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Now do doctors.

If you don't already know how thoroughly any standards for graduation from medical school have been discarded, it will scare the shit out of you, thereby saving you a potentially deadly visit to a proctologist.

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Feb 7, 2023·edited Feb 7, 2023Liked by Chris Bray

As GM knows, I have been harping on this for years. The fundamental problem in this case sits squarely at the feet of the Liaison Committee for Medical Education (LCME). This is the obligatory credentialing agency for all medical schools and is, without a doubt, amongst the most biased/woke of medical organizations -- and almost all of them are pretty far gone which is saying something.

This all begins long before graduation. It starts with them having changed the criteria for medical school admission. It used to be that the essential criteria were: 1) the mental brainpower and tenacity (both are required) to actually learn medicine; this has always been an overwhelmingly difficult task because there is a lot to learn and even more to understand if one is to be competent at this level; and 2) An obsession with caring for each individual patient as both an intellectual and a "spiritual" necessity -- making people better is the whole point. This is why it is a calling/profession and not just a job. It is a principle to which many of us have dedicated our entire lives.

The criteria are now radically different (take it from someone involved in admissions). For the last decade, getting much worse over the last five years, the criteria have become: 1) Demographic score; 2) Social Justice Warrior (now, more appropriately, Woke) score; 3) "how much time did you spend following some doctor around" score; and 4) "distance travelled" score. We are no longer ON THE ADMISSIONS COMMITTEE even privy to the grades and MCAT scores for fear we might screen out someone because they are just not qualified in the core attributes (see above) to succeed. It has become a travesty but we have succeeded -- our demographic scores are increasing!

Because the admitted students are not up to the task (as has been shown to be true in all such efforts) after protestations that the school learning standards would not be diminished, they have all been (and continue to be) diminished. All grading went to pass/fail...that way it is easy to move the pass point around. Even the National Boards, an independent measure, have been reduced to pass/fail because...equity. (Yes, everyone can pass except a token couple irrespective of their actual scores. Couldn't have too many people left behind, you know.)

Since there are no scores, there is no decent way to select the really good graduating students (and there are some that are really, really good, still) for better/more strenuous residencies. So those positions, too, get selected demographically further making sure that everyone is equally bad when they finish that phase of their training.

Finally, after residency many now go into salaried positions. Many of these require one to know almost nothing about the patient other than a few facts gleaned when coming on shift (non-critical-care hospitalists are the biggest group). These have now become largely shift-worker doctors -- sort of like nurses but with MDs. Nurses are there to care and to execute instant tasks for acutely ill patients. Doctors are supposed to have more to contribute, but the system ensures that even if they had the capacity, they often cannot. Electronic medical records, designed for billing with patient care added as a "tack on" are generally worse than the paper chart of long ago. But they make finance offices and lawyers happy while making sure that health care is even further deprecated.

This is serious stuff. Most of my graduating cohort will see no doctor under 40. I suggest you seriously consider this when choosing yours. (To be clear, some of the recent graduates are really quite good. You and we just have no way to identify them.) Until we toss out the LCME and begin to fix this from the bottom up, it is only going to get worse.

As the COVID response has shown, no health care bureaucrats care about any of this. But as a patient and for the physicians still trying to do the right thing...we care. We are all trying to stem this tide. Perhaps on the backs of the COVID rebellion, some of this just might happen. Hope springs eternal.

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And many of the medical students are lazy and entitled. They not infrequently leave in the middle of surgeries to go to required lectures that often have nothing to do with their rotation. Where’s the value in doing a surgical rotation if you can’t see the whole operation on your patient from start to finish because you have other obligations? Idiotic. They don’t read up on cases a priori. And you can’t embarrass them by exposing their ignorance or they run to some assistant dean and complain. I stopped taking students. It drove me crazy. They’d say “ I don’t know anything about your specialty.” So I’d say”Okay. You’re here to learn. But, tell me which rotations you’ve completed and I’ll talk with you about topics from those specialties.” Well, they didn’t know anything about those topics either. They want a good grade, but they don’t want to sweat. We used to be ashamed if we didn’t know something on rounds as a student. Now they have no shame. As the late, great BB King said “ Everybody wants to go to heaven. But nobody wants to die.” The medical school experience ( and residency training to be honest) has devolved from a rigorous right of passage with progressive responsibility to a much less challenging, overly protected and coddled experience. When my generation finished training, we were ready to hit the ground running. Now, not so much.

