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Umbereen S Nehal, MD, MPH Profile picture
Umbereen S Nehal, MD, MPH
@usnehal
MIT Sloan fellow, coach, fmr Chief Med Officer & Medicaid med dir, Top Voice 4x, data nerd, digital health, MedEd, humanist, Tweets personal, RT🚫endorsement
May 29, 2023 • 13 tweets • 5 min read
This. When I had experiencing #bullying towards myself, I had just walked away or been silent, keep moving forward.

Once I had some degree of “rank”, felt others should not “just deal”

I did speak up on behalf of those less powerful… which only set me up for this mislabeling. That is not to say that as faculty you should not speak up for or defend students are trainees

but you should be aware of this.

If the #bully is a woman, then she can always claim that she is being “attacked”… “as a woman”

That narrative aligns with a common reality.
Jun 24, 2022 • 5 tweets • 7 min read
@ErinMarieMHCMEd @danpreston @JoshuaMZeitz @AmandaMarcotte All of this was already tested out vs American Muslims - the country was just fine with it. Regardless of what you think of the dad, killing/executing American citizen children by drone, along with father, should have been a big red flag on due process.

theatlantic.com/politics/archi… @ErinMarieMHCMEd @danpreston @JoshuaMZeitz @AmandaMarcotte ~Half of Americans approve of/support torture. The idea is you can use profiling/bias to assume someone is a terrorist or sympathizes with terrorists, assume has information, torture them first, then retroactively justify violation of human rights.

pewresearch.org/fact-tank/2017…
Jun 23, 2022 • 5 tweets • 3 min read
I think I need to go to law school. It might be a bit late to be #RBG & make it to SCOTUS… but seriously, it is all about the courts, the law, legal precedents.

Or maybe I just need to make myself small/silent enough to be able to fit into a government job again? As hard as it is for me to stay in government long term given all the regulations that box you in/tie you up

plus needing to be a public servant to serve every taxpayer, even the ones you don’t agree with/like

Despite that, you *can* have an impact…small things at scale matter
Jun 23, 2022 • 5 tweets • 4 min read
For the first time in my life I felt unsafe doing #GOTV & got personally targeted & my photo posted on a QAnon type site.

More appalling was how many on #healthcare & #academia, if you are connected on social media like FB, are pro-violence & anti-rule of law & support J6. If you are a Black, immigrant, LGBTQ, chronic illness, Muslim, etc person, patient, #HCW, teacher, heck yeah, is scary

Thing is those who have been safely tucked in cocoon of suburbia, worried about junior making the cut for the bball team
now feels suddenly scary

Us: not new
Jun 22, 2022 • 5 tweets • 5 min read
Anyone who did not see this coming does not understand #tech…(which includes people who design #AI).

“Important nuances were lost in translation when a rule commonly used to measure disparate impacts on protected groups in hiring was codified for easy-to-use tools…AI fairness” Every time I see “our #AI will solve bias! Give us your #DEI budget!” win an #innovation award, accelerator, #hackathon I feel exhausted…

institutions would rather purchase ineffective & worsening-the-problem #tech than hard work of holding ppl accountable or change culture
Jun 21, 2022 • 22 tweets • 16 min read
When will we admit that “clash of civilizations” of Islamophobia narrative is not only false but dangerous. “War on Terror”=waging war vs Muslims but #J6 & #BuffaloMassacre reveal terror is not one religion. When Muslims are “legit” targets…that supremacist hate spreads further. ImageImageImageImage Who was it “okay” to torture? (assumed is a terrorist?) Whose civil liberties disappeared 20 years ago? Muslims.

“But you all ‘deserve’ it” we’ve heard &: Why didn’t you stop terrorism? Why haven’t you apologized about x & y?

Now: consequences of that

vox.com/2016/3/31/1133…
Jan 3, 2022 • 16 tweets • 20 min read
This 👇👇👇 (h/t @joemd)

Also, at midcareer female success is threatening to men our age AND to younger men who rely on patriarchal patronage systems. Women, overpoliced by the system, then, yes, are tougher bosses AND we *do* tend to adhere more closely to ethics.

