@mcnado@mstdn.social avatar

mcnado

@mcnado@mstdn.social

Hunter, ER doc, believer in democracy. I’m here to rant, combat medical misinfo, and get social therapy. Posts aren’t medical advice. This is the only platform I am currently on. If you find “me” elsewhere, it isn’t me. If you have COVID vaccine questions, I’m always happy to try to answer. Let’s all share good info, facts, and science, and keep ourselves and each other safe! “You can’t love your country only when you win” — JB ‘24

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mcnado, to snowboarding
@mcnado@mstdn.social avatar

Now is a great time to remind everyone venturing into the in that until July, it is functionally still winter at altitude. It often freezes at night, and can be very cold and wet for days on end. Carry clothing layers, dry backups, and gear to survive wet nights below freezing. Expect deep, wet snow in the woods, making route finding difficult, and travel frankly exhausting and slow. Weather can go from T-shirts to needing a parka in minutes as storms hit the divide.

mcnado, to random
@mcnado@mstdn.social avatar

UN vehicle struck, UN worker from India killed. UN has not identified attacker, but IDF is not denying responsibility and blamed the occupants for traveling through a war zone.

https://www.bbc.com/news/world-middle-east-69006734

ai6yr, to random

Longs Peak, Colorado, Keyhole Route. https://www.14ers.com/route.php?route=long1

mcnado,
@mcnado@mstdn.social avatar

@ai6yr eats people. Folks go up there in running shoes and jeans. Weather comes over the divide with no warning, the last few moves to the summit are slick as hell in the wet, and when there is snow in the couloir on the back, people are looking a few thousand feet down with no protection. Honestly blows my mind that more people don’t die.

mcnado, to random
@mcnado@mstdn.social avatar

When someone commits large scale tax fraud, they are stealing from you. They benefited from public services like roads, fire protection, and police, but they didn’t pay for it.

mcnado, to random
@mcnado@mstdn.social avatar

So a gun owner gets killed in his own home by a cop raiding the wrong apartment, and yet the NRA doesn’t have a thing to say about it. Huh.

Must be something about the case. Something that just isn’t quite white about it.

mcnado,
@mcnado@mstdn.social avatar

@GreenFire @JamesK @bodhipaksa may be that. May be Florida. May be the lack of cellphone video. Interesting question.

mcnado, to random
@mcnado@mstdn.social avatar

I don’t give a fuck what FDA is gearing up for with respect to fowl fever. What I care about is what HHS and DHS are doing with the National Strategic Stockpile.

If a lethal, contagious respiratory virus gets rolling like it’s 2020, we’ll be shit out of PPE in days, out of ventilators, out of sedatives, out of pressors, our of saline and lactated ringers, and out staff. How do I know? Because we already ran this scenario, and nothing has gotten better.

mcnado, to random
@mcnado@mstdn.social avatar

Another law-abiding gun owner killed by police in his own home. (Oh, forgot a key detail, he’s black).

https://www.nbcnews.com/news/us-news/air-force-airman-killed-florida-deputies-wrong-apartment-attorney-says-rcna151387

mcnado, to random
@mcnado@mstdn.social avatar

Two things are true:

  1. Hamas uses civilian infrastructure to hide.
  2. IDF has managed to destroy half of Gaza’s water and sanitation facilities, including wells services by small pumphouses.

https://www.bbc.com/news/world-middle-east-68969239

mcnado, to random
@mcnado@mstdn.social avatar

If you are worried about the 2 babies that died on Oct 7th and not the hundreds (likely more) that have died in Gaza since, it suggests that you value some babies more than others.

They’re all babies. People killing babies are bad people. Hamas are bad people. IDF personnel killing babies are also bad people. Politicians on both sides deciding to have their footsoldiers kill babies are bad fucking people.

That part of this is not complex at all.

mcnado,
@mcnado@mstdn.social avatar

When the US invaded Iraq we blew up powerplants and water treatment plants. That was bad.

When Russia blows up powerplants, hospitals, and schools in Ukraine, that is bad.

We can debate the ethics of bombing cities, but at the end of the day, it is fucking bad.

Killing civilians, by direct force, by starvation, by deprivation of medicine, is always bad.

mcnado, to random
@mcnado@mstdn.social avatar

Brain worms, or more specifically, beef and pork tape worms (taenia saginata and taenia solium) are not rare in the US. We find the calcified cysts from these on brain CT scans all the time, particularly in communities with large populations of South and Central American immigrants. They don’t make people into racist, antivaccine, profiteering, grifters.

Some people are just bad people. The tapeworms don’t deserve the shade.

mcnado, to random
@mcnado@mstdn.social avatar

I want everyone to remember the debates that folks had, when, in a few years, the pictures of all the dead kids being dragged out of holes in Rafah surface.

Go look up Bosnia. Go look up Rwanda. At the end of the day, many of us grew up with the press photos of what happens when we don’t keep massacres from happening. Seems like we’re continuing the trend.

mekkaokereke, to random
@mekkaokereke@hachyderm.io avatar

"Trump is worse!" And then I'm blocked.

People get so cranky at Black folk for pointing out the irrefutable evidence that Biden's Covid policies got a lot of people long Covid, and caused a lot of other people to die of Covid unnecessarily.