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That's....not really great to hear.

"They want a good grade, but they don’t want to sweat." Can't wait for someone like this to CUT MY BODY OPEN.

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Feb 7, 2023Liked by Chris Bray

I know quite a few surgical residents (in Canada) and I will say that while some are...concerning from the stories the ones I have exposure to in this particular specialty do put in the sweat and when they don't know something feel immense shame and are constantly putting tons of pressure on themselves to hit their next level of progression and responsibility.

I haven't seen much illusion to the belief that 5 years of residency is the absolute minimum and depending on the school they will know it is actually not enough to be confident and hit the ground running.

From this exposure the biggest thing that really shocks me is the hours they are put to, which makes it very difficult to study extra and the tests/exam are designed to be exercises in memorization it seems, at least for medical school and certain first year ones.

Can't speak to all specialties, countries, or schools of course, this is a one anecdote from one Canadian city in one focused area. But broadly speaking from what I can see...the outliers in a negative sense are apparent and interventions are quick.

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I’m generalizing, so there are exceptions. I commonly worked 100 hours a week during 8 years of residency in two different specialties. You don’t know everything after residency. You don’t know everything as a practicing surgeon or physician. But the system in the USA is changing and not for the better. Regulations reducing hours mean less experience. You have to get your reps in. If you have a system that’s afraid to fire somebody because of identity politics, you run into a problem. That problem is not hypothetical. That doesn’t mean you’re going to have a bad outcome most of the time. That’s not the problem. It pertains more to diligence and having a sense of urgency. Additionally more complex problems require more thought and experience to manage.

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Feb 7, 2023Liked by Chris Bray

Surgical specialties in very good institutions are highly filtered, have a particular personality type, and often are among the better folks. But there are not many of them, their work is a small fraction of total medical care, it does not really matter in many cases how complete a view of the patient they have (and many are proud of the fact that they do NOT have one -- they just want to cut, manage the lytes [no one does it better] and send them back from whence they came) and they have a far more procedural than holistic view of any individual -- not a slur, just the nature of the specialty.

So an anomaly, but, sadly, not a highly relevant one in the broader context of caring for a massive population with, primarily, chronic disease (which surgeons generally get to avoid as well.)

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Do y'all listen to Dr. Suneel Dhand? Because his argument is that there's no better healthcare system in the world than the American system, if you have an acute injury or illness, and no worse system if you want to stay healthy and avoid chronic health conditions.

https://youtu.be/v_aOzcD1e6Y

This seems consistent with the view you're expressing here.

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Find an old semi-cranky guy who’s not a primadonna but tells you the bottom line and cares about your outcome. The nurses usually know who has frequent complications and who does not. You can tell if somebody cares. You want somebody who’s not a cowboy, but also not afraid to do the operation. Paper credentials are not enough. But yes, care is getting better, even while technology advances.

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I meant care is not getting better.

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Feb 7, 2023Liked by Chris Bray

Dr K., do you think that patients can make a difference by reporting ineptitude via patient satisfaction surveys, complaints to the state licensing boards, and/or whatever other state avenues might exist? And/or to insurance companies? I imagine people don’t write complaints as often as they could. If they did, however, what do you think could be either a theoretically possible, or currently likely (these two are not the same) outcome? Persistence and a long view implied.

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Feb 7, 2023·edited Feb 7, 2023Liked by Chris Bray

This is an excellent question. It appears to me that the state licensing boards are thoroughly captured -- what they are doing to Cole in Washington at the moment, or Ness in Maine is criminal. They are pursuing these matters on one or two complaints THAT SUPPORT THE OUTCOME THE BOARD WANTED TO BEGIN WITH...You cannot say anything against whatever the diktats of the democrats are currently...that is the long and short of it, whether they are right or wrong medically for a particular patient/physician axis is irrelevant. Because these boards (as well as organizations like AAP, AMA, etc. seem to support the Woke parameters I reviewed rather than the good practice of medicine, other than a rare state (Tennessee, Florida) the medical boards do not seem like a way of resolving this, sadly.

