#I needed some excuse to post md content

[kekeartzworld]

Uzi (Partial) Cosplay

I had not made Murder Drones posts on here in a hot minute so YEAH

Partial Uzi cosplay photo shoot time

Me with my Uzi plush

N plushie

V plushie

Stare down with Crowzi

More normal pose with Crowzi

Solver pin

Gender fluid + bisexual Uzi is canon in my mind

Mainly because Uzi is one of my kins

That’s all I wanted to show

Hopefully you liked these pictures

That’s all for now!

GOOD BYE!!!

[frostandflamesfanfic]

July 19th. (Strange x Reader)

July 19th. (Rated T)

Request?: Kinda??? Inspired by this post by @sobeautifullyobsessed

Pairing: Stephen Strange x Spouse!Reader; Parent!Stephen Strange & Daughter!America Chavez

Word Count: 3.3k+

Warnings: Slight suggestive content, fluff. pure fluff, a few curse words -- SLIGHT MoM spoilers if you squint

Summary: When you confront your husband, Stephen Strange, about a mysterious date highlighted on the calendar, you find yourself in for a bit of a surprise. Why is he so flustered? To make matters even more interesting, does it has something to do with your unofficially-adopted daughter, America?

July 19th. It was a date circled and marked with two large exclamation marks on the calendar in bright red ink. You had asked your husband what the occasion was, though he claimed he didn’t remember with a quick shrug. It wasn’t an anniversary or a birthday. You were sure about that, at least. Those were marked in your personal calendar and Stephen never forgot most of the time. 

When you first met your husband, the two of you had bumped into each other at the Columbia student library. You were both graduate students at the time. You were pursuing a Master’s in children’s education. For Stephen, it was his MD and PhD. There were numerous times that day you heard about his photographic memory. You weren’t sure who he was trying to impress then: you or his over-inflated ego. 

That’s what made the entire situation so odd. Years ago, this man never forgot a single day of his life. Now here he was claiming not to remember a calendar event he added on without a doubt. What was it that he wasn’t telling you? 

“Stephen,” you called around the Sanctum. You were sure he was still inside; he wasn’t due to visit Kamar-Taj until later this afternoon. Wong had made the decision to ban your husband from the area on the days America was scheduled for training. You couldn’t help but laugh at the memory of Stephen’s dejected face that day. 

“I just want to make sure she’s doing alright,” he had argued. “She was having trouble with Astral Projection last week-”

“She is fine, Stephen.” The current Sorcerer Supreme rolled his eyes. “Everyone who starts training in the Mystic Arts has an adjustment period. You should understand, given your experience.”

“That’s exactly why I need to be there to help her-”

“No.”

There was a low hum of acknowledgement as the man of the hour came out of the library with a giant leatherbound book in hand. “What’s going on, sweetheart?” he asked, half-distracted by the ancient text. 

“What’s really happening on the nineteenth?” You leaned against the doorframe to lock his appearance within your core memories. He looked more like a dad than anything in his oversized Columbia sweatshirt and sweatpants. It did things to you, needless to say. The Cloak of Levitation fluttered when it heard your voice. Obviously, the article of clothing knew what was going on, but couldn’t speak up. 

“Uh, it was something really important,” your husband couldn’t get rid of the tinge of mystery present in his tone. Much to his chagrin, you had already latched on and began deducing a variety of guesses. “Honey…you’re doing it again.”

“Doing what?” you asked, still distracted by your observations. 

“The thing where you try to figure out if I’m lying.”

You stepped back. “Oh, uh, sorry.” It always freaked Stephen out when you would try to tell a person’s life story in merely moments of knowing them. He often joked that you were in the wrong field, stating the police were always hiring. “What…what even did you say it was again?”

Your husband hesitated, clearly in an internal battle with himself. At first, he thought about coming up with some kind of excuse. Then he remembered you would never buy it. "Do you promise not to tell?" he asked begrudgingly. When you gave a quick nod, Stephen sighed and pulled out a crumpled piece of paper from his pocket. He handed it to you before letting his hand become distracted by the spell book in his possession.

GREENWICH JUNIOR HIGH INVITES YOU. . . TO THE FATHER-DAUGHTER DANCE. TICKETS ARE ON A FIRST-COME, FIRST SERVED, SO MAKE SURE TO RESERVE YOUR PLACE TODAY. PURCHASE THEM FOR $15 EACH AT THE OFFICE.

Your heart swelled for a moment as you read and re-read the short message over again. On top of her training at the Sanctum, both you and Stephen thought it would be a good idea to enroll America into the local high school. She deserved to have a real school experience. At first, your husband was against it (which you had a sneaking suspicion had something to do with the local spider-man), but he eventually gave in. Being a multidimensional traveler at such a young age meant she really had no true home. America needed to interact with people, she needed the education to succeed in the future. 

Upon seeing the invitation, you couldn’t help but giggle. “You want to go to a father-daughter dance?” you asked between snorts, magic still present in your body. 

Your husband shifted from his seat facing you to staring at the wall. “I didn’t say that.”

“You’re a horrible liar,” you stated plainly. 

“Now that's just rude to point out.” Stephen waggled a shaky index finger at you before nervously turning his attention back to the ancient text. 

A laugh bounced against the hallway. “We're married, Stephen,” you replied as you lifted your left hand into view. “It's part of the expectations. I’m only telling the truth.”

There was a sparkle of light as your engagement ring and wedding band created a kaleidoscope of rainbows throughout the room. The settings were simple, but you loved them regardless because Stephen had them made specially for you. Quite literally, in fact, as he had used the sacred spells of Alara to create the jewelry himself. After the two of you returned from being Blipped, you had decided to not to waste anymore time when life could be so short. You had thought it was the start of the craziest adventure the two of you ever faced, which was saying something after you had dissolved into dust for five years in order to save the world from a purple-faced genocidal maniac. Unfortunately, the universe had something much crazier in store for you in the form of a multiverse-traveling teenager with a plucky attitude and a jean jacket. 

Your husband grunted in annoyance at your confession, although you could see the faintest hint of a smile tugging at the corner of his lips. He knew that he was a horrible liar, but he also knew how to push your buttons. 

“Stephen,” you chided, lifting up additional paper attached to the invitation. “You already purchased the tickets. You’re too far gone at this point.”

“I didn’t want her to worry about the money,” he responded dejectedly. “She didn’t say anything about it, so I thought maybe she forgot, too…”

You walked over and ran a thumb against his cheek. Your eyes searched his before you pressed a kiss to his lips after a moment. “I knew it.”

Stephen raised an eyebrow in question. 

“You, Stephen Strange, are just one big old softie.”

Your husband was not amused by the observation. “Stop that,” he said in a flat voice. “I love you, but you can be a pain in my ass sometimes. Do you know that?” 

You simply shook your head fondly at the sorcerer before you. “Anything you say, teddy bear.”

“Don’t start doing that.” Stephen flicked his hands and the ancient textbook he was reading vanished back into the library. He brushed past you for only a moment before moving to pace in front of the fireplace. 

“Aw, why not?” you teased. “You’re soft just like one.”

“Because I’m anxious and you’re not helping matters by teasing me.”

You reached out to rub his forearm as an act of comfort. “Why are you anxious? What could possibly go wrong giving a teenager a ticket to the dance?” That definitely didn’t come out right.

Stephen shot you a look before he continued his pacing. “Everything. I don't know if she'd even want me to be there.” It surprised you how nervous Stephen was about the entire prospect of going to a dance with America. As long as you had known the doctor-turned-sorcerer, he had always made his stance on children quite clear: he didn’t want any. 

Then after the events of the Latina’s appearance, his demeanor started to change. There was a more caring and compassionate side to Stephen that you had rarely seen outside of special moments you’d manage to steal with him.He did his best to oversee her learning at the rebuilt Kamar-Taj. He offered advice when she struggled, providing a gruff, “well done,” at the end of every session. 

“Well, has she even asked you about it?” The silence you received in return spoke volumes. So he hadn’t brought the subject up to her or vice versa. That would make sense, come to think about it, as you couldn’t recall hearing about such an event. “Do you want her to?”   

There was another period of silence before a timid, “yes,” escaped Stephen’s throat. 

Your heart practically melted in your chest like ice cream on a swelteringly hot summer day. “God, I swear I fall in love with you more and more every day,” you admitted before you kissed him again. 

Stephen hummed in agreement as his arms wrapped around your waist. 

“So when are you going to ask her?” you asked with a voice that was clearly muffled by the fabric of his sweatshirt.  

“I... don't know,” he admitted again. “I don't even know if she's interested in going. Last week she was talking about how stupid school events were-”

“Probably because she never had these experiences before and is overwhelmed by it all! God, Stephen, give her some time to adjust!” You loved your husband, you really did. But sometimes he could be a real idiot. “Stephen, relax. What is the worst that could happen in this situation?”

“She rejects me.”

Leave it to Stephen Strange to list the most obvious and frustrating conversation in the history of the world. “Okay? It doesn’t mean she hates you.”

“But what if she does?” your husband had begun to wear holes into the main floor of the Sanctum Sanctorum. Since you didn’t need a surprise visit from one of the other sorcerers in the building during this time of stress, you walked over and held his arms from a short distance. 

“Stephen, look at me.”

The man in front of you avoided your gaze as long as possible before his blue-green eyes flickered over yours. “What?” he asked half-heartedly.

“You need to relax,” you gently ran your hands up and down his arms. The Cloak around his shoulders fluttered in agreement, causing you to smile. 

“I can’t relax,” Stephen argued. “I don’t relax.”

A smug smile flittered against your lips. “I can think of a few times you’ve been able to relax.” God, flirting really wasn’t your strong suit, was it? “How about this: if you ask her and she says no, I'll help you relax.”

The response was instantaneous: “Deal.”

You led him over to the sofa by the fireplace, hand clasped tightly in his. After the two of you sat down, you gave his hand a gentle squeeze and pressed a kiss to his lips. “You know,” you said with a lower voice, “even if she says yes- and you're good- maybe I'll help you relax then, too.”

Stephen smirked in return. “I like that, too.” You sat in silence for a moment, staring at the crackling fire in front of you. “It’s just,” he started to admit, “if I ask her, I don’t want to seem like I’m not . . .” 

“Like you’re not…what?” you gently pressed as he hesitated. 

Your husband sighed dejectedly. “...cool.”

You couldn’t help another laugh. This time, it stemmed from your midsection in a loud, obnoxious tone. “Oh, oh god-” you got out between chortles. 

“Nice to know that brings you joy, honey.”

“Stephen,” you wiped a few stray tears that had sprung to your eyes. “Honey, you’re a frickin superhero. You’re a wizard-”

“Sorcerer.”

“Sorcerer, right. You can summon magic at will, you saved her life when other versions of you had ultimately tried to kill her.” You crossed your arms against your chest. “I would say that makes you pretty damn cool. So grow a pair and just ask her, why don’t you?”

Just as your husband was about to retort, you were interrupted by the distraction of orange sparks in the living room. It took a few minutes before a clear circular portal made an appearance, revealing the young traveler lugging a backpack on her shoulder. It was one of the first times America had been able to use her sling ring. You glanced at Stephen, who looked more than impressed by her progress, to see if you should celebrate the milestone. Given the fact she made a beeline to the kitchen, the two of you figured it was best to let it go. 

“What,” you tried to joke, “did Wong not feed you?”

“Nope.” America’s voice carried in from the kitchen across the hall. There was a clanging of glass jars and bottles as she navigated her way through the fridge. “Do we have any pizza left?”

“Top shelf on the left,” Stephen called back in a bored tone. Somehow in the process of the chaos, he had summoned his ancient textbook. That man had a stress-reading habit. The sight caused you to shake your head in frustration and groan as you fell into his lap. “. . .do you mind?” your husband asked while he looked down at you in amusement.  

“Thanks!” A few moments later, the young student made her way back into the living room, juice box and pizza in hand with a few bites taken out of it. She flopped into the armchair across from the sofa, relishing in the taste of her cold Italian treat. Upon noticing your position, she waved the slice of pizza between you and Stephen. “What’s going on with you two?”

 “Nothing,” Stephen was quick to respond as you said, “adult things.”

The child wrinkled her nose and narrowed her eyes ever-so-slightly as she leaned forward. She was analyzing you both, a habit she had unfortunately picked up from you. You could feel Stephen twitch underneath your form. He was clearly afraid that America was about to determine his plans for the dance. After a minute long stare down, the young girl leaned back in the chair and took another bite of pizza. “Just don't do it in the laundry room. Again.”

A coughing fit wreaked havoc on your throat as you felt yourself choke on spit. The look on Stephen’s face showed he was equally surprised. “We- we were just grabbing detergent,” you responded, clearly flustered. 

“You were not reaching for the cabinets,” the teenager across from you said with a shake of her head. “You were reaching for his-”

“All right!” Stephen drew out the syllables and snapped his book shut, causing you to flinch and sit up. 

“She’s growing up too fast, Stephen,” you said with a dramatic gasp. “She’s going to college tomorrow, getting married next week. We’ll be empty nesters by the end of the month. Quick, give me another baby.”

Your husband merely shook his head at you. “Sometimes I wonder why I married you,” he admitted.

“Because you fell for my immaculate beauty and quick-witted charm.”

“Yeah. . .I’m sure that’s it.” Stephen smirked at you, which was replaced with confused annoyance by the sound of America’s juice box being emptied. 

You gaped at him. “Rude!” 

“That’s just honesty, darling.” He held up a shaky hand to reveal his ring, clearly mocking your earlier gesture. 

“Why you little-” you started but sighed and pinched the bridge of your nose. “Forget it. How were your lessons today, America?”

The teenager shrugged. “Boring. We learned how to turn elements into useful objects, so that was cool, I guess.”

You nodded. “How about school? Anything interesting coming up?”

“Uh,” America took the opportunity to squint up at the ceiling. “There is this dance coming up.”

“Oh, really?” you hoped your excitement wasn’t too obvious. You could see Stephen stiffen in your peripheral vision. “That sounds fun.”

“Yeah,” America nodded slowly, fingers absentmindedly toying with the sling ring on her opposite hand. “It’s a father-daughter dance, though. All the other girls are going. Even Tasha, who’s dad is like, never around. I’m pretty sure he’s cheating on her mom with his secretary.”

“Really?” You not-so-subtly nudged Stephen’s leg with yours. 

Taking the hint, Stephen cleared his throat. “Uh, America,” he started. “I, uh, I know you don’t have your moms here right…right now. And I, uh, I know I can’t replace them- not that I’m trying to at all! I just, uh, wanted you to know that if…uh, if you did want to go to the dance…” He shifted uncomfortably in his seat. “I would be more than happy to take you. Now, I know I’m not your dad-”

“You. . .you would do that?” America’s voice was small and quiet. You had never heard her sound like this before. Ever since she had crossed paths with Stephen, America had been anything but quiet. 

“Yes,” Stephen said with a sincere nod. “Of course.”

America’s voice cracked as she asked the next question. The poor girl looked to be on the verge of tears. “W-why?”

Your husband cleared his throat again. “Um, well,” he tilted his head toward her, “America, I know. . .I know what it’s like to feel like you’ve lost your family – to think that you’re entirely alone. But I also know what it’s like to find another family, to let yourself be loved and to love others.” His hand snaked its way over to intertwine with your own. “I just don’t want you to feel like you’re alone, America, because you’re not. You have me, Wong, all of us here at the Sanctum.”

By the time Stephen had finished with his little speech, you felt yourself getting a little misty-eyed. Being open and vulnerable was never something Stephen was known for. It was truly something to hear him express himself, especially with someone so young. You really did find yourself falling further and further in love with the dark haired man next to you. 

Without another word, America got up and launched herself into Stephen’s arms. You watched with a small, sad smile as she shook in the hug. Her lips were moving, but you couldn’t hear what she was saying. You gave them their space, scooting to the other edge of the sofa. A few moments later, America stepped away from her mentor and beamed. “I guess I need to find something to wear,” she remarked.

“Oh, I can help you with that!” you volunteered. “I have a few things in my closet you might like. Why don’t you head upstairs and we can go find something? I’ll be right there.”

The offer appeared to please the young girl as she all but skipped up the stairs. When you turned back to your husband, you noticed he had a grin plastered against his face that was fit to beat the band. “What’s up with you?” you asked with a smile. “What did she say?”

Stephen looked at you proudly before he kissed you with a bit of passion. As you broke apart, he leaned his forehead against yours and whispered, “she said, ‘thanks, dad.’”

“Aw, look at you smiling,” you teased. “I told you; you’re a great big softie.”

“Oh, stop it,” Stephen said firmly, but his eyes were playful. “Or else.”

“Or else what?”