I do do all: On #MedTwitter there is a pattern of “callouts”, yes vs all genders & ages, but also pattern of misogyny and misogynoir. It happens towards nurses & doctors alike. One of the reasons I connected with @ShrimpBrokkoli is because I saw a yt male resident ridiculing her online.
Jan 3, 2022 • 8 tweets • 4 min read
Thing is… even prior to #COVID19, it was known that viral shedding can occur in feces up to 3 weeks or longer. Isolation periods have always been subjective. That said, for airborne spread, there is a need to take precautions while infectious in that way #Omicron Specific to #COVID19 (in #Pediatrics)

“duration of viral shedding in infected pediatric patients. Virus was detectable for a mean (SD) of 17.6 (6.7) days overall and was detectable for a prolonged period of time in all cohorts of children”

jamanetwork.com/journals/jamap…
Jan 2, 2022 • 9 tweets • 8 min read
Directness & saying what you mean is important. The receiver also needs to be ready to tolerate this. Society & business places tend to prefer the passive aggressive so being direct does invoke blowback. There is particular social cost to being direct & going against social norms

if your optics/demographics invoke mental models …say of expected discretion, “civility”, or “be kind” or “softness”

OR

if mental model invoked is “angry Black woman/man”

fastcompany.com/90413951/women…
Jan 2, 2022 • 5 tweets • 7 min read
As a #vaccine & #publichealth advocate I *always* respond to any question with sincerity. Since I got put on lists of pro-#DEI/#equity/#BLM docs to target is anonymous accounts will “@“ me then when I respond in good faith it is tallied as my “harassing” = manufacture fake #data. This is a deliberate anti-#publichealth #SciComm strategy to bully, harass (but then claim opposite), intimidate, & drive out

Sadly, it is successful

Hundreds of public health officials have left jobs, mislabeled by #disinformation smears

#MedTwitter

cnn.com/2021/05/23/hea…
Jan 2, 2022 • 4 tweets • 7 min read
Good question. Not everyone in #SciComm is actually equipped either, is the issue, as there is no credentialing, training, or gatekeeping of quality on #science #communication, much of which is #marketing or reputation management for hospitals & for profit #healthcare companies. In particular, there is a real dearth of credible, reliable #publichealth #communication & #scicomm. Much of what I have seen called as “SciComm” is “personal brand” & #marketing a private practice for revenue goals. Critical thinking or unbiased communication is still lacking.
Jan 2, 2022 • 4 tweets • 4 min read
This is happening in U.S. & U.K. Once I got to the management & C-suite, especially in #NYC, I was unwilling to send #HCW into unsafe spaces to be injured or die.

@drbreenheroes this is the crux of the issue. “#Mentalhealth” is really #moralinjury from #ethics violated. The frontline is disproportionately POC, women. Those making guidelines or in C-suite are able to protect themselves. Leadership manipulates data/definitions, then shames, gaslights. Non-clinicians hired to override #HCW with “opinion.” Those at frontline who speak up: fired.
Jan 1, 2022 • 76 tweets • 67 min read
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.
Dec 31, 2021 • 7 tweets • 5 min read
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…
Dec 30, 2021 • 4 tweets • 2 min read
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…
Dec 30, 2021 • 33 tweets • 32 min read
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…
Dec 25, 2021 • 23 tweets • 35 min read
#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
Dec 24, 2021 • 16 tweets • 13 min read
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/…
Dec 23, 2021 • 45 tweets • 73 min read
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…
Dec 12, 2021 • 32 tweets • 22 min read
At every critical step past the early life & career stage (then rewarded for just delivering)

when protecting loved ones from harm
or #leadership

listening to #BlackExcellence/Black women gave me the framework to understand & the tools to be effective.

time.com/5869662/black-… “Model minorities” chase impossible standards? Then let’s try to match of achievement level set by Black women

…who accomplish so much while mislabeled, hated, un-/underpaid, killed, losing their children to violence of others’ fear/anti-Blackness

wbur.org/cognoscenti/20…
Dec 11, 2021 • 47 tweets • 32 min read
Those of us with immigrant backgrounds have NO idea what debt we owe these women for risking their lives so some of us can shop at Whole Foods with other suburban moms, then drive a Lexus home to ride on a Peloton, & think only our own hard work created this access to success. Those of us who are Muslim have a partial experience of what it is like to be made the face of threat and danger and vilified.

…But “the West “still wants to “save” Muslim women… make us a token or mascot of saviorism & evidence of being a shining city on the hill.