As far as "I follow the cookbook" doctors being graduated today, I suppose that a large number of consumer comments that say exactly that: "This doctor follows a cookbook and does not want to listen to me, other opinions, or anything other than what the government tells them to say which causes me to question their general competence" might have an effect if there were enough of them -- at least for patients smart enough to know that is not what they want. The trouble with all of the consumer sites is that comments are few and it is trivial and cheap to buy good comments to make up for them.

Sadly, the way that seems most likely to help is electing/persuading politicians that they are going to lose the next election if they do not fix this issue. Any state could remove their medical schools from LCME and endorse some other accreditor. Would be a biatch if only one state did it, but if several did, would hold water and might start a different, better path. Similarly, a school needs a state license (in most states); if the state requirements were different than LCME, would create an interesting situation that might have a good end.

I have been beating on this issue for a long time and, short of moving the horrible political and bureaucratic engine in place (which, somehow, we must) I am bereft of simple solutions. :(

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And Ryan Cole.

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Feb 7, 2023Liked by Chris Bray

My bad...that was who I meant in Washington. Too many four letter names. Corrected.

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Dr. K,

Thank you for your very inforrmative reply. I didn't know what was happening to Drs Cole or Ness. It's a chilling situation. I can imagine it causing more doctors (and physical therapists and other clinicians too) to go by what the cookbook says, even in other situations unrelated to this highly politicized one. I hope not but I feel that habits of mind tend to be reused in all situations even if they started out as a specific approach to a specific situation.

It liifted a weight to read that about "follow the cookbook" being common today. I've run across it time and again, it's made identifying and treating a totally solvable medical issue much more difficult than it needs to be, and it usually doesn't respond to self-advocacy. Sometimes it does, which has puzzled me, and now that I've read what you said, I wonder if the nonresponsive clinicians are working at capacity whereas those who open up in response to advocating for a more engaged approach have some other reason for "coloring within the lines". I think there are some more tools/techniques for establishing communication to be explored, starting from that line of thought, so thank you.

It took me quite a while to even see that sometimes I'm encountering a "cookbook" approach. I was also lucky in that I ran into a few outstanding doctors, DPT, etc. early on and so I had some basis for comparison. Other patients might not be so lucky. Especially with the madness of legislation such as in California. I've noticed that some clinicians are willing to have a risk of acting/impact of not acting discussion, whereas others aren't, but I can see that being chilled along with whatever other speech becomes forbidden or compelled. So thank you for the thoughts on how to address the total incompetence of scripted interactions.

I don't think it's simple. I think shifting big institutions is a many-pronged approach. I guess that means many pitchforks are needed.

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Excellent note. Don't forget the torches...I like fire...

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I am not surprised, yet still appalled. Thank you for the insight and the important tip!

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"Since there are no scores, there is no decent way to select the really good graduating students."

Oh, ve have our vays.

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Even in veterinary medicine.

I graduated in 1996...back when we still read medication labels. Now vets give your pets whatever the salesperson says will make the practice the most money, efficacy be damned.

When my generation has retired, good luck with Fluffy.

I have a young associate who shared my OCD for good medicine, but there are not many out there....and most can't do a good physical exam.

Human doctors for SURE can't do physical exams...hell, they don't even want to touch people....they look at you like 'Eeeeew, sick person.'

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You got that right. I moved to Florida, escaping from Chicago and found a sub-par primary care physician in the corporate hospital mill that's supposed to be "the best"- he was horrible and treated me like I had leprosy because I refused to get the C- jab, the flu shot and the shingles shot - I asked him respectfully why I should get the Covid shot if I could still get Covid and give Covid. He said "Because of the children!! There are hundreds of children on ventilators dying of the Delta variant!" Liar. Never went back. I got all the jabs I thought I needed over the years and forced my kids to do the same, with the ungodly childhood vaccine schedule that i heartily regret with every ounce of being. Even the stupid freaking chicken pox vaccine - they ended up getting chicken pox twice anyway. Except for the doctors who knew from the beginning this was a farce (like Dr. John Littell in Ocala), I have lost all faith in the medical community. Put a fork in them, they're done.

