From www.sciencedaily.com
Impressive.
Here is the link.
https://www.sciencedaily.com/releases/2024/09/240906141608.htm
Sunday, September 08, 2024
Saturday, September 07, 2024
Do Good Guys with Guns stop mass shootings?
From John Lott at the Crime Prevention Research Center.
JL’s statistics and analyses are among the best available.
Here is the link
JL’s statistics and analyses are among the best available.
Here is the link
Are AI Chatbots left-leaning?
From John Lott at the Crime Prevention Research Center.
JL is a top-notch researcher. I’ve taught statistics – JL’s is among the best on the topics he addresses.
Here is the link
JL is a top-notch researcher. I’ve taught statistics – JL’s is among the best on the topics he addresses.
Here is the link
Friday, September 06, 2024
Aquatic Lumberjacking
How a Precision Rifle doubles as a Chainsaw
By Will Dabbs, MD, at Guns magazine.
Hilarious
Here is the link
By Will Dabbs, MD, at Guns magazine.
Hilarious
Here is the link
Thursday, September 05, 2024
Reasons for concealed carry: My interview with a psychopath
By Will Dabbs, MD at www.thearmorylife.com.
Crazy is a lyrically overused term these days. Psychiatrists institutionally despise that word. Labels are passe in today’s enlightened society. Such antiquated terminology invariably foments subconscious bias.
What most people mean when they use the word “crazy” is psychosis. Distilled to its essence, this just means disconnected from reality. People with schizophrenia, for example, typically hear voices or, more rarely, see things that are objectively not real. The age of onset is typically late teens or early twenties. The experience is uniformly horrifying for all involved, particularly the patient.
The overwhelming majority of folks who develop such maladies are utterly harmless. They might make you feel a little bit weird when first you meet. However, once you get to know them, in my experience they are people just like the rest of us. In fact, I’ve found that schizophrenics and folks with notable bipolar disorder are often a bit more artistic and creative than the rest of us. AntiSocial Personality Disorder (ASPD), by contrast, reflects an inability to empathize with the suffering of others.
One cute little blonde-headed kid I met in the hospital with ASPD looked perfectly normal. However, he came to us because he had spontaneously stabbed his foster mother in the thigh with a pencil. Thankfully, such extreme psychopathy is fairly rare. However, it is in those rare outliers where the real excitement can be found.
I met the subject of this article in the ER of a large metropolitan trauma center. Let’s call him “Frank.” He was 25 years old. At first impressions, Frank was incredibly imposing. I would guess he was maybe six feet one and weighed perhaps 210 pounds without a gram of extraneous body fat. This guy was built like Arnold Schwarzenegger circa 1984. He was a simply incredible specimen. I met the subject of this article in the ER of a large metropolitan trauma center. Let’s call him “Frank.” He was 25 years old. At first impressions, Frank was incredibly imposing. I would guess he was maybe six feet one and weighed perhaps 210 pounds without a gram of extraneous body fat. This guy was built like Arnold Schwarzenegger circa 1984. He was a simply incredible specimen.
Frank’s family had brought him to the ER because he was acting strangely at home. In the presence of a nurse, he proceeded to swallow a drywall screw along with a hypodermic needle he had retrieved from a sharps container. This bought him a ticket to the lockdown psych ward.
Frank was engaging and articulate, if a bit strange. I inquired regarding his story, and he was quite forthright. Frank ultimately taught me quite a lot. One of the things he taught me was that I should never leave the house without a gun. Let me explain.
When Frank was a teenager he developed an insatiable interest in the occult. He read rapaciously on the subject and subsequently began actively praying to Satan. When the time was right, he asked the Prince of Darkness to send him some company. Old Mephistopheles complied. At the time of our meeting, Frank said his head played home to three entities — Dagon, Demidagon, and Begorred. He said one of the three talked to him all the time.
Frank eventually took a job in a rough part of town. One day he was strolling past a group of four males just listening to his three pet demons having a confab. One of the three, I forget which, directed his attention to the four men. Let’s assume it was Dagon.
Dagon pointed out one man in particular for attention. He told Frank that he needed to “do something” about that guy. When Frank pushed back, Dagon explained that, if he failed to “do something,” then the man might hurt somebody. Frank explained that he didn’t care. Dagon said failure to intervene meant that this gentleman would actually hurt Frank.