“Or else I’ll kiss you senseless.”

“Oh no, the horror of being appreciated by my husband,” you giggled. 

Stephen raised an eyebrow. “Keep this up and I’ll do more than just kiss you senseless,” he spoke before kissing you again.

“Mm, do you promise?” Your heart swelled three sizes as you got up and took the Sanctum stairs two at a time. Stephen was right. There would be times that you felt alone, but it was important to remember everyone in your life that did care. For you, it was your husband and unofficial young ward. The three of you made the most chaotic (and sarcastic) little family, but you wouldn’t have it any other way. 

====================

Author's Note: Oh my god, this now has to be my favorite fic that I have ever written. I enjoyed putting this together SO much. Shoutout to my friend mischief-and-mercy on AO3 for helping me out with some of the dialogue in the fic. It was meant to be a super short fic, but it kind of got away from me...again.

To ohsobeautifullyobsessed, I blame and thank you for setting my brain on this path. I accept this as a headcanon and love Parent!Stephen with all of my heart. I meant to get this out for you yesterday, but life got in the way. Hope you enjoyed it :D

I will get back to my other requests as soon as possible. I do have another fic scheduled to be posted on June 1st. It has to do with Stephen and a certain prideful month... so stay tuned, little sparks!

Until then, make sure to leave a comment, a heart, and a reblog to help me out with the Tumblr algorithm. It also really helps me see what types of stories you all like to see on my blog! Until next time, loves!

[kristinsimmons]

#USMLEPassFail: A Brave New Day

By BRYAN CARMODY, MD

Well, it happened.

Beginning as soon as 2022, USMLE Step 1 scores will be reported pass/fail.

I’m shocked. Starting around two weeks ago, I began hearing rumors from some well-connected people that this might happen… but I still didn’t believe it.

I was wrong.

The response thus far has been enormous – I haven’t been able to clear my Twitter mentions since the news broke. And unsurprisingly, the reaction has been mixed.

In the future, I’ll post more detailed responses on where we go from here – but for now, I’d like to emphasize these five things.

1. By itself, making USMLE Step 1 pass/fail doesn’t fix much.

Simply getting rid of three digit scores doesn’t improve medical education. And it doesn’t make residency selection any better, either.

It does give us the opportunity to make changes. And the importance of that should not be understated.

Put simply, this is the greatest opportunity for medical education reform since Flexner, and the greatest opportunity to re-design residency selection since… ever.

“WHAT WILL REPLACE STEP 1?” IS A HARD QUESTION. AND MAKE NO MISTAKE, THE FACT THAT IT’S A HARD QUESTION IS ONE OF THE VERY REASONS MANY CLUNG TO STEP 1 SCORES SO DOGGEDLY.

2. The path of least resistance does not take us where we want to go.

Most of the commentary on social media thus far has taken the following form:

Now only Ivy League medical students will get into competitive specialties.

Don’t worry! USMLE Step 2 CK will just be the new Step 1.

I guess DOs and IMGs can forget about getting into top residency programs.

And you know what? Most of these concerns are justified.

If we do nothing, Step 2 Mania is the natural result of a pass/fail Step 1. And unless we give program directors more useful information – and the time to thoughtfully review all the applications they receive – they’ll gravitate to another convenience metric out of necessity.

But that does not mean it’s inevitable.

3. We all have a say in what comes next.

If the rise and fall of a scored Step 1 teaches us nothing else, it should clearly demonstrate these two things.

First, advocacy works. There is no way that the NBME’s entrenched, out-of-touch bureaucracy would have ever voluntarily changed Step 1 to pass/fail – unless their feet had been repeatedly been held to the fire by the public over the past year. Change is possible – but you have to speak up.

Students, I’m looking at you – especially those from “non-elite” or international medical schools. You have a say in what comes next. How should residency programs evaluate you? Surely, answering multiple choice questions with peripheral relevance to real patient care is neither the best nor the only way to identify your talent. It’s time to dream bigger – and demand more meaningful evaluation.

Second, medical students will rise to whatever bar we set for them.

Ask them to memorize an 800 page review book so they can excel on a multiple choice question test of basic science esoterica? Done and done. Students knew most of what they were learning was pointless – but they worked tirelessly because we told them it mattered.

So program directors, now I’m looking at you. Whatever you tell students to do, they’ll do. You want high Step scores? Students will give them to you. But what really matters to you? Do you want residents who will serve the underserved? Contribute to research? Arrive on July 1 with specialty-specific knowledge? Whatever you say, goes. If you choose to grump about the loss of the bad old days, you’re abdicating your authority to set the standards you want.

YOU WON’T FIND ME SHEDDING ANY TEARS OVER THE DEMISE OF A SCORED STEP 1.

4. No one should mourn the loss of a scored Step 1.

Look around my Twitter mentions, and you can find touching testimonials mourning the demise of Step 1 scores. There are tales of useful factoids brought to bear on patient care decades later; of students inspired to consume as much (mostly useless) scientific knowledge as possible; of doors opened and careers launched because of one shining moment on test day years ago.

Give me a break.

The Step 1 score was the biggest false god in medical education, and no one should be too sad that it’s going away.

Was it objective? Sure. But the ability of three-digit scores to discriminate between applicants was actually fairly imprecise.

Did it test some useful concepts? Of course. But scoring highly required memorizing esoteric information that would never benefit an actual human patient.

Did some students benefit from scoring highly? Absolutely. But did Step 1 scores really “level the playing field” for students from international or non-prestigious medical schools overall? I doubt it.

Did it give program directors an easy way to screen applications? Yup. But was that way meaningful? Probably not. The main value of Step 1 was that it gave you a number. But if the content of the test doesn’t matter, why not just have medical students throw darts, or race go karts, or memorize digits of pi?

And of course, our idol worship of Step 1 came at a significant opportunity cost. The fact that most of us turned out okay doesn’t prove that Step 1 was the best way, or that that we wouldn’t have been better off under another system.

Here’s the thing:

Whether you liked a scored Step 1 or not, the current system is not what any of us would have designed if we were building something from the ground up.

In the scored Step 1 era, we sat back and watched as preclinical medical education turned into a glorified USMLE prep course with a five-figure/year tuition bill attached. We did nothing as residency applications spiraled out of control and program directors’ outsourced their most important decision-making to the NBME.

We shouldn’t be proud of any of this. And we shouldn’t mourn the loss of the three-digit score that enabled us to neglect the need for reform for so long.

More importantly, there is no turning back now.

If you opposed #USMLEPassFail, do your grieving for the scored USMLE – and then get to work. Saying “I told you not to make Step 1 pass/fail!” is a hollow victory. There is an opportunity here to engage our students in tasks that could actually lead them to be better physicians – but we have to seize it.

And if you supported #USMLEPassFail, now is not the time to dance on the three-digit score’s grave. We need to get to work, too – or this hard-won victory will go for naught.

5. The way forward… my opinion

Expect more from me on these topics in the future, but for now, let me put these three thoughts in your head.

WE NEED MEANINGFUL EVALUATIONS.

My 5th grader’s report card provides more useful information than any medical school transcript I’ve ever seen. He doesn’t get an “A” in math – I get to see a lengthy list of math skills and an assessment of where he’s at with all of them. Maybe he’s comfortable dividing fractions, but still developing proficiency with using variables to set up algebraic equations.

Letter grades are nice – but they don’t tell me what he knows and what he doesn’t. (I don’t get a histogram of other students’ performance and where he falls – because how other students performed is kind of irrelevant if my goal is to help him become better in math.)

The fact that elementary schools provide more information-rich evaluations than medical schools is shameful. In the past, we’ve justified this because of Step 1. Starting in 2022, that excuse will ring hollow.

Let’s be honest: there should never be a medical school evaluation in which a students is exceptional in every area. (If there is, it tells you more about the school than the student.)

Our goal should be to make medical school formative, not performative; to help learners maximize their potential without fearing failure; to provide and communicate honest feedback that leads to improvement and growth along the spectrum of medical education. (For their part, program directors need to focus less on relative accomplishment and more on potential to grow and thrive in that program/field.)

We don’t need another arms race. We do need more thoughtful evaluation. We should require students to engage in tasks that leave them – and their future patients – better off. And schools that refuse to participate in this process should be penalized by program directors and medical school applicants alike.

WE NEED HOLISTIC REVIEW.

I don’t think we need a one-size-fits-all metric to tell us who are the “best” applicants. Honestly, we don’t.

Certain talents and traits get you a lot farther in certain disciplines than others. Even within the same discipline, different programs have different needs and serve different missions. What makes a good doctor? It’s complicated. And trying to reduce that complexity down to a single three digit number is silly.

Holistic review is possible. It’s what we do at the residency program at which I’m an associate program director. But it’s labor intensive – and it requires human judgment. That last part makes some people uncomfortable, and I understand why. Holistic review has the potential to devolve into bias and cronyism. But that’s not a reason to not do it – it’s a reason to strive to do it well, to make decisions deliberately, and to build some checks and balances to make sure you stay aligned with your values.

WE ALSO NEED APPLICATION CAPS.

The only way to get away from screening metrics and treat every applicant as an individual is to limit the pile of applications that program directors receive.

THE EXISTENCE OF A SCORED STEP 1 ALLOWED US TO PRETEND THAT THIS WASN’T HAPPENING.

Look, I’ve preached this sermon before. But you’d better believe I’m gonna be carrying this particular gospel to the people again in the near future.

Afraid of application caps? Worried that they’ll disadvantage students from non-elite schools? Stay tuned for a data-driven expose of the misinformation surrounding caps coming soon.

Dr. Carmody is a pediatric nephrologist and medical educator at Eastern Virginia Medical School. This article originally appeared on The Sheriff of Sodium here.

The post #USMLEPassFail: A Brave New Day appeared first on The Health Care Blog.

#USMLEPassFail: A Brave New Day published first on https://wittooth.tumblr.com/

[lauramalchowblog]

#USMLEPassFail: A Brave New Day

By BRYAN CARMODY, MD

Well, it happened.

Beginning as soon as 2022, USMLE Step 1 scores will be reported pass/fail.

I’m shocked. Starting around two weeks ago, I began hearing rumors from some well-connected people that this might happen… but I still didn’t believe it.

I was wrong.

The response thus far has been enormous – I haven’t been able to clear my Twitter mentions since the news broke. And unsurprisingly, the reaction has been mixed.

In the future, I’ll post more detailed responses on where we go from here – but for now, I’d like to emphasize these five things.

1. By itself, making USMLE Step 1 pass/fail doesn’t fix much.

Simply getting rid of three digit scores doesn’t improve medical education. And it doesn’t make residency selection any better, either.

It does give us the opportunity to make changes. And the importance of that should not be understated.

Put simply, this is the greatest opportunity for medical education reform since Flexner, and the greatest opportunity to re-design residency selection since… ever.

“WHAT WILL REPLACE STEP 1?” IS A HARD QUESTION. AND MAKE NO MISTAKE, THE FACT THAT IT’S A HARD QUESTION IS ONE OF THE VERY REASONS MANY CLUNG TO STEP 1 SCORES SO DOGGEDLY.

2. The path of least resistance does not take us where we want to go.

Most of the commentary on social media thus far has taken the following form:

Now only Ivy League medical students will get into competitive specialties.

Don’t worry! USMLE Step 2 CK will just be the new Step 1.

I guess DOs and IMGs can forget about getting into top residency programs.

And you know what? Most of these concerns are justified.

If we do nothing, Step 2 Mania is the natural result of a pass/fail Step 1. And unless we give program directors more useful information – and the time to thoughtfully review all the applications they receive – they’ll gravitate to another convenience metric out of necessity.

But that does not mean it’s inevitable.

3. We all have a say in what comes next.

If the rise and fall of a scored Step 1 teaches us nothing else, it should clearly demonstrate these two things.

First, advocacy works. There is no way that the NBME’s entrenched, out-of-touch bureaucracy would have ever voluntarily changed Step 1 to pass/fail – unless their feet had been repeatedly been held to the fire by the public over the past year. Change is possible – but you have to speak up.

Students, I’m looking at you – especially those from “non-elite” or international medical schools. You have a say in what comes next. How should residency programs evaluate you? Surely, answering multiple choice questions with peripheral relevance to real patient care is neither the best nor the only way to identify your talent. It’s time to dream bigger – and demand more meaningful evaluation.

Second, medical students will rise to whatever bar we set for them.

Ask them to memorize an 800 page review book so they can excel on a multiple choice question test of basic science esoterica? Done and done. Students knew most of what they were learning was pointless – but they worked tirelessly because we told them it mattered.

So program directors, now I’m looking at you. Whatever you tell students to do, they’ll do. You want high Step scores? Students will give them to you. But what really matters to you? Do you want residents who will serve the underserved? Contribute to research? Arrive on July 1 with specialty-specific knowledge? Whatever you say, goes. If you choose to grump about the loss of the bad old days, you’re abdicating your authority to set the standards you want.

YOU WON’T FIND ME SHEDDING ANY TEARS OVER THE DEMISE OF A SCORED STEP 1.

4. No one should mourn the loss of a scored Step 1.

Look around my Twitter mentions, and you can find touching testimonials mourning the demise of Step 1 scores. There are tales of useful factoids brought to bear on patient care decades later; of students inspired to consume as much (mostly useless) scientific knowledge as possible; of doors opened and careers launched because of one shining moment on test day years ago.

Give me a break.

The Step 1 score was the biggest false god in medical education, and no one should be too sad that it’s going away.

Was it objective? Sure. But the ability of three-digit scores to discriminate between applicants was actually fairly imprecise.

Did it test some useful concepts? Of course. But scoring highly required memorizing esoteric information that would never benefit an actual human patient.

Did some students benefit from scoring highly? Absolutely. But did Step 1 scores really “level the playing field” for students from international or non-prestigious medical schools overall? I doubt it.

Did it give program directors an easy way to screen applications? Yup. But was that way meaningful? Probably not. The main value of Step 1 was that it gave you a number. But if the content of the test doesn’t matter, why not just have medical students throw darts, or race go karts, or memorize digits of pi?

And of course, our idol worship of Step 1 came at a significant opportunity cost. The fact that most of us turned out okay doesn’t prove that Step 1 was the best way, or that that we wouldn’t have been better off under another system.

Here’s the thing:

Whether you liked a scored Step 1 or not, the current system is not what any of us would have designed if we were building something from the ground up.

In the scored Step 1 era, we sat back and watched as preclinical medical education turned into a glorified USMLE prep course with a five-figure/year tuition bill attached. We did nothing as residency applications spiraled out of control and program directors’ outsourced their most important decision-making to the NBME.

We shouldn’t be proud of any of this. And we shouldn’t mourn the loss of the three-digit score that enabled us to neglect the need for reform for so long.

More importantly, there is no turning back now.

If you opposed #USMLEPassFail, do your grieving for the scored USMLE – and then get to work. Saying “I told you not to make Step 1 pass/fail!” is a hollow victory. There is an opportunity here to engage our students in tasks that could actually lead them to be better physicians – but we have to seize it.

And if you supported #USMLEPassFail, now is not the time to dance on the three-digit score’s grave. We need to get to work, too – or this hard-won victory will go for naught.

5. The way forward… my opinion

Expect more from me on these topics in the future, but for now, let me put these three thoughts in your head.

WE NEED MEANINGFUL EVALUATIONS.

My 5th grader’s report card provides more useful information than any medical school transcript I’ve ever seen. He doesn’t get an “A” in math – I get to see a lengthy list of math skills and an assessment of where he’s at with all of them. Maybe he’s comfortable dividing fractions, but still developing proficiency with using variables to set up algebraic equations.

Letter grades are nice – but they don’t tell me what he knows and what he doesn’t. (I don’t get a histogram of other students’ performance and where he falls – because how other students performed is kind of irrelevant if my goal is to help him become better in math.)

The fact that elementary schools provide more information-rich evaluations than medical schools is shameful. In the past, we’ve justified this because of Step 1. Starting in 2022, that excuse will ring hollow.

Let’s be honest: there should never be a medical school evaluation in which a students is exceptional in every area. (If there is, it tells you more about the school than the student.)

Our goal should be to make medical school formative, not performative; to help learners maximize their potential without fearing failure; to provide and communicate honest feedback that leads to improvement and growth along the spectrum of medical education. (For their part, program directors need to focus less on relative accomplishment and more on potential to grow and thrive in that program/field.)

We don’t need another arms race. We do need more thoughtful evaluation. We should require students to engage in tasks that leave them – and their future patients – better off. And schools that refuse to participate in this process should be penalized by program directors and medical school applicants alike.

WE NEED HOLISTIC REVIEW.

I don’t think we need a one-size-fits-all metric to tell us who are the “best” applicants. Honestly, we don’t.

