-authority, she's enough of an authority figure to take her claim at face value. Or not?!


----------



## Mark

@SuperMatt

your reference to one of the most inspirational of all texts in the English language, is most amazing. thank you.

the wiki article on the background of the phraseology of this sentence was most enlightening to me:



> *After Jefferson finished he gave the document to Franklin to proof. Franklin suggested minor changes, one of which stands out far more than the others: "We hold these truths to be sacred and un-deniable..." became "We hold these truths to be self-evident."*




to me this change made by Franklin is most revealing, and has significance even in this thread in a faceless internet age.

the change references that indeed, some things, even self-evident ones, could and would still be denied by some people.
while people do continue to deny truths that are indeed, self-evident, it doesn't make them any less self-evident. period.

during an age of slavery, for Jefferson and Franklin to assert that it is* self-evident* that all men are created equal - wow this blows my mind at how revolutionary that thinking was at the time.

Americans can be justly proud of this document. Although America has never lived up fully to its provisions, it is still an aspirational document for America and the entire world.

thanks for reminding me of this important phrase - of what it means for some truths, justices, and moral imperatives to be, indeed, self-evident.


----------



## Renzatic




----------



## Gutwrench

SuperMatt said:


> America’s Declaration of Independence begins with truths the founders of the country felt were obvious:
> 
> ”We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.”
> 
> Perhaps nothing is obvious to everyone, but anything can be obvious to someone.




Declaring concepts as self evident as in the Declaration of Independence is not in the same universe as making a claim of being wronged and then saying the evidence of it is self evident. 

This logic is wholesale entertainment.


----------



## User.45

Renzatic said:


> View attachment 2157



When clamnog is more inspiring than the discussion about logic.


----------



## Thomas Veil

Renzatic said:


> View attachment 2157


----------



## SuperMatt

https://www.washingtonpost.com/opinions/2020/12/26/say-her-name-dr-susan-moore/
		










						Black Indiana doctor died of coronavirus weeks after accusing hospital of racist treatment
					

A Black Indiana doctor died of COVID-19 after accusing a hospital of racist treatment.




					abc7chicago.com


----------



## Renzatic

SuperMatt said:


> The American founders claimed to have been wronged by England, sparking the Declaration. They said the rights being violated were self-evident.
> 
> What’s the difference? There were more of them? They were men? They were white? It was a long time ago?




To be fair, they did have the documentation to back up their claims of self evidence. They had been bitching about it for years by that point.


----------



## JayMysteri0

This was probably NOT the best statement to put out about this...



> I am even more saddened by the experience she described in the video. It hurt me personally to see a patient reach out via social media because they felt their care was inadequate and their personal needs were not being heard. I also saw several human perspectives in the story she told – that of physicians who were trying to manage the care of a complex patient in the midst of a pandemic crisis where the medical evidence on specific treatments continues to be debated in medical journals and in the lay press. *And the perspective of a nursing team trying to manage a set of critically ill patients in need of care who may have been intimidated by a knowledgeable patient who was using social media to voice her concerns and critique the care they were delivering. All of these perspectives comprise a complex picture.* At the end of the day, I am left with the image of a distressed patient who was a member of our own profession—one we all hold dear and that exists to help serve and better the lives of others. These factors make this loss doubly distressing.




That statement kind of leans into the 'blame the victim' aspect we see far too often.

It's also some interesting logic used there, that a patient that is known to the public is treated differently because they are known to the public.  What did anyone imagine would happen if said patient passes?   No one would know & want to know why?


----------



## Renzatic

Thomas Veil said:


>




You dissin' my nog, son?


----------



## User.45

SuperMatt said:


> More doctors are coming forward to draw attention to this unfortunate death. It is only one example of what people of color face within the American health system, as shown by the statistics (linked earlier in the thread and in the 2nd story below).
> 
> 
> 
> https://www.washingtonpost.com/opinions/2020/12/26/say-her-name-dr-susan-moore/
> 
> 
> 
> 
> 
> 
> 
> 
> 
> 
> 
> Black Indiana doctor died of coronavirus weeks after accusing hospital of racist treatment
> 
> 
> A Black Indiana doctor died of COVID-19 after accusing a hospital of racist treatment.
> 
> 
> 
> 
> abc7chicago.com
> 
> 
> 
> 
> 
> Some people would rather we go on a tangent on whether something is obvious or not. That was never the point of this post. Perhaps it isn’t obvious to everybody, but there is a great deal of evidence that people of color get worse treatment when it comes to healthcare in America.



