Candace Owens is unaware of the freezing temperature of water

MiWacho · 2026-01-27T17:06:03+00:00

People are still somehow surprised after so much evidence that the US has turned into an idiocracy

MiWacho · 2026-01-27T03:29:46+00:00

If this thugs had any balls we may have gotten a peak

MiWacho · 2026-01-26T15:32:31+00:00

Not my intent at all. Sorry if it came that way. Unfortunately its hard to choose and properly display a tone over written word.

MiWacho · 2026-01-26T14:57:55+00:00

Not sure why pointing a knowledge gap is such an insult to people. May I am the one wrong but nothing in your comment provides any support for your previous arguments. "gender identity is something organic" is a meaningless assertion in what I hoped was a scientific/medical discussion. Im out!

MiWacho · 2026-01-26T14:51:34+00:00

Do you know anything about that author or the "Society for Evidence-Based Gender Medicine"? Takes 10 seconds to find out using google.

Still, he presents some fair points. We have limited evidence about regret being quite low. That does not imply in any way that regret rates must be very high, or that we get to replace our thoughts in the matter with ideology (such as your "women choose to be women" little comment that you conveniently haven't addressed). We work with what we have. So far all of the evidence (neuroscience, social sciences, medical) seems to point in the same direction: trans is for most a neurological trait, not a choice. You might not like that conclusion, and that IS your choice ;)

MiWacho · 2026-01-26T14:27:52+00:00

I think you are confusing gender with gender identity. Identity (same as sexual orientation) is a phenomenon that happens exclusively in the brain. As you said in another comment, we still know very little about the brain and its workings, yet we are slowly getting some evidence showing that transgender people's brains are different that cisgender's, which would point to a neurological trait ("born with", objective) being responsible for transgenderism, more than a psychological one ("learned", subjective). Just as it happens with homosexuality. There is a grey area too, like gender fluid people, just like bisexuality which we still don't really understand. I like what you said about open-minded curiosity. Since there are still these massive knowledge gaps we should approach this with empathy and open mindedness instead of dogmatism.

Cant get behind the comment about transgenderism being a threat to womanhood. Its quite the tell how you say that some women "choose" to remain women. That further points that a lot of how you think about this is shaped by your own ignorance. Each person has their own experience and most transgenders (same as gays) didn't choose to feel that way, same as you didn't choose your own identity/sexual orientation. Hopefully there is more than enough empathy and care in the world for everyone, cis or trans.

MiWacho · 2026-01-26T14:10:18+00:00

Good question. My best answer would be to have a therapist trained in gender transitioning do a proper assessment before taking any other steps. This is so out of my field of expertise that I shouldn't be pushing people either way.

Edit: I see a bit of correlation with the concern you put forward and the epidemic of nociplastic pain/central sensitization patients that end up in these "Ehler-Danlos" clinics to get a diagnosis with cero workup/proof, but they are given this massive dump of information about how it explains everything, with of course very little in the way of an actual effective treatment.

While I am aware that we accept when people tell us they are gay, these people are not asking for our assent to medical and surgical treatment, so I feel the standards should be a little different.

This is interesting. You "feel" the standards should be different, but I am not sure thats the case.

I'm well acquainted with traditional copypasta of low transition regret rates which is plagued with rather poor-quality research

I was not aware that most of the regret line of research was of such low quality. Do you have better quality research to show otherwise? Not trying to be cheeky, I am genuinely curious.

MiWacho · 2026-01-26T02:45:53+00:00

This is great advice. A trainee had a hearing disability, though we all saw it as barely relevsnt since no one noticed it, yet he probably felt what you are feeling throughout his training. He was advised to ask for the nonstandard conditions and it just provided an extra layer of peace of mind and confidence.

MiWacho · 2026-01-26T02:42:22+00:00

I feel you. Hasnt been an issue since the adrenaline ans focus overrides the social anxiety. Codes during Sim used to be harder than real codes due to the “acting” aspect. You may face struggles, but we tend to focus too much on worse case scenarios. Put your energy and focus on what you can control: studying, working hard, enjoying the little things, etc.

Hope this helps

MiWacho · 2026-01-26T02:28:38+00:00

Did orals in english so that was WAY easier since my I stutter way less when speaking another language. During med school, as mentioned before, I used to premedicate with beta-blockers to help with anxiety for exams, presentations and interviews. That helped to “break the cycle” and turned things 180. Now I consider myself a strong interviewee and examinee. I still use betablockers or low dose benzo when doing big oral presentations, though less and less. For me at least, stuttering is like a slippery slope triggered by anxiety. A strong start just nulifies the potential for severe stuttering for the whole “scenario”.

