Physicians strike

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It's been 0 days since a libertarian called another libertarian not a real libertarian. All is right in the world.
Ha! I love it. I think @pgg is more libertarian minded than me. Certainly has more concrete ideas and opinions about more things!

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I DO NOT think all the schools should be equal. There are schools that NEED more (however you know that). My kids' school gets a lot of extra money per student compared to other elementary schools in our state because the school population is of a very low socio-economic status. Many broken homes, single parent homes (working 2 jobs and no time to help with school work), refugees, ESL kids, etc.

Their student:teacher ratio is 11:1 as opposed to the state average of 15:1. There's free lunch for all the kids, and many kids get sent home with food (extra on weekends) because that may be the only meal they get to eat. We have unbelievably devoted and passionate staff who work there because they love the kids. Despite all this extra help, the average test scores are all way below the state averages. I can't imagine how much worse this would be if their school didn't have all this extra funding.

So, I hear you on "funding rich kids' schooling" with your property taxes. However, our school is in the same district as the the "rich kids" so all the property taxes get pooled for all the schools and distributed. Our school benefits from being in the same district as more well-off schools. Something to consider.
I think we are saying the same thing differently. I can’t make sense of this otherwise.
 
I am not here to pander to your comfort.

Again (I seem to say this a lot :)), you're not making me uncomfortable. If you write something that I think is wrong, dumb, internally inconsistent, or just different from the strongly worded opinion you wrote 12 minutes earlier, then I'm going to point that out.

Does that make you uncomfortable?

Soo… whatever. Argue all day.
That's what I'm here for. Echo chambers are boring. :)

Look, I've always held you in high regard as an obviously decent, altruistic person. Your pandemic work and now this plan to build a hospital in Africa - amazing. Looking forward to the YouTube channel.

But you might want to consider the possibility that the constant ranting about white people and how you can't wait to get away from them, effectively undermines other arguments you make. Plenty of white people have plenty of common ground with you. But I can't be the only one that takes you less seriously when you go off on those tangents.
 
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Again (I seem to say this a lot :)), you're not making me uncomfortable. If you write something that I think is wrong, dumb, internally inconsistent, or just different from the strongly worded opinion you wrote 12 minutes earlier, then I'm going to point that out.

Does that make you uncomfortable?


That's what I'm here for. Echo chambers are boring. :)

Look, I've always held you in high regard as an obviously decent, altruistic person. Your pandemic work and now this plan to build a hospital in Africa - amazing. Looking forward to the YouTube channel.

But you might want to consider the possibility that the constant ranting about white people and how you can't wait to get away from them, effectively undermines other arguments you make. Plenty of white people have plenty of common ground with you. But I can't be the only one that takes you less seriously when you go off on those tangents.
Again. I brought up classism and you tried to make it that I brought up racism. When I didn’t in this instant.
The constant ranting I do online is how I let out my frustrations. And I don’t really care if you think of my arguments undermined or not. It is my and my friends and lots of POCs lived experiences. I don’t care if you to take me seriously, but I will not be silenced. Take me whatever way you want. And 12 minutes earlier I did say discounted taxes but you of course chose to ignore that to further your agenda.
So unless you have walked in a POC shoes, you really can’t comprehend. Simple as that.

And I can assure you there are lots of us who feel this way but many are afraid to speak on it because of the negative comments and disbelief we get from people like you. But these are things that POC talk about frequently away from White people. Many of us are just trying to maintain peace with y’all so we keep our mouths shut. Who can blame us? We don’t hold the power and the cards. Me I just don’t care. I have had it. And so I stay true to me and the lived experiences of POC supported by research and facts.
 
This notion of "I don't want to pay for other kid's schools" is the exact reason why our public school system in this country is trash to begin with. For how much people hate how much Nikole Hannah-Jones because she talks so much about race, she's actually done some very thoughtful and interesting reporting on US public schools. One very interesting article she points out that upper middle class and upper class black families are just a much to blame as white families. It's a very interesting read.

As someone with a small child who is heading towards school but also want's to the child to grow up around people that look like her, I'm also experiencing this moral dilemma and honestly sometimes come to the same conclusion as one person said in the article. "My child is not an experiment." But on the other hand, what am I actually doing about the problem but living in neighborhood with people that look like me but not investing in the school system, because anyone who read up on this stuff knows it's not just property tax that makes a school system good. Yes it's a factor because the more kids that are enrolled the more money that comes to the school but it's also voluntary parent contributions that also funds things that make the school better.

And I'm not just coming down on Choco for that statement. Ive read that statement from others on here in the past and have certainly heard it among water cooler discussions at work.
 
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This notion of "I don't want to pay for other kid's schools" is the exact reason why out public school system in this country is trash to begin with. For how much people hate how much Nikole Hannah-Jones because she talks so much about race, she's actually done some very thoughtful and interesting reporting on US public schools. One very interesting article she points out that upper middle class and upper class black families are just a much to blame as white families. It's a very interesting read.

As someone with a small child who is heading towards school but also want's to the child to grow up around people that look like her, I'm also experiencing this moral dilemma and honestly sometimes come to the same conclusion as one person said in the article. "My child is not an experiment." But on the other hand, what am I actually doing about the problem but living in neighborhood with people that look like me but not investing in the school system, because anyone who read up on this stuff knows it's not just property tax that makes a school system good. Yes it's a factor because the more kids that are enrolled the more money that comes to the school but it's also voluntary parent contributions that also funds things that make the school better.

And I'm not just coming down on Choco for that statement. Ive read that statement from others on here in the past and have certainly heard it among water cooler discussions at work.
Upper middle class and upper class families are pretty much the same, regardless of skin color etc. A successful person usually has the right IQ, the right knowledge and the right attitude. A poor person quite the opposite, again regardless of race.

Intelligence does not have a skin color. But I would bet there are more smart people among successful people than among poor ones, and smart and successful people like to surround themselves with other smart and successful people, not people who think about themselves as victims and continuously blame others for their insuccesses, like many poor people, again independently of race. Let's not mention all the envy... All the extremism and hate we see in the world is mostly because of envy (or fear).
 