I've read this one. It covers a lot of my concerns as well, although I found the title a little off-putting.
There are other complexities here, so while hospitalization outcomes are generally worse for Blacks, COVID in-hospital mortality rates seems to be similar or even better than that of Caucasians (data published in Circulation and JAMA - top journals). I haven't yet had time to dive into how the numbers look after adjusting for other risk factors. In general being Black is a risk factor for testing positive for COVID, so that is undoubtedly a pre-hospital risk factor.



JayMysteri0 said:


> This was probably NOT the best statement to put out about this...
> 
> From the release:
> 
> 
> 
> That statement kind of leans into the 'blame the victim' aspect we see far too often.
> 
> It's also some interesting logic used there, that a patient that is known to the public is treated differently because they are known to the public.  What did anyone imagine would happen if said patient passes?   No one would know & want to know why?



I'm glad it was included, because she was definitely not easy to take care of. Many patients use social media immediately to complain about their care. There's a certain type of patient usually with a business or "hard-science" background who dunning-kruger their way to retain control by micromanaging their own care that lead to deviations from protocol, more microerrors, worse care and more dissatisfaction. This situation is different however, because she did have the expertise. The stuff she complained about were basic items of care, with most controversial being remdesivir...

Again, we don't have enough information here to make adequate judgement, but only """tough guys""" think that discussing it will make us "tender-hearted".


----------



## Gutwrench

SuperMatt said:


> The American founders claimed to have been wronged by England, sparking the Declaration. They said the rights being violated were self-evident.
> 
> What’s the difference? There were more of them? They were men? They were white? It was a long time ago?




The founders declared a presumption essentially making it law.  That presumption is that all are created equal. 

When someone claims to have being wronged, like in civil or criminal matters, one must establish the claims are true to a preponderance. And the other party can rebutt. Their claim is not self evident proof. It is merely a claim.

Do you need more of an explanation?


----------



## User.45

I'll make one more comment on this ancient interpretation of illusionary absolute truths. I've encountered a lot of racists who learned that as long as they don't make explicit statements and keep things subtle, they will not be called out. And some even push it so the target can read it but cannot do much about it because if they call it out in anger, the person who feels victimized looks "soft-mindend" and is easier to discredit and dehumanize.

Certain people will take a cops' account in the absence of hard evidence as truth, but a victim's account requires holographic evidence and scientific rigor, even if the person is at least as trustworthy as a cop. They also have difficulty distinguishing criminal law, from evaluating institutional medical errors.

At the end of the day the best outcome we can have is a statistical approximation of a reproducible truth. Something that is worthy of discussion, interpretation and identification of things we can improve upon to create a society that fits our values (here, the Constitution). Yet, some are really motivated to nit-pick and block the flow of the discussion, just to prove a point that adds very little to the discussion. Patterns clearly show that it is the goal.

Lastly, I prefer to use Hanlon's razor when it comes to racism (i.e. don't attribute to malice that can be explained by ignorance), yet again, we need to understand the effects of actions, perceptions, and ways to make us less ignorant and thus improve our society.


----------



## Gutwrench

PearsonX said:


> Certain people will take a cops' account in the absence of hard evidence as truth, but a victim's account requires holographic evidence and scientific rigor, even if the person is at least as trustworthy as a cop. They also have difficulty distinguishing criminal law, from evaluating institutional medical errors.




The government must prove their case beyond reasonable doubt. The defense can impeach the testimony of any witness and present counter evidence. A jury is the trier of fact and in almost every state a conviction must be unanimous. The best system in the world.

The last sentence makes no sense.


----------



## User.45

Gutwrench said:


> The government must prove their case beyond reasonable doubt. The defense can impeach the testimony of any witness and present counter evidence. A jury is the trier of fact and in almost every state a conviction must be unanimous. The best system in the world.
> 
> The last sentence makes no sense.



Your confusion stems from the assumption that an internet forum is some sort of a formal part of the judiciary system. It's a platform to aggregate and process information to fight ignorance. Less ignorance, better juries in general. Not that difficult, unless you want it to be.


----------



## Gutwrench

PearsonX said:


> Your confusion stems from the assumption that an internet forum is some sort of a formal part of the judiciary system. It's a platform to aggregate and process information to fight ignorance. Less ignorance, better juries in general. Not that difficult, unless you want it to be.




Hence post 2 questioning what made the op convinced something happened that was clearly due to the color of someone’s skin. All we had is a one sided claim.

The tough minded examines facts before reaching conclusions in short they postjudge.

The soft minded reaches conclusions before examining the facts. In short they prejudge.

