This is what targeted racial harassment looks like: nitpicking things like “smiled” or “wore clothes like a celebrity, as a celebrity” or “bought cookware.” It is part of the “gold digger” narrative.
This is common in #healthcare#professionalism” where there is hazing & bullying by racist &/or classist made up non-rules lacking standards…yet people are called “breaking the rules.”

It’s exactly how bullies operate: double standards, mislabel/smear, exclude, marginalize.
In the U.K., “BAME” includes the formerly colonized, thus making race constructs or power different from U.S. as latter had race-based chattel slavery.

Thing is, those formerly colonized have many who have internalized self hate & racism.

psycnet.apa.org/record/2021-69…
“POC” “BIPOC” in U.S. & “BAME” in U.K. cause confusion/controversy

"White people made it so they don't have to say 'black', because they feel weird saying black for some reason.
"I feel like 'BAME' is just their safe word to not come off as racist."

bbc.com/news/uk-531943…
Except, that exclusion from whiteness *does* correlate with higher #COVID19 mortality & access to services & how one is assessed & treated. South Asians were colonized for centuries with established mechanisms & mental models of exploitation.

bbc.co.uk/news/uk-522190…
The supremacist view is “it is their culture” but realistic look at history & current distribution of resources + systems thinking shows it is a system of inequity & exploitation. Yes, famine also happened in Ireland while British *exported* food like: theguardian.com/world/2019/mar…
It is both racism & classism where race is a proxy for class often

Look at how often you see South Asians quote Churchill when this was his opinion of racial superiority to justify death & wanted British to violate human rights.

Love of your own oppressor = internalized racism
In #COVID19 I have seen South Asians blaming South Asians, in a very classist, internalized racism way, for the higher deaths in BAME, both population & healthcare #HCW.

6 of 10 doctors deaths in U.K. were BAME.

bma.org.uk/advice-and-sup…
Speaking as a Harvard/Baylor-trained doc, former Medicaid med director & former #NYC #FQHC CMO

I have seen the vast disparities in resources by #healthcare setting AND identify.

Will a resident dependent on an immigrant visa speak up this way? Or be bullied into being unsafe?
We are seeing death by exposure AND by suicide, particularly in #NYC. Also, @drbreenheroes on Dr. Lorna Breen.

Thing is, I can relate both to a woman medical director of a more privileged position/background

AND the bullied non-white trainee & “IMG.”

thecity.nyc/2021/7/29/2260…
I did not accept a CMO offer in #NYC in the #pandemic, cuz realized the resources were not there, especially #PPE, my own “heroism” was not going to keep frontline #HCW safe, guidelines wrong, & my gender/race in #healthcare #leadership were not respected. nytimes.com/2020/07/11/nyr…
Some of the people most aggressive in shushing on my identifying #implicitbias ARE South Asian or “POC.”

Being a “token” POC & “model minority” to be the face/voice to cut social services ➡️ career success. Speaking this truth makes some people look bad.

americanindependent.com/donald-trump-a…
Because I pull back this curtain from the so-called “model minority” role, I make enemies.

But anyone who has ever spoken up as a physician, as a human with a any ethical core, is retaliated against, silenced.

Too many #HCW & patients have died to 🤐

theguardian.com/education/2020…
#BlackintheIvory of #HigherEd is in #MedEd too. Policing is also by “POC” with internalized racism.

Some in #compliance also have body dysmorphia that needs #mentalhealth treatment, not being placed into positions to control/police/shame others’ bodies.

insidehighered.com/advice/2020/06…
Self-hate & what could otherwise fall under a form of body dysmorphia is normalized in certain cultures. There are even vaginal lightening creams. This colorism is a hatred of half of humanity.