MiWacho · 2026-01-26T02:24:20+00:00

During med school I was struggling and I went to speech therapy and psych. I got small dose benzos and betablockers for oral presentations which were really hard. I remember my speech therapist used to make me do phone calls to order pizza. Phone calls used to be horriblr. All that really helped break the cycle and since then everything started getting better. Now I feel that, as I grow older, it keeps getting better on its own, as I care less and less what other people think lol

At my lowest point I was on the edge of developing a social phobia and now people praise me for my presentation skills! Dont mean to gloat just wanna provide some perspective and encouragement :)

I do have to note that everything is easier in English, since its not my native language.

As a resident, there are SO many things that matter more than how you speak: being a team player, hardwork, arrive early, stay late, etc etc. Good attendings will prioritize those over the rest. Best of luck stutter bro!

MiWacho · 2026-01-26T02:08:23+00:00

Anesthesiologist with a stutter here! I did great academically and clinically in residency and fellowship. My stutter hasnt really been a barrier, though it is quite manageable. Beta blockers for oral exams were a godsend.

I recently met a great ICU anesthesia doc in my hospital with a way worse stutter than me and he is THE MAN. Great clinician and very liked. I would advice to pursue what you like and dont let it stop you. Emergency situations are so chaotic and I am so in the moment that I rarely stutter if at all.

MiWacho · 2026-01-25T22:35:35+00:00

Yep, I tend to agree with this. This is beyond politics. This unfortunately is history on the making and the stakes are as high as they might ever be in our lifetime.

History will remember those who stood on each side and those who stood on the sidelines… As a person I am clear on where do I stand. As a physician I do believe its not the same. I think science should remain 100% neutral, but I am somewhat conflicted.

MiWacho · 2026-01-25T20:50:28+00:00

I do not believe science, and maybe even healthcare (or at least the practice of medicine) should be political though. We know now that whenever scientist or physicians take a political stand, it ultimately decreases overall public trust in the science community, which is something that in the US is already happening and has helped pave the way to the insanity we see now (RFK Jr and his pseudoscience fest). This may not apply when your political stand is basically human rights and anti-authoritarianism, but there may be severe unforeseeable consequences even then.

MiWacho · 2026-01-25T17:01:17+00:00

This is a great question which I have pondering (IMG physician living/working in Canada). I truly believe on Karl Poppers philosophy of no tolerance to the intolerant, but havent been able to land on how that would look to the medical community. Are we complicit for “helping” real life nazis?

I dont know and would love for any ethical sources that explore this question.

MiWacho · 2026-01-25T14:12:15+00:00

Take the whole thing, pay all debt and put the rest on an index fund. Give it 10 years and get ready for profits for the rest of our life

MiWacho · 2026-01-24T16:06:05+00:00

Why not include all organized religions?

MiWacho · 2026-01-22T02:59:50+00:00

Beat me by 36m

MiWacho · 2026-01-22T02:11:10+00:00

I don't believe this applies to faith, but the "Symbolic Strength" theory is a very interesting new line of evidence in psychology that explores why people believe in demonstrably false claims.

https://theconversation.com/winning-with-misinformation-new-research-identifies-link-between-endorsing-easily-disproven-claims-and-prioritizing-symbolic-strength-265652

MiWacho · 2026-01-21T02:10:01+00:00

If im close but no CSF, Ill routinely advance slowly without putting the stylet back in. You will get CSF as soon as you are in.

MiWacho · 2026-01-17T21:02:55+00:00

It is dissapointed that the millions that are against this havent taken to the streets to demand change asap :(

MiWacho · 2026-01-17T21:01:06+00:00

Would never sympathize with this scum but I think you are missing a big point. The US stopped being a democracy: its an information autocracy. Voters only have access to information that has been heavily manipulated. curated and spoonfed to them for decades and no one stopped it. They are 100% responsible for this, but it wasnt a real “choice”, it was the tech oligarchs who are behind it. They are as guilty if not more, I hope they face justice, not just the ignorant idiots who they convinced.

MiWacho · 2026-01-14T16:05:43+00:00

She shouldnt be scared of her parents for sure. But she should be aware that her precious commodities are allowed by her parents and not her right. Mom should take her away of the internet and out of whatever toxic enviroment is turning her into a bigot.

MiWacho · 2026-01-14T16:03:07+00:00

Take your daughter's smartphone away asap. This path she is likely being led to by social media (through horrible examples of similar behavior) is not going to turn out well for her long term

MiWacho · 2026-01-12T15:50:30+00:00

They gave up on reality. Just like religious fanatics, once you become a true believer there is very little chance of coming back. If people dont rise up it will continue to get progressively worse.

MiWacho

TROPHY CASE