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Again. I brought up classism and you tried to make it that I brought up racism. When I didn’t in this instant.
The constant ranting I do online is how I let out my frustrations. And I don’t really care if you think of my arguments undermined or not. It is my and my friends and lots of POCs lived experiences. I don’t care if you to take me seriously, but I will not be silenced. Take me whatever way you want. And 12 minutes earlier I did say discounted taxes but you of course chose to ignore that to further your agenda.
So unless you have walked in a POC shoes, you really can’t comprehend. Simple as that.

And I can assure you there are lots of us who feel this way but many are afraid to speak on it because of the negative comments and disbelief we get from people like you. But these are things that POC talk about frequently away from White people. Many of us are just trying to maintain peace with y’all so we keep our mouths shut. Who can blame us? We don’t hold the power and the cards. Me I just don’t care. I have had it. And so I stay true to me and the lived experiences of POC supported by research and facts.
Guess what? There are many things whites too talk about when there are no people to get offended around. And so on. Blacks and whites of same income and social status are much more alike than dissimilar. Most people are decent sheep and just want to live and let live.

Not all whites were born with a silver spoon. Especially those who have served in the military, like @pgg. You haven't walked in his shoes either.

And the plural of "lived experience" is still anecdotes, not data.
 
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Upper middle class and upper class families are pretty much the same, regardless of skin color etc. A successful person usually has the right IQ, the right knowledge and the right attitude. A poor person quite the opposite, again regardless of race.

Intelligence does not have a skin color. But I would bet there are more smart people among successful people than among poor ones, and smart and successful people like to surround themselves with other smart and successful people, not people who think about themselves as victims and continuously blame others for their insuccesses, like many poor people, again independently of race. Let's not mention all the envy... All the extremism and hate we see in the world is mostly because of envy (or fear).
An upper class professional, regardless of race as you say, that lives in a gentrifying (sic poorer) community with worse schools and sends their kids to the private school or a better public school in a richer district isn't doing anything to improve the public school in their own community. That's the point being made. But as stated in the article, a maybe rightfully so, many people don't want to use their kid as an experiment. Now Nikole sent her kid to the school in the "worse" district, but she's also a writer for the NYT, university educator, and has written books, so she has the resources at home to supplement what maybe is lacking at the school. Not every poor family in the poor community has those resources.
 
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An upper class professional, regardless of race as you say, that lives in a gentrifying (sic poorer) community with worse schools and sends their kids to the private school or a better public school in a richer district isn't doing anything to improve the public school in their own community. That's the point being made. But as stated in the article, a maybe rightfully so, many people don't want to use their kid as an experiment. Now Nikole sent her kid to the school in the "worse" district, but she's also a writer for the NYT, university educator, and has written books, so she has the resources at home to supplement what maybe is lacking at the school. Not every poor family in the poor community has those resources.
There is an American expression I adore: putting one's money where one's mouth is. Or "skin in the game".

I am not at all surprised that people don't want to use their kids as an experiment. That's exactly the skin in the game. So one of my favorite questions to complainers is: What have you personally and meaningfully done to change that? Like @chocomorsel living in a poorer neighborhood, so her tax money would help the community she cares about. That's how it's done, not by playing victim or waiting for those who have no skin in the game.
 
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So you think I don’t know that there are poor whites? I am not stupid FFP. Here you go again with your narcissism.
There is research on the minority experience to back up lived experiences.
And I am of the same social status as as my White coworkers and I can assure you that I am unlike plenty of them. I don’t forget my roots as I climb the economic ladder like plenty of people do.
Guess what? There are many things whites too talk about when there are no people to get offended around. And so on. Blacks and whites of same income and social status are much more alike than dissimilar. Most people are decent sheep and just want to live and let live.

Not all whites were born with a silver spoon. Especially those who have served in the military, like @pgg. You haven't walked in his shoes either.

And the plural of "lived experience" is still anecdotes, not dat
 
So you think I don’t know that there are poor whites? I am not stupid FFP. Here you go again with your narcissism.
There is research on the minority experience to back up lived experiences.
And I am of the same social status as as my White coworkers and I can assure you that I am unlike plenty of them. I don’t forget my roots as I climb the economic ladder like plenty of people do.
And here you go again with calling people names and putting words in their mouth.

Always assume the best intentions, choco, not the worst.

Most middle-class and relatively successful people don't think about themselves as their roots, or as members of a group they don't belong to by choice. Most people are selfish beings, so it's normal, especially in a society where different generations of the same family don't live together. As I said, skin in the game.

And it's one thing to be proud of one's roots, and completely different to let oneself be defined by them. Or by any ideology, for that matter. I'm not a white male anesthesiologist etc; I'm FFP, one of a kind. And you are you, not some stereotype. There won't be another you in history, and there has never been. (OMG, I sound like Mr. Rogers.)
 
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This notion of "I don't want to pay for other kid's schools" is the exact reason why our public school system in this country is trash to begin with. For how much people hate how much Nikole Hannah-Jones because she talks so much about race, she's actually done some very thoughtful and interesting reporting on US public schools. One very interesting article she points out that upper middle class and upper class black families are just a much to blame as white families. It's a very interesting read.

As someone with a small child who is heading towards school but also want's to the child to grow up around people that look like her, I'm also experiencing this moral dilemma and honestly sometimes come to the same conclusion as one person said in the article. "My child is not an experiment." But on the other hand, what am I actually doing about the problem but living in neighborhood with people that look like me but not investing in the school system, because anyone who read up on this stuff knows it's not just property tax that makes a school system good. Yes it's a factor because the more kids that are enrolled the more money that comes to the school but it's also voluntary parent contributions that also funds things that make the school better.

And I'm not just coming down on Choco for that statement. Ive read that statement from others on here in the past and have certainly heard it among water cooler discussions at work.
How about it’s trash because the people in power, mostly White elites benefit by keeping poor people poor. And most of those poor people are minorities?
As a fellow minority don’t act like this is news. And no, I still don’t want to keep propelling upper class and rich kids advantages in school while leaving the poor behind it so therefore
I choose to live in a decent but not fancy neighborhood where I save on taxes, more people look like me and remain in touch w reality. If the poor neighborhoods were safer I would probably live there.
 
And you are literally explaining to me that there are poor white people. Like I am so damn stupid to think all White people are rich. You think before you put this crap down.
And here you go again with calling people names and putting words in their mouth.

Always assume the best intentions, choco, not the worst
 
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And you are literally explaining to me that there are poor white people. Like I am so damn stupid to think all White people are rich. You think before you put this crap down.
Yes, ma'am.