Then this mindset is put into #healthcare #compliance? 😱

npr.org/sections/goats…
Personally, as long as I stay out of the sun, I am the so-called “right” shade. I blend in reasonably in white-majority settings. I’ve been told “If you just change your make up & jewelry you would look white” as a “compliment.” Ultimately am “white passing” or “white adjacent.”
By fitting into these spaces well enuf, tho = “elite feminism”
Elite 👩🏼: over-representation of #GhislaineMaxwell types. That’s another reason I have been wary of future c-suite roles as cannot avoid being 1-2 degrees of separation from #MeToo perps or even child trafficking.
Tolerance of sexist culture of #business (& #healthcare), is overtly taught as a “#leadership skill” to women seeking c-suite roles. Want to be let into the boy’s club? Prove how tough/cool you are by going to the business meeting at the strip club.

bizjournals.com/bizwomen/news/…
=deliberate selection process

the woman who perceives herself as “strong” for tolerating sexism to enter room of power

will never be a woman who speaks up on behalf of a lower ranking woman, when #MeToo happens

➡️Ethical woman avoid leadership

cnn.com/2013/05/15/bus…
Mental models matter

when the media frenzy/attacks vs #MeganMarkle or @VP over cost of clothes or cookware or @MichelleObama over bare arms

is racism + classism over things that are normal for “elite women”

but not if you are seen as servant, enslaved, trafficked woman
Media teaches execs
who already hold #business meetings in strip clubs

NOT to see my having a license as a medical professional & 1-2 decades of experience

Instead to see my “optics”
& invoke this mental model
My own professional society teaches this: Black women & WOC/POC remain the workhorses, frontline, “mammy” (as I learned from following @mdawriter)

When you are at the frontline, you have more exposure than the person writing guidelines & publishing papers

➡️higher morality
Cuz I look 10-15 years younger than my actual age, I also invoke this mental model

“blonde women are not only assumed to be younger than their darker haired counterparts, but are also judged to be less independent-minded and less willing take a stand”

businessinsider.com/heres-why-so-m…
Thing with “daughter” mental model is that most elite families (many or whom in upper echelons of business & non-profit) groom their *own* daughters early

by either abusing *them*
or exposing them early to abuse of others
that is then tolerated, justified
➡️#GhislaineMaxwell
Even father of modern #psychiatry lacked courage to call sexual abuse of own children in wealthy families, his clients, what it was.

It’s not normal to harm other humans. It takes a cycle of abuse withIN families of power & privilege & wealth

irishtimes.com/opinion/legacy…
No one who values own #mentalhealth should enter a royal or ultra wealthy family… SO much pathology, depraved forms of humanity there

We all saw what happened to Diana. Of course that was going to repeat if a new daughter in law, that too if not white

apnews.com/article/meghan…
My issue is with how #media & “optics” they produce

reinforce mental models/heuristics that affects everyday women, WOC, POC, etc…

when we try to do real things like be #HCW or if we enter #leadership

In medical #professionalism “optics matter” taught

mndaily.com/269471/arts-en…
We should NOT be teaching “optics matter” in #MedEd & #professionalism

Focusing on optics reinforces all the wrong mental models. We spend 95% of our time in biased “System 1” thinking

Teach that #ethics, humanism, #quality, #safety, outcomes matter

System 2 #criticalthinking
Literally, lives depend on it.

We MUST stop tolerating or adding to ….even what seems like silly memes or tabloid drama.

All of it represents culture & mental models & all reinforces what causes us to misjudge, deny, or harm.

ama-assn.org/delivering-car…
This in #healthcare #MedEd is a holdover from slavery and Colonialism, truly embedded in culture

the ability to exploit, enslave, r*pe, harm, kill someone else depends on a belief that they are not fully human and do not even feel pain

statnews.com/2016/04/04/med…
I used to see these seemingly figurehead/powerless royal families as irrelevant.

Now, I understand why #abolishthemonarchy was trending recently.

Glorify the same families who created current systems of oppression & still abuse power?

No.

marieclaire.com/celebrity/a381…
Even without power, still feuding.

No, inheriting a throne is not women’s empowerment.

