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religion-is-a-mental-illness · 7 months ago

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By: Winkfield Twyman, Jr.

Published: May 26, 2024

Every time a crusading medical school dean admits an uncompetitive, unqualified black student, said medical school dean hurts my niece. When you make crazy assumptions about the health needs of black women, you are harming my black niece. And by giving the incompetent false hope, you have made my niece’s journey in life that much harder.

Let me explain since the narrative only seems to go one way these days.

My niece is a smart pre-med student at a top university. She has several doctors in her family. Is she a privileged black person? Yes, she is. She is a graduate of a prominent private prep school. She has traveled the world. Her parents are no strangers to acclaim on the world stage. She is an Ivy League legacy daughter, the descendant of a Central American family, and wants to become a doctor.

Sadly, these are lousy times for my niece to apply to medical school.

First, there are crusading medical school deans who are not holding black applicants to the same standards as white and Asian students. Expectations for blacks have totally collapsed at some medical schools to my horror. At one local medical school and to boost diversity, standards are no more. “Standardized tests that up to 50 percent of some UCLA cohorts now fail…Nationally, only 5 percent of students fail those exams.” At this medical school, eight medical school professors, including four members of the medical school admissions committee, revealed that black applicants have a lower bar to overcome.

The first-year curriculum contains a mandatory course on “structural racism.” Structural racism. “Other units discuss the ‘sickness of policing’ and link ‘Queer liberation to liberation from the carceral state.’" Meanwhile, what are the failing medical students learning? “And the students that remain have become increasingly entitled about their ignorance with one professor reporting that he was berated by a student in the operating room who accused him of putting her on the spot when she could not identify a major artery.”

If I can help it, this incompetent student will never see me in a medical capacity.

Second, my niece deserves to be admitted in flat out competition with other applicants for admission. To do otherwise plants doubt in her mind as to her qualification and doubt in the minds of her white and asian classmates and doubt in the minds of her faculty members. Why set my niece up for the imposter syndrome, that she doesn’t belong and can’t handle the work?

Third, my niece is not marginalized. She is not oppressed. She is not suffering from structural racism. The required first-year curriculum would expose my niece to zany dogma and slogan words. She needs to learn about major arteries. Her instruction should be color indifferent.

Fourth, the longer lasting evil is the poor perception of black doctors as a group in the larger world. Who in their right mind would feel comfortable going to a doctor who has failed their first and second-year exams? I wouldn’t. It is not about race. It is about competency. My niece deserves an admissions process that allows my niece to hold her head high in medical school. One does the opposite when one erases grades and MCAT scores in favor of boosting diversity.

Let’s talk about the foreseeable consequences of throwing standards to the wind for black applicants to medical school. One doesn’t magically become a medical genius in medical school. That is magical thinking. As with all things in life, garbage in becomes garbage out.

Did you know that Michael Jackson died because his black doctor, Conrad Murray, negligently administered the drug propofol? Dr. Murray lacked specialty training. The drug was not supposed to be administered as a sleep aid. Jackson’s death was ruled a homicide by the Los Angeles’ Coroners Office. Dr. Murray graduated from Meharry Medical School where the average MCAT score is 503. For purposes of comparison, the median MCAT score at Yale Medica School is 522. The median MCAT score for black applicants is 494. There is a world of difference between 494 and 522.

Michael Jackson was a part of my growing up. I loved Michael Jackson. I cut Dr. Murray no slack.

We have been down this road before with no competitive standards for admissions to medical school. Remember the Bakke case in 1978? I do. The white male applicant Alan Bakke's MCAT score overall was 72; the average applicant to UC Davis scored a 69 and the average applicant under the special program for black applicants was a 33. The UC Davis Medical School denied Bakke admissions. Bakke had to go the U.S. Supreme Court to gain admissions to medical school. He graduated in 1982 and led a fine career as an anesthesiologist at the world-renowned Mayo Clinic.

And as for the applicant who replaced Bakke? What became of the black medical student Dr. Patrick Chavis admitted with almost non-existent MCAT scores?

Dr. Chavis left a wake of carnage in his medical career. Dr. Chavis “performed liposuction on 43-year-old Tammaria Cotton and killed her. Two other women came close to being killed at Chavis’s incompetent hands.” Note well about the character of Dr. Chavis: “Yolanda Mukhalian lost 70 percent of her blood after Chavis hid her in his home for 40 hours following a bungled liposuction; she miraculously survived.”