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They got Chicken pox TWICE? Damn...when I was a pup, parents had Chicken Pox parties....the infectious kid was mingled with all not exposed yet so that everyone could get it and be done with. My CP infection occurred when I was 4...still have a scar on my forehead from picking at a scab. I never got infected again....that dern old natural immunity...so unreliable.

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Feb 8, 2023Liked by Chris Bray

I also got a good case of CP when I was 7. It was going around the neighborhood and my mom just let us play outside with all the kids until we came down with it. I am proud of that immunity. I also remember having a forced TB jab in public school - we all still have the injection scar on our arm. Why were they allowed to do that? Did my parents have informed consent for us? I doubt it. My own kids got 2 mild cases of CP which was a real pain because it meant being out of school longer than if they had gotten CP once. It showed me that the the jab interfered with their natural immunity. I remember asking my pediatrician was it really necessary, not knowing at the time of all the kick backs and incentives. I even tried to do my own research on it and could only find a positive peer reviewed study out of Japan, as this was 20 years ago. Since we now know we can no longer trust any peer reviewed anything, my focus is solely on building up my own health with nutrition and proper strength training, the correct supplements and following the medical community that actually cares about our longevity. I can thank Substack for plugging me into the right sources to be able to discern and make educated decisions on my health. Cheers to you, Radicalpony!

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The trust issue is amplified for me because I am part of the medical community. I'm just a vet so not exactly the same, but all the same chicanery goes on. Drug reps constantly pushing new products with questionable efficacy and side effects out the ying yang.

And then the vaccination issues. I used to believe that clients who didn't want to vaxx their pets were nutters. Now, I am not so sure. The thing that this COVID vaxx thing did that was GOOD, was to lift the veil and expose the corruption. Now I am questioning all my vaccine recommendations. I see people just pumping their dogs full of vaccines....all these vaccine clinics popping up at places like CVS and Tractor Supply....do the people even KNOW why they are doing it? I doubt it. And it really bothers me because I think some vaccines are absolutely needed--Rabies, for example, but how many are just BS? I'm at the end of my career...I truly hope some of the younger vets are skeptics now as well. We need to call this out as much as possible and get to the truth.

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Feb 8, 2023Liked by Chris Bray

I would definitely not classify Veterinarians as "just a vet" as your training is every bit as rigorous in my opinion. One of my dogs (10# yorkie poo) had a very bad reaction to one of the vaccines that was on the recommended/required schedule - don't get me wrong, I absolutely loved our Vet - but it was strange because they simply put a notation on her chart that she could no longer get the follow-up or boosters and it suddenly became no problem for her to board or go anywhere else without it. Just a doctors's note saying she had a bad reaction. So I was a little upset - why give it to her in the first place? Why experiment with a little animal that can't give consent?

Yes I agree there are many silver linings to this whole jab thing being exposed, but it sure is no consolation to the millions who have lost loved ones at this point - knowing that they could have survived with proven, stable treatments and not remdesivir and a ventilator or being starved to death and left to die in a hospital with passive aggressive measures because they wouldn't get jabbed. I pray for the family members too, who were blamed for their loved ones deaths. I also had an elderly relative killed with Remdesivir - kidney failure within 48 hours, no real treatment to help him. Unconscionable.

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🙌 And that's exactly how they make you feel. Even when you're just there for the every 6 months money grabbing. They treat you like you have cooties.

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I think I'm gonna go to med school. I hear they're handing out degrees like hot dogs at a ball game. Pretty soon you'll be able to get a medical degree online.

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Not so fast hetero white guy. Your type may not be welcome. 😡

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Feb 7, 2023Liked by Chris Bray