"I think it's a very important act, especially now in 2021 where women are standing so much for their rights,"

abcnews.go.com/International/…
Women on thrones? Won’t save lives
as royal/elite families’ success is based on exploitation & inequity

Allowing the media to glorify predatory & abusive behavior patterns over centuries & attacking “upstarts” perpetuates racism, classism, exploitation

theguardian.com/artanddesign/2…
The power of image was utilized by Diana in ways that threatened the “I am too above you” persona of a queen/royalty.

She was a *direct* threat to power by being doing to earth

& “the people’s Princess”

as well as this famous #HIV/#AIDS advocacy.

elle.com/culture/movies…
Literally, you are not allowed to touch the queen. These royal protocols are not just cute antiquated customs

=ongoing, relevant power hierarchies today that play out in society

Think about clubs, country clubs, gated communities, what police protect

reuters.com/article/us-bri…
In #healthcare #MedEd there is also a “country club” culture, literally, and figuratively. @WSJ had published an OpEd on “social elitism” in medicine as a good thing. No, if you or your mother are a Black woman/man, POC, social elitism in hospitals ➡️ disparity in care➡️mortality
In a #pandemic, @JAMA_current was focused on #professionalism by optics, that too using online survey that has selection bias, only white models for “doctor” & then focused on optics, not #ethics …of say, whether #HCW should don #PPE prior to #CPR in #Omicron surge
#MedTwitter
In an attention economy, if #professionalism is defined by clothing, even by @JAMA_current, in a #pandemic ➡️misdirection
& becomes a form of #misinformation or #disinformation in #MedEd & #healthcare.

Not discussed: #DNR, #endoflife, #Whistleblower

econreview.berkeley.edu/paying-attenti…
This is on top of existing misdirection like by Dr. Birx who ridiculed #DNR

1-it is *always* the right time to talk of DNR.. well before crisis
2-given current #healthcare & #hospital capacity issues + AHA & CPR controversy

Will families believe hospitals now on DNR/#endoflife?
What is #MedEd healthcare #hospital#professionalism” doing about this vs #HCW?

“Workplace violence is more common by 4 to 5 times in healthcare than in other industries. And about 75% of all workplace assaults happen to #healthcareworkers

#MedTwitter
cbs6albany.com/news/local/vio…
This at frontline are facing this every single day. #Professionalism of optics has abandoned #HCW

Personally when my mother passed.. I & my family were quiet, we did not scream. My family did not even cry. We’re a doctor family & so-called “elite” lineage generations ago.
All of this is interconnected. #Professionalism of suppressed emotions (common in social “elitism” AND in #healthcare) ➡️ #PTSD from unprocessed #trauma. Lack of humanism & “optics matter” & unprotected ➡️ #HCW & #physician leaving profession or #suicide

linkedin.com/posts/usnehal_…
“Queen Elizabeth kept her stoic composure throughout her husband’s funeral service”

Thing is, when #professionalism in #healthcare tells #HCW: not allowed to smile or cry…we are NOT royalty. Humans are frontline are more made disposable than N95 masks.

pagesix.com/2021/04/17/que…
When we start to compare between & judge, control what others wear as “too much”

when optics are managed for liability, NOT safety

parallel in media teaching us how to view Meghan Markle
&
#HCW told they cannot buy selves own #PPE

what if a Black immigrant nurse protects self?
“whether BAME doctors felt less able to complain about inadequate personal protective equipment (#PPE) – a recurring complaint among healthcare workers during the crisis”

That is plausible. If you are the exploited identity, not allowed to protect self.

theguardian.com/society/2020/a…
This exists in #healthcare all over. French doctors wanted to run #clinicaltrial in Africa yet when it came to #vaccine distribution? Parts of Africa had such low access had 1% #vaccination rates

Now, this “disposable” attitude toward all frontline #HCW

bbc.com/news/world-eur…
Must be pro-justice always. If you ignore it when “only” affecting those at the margins & wait until you, safely in middle of society, are affected
too late

Do I care about an actress hounded by media?