Can you please stop taking the posts so personally, and assume good intentions?
 
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Again. I brought up classism and you tried to make it that I brought up racism. When I didn’t in this instant.
The constant ranting I do online is how I let out my frustrations. And I don’t really care if you think of my arguments undermined or not. It is my and my friends and lots of POCs lived experiences. I don’t care if you to take me seriously, but I will not be silenced. Take me whatever way you want. And 12 minutes earlier I did say discounted taxes but you of course chose to ignore that to further your agenda.
So unless you have walked in a POC shoes, you really can’t comprehend. Simple as that.

And I can assure you there are lots of us who feel this way but many are afraid to speak on it because of the negative comments and disbelief we get from people like you. But these are things that POC talk about frequently away from White people. Many of us are just trying to maintain peace with y’all so we keep our mouths shut. Who can blame us? We don’t hold the power and the cards. Me I just don’t care. I have had it. And so I stay true to me and the lived experiences of POC supported by research and facts.
Here you go again with your "I will not be silenced" persecution complex.

My criticism of your schizophrenic arguments and flight of ideas posts is not an attempt to silence you.

And I know you come here to vent. But every time I read what you post, I find myself less sympathetic to your background and struggles. I have to consciously remind myself that despite your unpleasant personality and penchant for picking fights here, you have valid complaints about US society.

I just read Twiggidy's post about his job search and I'm appalled and angry about it. I believe what he says and take it at face value. It's depressing. It makes me notice the relative lack of racial diversity at my hospital (in Rural Farmville, Virginia) and wonder, and think about it.

But I read your constant litany of complaints, all explicitly laid at the feet of white people you can't wait to get away from, and while sorting through the chaos of your internally inconsistent venting, I wonder how much of it's real and how much is just more histrionic chocodrama.

For example, you have mentioned how toxic your residency was, and how badly you were treated there. And it's believable. Residency is toxic for lots of people. Sexism is real. Racism is real. It's plausible that you were treated unjustly because you're a black woman. But I can't shake the idea that you were treated poorly in residency simply because you were just as unpleasant and obnoxious there as you are here.
 
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And here you go again with calling people names and putting words in their mouth.

Always assume the best intentions, choco, not the worst.

Most middle-class and relatively successful people don't think about themselves as their roots, or as members of a group they don't belong to by choice. Most people are selfish beings, so it's normal, especially in a society where different generations of the same family don't live together. As I said, skin in the game.

And it's one thing to be proud of one's roots, and completely different to let oneself be defined by them. Or by any ideology, for that matter. I'm not a white male anesthesiologist etc; I'm FFP, one of a kind. And you are you, not some stereotype. There won't be another you in history, and there has never been. (OMG, I sound like Mr. Rogers.)
And that last part is your opinion based your culture, background and experiences. Don’t try to blanket it to my culture. We are all different. Maybe most middle class and successful people you know don’t define themselves by their roots. I find White American Culture to be very individualistic and it doesn’t work for me. Not how I was raised and no I don’t forget where I am from even though I am the most educated person in my family. If that defines me, then so be it. I am proud to not be so individualistic because I am not an island.
You have a tendency to speak to people with a very narcissistic tone. Like people are beneath you, and you know better than all the others. More so even in clinical threads. It irks me.
 
And that last part is your opinion based your culture, background and experiences. Don’t try to blanket it to my culture. We are all different. Maybe most middle class and successful people you know don’t define themselves by their roots. I find White American Culture to be very individualistic and it doesn’t work for me. Not how I was raised and no I don’t forget where I am from even though I am the most educated person in my family. If that defines me, then so be it. I am proud to not be so individualistic because I am not an island.
You have a tendency to speak to people with a very narcissistic tone. Like people are beneath you, and you know better than all the others. More so even in clinical threads. It irks me.
I'm sorry that you feel like that. Thank you for letting me know.

Then it's indeed better if I don't post. But do also consider what Epictetus said 2,000 years ago: offense is taken, not given.
 
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Here you go again with your "I will not be silenced" persecution complex.

My criticism of your schizophrenic arguments and flight of ideas posts is not an attempt to silence you.

And I know you come here to vent. But every time I read what you post, I find myself less sympathetic to your background and struggles. I have to consciously remind myself that despite your unpleasant personality and penchant for picking fights here, you have valid complaints about US society.

I just read Twiggidy's post about his job search and I'm appalled and angry about it. I believe what he says and take it at face value. It's depressing. It makes me notice the relative lack of racial diversity at my hospital (in Rural Farmville, Virginia) and wonder, and think about it.

But I read your constant litany of complaints, all explicitly laid at the feet of white people you can't wait to get away from, and while sorting through the chaos of your internally inconsistent venting, I wonder how much of it's real and how much is just more histrionic chocodrama.

For example, you have mentioned how toxic your residency was, and how badly you were treated there. And it's believable. Residency is toxic for lots of people. Sexism is real. Racism is real. It's plausible that you were treated unjustly because you're a black woman. But I can't shake the idea that you were treated poorly in residency simply because you were just as unpleasant and obnoxious there as you are here.
And I told you I know how to behave myself around White folks. And if I had all these issues in residency why do I not have them now? Why have I not been in trouble in attending life? And these hospitals ask for an dingus to come back after my assignment is done.

There was a White man who literally raped my friend and was pushed along to graduate, his actions swept under the rug and he got good letters and go on to do a pain fellowship. And he missed one weekend of call as he didn’t know the schedule and he was out of state. And he’s now in the midst of another lawsuit for similar rapist behavior against his very young ex wife. And the woman he raped was let go of the program.

And that when I asked to be moved to night shift, a tougher shift with the NP due to the surgical residents acting all clickish and undermining me by not sharing the plans and info w me and us being on the same page even though we were both supposed to be chiefs, I was told I was shirking responsibility. And when I stated I preferred MICU to SICU when someone asked it was used against me against me by the SICU attendings due to their egos. And that yes, I lost my temper once when being yelled at by an attending repeatedly for pushing pressors in a vascular case. And another at at the Unit secretary when she yelled at me and hung up on me when I asked for help from the techs. And that every mistake was magnified and I was made to feel like I did not deserve to be there. And even though my friend Sally and I scored poorly on the first ITE she was allowed to moonlight but I wasn’t. Was told it was individually decided even thought it stated in the rules that we wouldn’t be allowed.