Btw, standard of proof is different in criminal and civil matters.


----------



## User.45

Gutwrench said:


> Hence post 2 questioning what made the op convinced something happened that was clearly due to the color of someone’s skin. All we had is a one sided claim.
> 
> The tough minded examines facts before reaching conclusions in short they postjudge.
> 
> The soft minded reaches conclusions before examining the facts. In short they prejudge.



You've already made this statement. You haven't looked into Bayes...just because from that angle this tough-soft dichotomy is very soft.


----------



## Gutwrench

PearsonX said:


> You've already made this statement.




Yet I have to keep reminding the thread that prejudging matters is wrong. A claim is not a statement of fact. Yet its being treated as one. Without facts, inflammatory statements, disseminating distortions and half truths sows abnormal fears and confusion.


----------



## User.45

Gutwrench said:


> Yet I have to keep reminding the thread that prejudging matters is wrong. A claim is not a statement of fact. Yet its being treated as one. Without facts, inflammatory statements, disseminating distortions and half truths sows abnormal fears and confusion.



Apparently I have to break it down for you:
We "pre-judge", we review data, we "post-judge", then comes a new scenario and we use our previous "post-judgement" as a "pre-judgement" and the process continues. This is just how intelligence works, biological and artificial alike. What you're trying to create is an experimental (imaginary) environment that assumes no input to work the algorithms that generate the output. According to Bayesian logic, an absolute truth can never be learned just approximated with a statistical certainty utilizing previously available information modulated by current information. Like a statistical machine. Dichotomies like soft vs. tough mind, where of course tough means good and the person proposing them is of course "tough" encode a lot of self-irony. To say the least.

Now your style that I'm growing tired of is when you disagree with others is to apply a single line passive aggressive question, instead of approaching it like:
Hey @SuperMatt, i think you have drawn a premature conclusion here, this is a sad situation (_acknowledge the emotional aspect of the untimely demise of a human being_), but here and here are the uncertainties and this is why we don't know enough to make a satisfying conclusion (_express opinion respectfully_). Then he will respond to that either by acknowledging or providing more information, then you respond to that and voila, a discussion emerges through which human minds process information and hopefully reach a conclusion that could be helpful in future scenarios (_something this forum is generally very very good at_). Simple as that.

Now you either have a difficulty processing the emotional component of these discussions, or you do this on purpose so your net gain is others' irritation. Since you polished this to a level that requires the least amount of time and effort, I suspect it's on purpose.
It's just sad because I used to be curious about your opinion and viewpoint, but this style that to date hasn't been balanced out with some uncanny brilliance, makes me not want to talk to you about anything beyond booze.


----------



## Gutwrench

PearsonX said:


> Apparently I have to break it down for you ....




Prejudging is unacceptable even when convenient. Prejudice is the basic cause of racism and a host of other problems. It’s time we become tough minded and be astute, objective, judge critically and be discerning to break loose from the shackles of ignorance.


----------



## User.45

Gutwrench said:


> Prejudging is unacceptable even when convenient.



Lol! You've just ""prejudged"" my post, which explained my interpretation of this concept. 
The extra irony is that I used quotation marks to avoid literal interpretation.

I'll save time for you:
1. quote 1 arbitrarily selected sentence (fuck gestalt!!!)
2. lament on a singular concept you disagree with
3. ignore everything else
4. use short clichés ad nauseam
5. rinse & repeat.

At the end of the day you again added NOTHING.


----------



## Gutwrench

PearsonX said:


> At the end of the day you again added NOTHING.




Dunning Kruger Effect strikes again.


----------



## User.45

Gutwrench said:


> Dunning Kruger Effect strikes again.






PearsonX said:


> 1. quote 1 arbitrarily selected sentence (fuck gestalt!!!)
> 2. lament on a singular concept you disagree with
> 3. ignore everything else
> 4. use short clichés ad nauseam
> 5. rinse & repeat.



You're not even trying.


----------



## Gutwrench

PearsonX said:


> You're not even trying.




ok


----------



## User.45

Gutwrench said:


> ok






PearsonX said:


> Your laziness if painful to watch.


----------



## Gutwrench

PearsonX said:


>




 Cheers


----------



## Thomas Veil

Renzatic said:


> You dissin' my nog, son?



That's not a real thing, is it?


----------



## User.45

Thomas Veil said:


> That's not a real thing, is it?