No. I care about the mental models created by media

What is the media teaching us by comparing of Kate & Meghan? ➡️ who is a “good (elite) woman”

“she is for the role of future queen,” while the Sun pronounced: “Kate Middleton looked every inch the graceful and stoic royal at Prince Philip’s funeral.”

jezebel.com/the-forging-of…
Protecting the royal house, being discrete, being stoic, smoothing over scandal…if you are a future queen=align with power/past

But Diana & Meghan were unwilling to comply, spoke off script

Plus,what happens if seek to protect “own”/seek access when of a marginalized identity?
Admittedly, I grew up with romanticized ideas of royalty princes, princesses, etc…my own middle name means queen

We are regular people now…after moving countries from generations of experiencing countries falling/torn apart.

I had to develop a new mental model to see this
This is plausible. Woman who fails to comply with royal expectations & who fits the mental model of “threat” or “gold digger” based on race, American, non-elite family thrown to media wolves to distract? Protect the royal lineage/brand/reputation/optics.

theguardian.com/uk-news/2021/m…
How is that different from a #hospital posthumously smearing #DrSusanMoore in a press release as part of own reputation management, claiming she “intimidated” nurses with voice or knowledge or hospitals firing nurses who wear own N95 to protect own selves?

Image/optics>lives
“optics matter”
needs to trigger us to 👀 🧐

people who use/saw that are *telling us* themselves that they are manipulating our mental models
to manipulate via racism, classism, sexism, etc

It is not merely superficial. Is sinister. #ghislanemaxwell slate.com/news-and-polit…
Look at the exact match of “feminist” language of Dr. Birx as a victim (not a rational adult or fully accountable for own actions in this “male-centered” defense of a/by female physician)

& the “male coerced” of female abusers as written about #ghislanemaxwell

= a mental model
Is maximizing profit for #safety flagged product
forced on women by men too?

This mental model of women as perpetual victims, forever children, incapable of integrity around a man, is HOW we fail to see that women DO have agency/voice

but mislabeled

theguardian.com/us-news/2021/m…
The docile, compliant, power-aligned woman with the “right” “look”/optics/lineage takes actions to harm yet is “the victim” to avoid accountability

While the women with voice, knowledge, drawing attention to harm to self or the marginalized, mislabeled

historyextra.com/period/modern/…
Specifically this is the ideal woman

It’s about optics & narrative of connection, belonging, humanism while actually being/doing the exact opposite. How can you model human connection when no one is allowed to touch you?

(And, shouldn’t ALL humans only be touched with consent)
These are mental models of harm, exploitation, abuse. When elitism/classism also invokes racism & sexism
+
savvy media/reputation management to protect someone royal by blood whose entitlement may have led to participation in human trafficking… you get media vs #MeghanMarkle
The media needs the royals & vice versa: “an ‘invisible contract’…Royal Family and reporters..orchestrated public exposure is offered…in return for privacy behind palace gates.

‘There's a reason that these tabloids have holiday parties at the Palace’”

bbc.com/news/entertain…
After the last 2-3 years on #MedTwitter, initially puzzled then appalled by #professionalism & some in #SciComm

it finally clicked. It’s less #science #communication for #publichealth

& more #marketing, customer acquisition, reputation management

blog.ucsusa.org/andrew-rosenbe…
The #ethics of #SciComm & #COI discussed more than a decade

Narcissism & Machiavellian: attracted to media, visibility, power, image

So science/#healthcare (“academic royalty”) & #media may have important parallels to royals’ media manipulation

ncbi.nlm.nih.gov/pmc/articles/P…
If we look at Wakefield & #vaccine #misinformation

his being “high born” + doctor family➡️mental model of trust

Ego/narcissism of intention to win Nobel Prize seen as valid

His COI, not scrutinized

His abuse of patients & staff, not reported

Savvy use of media/smears
The “ability” of both of these Andrews - Prince Andrew & Andrew Wakefield - from “right” British lineage, relationships, & access to media

they fit our mental models of intelligence, “elegance”, “prestige” & “clubs” commoners vie to join?