Give me a break. White men can literally get away with rape and assault but plenty women and POC have to walk on eggshells and every little mistake they make is magnified.

Tell me why it is Black peoples fault out of residency at a rate of 20% versus in medical school at a rate of 5%.

You don’t know me in real life. You don’t know how obnoxious I am in real life. I don’t care what ideas you can’t shake. I am not here to dance for you and make myself this version of a person online that you find acceptable. I do enough of that in real life. Doing it online would add to my exhaustion.
 
I'm sorry that you feel like that. Thank you for letting me know.

Then it's indeed better if I don't post. But do also consider what Epictetus said 2,000 years ago: offense is taken, not given.
No one is preventing you from posting. That’s just how you come off and I don’t know if you realize it. Just like I come off abrasive and angry. I still post.
 
No one is preventing you from posting. That’s just how you come off and I don’t know if you realize it. Just like I come off abrasive and angry. I still post.
Life is too short to waste it on people who don't appreciate you.
 
I DO NOT think all the schools should be equal. There are schools that NEED more (however you know that). My kids' school gets a lot of extra money per student compared to other elementary schools in our state because the school population is of a very low socio-economic status. Many broken homes, single parent homes (working 2 jobs and no time to help with school work), refugees, ESL kids, etc.

Their student:teacher ratio is 11:1 as opposed to the state average of 15:1. There's free lunch for all the kids, and many kids get sent home with food (extra on weekends) because that may be the only meal they get to eat. We have unbelievably devoted and passionate staff who work there because they love the kids. Despite all this extra help, the average test scores are all way below the state averages. I can't imagine how much worse this would be if their school didn't have all this extra funding.

So, I hear you on "funding rich kids' schooling" with your property taxes. However, our school is in the same district as the the "rich kids" so all the property taxes get pooled for all the schools and distributed. Our school benefits from being in the same district as more well-off schools. Something to consider.
I'm thinking about the school situation you present. I understand the poor school getting more funding for lunches, teachers, etc versus the other "rich schools" but how much of that extra funding goes to enrichment programs/after school programs that the "rich school" may have versus the "poor school"? I'm not saying that makes up the difference but that tends to be one of the big factors, ie "rich school" may get parent donations etc for computer club, extra tutoring, etc whereas the extra money to the poor school is needed just to feed the kids. I'm generalizing a bit but that's what's circling around my brain.
 

Physician union? Is this a thing? Apparently so.

Will this be a trend?
Hopefully. Why not since everyone else in the hospital is empowered by a union and the government pushes for unionization.
 
I'll go ahead and say the quiet part out loud - Parents are as important, if not more important, for a childs education as the school/school district. Talk to a teacher for 5 minutes and they will tell you this.

Many states spend $20K or more per student. Money to schools is not the problem. Parents don't want to hear it, but they (parent, and absence of a parent) are largely the problem.
 
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You don’t know me in real life. You don’t know how obnoxious I am in real life.
Is that supposed to be some kind of defense of your online persona? Oh I know I'm unpleasant here, but in real life I'm really nice? :)

And you're right, of course. I've never met you. I can only judge you based on what you write here.

I don’t care what ideas you can’t shake. I am not here to dance for you and make myself this version of a person online that you find acceptable. I do enough of that in real life. Doing it online would add to my exhaustion.
For someone who doesn't care, you sure go to great lengths to explain how your dislike of the white man and the white man's dislike of you, have nothing to do with your own behavior.

I have no reason to not believe you when you say you're enjoying professional success post residency. Maybe that's because you're an excellent physician? We all know that great clinicians, especially working in high demand / low supply places, have historically gotten away with a lot of bad behavior and abusive or obnoxious personalities. It's a cliche among surgeons. :)

The threshold for getting invited back as a locums - especially in this market - amounts to availability to cover shifts, and not boxing patients. I'm not sure that ongoing employment as a locums is a point in favor or against the presence of a personality disorder.

Tell me why it is Black peoples fault out of residency at a rate of 20% versus in medical school at a rate of 5%.
I don't know. Maybe it's because residency is a lot harder than medical school, and the academic stats of black med school matriculants are broadly/generally lower than others, and these very real academic deficiencies can be overcome (or ignored) in medical school, but not residency? And there comes a point when PDs have to do the right thing and not graduate bad residents, no matter how many professors and preceptors before them looked the other way and deferred action? Maybe AA in admissions didn't help those 20% as much as we're supposed to believe it did?
 
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I'll go ahead and say the quiet part out loud - Parents are as important, if not more important, for a childs education as the school/school district. Talk to a teacher for 5 minutes and they will tell you this.

Many states spend $20K or more per student. Money to schools is not the problem. Parents don't want to hear it, but THEY (parent and absence of parent) are largely the problem.
I don’t think anyone will argue with you on this but you also have to acknowledge that the extra money that wealthy parents use to support the schools also plays a factor.
 
I don’t think anyone will argue with you on this but you also have to acknowledge that the extra money that wealthy parents use to support the schools also plays a factor.
Agree. Also private tutoring for students at wealthier schools is probably a difference maker as well.
 
I don’t think anyone will argue with you on this but you also have to acknowledge that the extra money that wealthy parents use to support the schools also plays a factor.
Teacher salaries, sure. Pay more, get better teachers. That matters.

I do wonder if a great deal of the money wealthier areas spend on schools is wasted though. They sure have nice athletic fields and computer labs and highly paid administrators. Whether more $/pupil spent on facilities and stuff translates into more kids passing the AP calculus exam is something I'm curious about. So many confounders though.
 
I found interesting when watching “Waiting For Superman” and listening to “Nice White Parents” (I know. Triggering title but it was still an interesting listen) was that when white parent kept their kids in public schools in NYC the scores of all students (white, black, and brown) improved. Not the average score of the school but all the scores of all the students. Again, data I found very interesting
 
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I found interesting when watching “Waiting For Superman” and listening to “Nice White Parents” (I know. Triggering title but it was still an interesting listen) was that when white parent kept their kids in public schools in NYC the scores of all students (white, black, and brown) improved. Not the average score of the school but all the scores of all the students. Again, data I found very interesting
Said way more intelligently here
 
Is that supposed to be some kind of defense of your online persona? Oh I know I'm unpleasant here, but in real life I'm really nice? :)

And you're right, of course. I've never met you. I can only judge you based on what you write here.


