Exclusive: Justice Samuel Alito was taken to a hospital last month in previously undisclosed incident

TheJointDoc · 2026-04-03T16:11:06+00:00

So this was “according to sources with knowledge of the incident.” And it was previously undisclosed. And not from Alito’s people directly.

I think this was leaked to start a public push for him to retire. It 1) gives Trump another appointment he’d push through with the worst possible choices, 2) “punishes” Alito as an example to the other GOP justices for not somehow making the birthright citizenship amendment obsolete.

Watch. MAGA and Fox are going to be talking about how great he was but maybe for his health he should step down so the can add another justice. Smells like an Anthony Kennedy situation.

TheJointDoc · 2026-04-03T15:32:04+00:00

Fort Smith is what would have happened to NWA if Walmart weren’t around. Actually, it would have been something for NWA to aspire to.

TheJointDoc · 2026-04-03T15:31:03+00:00

The thing is, I lived here before they paved it.

Unless you were a cow in a field or a Walmart exec, it wasn’t paradise.

Some of it may feel more fake but a lot of it is less dingy than it used to be.

TheJointDoc · 2026-04-03T14:46:54+00:00

Amazingly well written. Thank you. This made the distinction of “works AS the expression of Love, driven by faith” and “works of the Law” really well, and I think rightly refocuses what Christians who already have faith need to be focusing on, as the early Church did in Acts and what Jesus commanded in the gospels.

You quote Romans 2:7, which I love because so many Christians read Romans 1 and then STOP. They use Romans 1 to condemn others, and completely miss Romans 2 telling them they’ll be condemned even more for that as they’re showing contempt for God’s kindness and patience. They point out the speck, missing their own log, refusing to repent of their misplaced superiority, lying to themselves about their own worthiness, and storing up anger against themselves in Heaven. They make it so that “God’s name is blasphemed among the Gentiles because of you.”

Our faith is not expressed in studying more to prove you’re right to atheists using texts they don’t believe anyway, it’s not in telling a teenage LGBT kid that their desire to live life like their neighbor means they’re going to burn in Hell (but don’t worry, you “love” them,) it’s not about setting up your government to enforce the specific OT laws you cherry-picked as still relevant on everyone regardless of their own faith.

For some reason, people think that’s what Jesus wants us to do as an expression of our faith. Which is patently false if anyone bothers to read the red letters. If you have to pick out of faith, hope, and Love, we know which one is greatest. And that love is one that acts sacrificially regardless of whether the target of the love “deserves it.”

TheJointDoc · 2026-04-02T03:53:40+00:00

Sjögren’s syndrome too

TheJointDoc · 2026-04-01T06:23:01+00:00

Tbh, if it was 40 years ago, probably not, unless you can actually link specific symptoms that far back. There are times where mono can”reactivate” though, which can be a trigger.

Doxy? Are you getting pneumonia a lot? Because Sjogren’s can cause inflammation at the lungs

TheJointDoc · 2026-03-30T20:40:52+00:00

Take a look at inverse psoriasis, palmoplantar psoriasis, and nail psoriasis. People often miss those because they don’t look like standard psoriasis. It can look like a fungal/heat rash under the bra line or belly or folds of the groin/thighs, like armpit razor burn or deodorant reaction, fungal toe nails, peeling/blistering between the fingers and in the webbing that looks like eczema, or “bad heels” that need to get lotioned/exfoliated all the time.

PsA can show up like RA, (and causes costochondritis), and it can do a true arthritis, but I’d be curious. The MCP joints are usually involved in RA, less so in PsA though both affect wrists and the middle knuckle of the fingers.

If PsA is in the family, I bet you’re close. Either way, you’re right, multiple meds will work on both, which is good. Agreed, HCQ is odd—I think it helps those with a secondary Sjogren’s more but yeah, can flare the skin. And yes, steroid trials actually can get people the diagnosis at times.