@gorskon’s mental model sees “ability”
That mental model is why Epstein, with help from a British socialite woman, found it so easy to influence & enter American #science & #academia. In what world can you propose a “s*x farm” to impregnate young women & keep getting invited back?

#HigherEd

theverge.com/2019/9/19/2087…
Scientists at the most “prestigious” institutions cannot recognize eugenics or human trafficking cuz:
1-see💰
2-too busy policing POC via #MedBikini pettiness
3-real medical history not taught #HenriettaLacks
🔥➡️mental models of intelligence, goodness⬅️🔥
nytimes.com/2019/07/31/bus…
Two decades after Wakefield we are still perpetuating same elitism in science culture that *produced* Wakefield

Prince Andrew
Andrew Wakefield
(& Epstein/Maxwell)
⬇️
Predictable results of the exact same groups & culture (elitism)
⬇️
#antivaxx
Royals/Wakefield/Maxwell: savvy use of #media, reputation management, optics, smears
+
shady, human rights violating donors eyeing #STEM, #science, #tech
+
narcissism/abuses in #science
➡️need to watch #SciComm carefully for COI, source of harm, perpetuating wrong mental models
It is more than “you can’t be what you can’t see”

Wakefield thinking he was just like his celebrated luminary grandfather proves

You *will* be what is held up as a role model, like perpetrators of sexual assault, eugenics, ethics violations etc

bostonglobe.com/metro/2018/06/…
And STILL those formerly enslaved or colonized do NOT get the 💰💰💰to study selves

& there is no Epstein banging down the door to invite to private islands vie private jets

It is very low budget & SO much #compliance paperwork to do #communityhealth

statnews.com/2021/09/23/hea…
All of this is about institutions + media & the coordination between two to shape our mental models that shape intuition, judgments, decisions, actions, trust, punishment. Who belongs, is “good” vs threat➡️outcomes in economics & health &…

@WorldBank

blogs.worldbank.org/developmenttal…
What is scary is that experts rewarded for narrow/deep thinking only + personal excellence beliefs + “elite” institutions + wrong mental models/role models + pace of world (attention economy)
➡️high level of bias in “most intelligent” & #science elites

apa.org/monitor/2021/1…
Epstein’s interest: #DNA #research, eugenics, believed self superior. Royals: self superior based on bloodline. Wakefield? Same Scientists often perceive selves of superior intelligence AND ethics (“science is self correcting”) plus this history:

😱

nature.com/scitable/topic…
Honestly don’t know how we get out of this self perpetuating loop

that keeps us seeing narcissism & exploitation as “noble” & “elite”

with outcomes of exploitation, environmental stresses ➡️ health issues, criminalization
then that wrongly called “bad genes”
I do know we MUST dismantle both #implicitbias AND #systemicracism. #AI & #algorithms & #ML give us MORE images & info that matches our biases & emotions, more so in #pandemic. & Experts have too much ego, hubris, ambition to pause to examine mental models
blogs.scientificamerican.com/voices/i-know-…
Let’s hope those who are designing #tech & #AI & #ML & who are in #STEM #media etc who are pro-equity can work faster than those justifying status quo or past…and we can build systems/models for right nudges & outcomes.

modelthinkers.com/mental-model/f…
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More from @usnehal

31 Dec 21
I am trying to understand this response. Yes, #mentalhealth access is very limited & victims of abuse or domestic violence are at risk: ~3 women are killed daily by domestic violence.

Generational trauma can create perpetrators in subsequent generations. #GhislaineMaxwell
As a #pediatrician I have one signed papers & worked with authorities to evaluate a family situation, even remove children from a home.

Working in #emergencymedicine we also had children boarding for days due to lack of access.