That Fed Ex pilot is squared away. He knew ground control was chewed up. He saw the danger before it was such and avoided it. I would not be surprised if he were ex-military. Regardless he saved dozens of souls that day!! That being said, why do we have to do things cheaper... because we have exported all our wealth to china. A strange segue I know, but it is what’s been on my mind lately. My resolution for this year, more like a desire that I am putting more effort into, is to avoid chinese goods and if at all possible to buy American goods. (With some exceptions for luxury goods. Italian leather, French wine, German tools, etc..) Long story short the USA undoubtedly is mostly a chinese market. Don’t get me wrong. I have found some hidden gems like All American Clothing, Marc Nelson Denim, Roam Luggage, James Avery Jewelry and SAS Shoes, but most every retail outlet I have been to is loaded with chinese goods. It’s absurd, astonishing and disheartening. America is drunk on cheaply made STUFF. Just take a look at your shoe collection! If we had not been exporting our wealth and prosperity to china for the last thirty years we would have a better more robust economy to better pay the aeronautical workers. Therefore attracting better skilled personnel and greatly reducing turnover. We can help ourselves. Start paying attention to where goods are made and make a decision based purely on self-preservation. It’s really that easy. Thanks for the article Chris! Disclaimer: I have nothing against and love the Chinese people. That being said, I am gravely concerned with the people of the country I know and Love. God Bless the USA!!!

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Feb 7, 2023·edited Feb 7, 2023Liked by Chris Bray

for me, the reason to buy global products was always and should always be to get the very best. if there is a certain kind of clay in italy and the potters with generations of experience making pots out of that clay, you buy those pots for your garden because they are the finest, not because they are the cheapest. everyday when you see those pots, your eye rejoices in the artistry. you can feel the spirit of the crafts person.

you buy olive oil from spain or greece or italy because it's the best, not because you can get a lot of it for a dollar. you use it in full appreciation of it's precious wonder.

when i had my costume shop in NY, we did a tiny section of Jersey Boys for the same money as the shop a block away that did 5 times as much as the show. how could that shop have had any fun? have taken any pride in their work?

i always said i would rather make one item for $1000 than 1000 items for a dollar apiece. the money is the same in the end, but oh the drudgery and soul killing in the second scenario. when i go into a place like Bed Bath and Be Stupid and see mountains of identical cutting boards or Old Navy with stack after stack of cheesy t shirts, i get physically ill and flee.

when we restored our old house, i looked at suites of light fixtures that were all more or less the same and all made god knows where, hundreds of styles virtually indistinguishable from one another.

instead i bought vintage lamps, made in a different time, full of history and the hand of the makers. there's not a light fixture in this house that matches and i don't care. they are all special and it gives me great joy to live among them

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Spot on, Carolyn!! I threw, I mean got rid of eight pairs of shoes made in.... well I repeat myself. The pairs I have left: 2 made in Italy, 1 made in Brazil, 3 made in USA and all of which are of much greater quality than the ones I got rid of. You know, the types of shoes one takes to get repaired when the need arrises.

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i think of it as very high quality recycling. instead of buying crap furniture that goes together with an allen wrench in 5 minutes, buy something that is 100 years old and has lasted through wars, hurricanes and changing tastes, something that was made by a master crafts person who put heart and soul into it, something that you will repair, restore and refinish as time passes and leave to your descendants. the other stuff goes in the waste stream with all the masks and covid tests and pollutes the earth

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Absolutely!! My wife’s Oma and father came to the US from Deutschland after the war. She brought her bedroom furniture with her and its solid. I have reconditioned the dresser and It is beautiful. Or oneself can try to make woodwork. One might surprise themselves and find something they can put their own heart and soul into.

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this is why Herr Schwab's vision of owning nothing and being happy will never work. humans need to take pride in something. look what happens when you give people things (welfare) without asking for them to put anything into it. peeing in the hallways, drug deals in the court yard, drive by shootings.

how does Schwab think all those unowned things will be maintained by the people who have no investment in them?

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We can not shortcut dignity. The end result is always shame, and without dignity civilization fails.

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He doesn't care if the items will be maintained. He doesn't have to use them. It will be up to us to deal with the crap we have to use.

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Read the article on why a pasta company quit making a particular shape. It's far more reaching than shoes, its the lack of tool and die makers, and that's not coming back. But all isn't lost, we can just learn to code because software manufacturing is the same as normal manufacturing, right..........