My new friend then walked up to a total stranger and killed him because the voices in his head told him to do so.
Frank spent the next several years in prison. As near as I could tell, all he did for those years was lift weights. He had been released some 30 days before we met. He stopped taking his medications, and, before you know it, was snarfing hypodermic needles in the ER. As an aside, the needle and the screw passed of their own accord without further intervention. The human body is a simply breathtaking machine.
As he and I were alone in his room talking, I innocently inquired as to whether or not these three entities were speaking to him at that particular moment. He called one by name and said it was his turn to talk. I asked what he was saying. Frank turned his head slightly, looked me in the eye, and said, flatly and without emotion, “Kill, kill, kill, murder, murder, murder, kill, kill, kill, murder, murder, murder…” He kept saying that until I asked him to stop.
The following morning I returned to his room, this time at the head of a train of nursing students, PT students, and sundry straphangers. Of the nine of us who went into Frank’s room, I was, incongruously, the only physician and the sole male. We were arrayed in a line with me being farthest from the door. Frank was sitting up in bed shirtless with the sheet pulled up to his waist. As I mentioned, he was jacked like an absolute beast.
Once we filed in, Frank suddenly shouted at everybody to stop. To use a tired metaphor, time momentarily stood still. I didn’t know if he was about to kill and eat me, the girls, or some random sampling. He put his hands together in a strangely unnatural way and indexed to each of us one at a time, twirling his mitts rhythmically in our direction. Once he completed this exercise he smiled and pleasantly asked what he could do for us. I naturally asked him what exactly it was that he had just done.
Explaining as he might to a child, Frank said he knew we were coming to visit that morning. He elaborated that, the night before, he had moved all the furniture aside before drawing a big pentagram on the floor with soap. He said this was designed to keep us safe while we were with him in his room. When he realized that the soap pentagram was invisible, he made do with this weird individual counter-curse hand thing. I thanked him for both the explanation and the effort.
Inpatient facilities for the mentally ill are incredibly expensive. By contrast, anti-psychotic drugs are relatively cheap. In their defense, these medications do typically work quite well…if you take them as you should. In Frank’s case, he explained that the voices in his head would direct him to stop his medications from time to time when they needed him to “think clearly.” Just such a chain of events had brought him to the hospital that evening.
Frank was a nice kid with a really bad disease. The overwhelming majority of those similarly afflicted are quite incapable of the sorts of violence that bought Frank five years in the state pen. Fortunately, Frank remained peaceful and calm when we interacted with him. I fear what might have happened if he had not.
Those of us fortunate enough not to carry such a weighty burden should take great care not to stigmatize those who do. However, for that rare minority who do embrace the darkness, I pack a gun. Until and unless they do something that brings them into the light, these folks do indeed walk among us. I feel it’s simply sound policy for me to be prepared if I must face a deadly and unavoidable threat.
Crazy is a lyrically overused term these days. Psychiatrists institutionally despise that word. Labels are passe in today’s enlightened society. Such antiquated terminology invariably foments subconscious bias.
What most people mean when they use the word “crazy” is psychosis. Distilled to its essence, this just means disconnected from reality. People with schizophrenia, for example, typically hear voices or, more rarely, see things that are objectively not real. The age of onset is typically late teens or early twenties. The experience is uniformly horrifying for all involved, particularly the patient.
The overwhelming majority of folks who develop such maladies are utterly harmless. They might make you feel a little bit weird when first you meet. However, once you get to know them, in my experience they are people just like the rest of us. In fact, I’ve found that schizophrenics and folks with notable bipolar disorder are often a bit more artistic and creative than the rest of us. AntiSocial Personality Disorder (ASPD), by contrast, reflects an inability to empathize with the suffering of others.
One cute little blonde-headed kid I met in the hospital with ASPD looked perfectly normal. However, he came to us because he had spontaneously stabbed his foster mother in the thigh with a pencil. Thankfully, such extreme psychopathy is fairly rare. However, it is in those rare outliers where the real excitement can be found.