Recipe:


> Egg Nog
> 
> 
> Whisk egg yolks and sugar until light and creamy
> Combine cream, milk, all spice, and salt over medium-high heat until simmering
> Add a large spoonful of the hot milk to the egg mixture and whisk vigorously
> Repeat until most of the milk has been added
> Pour the egg mixture back into the pan and whisk constantly for a 3 minutes until nog slightly thickens
> Remove from heat and stir in vanilla
> Let cool in refrigerator for several hours
> Add half and half and mix to vigorously to thin the nog to desired consistency
> Stir in cognac to each serving
> 
> New England Clam Chowder
> 
> 
> Cook onions in melted butter over medium-high heat until softened
> Stir in flour to coat evenly
> Add stock, clam juice, cream, and potatoes
> Bring to a simmer, stirring occasionally then reduce heat to medium-low and cook for 20 minutes, stirring often
> Add clams and cook until clams are just firm, approximately 2 minutes
> 
> *New England Clam Nog*
> 
> 2 Parts Egg Nog
> 1 Part New England Clam Chowder



Although I think the Clam Nog contributed to this thread no less than some, but I think such delicacy deserves it's own separate thread.


----------



## Thomas Veil

I'll be darned. You learn something new every day. Between the meme-ish text with thick outlines and the Campbell's Chunky designation (which here is applied only to soup), I thought it was a put-on. You know, like Tomacco, the tobacco-laced tomatoes.


----------



## User.45

Now after all these, can we discuss the actual topic?


----------



## Gutwrench

PearsonX said:


> Now after all these, can we discuss the actual topic?




see post #2


----------



## User.45

Gutwrench said:


> see post #2





PearsonX said:


> Now after all these, can we ACTUALLY discuss the actual topic?


----------



## User.45

SuperMatt said:


> What seemed obvious to me apparently isn’t obvious to everybody. I can accept that; let’s move on. This is really entering troll territory at this point.



To get this topic back on track...in my personal experience, healthcare is generally the least racist work sector. This is why Nigerian parents tell their kids to get medical or pharmacy degrees, as they are much more likely to succeed in this field than with an MBA.


----------



## Gutwrench

SuperMatt said:


> What seemed obvious to me apparently isn’t obvious to everybody. I can accept that; let’s move on. This is really entering troll territory at this point.




i haven’t any doubt you’d like to move on from post 2 by slipping in a dark unmarked suburban and slide on outta here.  Then toss aside  reason, accountability, logic, objectivity, and simple fairness out the window once you hit the freeway because so you clearly don’t know how to use those inconveniences.


----------



## User.45

Gutwrench said:


> i haven’t any doubt you’d like to move on from post 2 by slipping in a dark unmarked suburban and slide on outta here.  Then toss aside  reason, accountability, logic, objectivity, and simple fairness out the window once you hit the freeway because so you clearly don’t know how to use those inconveniences.





Gutwrench said:


> Dunning Kruger Effect strikes again.



.


----------



## User.45

SuperMatt said:


> It does seem that doctors are valued based on their skills and expertise moreso than in other fields.



It also collects a lot of altruistic people. It's just that altruism can burn out with you. Which happens to most at one point.


----------



## Eric

Gutwrench said:


> i haven’t any doubt you’d like to move on from post 2 by slipping in a dark unmarked suburban and slide on outta here.  Then toss aside  reason, accountability, logic, objectivity, and simple fairness out the window once you hit the freeway because so you clearly don’t know how to use those inconveniences.



Okay, let's try to refrain from these brutal attacks here. We're open to heated debate but this is crossing the line.

Let's also try to stay on topic and somewhat civil here. And @Renzatic you're getting your own thread, I'll create it and move those posts into it.


----------



## User.45

To examine some of the circumstances, state-wide they are stretched but have had a 20% headroom in terms of ICU capacity. (According to some of my intensivist friends the goal is about <75% occupancy to be able to accept an unexpected surge of patients).


----------



## Gutwrench

SuperMatt said:


> You’re right; I’m wrong. You win. Now please leave me alone; thanks.




lol.... Ambien strikes again.


----------



## Gutwrench

ericgtr12 said:


> Okay, let's try to refrain from these brutal attacks here. We're open to heated debate but this is crossing the line.
> 
> Let's also try to stay on topic and somewhat civil here. And @Renzatic you're getting your own thread, I'll create it and move those posts into it.




lol...Ambien strikes again. I haven’t a clue what it says. At least I didn’t buy a refrigerator shelf from Amazon with expedited shipping this time. lol


----------



## Eraserhead

SuperMatt said:


> To summarize this in a one-liner:
> 
> OP is ignorant, and everybody who replied to this thread except @Gutwrench is an incompetent thinker.
> 
> Got that about right? Why waste your time talking to a bunch of idiots? Surely you can find people with IQs of 200 like yourself instead of the proletariat here.