You can get mad at me. You can yell "Trump is worse!" until your voice gets hoarse. I'm not talking about Trump. I'm talking about pandemic decisions made during this administration.

Y'all know I'm right.

https://hachyderm.io/@mekkaokereke/112397660473954665

mcnado,
@mcnado@mstdn.social avatar

@aintist @mekkaokereke that isn’t entirely fair — SCOTUS had already signalled their willingness to rule such public health measures unconstitutional, and multiple states had made it essentially impossible to enact or enforce at the state level. Should CDC have pulled back from mask guidance? No. Was that the thing that killed the possibility of a federal mask mandate? No.

The GOP set up all of this, and folks dropping the blame on Biden is precisely the strategy they wanted.

mcnado,
@mcnado@mstdn.social avatar

@mekkaokereke @aintist unenforceable isolation recommendations, without being paired with paid disability, simply lead to people chosing between following the guidance or keeping their job. When you tell someone they can’t work for 14 days, but nobody is paying them for that time off, and their boss fires them for their absence, you haven’t saved anyone.

Again, CDC under (and before) Biden has made some really stupid calls, but this is a much bigger policy issue.

mcnado, to random
@mcnado@mstdn.social avatar

Article in TheHill today arguing that Boomers have money the country could use to pay off the debt. Sure, but you know who also has money, which they don’t know what to do with, and don’t need for retirement? Guys like Elon Musk and Jeff Bezos. If they paid the same tax rate I do, we wouldn’t have a problem.

mcnado, to random
@mcnado@mstdn.social avatar

I deleted the below referenced rant-post because my wording doesn’t accurately reflect how this works in Colorado, and there’s some nuance to the rates I cited. The point I was making is that med mal cases as a whole are not often successful, and increasing damage caps doesn’t really help patients, but it does enrich ambulance chasers. For the longer discussion, see thread below…1/x

Thanks @WhenISayJ for pointing out where this post went off the rails!

mcnado,
@mcnado@mstdn.social avatar

To start: if someone gets bad care, there has to be a way for them to deal with that. If that care caused actual harm so that they can’t work, or can’t care for themselves, there has to be a mechanism for making it right. Without that, people resort to various not ideal ways of “fixing” it in their mind, and society doesn’t function. So to be clear, I am not ever saying we don’t need ethical plaintiff’s lawyers, or that all medical malpractice suits are bad. 2/x…

mcnado,
@mcnado@mstdn.social avatar

When someone wants to sue a doctor, they hire a lawyer. That lawyer may charge them for the service now, or, often in Colorado, will take the case on contigency, meaning the person suing the doctor pays little or nothing until they win a settlement or win at trial. If they don’t win, they may or may not owe the lawyer anything.

My understanding is that in Colorado a lawyer can charge up to a 40% contingency fee (as well as other fees).
3/x…

mcnado,
@mcnado@mstdn.social avatar

Most lawsuits against doctors never go to trial. They are usually settled out of court for a pretty small amount. Of those that go trial, the overall rate of verdicts against the doctor is often cited as around 10-20%. However, that figure is a little misleading. When those are broken down by the strength of the case, the rate is much different. In short, very bad medicine results in decisions against the doctor around half the time.
4/x…

mcnado,
@mcnado@mstdn.social avatar

If patients pay nothing to the attorney for the cases that don’t win, the only people who lose are the lawyer, the doctor, and every future patient who is paying for the doctor’s costs for malpractice insurance. However, not all contigency arrangements are that clean (I can’t find data to say what that actually looks like — anyone familiar that wants to educate here, I’m all ears).
5/x…

mcnado,
@mcnado@mstdn.social avatar

So why am I ranting about this? The Colorado Trial Lawyers Association held CO hostage using very hostile ballot initiatives, and eventually got the legislature to agree to increase malpractice damage caps dramatically, and add in a new “wrongful death” award. This means they can market their services as having a chance at winning a huge amount of money, when in fact that outcome is not common.
6/x…

mcnado,
@mcnado@mstdn.social avatar

What this all leads to is people who feel they were harmed by malpractice (who very often were not) trying to sue everyone involved in their care because they saw the billboard that said they could win millions. Even a very short response to a bullshit lawsuit, even one where the plaintiff just plain drops the case, costs an enormous amount of money in legal defense fees. That is factored into medical malpractice insurance rates. That cost is passed on to patients eventually.
7/x…

mcnado,
@mcnado@mstdn.social avatar

Right now, ER docs like me have had their reimbursement (what we get paid by health insurance) cut dramatically. Costs of providing care have gone up. Health insurance companies are also just plain not paying many bills, because we have no easy way to force them to pay due to recent regulatory changes. Add to that higher malpractice insurance rates, and small local practices can’t stay in business. Patients get stuck with BigEvilMedicine TM as the only option.
8/x…

ElleGray, to random
@ElleGray@mstdn.social avatar

don't get me wrong, the rap battle is fun, but a fight between men named Kendrick Lamar Duckworth and Aubrey Drake Graham should really involve dueling with swords at dawn

mcnado,
@mcnado@mstdn.social avatar

@samhainnight @ElleGray big duck energy.

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