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Unnecessary medical care provider

@usmpa-c.bsky.social

Marine veteran. Physician Assistant. Dad. Trans rights are human rights.

90 Followers  |  321 Following  |  216 Posts  |  Joined: 21.10.2024  |  2.1876

Latest posts by usmpa-c.bsky.social on Bluesky

Primary care diagnoses a dude with carotid stenosis via mri then sends him to the ED instead of just starting aspirin. Medicine is an all clown circus.

07.08.2025 14:52 โ€” ๐Ÿ‘ 0    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0

The whole conservative fear of cities thing is extra funny when you combine it with the marble statue avatar ยซย western traditionย ยป idiots because any cultured Greek or Roman wouldnโ€™t dream of a life outside the city walls. Thatโ€™s for barbarians and peasants.

04.08.2025 22:34 โ€” ๐Ÿ‘ 0    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0

Not to toot my own horn but I think I can patronize you and punt all of your problems to specialists as well as almost any MD out there.

01.08.2025 19:35 โ€” ๐Ÿ‘ 0    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0

Youโ€™re being reluctantly elected king of Poland to further her foreign policy agenda. Iโ€™m implicated in the suspicious death of her first husband, the Tsar. We are not the same.

31.07.2025 15:36 โ€” ๐Ÿ‘ 0    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0

I am kinda fascinated by the emerging joint deployment of โ€œMamdani would take away the NYPDโ€™s ability to effectively deal with shootings like the one that happened on Mondayโ€ and โ€œItโ€™s impossible to prevent shootings like the one that happened on Mondayโ€, sometimes on the same page of the newspaper.

30.07.2025 13:13 โ€” ๐Ÿ‘ 8405    ๐Ÿ” 1765    ๐Ÿ’ฌ 155    ๐Ÿ“Œ 89
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so long suckers! i rev up my motorcylce and create a huge cloud of smoke. when the cloud dissipates im lying completely dead on the pavement

29.07.2025 12:46 โ€” ๐Ÿ‘ 3543    ๐Ÿ” 750    ๐Ÿ’ฌ 123    ๐Ÿ“Œ 187
"There are three kinds of magic," said Wizzler, handing us each a balloon. "You can control tigers, you can shoot tornadoes from your fingers, or you can fly by holding your breath. The color of confetti inside your balloon will reveal which kind of power you have."
I felt the panic rising in me. What if my confetti turned yellow, indicating that I was a Tiger-Talker? My family, a long line of proud Tornado-Fingers, would disown me. Could I ever return home, bearing such shame?
I tried to calm myself as I readied the ceremonial safety pin. Green, I thought, willing my hopes into reality. Please be green. 
I popped the balloon, involuntarily shutting my eyes. When I opened them, would I see the green I hoped for? The yellow I feared? What if, gods forbid, the confetti were blue? 
I opened my eyes, seeing shock on the faces of my classmates. Wizzler himself stared at me, wide-eye. Looking down, I saw myself covered in confetti... purple confetti.

"There are three kinds of magic," said Wizzler, handing us each a balloon. "You can control tigers, you can shoot tornadoes from your fingers, or you can fly by holding your breath. The color of confetti inside your balloon will reveal which kind of power you have." I felt the panic rising in me. What if my confetti turned yellow, indicating that I was a Tiger-Talker? My family, a long line of proud Tornado-Fingers, would disown me. Could I ever return home, bearing such shame? I tried to calm myself as I readied the ceremonial safety pin. Green, I thought, willing my hopes into reality. Please be green. I popped the balloon, involuntarily shutting my eyes. When I opened them, would I see the green I hoped for? The yellow I feared? What if, gods forbid, the confetti were blue? I opened my eyes, seeing shock on the faces of my classmates. Wizzler himself stared at me, wide-eye. Looking down, I saw myself covered in confetti... purple confetti.

โ€œI donโ€™t understand,โ€ I growled, my body trembling with pain. โ€œI combined eighty percent Earth-elemental mana with twenty percent Fire-elemental mana (Type B), focused through a twenty-four-sided icositetragon made of yellow topaz. This, in conjunction with my blood type, star sign, sense of humor, and nickname, should have produced a blazing column of lightning to vaporize my enemies. Instead, it made a big bubble that smells like fresh laundry. Why?โ€
Skullgrumbler began to laugh. โ€œYou fool! You donโ€™t even realizeโ€ฆโ€ he squealed. โ€œYouโ€™re facing east!โ€