An incompetent doctor tends to remain a danger to the public. “In 1997, the Medical Board of California suspended Chavis’s license, citing his ‘inability to perform some of the most basic duties required of a physician.’ The board further noted Chavez’s insensitivity to patients’ pain. The board had access to a tape recording of patients screaming in agony while Chavez humiliated them.”

How did Dr. Chavis meet his end? “According to a Los Angeles County Sheriff's detective I spoke with last week, Chavis was murdered on the night of July 23 in Hawthorne, an economically depressed neighborhood on the southern edge of Los Angeles. Three unknown assailants shot him during an alleged robbery at a Foster's Freeze.”

I fault the admissions committee at UC Davis that admitted an uncompetitive and unqualified applicant to medical school for reasons of boosting diversity, not merit. Black patients like Michael Jackson and Yolanda Mukhalian deserved competent black doctors.

It is difficult to identity all instances where nominal standards for medical school admissions have caused patient harm on the back end. The internet doesn’t easily lend up stories of failed black doctors who should not have been admitted to medical school in the first place. If one can’t identify a key artery in medical school, stay away from me and my family. I don’t care about your race. I care about your competency.

I know a doctor who failed his residency boards over twenty times. He spent perhaps half of his adult life taking the boards twice a year. He never passed but he could always take the boards again, and again, and again. The medical school admissions system failed this person. He should have been encouraged to discover his real talents in life in his early 20s. Indeed, the hunger for increasing the number of black doctors sucked in this young man and the rest was a long slog through study all the time year after year after year. He grew to hate his profession and life. Would you want to be his guy’s patient? He eventually passed as a middle-aged man. It was poignant, a dream deferred.

These are the foreseeable consequences of choosing race over qualifications. Wasted lives and endangered patients.

Conclusion: My niece deserves a world where she can pursue her medical school dreams free of ideology, dogma and slogan words. She doesn’t want to become a Dr. Conrad Murray, a Dr. Patrick Chavis or a resentful young doctor who can’t pass her boards. She wants a fair and square opportunity to be admitted on good faith terms. Medical school deans do my niece no favor if they play around with identity politics and the dreams of my niece.

She wants to do no harm. And admissions committees for medical schools should do the same.

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primofate · 1 year ago

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You, Wriothesley's therapist.

TW: mentions of murder, depression, trauma

Sigewinne takes care of the physical injuries in the Fortress...but that place must have a lot of mental instabilities, trauma, depressive states as well, right?

Enter you who is hired by the Iudex to take frequent visits to the fortress and check on a list of people's well-beings.

The Iudex hired you, not the duke, though it WAS the duke's idea, he didn't think he was fit to choose and hire a "therapist", Neuvillette was probably more adept at that.

On the first day of your job, the list or people to check on is rather extensive and you talk and meet with a lot of new people just on the first day.

That guy who killed his best friend and is haunted by dreams of the scene.

That young lady who has spiralled into depression because she's separated from and unable to see her daughter.

That old man who has anger issues because he just didn't think he had done anything wrong.

It was probably a week or two after you were appointed that you finally met the person in charge of the place. The Duke, as they call him.

He seemed like a pretty strict guy, but when he thanked you for looking after the people here, you thought he wasn't that bad.

"I'm just doing my job,"

"A really hard one at that," he comments.

The next time you see him is months after, but this time he only passes you a glance, and rather quickly strides off to his office.

The next day, he seeks you out and apologizes for it.

"I was...in a bit of a rush,"

You wonder why he even apologizes. "...It's no big deal,"

"...I hope that you know that you're welcome here. I don't think you quite understand how difficult your job is, trying to shoulder everyone's past and fixing their psyche for their future,"

You look up at him, and tilt your head a little, squinting your eyes and trying to get a good read out of him...then it hits you.

The Duke needs therapy too.

"...I think you're a little stressed, your grace. Is there a quiet place where we can comfortably chat in?"

How were you to know it was going to end up in tea time? Yes the duke had issues, some deep seated ones, but not as much as the common folk that you were trying to work with. And yet you found yourself having tea with him even though it wasn't "work" related anymore.