Access *is* limited.

wbur.org/news/2021/02/0…
As I learned more about disparities & social justice & bias, I began to understand that *the system* is the source of “broken” Black & brown families, criminalizing certain parenting while much worse is *not* identified in privileged families.

time.com/5946929/child-…
Read 7 tweets
30 Dec 21
When you identify your own abuser as the source of power, strength, status…you become them, seek similar control. This is the cycle of abuse generation to generation.

#Trauma-informed therapy allows you to see abusive need for control =inner emptiness

Choose humanism instead.
Removing a child from an abusive situation is one way to break this cycle *if* also coupled with appropriate therapy.

law.marquette.edu/facultyblog/20…
That said, availability of that needed #trauma therapy is minimal to nil. We have a dearth of #mentalhealth clinicians. The pandemic has worsened that. There are disparities by insurance, state, country, socioeconomic factors, race, gender, etc.

socialsolutions.com/blog/barriers-…
Read 4 tweets
30 Dec 21
This makes me so 🤢

The idea that women are automatically “safe” is exactly what creates this “opportunity” for some women to exploit children & monetize their “optics” of “trustworthy” on behalf of predators.

Gender does not predict ethics, integrity, safety.
Why does #GhislaineMaxwellTrial matter to #womeninSTEM?
⬇️federal funding
➡️private donors (Epstein)

“Socialites” open doors to elite spaces, including #academia #science #STEM
Women=“optics” & “reputation management” for these wealthy predator men

theverge.com/2019/9/19/2087…
These same connected women, often daughters of powerful businessmen

are on boards of #WomeninSTEM “empowerment” organizations or on #MeToo (TimesUp scandal)

the very women who are predators of young women are given access to women’s “safe spaces”? (!!!)

bustle.com/entertainment/…
Read 33 tweets
25 Dec 21
#antivaxx efforts now even use #deepfake

to target #refugee, Black, religious minority communities

like measles outbreak in Minnesota in 2019: Wakefield was flown in TO spread #misinformation & #disinformation

Now: online fake accounts/fake identities vs #VaccinesWork
What has #healthcare been doing meanwhile?

#Medbikini: Teach (male Asian) med students to make fake accounts to cyberstalk trainees’ personal Facebook for: bikini
or “being political” or “religious” (#BLM)

➡️“model minority” pipeline for “shadow faculty” vs Blck @ayshakhoury
#Medbikini #research got flak for men vs women

BUT was ALSO fake acct #surveillance vs #BLM like drove out @ayshakhoury @uche_blackstock @nhannahjones

While academia has ignored #vaccineequity
➡️ongoing #pandemic & deaths in marginalized targeted by #antivaxx

@womanistpsych
Read 23 tweets
24 Dec 21
He spent his life as a first responder when others needed him. When he had a heart attack on the job, system overwhelm meant no resources available for him.

This is betrayal.

We’ve been asking, pleading, negotiating, screaming for this not to happen.
Those #HCW who spoke up early on #safety? Fired.

bloomberg.com/news/articles/…
Maybe listen to the ones who care enough to speak up on REAL #safety issues rather then fire them.

The current #HCW correct dismissals over refusal of #VaccineMandate claim administrators are “bullies” because that HAS been true in past.

npr.org/2021/10/24/104…
Read 16 tweets
23 Dec 21
This 👇🏽👇🏿👇🏻 This is why #BLM exists & why “implicit bias” is not only real but it kills

Why, when you see it, say something, do something
The system changes not by sharing tweets & hashtags but actions & consequences & removal of toxicity from the system

Follow #BlackTwitter
Above #MedEd #TikTok improvement: #citeblackwomen who lead this work (not only utilized the savior mindset of Black & brown as victims) #Blackexcellence @citeblackwomen center Black women
Send #SoMe traffic to Black creators & activists. #healthcare twitter.com/i/lists/122380…
Take #sharethemic initiative. It allowed #Blackexcellence to speak thru #influencer accounts to large followings for a day. I looked at before/after numbers, it did NOT drive any additional traffic to the actual accounts of those voices. Resurfacing this:

https://t.co/VZ26WWNxRP
Read 45 tweets

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