1/ ***PERSONAL THREAD***

I have a condition called "Prosopagnosia" or "face blindness." It's a neurological disability my brain literally just does NOT TELL ME if I should recognize a face or not.

New hairstyle? new person!
Hoodie? no recognition!
Formal setting? who is that?
2/ Until I knew what this was, I was TERRIFIED of meeting or running into people. I would always criticize myself for "forgetting names" or "not being polite" when someone would tell me "hey, why didn't you say hi?" or "what you're just gonna walk by me?"

I felt rude. Uncaring.
3/ I went to med school! Oh god! Surgical masks and hoods. Scrubs. Everyone looked EXACTLY (not sort of) the SAME! My bosses would "pop by to ask me a question" and I wouldn't even recognize who they were. "Can you email me later?" "uh... sure... [oh no, who do i email?]"
4/ I would go to social gatherings! "Oh have you met my Jennifer?"

OH NO I'M RIGHT IN FRONT OF JENNIFER. HAVE I? I DON'T KNOW. CHEAT TIME.

"Hi there!"

[wait to see what Jennifer says]
5/ The area of my brain that was supposed to tell me "hey! you know this person!" or even better "That's your friend Mike!" just wouldn't do it (we think the "fusiform gyrus").

Anytime someone changed clothes or hairstyles, or was in a setting I didn't expect, nothing.
6/ Now that I know me, I know that my memory is *terrific!* If you tell me one of my patient's last names, I can tell you their first name and even their parents names, and what they enjoyed for hobbies (a standard question I ask), and ive seen THOUSANDS of patients in my career!
7/ Understanding the way my brain was different and this neurological disability helped me to feel *better,* not worse about myself. I wasn't lamenting my disability, I was so glad that this barrier had a name and I could try my best to adapt (better, have others) adapt to it.
8/ After reading an article about Brad Pitt (not kidding!), who apparently has it, I first took an online test, then a specific diagnostic test with a prosopagnosia team.

It turns out I score in the LOWEST percentile (literally <1%) of all people for facial recognition.
9/ I talk openly about it with people I know now, especially people I may meet in the future, so they know I'm not being rude if I walk by them wearing a hoodie and I don't say hi. I study walking, shape, clothing styles and hair styles to help me recognize people.
10/ I change how I watch movies so when a character is introduced i study their costume, so when the "Face reveals" or undescribed entrances occur, it's easier for me to follow along.
11/ It turns out, that I was a lot harder on myself than I needed to be. I was filled with self-blame and fear in any situation I might "run into" someone. By knowing and being open, people are super kind about it and forgiving.
12/ I guess the main reason I'm writing this is because sometimes I will sit and think about how many people think poorly about themselves when in reality their brain just works differently. I'll diagnose a kid with ADHD who HATES who they are because they "don't pay attention".
13/ Brains are awesome. My whole career is about 'em! I love brains! But they're different. There is diversity in what they are good at & not so good at (this is what we call "neurodiversity"). Brain differences are normal!
14/ Try to understand neurodiversity in our social interactions, in how we design things, and in how we set up systems. Try to understand it for yourself, if you keep running into the same barriers.

Reducing barriers to neurodiversity really helps.
15/ Composed in Chirr App, which doesn't support alt-text for planned posts. But for people with readers: all images are clip art highlighting the point made in the tweet, to reinforce the text.

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More from @tylerblack32

6 Mar
1/ VERY SERIOUS, VERY COMPLEX DISCUSSION AHEAD:

The @FAIRHealth White Paper showing MH insurance claims in kids is being reported deceptively.

WRONGLY (!!!), people are using it as evidence that "Mental health claims are up in kids."

Why is that wrong? Let's break it down. Image
2/ What is it?

It's an insurance report that does a breakdown of 32 BILLION claim records, looking at month-to-month changes Jan-Nov 2019 vs 2020. It focuses on pediatric (13-18) mental health insurance claims:

* overall
* self harm
* overdoses
* diagnoses
3/ This very important part of the methodology is at the heart of the confusion on how this paper is being reported.

It is NOT looking at raw #'s increasing, it's looking at percentages of overall claims.

In other words, what % of claims were for mental health. Image
Read 30 tweets
1 Mar
This week: a lot of famous medtwitter accounts "oh sorry I've been away for a bit did I miss anything important? 😅"

Cowardice.
This week a major medtwitter/tiktok influencer was accused with evidence of serious sexual harrassment and assault. One of the major figures of medtwitter, @choo_ek (who I looked up to immensely) is named directly in the lawsuit. There may be more to the story. It's a lawsuit.
But it is crucial that we unequivocally stand up and tell all vicitms that the system failed this person, that when they report things to program directors + residency supervisors there should be mandatory actions taken, and that we cannot in any way discourage people reporting.
Read 7 tweets
1 Mar
1/ Quick Suicidology 2020 Updates:

Canada:
No updates.

USA:
2 Counties (Butler, OH; Bartholomew, IN) and Puerto Rico (total pop for all 3 jurisdictions = 3.6M) 10% fewer suicides in 2020, all 3 showing a decrease.
2/ International:

* Albania: 25% decrease
* Austria: "No increase"
* Germany: "No increase seen so far"
* Poland: "No change"
* IDF (Israeli Defense Force): 12 suicides in 2019, 9 in 2020.
3/ Puerto Rico has quite a breakdown:
* no change in youth rate (slight decrease)
* no diff b/w males or females change
* monthly comparison shown here
Read 5 tweets
27 Feb
Saturday morning fun: Photography thread!

Let's have fun with different lenses, zoom, and framing!

I'll quickly teach how lens and focal length can make a huge difference.

#photography
1/ This is the view from my balcony, (i love #Vancouver !!), and we're not gonna leave here, but our lesnes will take us all over. At 70mm, this is about "what the eye sees" in terms of zoom and detail.
2/ Just panning to the north intersection, uhoh! Fire trucks are here for an incident!
Read 24 tweets
27 Feb
Saturday morning fun: Photography thread!

Let's have fun with different lenses, zoom, and framing!

I'll quickly teach how lens and focal length can make a huge difference.

#photography
1/ This is the view from my balcony, (i love #Vancouver !!), and we're not gonna leave here, but our lesnes will take us all over. At 70mm, this is about "what the eye sees" in terms of zoom and detail.
2/ Just panning to the north intersection, uhoh! Fire trucks are here for an incident!
Read 24 tweets
25 Feb
2020 US Suicidology Update:

3 new states (HI, ND, NJ) have been added to the total, all showing decreases from 2020. I added Cook County IL (oct-dec) to the list and removed Howard, IN, though its in final calculations. To keep the list down, I have to sacrifice small for big.
1/ At this point, my scan has captured almost 87M person-years, about 1/5th of the US. Because it is a nonrandom sample, it can't yet be used to estimate, however, the skew is on and clear - no major increases in 2020, most states and counties showing decreases.
2/ There are no surprises at this point - we are seeing clear and consistent trends across the nation.

It is with fairly high confidence that I repeat:

"The data does not support an increase in suicides in the US during 2020, in fact, if anything, it supports a decrease."
Read 4 tweets

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