All the two of you talked about were stories of the past, and shared a laugh or two about some silly or outrageous story he or you shared.

Weeks later there came a time when the angry old man you'd been working on had an outburst. He didn't mean to. None of your patients ever mean to, not when they had such big emotions, such big events to get over, such pent up emotions and such deep, deep regrets.

Old man had thrown a wrench at you, he was surprisingly strong, probably from working in the fortress for a while. You were caught off guard, not to mention you weren't even sitting too far away from him. You managed to shield yourself from it, but your arm bruised hours later.

You didn't think it merited a visit to Sigewinne, besides it was nearly home time for you.

"Done for the day?" You bristled a little at the sudden voice of the Duke, not expecting to see anymore of him today.

"Mmhmm," you simply answered his grin. You also didn't think it was something to hide from him. So your bruised arm was there for him to see in plain sight.

His grin disappearing and his eyes narrowing at the sight alerted you that it was perhaps something that you should've kept from him. "Where'd you get that?" He was 1000% sure you didn't have it when you had tea with him at noontime today.

"This...Well...Corrin was...having a particularly bad day," you moved your arm behind your back with a small smile, wanting to brush it off, but Wriothesley puts his hand out in expectation.

"Let me see it,"

For a moment the two of you just stare each other down. You wondering what the big deal was, him not backing down. When you didn't move an inch he gives in and adds the magic word. "Let me see it, please,"

You lift your arm up towards his head with a sigh and he receives it shockingly gently. He inspects it like it's some kind of puzzle he needs to solve, thorough and detailed. "Did you let Sigewinne see?" before you could even reply he adds "How did this even happen? Why was I not told?"

"It's..." You start. How do you explain? That you were supposed to be your patients' safe space. That nothing is supposed to harm them when in a session with you, that everything was in confidentiality. Working with troubled people, things like this were bound to happen, and it was only the first time.

He catches on to it quite quickly. "...It's your job," he finishes for you.

"...Precisely,"

The big sigh he lets out at the same time as releasing your arm has you wondering, really, why he seemed so stressed all over again. Over you.

Did you really not know the reason? You had an inkling why, you were a therapist after all. You got into people's minds for a living and Wriothesley wasn't exactly being subtle, but... you didn't want to assume.

"...How about I come with you next time?" he offers. You smile a little. "I don't think Corrin would be comfortable enough to talk with you hovering around,"

He grumbles something under his breath, like a defeated, stubborn puppy. "He doesn't have to know... I'll stand outside, or something,"

You laugh a little. "...The Iudex already has terms on my working contract when things like this happen. I'm supposed to drop the patient if "physical disputes" happen a total of three times and after three warnings are given."

Wriothesley huffs, though it sounds more like a scoff. "Leave it to him to think of everything. Doesn't seem fair," he moves so that he stands next to you, and places a hand on your upper back, pushing you the slightest bit to walk with him. You notice he's steering you towards the Fortress' infirmary.

"What doesn't seem fair?" You ask with genuine curiosity, not knowing what he was implying.

He's silent only for a beat more, but he doesn't look at you as he answers, only continues walking forward. "That he gets to protect you and I don't,"

You can't mistake the somersault your heart makes, you bite the inside of your cheek to keep from smiling silly.

The Duke needs the occasional therapy.

Or maybe he just needs you.

#genshin impact #genshin impact fluff #wriothesley #wriothesley x reader #wriothesley fluff #genshin impact wriothesley

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mostlysignssomeportents · 4 months ago

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Marshmallow Longtermism

The paperback edition of The Lost Cause, my nationally bestselling, hopeful solarpunk novel is out this week!

My latest column for Locus Magazine is "Marshmallow Longtermism"; it's a reflection on how conservatives self-mythologize as the standards-bearers for deferred gratification and making hard trade-offs, but are utterly lacking in these traits when it comes to climate change and inequality:

https://locusmag.com/2024/09/cory-doctorow-marshmallow-longtermism/

Conservatives often root our societal ills in a childish impatience, and cast themselves as wise adults who understand that "you can't get something for nothing." Think here of the memes about lazy kids who would rather spend on avocado toast and fancy third-wave coffee rather than paying off their student loans. In this framing, poverty is a consequence of immaturity. To be a functional adult is to be sober in all things: not only does a grownup limit their intoxicant intake to head off hangovers, they also go to the gym to prevent future health problems, they save their discretionary income to cover a down-payment and student loans.