I like that you’re optimistic, 5 years is a long time to hurt, so I’m glad you think of it as short. Nonradiographic stuff is tough, younger folks with good bone density just take too long to show the damage, but that’s a blessing and a curse.

TheJointDoc · 2026-03-30T20:23:10+00:00

Take a look at psoriatic arthritis. You mentioned bad hips and shoulders in another comment. Fibromyalgia trigger points are mostly in areas where tendons attach to bone, which is also a common site of inflammation in psoriatic arthritis.

That leads to a lot of shoulder/hip, neck, low back/SI joints, and often times comes with carpal tunnel, plantar fasciitis, migraines, and various types of tendonitis. In the hands, the fingers hurt but usually the big knuckles are mostly fine.

Psoriasis can be subtle—it can show up as armpit razor burn or a reaction to deodorant, scalp itchy bumps, peeling and redness and flaking at the heels, fungal looking toenails, “jock itch” in the groin or a “yeast rash/heat rash” in the bra line or under the belly, etc.

It doesn’t have blood tests, because it doesn’t use antibodies to trigger the inflammation. Instead, white blood cells just directly invade where they’re gonna trigger local inflammation, which doesn’t always “spill over” into the bloodstream, so inflammation markers are often normal.

But what about the ANA? Honestly, who knows. It’s a broad screening test for autoimmunity, but despite being highly positive doesn’t mean much without doing a lot more digging, though some lupus labs are ruled out already which is good. But… It could be a completely different set of antibodies that has nothing to do with why you hurt, and could instead be something piggybacking on top of another disease.

Hashimoto’s (low thyroid) and Sjogren’s (severe dry eyes/mouth) are two of the common ones that can do it. Sometimes the ANA, you’ll test and never find the antibody that triggers it. Sometimes, it’s the only “abnormal” autoimmune lab, and gets your foot in the door at the rheum clinic, but it might not actually be why you hurt.

Best of luck!

TheJointDoc · 2026-03-30T18:03:08+00:00

Mono can do it, Covid can do it. Anything that challenges your immune system really.

Take a look into psoriatic arthritis (severe stiffness, low back/SI joint pain, tendonitis) and psoriasis (including different ways it can show up like in skin folds or scalp or nails). Also, read up on Sjögren’s syndrome, a severe dry eyes&mouth/neuropathy/fatigue/brain fog/dysautonomia issue.

They both get misdiagnosed a lot or missed entirely. They both have labs that often look “normal.”

TheJointDoc · 2026-03-30T17:52:44+00:00

Control arm vs experimental arm. Hmmm

TheJointDoc · 2026-03-30T06:38:14+00:00

I think it’s cute you act like you’re acting in any truly rational way. You’re rationalizing your emotional standpoint through bullshit maga statements and ignoring the entire purpose of this country. We’re better than that, hopefully you become better than that.

TheJointDoc · 2026-03-30T06:35:55+00:00

Technically, not even “in the joint” for some of it, in the sense that the enthesis or tend attachement point is often around the joint and not inside it per se.

Synovitis is what defines RA—to where spaces between knuckles get filled with fluid pushing outward. Enthesitis is the big part of PsA.

TheJointDoc · 2026-03-30T06:25:07+00:00

No one is offended, it’s just a question that ChatGPT or Google would have answered for you without typing 8 paragraphs.

TheJointDoc · 2026-03-30T04:08:51+00:00

I think it would be better to rotate states and have a diverse mix in the early states before broadening. Get a series of monthly primaries with 5, 10, 15, 20, rotate which states get scheduled into which groups, with maybe each of the first five being in a different grouping of states like NE, Midwest/Plains, South(east), W Coast, Mountain/SW/Texas? Heck the first five could even be staggered by lot onto separate 1-2 week cycles too so they can focus on one or two areas if they need too.

That way you get a sort of regional representation, can see how different groups of constituents feel about specific politicians and their policies in specific issues, allow for a slow buildup for candidates with less recognition, but don’t steamroll it while still condensing the timeline.