Certain talents and traits get you a lot farther in certain disciplines than others. Even within the same discipline, different programs have different needs and serve different missions. What makes a good doctor? It’s complicated. And trying to reduce that complexity down to a single three digit number is silly.

Holistic review is possible. It’s what we do at the residency program at which I’m an associate program director. But it’s labor intensive – and it requires human judgment. That last part makes some people uncomfortable, and I understand why. Holistic review has the potential to devolve into bias and cronyism. But that’s not a reason to not do it – it’s a reason to strive to do it well, to make decisions deliberately, and to build some checks and balances to make sure you stay aligned with your values.

WE ALSO NEED APPLICATION CAPS.

The only way to get away from screening metrics and treat every applicant as an individual is to limit the pile of applications that program directors receive.

THE EXISTENCE OF A SCORED STEP 1 ALLOWED US TO PRETEND THAT THIS WASN’T HAPPENING.

Look, I’ve preached this sermon before. But you’d better believe I’m gonna be carrying this particular gospel to the people again in the near future.

Afraid of application caps? Worried that they’ll disadvantage students from non-elite schools? Stay tuned for a data-driven expose of the misinformation surrounding caps coming soon.

Dr. Carmody is a pediatric nephrologist and medical educator at Eastern Virginia Medical School. This article originally appeared on The Sheriff of Sodium here.

The post #USMLEPassFail: A Brave New Day appeared first on The Health Care Blog.

#USMLEPassFail: A Brave New Day published first on https://venabeahan.tumblr.com

[siliconwebx]

Continuous Integration: The What, Why and How

Not long ago, I had a novice understanding of Continuous Integration (CI) and thought it seemed like an extra process that forces engineers to do extra work on already large projects. My team began to implement CI into projects and, after some hands-on experience, I realized its great benefits, not only to the company, but to me, an engineer! In this post, I will describe CI, the benefits I’ve discovered, and how to implement it for free, and fast.

CI and Continuous Delivery (CD) are usually discussed together. Writing about both CI and CD within a post is a lot to write and read about all at once, so we’ll only discuss CI here. Maybe, I will cover CD in a future post. 😉

Table of Contents:

What is CI?

Why CI should be used everywhere

No excuses, use CI

What problems does CI solve?

Recommended CI tools

High level CI setup

Summary

What is CI?

Continuous Integration, as I understand it, is a pattern of programming combining testing, safety checks, and development practices to confidently push code from a development branch to production ready branch continuously.

Microsoft Word is an example of CI. Words are written into the program and checked against spelling and grammar algorithms to assert a document's general readability and spelling.

Why CI should be used everywhere

We’ve already touched on this a bit, but the biggest benefit of CI that I see is that it saves a lot of money by making engineers more productive. Specifically, it provides quicker feedback loops, easier integration, and it reduces bottlenecks. Directly correlating CI to company savings is hard because SaaS costs scale as the user base changes. So, if a developer wants to sell CI to the business, the formula below can be utilized. Curious just how much it can save? My friend, David Inoa, created the following demo to help calculate the savings.

See the Pen Continuous Integration (CI) Company Cost Savings Estimator by David (@davidinoa) on CodePen.

What really excites enough to scream to the top of the rooftops is how CI can benefit you and me as developers!

For starters, CI will save you time. How much? We’re talking hours per week. How? Oh, do I want to tell you! CI automatically tests your code and lets you know if it is okay to be merged in a branch that goes to production. The amount of time that you would spend testing your code and working with others to get code ready for production is a lot of time.

Then there’s the way it helps prevent code fatigue. It sports tools like Greenkeeper, which can automatically set up — and even merge — pull requests following a code review. This keeps code up-to-date and allows developers to focus on what we really need to do. You know, like writing code or living life. Code updates within packages usually only need to be reviewed for major version updates, so there’s less need to track every minor release for breaking changes that require action.

CI takes a lot of the guesswork out of updating dependencies that otherwise would take a lot of research and testing.

No excuses, use CI!

When talking to developers, the conversation usually winds up something like:

"I would use CI but…[insert excuse]."

To me, that’s a cop out! CI can be free. It can also be easy. It’s true that the benefits of CI come with some costs, including monthly fees for tools like CircleCI or Greenkeeper. But that’s a drop in the bucket with the long-term savings it provides. It’s also true that it will take time to set things up. But it’s worth calling out that the power of CI can be used for free on open source projects. If you need or want to keep your code private and don’t want pay for CI tools, then you really can build your own CI setup with a few great npm packages.

So, enough with the excuses and behold the power of CI!

What problems does CI solve?

Before digging in much further, we should cover the use cases for CI. It solves a lot of issues and comes in handy in many situations:

When more than one developer wants to merge into a production branch at once

When mistakes are not caught or cannot be fixed before deployment

When dependencies are out of date

When developers have to wait extended periods of time to merge code

When packages are dependent on other packages

When a package is updated and must be changed in multiple place

CI tests updates and prevents bugs from being deployed.

Recommended CI tools

Let’s look at the high level parts used to create a CI feedback loop with some quick code bits to get CI setup for any open source project today. We’ll break this down into digestible chunks.

Documentation

In order to get CI working for me right away, I usually set CI up to test my initial documentation for a project. Specifically, I use MarkdownLint and Write Good because they provide all the features and functionality I need to write tests for this part of the project.

The great news is that GitHub provides standard templates and there is a lot of content that can be copied to get documentation setup quickly. Read more about quickly setting up documentation and creating a documentation feedback loop.

I keep a package.json file at the root of the project and run a script command like this:

"grammar": "write-good *.md --no-passive", "markdownlint": "markdownlint *.md"

Those two lines allow me to start using CI. That’s it! I can now run CI to test grammar.

At this point, I can move onto setting up CircleCI and Greenkeeper to help me make sure that packages are up to date. We’ll get to that in just a bit.

Unit testing

Unit tests are a method for testing small blocks (units) of code to ensure that the expected behavior of that block works as intended.

Unit tests provide a lot of help with CI. They define code quality and provide developers with feedback without having to push/merge/host code. Read more about unit tests and quickly setting a unit test feedback loop.

Here is an example of a very basic unit test without using a library:

const addsOne = (num) => num + 1 // We start with 1 as an initial value const numPlus1 = addsOne(3) // Function to add 3 const stringNumPlus1 = addsOne('3') // Add the two functions, expect 4 as the value /** * console.assert * https://developer.mozilla.org/en-US/docs/Web/API/console/assert * @param test? * @param string * @returns string if the test fails **/ console.assert(numPlus1 === 4, 'The variable `numPlus1` is not 4!') console.assert(stringNumPlus1 === 4, 'The variable `stringNumPlus1` is not 4!')

Over time, it is nice to use libraries like Jest to unit test code, but this example gives you an idea of what we’re looking at.

Here’s an example of the same test above using Jest:

const addsOne = (num) => num + 1 describe('addsOne', () => { it('adds a number', () => { const numPlus1 = addsOne(3) expect(numPlus1).toEqual(4) }) it('will not add a string', () => { const stringNumPlus1 = addsOne('3') expect(stringNumPlus1 === 4).toBeFalsy(); }) })

Using Jest, tests can be hooked up for CI with a command in a package.json like this:

"test:jest": "jest --coverage",

The flag --coverage configures Jest to report test coverage.

Safety checks

Safety checks help communicate code and code quality. Documentation, document templates, linter, spell checkers, and type checker are all safety checks. These tools can be automated to run during commits, in development, during CI, or even in a code editor.

Safety checks fall into more than one category of CI: feedback loop and testing. I’ve compiled a list of the types of safety checked I typically bake into a project.

All of these checks may seem like another layer of code abstraction or learning, so be gentle on yourself and others if this feels overwhelming. These tools have helped my own team bridge experience gaps, define shareable team patterns, and assist developers when they're confused about what their code is doing.

Committing, merging, communicating: Tools like husky, commitizen, GitHub Templates, and Changelogs help keep CI running clean code and form a nice workflow for a collaborative team environment.

Defining code (type checkers): Tools like TypeScript define and communicate code interfaces — not only types!

Linting: This is the practice of ensuring that something matches defined standards and patterns. There’s a linter for nearly all programming languages and you’ve probably worked with common ones, like ESlint (JavaScript) and Stylelint (CSS) in other projects.

Writing and commenting: Write Good helps catch grammar errors in documentation. Tools like JSDoc, Doctrine, and TypeDoc assist in writing documentation and add useful hints in code editors. Both can compile into markdown documentation.

ESlint is a good example for how any of these types of tools are implemented in CI. For example, this is all that’s needed in package.json to lint JavaScript:

"eslint": "eslint ."

Obviously, there are many options that allow you to configure a linter to conform to you and your team’s coding standards, but you can see how practical it can be to set up.

High level CI setup

Getting CI started for a repository often takes very little time, yet there are plenty of advanced configurations we can also put to use, if needed. Let’s look at a quick setup and then move into a more advanced configuration. Even the most basic setup is beneficial for saving time and code quality!

Two features that can save developers hours per week with simple CI are automatic dependency updates and build testing. Dependency updates are written about in more detail here.

Build testing refers to node_modules installation during CI by running an install — for example, (npm install where all node_modules install as expected. This is a simple task and does fail. Ensuring that node_modules installs as expected saves considerable time!

Quick CI Setup

CI can be setup automatically for both CircleCI and Travis! If a valid test command is already defined in the repository's package.json, then CI can be implemented without any more configuration.

In a CI tool, like CircleCI or Travis, the repository can be searched for after logging in or authentication. From there, follow the CI tool's UI to start testing.

For JavaScript, CircleCI will look at test within a repository's package.json to see if a valid test script is added. If it is, then CircleCI will begin running CI automatically! Read more about setting up CircleCI automatically here.

Advanced configurations

If unit tests are unfinished, or if a more configuration is needed, a .yml file can be added for a CI tool (like CircleCI) where the execute runner scripts are made.

Below is how to set up a custom CircleCI configuration with JavaScript linting (again, using ESlint as an example) for a CircleCI.

First off, run this command:

mkdir .circleci && touch .circleci/config.yml

Then add the following to generated file:

defaults: &defaults working_directory: ~/code docker: - image: circleci/node:10 environment: NPM_CONFIG_LOGLEVEL: error # make npm commands less noisy JOBS: max <h3>https://gist.github.com/ralphtheninja/f7c45bdee00784b41fed version: 2 jobs: build: <<: *defaults steps: - checkout - run: npm i - run: npm run eslint:ci

After these steps are completed and after CircleCI has been configured in GitHub (more on that here), CircleCI will pick up .circleci/config.yml and lint JavaScript in a CI process when a pull request is submitted.

I created a folder with examples in this demo repository to show ideas for configuring CI with config.yml filesand you can reference it for your own project or use the files as a starting point.

The are more even more CI tools that can be setup to help save developers more time, like auto-merging, auto-updating, monitoring, and much more!

Summary

We covered a lot here! To sum things up, setting up CI is very doable and can even be free of cost. With additional tooling (both paid and open source), we can have more time to code, and more time to write more tests for CI — or enjoy more life away from the screen!

Here are some demo repositories to help developers get setup fast or learn. Please feel free to reach out within the repositories with questions, ideas or improvements.

Developer CI Benefits Repository

Developer CI Benefits Demo

Developer CI Benefits Demo Dependent

Jonathan Ong’s CI Workshop

The post Continuous Integration: The What, Why and How appeared first on CSS-Tricks.

😉SiliconWebX | 🌐CSS-Tricks

[relaxforadelicatefew]

My life revolves around volleyball, let's be honest

Holyyyy shit. I wish I had the energy and time to dedicate to fully updating this blog for the last year that I have been MIA. But basically since I met Josh (see a few posts back), I haven’t needed to vent to an online forum because I was happy. And when I wasn’t happy, or Josh and I were having problems, etc I still turned to friends and other outlets instead of the blog. Which I guess is a good thing, but nonetheless, I’ve missed so much here. I’ll attempt to give a brief synopsis of some of the major events over the past year…. Here goes nothin! And as usual, I’ll attach a bunch of pictures for reference.   Let’s start with the topic of Josh, since that’s kinda where I left off last time. We officially started dating March 20th, 2016. All was going great for a long time. He moved into my house in August and started contributing to house costs instead of his apartment rent down in York. He was easily my best friend and I could tell him literally anything without fear of judgement. We hit a lot of “milestones” and went on a lot of adventures together. I could honestly say that I could have pictured myself marrying him and being 100% content with life. That’s not today we didn’t have our problems…there were many times that I came across something in his phone that made me not trust him (an inappropriate picture, text convo, etc). We talked about it a few times, and I probably let it go more times than I should have. His fairly heavy drinking was also a factor in that, to which we know my answer is always “drunk is not an excuse”! There are months’ worth of stories on this topic, but its not worth going into detail. Nonetheless, we broke up at the end of May 2017 when I found his PlentyofFish account with lots of recent conversations with other women. That was the last straw. After cooling down from the break up, we talked and decided we still wanted to be friends, etc. That lasted for about a month, and now we’re not speaking. He moved back down to York and I haven’t heard from him in awhile. While I am sad that it didn’t work out because he really was one of my best friends, and I truly did love him, I know its for the better. I have to keep reminding myself that to stay sane.   Summer of 2016 was 100% packed with as many tournaments as I could afford. It was super helpful to have Josh around to help with Baron, which allowed me to play lots of weekends back-to-back days. I didn’t do much else last summer besides volleyball, kayaking, a few small beach trips, etc. We did go to OC, MD at the end of July for Josh’s birthday, and that was my only real vacation for the summer. Highlight of the summer came at the 2nd largest grass tournament on the east coast, Susquehanna Smash, where I won BOTH DAYS! Becky and I won Women’s BB Saturday, and then Quincy and I won RevCo BB on Sunday! Longest 2 days of volleyball ever, but 100% worth it. There’s a picture above of both of my amazing partners for the weekend. What a way to end the summer

[type2diabetestreatments-blog]

Ask D'Mine: Sick Day Questions

New Post has been published on http://type2diabetestreatment.net/diabetes-mellitus/ask-dmine-sick-day-questions/

Ask D'Mine: Sick Day Questions

Ugh. Some days diabetes is sickening... and some days we just get sick! Welcome to another edition of our diabetes advice column, Ask D'Mine, hosted by veteran type 1, diabetes author and community educator Wil Dubois.

Send us your queries related to life with diabetes — nothing is off-limits here! (except ofcourse specific medical instructions for your own care; that's what doctors are for)

Need help navigating life with diabetes? Email us at AskDMine@diabetesmine.com

Elisheva from Israel, type 1, asks: Do I need to bolus for cough syrup? I'm using Benylin Dry Cough Regular Strength.

Wil@Ask D'Mine answers: The answer lies in the name of the product. Cough syrup. What's syrup? Yeppers. A thick liquid sugar. A yummy camouflage to hide the nasty taste of the meds for your dry cough.

Benylin is an overseas brand name for Johnson & Johnson products (who also make Benadryl here in the states). As bad luck would have it, the link on their Canadian website that gives us the contents of the bottle you use is dead, and the UK website doesn't list contents at all. But the "Tickly Throat & Cough" version of the same product has an unspecified "artificial sweetener enhancer," plus sorbitol (a sugar alcohol that has less impact than sugar or corn syrup, but will still raise your blood glucose), and of course red dye number 33 and red dye number 40. I see that it has around 8 calories in five milliliters. An adult dose is 10 mL, so it would be 16 calories. Calories to carbs aren't a clear-cut relationship; but where there's smoke there's fire, and where there's calories there's carbs.

Reviewing everything I could find in the medicine cabinet here at home, and poking around online, I find that most cough products seem to have both high fructose corn syrup and sorbitol, so you can expect them to raise your blood sugar if you don't cover them. Of course the devil is in the details, and in this case the details are how much to bolus.

Here in the U.S., cough syrups come with a "Drug Facts" label, rather than a "Nutrition Facts" label. This lets you see that there's corn syrup in the cough syrup, but not how much.

The drug company's websites aren't too helpful either, but third-party carb sites like Calorie King generally show the carb count of most cough syrups at north of five carbs per dose. You could use that as a starting point and work it out on a trial and error basis from there.

Of course, there're also "diabetic friendly" sugar-free cough syrups from many different companies you could try for bolus-free cough suppression. Any that use sugar alcohols will still need some insulin coverage, but many others, like Robitussin Peak Cold, are sweetened with saccharin and shouldn't require any insulin coverage.

And if it makes you feel any better, you're not the only one under the weather.