For someone who doesn't care, you sure go to great lengths to explain how your dislike of the white man and the white man's dislike of you, have nothing to do with your own behavior.

I have no reason to not believe you when you say you're enjoying professional success post residency. Maybe that's because you're an excellent physician? We all know that great clinicians, especially working in high demand / low supply places, have historically gotten away with a lot of bad behavior and abusive or obnoxious personalities. It's a cliche among surgeons. :)

The threshold for getting invited back as a locums - especially in this market - amounts to availability to cover shifts, and not boxing patients. I'm not sure that ongoing employment as a locums is a point in favor or against the presence of a personality disorder.


I don't know. Maybe it's because residency is a lot harder than medical school, and the academic stats of black med school matriculants are broadly/generally lower than others, and these very real academic deficiencies can be overcome (or ignored) in medical school, but not residency? And there comes a point when PDs have to do the right thing and not graduate bad residents, no matter how many professors and preceptors before them looked the other way and deferred action? Maybe AA in admissions didn't help those 20% as much as we're supposed to believe it did?
Maybe it’s because in residency there are hardly any objective tests. Mostly subjective evaluations on who can kiss ass and brownnose the best and pander to the White people in charge. How do you ignore or overcome these deficiencies in medical school and not residency? Your logic used to rationalize the unfair treatment of blacks is quite weird. Maybe you should actually do some reading on the subject before being so quick to rationalize mistreatment of minorities. You think if a black man was accused of rape they would graduate residency? Or are you gonna ignore that huge act of abuse.
Residency is not harder than medical school besides the hours and technical skills. The problem is It’s about personality and who these mostly White people in charge find to have a “good” personality. In other words who can “act” like they are decent human beings when in reality they are dinguses and that shows up in the ORs of the attending world. Objective tests hold a hell of a lot more weight in Medical school. Piss off the wrong person in residency and you are a minority doesn’t matter how well you perform on tests. Many don’t think you should be there and want you out.

Obnoxious dingus? That’s me. I like to treat people like **** because I was treated like ****. And you my dear White Man are wonderful. I mean it’s in your DNA to be righteous and good. Everything you touch is golden. Because we all know that all that’s White is Right.

You sound like the dingus entitled surgeons you talk about here. Cut the crap about respecting me. All you try to do is put me down w pretense of “I respect you” blah blah blah fakeness. You are full of it. I don’t respect you. You showed who you were a long time ago. And I don’t care if you were in the military. The military is full of black folks in the Enlisted Side and therefore people are sold on lie that is the “diversity” of the military. While the officer side is full of Good Old White Boys.

I was doing locums way before Covid. I don’t like being employed because I hate to deal with all the crappy Old White Boy politics that most of these groups are about. No Thanks. Got nothing in common with the Good Old White Boys like you. I don’t give a **** about your spouses, your kids, your golf game, your boat and most importantly your dogs unless I actually like you and find you a decent human being. I am there to work, not brownnose, be pretentious and perform as a caricature for the likes of you who want me to behave in what’s you consider the right/white way. I keep my head down and do the job, joke a little w folks I like and go home. Work is something I do to survive not to socialize and pander.

Yeah, I am a total dingus. I can’t keep a job. I am fired left and right, that is why I am a crappy, no good, locums doc. And because they are so desperate they want me back.

Signed, Angry Black Woman who’s tired, simply exhausted of entitled White Men like you.
 
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I'm thinking about the school situation you present. I understand the poor school getting more funding for lunches, teachers, etc versus the other "rich schools" but how much of that extra funding goes to enrichment programs/after school programs that the "rich school" may have versus the "poor school"? I'm not saying that makes up the difference but that tends to be one of the big factors, ie "rich school" may get parent donations etc for computer club, extra tutoring, etc whereas the extra money to the poor school is needed just to feed the kids. I'm generalizing a bit but that's what's circling around my brain.
My kids have only been to this school, so I don't know how its resources and "extras" compare to that of others in our district. I know that there are a lot more extras than where I went to school growing up. There are after school programs Mon.-Thur., sports, computers for all the kids, and I don't even know what else (my wife is much more tuned into it all and is on PTA and whatnot). Are these funds "enough"? I don't know. I certainly don't have the answers, but I would readily pay more in property taxes to help these kids. As noted above, all the help and funding in the world isn't enough if parents aren't engaged, or able to support the kids' needs.

My wife and I work with our kids a lot at home on things like math and reading. We talk about science and money and careers. We teach them piano. We talk to them about college. In contrast, my 10-year-old tells me all about her friends (yes, plural) from school who spend their entire day after school at home by themselves just watching youtube and TikTok, or playing video games all day. They go to bed after midnight on the regular while playing on an iPad, and then they fall asleep at school all the time. I don't know how more funding for the school can do anything about that.
 
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Here you go again with your "I will not be silenced" persecution complex.

My criticism of your schizophrenic arguments and flight of ideas posts is not an attempt to silence you.

And I know you come here to vent. But every time I read what you post, I find myself less sympathetic to your background and struggles. I have to consciously remind myself that despite your unpleasant personality and penchant for picking fights here, you have valid complaints about US society.

I just read Twiggidy's post about his job search and I'm appalled and angry about it. I believe what he says and take it at face value. It's depressing. It makes me notice the relative lack of racial diversity at my hospital (in Rural Farmville, Virginia) and wonder, and think about it.

But I read your constant litany of complaints, all explicitly laid at the feet of white people you can't wait to get away from, and while sorting through the chaos of your internally inconsistent venting, I wonder how much of it's real and how much is just more histrionic chocodrama.

For example, you have mentioned how toxic your residency was, and how badly you were treated there. And it's believable. Residency is toxic for lots of people. Sexism is real. Racism is real. It's plausible that you were treated unjustly because you're a black woman. But I can't shake the idea that you were treated poorly in residency simply because you were just as unpleasant and obnoxious there as you are here.
Thoroughly off topic, but you're at that hospital? I went to Hampden-Sydney and volunteered there for 2 years for my medical experience.
 
