All modern research questions frame your mindset and self-frame research paradigm. Broad thinking: how little of everything can a citizen survive on; how cheap can your upkeep be? /1
When an American patient lands in an Austrian hospital for a back problem, a doctor tells him to perform a set of exercises.

- How many?
- Do you have anything else to do? /2
This interchange illustrates two mindsets colliding at bedside. How little can I get away with vs there is no limit to effort when it comes to your wellness. /3
When you were robbed of movement, somebody started selling you exercise. To understand that digging a ditch, to build a house, or to carry a child around, or waking to your grandparents for an hour is not the same as jogging on a treadmill... will reveal what research hides.
/4
When I talk about doing a purposeful activity outdoors, I look at complexity of movement, purpose, meaning, sun, and air, even an opportunity to meet a neighbor... that is now reduced to a calcium pill, vitamin D, an antidepressant, an osteoporosis shot, and an oxygen tank. /5
By shifting your focus from now to some distant future you may never see because a brick may fall in your head long before mythical longevity befalls upon you, you miss the opportunity to find out that hard work outside from sunrise to sunset does wonders to your soul. Now. /6
By accepting the rhetoric of managed time and effort for health and longevity, you buy into constant relentless stress of time management that will always make you feel poor and exhausted. /7
You can be a body project to be efficiently self-managed as an industrial production line. Or you can be luxurious, inconvenient, boundless in how much you do for yourself to thrive. /8
It may take you five years to mourn death, breakup. It does take many hours a week to find and cook food. It takes many hours to sleep. You will have to accept that you won’t be able to fly to space?and work on your car. Setting voluntary limits becomes important./9
Convenient low maintenance happy slaves are very desirable. Inconvenient people who sleep, cook, build, make, mourn, cry, hurt, and get sick - aren’t. Your cumbersome inconvenience ensures you thrive. /10

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More from @Medical_Nemesis

21 Jan
No matter how much scientists and experts throw words nobody understands around in an attempt to convince us we know something, surgical masks alone and surgical masks worn over N95 masks with visors did not protect from the viral outbreak in the hospital where I work. /1
In Jan-Feb 2020 we had what was called the flu outbreak. We closed units that were affected to control the outbreak. Not once any unit was closed during 4-5 outbreaks of the virus we had so far despite control measures. /2
It is obvious to all on the clinical side, we cannot control the virus. It will spread. You will or will not get sick. For majority we have seen with positive tests, it is an unnoticeable condition. They were well and healthy. We wouldn’t notice it in a regular year. /3
Read 5 tweets
6 Nov 20
“This is an internal medicine didactic conference held in purgatory.”

You want to read a book that is so subtle in its acerbic analysis of treating populations as opposed to individual people. /1
Moving Mountains by @michelaccad is cleverly written as a dialogue between Socrates and Geoffrey Rose, a father of population health medicine that is likely ruining your life as I type this. /2
I liked the book so much I read half of it out loud in the evening to my family. My excitement and enthusiasm overshadowed their lack of enthusiasm about the fallacies of public health. /3
Read 13 tweets
4 Nov 20
A year ago in the summer a local church held a talk by a former governor on science. I know little of churches but science holds a special place in my heart. Enough for me to venture out to this Lutheran church founded by first settlers 150 years ago. I was not disappointed. /1
Villagers (without torches and pitchforks) dutifully gathered to listen to a PowerPoint presentation of what seemed to be proof of God’s existence. /2
A former chemistry professor at one of country’s best liberal colleges was showing us pictures of dinosaurs and DNA strands for nothing screams science more than dinosaurs and a DNA strand. /3
Read 11 tweets
4 Nov 20
Ispired by randomness and suddenness.

Cases of sudden afflictions and deaths in medicine abound. I always believe in them, terrified at the thought I can wake up to find my ears fell off.

Ears don’t fall off. /1
What brought you to the hospital?
I can barely make out words of a woman in her late 70’s. She is weak. Doesn’t eat. She has a leaking feeding tube in her stomach to make up for her lack of appetite.
I hear a story of a pancreatic cyst removal. The lady asserts she’s cured /2
Judging by the fact her pancreas and spleen were taken out, she is probably in denial. Not uncommon to misunderstand medical communication. Her story makes no sense but I shut up, tell her I will review her records and come back to tell her what happened. /3
Read 13 tweets
3 Nov 20
The most bizarre tweet I saw during COVID was from this doctor. She was upset her father died before a doctor could murder him.

Of note this person was all about saving lives, masking, etc. /1 cbc.ca/news/canada/ma…
This story shows how little doctors understand what they are doing to their loved ones and how much suffering the elderly suffer due to contradictory demands of confused relatives regardless of education. /2
It’s a story of a very old man who should have died quickly and at peace at home. Yet his fate was to be saved. Saved he was into endless suffering. /3
Read 12 tweets
3 Nov 20
Traditionally there were ways to circumvent compulsion by authority do something that goes against your convictions. /1
Dissent is never easy. Two broad possibilities in traditional cultures: voluntarily exit from a tribe (exile or becoming a hermit) or voluntary adoption/acceptance of madness/craziness. Both practices tied to Eastern religions. /2
Fools for Christ/Holy fools/Blessed fools were people who pretended to be insane to expose the sins of the world.

Hermits went into seclusion to find God.

Both practices are ascetic and derive from the conflict of what one may find true colliding with reality around. /3
Read 4 tweets

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