Tricia from Massachusetts, brand new LADA type 1, writes: I had a scary stomach flu last night with vomiting/diarrhea (ewww) and didn't/don't know yet how to care for myself as I'm not on insulin yet. I saw my BG's go to 221 before I fell asleep. This morning my BG was at 150, just now I'm 113. I feel so disconnected on how to take care of myself, any suggestions?? Today I've had basically broth, but feel scared to eat/not eat... Thanks!

Wil@Ask D'Mine answers: Well, it's good news that your sugar dropped overnight, and dropped even more as the day has gone on. The main thing with stomach bugs is to be sure to drink lots of fluids to replace the ones you are losing out of... you know... both ends of your system.

Food wise, it's actually OK to stick to just broth for a couple of days; it'll keep you going. But don't be afraid to eat. Once your stomach isn't so rocky, you can look to low-carb foods for a week or so to keep your blood sugars low while the virus clears from your system. Low-carb food is anything that used to crawl, walk, run, fly, swim, or slither. So any meat, in modest portions, won't raise your blood sugar. Neither will green leafy veggies and most cheeses.

Actually, as far as sick days go, your life will be easier once you do start insulin. Insulin is a blessing because it's the ultimate in scalable medications. If an illness raises your blood sugar for a while, you just increase your insulin dose. As you get well again, you just lower your dose again. It's actually as simple and safe as it sounds!

And speaking of illness and insulin...

Chris from Maryland, type 1 on a CGM and a pump, writes: Within the last week, I have been experiencing quite a few high blood sugar readings and have started bolusing pretty aggressively to combat that. In doing so, my daily insulin uptake has jumped from 25-30 units to 35-40 units daily, and I'm still running on the high side of things. I've rotated my pump sites with no effect and the vial of insulin I'm using is just 2 weeks old.I just got over a bad cold, so I feel that may have caused some abnormally high readings, but it's been a few days since I've experienced any cold symptoms. It sort of feels like a switch went off in my body that drastically changed my metabolism or insulin sensitivity. Is that possible?

Wil@Ask D'Mine answers: Anything is possible. Have I ever heard of an instant insulin sensitivity switch? No. I haven't.

But here are a few things to think about: just 'cause the symptoms are gone, doesn't mean that the cold is. That's actually one of the causes of the new antibiotic-resistant strains of bacteria we're seeing out in the world—people stop taking their antibiotics when they start feeling better, and the only remaining bugs in their systems are the tougher ones that survived the initial onslaught of the meds. Stopping treatment early lets these stronger super-bugs reproduce in greater numbers, eventually leading to drug-resistant strains. That's why the bottle has a label that says to finish the whole frickin' bottle, even if you feel better. Now that has nothing to do with you, other than to show that it's possible for a cold to outlive the symptoms.

So you might still be a little bit sick. Enough so that your body is still on high alert.

Or it might be because the moon is in Leo, the wind is blowing from the northwest, and the barometric pressure is rising. Because all things, great and small, can affect your insulin needs.

I recently attended a conference hosted by the Joslin Diabetes Center, one of the themes was brittle-bashing. For those of you who don't know, "brittle" is an old-fashioned and out-of-favor term for impossible-to-control diabetes. Doctors Richard Beaser and Philip Levy who were the seminar's hosts, refused to take brittle for an answer. They felt that for physicians to fall back on brittle was an excuse for not looking hard enough, or close enough, for the real answers.

At first I disagreed with that notion, because I sometimes view myself as brittle. But the more I thought about it, the more I found myself re-thinking. Maybe brittle is a cop-out. And I finally decided there's always a cause behind mystery blood sugar but it may be too remote to view, or too complex to comprehend, or it may be too many little things working together for us to connect the dots.

I don't know what flipped your switch. We may never know. But, you're blessed to have both a pump and CGM. You've already bumped up your insulin. Sounds like an even bigger bump may be in order, at least for the time being.

And in the end, does it really matter what caused the surge? I mean, it would be nice to know why all of a sudden you need more insulin; but you don't really need to know why to do something about it. The simple solution is to keep increasing your insulin until your numbers get back where they belong.

This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.

Type 2 Diabetes Treatment Type 2 Diabetes Diet Diabetes Destroyer Reviews Original Article

[allah-higherself]

My documentation of “Acts of Terrorism,” while earning $8.75(minium wage per hour) working to Allah & Dewayne Byfield-Bey

Acts of Terrorism while earning money

Awakening Mu’ur Documentation while working to earn money and Re-claiming Her Birth-Right and Inheritance. Implementing Abraham Lincoln’s executive will, 13/20. Fact or Fiction(rough draft)

Dewayne There are 12 short( I start Recent documents after the documentation of 12/8/16 in reference to those who Imply or stated they are connected to the military and or Navy) paragraphs of Introduction of Reading of me trying to Articulate what I am experiencing.

(A)I added documentations of When Imani Gray-Bey and (I) Rhonda Arrington-Bey first moved to Annapolis,Maryland

Then I start Documentation. I am thankful and grateful for my (Carribean/Moors Angels) helping to keep me and other Divine energies Safe mentally, spiritually,in many ways, Allah is Great.

These Unclean Spirits Can use Devices that can Cause You to have thoughts, move Your limbs,Manipulate Your dreams, Attack Your Genitals. These are “Acts of Terrorism.” They will try to make Divine energies think they have a right to perform these “Acts of Terrorism.” Just like Our Air being Poisoned, Our water being Poisoned, Our Food Poisoned, and stealing the Earth’s Natural resources, They are Invaders and opportunists.

Documentation While Working to earn Money at  which is owned by a woman from China and a Man who looked to be Pale skin”White American?” They are Married. “Acts of Terrorism,” From those who have the “CODE,” as I work to earn money.

My manager has “Implied” to be (Free Mason/Eastern Star). This Manager(P) who work for a Chinese, is a Black, Negro, Colored Woman under the status according to Constitutional Law. She hasn’t reclaimed a Nationality, nor has she been Naturalized(Possibly) She is considered “Chattel Property,”(Possibly) according to Constitutional Law.She seems to Speak of Going to Church along with the Owner of the Restaurant who is “Chinese”. She has attacked along with her Negro(Male/Female) & Pale skin (Free Masonic Eastern Stars)Friends. She seemed to do this when I do not allow her to engage willingly mentally. This has happen ,while I am sleeping at my place of rest & other places. She seemed to be connected to the Military.

CODE WORDS

She(Along with the Chinese female Owner) use code words such as “I LOVE YOU,”(They use these words “I love you” a lot while performing “acts of Terrorism.”“take it”(Rape), We paid for her, We Got It, Peace,Lay down, She is Nobody, they are Coming,  Home(When she thinks I am heavily connected to Dewayne Byfield-Bey or the Women of Moorish Science). They all seem to be connected to those that are from India(Some) (Middle East/Some) who have perform “Acts of Terrorism,”(Spiritually, Mentally, ) but aren’t in the Constitutional Fold. To possibly force a “Code,” of bondage; do not represent Love, Truth, Peace, Freedom and Justice. https://clyp.it/rcjdbva4

She along with others that “imply,” to be Free Masonic/Eastern Star(Chattel property according to Constitutional Law) have encourage “Rape,Threatened to cause harm(possible Murder), and other means of unclean behavior. On camera she looks like a Business woman. These attacks are done Mentally and spiritually. https://clyp.it/rcjdbva4

My son Imani Gray-Bey and (I) Rhonda Arrington-Bey pays almost 2,000.00 a month, to live at Extended American Inn.People down the hall are closing doors constantly and saying “Brother,” or (3). .

It is obvious these are “Acts of Terrorism,” done to force Relinquishing of Birth-Rights, Inheritance, which includes getting Back into the U.S.A. Constitutional Fold, Implementing Abraham Lincoln’s Executive Will/13/20. This is an attempt to place us a MOORISH AMERICANS with those that are content with being in the Status of Chattel Property, and used as Slaves.

These are “True Acts of Terrorism.”

It is obvious those that are born with this CODE and have taking this CODE WILLINGLY (SOME) are being used to form “Acts of Terrorism,.” Their Abilities: 1) They are able to engage mentally forcefully (2) manipulate computers (3) Manipulate Dreams (4) with help, Plot Different Thought (Force Thoughts), (5)Cause Genitals to Contract (6) Cause different limbs to move (7) Cause a person to feel a sexual feeling ( They call this taking someone’s cookies) (8) See what You are Seeing Forcefully.. “These are True “Acts of Terrorism.”

I don’t know these people who attack mentally,so why are they Attack mentally Forcefully while I am earning Money? How many other Women, Children, Young men, have they attacked Mentally forcefully?

My Performance at this place where I work and earn $8.75 per hour.

(A) I have called out twice since June 2016. Both times because I was walking with holes in my shoes. I walk 30 to 40 minutes to work everyday. I needed to purchase shoes. (B) I have been late 5 to 7 minutes late, too many times(they seem to be relax on coming in a few minutes late). The manager (Phy) have stated this is no big deal; nonetheless it is not acceptable as responsible moor. I have never been a No show. I have receive many compliments by customers who have not forced Engage Mentally. They actually just want to sit down and eat. The times of day I posts are Approximated.

(B)Note:(Charl the Black male ) Has recently start opening the doors for the Elderly at my place of work (It looks Hu-Mane on the Fleshy Eye)……. Around 12/15/16 The Black Female Diam(Co-Worker) Said, she was ready to start “Working,” while having a conversation with another co-worker. Since she made this Comment, she has been attacking Mentally More.

12/8/16-“Acts of Terrorism,” by those who Imply to be Military. The Co-Worker (Khal didn’t work 12/5/16 thru 12/10/16) that I saw.

12/8/16- 2:45pm approximately- I am working on the front. My back is towards the window. I feel a Black Male presence. I turn around. There is a Black Male with a Military(Green) Uniform(license plate-MLV 290) on. It is him who is “Forced Engaging Mentally.” (A) As I hand him his Food, I asked him was he Army or Navy? He said, “ I am Navy.” I asked him what are the duties of a Navy officier. He spoke of fighting against Piracy and Maintaining a form of “Good.”

(B)I asked, “how can you tell if a officer is mentally healthy or not?” How do you make sure the military officer do not attack Women and Children? He replied, very professional in describing how to watch out for mental break down among Military officers.

© As He was leaving he mentally Attacked or Forced engaged again. As he walked out of the Door, I asked him his Age? He said, He was 23 years of age. I told him I am 43. License plate ( MLV 290)

12/8/16- By 9am Brown Suv(5a/m 3350/ Brown SUV a Black male 55+”6′1 300lbs) (Charlie”A black male 55+ over 5′8, that has been at my place of work almost everyday I worked starting early in the morning until I leave” seem to have caught a Ride with this Male. Navy -1 (pale skin white american woman have not shown up in two days), Gray Pick up Truck(9b/F 5567?)appeared, The black male who wears the (hawks cap drives a Truck HDV 0818 appeared”Black male” over 5′8 55+years)

(A)-When the male they call Charlie appeared I was outside doing Trash. I bit my Tongue all of the sudden. As he walked in the Restaurant, he said, “We got it and started to attack my genitals from behind.    

Note: Navy-1 I have seen given Charlie(Black male 55+) rides to the restaurant.

(B)Reg, Black Male 6′4 who has been in the Restaurant when I arrived started to attack mentally. He is walking. I have never seen him drive.

9:30am Purple Heart cap (Red Fancy Pick up 59031 HV) (Black male over 6′2)He usually wears the purple heart cap. I have heard him say, while speaking to others and looking towards me “LET US GET THEM OFF OF YOU”HELP.”

9:30AM I am noticing the Pale skin (white american male customers) are attacking More Mentally when they come into the restaurant. It seems they are usually telling or directing the “Negro/Black.”

1/6/17

1/4/17 

By 9:30am A Black male with a (Red Skin) cap came in to the Restaurarnt. He has two young Black children with him and another Black male. He started to speak about how he was a Single Parent as he started to Attack Mentally as I was getting his Food. 

By 9am A black woman arrived with her child. I have seen her at the Rest.before. She Spoke to the Black Female Manager(Phy) and then started using Code words. She is light skin and short. She then started to Attack Mentally with her Child next to her. Her child looked to be 10 years of age.  she was driving a Mini Van ( 9CN 9011)

12/31/16-

11:00am- Demonic Games (Rituals)

(A)I am at Annapolis Library (1410 West St. Annapolis, MD 21401) A Black male is sitting across from me and a Pale skin woman”White American?”is talking to him as though she is helping him with the Computer. I have noticed when I come into the Library, it seems to be Quiet, when I sit down, two people would Usually start speaking very loud to one another. (1) person seem to be Presenting themselves as a “Helper,” the other receiving information.

(B) I started to Document about the holy Koran and my Studies. He becomes quiet and started saying “Excuse me,” a few times. He is a short Goaty. He body language change he seem to become irritated. As I think about the correlation with the “Acts of Terrorism,” I have experienced by those who say or “Imply,” to be with the U.S. Military and the “Perceived Muslim.”

©-Then I notice I am feeling Pressure around my head. I start casting out Spirits. Thy looked to be possibly “African or from apart of Africa.” A woman who comes into the Restaurant & a African Male with a bald Head.

(D)-I start to Pray for Protection from the U.S. Military that is operating as a Corporation(Not upholding our U.S.A. Laws of Freedom and Liberty) and are Using those Under a Foreign Jurisdiction to Perform “Acts of Terrorism.”

(E) All of the Sudden, the Black male that was sitting across from me says, “he Paid,” as I see a Visual of the (Middle Eastern/Indian Demon)https://clyp.it/rcjdbva4, I feel a slight sensation on my Genitals(sexual) for about 2 to 3 seconds at the same time. T

(F) Then a Tall Black Male starts talking with the young Black male with a Goaty that says, “He paid.” A Pale skin woman “White American,” comes and sit between us. This is a Demonic, Ritualistic Game.

(G) 12:45pm at the Library, a Male says Loudly about receiving Foundation “Money,” sounds like with a (Perceive Co-worker of the Library)I feel a sharp pain, on my Shoulder, about 10 seconds later he stops talking. I start praying for the Patients(Elderly, Children,Women and men) who are in the Hospitals with Aches,Diseases, and aren’t knowledgeable of what is attacking them.

12/30/16(Friday)

8am When I arrive the Black male 55+years(__Burganday SuV 1B/F 9631&  Gray Pick Truck) of age is at my place of work

By 9am–Asain Male appears(_7A/V 7879_______________). Jane(She Attacks mentally too many times while I am working that day) the owner is working.Charl (He attack several times while I was working mentally)Appear along with the Black male that drives the Brown (SUV HDV 0818) Black male over 250lbs 55+years arrive (Green Pick up Truck 93/Z 4546).

By 12pm The Black male(6′2 &200lbs) with the Purple Hear Verterans Cap appears (Red Fancy Pick up 59031 HV).

(A)The Co-Worker Diam(Black Female) attacks several times mentally.I have to cast Out her Spirit. The co-worker Tra(Black Female) she walks with a Limp has been attacking mentally as well at night at my place of rest.

(B) 12/30/16-1pm-Charli(Black male who is at the Rest. almost every day- for the past two weeks have been asking me to Place the money and receipt on the counter. Two months approximately before that he was going back and forth. Sometimes he wants me to place the money on the counter and sometimes in his hand. For the Past few weeks I have notice Charl has been opening the doors for the Elderly when then arrive.

©By 12pm the White male over 300lbs 6′2. that drives the White Minie Van (NP0027) arrive. Since approximately June or beginning of July2016 he has not allowed me to take his Order. The managers( Black Female Phy (Pale skin “White American?” manager Tina) & Co Workers and have pretend to not know Why?). I have told Them he has never told me why and I don’t know Why he doesn’t want mt to take his order. They replied,”They don’t know either and Tried to play along with him by saying or telling him he can’t do this.” Playing as though they don’t understand Why?

(D) The White male (NP0027) For the past two days have allowed me to take his order.Friday 12/31/16- Jane the owner stood Next to me as I took his Order and Watched. When I was done she said, “Very Good.’

(E) 12/30/16-3pm I am getting off of work. I go to the bathroom(chanting mentally Forgiveness) at my place of work. While in there I hear a Male Voice say, “Um Hum,” like I hear sometimes in the hall and maybe in my room at my Place of Rest(Where I pay almost 2, 000) dollars to rest my head. I go outside the Bathroom, The owner’s husband Jane  ( She is Chinese, her husband pale skin”White American?”) was sitting next to the Bathroom at a table along with another Pale skin male. The other Pale skin Male seem odd and had “Attacked Mentally,” approximately 2:45pm as I was taking his order (License plate 3A/Y 4055 Green Mercedez)

12/26/16—6am-the Co-worker Diam Attacked Mentally early in the Morning.  