Thoroughly off topic, but you're at that hospital? I went to Hampden-Sydney and volunteered there for 2 years for my medical experience.
No not "the" Farmville, just "a" farmville. :)

Without outing myself completely - not that it'd be hard to figure out where I am :) - I was being vague. There are a bunch of places in the not-NOVA and not-Hampton parts of the state that fit the rural ag/ranching bill.
 
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Tell me why it is Black peoples fault out of residency at a rate of 20% versus in medical school at a rate of 5%.
Didn't we have a thread about this a few months ago and someone did the math and like 97% of black residents complete their residency? Where are you coming up with 1 in 5 not completing residency?
 
My kids have only been to this school, so I don't know how its resources and "extras" compare to that of others in our district. I know that there are a lot more extras than where I went to school growing up. There are after school programs Mon.-Thur., sports, computers for all the kids, and I don't even know what else (my wife is much more tuned into it all and is on PTA and whatnot). Are these funds "enough"? I don't know. I certainly don't have the answers, but I would readily pay more in property taxes to help these kids. As noted above, all the help and funding in the world isn't enough if parents aren't engaged, or able to support the kids' needs.

My wife and I work with our kids a lot at home on things like math and reading. We talk about science and money and careers. We teach them piano. We talk to them about college. In contrast, my 10-year-old tells me all about her friends (yes, plural) from school who spend their entire day after school at home by themselves just watching youtube and TikTok, or playing video games all day. They go to bed after midnight on the regular while playing on an iPad, and then they fall asleep at school all the time. I don't know how more funding for the school can do anything about that.


There was a effort in NYC to improve enrollment by underrepresented minorities in their competitive admission public high schools (Stuyvesant, Bronx science, etc). They identified and recruited talented middle schoolers, and offered them free after school tutoring, free test prep, etc. It was an utter failure because the underrepresented kids were still competing against overrepresented kids whose entire communities, families and social networks are completely and single-mindedly OBSESSED with admission to these schools, often in an unhealthy way. It’s not a soft way to live, it’s harsh. I can tell you that many of their parents have no idea who the Astros and Phillies are, have never heard of Kanye or the Beatles, but they absolutely know Stuyvesant, MIT, and Yale. My parents were that way. No amount of “funds” can make up for these differences.
 
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Didn't we have a thread about this a few months ago and someone did the math and like 97% of black residents complete their residency? Where are you coming up with 1 in 5 not completing residency?
Yeah. That stat wrong. Black residents are 5% of residents but are 20% of residents dismissed, but this is cautionary numbers because we’re so few in the field.


Who knows the reason anyone was fired. I’m just repeating the data
 
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Didn't we have a thread about this a few months ago and someone did the math and like 97% of black residents complete their residency? Where are you coming up with 1 in 5 not completing residency?

Yeah. That stat wrong. Black residents are 5% of residents but are 20% of residents dismissed, but this is cautionary numbers because we’re so few in the field.


Who knows the reason anyone was fired. I’m just repeating the data


If the overall percentage of residents being dismissed is lower than 0.75%, then both can be correct.

0.75%x4=3%
 
There was an effort in NYC to improve enrollment by underrepresented minorities in their competitive admission public high schools (Stuyvesant, Bronx science, etc). They identified and recruited talented middle schoolers, and offered them free after school tutoring, free test prep, etc. It was an utter failure because the underrepresented kids were still competing against overrepresented kids whose entire communities, families and social networks are completely and single-mindedly OBSESSED with admission to these schools, often in an unhealthy way. It’s not a soft way to live, it’s harsh. I can tell you that many of their parents have no idea who the Astros and Phillies are, have never heard of Kanye or the Beatles, but they absolutely know Stuyvesant, MIT, and Yale. My parents were that way. No amount of “funds” can make up for these differences.
Totally. It’s a big deal to get into one of the NYC Top 5 HS. If you’re an NYC parent with any means it’s either one of them, private school, or Westchester
 
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Totally. It’s a big deal to get into one of the NYC Top 5 HS. If you’re an NYC parent with any means it’s either one of them, private school, or Westchester


It’s even more important for NYC parents without means. Private schools and Westchester are not options for them.
 
There was a effort in NYC to improve enrollment by underrepresented minorities in their competitive admission public high schools (Stuyvesant, Bronx science, etc). They identified and recruited talented middle schoolers, and offered them free after school tutoring, free test prep, etc. It was an utter failure because the underrepresented kids were still competing against overrepresented kids whose entire communities, families and social networks are completely and single-mindedly OBSESSED with admission to these schools, often in an unhealthy way. It’s not a soft way to live, it’s harsh. I can tell you that many of their parents have no idea who the Astros and Phillies are, have never heard of Kanye or the Beatles, but they absolutely know Stuyvesant, MIT, and Yale. My parents were that way. No amount of “funds” can make up for these differences.

Jews who came of age in the 60s, 70s, 80s are very familiar with this culture. I am one of them. Many of our kids got lazy. These schools are now overwhelmingly Asian students. They earned it. Simply outworked the competition.
 
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Jews who came of age in the 60s, 70s, 80s are very familiar with this culture. I am one of them. Many of our kids got lazy. These schools are now overwhelmingly Asian students. They earned it. Simply outworked the competition.


Maybe the kids just found “balance”. Swimming in that culture works for some kids but it can feel like a prison for others. Academic overachievement is presented as the only option. I knew some kids who flamed out hard and their families made things worse.
 
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Yeah. That stat wrong. Black residents are 5% of residents but are 20% of residents dismissed, but this is cautionary numbers because we’re so few in the field.


Who knows the reason anyone was fired. I’m just repeating the data
Didn't we have a thread about this a few months ago and someone did the math and like 97% of black residents complete their residency? Where are you coming up with 1 in 5 not completing residency?
Nope. Read above. Subjective measures fail these residents. I have spoken to some of my friends who had issues and one who got dismissed. Most from medical school some I have met traveling, some I have heard about. All due to subjective measures. Not knowledge base or grades.
 
Maybe it’s because in residency there are hardly any objective tests.

That's probably part of it. I've written here before about my frustration with writing and reviewing resident evaluations that are full of vague BS that amounts to personality judgements. Evaluating residents is hard and most faculty don't get any specific training on how to teach, evaluate, or remediate learners.

But there is an issue with some residents who've been marginal or poor performers all along, whose teachers and preceptors in medical school and internship have deferred difficult tasks (like remediation, probation, or termination). They've been given passing grades and the benefit of the doubt in clerkship and rotations where they don't have any true responsibility and their preceptors only see them for a few weeks.