I met the subject of this article in the ER of a large metropolitan trauma center. Let’s call him “Frank.” He was 25 years old. At first impressions, Frank was incredibly imposing. I would guess he was maybe six feet one and weighed perhaps 210 pounds without a gram of extraneous body fat. This guy was built like Arnold Schwarzenegger circa 1984. He was a simply incredible specimen. I met the subject of this article in the ER of a large metropolitan trauma center. Let’s call him “Frank.” He was 25 years old. At first impressions, Frank was incredibly imposing. I would guess he was maybe six feet one and weighed perhaps 210 pounds without a gram of extraneous body fat. This guy was built like Arnold Schwarzenegger circa 1984. He was a simply incredible specimen.
Frank’s family had brought him to the ER because he was acting strangely at home. In the presence of a nurse, he proceeded to swallow a drywall screw along with a hypodermic needle he had retrieved from a sharps container. This bought him a ticket to the lockdown psych ward.
Frank was engaging and articulate, if a bit strange. I inquired regarding his story, and he was quite forthright. Frank ultimately taught me quite a lot. One of the things he taught me was that I should never leave the house without a gun. Let me explain.
When Frank was a teenager he developed an insatiable interest in the occult. He read rapaciously on the subject and subsequently began actively praying to Satan. When the time was right, he asked the Prince of Darkness to send him some company. Old Mephistopheles complied. At the time of our meeting, Frank said his head played home to three entities — Dagon, Demidagon, and Begorred. He said one of the three talked to him all the time.
Frank eventually took a job in a rough part of town. One day he was strolling past a group of four males just listening to his three pet demons having a confab. One of the three, I forget which, directed his attention to the four men. Let’s assume it was Dagon.
Dagon pointed out one man in particular for attention. He told Frank that he needed to “do something” about that guy. When Frank pushed back, Dagon explained that, if he failed to “do something,” then the man might hurt somebody. Frank explained that he didn’t care. Dagon said failure to intervene meant that this gentleman would actually hurt Frank.
My new friend then walked up to a total stranger and killed him because the voices in his head told him to do so.
Frank spent the next several years in prison. As near as I could tell, all he did for those years was lift weights. He had been released some 30 days before we met. He stopped taking his medications, and, before you know it, was snarfing hypodermic needles in the ER. As an aside, the needle and the screw passed of their own accord without further intervention. The human body is a simply breathtaking machine.
As he and I were alone in his room talking, I innocently inquired as to whether or not these three entities were speaking to him at that particular moment. He called one by name and said it was his turn to talk. I asked what he was saying. Frank turned his head slightly, looked me in the eye, and said, flatly and without emotion, “Kill, kill, kill, murder, murder, murder, kill, kill, kill, murder, murder, murder…” He kept saying that until I asked him to stop.
The following morning I returned to his room, this time at the head of a train of nursing students, PT students, and sundry straphangers. Of the nine of us who went into Frank’s room, I was, incongruously, the only physician and the sole male. We were arrayed in a line with me being farthest from the door. Frank was sitting up in bed shirtless with the sheet pulled up to his waist. As I mentioned, he was jacked like an absolute beast.
Once we filed in, Frank suddenly shouted at everybody to stop. To use a tired metaphor, time momentarily stood still. I didn’t know if he was about to kill and eat me, the girls, or some random sampling. He put his hands together in a strangely unnatural way and indexed to each of us one at a time, twirling his mitts rhythmically in our direction. Once he completed this exercise he smiled and pleasantly asked what he could do for us. I naturally asked him what exactly it was that he had just done.
Explaining as he might to a child, Frank said he knew we were coming to visit that morning. He elaborated that, the night before, he had moved all the furniture aside before drawing a big pentagram on the floor with soap. He said this was designed to keep us safe while we were with him in his room. When he realized that the soap pentagram was invisible, he made do with this weird individual counter-curse hand thing. I thanked him for both the explanation and the effort.
Inpatient facilities for the mentally ill are incredibly expensive. By contrast, anti-psychotic drugs are relatively cheap. In their defense, these medications do typically work quite well…if you take them as you should. In Frank’s case, he explained that the voices in his head would direct him to stop his medications from time to time when they needed him to “think clearly.” Just such a chain of events had brought him to the hospital that evening.
Frank was a nice kid with a really bad disease. The overwhelming majority of those similarly afflicted are quite incapable of the sorts of violence that bought Frank five years in the state pen. Fortunately, Frank remained peaceful and calm when we interacted with him. I fear what might have happened if he had not.