7:30am I am walking to Work on my Usual Route, I see a White BMW Drive Past me. A Black Woman is walking towards with a dog on a leash. All of the Sudden I a visual of the Black Female Manager (P) appear. She says, “You can Go Telepathically.” I look to my Right and I see the Light Brown (SUV 5A/M 3350) riding quickly past me. he is at my place of Work early in the Morning and lately I have Seen the Black Male they call (Charl) get out of the Car in the Morning with him. He always sits as at the table with the Regulars.

(A) He too started to Attack Mentally as I was walking to Work. (SUV 5A/M 3350) He usually has on a Security Guard Uniform with a US Military Flag Patch on his Shoulder.

8:30am Charl (Black male arrived) he gets out of the car SUV (5A/M3350)

9:am the T.V. is on the News(Weather) 9:05am I am in the cooler filling up the Creamers, An Erie Voice say “Brother,” After I hear a “Tap,” like the ones I hear in my Room

9:30am Asain Chinese Male ( who was at the store when Khal sprayed Mace) ( 9a/a 0292 brown honda/green mini Van ) he was speaking with a co-worker about Buying cookies. He stated, “ he ate a lot last night as he looked towards my way

(A) My Sacred Womb has been attacked several times while I am at my place of Rest in my bed

9:40am C.J. the owners son appeared. He starts attacking Mentally

10am- The News is on “Weather,” at work. the Weather person start to use “Code Words as I am cleaning the Glass Doors. Charl starts attacking “Mentally,”..Diam and Others say “Are You Ready. As I start Documenting the T.V. Starts Gliching.

10:15am An Black male with an African Accent came into the store. He use to come in a lot and Attack me Mentally(Force engage) when I first started working in June 2016. I didn’t know why? He came in again and attacked mentally driving  ComCast White Truck (2C/K 8636 on the side of the Truck 31259)

BEGINNING OF MY DOCUMETATION OF WHEN WE(IMANI GRAY-BEY AND RHONDA ARRINGTON-BEY) FIRST MOVED TO ANNAPOLIS MARYLAND

***** https://clyp.it/rcjdbva4“Acts of Terrorism done by those who present, themselves as Musilm, Hindu,Christian,(“SOME” Black” American, Pale Skin, Indian from India, Asians,etc.) those who are operating under a Foreign Jurisdiction, Who have not Re-claim a Nationality; who don’t  uphold the U.S.A. Constitution; Who don’t encourage “Freedom-Love,”/Emancipation of all Men and Women, and or have chosen to Contract with a Un-Clean Demonic Spirit.“ Descending Order. We ForgiveDisclosure: This Testimony could be seen as Fiction or non-Fiction, by those who can read and see. This Testimony does not place all Ethnicity in one Basket. Individual evaluation of a person and individual experience of person should always be priority to me. The “Nature” of a group of People should also be taking in consideration “Nature,”. Over-all we are Among Spirits.. some are Clean and Some are Un-clean. We Forgive

https://clyp.it/rcjdbva4

( This is another upload of the Declaration ( I) Rhonda Arrington–Bey and her son Imani Gray–Bey had to do to demonstrate we Reject the forced Engagements of This Demon and or Demons who control some of the Birds and also have implied possibly to be a Demon (Un-Clean Spirit ) That “USE"the Science of Free Masonry to Cause Harm. Description of the Demon: Brown Skin, Pitch Black hair look like a middle Eastern or a man from India the Country. This is the Description of the Low Life, Filthy, Un-clean Spirit, Demon that Forcefully Try to engage when the Birds come and Chirp at the Window

August 6, 2016 (manipulating my dreams while I was sleeping at the bus stop)I am 43 years old and a woman. My son is 22. Last night August 5, 2016 we miss read the Bus Station that would take us back into the City in Maryland where we domicile in. We waited and waited.. We realized we miss read the schedule. So we fell asleep around 2 am on the bench waiting at the bus..Station. As I was sleeping I would awake periodically.. I kept hearing females and males not to far from us. Laughing and speaking words that we would hear, behind the gates of the Shelter,in Annapolis…The people or Entities would actually stand behind the Shelter’s gates, and start threatening and using code words.. My son and I are not on the Shelter Property but close so that we can use the Federal Funded Program for those who are in "need.”  While we are sleeping my dreams have been manipulated while we are sleeping in our “Tent"and when I awake I would usually hear a male voice grunting or clearing their throat.. Sometimes someone would "yell,” “

Brother, or Three

These are a distraction.

Last night we were at the bus stop sleeping..My dream was manipulated..What I remember was, before this happened, A male in a police car drove by in the parking lot. he look “Black,” This is before we realize the bus was not coming. He just drove by and sort of stared at me..Then I noticed a Bus came and dropped off another “Black Male,” he was sitting or lying down in another Booth and he too slept in the booth over night. After my dreams was manipulated in a sexually manner.( Many times those that Yell the Number 3 will say, “Lay Down!”..This number is being used in a negative way and is a Distraction because of “EGO AND iGNORANCE”.. ), I awoke and “Prayed to "ALLAH,” and I heard a male slightly laughing.

August 8, 2016Imani and I slept at American Stay extended ..When I awoke and started to walk to work. I saw a “Middle Eastern,” male, walking not too far with a cell phone to his Ear.. He looked Odd.

August 7, 2016I was down town. A Family that looked to be Asain was standing across from me. All of the sudden one of them, Said, “Sit Down,” out of the blue. I ignored them. stood for a minute and Thank ALLAH (Mentallay)For keeping me and my Ancestors out of “Bondage.” and Walked away.

August 2016,

This Demonic Spirit that Many(People/Nations) have Contracted to Serve and what I have experienced by it.

This Demonic Spirit, have the Capability, to create a Reality (Matrix) That does not exists; By thoughts, Visualization, Words. This or These Demonic Spirits, are Common “Terrorists,” “Invaders,” of Divine Energies, That have relied upon “LACK OF KNOWLEDGE,”  of their or Its Existence to Perpetrate Mental Bondage(If Allowed), Spiritual Bondage( If Allowed), and other forms of Bondage if Allowed. Imagine masses of People Speaking of “ Bondage,” as a form of “Normality,” Like there is nothing wrong with it, “It is, What It Is.”    Imagine. This Demonic and Un-clean Spirits or Spirits use the Wind to speak, Use People “ Look like other Divine Energies,” Use Music, and other Forms of Communication(T.V.) to “ENGAGE,” Forcefully and Create a  false reality… Creating another energy that looks like you and me, but missing key elements that only “ALLAH,” can create and give.. Imagine.  Imagine a Demonic Spirit feeling So comfortable to Attack, That it does it in broad day light because it has ROAM FREE and UNCHECKED  for So Long Because so Many have Contracted to Serve this Un-clean and Demonic Spirit. Imagine

August 2016"Those that “Imply,” to be connected to Free Masonry/ Eastern Star and then Attack when their Engagements are not Accepted Willingly. “Special Note: In New York, The pale Skin ( Some may call them "White American), at the Library would forcefully engage mentally. While I would be at the Library using the computer. Many times they would use body languages, the have been connected to those who are have presented themselves as "Perceive,” Free Masons or Eastern Star. Why? Usually after a “Perceive Black american,” ( who is possibly considered “Chattel Property,” have not re-claim a Nationality, an is out of the U.S.A. Constitutional Fold and Operating Under a Foreign Jurisdiction. ) Would Forcefully try to engage mentally. The “Perceive Black Americans, to have "implied,” to be connected to Free Masonry/ Eastern Star. ALLAH,  I Forgive

When I came MD. The same thing has happened.. The Females and Males that are Black American, (have not re-claim a nationality, are out of the U.S.A. Constitutional Fold, considered “Chattel Property” and dead by Constitutional Law, operating under a Foreign Jurisdiction) but have “Implied,” to be connected to Free Masonry/ Eastern Star, have tried to Engage Forcefully Mentally.. Too many times.. I have to keep Casting out their Un-Clean Spirits.. Soon later, a (Pale skin “White American,” male/ female) will do the same.. The Blacks seem to be Happy and content as though I DESERVE THIS TREATMENT.. THEN USUALLY THEY WILL TRY AGAIN..  ALLAH, I Forgive

August 2016, Psychological/Spiritual Attacks done by those who are from “Perceive,” Asia “China,”. Note: The first time I started to connect the dots with those who “looked Asian "Mainly China,” possibly was in New York, in reference to The Spiritual Attacks towards my “Sacred womb,” Vagina. Those who have accepted this Science that cause many to behave as “Savages,” call it “Eating,”..I have always admire the culture from “China,” so what I was experiencing was shocking and could be considered Hurtful; but when I started to Individualized the situation. What I mean is, Accept THAT WE ARE( AS DIVINE ENERGIES) AMONG UN-CLEAN SPIRITS, then I was able to keep balance. In realizing this, I acknowledge Un-clean Spirits can exists anyway. Unfortunately the Un-clean Spirits that I have come across from “China,” (like the black Americans, the Pale Skins, Indian from

India etc) have implied to have the ability to Act savage by a transfer of payments.

“ I HAVEN’T GAVE CONSENT TO AN ATTACK MENTALLY, SPIRITUALLY, THAT COULD RESULT IF ALLOWED PHYSICAL DAMAGE. So I choose to believe in ALLAH, and state Truth of

Their Involvement of "Acts of Terrorism,”.. Why “Some"The Un-clean Spirits seem to show themselves that are from Asia (Chinese), I am not sure?..  I Forgive

Note: When I was in New York, it seem those that have the Characteristics of a Hybrid, (The Un-clean Spirits that Looked like Chinese) had a Strong Connection to them. These Hybrids that were used there mostly "Perceive Black American/ and Puerto Rican,” (To attack me While I was sleeping, My Sacred Womb, or obviously possessed this Science that Cause Masses to behave like “Savages,”)Possibly did not have a Nationality, They are operating under a Foreign Jurisdiction, There are not in the constitutional Fold, They no doubt are consider “Chattel Property,” but seem to be Content with why they are Created and what they are used For.

jULY 2016I was hired at Burger King in June. This Burger King is owned by a woman from “China.” She seem nice and I was Very excited to be working. There is a group of Black Males that sit at the table since I was Hired, using Code Words and “Yes,” my sacred Womb has been attacked there. When my manager said, I was hired, I didn’t know who owned it. What I knew was, I was thankful and grateful to work there and earning Money. Many times the “Black Males,” that all looked to be over 50 years of age have tried to Attack Mentally. I have had to Reject their engagements by cleansing my Spirit. these men over 50 are usually speak a lot of “Hate,” and Viciousness while they sit there.  ALLAH, I Forgive

August 2016, About a Month ago, Imani filed a complaint against Green Dot Temporary Card with Better Business Bureau. They have started taking a Fee ($4.95) from the $150.00 dollars that was placed on the card, but the company Green Dot still has not allowed Imani Access to the Money, because they state his Identification is not valid. After he was told it was.

Note: When we first started to have a problem with Green Dot, There was a woman, who addressed me on the phone Miss Bey about 3 times when I tried to call to have access to our money.  She had a Accent from India(British). Then she discontinued the call. I could not get through

August 2016, Many times the number (3)“Distraction,” is spoken, apparently for no reason that is obvious to the Rational Eye. .. and those that present themselves Pale skin male and female, Black American male and female, seem to be more and more aggressive.

Islam June, 2016.. My son Imani is standing outside of Papa Johns. We are putting an application in.  I notice a woman who look possibly from India? I am not sure speaking with him. I go outside to see and listen. She Offered Imani money. I TOLD HER WE CAN’T ACCEPT THIS MONEY. BUT THANK YOU.    She still tried to offer it, this time she was Licking her Lips and she winked Subtle. I thought it was odd, but I still reject the money and said “Thank You,” humbly. Later about in July 2016, I am at the 7/11 convenient Store. The Clerk wanted to give me tell me I did not have to pay about 10 cents of my purchase. He looked from the middle east, I am not Sure. He too licked his lips as he offered to pay the 10 cents. I told him, I have it , and thank you.. Humbly.

7/30/16 (4:58pm)I am sitting at the Grocery Store. A woman is Speaking Arabic behind me. Then I notice she Squats down. She is speaking sort of Loud.Then all of the Sudden I feel my “Vagina Contract.” This is a Spiritual Attack.

7/19/2016Imani and I are sleeping in a Tent I am still noticing there is a demonic filth, that control the birds that might still be around. There is a guy name “henry,’ that works at Burger King, he look to be in his early twenties. He look to be Middle eastern, I am not Sure. One day, he started attacking me mentally. I had to cast out his spirit even after I left Burger King. Literally he was trying to mentally engage. Like too many who have this  Science that cause them to telepathic but behave as "Savages.”

July 15, 2016 approximatelyI was at the mall at Annapolis Maryland. I needed to asked someone how to get to the bus station. There was a lady bent over I couldn’t see her face. when she looked up, she was or appeared to be from India the country. I told her never mind politely..I walked away..Then I realized that possibly that seem to be rude, so I turned around. When I turned, around I gave her a compliment about the black mold in the middle of her head. She was a pretty woman, I think. I didn’t want to seem rude..Judging people individually.. As I left, I noticed there was another Perceive Indian?(middle Eastern guy) on the side of me. He had a stand for selling products. As I walked by him, He seem upset and had a Cell phone in his hand.. As I left the Mall, I started to hear constantly a raven or Crow Squaking like I do, while I am sleeping in the Tent, and the “Perceive Indian from India or Middle Eastern male,” tries to engage forcefully and I have to cast out this Demonic un-clean Spirit. It looks like the Demonic Unclean Spirit that control some of the Birds that I noticed in New York and Possibly have been Stalking since I was in New York. ( “The Perceive Muslim Family.”  

  July 9, 2016 I arrived at Annapolis Regional Library in Maryland

(410-222-1750

) at 12:25pm.. About 10 minutes after I arrived, a Cab drove up. (Annapolis, Maryland Tag– 605-08B) A middle Eastern/ Possibly Indian from India male gets out of the Car. He walks into the Library and approximately 5 minutes He walks out.  Note: There have been a unclean spirit that looked Middle eastern (maybe the same one, it look like) trying to engage mentally in the mornings while when I awake. There is usually a (Black Male) behind the gates of the Shelter talking and using Code words, as though someone has paid him.. Sometime my Sacred Womb has been attacked). A Helicopter flies over the Library soon after the cab arrives.  There is a

black female that Imani and I have noticed on the Street and at the library as well. One night she actually sat down across from me and seem to be just staring or directing her energies towards me while I was on the computer. I was on the Computer that night for about 2 hours.

July 7, 2016As of today, Green Dot still have not released the Block from Imani Gray-Bey’s Card where $150.00 still is on the Card. They have applied maintenance Fees to the Card. which equals to about $5.00.

July 6, 2016I am working at Burger King. There are a group of males that looked to be “African American,” always sitting at the Table. There is one who is name or they Call him Mr. Charlie who is always sitting at the table among them. While I am working he tries to forcefully mentally engage with me..I have to Cast his unclean and demonic Spirit out. I have told him at least Three times I am Married. Even though I have said this, he approached me at the Counter, he said, “ I beep at you the other day,” did you see me? I told him( The Black Male)  again, I am Married again, I do not approach Cars, or speak to men when I am out, Can you Please not Beep at me if you see me walking outside or APPROACH ME.  Note: it is not only him,that have tried engage forcefully, others ( African American, Pale Skin, etc)have too, but it seem as though he has been paid to be at the Burger King( Where I work) and to perform “Acts of Terrorism.”

July 7, 2016 5pm  I arrived at the library at Annapolis, Maryland, when I arrived, a Yellow Cab drove in quickly. I started to see the Yellow Cabs ( 32847B) (There was an “Perceive Indian man driving the Car)many times, in Annapolis, Maryland around where me and Imani are domiciling at. I also noticed a Black Crow have appeared on the right of me. I noticed a Black Raven or Crow appearing while we are domiciling at the tent.  

July 7, 2016I have noticed that when I awake in my tent in Annapolis, Maryland, there is a male entity that looks like the Indian or Middle Eastern Guy from New York trying to engage. I have to cast out his spirit. I had a dream that morning of being in a town, where mostly Muslims, or "Perceive Muslims,” live in. I felt as though my dream was being Manipulated. when I awaked, I heard the Black males inside of the Gate talking.. It seem there were many thoughts that appeared that seem to be negative towards Celina and Aseer El that morning. I had to counteract the Thoughts with love..I have asked Celina and Aseer EL forgiveness.

July 4, 2016, Annapolis MarylandI was at the Shelter Light House. I asked could I could take a shower. I started to notice a male that looked Indian that worked there kept engaging mentally. I had to cast out his Spirit. When I saw him, I engage in casual conversation with him to ask him where is he from..he said, he was from Pakinstan. I was trying to take a Shower later, he tried to engage mentally then I saw a spirit that looked like the Moor that I used to E-mail constantly appear. It was an Imposter. I was not him.