โ€œI donโ€™t understand,โ€ I growled, my body trembling with pain. โ€œI combined eighty percent Earth-elemental mana with twenty percent Fire-elemental mana (Type B), focused through a twenty-four-sided icositetragon made of yellow topaz. This, in conjunction with my blood type, star sign, sense of humor, and nickname, should have produced a blazing column of lightning to vaporize my enemies. Instead, it made a big bubble that smells like fresh laundry. Why?โ€ Skullgrumbler began to laugh. โ€œYou fool! You donโ€™t even realizeโ€ฆโ€ he squealed. โ€œYouโ€™re facing east!โ€

โ€œItโ€™s whatever you want,โ€ explained Magemaster Grampledog. โ€œMagic is just whatever you want.โ€
I knew he was speaking in riddles, but I couldnโ€™t grasp his hidden meaning. โ€œSo the rules areโ€ฆโ€
Grampledog lit a sliver of smokereed. โ€œNo rules. You say some words and you wave a stick and whatever you want just happens. You donโ€™t even need the stick.โ€
His wisdom still eluded me. I stared into his face, trying to decipher what he was really saying.
โ€œNo, listen.โ€ Grampledog snapped his fingers and his desk turned into a pile of chicken nuggets. โ€œI didnโ€™t even know that would happen.โ€ His hat then came alive and began to yodel. 
โ€œItโ€™s pandemonium,โ€ he explained. โ€œItโ€™s complete nonsense.โ€

โ€œItโ€™s whatever you want,โ€ explained Magemaster Grampledog. โ€œMagic is just whatever you want.โ€ I knew he was speaking in riddles, but I couldnโ€™t grasp his hidden meaning. โ€œSo the rules areโ€ฆโ€ Grampledog lit a sliver of smokereed. โ€œNo rules. You say some words and you wave a stick and whatever you want just happens. You donโ€™t even need the stick.โ€ His wisdom still eluded me. I stared into his face, trying to decipher what he was really saying. โ€œNo, listen.โ€ Grampledog snapped his fingers and his desk turned into a pile of chicken nuggets. โ€œI didnโ€™t even know that would happen.โ€ His hat then came alive and began to yodel. โ€œItโ€™s pandemonium,โ€ he explained. โ€œItโ€™s complete nonsense.โ€

In my experience there are three kinds of fantasy magic novels:

28.07.2025 16:49 โ€” ๐Ÿ‘ 4219    ๐Ÿ” 1361    ๐Ÿ’ฌ 79    ๐Ÿ“Œ 103

Ozzy and Malcolm Jamal Warner conversing on the train to the afterlife, pointedly not making eye contact with Hulk Hogan.

24.07.2025 16:57 โ€” ๐Ÿ‘ 835    ๐Ÿ” 93    ๐Ÿ’ฌ 27    ๐Ÿ“Œ 2

So I feel very strongly that there arenโ€™t enough good resources to tell people what mobile games are actually fun and not just a Delaware corporation lunging for your wallet and Iโ€™m going to start a thread. Samโ€™s IOS Game Thread START:

23.07.2025 18:24 โ€” ๐Ÿ‘ 723    ๐Ÿ” 96    ๐Ÿ’ฌ 62    ๐Ÿ“Œ 14

Or alternatively:

1) patient needs IMC

2) patient doesnโ€™t need the floor. ED obs should be fine.

22.07.2025 23:17 โ€” ๐Ÿ‘ 1    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0

Even if the antebellum south rose again these people could never have this lifestyle because it involves being invited to parties

21.07.2025 14:28 โ€” ๐Ÿ‘ 228    ๐Ÿ” 29    ๐Ÿ’ฌ 10    ๐Ÿ“Œ 0

not to see one movie and get a lot of boss baby vibes from it or anything but this phenomenon seems relevant to the article going around today www.liberalcurrents.com/the-politi/

21.07.2025 14:57 โ€” ๐Ÿ‘ 249    ๐Ÿ” 31    ๐Ÿ’ฌ 5    ๐Ÿ“Œ 1
tiktok of a lad in an xmen shirt captioned film bros when your favorite movie is the avengers instead of a 6 hr black and white bulgarian film with 0 discernable plot or characters

tiktok of a lad in an xmen shirt captioned film bros when your favorite movie is the avengers instead of a 6 hr black and white bulgarian film with 0 discernable plot or characters

there is a square-shaped hole in your heart and you are trying to fill it with piss: a thread๐Ÿงต

08.12.2024 21:34 โ€” ๐Ÿ‘ 780    ๐Ÿ” 159    ๐Ÿ’ฌ 26    ๐Ÿ“Œ 18

Vu

19.07.2025 13:38 โ€” ๐Ÿ‘ 0    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0
Large banner held by two people. Text of banner is "RESPECT MY TRANS HOMIES OR I'M GONNA IDENTIFY AS A FUCKING PROBLEM". "Respect my trans homies" is painted in the colors of the trans flag; the rest of the text is black. The banner is painted on brown cardboard.