Those of us fortunate enough not to carry such a weighty burden should take great care not to stigmatize those who do. However, for that rare minority who do embrace the darkness, I pack a gun. Until and unless they do something that brings them into the light, these folks do indeed walk among us. I feel it’s simply sound policy for me to be prepared if I must face a deadly and unavoidable threat.
Wednesday, September 04, 2024
Harris Denounces Unfettered Free Speech
From Jonathan Turley.
JT is on target.
Too many people in this country do not sufficiently value freedom, which will eventually destroy it. We are on that road, and there is no sign that people will vote to preserve it.
Here is JT’s blog entry.
“That Has to Stop”: Harris Denounces Unfettered Free Speech in 2019 CNN Interview
I previously wrote how a Harris-Walz Administration would be a nightmare for free speech. Both candidates have shown pronounced anti-free speech values. Now, X owner Elon Musk and former independent presidential candidate Robert F. Kennedy Jr. have posted a Harris interview to show the depths of the hostility of Harris to unfettered free speech. I have long argued that Trump and the third-party candidates should make free speech a central issue in this campaign. That has not happened. Kennedy was the only candidate who was substantially and regularly talking about free speech in this election. Yet, Musk and Kennedy are still trying to raise the chilling potential of a Harris-Walz Administration.
In my book “The Indispensable Right: Free Speech in an Age of Rage,” I discuss how the Biden-Harris Administration has proven to be the most anti-free speech administration since John Adams. That includes a massive censorship system described by one federal judge as perfectly “Orwellian.”
In the CNN interview, Harris displays many of the anti-free speech inclinations discussed earlier. She strongly suggests that X should be shut down if it does not yield to demands for speech regulation.
What is most chilling is how censorship and closure are Harris’s default positions when faced with unfettered speech. She declares to CNN that such unregulated free speech “has to stop” and that there is a danger to the country when people are allowed to “directly speak to millions and millions of people without any level of oversight and regulation.”
Harris discussed her view that then-President Trump’s Twitter account should be shut down because the public had to be protected from harmful viewpoints.
“And when you’re talking about Donald Trump, he has 65 million Twitter followers, he has proven himself to be willing to obstruct justice – just ask Bob Mueller. You can look at the manifesto from the shooter in El Paso to know that what Donald Trump says on Twitter impacts peoples’ perceptions about what they should and should not do.”
Harris demanded that Trump’s account “should be taken down” and that there be uniformity in the censorship of American citizens:
“And the bottom line is that you can’t say that you have one rule for Facebook and you have a different rule for Twitter. The same rule has to apply, which is that there has to be a responsibility that is placed on these social media sites to understand their power… They are speaking to millions of people without any level of oversight or regulation. And that has to stop.”
In other words, free speech should be set to the lowest common denominator of speech regulation to protect citizens from dangerous viewpoints.
Harris’s views have been echoed by many Democratic leaders, including Hillary Clinton who (after Musk purchased Twitter) called upon European censors to force him to censor American citizens under the infamous Digital Services Act (DSA).
Other Democratic leaders have praised Brazil for banning X after Musk balked at censoring conservatives at the demand of the socialist government. Brazil is where this anti-free speech movement is clearly heading and could prove a critical testing ground for national bans on sites which refuse to engage in comprehensive censorship. As Harris clearly states in the CNN interview, there cannot be “one rule for Facebook and you have a different rule for Twitter.” Rather, everyone must censor or face imminent government shutdowns.
The “joy” being sold by Harris includes the promise of the removal of viewpoints that many on the left feel are intolerable or triggering on social media. Where Biden was viewed as an opportunist in embracing censorship, Harris is a true believer. Like Walz, she has long espoused a shockingly narrow view of free speech that is reflective of the wider anti-free speech movement in higher education.
Harris often speaks of free speech as if it is a privilege bestowed by the government like a license and that you can be taken off the road if you are viewed as a reckless driver.
Trump and the third party candidates are clearly not forcing Harris to address her record on free speech. Yet, polls show that the majority of Americans still oppose censorship and favor free speech.
In my book, I propose various steps to restore free speech in America, including a law that would bar federal funds for censorship, including grants and other funding that target individuals and sites over the content of their views. The government can still speak in its own voice and it can still prosecute those who commit crimes on the Internet or engage in criminal conspiracies. Harris should be asked if she would oppose such legislation.
