There’s this weird magical thinking that if you hang around with people who think different than you it will run off on you.
Or you’ll catch it. Get infected with some opinions you disagree with. 1/
Don’t be so afraid of people with different opinions than you. There’s no virus you might catch.
Guys back in the oldem days like Jesus and Buddha said this is actually good for you. 2/
Even criminals and your enemies. You won’t even catch the cooties from them.
Expand your little provincial life. Stop imagining how people think. 3/
If you disagree on one topic don’t run away all ascared.
Move on and seek out a different topic where you might find some connection. 4/
Or don’t I don’t care. Don’t come crying to me when you don’t have any real friends and live in a tiny isolated sterile glass box all lonely and sad. 5/
Or if everyone you know looks like you, thinks like you, and votes like you and you are bored as hell sitting in a room full of mirrors. 6/
I used to be more like this and I suffered the fixed delusion that I was important enough that other people would change their opinions to meet the standard I set for people to qualify as my friends. 7/
Actually, nobody gave a good god damn. 8/
They just made friends with other people who were more tolerant than me.
I never changed shit. I just isolated myself with my many deal breaking criteria all alone and sad. 9/
I have a lot more friends now. Much more diverse both in appearance and in opinions, priorities, and beliefs. 10/
Sometimes we discuss points of disagreement. It’s also okay just to avoid those topics.
Yup. Just skitter around.
Notice that there is actually nobody on this entire earth with whom you agree about everything. 11/
As you do this project and expand your mind, you may begin to see that other people grant you the same prerogative to have your own peculiar set of beliefs that you grant them.
It’s like a 2-way street or whatever. 12/
There’s a prayer that says when you trespass in your neighbors property then don’t get pissed when he cuts across yours or something like that.
This is what I’m talking about. 13/13
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Here’s the K-M survival curve from the recent #semaglutide #ozempic paper in non diabetics from the NEJM.
I’m going to teach you how to read a KM curve in a few steps.
First, let’s discuss the deception presented here.
Lincoff AM, Brown-Frandsen K, Colhoun HM, Deanfield J, Emerson SS, Esbjerg S, Hardt-Lindberg S, Hovingh GK, Kahn SE, Kushner RF, Lingvay I, Oral TK, Michelsen MM, Plutzky J, Tornøe CW, Ryan DH; SELECT Trial Investigators. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes. N Engl J Med. 2023 Nov 11. doi: 10.1056/NEJMoa2307563. Epub ahead of print. PMID: 37952131.
This is actually 2 KM curves superimposed on one another. The honest KM curve is shown here.
If you are reading this correctly, you should be unimpressed. Which is why the authors chose to add a magnified version on top of all that white space.
Here’s what they added. It’s like a photo of the other curve taken under a microscope.
It makes the effects look much bigger (and faster). Which is a fair goal if you are trying to impress…
I take a call from the ER about Miguel McJohsonberg in room 13. While I’m on the phone I open up his chart and start reading his personal business. His labs. His meds. The DC summary of his last admission. …
All the while he has not given me expressed permission. It is a violation.
We all agree to this violation. He bought his ticket. He knew what he was getting in to. …
Twelve hours later he is unconscious and intubated and the surgeons get permission from his friend to disarticulate his left leg at the hip for a necrotizing skin and soft tissue infection. …
(For those who don’t know my schtick, I often start with a controversial statement like this. While it’s true, it’s not the point of this essay. You have to keep reading…)
Your employer is smart.
They know what they sell—completed, signed notes. They need lots of them. Big ones. Procedural ones. It doesn’t actually matter at all who is writing them as long as they are good enough to sell for revenue. 2/x
The one thing your employer does not want is a bunch of expensive grey haired doctors shuffling around caring about stuff. That business model stinks.
The work is slow. They cost of labor is high. Old doctors are finicky. What a disaster.
3/x