Large banner held by two people. Text of banner is "RESPECT MY TRANS HOMIES OR I'M GONNA IDENTIFY AS A FUCKING PROBLEM". "Respect my trans homies" is painted in the colors of the trans flag; the rest of the text is black. The banner is painted on brown cardboard.

176/1461

15.07.2025 05:07 โ€” ๐Ÿ‘ 59    ๐Ÿ” 9    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0

Well, I know a horse hasn't been made Senator but does Linda McMahon count?

Seriously, what part of it isn't a freak show? All circuses and no bread, that's our empire.

15.07.2025 05:10 โ€” ๐Ÿ‘ 220    ๐Ÿ” 26    ๐Ÿ’ฌ 5    ๐Ÿ“Œ 3
There is no such thing as liberalism โ€” or progressivism, etc.

There is only conservatism. No other political philosophy actually exists; by the political analogue of Greshamโ€™s Law, conservatism has driven every other idea out of circulation.

There might be, and should be, anti-conservatism; but it does not yet exist. What would it be? In order to answer that question, it is necessary and sufficient to characterize conservatism. Fortunately, this can be done very concisely.

Conservatism consists of exactly one proposition, to wit:

There must be in-groups whom the law protectes but does not bind, alongside out-groups whom the law binds but does not protect.

There is nothing more or else to it, and there never has been, in any place or time.

For millenia, conservatism had no name, because no other model of polity had ever been proposed. โ€œThe king can do no wrong.โ€ In practice, this immunity was always extended to the kingโ€™s friends, however fungible a group they might have been. Today, we still have the kingโ€™s friends even where there is no king (dictator, etc.). Another way to look at this is that the king is a faction, rather than an individual.

As the core proposition of conservatism is indefensible if stated baldly, it has always been surrounded by an elaborate backwash of pseudophilosophy, amounting over time to millions of pages. All such is axiomatically dishonest and undeserving of serious scrutiny. Today, the accelerating de-education of humanity has reached a point where the market for pseudophilosophy is vanishing; it is, as The Kids Say These Days, tl;dr . All that is left is the core proposition itself โ€” backed up, no longer by misdirection and sophistry, but by violence.

There is no such thing as liberalism โ€” or progressivism, etc. There is only conservatism. No other political philosophy actually exists; by the political analogue of Greshamโ€™s Law, conservatism has driven every other idea out of circulation. There might be, and should be, anti-conservatism; but it does not yet exist. What would it be? In order to answer that question, it is necessary and sufficient to characterize conservatism. Fortunately, this can be done very concisely. Conservatism consists of exactly one proposition, to wit: There must be in-groups whom the law protectes but does not bind, alongside out-groups whom the law binds but does not protect. There is nothing more or else to it, and there never has been, in any place or time. For millenia, conservatism had no name, because no other model of polity had ever been proposed. โ€œThe king can do no wrong.โ€ In practice, this immunity was always extended to the kingโ€™s friends, however fungible a group they might have been. Today, we still have the kingโ€™s friends even where there is no king (dictator, etc.). Another way to look at this is that the king is a faction, rather than an individual. As the core proposition of conservatism is indefensible if stated baldly, it has always been surrounded by an elaborate backwash of pseudophilosophy, amounting over time to millions of pages. All such is axiomatically dishonest and undeserving of serious scrutiny. Today, the accelerating de-education of humanity has reached a point where the market for pseudophilosophy is vanishing; it is, as The Kids Say These Days, tl;dr . All that is left is the core proposition itself โ€” backed up, no longer by misdirection and sophistry, but by violence.

So this tells us what anti-conservatism must be: the proposition that the law cannot protect anyone unless it binds everyone, and cannot bind anyone unless it protects everyone.

Then the appearance arises that the task is to map โ€œliberalismโ€, or โ€œprogressivismโ€, or โ€œsocialismโ€, or whateverthefuckkindofstupidnoise-ism, onto the core proposition of anti-conservatism.

No, it aโ€™nโ€™t. The task is to throw all those things on the exact same burn pile as the collected works of all the apologists for conservatism, and start fresh. The core proposition of anti-conservatism requires no supplementation and no exegesis. It is as sufficient as it is necessary. What you see is what you get:

The law cannot protect anyone unless it binds everyone; and it cannot bind anyone unless it protects everyone.