June 21,2016Imani and I are sleeping in a Tent. I awoke hearing Birds chirping outside the Tent.I saw a visual of a (Description :Middle E\astern/ Indian) man that I would see in New York. I had to Cast out this un-clean spirit When I opened my eyes, the Birds stop chirping. I now truly believe the Foreign Entity has paid this demonic Filth to engage, this is in connection to accepting a Science that cause Masses to be Telepathic and behave as Savages that me and my son has Rejected.. Me and Imani Tent is outside of the Gate that surrounds the Light House Shelter. Our tent is not on the Property. But those that Have paid Unclean Spirits to stand and use Code words and engage in am “Act of Terrorism,” Actually, have paid people to be inside of the Gate of the Light House Shelter, to stand close to wear our Tent is, and try to Attack mentally, and Spiritually. Imani Gray-bey and (I)Rhonda Arrington-Bey reject the science that cause Masses to be Telepathic and behave as savages.

THE END OF MY DOCUMENTATION OF WHEN WE (IMANI GRAY-BEY AND RHONDA ARRINGTON-BEY) FIRST MOVED TO ANNAPOLIS MARYLAND

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12/7/16

8:40am 2B/F 0944? Gray pick up Truck appears(both Black males over 55 year of age).

(A) another Black Male dark skin over 6′4 walks into the restaurant. I never see him driving but he starts attacking mentally as soon as he arrives. He is usually in the Restaurant when I arrive in the morning. I have also seen him at the Library. He has attacked mentally while I was at the library on the computers

By 9am Charlie appears He is usually at The Restarurant in the earlie morning until I leave in the afternoon between 3 and 4 pm.

8:10am Asain Male appears that drives a Suv. He was at the Restaurant when (Khl)sprayed Mace and he yelled, (3) and we got it as he walked out.

8:40am 8420D/A license plate appeared. A black male that wears glasses and have attacked mentally while working and while I was at my place of sleep. As soon as he appeared he started to Attack Mentally.

9am I go to the parking to take out the Trash. The female Black Manager (Phyl) starts attacking mentally.

Note: NP0027 (White Mini van) Description- white Pale(white american?)skin male has been coming into the Restaurant since I have been working(Almost everyday and he sits at the table with Navy-1). Approximately- since July 2016- He has not allowed me to wait on him. The Black (Phy) Manager stated that he has never complained about me. He has attacked me while I was working, while I walk back to the room, and while I am  at my place of rest. Usually the (Black/Negro) male will then try to Force engage afterwards.

9:05am I am with the help of my Carribean Angels is protecting myself mentally from forced engagements. Charlie gets up and come to the front counter. the black male 55+ over 5′9 that wears the (“Hawks Cap,” HDV 0818) is attacking mentally constantly.

Topic:Every Body

9:10am A Black Male came into the Restaurant. As He walked towards the counter, he says, “Every body.” all of the sudden he started attacking Mentally.

(A) Many times, these Black Males who have tried to force engage mentally and Black females will say “Every body. I come to find out this is everyone who have accepted this “Code,” and are serving this Un-Clean and Demonic Spirits. It is the same as when they say, “Brother/3” and Force Mental Engagements

9:20am The Black Female Manager (Phy) is staring or looking out the window for about 30seconds. All of the Sudden the Black male the drives the Fancy Black SUV(license plate JASON?) starts to force mental engage. He is over 6′2 300/lbs possibly. I sneeze once and see a slight visual of him. I cast his spirit out. (phy) the Black female manager, seem to be happy or show emotions of happiness as this is going on. She smiles. This Black male over 6′2 has mentally attacked while I was at my place of Rest( My elders/Angels help cast his Filthy spirit out) when I first started working at this Restaurant in June 2016. I didn’t understand Why? He has attacked several times when he entered into this restaurant.  

9:45am The Black male over 6′1 and 300lbs? ( wears a Purple Heart cap) comes into the Restaurant. (Drives a fancy  Red pickup 59031 HV).He starts to engage forcefully mentally. He also have stated out of his neck, “LET US GET THEM OFF OF YOU.”  As he looked towards my way.

(A) someone attacks my Vagina/Sacred Womb and Charlie yells,” Brother.” (B) I go to the cooler to get supplies to stock the front. someone says “Prostitute.” While I am getting supplies

10:00am the Middle Eastern/Demon https://clyp.it/rcjdbva  male  attacks . My Carribean Angels and I cast him out.

10:16am The (Hawks cap HDV 0818) starts attacking again. the phone rings twice.the black female mangager (Phy) walks towards the office where the phone is ringing. The Demon that looks to be from India (Middle eastern) begins to Attack Mentally( My angels as usual cast him out).https://clyp.it/rcjdbva4

(A)Gray honda 65081C/F? ( Black male 55+) arrives. When I was allowed to wear my MOORISH AMERICAN National Headress, he tried to have a conversation about members of his family being “Muslim.” He too started to force engage Mentally.

10:30am the Hawks cap Black male 55years + over 5′9 (HDV 0818 Brown SuV leaves)

The Black male over 6′1 who wears the Purple heart cap  (Drives a fancy Red pickup 59031 HV). is still at the Restaurant. The office Phone Rings, He force Mental engage . My angel help me cast him out.

11am While on Break, I bent over to get a couple of Ranch Dressings , As I was bending over, Charlie yells “Thats Peace Ho!” Then the Black male with the Hawks cap (HDV 0818 brown SuV) Engage Mentally forcefully.

11:40am The pale skin female manager ( Tin) seem upset. she is using threats as she speak to ( Phy) the black female manager. Navy-1 ( A pale skin white “american,” woman) that drives a SUV with a 50 star flag U.S. on each side says, “Stop,” “Peace,” ..I bite my tongue with out me doing it.

Navy-1 is still at the Restaurant

12:30pm A black male the usually comes on his break (Description over 5′9) he usually doesn’t engage forcefully. A pale skin White “American?”Male? said, “Yes.” Then he started to Attack mentally.

1:20pm The Black Female (Phy) Manager came close to me as she walked by. I felt my Sacred womb (Genitals) attacked. someone Yelled, “Paid.” in the Restaruant.

2pm, I am casting spirits out. (Phy) the female black manager starts saying “Mix,” several times. “Mix,” then she engage Mentally.

(A) Sometimes these demons have “Implied,” that I was Mixed with one of their Species in order to Justify their Mental Attacks and their “Force,” Engagements.

2:30pm some of those Regulars that left returned.

2:45pm to 3pm (2CR9076 remembering this license plate) I sit down to eat.

A  Implied Black Muslim? came into the restaurant. He has a long beard. he sits with another Regular Black male ( Drives the brown Mecedes 5CR5899?) and wears a “Christian Cross,” around his neck. He also sits at the table Navy-1, Charlie, Np0027, HDV 0818, Purple Heart). They are three of them sitting at a table across from me.

(A) He has has hand and fingers together, like someone is praying. This Disposition has been implied to mean Force Sex or Amalgamation with that which imply to be a “brother,” (Imply) Free Masonic/ or “Other.”

(B) As I am eating the Black male that is wearing a “Christian Cross,” start speaking of or using the word “Killing.” “Paid.”

12/7/16— As I document, that day, one of the  female Co-Workers yell, he “Paid Moor.”

11/21/16

Experiencing Acts of Terrorism while Using the “Government” funded Program(Shelter) Free Food

Going to the Light house( A shelter) to get free food. Approximately 11/17/16 I went to the Light house to get food. A Pakistani Male who works there gave me the Free food. This is a service the Shelter provides and is being Funded to Provide this Service. His name is (Pakistani ** Sa**). After he handed me the lunch bags, he started to engage Mentally Forcefully. I had to cast his spirit out .  This is not the First time, I had to do this. https://clyp.it/rcjdbva4 (He too demonstrates to have the “CODE.” and a “Other.”

When I would use their Service to take Showers(When I was homeless), if he was working, he would engage mentally forcefully until an (“ Black/Negro–Impostor,”) that looked like my Spiritual Husband would appear.

I waited a few days later and asked to use their Services of Free Lunches. This time the Black/Negro Male  (Terr*** Mit**) started to Force Engage while I was using the rest room and after I was given the food. He too would force mental Engage when I asked to use their Services in the past of Free Lunches and He too demonstrate to be an “other,” and have the Code

11/21/16

I arrive to work at 8am. I saw the Co-worker (Kha Mu) working along with (P) the manager. I said Good Morning everyone. He started to Force engage Mentally immediately

9:45am The manager female black/negro (P) who implies to represent Free masnry/Eastern, starts to force engage mentally as I Visualize My Moorish Symbol (MA (Moorish American). Then I feel my Sacred Womb being(Vagina) being Attack. She comes around the Corner licking her lips with her Hands in her pocket right I after this is done.

These are Mostly Black(Negro Males(55+) who have come in to the Place I worked almost every day I have worked. 1) they have force engage mentally forcefully,(Acts of Terrorism) while I am working 2) Demonstrate they have the “CODE.” 3) Represent or Imply to Represent  the Military and Free Masonry. 4) They are probably An “Other.” Look like me and my son but are not the same.

8:10am(11/21/16)–The black male drives green pick up appeared with a hat on, He looked to be over 55.

8:25am 1B/F 9631 liscence plate. The co-worker/employee (Kha Muh/Black male over 25) started to engage mentally forcefully.

8:30am 11/21/16the Pale skin woman who drives the suv with the liscense plate Navy 1 arrived

9:10am 11/21/16 the guy they call Charlie( black male 55year+ appeared. Last week he seem to know an Indian male from India who have attack mentally more than once when he arrived as a customer. This day he didn’t arrive with the pale skin lady that drives the SuV Navy 1.

11/21/16 This pale skin male/other/military? Drives a White mini van. liscense plate NP0027. He has come into the Restaurant almost everyday. He too have attack mentally while he was there. He sits at the table with the regulars. He has attacked Mentally at the place where I lay my head and sleep. He has attacked mentally when I have walked back to the place where i sleep. He has Attack Mentally too many times to count. I don’t know these people personally Why are they doing this?

The Black male they call “Charlie,” attacked several times mentally at my place of sleep 11/19/16 and 11/20/16. My spirit guides along with my Elders helped my Cast out his energy.

The Sequence of Events dealing the male they call “Charlie and others.” 11/18/16( Acts of Terrorism, Creating situation to Justify Un-Clean and Demonic Behavior). Remember Charlie Demonstrates to have the “Code.” and to be an “Other/ possibly.”

(A) Last week I think it was 11/17/16. The male they called Charlie, Stood at the counter. Next to him was a woman with (Hair/Locks (black?) and a Black-male/possibly working for the system). I started to feel heat around my Genitals. I stood there to Study what was happening. The Black couple seem to be communicating with “Charlie.” As though this was a sign that it is okay to engage(Mentally Forcefully). They call this “Taking Cookies.” I continue to work. Then all of the sudden, a Pale skin Male arrived with a Police Badge on. Placing an Order at this Restaurant I work at.

10am- liscense plate 9B/X 5567 Gray Pick up Truck Male 55

When I leave work at 4:30pm 11/21/16.  The male they call Charlie is still there, The Black male that drives the Burgandy car Liscence plate 1B/F 9631 is still there.  The green pick truck (93/Z 4546)..I did see when the pale skin woman left who drives Navy 1 and the two U.S. American Flags on each window.

11/18/16-8:08am the Gray chevrolet appeared

11/18/16Brown old Mercedez (5CR5899) Black male (the Negro they call Charlie Appears )He attacks mentally

11/18/16Old black/negro male 55+ (1 B/F 9631) appears 11/18/16 before 10:30am

Liscence plate- 5 A/A 2884- Arrived before 10:30am He attacked before he left. he usually sits with the “Other,” Negro Males or close by in the corner

Those that stay until 4pm 11/17/16- Navy 1, the guy they call charlie

11/17/16 Liscense plate HDV 0818. he is a Black(Negro) male 55+. He arrives appr. 9am. He starts Mentally attacking me while I am working. Saturday and Sunday night He attacks as well. I have to along with help from my elders Cast him out.

11/17/16- 5A/A 2884 Black(Negro) male that drives a Black SuV. He always attack when he arrives.  He usually sits near the table the other Black/negro males sit. eat his number 2 Value meal.

Burgandy Car NB/F 9631-the old(Black/Negro)male 55+ arrives ( I have heard him whistle like some of the males from India do. ) this day he arrived and stood behind me. I felt slight heat coming around me close to my Genital. They call this taking (Cookies) another for of Act of Terrorism. He too have Implied to Represent Free masonry and to be an “Other.”

11/15/16  update- The woman that drives the Truck that has the 50 star U.S. flag and license plate Navy 1 was at my place of work. She along with the Black male they call Charlie, 2 black males one who looked to be 50+ and the other his father(possibly, they both seem to “Imply,”represent Free Masonry/or the Military/Navy,) are at my place of work every day. They stay there for over 6 hours Why or are still there even when I leave? The two black males drove a Gray pick up truck (License plate 2B/F 0944). Many times they yell code words such “Stop,” Peace, Lay down” “Brother,” etc.

1)I noticed when a few times when they yelled stop, I felt my mouth jerk where I almost bit my tongue. I noticed my mouth Jerking before out of the blue, & I thought something then was not right. “Acts of Terrorism,” Invading my mental space without consent. These “Acts of Terrorism,” by Invaders or Opportunists, are done, and constantly they want Free Men and women to relinquish their birth-rights by accepting their “Savage”,Terroristic Behavior

(A) So I could Focus, on my job, I didn’t cast them out. Also I needed to save my energy to study/All day long while I was working customers would engage mentally(black males mostly). The Female Manager (P/Who “imply,” to be connected to Eastern Star) notice I was not casting anyone out, She too started to engage mentally.  The Co-workers, The Night manager (J). Today, I deliberately didn’t cast anyone out. They continued to attack mentally.  

2) I noticed when I Meditate on my break, I see my Carribean Elders sitting with me, All of the sudden my Eye lids will start jumping rigorously as though I am being mentally attacked. My Carribean Elders and other Angels fight to keep me and others protected from these un-clean Spirits. Most Imply to be connected to Free Masonry/Eastern Star, (Distraction but still true none the less)

A)The woman(pale skin) that drives the Navy 1- arrived 11/15/16- at approximately between 8 and 9 am. I got off work at 4pm. The Black male they called Charlie appeared either with her or not too much longer. He has been there almost every day I have work.

(1) This morning when I awoke, I heard someone say “yea!” Then I saw a visual of this male Charlie who is 50+. He was mentally engaging forcefully. I have had to tell him I was Married a few times. He too have attacked mentally a few times while I was working along with the Pale skin female that drives the truck Navy 1.

(3) When the Employee (Kha) sprayed Mace/Pepper Spray, at this place of Work. that day, an Asain (Chinese?)male ( today he was driving Gray Quest Van license plate- (7A/V 7879) left out of the Restaurant. As he walked of the Restaurant, He yelled “ We Got It.” (3?/ possibly). That day, I had was casting out the Coe-worker (Kha/ Black/Negro male over 25 years? of age who “Imply,” to be connected to Free Masonry & other)several times with the help of my Carribean Elders ( Moorish Angels). That day when the Asain male left, a few minutes later, I was told to go on break. then (Kha) sprayed Mace/Pepper Spray soon later.(Acts of Terrorism)

(A) Today 11/15/16- Around 1:30pm He started (Kha) to sing, R Kelly songs. One verse ..( My Mind is telling Me No!). Then he would “Imply” thru body language a sexual act. His voice would reply over again. (Acts of Terrorism).

(B) Today 11/15/16- I stayed focus, on my job, It seem I started to feel a head ach slightly at the parietal region. the pale skin Navy 1, Charlie, Regulars were there. I was thinking I drank too much caffine. The Head ache had stop for a little while Maybe 20 minutes later, a “Black/Negro male customer came in the Restaurant, speaking about someone having a Head Ache. Then all of the sudden the Head Ache started again. I now think someone was attacking Mentally , The same as Attacking my Genital(Sacred Womb) and calling it Eating.

11/14/16

This Morning I awoke from being Attacked mentally in my dreams. There was a guy who looked like Dewayne almost but was not. It wasn’t sexual but odd. I had the dream after I awoke, and Prayed for Protection from the Negros/Black(Female/Male). There seem to be Negro Males walking around our room using words of engagements like at “Burger King,” from the Negro Males over 55 years of age. After My angels protected me..Casting them out.