For free speech advocates, the 2024 election is looking strikingly similar to the election of 1800. One of the greatest villains in our history discussed in my book was President John Adams, who used the Alien and Sedition Acts to arrest his political opponents – including journalists, members of Congress and others. Many of those prosecuted by the Adams administration were Jeffersonians. In the election of 1800, Thomas Jefferson ran on the issue and defeated Adams.
It was the only presidential election in our history where free speech was a central issue for voters. It should be again. While democracy is really not on the ballot this election, free speech is.
Jonathan Turley is the Shapiro Professor of Public Interest Law at George Washington University and the author of “The Indispensable Right: Free Speech in an Age of Rage.”
JT is on target.
Too many people in this country do not sufficiently value freedom, which will eventually destroy it. We are on that road, and there is no sign that people will vote to preserve it.
Here is JT’s blog entry.
“That Has to Stop”: Harris Denounces Unfettered Free Speech in 2019 CNN Interview
I previously wrote how a Harris-Walz Administration would be a nightmare for free speech. Both candidates have shown pronounced anti-free speech values. Now, X owner Elon Musk and former independent presidential candidate Robert F. Kennedy Jr. have posted a Harris interview to show the depths of the hostility of Harris to unfettered free speech. I have long argued that Trump and the third-party candidates should make free speech a central issue in this campaign. That has not happened. Kennedy was the only candidate who was substantially and regularly talking about free speech in this election. Yet, Musk and Kennedy are still trying to raise the chilling potential of a Harris-Walz Administration.
In my book “The Indispensable Right: Free Speech in an Age of Rage,” I discuss how the Biden-Harris Administration has proven to be the most anti-free speech administration since John Adams. That includes a massive censorship system described by one federal judge as perfectly “Orwellian.”
In the CNN interview, Harris displays many of the anti-free speech inclinations discussed earlier. She strongly suggests that X should be shut down if it does not yield to demands for speech regulation.
What is most chilling is how censorship and closure are Harris’s default positions when faced with unfettered speech. She declares to CNN that such unregulated free speech “has to stop” and that there is a danger to the country when people are allowed to “directly speak to millions and millions of people without any level of oversight and regulation.”
Harris discussed her view that then-President Trump’s Twitter account should be shut down because the public had to be protected from harmful viewpoints.
“And when you’re talking about Donald Trump, he has 65 million Twitter followers, he has proven himself to be willing to obstruct justice – just ask Bob Mueller. You can look at the manifesto from the shooter in El Paso to know that what Donald Trump says on Twitter impacts peoples’ perceptions about what they should and should not do.”
Harris demanded that Trump’s account “should be taken down” and that there be uniformity in the censorship of American citizens:
“And the bottom line is that you can’t say that you have one rule for Facebook and you have a different rule for Twitter. The same rule has to apply, which is that there has to be a responsibility that is placed on these social media sites to understand their power… They are speaking to millions of people without any level of oversight or regulation. And that has to stop.”
In other words, free speech should be set to the lowest common denominator of speech regulation to protect citizens from dangerous viewpoints.
Harris’s views have been echoed by many Democratic leaders, including Hillary Clinton who (after Musk purchased Twitter) called upon European censors to force him to censor American citizens under the infamous Digital Services Act (DSA).
Other Democratic leaders have praised Brazil for banning X after Musk balked at censoring conservatives at the demand of the socialist government. Brazil is where this anti-free speech movement is clearly heading and could prove a critical testing ground for national bans on sites which refuse to engage in comprehensive censorship. As Harris clearly states in the CNN interview, there cannot be “one rule for Facebook and you have a different rule for Twitter.” Rather, everyone must censor or face imminent government shutdowns.
The “joy” being sold by Harris includes the promise of the removal of viewpoints that many on the left feel are intolerable or triggering on social media. Where Biden was viewed as an opportunist in embracing censorship, Harris is a true believer. Like Walz, she has long espoused a shockingly narrow view of free speech that is reflective of the wider anti-free speech movement in higher education.
Harris often speaks of free speech as if it is a privilege bestowed by the government like a license and that you can be taken off the road if you are viewed as a reckless driver.
Trump and the third party candidates are clearly not forcing Harris to address her record on free speech. Yet, polls show that the majority of Americans still oppose censorship and favor free speech.