Then they reach residency, and PDs observe them for a year or two and can't in good conscience let them graduate.

I was faculty at a residency program for about 10 years, and for a few of those years I was the program's education coordinator and assistant PD. This was a military program, and our trainee pipeline through medical school scholarships is not diverse at all - I'd guess about 90%+ white, and about 80%+ male. I think one class was 6/6 white male residents.

I won't bore you with all the details, but because there's a smaller pool of applicants, and our selection process is a group meeting with all of the military program directors discussing all the applicants, and the scoring system gives credit for non-academic factors like time with the fleet or Marine Corps between internship and residency, every so often there was a resident with a poor academic record who nonetheless ended up in our program. They struggle and have a much higher rate of dropping out or being dropped. We had one who scored in the 1st (lowest) percentile on multiple ITEs.

I am suggesting that the racial disparity you noted on residency failures could be connected to the well-documented lower average grades and MCAT scores of some minorities in medical school admissions. Because I've seen (and so has every PD in the country) how residents with worse academic records consistently score lower on ITEs, have more board failures, and a higher rate of not completing residency. In my personal experience, that has held true despite a decade of overwhelmingly white and overwhelmingly male classes at our program.

Mostly subjective evaluations on who can kiss ass and brownnose the best and pander to the White people in charge. How do you ignore or overcome these deficiencies in medical school and not residency?

The issue, which is nearly universal, is that preceptors who see students for only a few weeks or a couple months at a time are almost NEVER willing to fail anyone, no matter what.

Poor students are given passing grades, even when they shouldn't be. In many cases - most of them probably - the poor performance is an anomaly, or they improve, and they go on to graduate and become safe, competent doctors. Some don't.

Your logic used to rationalize the unfair treatment of blacks is quite weird. Maybe you should actually do some reading on the subject before being so quick to rationalize mistreatment of minorities. You think if a black man was accused of rape they would graduate residency? Or are you gonna ignore that huge act of abuse.
Criminal acts are a separate issue, apart from professional competence.

I completely agree that the US legal system has bias and racism problems. I've written about that here many times.

Residency is not harder than medical school besides the hours and technical skills.
Completely disagree.

The technical skills are the easiest part and I'm surprised you think that's what makes our job hard. Hell, nurses can learn and completely do the technical skills.

What makes residency harder is twofold -
1) A new demand for professionalism and higher level of responsibility for patients, where lack of preparedness or knowledge can't be hidden (unlike for example a med school anatomy lab where a lousy student can just be quiet in the corner while the other 3 partners do the dissection). There are immediate, obvious consequences for not having your **** together when you're the primary doc for a real patient, despite the attending backup.

2) The depth of the material, and the need to retain it forever. You can get through med school cramming and dumping. Residency is different.

Cut the crap about respecting me.
I respect you less and less every day, but I try to give you the benefit of the doubt, and hope that the decent things you do in real life are a better measure of who you are than your awful, horrible, straight up bitchy behavior here.

The military is full of black folks in the Enlisted Side and therefore people are sold on lie that is the “diversity” of the military. While the officer side is full of Good Old White Boys.
This is a huge problem with the military and I've written about that before too. Enlisted ranks recruit from poorer economic strata. Officers all have college degrees.
Signed, Angry Black Woman who’s tired, simply exhausted of entitled White Men like you.

I don't know why I try discussing anything with you.

Your inevitable refrain is to insult and dismiss everything I write because I'm a white man.

You're the most racist and sexist person on this forum.
 
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That's probably part of it. I've written here before about my frustration with writing and reviewing resident evaluations that are full of vague BS that amounts to personality judgements. Evaluating residents is hard and most faculty don't get any specific training on how to teach, evaluate, or remediate learners.

But there is an issue with some residents who've been marginal or poor performers all along, whose teachers and preceptors in medical school and internship have deferred difficult tasks (like remediation, probation, or termination). They've been given passing grades and the benefit of the doubt in clerkship and rotations where they don't have any true responsibility and their preceptors only see them for a few weeks.

Then they reach residency, and PDs observe them for a year or two and can't in good conscience let them graduate.

I was faculty at a residency program for about 10 years, and for a few of those years I was the program's education coordinator and assistant PD. This was a military program, and our trainee pipeline through medical school scholarships is not diverse at all - I'd guess about 90%+ white, and about 80%+ male. I think one class was 6/6 white male residents.

I won't bore you with all the details, but because there's a smaller pool of applicants, and our selection process is a group meeting with all of the military program directors discussing all the applicants, and the scoring system gives credit for non-academic factors like time with the fleet or Marine Corps between internship and residency, every so often there was a resident with a poor academic record who nonetheless ended up in our program. They struggle and have a much higher rate of dropping out or being dropped. We had one who scored in the 1st (lowest) percentile on multiple ITEs.

I am suggesting that the racial disparity you noted on residency failures could be connected to the well-documented lower average grades and MCAT scores of some minorities in medical school admissions. Because I've seen (and so has every PD in the country) how residents with worse academic records consistently score lower on ITEs, have more board failures, and a higher rate of not completing residency. In my personal experience, that has held true despite a decade of overwhelmingly white and overwhelmingly male classes at our program.



The issue, which is nearly universal, is that preceptors who see students for only a few weeks or a couple months at a time are almost NEVER willing to fail anyone, no matter what.

Poor students are given passing grades, even when they shouldn't be. In many cases - most of them probably - the poor performance is an anomaly, or they improve, and they go on to graduate and become safe, competent doctors. Some don't.


Criminal acts are a separate issue, apart from professional competence.

I completely agree that the US legal system has bias and racism problems. I've written about that here many times.


Completely disagree.

The technical skills are the easiest part and I'm surprised you think that's what makes our job hard. Hell, nurses can learn and completely do the technical skills.

What makes residency harder is twofold -
1) A new demand for professionalism and higher level of responsibility for patients, where lack of preparedness or knowledge can't be hidden (unlike for example a med school anatomy lab where a lousy student can just be quiet in the corner while the other 3 partners do the dissection). There are immediate, obvious consequences for not having your **** together when you're the primary doc for a real patient, despite the attending backup.

2) The depth of the material, and the need to retain it forever. You can get through med school cramming and dumping. Residency is different.