(B) I notice an Asain Male kept trying to attack. I have heard(black males/females) speak of the Chinese, Indian, Muslim as though they are relying on my son Imani Gray-Bey and (I)Rhonda Arrington-Bey to feel so Scared(Fearful) that we go running into One of them(usually Free Masonic/eastern star) or churches; When all them are working together.

© The Asain who looked from “China,” kept attacking mentally. All of the sudden I heard a Loud Voice from one of my Angels stating “China,” has lost all Credibility and is apart of “Acts of Terrorism.” Then I noticed, the male and female voices around the room ceased for awhile.

(D) The Asain Male continued to Attack a little while later. The Chinese or others from Asia/India(Pale skin American & other nations) are known to use the “Negro,” to perform “Acts of Terrorism.”

At Work

11/14/16 When I arrive at work, I say Good Morning to my Manager(P). She soon begin to Attack Mentally/Spiritually. I have cast her out a few times, but was trying to stay focus and maintain my energy.

(10:00am) (K) comes into the place to work.He begins to attack mentally. I cast him out with the Assistance of my Angels. All of the Sudden (P) started to behave as though He was doing something wrong. (She tried to engage visually(eye contact) and shake her head. She and others are great Actresses when it comes to demonstrating “Compassion or emotions.” Remember she attacked just a few hours ago. (Psychological warfare/attempting to break a person).

10:30am i go outside to have my break. I choose to meditate. The Manager(P) while my eyes were closed meditating start to Force Engage Mentally. Also the (khal) and a Pale skin Male who sits at the table with the negro males that “Imply,” to represent Free Masonry and the Military(Navy).

(E) 11/14/16 I am working Approximately 1:30pm, The owner (Jan) comes into the job. While I am mopping the Floor, she starts Force Mentally Engage. ( I cast her out while Mopping her floor)Then I noticed a Pale skin male comes into the Restaurant that has a Nasal Canula hooked up to him. He seems like he going to pass out.  The Negro Male (Charlie) comes to the Counter. Then (Khal) starts singing a song “I AM GOING TO TAKE MY TIME.” “I AM GOING TO TAKE MY TIME.” Then I kept hearing his voice say this over again. This is “Acts of Terrorism.” Psychological Warfare.  The Manager (P) and the owner (Jan) starts talking out loud in the office. She and the Black/African American/ Negro manager (P). are speaking about someone Paying for someone, and other code words. I continued to work.

A)License plate(Z83934?) (11/14/16) A black/negro male look over 50 drives a white pick up truck(Z83934?). Sits at the table with the regulars. He has forced engage Mentally several times at my place of rest. I have to cast him out. the last time he drove a car with the licenses plate beginning with (A) Maryland

B) Asain Male(China) (license plate-820M292)has forced engage mentally several times.(I with the assistance of my elders) he looked to be over 50. On camera he looks harmless.

C)93/Z 4546 Licence plate Green Truck

Update 11/12/16

11/11/16- This Morning I awoke around 6am. A Black Male seem to have tried to Molest me sexually with a bald Head( Spiritually). I awoke Immediately. My Angels seem to have Awaken me Immediately. I saw Angels(Carribean Angels/ Moors) Fighting to keep other Spirits from attacking also casting the Black(Negro,Brother) Out. I Forgive Him

(B) All of the sudden Middle Eastern Males, Looked to be from India, Pakinstan, Etc.  that Region, https://clyp.it/rcjdbva4 Kept trying to Engage mentally. My Angels help to keep them off of me and out of my Mental Space. I Forgive Him

© Remembering hearing the voice of KHalid(saying I am inside) but I was able to Cast his Spirit Out with my Eyes opened. I forgive Him

D)That night, Paleskins(Male) that I have seen at my place of Work, also Engaged After I would not allow (Black, Negro Brothers) to engage Mentally. I had to cast them out as well. Many of them seem to Imply to be(3) Free Masons or Eastern star in a Negative way.I forgive them

11-10-16 8:00pmImani Arrived at the room. when He arrived the people from Next door room 118 where I saw a “U.S.Military Male,” ( He started shaking the door knob as I walked by the room one morning.Then he Actually opened the door as I walked by, so I could see him (possibly) he didn’t come out of the room. He was either Spanish or Pale skin Male). When Imani Arrived, A male and female voice started to make noise in the room 118. The male Voice said “Relax.” I forgive them

3:00am I awoke to hear the voice of my Co-worker Telepathically (Khalid). He sound like he was Talking to someone. “He started to speak of someone “BEING INSIDE.”of someone else. When I awoke, I felt his presence on the Right side of my Temporal part of my brain Strongly. I started to Cast him Out with my Eyes Close. As I was doing this, My eyes started to Jumb where I couldn’t do it(This could be a form of trying to Block). I opened my eyes and I was Able to do it with Strength. As my Eyes were Jumping Continously ( A form of Trying to Block), The female Voice in room 118 Started to Say “ I love YOU.” So close to the Wall I could hear. I have also heard the Male Voice sound like he was chanting in the Middle of the night in room 118.

11/09/16-While Working

“ True Acts of Terrorism,”  

Too many times, That which Black/Negro American will say, “Stop Her,” “Block Her?” “Watch her,” They speak of someone being Sold, or Shot, Rapine,”Why?” would anybody that is suppose to be of Asaitic descent want this. They usually have the ‘CODE, Imply (3/Free Mason& Eastern Star) Considered Chattel Property by Constitutional or an (Other), and are connected to the U.S. Military or Foreign Governments.

1:18pm Wile working, I noticed a car in the Drive thru with North Carolina licence Plates the word “Navy,” going around the plates (1520?) As I was documenting someone Yelled, “Lay Down!” remembering the same group(Black males/Negro “other”55+)charlie etc, has been coming into the restaurant, force engaging Mentally, some has represented themselves as being connected to the U.S. Military& Foreign Governments. I have been working there since June 2016. https://clyp.it/rcjdbva4

9:00AM(random) Many times the word “Brother,”(3) is yelled at the place where I lay my head. A visual of a Black Male(possibly an other) would appear. He usually has a Bald head and brown skin. This too is an “Act of Terrorism.” These Brothers/3(others) are consider chattel property by Constitutional Law and the U.S. Military along with foreign Governments are involved.

10:00 am The Employee (K/Black/Negro male/other), when a Black male or female Force engage mentally, I cast them out, He is able to place a visual of his hand or Arm mentally, to block me from casting them out; or protecting myself. I can still do it, but I have to concentrate. Usually it is a Black male/female that  Imply(”Free Mason-3/U.S. Military) . Those that are consider slaves/Chattel Property, by Constitutional Law and most likely/possibly an (Other).

10:30am approximately, While I was in the Bathroom, (K) the male black/Negro employee, Forced engage mentally, while I was working. This is a form of Terrorism. He also attacked Several times while I was sleeping last night. He is connected to the U.S. Military  ( he is possibly and other) and to the Demon Spirit. https://clyp.it/rcjdbva4

11:15am Asain Male YNT 671? License plate. He force engage. (P) the manager starts speak of someone “Taking It.” Usually this is a code for “Rapine,” of someone. I forgive them

11:44am-There is a Big pale skin Male who sits at the table with the “Black males,” that represents U.S. Military,Foreign Governments, He has forced engaged Mentally too many times to count. Remembering the Restaurant is owned by a woman from China, and a Pale skin (American male).

11:58am An Asain Male comes into the Restaurant Someone say, “Thats Peace,” License plate states (240988?). He too has engage mentally forcefully. Many Asians from Asia have forced mentally engage while I was working at this Restaurant that is owned by and woman from (China) and a Pale skin white American.  

12:40pm the male Charlie(He is there every time I work. Force mental engaging), that has come to the restaurant with the pale skin White american female that drives, the Truck that has the license Plate” Navy 1,” has asked me to place money on the counter instead of his hand. I have spoke to the Manager (P) about it. Today, He said place the Money in his hand.

12:47pm 2 Black women came into the Restaurant. A pale skin male start to speak of the government. I heard someone say, “Can I help You?”  As Khalid was taking their order, out of the blue one of them says, “Watch her.” They too seem to be connected to the co-workers. etc.  

(A) All of the sudden (P) Manager started to speak into her conversation of someone going to “JAIL.” I forgive them

1:40pm A pale skin (white american)woman who seem to know (P) & sits near the table with the group(black/negro males)  that is connected to the Military& (3/Eastern Star?) force engage mentally. She has come into the restaurant several times, & Attack me Mentally while I was working. I didn’t cast her out but waited to see, how long she was going to force engage. She attacked for over 15 minutes. I also felt the presence of the Foreign Demon Spirit that could be from Pakinstan or India   .https://clyp.it/rcjdbva4 at the same time she was attacking. The Demon spirit seem to be working with Asains, Black, pale skin, female and male Free Masons(U.S. Military).(P) the manager seems to be connected to the U.S. Military. I forgive them

2:00pm approximately, a Black/Negro male people call Peanut( Clyde) (D/employee) knows him. He has come to the restaurant, and forced engage mentally as well.

2:41pm while I was taking an order, A Black male step up to the counter. As he stepped up, he said, “Stay,” Then I felt my Vagina Contract. This is an ability those that have the “CODE,” can do. He looked to be over 40 years of age.

93/Z 4546 Licence plate Green Truck Is there almost every day. Forced Engage Mentally

Asain Male licence plate (YNT671?) forced engaged Mentally while I was working

11:58am Asain Male( 240988 licence plate) Forced Engage Mentally while I was working

2A169Bor8? Negro male- Forced Engage mentally while working

2Bf 0944 Blue Pick up ( Black Male is there almost every day I work. Forced engage mentally

It seem  that the chip that was forced in my head is able to cause me to bite my tongue without me doing it. The Black males along with the manager (P) seem to be getting help by that which is able to do this. (Acts of Terrorism)

My Manager is a woman who name (P). She is an African American/ Black according to constitutional Law. I work among a male who seem to be African American (k) as well. I also work among other women who are African American/ Black according to Constitutional Law. At this Restaurant that starts off Minimum Wage, I work among those from Mexico, and South America.  Many of them seem to represent the number (3) or that Science, Group.

My son Imani and I Know we are among those who look Like us but are not the same, and or have receive a “Code,” that cause them to be Telepathic Artificially and obviously in “Too,” cases behave as “Savages.”

10/3/16- One of the Regulars Black Males that comes into the restaurant almost every day I work is name charlie( I have told him several times, I am married). He too has forced Engage Mentally while I was working. He too has Attack me while I was resting at Extended American Inn, mentally.I forgive them

(A) 10/3/16 I spoke to the owner about him and his Attitude when he is not able to personalize his greetings with me. The owners seem to know him. After I spoke to the female owner from (China) about Charlie, maybe 20 minutes later, I was told I couldn’t wear my National headress at Work anymore. I have been working and wearing it since July 2016.  My Nationality is Moorish American.

11/07/16- While I was sleeping at Extended American Stay, I had a dream of the Asain, Male who seem to be forcing, Sex upon me. I didn’t feel any thing or satisfaction. In the dream it seem as though this Asain Male was encouraging others to Force Spiritual Sex upon me while I am sleeping.

11/7/16- I arrive at work at 8am approximately. Maybe a few minutes later, some of the Regulars appeared that force engage mentally. About an hour later, 6 black males that have been coming there since I started working there had arrived. some of them represent the Military. They all looked to be over 50 years.

The boy (K) arrived that sprayed the Mace. He engage mentally forcefully. The Black female Manager (P) attacked several times mentally last night. Her daughter arrived at the restaurant 9:45am, (11/7/16)with a child(baby) in her arms. She begin to force engage as well mentally. I didn’t not defend myself. I wanted to see how long she was going to attack with the Baby in her arms.

(A)The boy (K) arrived I noticed before I stopped working, I started to chant about Unity with my Moorish. Then I started to hear the boy (K) sing a song by R Kelly that he would sing out loud( mentally). The Song is about Sex. As I was preparing food for the Customers, I started to hear him sing,then he started to move, his pelvic back and forth. This is the boy who Sprayed Mace or Pepper Spray.

(B)

Some of the Regulars Black Males over 50 that sit at the Table forceengaging mentally while I am working and trying to earn Money Licence plates

1) A black male brown skin, with glasses, 52k 192? Gray Pick up. This Black male has also attacked while I was sleeping at American Extended Inn Mentally.

2) red Pick Truck “Black Male,” 50931. He too have attacked Mentally while I was trying to Rests at American extended Inn.

3)Black Male- He has attacked several times while I was working at the Restaurant. He usually gets his food and leave. He look to be over 50 years of age. His Truck is Black with the licence plate “JASON,”

4) African Male comes into the restaurant. He would start force engaging mentally. He too also forced engaged,  while I was sleeping mentally. He drove a car with the liscence plate 2cr9067 golden brown

5) A pale skin woman who drives a truck with the liscence plate Navy 1 comes into the restaurant as well almost every day I work. I seen her and Charlie arrive together

93/Z 4546 Licence plate Green Truck

Awakening Mu’ur Documentation while working to earn money and Re-claiming Her Birth-Right and Inheritance. Implementing Abraham Lincoln’s executive will, 13/20. Fact or Fiction(rough draft)Documentation While Working to earn Money at  which is owned by a woman from China and a Man who looked to be Pale skin.

My Manager is a woman who name (P). She is an African American/ Black according to constitutional Law. I work among a male who seem to be African American (k) as well. I also work among other women who are African American/ Black according to Constitutional Law. At this Restaurant that starts off Minimum Wage, I work among those from Mexico, and South America.  Many of them seem to represent the number (3) or that Science, Group. My son Imani and I Know we are among those who look Like us but are not the same, and or have receive a “Code,” that cause them to be Telepathic Artificially and obviously in “Too,” cases behave as “Savages.”

11/5/16-When I first started working there, I was so happy. I started working there in June 2016. The African American Manager (P), didn’t give me an interview, like most. She hired me right away. I started to notice each time, I arrive at the Restaurant to work, the same group of people would be sitting at a table at the Restaurant.

They mostly looked to be African American/ Black males who seem to be over 50 years of age, and some Representing the Military. Almost every single day I arrive, they would be there or come soon after.  There is a pale skin woman who drives a car that Represents the U.S. and the Navy. They seem to also Represent the Number (3) as well by implying to Represent a Science or Group.

ONE DAY, I NOTICED THEY STARTED TO SPEAK OF FORCING A PERSON TO RECEIVE A “CODE.”I noticed some customers would come into the Restaurant with Children in their arms, that seem to have the “Code” would still Attack Mentally. Some of these Customers, obviously don’t care about the Children who have the “Code,” because it is obvious they know I will cast them out, Mentally if I can. So Some are using these Children that have the “Code,” or don’t care enough about them to be protectors.

USING PSYCHOLOGICAL WARFARE There is a African American/Black male(Co-Worker)(K) he looked to be over 25 years of age, who also seem to be representing the (3) and possibly ( an other), who constantly Attack Mentally. It is obvious he is being paid possibly, to perform these Acts of Terrorism. When I started to cast him out mentally, He would begin to sing (R&B) music, which them would Replay several times mentally. Note: Remembering the Group that Represents the Military that sits at the table every day Mostly (Black Males over 50 & Represents (3)). I am 43 years old and my Nationality is MOORISH AMERICAN.

THESE “ACTS OF TERRORISM,” ARE ABOUT DISCOURAGING AWAKENING MOORS/MU’URS FROM RE-CLAIMING THEIR BIRTH-RIGHT, NATIONALITY, INHERITANCE, IMPLEMENTATION OF ABRAHAM LINCOLN’S EXECUTIVE WILL AND THIRTEENTH AMENDMENT WITH ITS 20 SECTIONS. THESE ATTACK OF TERRORISM ARE COMING FROM THOSE WHO LOOK TO BE MOORISH AMERICAN BUT ARE UNDER THE STATUS OF AFRICAN AMERICAN, NEGRO, BLACK, COLORED ACCORDING TO CONSTITUTIONAL LAW AND SEEM TO BE A REPRESENTATION OF THE NUMBER (3) A SCIENCE/GROUP.

There is an Attempt to Engage Forcefully by These African American/Blacks (3), who are consider “Chattel Property” and possibly Others. They are being helped by those from the Military, Indian from India, Asians, Pale skin “American?” Once again, They represent (3) Science/Group and are considered Mostly by constitutional Law Chattel Property.