In my book, I propose various steps to restore free speech in America, including a law that would bar federal funds for censorship, including grants and other funding that target individuals and sites over the content of their views. The government can still speak in its own voice and it can still prosecute those who commit crimes on the Internet or engage in criminal conspiracies. Harris should be asked if she would oppose such legislation.
For free speech advocates, the 2024 election is looking strikingly similar to the election of 1800. One of the greatest villains in our history discussed in my book was President John Adams, who used the Alien and Sedition Acts to arrest his political opponents – including journalists, members of Congress and others. Many of those prosecuted by the Adams administration were Jeffersonians. In the election of 1800, Thomas Jefferson ran on the issue and defeated Adams.
It was the only presidential election in our history where free speech was a central issue for voters. It should be again. While democracy is really not on the ballot this election, free speech is.
Jonathan Turley is the Shapiro Professor of Public Interest Law at George Washington University and the author of “The Indispensable Right: Free Speech in an Age of Rage.”
Behind the Brow That Furrows
Neha Aggarwal at jamanetwork.com
Growing up as the youngest child, I always sat in the back seat of the car. This was a position enabling infinite wonder. My gaze was unfettered and I could freely observe the world, as I was rarely turned to first for conversation. One sunny Georgia afternoon when I was 13 years old and had assumed my usual position in the back seat on the drive to our weekend outing, my gaze wandered. I saw the teeth of my older sister in the front seat as she vivaciously laughed while chatting with our mother. When the conversation mellowed into peaceful silence, my gaze shifted upward to the oval rearview mirror. I noticed a vertical line etched into the space between my mother’s eyebrows. Her brow was furrowed, and she did not seem to notice it.
I asked, “Mom, what is that line between your eyebrows?” She sighed, touching her brow in detached but slightly self-conscious frustration. She replied, “Do me a favor, and don’t stress about what you cannot control. Don’t inherit this from me.” This crease was a remnant of the stresses she has borne throughout her life. As I gazed solemnly at the line, I imagined what might have happened. Every time that she furrowed her brow, the skin pulled closer together, as if it were embracing itself to protect against the stressor. This continued until the skin could no longer risk being unshielded, choosing instead to remain connected at rest.
I did not fully comprehend her words at the time, so I exhaled my concern and hoped that my innocent question had not bothered her much. Yet I still wondered how raising my sister and me might have contributed to my mother’s stress lines, which she had accepted as a characteristic of her flesh. Would my sister’s laughter in the car have been possible without this mark on our mother’s forehead? Would my serenity in the back seat have been replaced by a different feeling altogether?
Eleven years later, I am a medical student in a maternal-fetal medicine clinic, and I meet you. You are a young single mother of 2 small children, but your presence at this clinic gives you an additional label: our patient. This label subjects you to our sensitive clinical eyes, which are perceptive not to make you feel exposed but so that we do not neglect to notice any detail that might impact your health. Embarking on the task of observation, I call upon my skills from afternoons in the back seat.
As we review the status of your pregnancy, I mentally check off the trimester-appropriate questions I am slated to ask you. I stay in my lane of medical questioning as a clerkship student on her obstetrics and gynecology rotation. However, in the midst of administering the formula-driven clinical questionnaire, I also bear witness to the linear indentations under your eyes. I turn away from the computer on which I was taking notes and angle my feet toward you. I discard the clinical questionnaire to ask what else has been impacting your pregnancy. The lines that were before just passengers on our conversation grow deeper, more consequential and consuming, with each new piece of your life you reveal to me.
I learn of your diagnosis of multiple sclerosis only 2 years ago. I imagine that the disease onset and eventual diagnosis felt utterly unjust. It injured your relationship with your body, which before implied a promise to never surprise you. You share with me how your body’s natural movements have changed, as has the way in which you interact with the world. The knowing look in your eyes testifies to this adjustment.
I see the pressure of motherhood you carry on your shoulders, your burning wish to bear life’s challenges before they can reach your children. I think about the line on my mother’s forehead, a small physical manifestation cluing an observer into her history of decades of struggle to ensure her family’s happiness. Bracing your children from these forces exhausts your energy, collapses the space between your shoulders, and pulls tension between your eyebrows until your skin can no longer stretch.
