Pippa Elayne Coulter MD PhD 💛🤍💜🖤

Yeah, I can't explain this 😂. My family being family

I think we should all get 12 weeks paid vacation a year. But that's bc I get 3 lol. Anyway he could take the next 3.5 yrs off and just stay out of our hair.

I just use Amazon to find a company selling whatever it is then go find their page and order directly. If I can't find from a non fascist place then I can live without it.

Is this a real change or is it that more workers now realize most employment is abusive and that accommodations can help a little?

Maybe we would do better with those melanoma sniffing dogs! One of the problems is that dysplastic nevi don't tend to become melanomas-- but a high number of dysplastic nevi means a person is at higher risk. So instead of removing them maybe the screening should be different for them.

Usual care means if people notice a concerning mole they go in. Some of this may be due to treatment becoming more effective and some due to screening itself being inaccurate. Maybe derm is missing stuff. I don't know.

I do some of these unevidenced rituals too TBF. I mean for myself. I get my mammograms even though Cochrane reviews concluded there's no improvement in all-cause mortality. As I stand in the squisher I think why am I doing this when it won't help me live longer? But I do it 😂

Same as when we learned back sleeping was safer for babies-- it didn't make sense at the time yet it was true. Or that PSA screens mostly shouldn't be done. Or that circumcision isn't beneficial on balance (I never thought it was but whoo this is a hurdle for some parents).

I don't know of any research to support that this would change the effectiveness of screening. Right now it's a ritual without any known benefit. I mean I get it-- very hard when evidence contradicts reason, but generally reasoning is inferior to evidence. It's hard for me too lol

USPSTF Review: Skin Cancer Screening This systematic review to support the 2023 US Preventive Services Task Force Recommendation Statement on screening for skin cancer summarizes published evidence on the benefits and harms of screening ...

Unfortunately, screening for melanoma doesn't increase detection or decrease mortality. We probably need better screening methods. jamanetwork.com/journals/jam... Skin Cancer Screening: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force |

Lol I am envious. Lifted heavy for decades and for whatever reason I just can't get hypertrophy. Even counting macros/protein. I still look like someone who should be a runner (I'm not) but got chubby 😂. But it's still good for us even if we can't show our work.

I told mine I'd like my body to be eaten by bears... but actually I am leaving them instructions for whole body donation that won't cost them anything 😂

It's only Wednesday and it's been a long week. I just scrolled past a headline about tariffs on semiconductors and read it as a 100% tariff on semi-colons. Idk what you pay that tax in... apostrophes? Em dashes?

Omg

The truth is there is no working class movement without gender diverse people. It cannot succeed without us. Not because of numbers but because attacking us is automatically an alignment with cruelty, and cruel seeds always lead to poisonous fruit. 7/7

I'll name her bc she's a public figure-- Ellin Jimmerson. She somehow thinks she can deny gender to trans kids but call herself an ally to trans adults. Her posts have invited ppl like my ex friend to blather their hate. 6/n

The post he was commenting on was by an immigrants rights activist back in Alabama whom I already knew was a big problem. Not trustworthy. She has gone full JKR on trans kids. She's obsessively posting on how support for trans rights prevents a working class movement. 5/n

Years ago a man I had met several times at work, whom all of us liked and got no bad vibes from, killed his wife violently. I had side-hugged him. I felt no fear. It made me distrust myself. How could I not know? This feels like that but worse 4/n

We had drifted apart over some differences I didn't think were related to any clash of values so much as how we arrived at those values. I never had any idea he could be transphobic. I feel nausea. I feel like crawling under my bed. Deep grief and dislocation. 3/n

I left FB months ago. But I have seen screenshots of people I knew. One is the son of a beloved friend. I thought he was an ally. He commented on someone else's post that no one could align with LGB people or women and support T, that T was a "deception". I am blown away. 2/n

I haven't been surprised yet by what the powerful have done. But I am horrified by what some people I have known personally have become. It makes me question my fundamental ability to know who anyone really is-- what did I miss? Why didn't I see it? 1/n

None of their reasons are religious IMO. Their non-religious reasons are bigotry and misogyny. White supremacism. Patriarchy. Lust for power.

I hope we never have to test your hypothesis. There will not BE food for the starving to eat. The worst case scenario would be beyond horrific. It's true nobody knows until it happens but I think the author has nailed it. I don't want that to be true FWIW. I wish you were right. Just doubt it.

It's dystopias all the way down from here unless we can turn it around. Which makes it even more urgent.

I think ppl forget to take the environmental catastrophe into account in their dreams of a post collapse utopia. These psychopaths won't go out without destroying as much as they can.

What I'm saying is it won't be a "large portion" of those who are already bad off, because as always they are the most vulnerable and most will not make it. There's a romantic kind of view out there of a restart we should let go of. The planet could be uninhabitable except for cockroaches.

QI measures in medicine = perfect example. Our state Medicaid makes some clinic funding contingent on a % of pts getting checkups. So the clinic starts having mass well child clinics to boost numbers instead of them getting continuity of care with pcp. Quality of care goes down.

Not if it includes even worse climate changes/extreme weather, crop failures, no water, nuclear fallout, etc. They won't be better off-- they'll be mostly dead.

😂😂😂 I turned down a management position and told my boss "I'm not doing it bc I'd have to give up my red card" and she was like well that figures

IWW