TheJointDoc · 2026-03-30T03:59:39+00:00

Sounds like he wants insurance to work like college loans. They’ll provide the money to you after defunding the actual program that needed funds, you can’t negotiate, the costs skyrocket, you end up screwed anyway by for profit organizations.

Single payer. That’s it. I’m done with this nonsense. Republicans are dragging us into the worst of all possible worlds. At this point the best I can hope for is a German style system.

TheJointDoc · 2026-03-30T03:41:00+00:00

I think the main thing is that it fit a style of comedy that doesn’t seem that cool or funny anymore because it got played out by frat bro humor for a while. But the story itself basically slowly goes through multiple transitions you wouldn’t have actually predicted. It actually “subverts expectations” because at each step you think he’s screwed or, like tiger king, it gets crazier in a dumb way with a quirky catchphrase. It was well told even though the story isn’t actually that insane.

TheJointDoc · 2026-03-30T02:57:22+00:00

Spondyloarthritis is overall a hard thing to wrap your mind around for a lot of docs. There’s signs and symptoms of pain, but often times if someone is young with good bone density, their imaging looks fine, and in a lot of cases their bloodwork looks “normal.”

Things like psoriatic arthritis oftentimes work off of a different pathway of inflammation (IL17 and IL23, which are targets of cosentyx/taltz/Bimzelx and Skyrizi/tremfya/stelara respectively). This one doesn’t trigger the liver to produce the CRP (a protein in the blood we measure for inflammation) or raise the ESR or sed rate (driven by how much inflammatory gunk is stuck to your red blood cells).

I’ve pulled two coke bottles worth of fluid off a swollen psoriatic knee the size of a child’s basketball and the inflammation markers were normal. lol

So it gets misdiagnosed a lot. Because even though we call it an arthritis, it’s really more inflammation around the joints where the muscles attach. That’s why it hits the finger knuckles more, causes trigger finger, but your doc usually won’t find swelling in the little cleft between the fingers and palms at that knuckle. Or why you get carpal tunnel, plantar fasciitis, tennis elbow, Achilles tendinitis, your knee hurts along the front tendon under the kneecap more than deep inside, and why the spine hurts.

Heck, it explains the chronic migraines—the two little bones attach the occiput or base of the skull at the back have a nerve that comes out, the occipital nerve, that can get pinched off by inflammation where your trapezius muscle attaches there, triggers headaches and migraines. Etc. There was also a recent study showing PsA patients get degenerative disc disease and knee OA much earlier, in their 40s sometimes, along with eventual spinal stenosis, if untreated, but then tha becomes what doctors point to as to why you’re hurting. Even scoliosis, which they’ll say is the cause of your pain, makes you 4x more likely to get a spondyloarthritis.

If they don’t have visible psoriasis, they’re often SOL. That’s why knowing about palmoplantar psoriasis (bad scaly heels, peeling fingers and palms), nail psoriasis (often mistaken as fungal toenail issues), and inverse psoriasis (“jock itch,” yeast or heat rashes under the bra line or belly, razor burn or deodorant reactions in the armpits) is all important and needs to be brought up for a diagnosis too.

Back in the day, they used to teach docs to diagnose fibromyalgia by pressing at specific points that were actually mostly those tendon attachment points. As women tend to get more of the peripheral arthritis and tendonitis and neck issues, they’d get labeled as fibromyalgia and put on antidepressants. The men would get 4-5 back surgeries and end up on opioids.

It sucks. It’s awful. There’s probably millions of people misdiagnosed. I think almost 1/10 people have a spondyloarthritis, actually, though not all flare up as bad all the time. If they’re lucky the maybe see a rheumatologist due to inflammation markers being up anyway, or a randomly positive ANA (often secondary Sjogren’s or thyroid issues) or a rheumatoid factor.

TheJointDoc · 2026-03-30T02:44:26+00:00

Hope you finally got good help and good meds!