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I hear ya J.W. The problem is our public companies have a fiduciary duty to make the most profitable decisions for stock holders. Once it is no longer prudent to have manufacturing outside the US they will not do so. The only way that can happen, without illegal dictates from a socialist/communist regime, is if consumers start buying goods made here in the US and stop buying goods made elsewhere. The solution really is that easy. Buy and demand goods that are made here. I went to two auto part stores for brake pads. One big chain had only made in china pads. The other had pads made in china, India and Mexico (not enough time to go into Mexico. Bottom line the cartels are underpricing the market with mexican goods and produce so they can smuggle illegal drugs in on the shipment of those goods. Effectively killing our citizens and our businesses). So rather than get the pads that day I ordered Good Year Made In USA brake pads online and waited a couple of days for the delivery. We will pay more for made in USA goods, and frankly that is how I can tell if something is really made here. I look at the overage as an investment in my children’s future. Pay attention where things are made. Do your homework and share your findings with those around you. You will be shocked. For instance: Volvo and AMC movie theaters are now chinese companies. Jaguar and Range Rover are now an Indian company. Our future is in our hands, and if we want a happy ending... it’s time to buy MADE IN THE USA!!!

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🙌

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I too prefer to buy American made products. Many items labeled “Made in Italy” are produced in Italy by Chinese workers in Chinese owned factories. There was an episode of Madam Secretary about this situation.

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The US should outlaw Dollar General, the Dollar Store, etc. 100% imported junk. Walmart should never have gotten away with destroying the mom and pop stores of the 60's, and Nike, well, I can't even look directly at that brand with its child and slave labor. iphones too - their facilities in China have nets strung around the tops of the buildings to prevent the workers from trying to jump off and commit suicide. And let's not forget the children working in the cobalt mines for all the electric car batteries which will end up in a toxic landfill before long.

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If we all start demanding Made In USA products the dollar stores will become ten dollar stores and start carrying USA goods. As far as EVs. Anyone who has a brain and can think for themselves knows that fossil fuels are a cornerstone of our advanced civilization. Why do you thin Elon came out and said we need fossil fuels?

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founding

Not strange at all. Well said

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This is a great example of your observation about our collapsing society, at all levels. There are many reasons but there just seems to be a large number of people in important positions, ones that can determine life and death, that don't know what they're doing.

Danny Huckabee

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And these are the kind of people that can ignore corrective criticism. Authority trumps excellence, and in fact they don't like it when people smarter point out the faulty goings-on.

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Just sent #.

Danny

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The Woke: “as long as all of these “do-stuff” places have majority POC/disabled/gay/trans LGBTQ2iABLMFU2 employees, that’s all I care about. Now let’s discuss something more important: the evils of whiteness”

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Nicely paraphrased. They (the self-anointed woke) often do, indeed, look for any and everything to FEEL a certain way; in spite of themselves, and any and all around them would rather just naturally BE -- i.e., BE a productive human being; BE a qualified human being; BE an extremely self accountable human being, etc

All those attributes are definitely lost on the woke.

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Feb 6, 2023·edited Feb 6, 2023Liked by Chris Bray

So many flight disasters and near-disasters are like this - simply not doing. Air France 447 is another terrifying one - two experienced FOs are utterly flummoxed by an intermittent instrument-reading outage. They animatedly tell each other that they don't understand what's going on while they quite literally act at cross-purposes - one pulling his stick forward, the other back - before the pilot emerges from his rest period to try to salvage the situation, to no avail. A farcical series of errors - but one borne of the fact that the two FOs entered a period of turbulence with no plan, and in fact no communcation beyond talking about other flights they'd been on. The fact that they were, like, FOs, meant they didn't need to actually worry about coordinating how to handle the plane.

The video you linked illustrates what happens when you deviate from the basics - watch the gauges and call out 'go-around' if needed. Watch the center line and call out 'center line' if needed. Ironically, this deviation probably saved the day, because someone *else* wasn't doing their job.

Aviation, moreso than any other sphere of human endeavor, has checklists and failsafes of monumental robustness. In the case of Air France 447, the crew just didn't think them that important, and by the time they realized the gravity of the situation they were too panicked to carry them out. In these recent near-misses, I can't even give the people involved the credit of knowing what they should have been doing. And here's the kicker - the more people who aren't doing their jobs, the more capable people will *have* to deviate, because they can no longer trust that the rest of the system is working.

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I will take your word for the monumentally robust fail safes in aviation, there used to be such things in the pharmaceutical industry. I think we all know how that went.