This isn't asceticism, though: it's a mature decision to delay gratification. Avocado toast is a reward for a life well-lived: once you've paid off your mortgage and put your kid through college, then you can have that oat-milk latte. This is just "sound reasoning": every day you fail to pay off your student loan represents another day of compounding interest. Pay off the loan first, and you'll save many avo toasts' worth of interest and your net toast consumption can go way, way up.

Cleaving the world into the patient (the mature, the adult, the wise) and the impatient (the childish, the foolish, the feckless) does important political work. It transforms every societal ill into a personal failing: the prisoner in the dock who stole to survive can be recast as a deficient whose partying on study-nights led to their failure to achieve the grades needed for a merit scholarship, a first-class degree, and a high-paying job.

Dividing the human race into "the wise" and "the foolish" forms an ethical basis for hierarchy. If some of us are born (or raised) for wisdom, then naturally those people should be in charge. Moreover, putting the innately foolish in charge is a recipe for disaster. The political scientist Corey Robin identifies this as the unifying belief common to every kind of conservativism: that some are born to rule, others are born to be ruled over:

https://pluralistic.net/2020/08/01/set-healthy-boundaries/#healthy-populism

This is why conservatives are so affronted by affirmative action, whose premise is that the absence of minorities in the halls of power stems from systemic bias. For conservatives, the fact that people like themselves are running things is evidence of their own virtue and suitability for rule. In conservative canon, the act of shunting aside members of dominant groups to make space for members of disfavored minorities isn't justice, it's dangerous "virtue signaling" that puts the childish and unfit in positions of authority.

Again, this does important political work. If you are ideologically committed to deregulation, and then a giant, deregulated sea-freighter crashes into a bridge, you can avoid any discussion of re-regulating the industry by insisting that we are living in a corrupted age where the unfit are unjustly elevated to positions of authority. That bridge wasn't killed by deregulation – it's demise is the fault of the DEI hire who captained the ship:

https://www.axios.com/local/salt-lake-city/2024/03/26/baltimore-bridge-dei-utah-lawmaker-phil-lyman-misinformation

The idea of a society made up of the patient and wise and the impatient and foolish is as old as Aesop's "The Ant and the Grasshopper," but it acquired a sheen of scientific legitimacy in 1970, with Walter Mischel's legendary "Stanford Marshmallow Experiment":

https://en.wikipedia.org/wiki/Stanford_marshmallow_experiment

In this experiment, kids were left alone in a locked room with a single marshmallow, after being told that they would get two marshmallows in 15 minutes, but only if they waited until them to eat the marshmallow before them. Mischel followed these kids for decades, finding that the kids who delayed gratification and got that second marshmallow did better on every axis – educational attainment, employment, and income. Adult brain-scans of these subjects revealed structural differences between the patient and the impatient.

For many years, the Stanford Marshmallow experiment has been used to validate the cleavage of humanity in the patient and wise and impatient and foolish. Those brain scans were said to reveal the biological basis for thinking of humanity's innate rulers as a superior subspecies, hidden in plain sight, destined to rule.

Then came the "replication crisis," in which numerous bedrock psychological studies from the mid 20th century were re-run by scientists whose fresh vigor disproved and/or complicated the career-defining findings of the giants of behavioral "science." When researchers re-ran Mischel's tests, they discovered an important gloss to his findings. By questioning the kids who ate the marshmallows right away, rather than waiting to get two marshmallows, they discovered that these kids weren't impatient, they were rational.

The kids who ate the marshmallows were more likely to come from poorer households. These kids had repeatedly been disappointed by the adults in their lives, who routinely broke their promises to the kids. Sometimes, this was well-intentioned, as when an economically precarious parent promised a treat, only to come up short because of an unexpected bill. Sometimes, this was just callousness, as when teachers, social workers or other authority figures fobbed these kids off with promises they knew they couldn't keep.

The marshmallow-eating kids had rationally analyzed their previous experiences and were making a sound bet that a marshmallow on the plate now was worth more than a strange adult's promise of two marshmallows. The "patient" kids who waited for the second marshmallow weren't so much patient as they were trusting: they had grown up with parents who had the kind of financial cushion that let them follow through on their promises, and who had the kind of social power that convinced other adults – teachers, etc – to follow through on their promises to their kids.