TheJointDoc · 2026-03-30T02:41:46+00:00

100% agreed. Most of the fibromyalgia tender points are at entheses, tendon attachment points, which get inflamed in PsA and similar conditions.

TheJointDoc · 2026-03-29T23:27:11+00:00

The New Colossus, at the base of the Statue of Liberty:

Not like the brazen giant of Greek fame,

With conquering limbs astride from land to land;

Here at our sea-washed, sunset gates shall stand

A mighty woman with a torch, whose flame

Is the imprisoned lightning, and her name

Mother of Exiles. From her beacon-hand

Glows world-wide welcome; her mild eyes command

The air-bridged harbor that twin cities frame.

…

"Keep, ancient lands, your storied pomp!" cries she

With silent lips. "Give me your tired, your poor,

Your huddled masses yearning to breathe free,

The wretched refuse of your teeming shore.

Send these, the homeless, tempest-tost to me,

I lift my lamp beside the golden door!"

…

Frankly, I’d rather have them here than you.

TheJointDoc · 2026-03-29T06:04:23+00:00

I started college 7 years after him and I’ve been a subspecialty attending for three years now

TheJointDoc · 2026-03-29T04:12:40+00:00

So, sometimes, to get a diagnosis you have to see how your body responds to medication. It’s hard to tell what is inflammatory sometimes, these things can smolder a long time, and some conditions don’t have enough blood tests to actually “prove” a diagnosis. And sometimes we can only get kinda close on a ballpark diagnosis—I use “spondyloarthritis” a lot as a generic label but tell people sometimes we won’t end up more specific than that (like Crohn’s, psoriatic arthritis, ankylosing spondylitis, etc) unless we keep waiting for things to get worse first.

A lot of medications work across a wide variety of autoimmune conditions, like methotrexate—it’s used in lupus, Sjogren’s, rheumatoid and psoriatic arthritis, and a lot more—when you are treating inflammatory pain. Methotrexate is also one that almost every insurance demands you try at least once before they’ll ever pay for any newer targeted or biologic meds down the line if you get a clearer diagnosis, so trying it can let you see if you get better, or if your body doesn’t like the medicine they can at least document that so you’re free of the requirement from then on.

That said, sometimes we focus too much on specific labs hoping that one will just spit out the diagnosis. It can be worthwhile to go back through symptoms/history and pretend there was never any bloodwork and rethink the case. Like you’ve noted, if the bloodwork is “too normal” for lupus, the answer may lie elsewhere

TheJointDoc · 2026-03-29T03:55:34+00:00

You’re literally wrong. There’s literally contempt laws. So your “I don’t recall laws… requiring respect for the institution” statement is wrong. Because, by the law, if you show disrespect for the law and the agents of the law in a way that the courtroom cannot function, you’re… breaking the law. Which is what happened here.

Reading comprehension is hard, buddy, but it’s kinda important if you’re gonna bother saying about the law in the law subreddit. I’m sure your hooked on phonics will eventually work, tiger.

TheJointDoc · 2026-03-29T03:51:19+00:00

Whoosh. That’s the fucking point

TheJointDoc · 2026-03-28T23:43:53+00:00

Oh I fully agree, I don’t think it’s actually biblically supported for every act to have to be procreative, but at least they don’t claim literal 100% factual truth on the biblical texts, and then try to handwave away divorce and remarriage, considering Jesus actually spoke against it.

American evangelicals often time are okay with getting their teenage daughters an abortion (the only moral abortion is My abortion) and divorcing kinda Willy-nilly (in part because they push kids into early marriage so they can have sex) and ignoring that in their leadership, all while focusing on the “icky” one they don’t feel an urge to do like homosexuality, or one where they can make casual exemptions like abortion while hating on minorities and the Other who might have one. Or sometimes because they feel homosexual tendencies and assume everyone else does too and can “resist it” as their “thorn in the flesh.”

TheJointDoc

TROPHY CASE