As you share your testimony of the challenges that multiple sclerosis has introduced to your everyday life, my observations deepen. Your multiple sclerosis establishes itself as the third person in the room, exerting a silent force over me as we interact. I see healing bruises on your legs from falls that came suddenly, irrationally—and, like a needled thread waiting to tighten, my legs tense from ankle to hip. I see laughter lines on your cheeks from watching your little ones growing up, and the corners of my mouth involuntarily rise. These pieces of you are not documented in our medical records, but they convey the silent stories that are woven into your flesh, subconscious but inexplicably alive.
Once I am educated on all this history with which you present, those tension lines never go away, and I see them more profoundly. They represent the challenges you have faced condensed into a small physical detail, easily overlooked if not further explored. The eyes that glimmered when we said hello to each other are now condensed by the skin underneath that bears the weight of the parts of your life to which your clinicians are uniquely privy. You trust us with your story, and we can only half-deliver for you. We cannot fix functional disability you have accumulated from prior relapses; we can only prevent future relapses with disease-modifying therapy. We cannot prescribe your disease-modifying therapy during pregnancy due to risks to the developing fetus. We know in the back of our minds that the smoldering disease course of multiple sclerosis over time exposes disability caused by old brain and spinal cord lesions. Our medicine lives in a world too entropic to capture its goals.
I bring in our attending physician, and we review the medical plan with you. We tell you to please let us know if the disability you notice from multiple sclerosis gets any worse during your current pregnancy or if you suspect a new flare is emerging. In the back of our minds, we consider the careful attention to fetal health involved in treating a flare during pregnancy. We veil our conversation with reassurances concluded from a qualitative estimate that pregnancy is an immunosuppressive state, which reduces the chance of a relapse happening while you are off your disease-modifying therapy. In the back of our minds, we hope the qualitative estimate will apply to you. We discuss routine care for the second trimester of pregnancy. In the back of our minds, we wonder how the guidebook to manage pregnancy would be different if it were tailored to patients with multiple sclerosis.
At the end of your visit, we say you are free to go. You stand and I observe your gait for the first time, as it is not part of routine examination in the obstetrics and gynecology clinic. As you begin to walk, you sway and immediately outstretch your arms, hoping to be steadied by the wall, or the computer, or anything nearby. I offer you my arm, and we walk down the hall together toward the clinic exit. I turn to you and say, “It was very nice to meet you, and please take care.” I try to listen to what you say in response, but all I can see are the lines under your eyes, and I feel my eyebrows furrowing.
Growing up as the youngest child, I always sat in the back seat of the car. This was a position enabling infinite wonder. My gaze was unfettered and I could freely observe the world, as I was rarely turned to first for conversation. One sunny Georgia afternoon when I was 13 years old and had assumed my usual position in the back seat on the drive to our weekend outing, my gaze wandered. I saw the teeth of my older sister in the front seat as she vivaciously laughed while chatting with our mother. When the conversation mellowed into peaceful silence, my gaze shifted upward to the oval rearview mirror. I noticed a vertical line etched into the space between my mother’s eyebrows. Her brow was furrowed, and she did not seem to notice it.
I asked, “Mom, what is that line between your eyebrows?” She sighed, touching her brow in detached but slightly self-conscious frustration. She replied, “Do me a favor, and don’t stress about what you cannot control. Don’t inherit this from me.” This crease was a remnant of the stresses she has borne throughout her life. As I gazed solemnly at the line, I imagined what might have happened. Every time that she furrowed her brow, the skin pulled closer together, as if it were embracing itself to protect against the stressor. This continued until the skin could no longer risk being unshielded, choosing instead to remain connected at rest.
I did not fully comprehend her words at the time, so I exhaled my concern and hoped that my innocent question had not bothered her much. Yet I still wondered how raising my sister and me might have contributed to my mother’s stress lines, which she had accepted as a characteristic of her flesh. Would my sister’s laughter in the car have been possible without this mark on our mother’s forehead? Would my serenity in the back seat have been replaced by a different feeling altogether?
Eleven years later, I am a medical student in a maternal-fetal medicine clinic, and I meet you. You are a young single mother of 2 small children, but your presence at this clinic gives you an additional label: our patient. This label subjects you to our sensitive clinical eyes, which are perceptive not to make you feel exposed but so that we do not neglect to notice any detail that might impact your health. Embarking on the task of observation, I call upon my skills from afternoons in the back seat.