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America is a tired and sloppy place right now, with jabbed ATC and pilots, exhaustion from social tension, and a rapid decline in merit and standards. With poor leadership in the administration filtering down like Soma to the rest of us, it feels like we are having the life drained from us.

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"If the government becomes the lawbreaker, it breeds contempt for law; it invites every man to become a law unto himself; it invites anarchy."

-Louis D Brandeis.

You guys remember that Christian Bale movie with the Joker? And the Joker takes over two boats on the river and gives them each a detonator to blow up the other boat to save themselves? That was covid except the boats weren't rigged, we now know that unlike the movie the Joker was right. That other group will blow you up if it benefits them.

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Yikes. I love flying. I love being close to major airports and seeing those massive beauties close up in flight. Makes me love the magic of humanity.

Of course same/similar dysfunction in healthcare. As a nurse I’m amazed every shift how often basic shit doesn’t work and how bad communication between docs/nurses is. Phones, computers, IV pumps are regularly on the fritz. I’m in a level one trauma center an hour outside Manhattan. Good news is that the shit show is forcing me to deepen my spiritual practice and connect more with the natural beauty on this still (for now) gorgeous planet. What else can we do?

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After the horrific Tenerife collision, US airlines suspended service to Tenerife and the Canary Islands until just recently. I think it was just reestablished. The Canaries are hard to get to, but are very beautiful and worth a visit, btw.

I was talking to an ex-aircraft controller just yesterday who still works for the FAA in other capacities. And he’s a pilot. He told me a couple of interesting things apropos your topic. So, the FAA makes ATCs retire at 56. So they lose a lot of highly experienced people at a ridiculously young age. There are no skills tests or simulations that they can perform to retain their positions. He also told me that they have incredible technology which would be beneficial in terms of safety and efficiency which the agency simply won’t implement because of institutional inertia. That’s the trifecta with our government, one part stupid, one part inertia/laziness, and one part malevolent corruption. Season to taste. Most people find it indigestible regardless.

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Not a great article to read six days out from a flight 😬

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I've been doing a lot of long-distance driving, but the airlines are still safe by historical standards. For now.

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Feb 7, 2023Liked by Chris Bray

So are vaccines. Lol

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Feb 7, 2023·edited Feb 7, 2023Author

ISWYDT

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I’m flying SWA to Austin in a couple of weeks myself... yikes.

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Feb 7, 2023·edited Feb 7, 2023Liked by Chris Bray

The Lac Megantic rail disaster occurred in my neck of the woods in 2013. I happened to be acquainted with a conductor that was friend of the engineer they pinned everything on. Basically a perfect storm of government regulation and corporate greed caused the accident. The conductor explained to me that the CEO of the Maine & Montreal Railroad became convinced that single operator trains would revolutionize rail freight. Canada's transportation authority became really strict with the hours of service rules at the same time.

According to my friend the conductor, you needed to be at your hotel before the hours of service ended - or you would get a large fine. The run to Lac-Megantic was so long that an engineer only had 20 minutes to secure the train and get to his hotel. If he needed 25 minutes he would get a $200.00 fine. The engineers used a bunch of shortcuts to secure the train in about 8 minutes. Basically leaving a locomotive running to keep the air pressure up, and setting a couple of hand brakes. The combination of single engineers on trains and stupid safety rules caused the Lac Megantic disaster.

The TSB report is below. Note the weasel words around the Single-Person Crews section.

https://www.tsb.gc.ca/eng/rapports-reports/rail/2013/r13d0054/r13d0054-r-es.html

https://en.wikipedia.org/wiki/Lac-M%C3%A9gantic_rail_disaster

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I was up there to Mt Megantic a few years ago — what a disaster. I worry about my little town in Vermont with the freight trains going through.

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This is what happens to society when the highest value is placed on making money instead of valuing human life. I am not particularly religious but over 2,000 years ago the people who wrote that “The love of money is the root of all evil.” , sure knew what they were talking about. Doing things cheaper and faster is only about making money for shareholders, screwing the rest of society as a result.