CHEMICAL ATTACKS (ACTS OF TERRORISM) One day, while I was Casting them(customers, co-workers) out mentally, A Customer who seem to be a regular came into the restaurant. He is from Asia. He walked out of the Restaurant, As he walked out, He yelled, “We Got her!” then Approximately 3 to 5 minutes later, The African American/Black woman (P) (Manager) Told me to go on Break. I did. Approximately 2 minutes Then I started to Cough and Sneeze. I looked outside the door and I saw the African American/ Manager female(P), vomiting, along with other Co-workers.  I had to leave out of the building along with others. I ate my food outside. When I came back in the Restaurant from Break, the African American/Black male (K)(Possibly an other), said, I apologize for Spraying Pepper Spray or Mace. SIMILAR BEHAVIOR IN NEW YORK Soon after I started working there, I started to hear them use some of the same “Code,” Words as N.Y. The group that sit at the table, mostly “Black Males,” over 50 years of age, have tried Forcefully to engage mentally Several times. I worked hard to cast them out. There have been those From India who have forced Engage as well(Males). At first I thought it was Isolated. Then I noticed Those African/Black Males & Females, the Indian males, asains, pale skins as well and some Mexicans that came into the Restaurant were working together.

I noticed those that have the  “Code” that are not Like Us (Moorish Americans,) in spirit, gives them abilities to invade mentally, while sleeping etc. I thought the Attacks by those who looked to be from India & Asia, being Isolated, ..https://clyp.it/rcjdbva4  , but now The Blacks/African American(3) , have shown to have been working along with them to cause “Fear,”. Also it seems they know they purpose to Encourage (MOORISH AMERICAN) to Relinquish their Attempts to Re-Claim Their Birth-Rights Through “Acts of Terrorism.”The African American/Black Female Manager who Represents (3) or imply to be apart of a Science/ Group

The African American/Black Manager Female who represents (3), has Tried almost every time I arrive to engage Mentally Forcefully. I had to cast out her Spirit too many times to count. Then I started to realize she was engaging Forcefully at the place where I live or rest. Engaging  mentally. While I was sleeping etc. I don’t know why she thinks this behavior is okay.  I start to notice, the customers who start engaging Mentally(Forcefully) as well. Especially those that were “Males,” African American/Black, Indian from India, Asains, pale skin(American?).She seem to encourage the”African American/Black Males(possibly an others) to engage or Imply some form of Rape or Molestation. They use the word “BROTHER,” A LOT.

When I would not allow her to engage mentally, she became more Aggressive, and others that would come into the Restaurant. She along with other Coe-workers have forcefully engage mentally while I was a the place where i sleep. https://clyp.it/rcjdbva4Her daughter has into the restaurant with her child in her arms and also have forcefully engage mentally. They I am going to protect myself casting her out. But it didn’t stop her.Others have come into the Restaurant with Children in their hands that also have implied to have this “Code,” and Have Attacked Mentally.

Some obviously don’t care about the Children/Others, that also possibly have this “Code.” USING TACTICS TO CAUSE FEAR

The unclean Spirit that looked to be from India ..https://clyp.it/rcjdbva4 , would Engage mentally, a pale skin male, a Black male at one time, while I am working and trying to earn money. After they are finished, The “Black Americans male female would start using words such as “Can I Help U” when they arrive, in the Store, or the manage co-workers. Once again, this is about Awakening Moors Re-claiming their Birth-Rights and Inheritance. Nov 5th, 2016 plate “JASON” I forgive them

ONE DAY, I NOTICED THEY STARTED TO SPEAK OF FORCING A PERSON TO RECEIVE A “CODE.”

I noticed some customers would come into the Restaurant with Children in their arms, that seem to have the “Code” would still Attack Mentally. Some of these Customers, obviously don’t care about the Children who have the “Code,” because it is obvious they know I will cast them out, Mentally if I can. So Some are using these Children that have the “Code,” or don’t care enough about them to be protectors.

USING PSYCHOLOGICAL WARFARE

There is a African American/Black male(Co-Worker)(K) he looked to be over 25 years of age, who also seem to be representing the (3) and possibly ( an other), who constantly Attack Mentally. It is obvious he is being paid possibly, to perform these Acts of Terrorism. When I started to cast him out mentally, He would begin to sing (R&B) music, which them would Replay several times mentally. Note: Remembering the Group that Represents the Military that sits at the table every day Mostly (Black Males over 50 & Represents (3)). I am 43 years old and my Nationality is MOORISH AMERICAN.

THESE “ACTS OF TERRORISM,” ARE ABOUT DISCOURAGING AWAKENING MOORS/MU’URS FROM RE-CLAIMING THEIR BIRTH-RIGHT, NATIONALITY, INHERITANCE, IMPLEMENTATION OF ABRAHAM LINCOLN’S EXECUTIVE WILL AND THIRTEENTH AMENDMENT WITH ITS 20 SECTIONS.

THESE ATTACK OF TERRORISM ARE COMING FROM THOSE WHO LOOK TO BE MOORISH AMERICAN BUT ARE UNDER THE STATUS OF AFRICAN AMERICAN, NEGRO, BLACK, COLORED ACCORDING TO CONSTITUTIONAL LAW AND SEEM TO BE A REPRESENTATION OF THE NUMBER (3) A SCIENCE/GROUP.

There is an Attempt to Engage Forcefully by These African American/Blacks (3), who are consider “Chattel Property” and possibly Others. They are being helped by those from the Military, Indian from India, Asians, Pale skin “American?” Once again, They represent (3) Science/Group and are considered Mostly by constitutional Law Chattel Property.

CHEMICAL ATTACKS (ACTS OF TERRORISM)

One day, while I was Casting them(customers, co-workers) out mentally, A Customer who seem to be a regular came into the restaurant. He is from Asia. He walked out of the Restaurant, As he walked out, He yelled, “We Got her!” then Approximately 3 to 5 minutes later, The African American/Black woman (P) (Manager) Told me to go on Break. I did. Approximately 2 minutes Then I started to Cough and Sneeze. I looked outside the door and I saw the African American/ Manager female(P), vomiting, along with other Co-workers.  I had to leave out of the building along with others. I ate my food outside. When I came back in the Restaurant from Break, the African American/Black male (K)(Possibly an other), said, I apologize for Spraying Pepper Spray or Mace.

SIMILAR BEHAVIOR IN NEW YORK

Soon after I started working there, I started to hear them use some of the same “Code,” Words as N.Y. The group that sit at the table, mostly “Black Males,” over 50 years of age, have tried Forcefully to engage mentally Several times. I worked hard to cast them out.

There have been those From India who have forced Engage as well(Males). At first I thought it was Isolated. Then I noticed Those African/Black Males & Females, the Indian males, asains, pale skins as well and some Mexicans that came into the Restaurant were working together.

I noticed those that have the  “Code” that are not Like Us (Moorish Americans,) in spirit, gives them abilities to invade mentally, while sleeping etc.

I thought the Attacks by those who looked to be from India & Asia, being Isolated, ..https://clyp.it/rcjdbva4  , but now The Blacks/African American(3) , have shown to have been working along with them to cause “Fear,”. Also it seems they know they purpose to Encourage (MOORISH AMERICAN) to Relinquish their Attempts to Re-Claim Their Birth-Rights Through “Acts of Terrorism.”

The African American/Black Female Manager who Represents (3) or imply to be apart of a Science/ Group

The African American/Black Manager Female who represents (3), has Tried almost every time I arrive to engage Mentally Forcefully. I had to cast out her Spirit too many times to count.

Then I started to realize she was engaging Forcefully at the place where I live or rest. Engaging  mentally. While I was sleeping etc. I don’t know why she thinks this behavior is okay.  

I start to notice, the customers who start engaging Mentally(Forcefully) as well. Especially those that were “Males,” African American/Black, Indian from India, Asains, pale skin(American?).She seem to encourage the”African American/Black Males(possibly an others) to engage or Imply some form of Rape or Molestation. They use the word “BROTHER,” A LOT.

When I would not allow her to engage mentally, she became more Aggressive, and others that would come into the Restaurant.

She along with other Co-workers have forcefully engage mentally while I was a the place where i sleep. https://clyp.it/rcjdbva4

Her daughter has into the restaurant with her child in her arms and also have forcefully engage mentally. They I am going to protect myself casting her out. But it didn’t stop her.

Others have come into the Restaurant with Children in their hands that also have implied to have this “Code,” and Have Attacked Mentally. Some obviously don’t care about the Children/Others, that also possibly have this “Code.”

USING TACTICS TO CAUSE FEAR

The unclean Spirit that looked to be from India, would Engage mentally, a pale skin male, a Black male at one time, while I am working and trying to earn money. After they are finished, The “Black Americans male female would start using words such as “Can I Help U” when they arrive, in the Store, or the manage co-workers.

Once again, this is about Awakening Moors Re-claiming their Birth-Rights and Inheritance.

Nov 21st, 2016

Dec 11th, 2016

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Dec 31st, 2016

[kristinsimmons]

#USMLEPassFail: A Brave New Day

By BRYAN CARMODY, MD

Well, it happened.

Beginning as soon as 2022, USMLE Step 1 scores will be reported pass/fail.

I’m shocked. Starting around two weeks ago, I began hearing rumors from some well-connected people that this might happen… but I still didn’t believe it.

I was wrong.

The response thus far has been enormous – I haven’t been able to clear my Twitter mentions since the news broke. And unsurprisingly, the reaction has been mixed.

In the future, I’ll post more detailed responses on where we go from here – but for now, I’d like to emphasize these five things.

1. By itself, making USMLE Step 1 pass/fail doesn’t fix much.

Simply getting rid of three digit scores doesn’t improve medical education. And it doesn’t make residency selection any better, either.

It does give us the opportunity to make changes. And the importance of that should not be understated.

Put simply, this is the greatest opportunity for medical education reform since Flexner, and the greatest opportunity to re-design residency selection since… ever.

“WHAT WILL REPLACE STEP 1?” IS A HARD QUESTION. AND MAKE NO MISTAKE, THE FACT THAT IT’S A HARD QUESTION IS ONE OF THE VERY REASONS MANY CLUNG TO STEP 1 SCORES SO DOGGEDLY.

2. The path of least resistance does not take us where we want to go.

Most of the commentary on social media thus far has taken the following form:

Now only Ivy League medical students will get into competitive specialties.

Don’t worry! USMLE Step 2 CK will just be the new Step 1.

I guess DOs and IMGs can forget about getting into top residency programs.

And you know what? Most of these concerns are justified.

If we do nothing, Step 2 Mania is the natural result of a pass/fail Step 1. And unless we give program directors more useful information – and the time to thoughtfully review all the applications they receive – they’ll gravitate to another convenience metric out of necessity.

But that does not mean it’s inevitable.

3. We all have a say in what comes next.

If the rise and fall of a scored Step 1 teaches us nothing else, it should clearly demonstrate these two things.

First, advocacy works. There is no way that the NBME’s entrenched, out-of-touch bureaucracy would have ever voluntarily changed Step 1 to pass/fail – unless their feet had been repeatedly been held to the fire by the public over the past year. Change is possible – but you have to speak up.

Students, I’m looking at you – especially those from “non-elite” or international medical schools. You have a say in what comes next. How should residency programs evaluate you? Surely, answering multiple choice questions with peripheral relevance to real patient care is neither the best nor the only way to identify your talent. It’s time to dream bigger – and demand more meaningful evaluation.

Second, medical students will rise to whatever bar we set for them.

Ask them to memorize an 800 page review book so they can excel on a multiple choice question test of basic science esoterica? Done and done. Students knew most of what they were learning was pointless – but they worked tirelessly because we told them it mattered.

So program directors, now I’m looking at you. Whatever you tell students to do, they’ll do. You want high Step scores? Students will give them to you. But what really matters to you? Do you want residents who will serve the underserved? Contribute to research? Arrive on July 1 with specialty-specific knowledge? Whatever you say, goes. If you choose to grump about the loss of the bad old days, you’re abdicating your authority to set the standards you want.

YOU WON’T FIND ME SHEDDING ANY TEARS OVER THE DEMISE OF A SCORED STEP 1.

4. No one should mourn the loss of a scored Step 1.

Look around my Twitter mentions, and you can find touching testimonials mourning the demise of Step 1 scores. There are tales of useful factoids brought to bear on patient care decades later; of students inspired to consume as much (mostly useless) scientific knowledge as possible; of doors opened and careers launched because of one shining moment on test day years ago.

Give me a break.

The Step 1 score was the biggest false god in medical education, and no one should be too sad that it’s going away.

Was it objective? Sure. But the ability of three-digit scores to discriminate between applicants was actually fairly imprecise.

Did it test some useful concepts? Of course. But scoring highly required memorizing esoteric information that would never benefit an actual human patient.

Did some students benefit from scoring highly? Absolutely. But did Step 1 scores really “level the playing field” for students from international or non-prestigious medical schools overall? I doubt it.

Did it give program directors an easy way to screen applications? Yup. But was that way meaningful? Probably not. The main value of Step 1 was that it gave you a number. But if the content of the test doesn’t matter, why not just have medical students throw darts, or race go karts, or memorize digits of pi?

And of course, our idol worship of Step 1 came at a significant opportunity cost. The fact that most of us turned out okay doesn’t prove that Step 1 was the best way, or that that we wouldn’t have been better off under another system.

Here’s the thing:

Whether you liked a scored Step 1 or not, the current system is not what any of us would have designed if we were building something from the ground up.

In the scored Step 1 era, we sat back and watched as preclinical medical education turned into a glorified USMLE prep course with a five-figure/year tuition bill attached. We did nothing as residency applications spiraled out of control and program directors’ outsourced their most important decision-making to the NBME.

We shouldn’t be proud of any of this. And we shouldn’t mourn the loss of the three-digit score that enabled us to neglect the need for reform for so long.

More importantly, there is no turning back now.

If you opposed #USMLEPassFail, do your grieving for the scored USMLE – and then get to work. Saying “I told you not to make Step 1 pass/fail!” is a hollow victory. There is an opportunity here to engage our students in tasks that could actually lead them to be better physicians – but we have to seize it.

And if you supported #USMLEPassFail, now is not the time to dance on the three-digit score’s grave. We need to get to work, too – or this hard-won victory will go for naught.

5. The way forward… my opinion

Expect more from me on these topics in the future, but for now, let me put these three thoughts in your head.

WE NEED MEANINGFUL EVALUATIONS.

My 5th grader’s report card provides more useful information than any medical school transcript I’ve ever seen. He doesn’t get an “A” in math – I get to see a lengthy list of math skills and an assessment of where he’s at with all of them. Maybe he’s comfortable dividing fractions, but still developing proficiency with using variables to set up algebraic equations.

Letter grades are nice – but they don’t tell me what he knows and what he doesn’t. (I don’t get a histogram of other students’ performance and where he falls – because how other students performed is kind of irrelevant if my goal is to help him become better in math.)

The fact that elementary schools provide more information-rich evaluations than medical schools is shameful. In the past, we’ve justified this because of Step 1. Starting in 2022, that excuse will ring hollow.

Let’s be honest: there should never be a medical school evaluation in which a students is exceptional in every area. (If there is, it tells you more about the school than the student.)

Our goal should be to make medical school formative, not performative; to help learners maximize their potential without fearing failure; to provide and communicate honest feedback that leads to improvement and growth along the spectrum of medical education. (For their part, program directors need to focus less on relative accomplishment and more on potential to grow and thrive in that program/field.)

We don’t need another arms race. We do need more thoughtful evaluation. We should require students to engage in tasks that leave them – and their future patients – better off. And schools that refuse to participate in this process should be penalized by program directors and medical school applicants alike.

WE NEED HOLISTIC REVIEW.

I don’t think we need a one-size-fits-all metric to tell us who are the “best” applicants. Honestly, we don’t.

Certain talents and traits get you a lot farther in certain disciplines than others. Even within the same discipline, different programs have different needs and serve different missions. What makes a good doctor? It’s complicated. And trying to reduce that complexity down to a single three digit number is silly.

Holistic review is possible. It’s what we do at the residency program at which I’m an associate program director. But it’s labor intensive – and it requires human judgment. That last part makes some people uncomfortable, and I understand why. Holistic review has the potential to devolve into bias and cronyism. But that’s not a reason to not do it – it’s a reason to strive to do it well, to make decisions deliberately, and to build some checks and balances to make sure you stay aligned with your values.

WE ALSO NEED APPLICATION CAPS.

The only way to get away from screening metrics and treat every applicant as an individual is to limit the pile of applications that program directors receive.

THE EXISTENCE OF A SCORED STEP 1 ALLOWED US TO PRETEND THAT THIS WASN’T HAPPENING.

Look, I’ve preached this sermon before. But you’d better believe I’m gonna be carrying this particular gospel to the people again in the near future.

Afraid of application caps? Worried that they’ll disadvantage students from non-elite schools? Stay tuned for a data-driven expose of the misinformation surrounding caps coming soon.

Dr. Carmody is a pediatric nephrologist and medical educator at Eastern Virginia Medical School. This article originally appeared on The Sheriff of Sodium here.

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