As we review the status of your pregnancy, I mentally check off the trimester-appropriate questions I am slated to ask you. I stay in my lane of medical questioning as a clerkship student on her obstetrics and gynecology rotation. However, in the midst of administering the formula-driven clinical questionnaire, I also bear witness to the linear indentations under your eyes. I turn away from the computer on which I was taking notes and angle my feet toward you. I discard the clinical questionnaire to ask what else has been impacting your pregnancy. The lines that were before just passengers on our conversation grow deeper, more consequential and consuming, with each new piece of your life you reveal to me.
I learn of your diagnosis of multiple sclerosis only 2 years ago. I imagine that the disease onset and eventual diagnosis felt utterly unjust. It injured your relationship with your body, which before implied a promise to never surprise you. You share with me how your body’s natural movements have changed, as has the way in which you interact with the world. The knowing look in your eyes testifies to this adjustment.
I see the pressure of motherhood you carry on your shoulders, your burning wish to bear life’s challenges before they can reach your children. I think about the line on my mother’s forehead, a small physical manifestation cluing an observer into her history of decades of struggle to ensure her family’s happiness. Bracing your children from these forces exhausts your energy, collapses the space between your shoulders, and pulls tension between your eyebrows until your skin can no longer stretch.
As you share your testimony of the challenges that multiple sclerosis has introduced to your everyday life, my observations deepen. Your multiple sclerosis establishes itself as the third person in the room, exerting a silent force over me as we interact. I see healing bruises on your legs from falls that came suddenly, irrationally—and, like a needled thread waiting to tighten, my legs tense from ankle to hip. I see laughter lines on your cheeks from watching your little ones growing up, and the corners of my mouth involuntarily rise. These pieces of you are not documented in our medical records, but they convey the silent stories that are woven into your flesh, subconscious but inexplicably alive.
Once I am educated on all this history with which you present, those tension lines never go away, and I see them more profoundly. They represent the challenges you have faced condensed into a small physical detail, easily overlooked if not further explored. The eyes that glimmered when we said hello to each other are now condensed by the skin underneath that bears the weight of the parts of your life to which your clinicians are uniquely privy. You trust us with your story, and we can only half-deliver for you. We cannot fix functional disability you have accumulated from prior relapses; we can only prevent future relapses with disease-modifying therapy. We cannot prescribe your disease-modifying therapy during pregnancy due to risks to the developing fetus. We know in the back of our minds that the smoldering disease course of multiple sclerosis over time exposes disability caused by old brain and spinal cord lesions. Our medicine lives in a world too entropic to capture its goals.
I bring in our attending physician, and we review the medical plan with you. We tell you to please let us know if the disability you notice from multiple sclerosis gets any worse during your current pregnancy or if you suspect a new flare is emerging. In the back of our minds, we consider the careful attention to fetal health involved in treating a flare during pregnancy. We veil our conversation with reassurances concluded from a qualitative estimate that pregnancy is an immunosuppressive state, which reduces the chance of a relapse happening while you are off your disease-modifying therapy. In the back of our minds, we hope the qualitative estimate will apply to you. We discuss routine care for the second trimester of pregnancy. In the back of our minds, we wonder how the guidebook to manage pregnancy would be different if it were tailored to patients with multiple sclerosis.
At the end of your visit, we say you are free to go. You stand and I observe your gait for the first time, as it is not part of routine examination in the obstetrics and gynecology clinic. As you begin to walk, you sway and immediately outstretch your arms, hoping to be steadied by the wall, or the computer, or anything nearby. I offer you my arm, and we walk down the hall together toward the clinic exit. I turn to you and say, “It was very nice to meet you, and please take care.” I try to listen to what you say in response, but all I can see are the lines under your eyes, and I feel my eyebrows furrowing.
Monday, September 02, 2024
Are climate models any good?
From Dr. John R. Christy, Distinguished Professor of Atmospheric and Earth Sciences at The University of Alabama
An informative video that puts climate models in perspective.
Watch it – the Q&A also is well worth listening to.
JRC makes a strong case that the climate models are not credible – bad statistics, bad science, and emphasizing agenda over the modelers’ own conclusions.
Here is the link.
An informative video that puts climate models in perspective.
Watch it – the Q&A also is well worth listening to.
JRC makes a strong case that the climate models are not credible – bad statistics, bad science, and emphasizing agenda over the modelers’ own conclusions.
Here is the link.
Thursday, August 29, 2024
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