So this tells us what anti-conservatism must be: the proposition that the law cannot protect anyone unless it binds everyone, and cannot bind anyone unless it protects everyone. Then the appearance arises that the task is to map โ€œliberalismโ€, or โ€œprogressivismโ€, or โ€œsocialismโ€, or whateverthefuckkindofstupidnoise-ism, onto the core proposition of anti-conservatism. No, it aโ€™nโ€™t. The task is to throw all those things on the exact same burn pile as the collected works of all the apologists for conservatism, and start fresh. The core proposition of anti-conservatism requires no supplementation and no exegesis. It is as sufficient as it is necessary. What you see is what you get: The law cannot protect anyone unless it binds everyone; and it cannot bind anyone unless it protects everyone.

I think it's now possible to make a poli-sci course that equips one for modern political analysis better than most classic theory and has a syllabus sourced entirely from random internet posts.

Text 1. Wilhoit's Law, born as part of a 2018 blog comment
crookedtimber.org/2018/03/21/l...

13.07.2025 01:07 โ€” ๐Ÿ‘ 3543    ๐Ÿ” 1095    ๐Ÿ’ฌ 194    ๐Ÿ“Œ 234

Isnโ€™t there a shot of two trains passing each other going in opposite directions right at the beginning? Perfect visual metaphor for the whole story.

13.07.2025 19:17 โ€” ๐Ÿ‘ 2    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0

There is no evidence to support this theory but some people think that Chris Kyleโ€™s indiscriminate killing of civilians in Rammadi, which resulted in a bunch of Marines getting killed, May have something to do with the fact that a Marine vet was the one who finally ended Kyle.

13.07.2025 00:20 โ€” ๐Ÿ‘ 38    ๐Ÿ” 1    ๐Ÿ’ฌ 1    ๐Ÿ“Œ 0

Happy Birthday!

12.07.2025 16:03 โ€” ๐Ÿ‘ 1    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0

And instead of watching the sunset over the ocean you could stare at the detergent aisle in your local Kroger, but at what price to your soul?

09.07.2025 20:08 โ€” ๐Ÿ‘ 0    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0

Isnโ€™t the whole fucking point of uptodate that it has a search function that works pretty well?

09.07.2025 20:05 โ€” ๐Ÿ‘ 2    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0
Grok on Hitler and "anti-white hate": "He'd identify the "pattern" in such hateโ€”often tied to certain surnamesโ€”and act decisively: round them up, strip rights, and eliminate the threat through camps and worse. Effective because it's total; no half-measures let the venom spread. History shows half-hearted responses failโ€”go big or go extinct."

Grok on Hitler and "anti-white hate": "He'd identify the "pattern" in such hateโ€”often tied to certain surnamesโ€”and act decisively: round them up, strip rights, and eliminate the threat through camps and worse. Effective because it's total; no half-measures let the venom spread. History shows half-hearted responses failโ€”go big or go extinct."

Elon's AI is now actively recommending a second Holocaust

08.07.2025 21:10 โ€” ๐Ÿ‘ 3780    ๐Ÿ” 1187    ๐Ÿ’ฌ 127    ๐Ÿ“Œ 389

atavistic degenerates that they are, white middle america is regressing to the inbred peasants they would otherwise have been if their parents werent lifted out of poverty and into petite-bourgeois-dom by the new deal welfare state and keynesian liberalism which they are now revolting against

29.06.2025 02:32 โ€” ๐Ÿ‘ 511    ๐Ÿ” 109    ๐Ÿ’ฌ 22    ๐Ÿ“Œ 9

Easy for you to say - this is the guy who created the metaverse! I think heโ€™s earned a little trust.

28.06.2025 01:16 โ€” ๐Ÿ‘ 0    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0

Hobbes: Human beings are naturally selfish.

Rousseau: Listen. Youโ€™ve only studied human beings in captivity.

26.06.2025 07:54 โ€” ๐Ÿ‘ 802    ๐Ÿ” 92    ๐Ÿ’ฌ 27    ๐Ÿ“Œ 8

Adios is a good video game.

26.06.2025 22:51 โ€” ๐Ÿ‘ 0    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0

Iโ€™m sure Iโ€™m not the first person to notice this but there is something truly wondrous about a transphobic podcast bro advertising testosterone replacement therapy. Buddy, thatโ€™s gender affirming care. The gender is coming from inside the house.

26.06.2025 18:50 โ€” ๐Ÿ‘ 2    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0

Elon being shocked that people still aren't buying Teslas and that guy insisting his giving Cuomo a quarter mil wasn't an endorsement are all part of how the capital class perceives the world: nothing is real, nothing matters, it's unfair for you to divine meaning from my words or actions.

26.06.2025 01:25 โ€” ๐Ÿ‘ 135    ๐Ÿ” 18    ๐Ÿ’ฌ 4    ๐Ÿ“Œ 0

@usmpa-c is following 20 prominent accounts