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I now fly in the planes of others, but I was an instrument rated pilot and, 25 years ago, flew a good bit for over a decade. At the time, I learned and kept learning, visited ARTCC Centers on a Sunday morning when not super busy (which one could do then) to learn about the "other side" of the radio, listened to complaints in the break room, visited major metro airport towers (again, at agreeable times), and learned about the technology we used at the time (NDB beacons were still in use, radar altimeters less reliable -- and no "autoland"). Langewiesche's Stick and Rudder was still basic then. Like the FedEx pilot at Austin, it wasn't just about "following orders," although we paid plenty of attention to what we were told, it was also about acting responsibly in an entire set of circumstances we were part of. Flying was fun. Flying was also serious, in a kind of Western buddhist "attention" way

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Someone should write a book about what happens when productive, capable, free people leave an industrialized economy in droves. A good title would be Atlas Shrugged.

Seriously, as Ayn Rand laid out do well, philosophy drives the course of human history & events. When our culture abandoned reason a few generations back, collapse was baked in the cake.

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This is definitely in play, I'm sure a lot of capable and experienced people decided to retire when mandates were put in place. That and the other nonsense already going on (like diversity training that has nothing to do with your job and it's assumed that we are all some kind of bigots) is not good for retaining quality people.

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Thank you for linking to me! Great article.

The incompetence is shocking. But here's something else that disturbs me personally. I am not woke, not vaccinated, not a recreational drug user. I had one Covid a long time ago. I own a small business where I have to dispatch trucks, equipment and personnel carefully, with lots of things to consider.

While I still manage, I noticed that I personally am becoming less competent at doing so. It is still acceptable, but the trend is not going in the right direction. Not sure if this is a purely individual, idiosyncratic problem or a part of a larger trend.

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And by the way, it's a sign of competence that you notice your own declining competence. You can't notice a loss of focus without focus.

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Interesting! Started during the pandemic, or when? If you write about this, I'll happily read it.

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No Igor, you are probably 100% capable of your job tasks. It’s the other people who don’t give a shit about their performance is what makes your job harder. I see it every day where I work(restaurant). My job daily is to come in at 6-8 and make sure the line is ready for service at 10 on weekends or 11 the rest of the week. Which I can do and still give myself a half hour or sometimes more before service starts to either prep things for next shift, or prep for tomorrow or next day, or use as my meal break. But lately since hiring diversity hires I have to spend an hour at minimum cleaning my area as well as dishes from the previous night to be able to have no greasy equipment to put fresh food on after I cook it, etc. the result is my production has gone down and now my “spare time to do other things” is now down to 5-10 minutes. God fobidz if I see anyfings bout dem new homies in da pit eyever.

Diversity is our strenfff!

Fuck that.

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It won’t be surprising if it’s found that the wifi now saturating the air is slowly frying our brains. But this very saturation, and thus frying of our brains, may prevent us from realizing it.

Thus I’m increasingly convinced that a thorough cleaning of the slate—total civilizational destruction on par with The Flood—is required to eventually restore sanity, after which the insanity of present conditions will fade into the misty stuff of cautionary myths and legends.

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Feb 7, 2023Liked by Chris Bray

The decay in competence was becoming apparent in public schools decades ago, as is evident from the long slide of this country into academic mediocrity.

The laser-like focus on objectives other than competence is affecting everything. Destroying a civilization’s competence is an important element of destroying the civilization itself.

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People are finally waking up to the fact that viruses are tricky little devils, mutate routinely and become resistant to many anti-viral therapeutics. Frankly, conventional medicine should be educating the public about how to strengthen their own immune systems, which if healthy routinely kill viruses, bacteria, malignant cell and the like 24/7.

The curious might want to read my new book due out on Amazon in the next few days titled: GET WELL—EVEN IN TODAY'S CONFUSION, UNCERTAINTY, AND FEAR. Because I write in two genres, my Substack articles are in the spiritual space and not related but this is my second book on holistic healing. My platform is having an amazing personal recovery history, being considered by some an expert on the holistic healing process and sharing with readers (in this book) my proprietary list of what strengthens and what weakens the immune system (physically, mentally/emotionally, and spiritually. That list will help the public make smarter decisions about prevention and their own healing.

Sorry for the shameless plug but your article jumped out at me, Chris, because it was totally in my wheelhouse.

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