I respect you less and less every day, but I try to give you the benefit of the doubt, and hope that the decent things you do in real life are a better measure of who you are than your awful, horrible, straight up bitchy behavior here.


This is a huge problem with the military and I've written about that before too. Enlisted ranks recruit from poorer economic strata. Officers all have college degrees.


I don't know why I try discussing anything with you.

Your inevitable refrain is to insult and dismiss everything I write because I'm a white man.

You're the most racist and sexist person on this forum.
That’s hilarious. There are plenty of White people on here I get along with just fine. Who I am not constantly arguing with. It’s literally you and @FFP and @VAhopeful sometimes used to be @saltydog but he’s gone now. And there are plenty I disagree with here and there that I still get along with and move on. I doubt they are all black. It’s not because you are a White man. It’s because I think you are an ignorant, entitled POS when it comes to race relations who happens to be White man. Who is not open to realizing that your world ain’t our world. And because I talk about it so much, you think I am racist. Because White people like y’all don’t like to be challenged and like the status quo.

“Professionalism” in America is based on EuroCentric standards that take no account different cultural backgrounds and experiences. As long as we come to work and brownnose, and smile, and joke with people many of us have nothing in common with on top of all the work we gotta do. I don’t suppose you have any idea what it’s like being colleagues with no one who looks like you that you have zero shared experience with? And then you are supposed to be all chummy chummy and friendly and joke and ask about the golf game. Tell you what. It’s uncomfortable. We are in survival mode and all the extras go out the window. You just want to do your job and get the hell out to your comfort zone. There are a few minorities who excel in this but many of us struggle and are looked upon in a negative way. Yeah, it’s gotta be because we are racist, not because we are uncomfortable, not because we have experienced unfair treatment compared to the White folks. It’s because we are racist. And speaking about it makes us even more racist.

And you respect me less and less. I am so sad and hurt. I will never wake up without crying. Woe is me. My life is over. I never asked for your respect and it matters to me because why? I don’t have to prove anything to closed minded White people like you.

You think I am a bitch and I think you are a closed minded, entitled POS.

So I guess we are even.
 
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“Professionalism” in America is based on EuroCentric standards that take no account different cultural backgrounds and experiences.
Can you be more specific? Or is this on the same page as concerns that standardized tests, ranging from the SAT to MCAT to the USMLE are culturally biased and unfair?

Here's the ASA's statement on professionalism: Statement on Professionalism

Which references this document, a portion of which is quoted below:


I'm genuinely curious how your culture, or another culture you're familiar with, differs or takes exception to these principles. Because they all seem pretty reasonable, as a minimum floor of acceptable conduct and professional behavior.

The following Principles adopted by the American Medical Association are not laws but standards of conduct which define the essentials of honorable behavior for the physician.
  • A physician shall be dedicated to providing competent medical care with compassion and respect for human dignity and rights.
  • A physician shall uphold the standards of professionalism, be honest in all professional interactions, and strive to report physicians deficient in character or competence, or engaging in fraud or deception to appropriate entities.
  • A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient
  • A physician shall respect the rights of patients, colleagues and other health professionals and shall safeguard patient confidences and privacy within the constraints of the law.
  • A physician shall continue to study, apply and advance scientific knowledge, maintain a commitment to medical education, make relevant information available to patients, colleagues and the public, obtain consultation, and use the talents of other health professionals when indicated.
  • A physician shall, in the provision of appropriate patient care except in emergencies, be free to choose whom to serve, with whom to associate and the environment in which to provide medical care.
  • A physician shall recognize a responsibility to participate in activities contributing to improvement of the community and betterment of public health.
  • A physician shall, while caring for a patient, regard responsibility to the patient as paramount.
  • A physician shall support access to medical care for all people.
 
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Can you be more specific? Or is this on the same page as concerns that standardized tests, ranging from the SAT to MCAT to the USMLE are culturally biased and unfair?

Here's the ASA's statement on professionalism: Statement on Professionalism

Which references this document, a portion of which is quoted below:


I'm genuinely curious how your culture, or another culture you're familiar with, differs or takes exception to these principles. Because they all seem pretty reasonable, as a minimum floor of acceptable conduct and professional behavior.

Not talking about interaction with patients.
 
I don’t have to prove anything to closed minded White people like you.

You think I am a bitch and I think you are a closed minded, entitled POS.
Right, I'm so closed minded I go out of my way to talk to you, and ask for your views.

Meanwhile you keep talking about white men and how eager you are to get away from white people.

Not talking about interaction with patients.
So you think professionalism is small talk about sports?
 
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Right, I'm so closed minded I go out of my way to talk to you, and ask for your views.

Meanwhile you keep talking about white men and how eager you are to get away from white people.


So you think professionalism is small talk about sports?
What I think it is is irrelevant. What it actually is and what the people in power think it is is what is relevant. What I have seen them using it to fire people they didn’t fit in while allowing atrocious, egregious behavior slide by White Males. And when you can’t consider that atrocious behavior “unprofessional” and let them get away with it but are busy using that very same term to get rid of and to make lives of women and POC miserable at work/residency then you are abusing your power. And we all know how unilateral the power balance is in residency and academic centers. The ones who tend to get away with horribly atrocious behaviors are also great chummy chummy people who know how to work a room and kiss the right ass and stroke the right egos and are considered personable. You know, many of the sociopaths working in the OR and subspecialties. While the rest of us, who don’t know how to charm and be fake can then make a mistake or two and it’s used to make our lives miserable especially if we are women and POC. And then you gotta worry about the ancillary staff being helpful and kid kind to you but you get bad behavior simply because you aren’t the usual White Man, that adds to the stress.

And like I said, it’s specifically White men like you who choose to remain quite closed minded and are uncomfortable with people talking about race relations more than what they think is allowed that get on my nerves. You act like you want to know, but all you want is more fire for continued arguments that “it’s not about race/sex” blah, blah.

My last job, was in a brown town, with brown patients, brown docs brown nurses everywhere. And when I tell you how at ease I was, how well respected I was, how nicely I was treated, you wouldn’t have a clue. You have never been there.

I am on vacation, eating organic food, chilling in the motherland and getting ready to go to the beach. I will entertain you. Give you something to chew on so you can come back and continue to try and tear my arguments down.
 
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