I think @Gutwrench may have a point.

Women as a group aren’t listened to as much as men with regards to pain as per https://www.amazon.co.uk/Invisible-Women-Exposing-World-Designed/dp/1784706280/ref=sr_1_1

However on race how much of the issue is a general lack of income/wealth for blacks and/or that predominantly black areas in the south of the US have very poor healthcare.

Edit: looks like I replied to an old post. I’m confused


----------



## User.45

Eraserhead said:


> I think @Gutwrench may have a point.
> 
> Women as a group aren’t listened to as much as men with regards to pain as per https://www.amazon.co.uk/Invisible-Women-Exposing-World-Designed/dp/1784706280/ref=sr_1_1
> 
> However on race how much of the issue is a general lack of income/wealth for blacks and/or that predominantly black areas in the south of the US have very poor healthcare.



Or you can argue it's was the time of the year, or the hospitalists patient load, etc. For example if I want to be facetious, I can point out that you guys are dismissing that (as far as I saw in the videos) *she herself complained about not getting adequate care because of being black and not because of being a female. *She wasn't in the South and she was receiving care at a university hospital.

You can  argue that she was hypoxic and under the influence of narcotic pain medications, but she seems to have capacity and expresses herself coherently on the videos. The line of facts and perceptions go like this here:

A) She complained of getting subpar care
B) She had the _perception _that she received poor care/communication *because* of being black
C) She had an outcome that definitely triggered a quality-of-care evaluation

Fact A is supported by Fact C. While Fact B may or may not link Facts A and C together, it is on its own is an outcome that good communication tends to prevent with great efficacy. What happens in this thread? The guy who has in the past advocated for us not to consider logical inconsistencies in others' values as a flaw but to "accept them as just different values and perceptions" now preaches about this tough-minded bullshit. Concurrently, he recreates the communication style that consistently lead to perceptions like described in Fact B.

One of my professors used to emphasize that bad communication will evoke the nocebo effect in patients, and even though you can't fix everything, what you should always strive for is to elicit a placebo effect in your patients. Soft skills matter a lot. So for example, what Dr Moore claimed is that she was told "_You're not even short of breath_" is a excellent nocebo trigger and very inappropriate communication. The source of such interaction is probably burnout and a shorter fuse (it happens to many of us at some point), but again implicit bias studies suggest that Blacks are more likely to be on the receiving end of such.


----------



## Eraserhead

PearsonX said:


> Or you can argue it's was the time of the year, or the hospitalists patient load, etc. For example if I want to be facetious, I can point out that you guys are dismissing that (as far as I saw in the videos) *she herself complained about not getting adequate care because of being black and not because of being a female. *She wasn't in the South and she was receiving care at a university hospital.
> 
> You can  argue that she was hypoxic and under the influence of narcotic pain medications, but she seems to have capacity and expresses herself coherently on the videos. The line of facts and perceptions go like this here:
> 
> A) She complained of getting subpar care
> B) She had the _perception _that she received poor care/communication *because* of being black
> C) She had an outcome that definitely triggered a quality-of-care evaluation
> 
> Fact A is supported by Fact C. While Fact B may or may not link Facts A and C together, it is on its own is an outcome that good communication tends to prevent with great efficacy. What happens in this thread? The guy who has in the past advocated for us not to consider logical inconsistencies in others' values as a flaw but to "accept them as just different values and perceptions" now preaches about this tough-minded bullshit. Concurrently, he recreates the communication style that consistently lead to perceptions like described in Fact B.
> 
> One of my professors used to emphasize that bad communication will evoke the nocebo effect in patients, and even though you can't fix everything, what you should always strive for is to elicit a placebo effect in your patients. Soft skills matter a lot. So for example, what Dr Moore claimed is that she was told "_You're not even short of breath_" is a excellent nocebo trigger and very inappropriate communication. The source of such interaction is probably burnout and a shorter fuse (it happens to many of us at some point), but again implicit bias studies suggest that Blacks are more likely to be on the receiving end of such.



That’s me refuted.


----------



## User.45

Eraserhead said:


> That’s me refuted.



Your point shared with @Scepticalscribe is valid tough. It isn't easy to be a female patient for many reasons. The most objective one is that preclinical drug testing mostly takes place in male rats/mice. Then women experience some weird (minor) drug side-effect and we either don't believe them, or throw our hands in the air like, "I have no idea what's going on."


----------