Once you understand this, the lesson of the Marshmallow Experiment is inverted. The reason two marshmallow kids thrived is that they came from privileged backgrounds: their high grades were down to private tutors, not the choice to study rather than partying. Their plum jobs and high salaries came from university and family connections, not merit. Their brain differences were the result of a life free from the chronic, extreme stress that comes with poverty.

Post-replication crisis, the moral of the Stanford Marshmallow Experiment is that everyone experiences a mix of patience and impatience, but for the people born to privilege, the consequences of impatience are blunted and the rewards of patience are maximized.

Which explains a lot about how rich people actually behave. Take Charles Koch, who grew his father's coal empire a thousandfold by making long-term investments in automation. Koch is a vocal proponent of patience and long-term thinking, and is openly contemptuous of publicly traded companies because of the pressure from shareholders to give preference to short-term extraction over long-term planning. He's got a point.

Koch isn't just a fossil fuel baron, he's also a wildly successful ideologue. Koch is one of a handful of oligarchs who have transformed American politics by patiently investing in a kraken's worth of think tanks, universities, PACs, astroturf organizations, Star chambers and other world-girding tentacles. After decades of gerrymandering, voter suppression, court-packing and propagandizing, the American billionaire class has seized control of the US and its institutions. Patience pays!

But Koch's longtermism is highly selective. Arguably, Charles Koch bears more personal responsibility for delaying action on the climate emergency than any other person, alive or dead. Addressing greenhouse gasses is the most grasshopper-and-the-ant-ass crisis of all. Every day we delayed doing something about this foreseeable, well-understood climate debt added sky-high compounding interest. In failing to act, we saved billions – but we stuck our future selves with trillions in debt for which no bankruptcy procedure exists.

By convincing us not to invest in retooling for renewables in order to make his billions, Koch was committing the sin of premature avocado toast, times a billion. His inability to defer gratification – which he imposed on the rest of us – means that we are likely to lose much of world's coastal cities (including the state of Florida), and will have to find trillions to cope with wildfires, zoonotic plagues, and hundreds of millions of climate refugees.

Koch isn't a serene Buddha whose ability to surf over his impetuous attachments qualifies him to make decisions for the rest of us. Rather, he – like everyone else – is a flawed vessel whose blind spots are just as stubborn as ours. But unlike a person whose lack of foresight leads to drug addiction and petty crimes to support their habit, Koch's flaws don't just hurt a few people, they hurt our entire species and the only planet that can support it.

The selective marshmallow patience of the rich creates problems beyond climate debt. Koch and his fellow oligarchs are, first and foremost, supporters of oligarchy, an intrinsically destabilizing political arrangement that actually threatens their fortunes. Policies that favor the wealthy are always seeking an equilibrium between instability and inequality: a rich person can either submit to having their money taxed away to build hospitals, roads and schools, or they can invest in building high walls and paying guards to keep the rest of us from building guillotines on their lawns.

Rich people gobble that marshmallow like there's no tomorrow (literally). They always overestimate how much bang they'll get for their guard-labor buck, and underestimate how determined the poors will get after watching their children die of starvation and preventable diseases.

All of us benefit from some kind of cushion from our bad judgment, but not too much. The problem isn't that wealthy people get to make a few poor choices without suffering brutal consequences – it's that they hoard this benefit. Most of us are one missed student debt payment away from penalties and interest that add twenty years to our loan, while Charles Koch can set the planet on fire and continue to act as though he was born with the special judgment that means he knows what's best for us.

On SEPTEMBER 24th, I'll be speaking IN PERSON at the BOSTON PUBLIC LIBRARY!!

If you'd like an essay-formatted version of this post to read or share, here's a link to it on pluralistic.net, my surveillance-free, ad-free, tracker-free blog:

https://pluralistic.net/2024/09/04/deferred-gratification/#selective-foresight

Image: Mark S (modified) https://www.flickr.com/photos/markoz46/4864682934/

CC BY 2.0 https://creativecommons.org/licenses/by/2.0/

#pluralistic #locus magazine #guillotine watch #eugenics #climate emergency #inequality #replication crisis #marshmallow test #deferred gratification

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