Thank you Drs. Julie and Chris, for once again daring to stick your heads above the parapet by simply speaking truth, and daring to question the current narrative being shoved down our throats. It’s shocking that we have reached a point where it is deemed necessary for taxpayers to pick up the tab for a biological man who wants to surgically create a vagina whilst also maintaining his penis, and yet another citizen must pay for remediation for varicose veins. It seems we’ve lost our minds if collectively we’re too afraid to take a stand against this. #TruthOverTribe
Back at the turn of the century I did a medicolegal report on a man in wheelchair after an accident, with severe chronic pain and immobility....he had been through all the usual over a few years and had persuaded a surgeon to try amputation of the leg as a last resort....indeed was scheduled for the surgery. Then the lawyers sent me the surveillance video of him trotting round on an extensive shopping trip with his wife and his case collapsed. He was essentially willing to sell his leg for 6 figure compensation......with his wife's connivance. The boundaries between personality disorder, Munchausen's, social contagion, hysteria and fraud are murky indeed! As we used to say in Yorkshire: "There's nowt so queer as folk", a comment that will get you 20 years without the option as a hate criminal in multiple jurisdictions these days. (love the Dalrymple quote....spot on as usual!)
Wow Duncan! That is an incredible story. Having worked in injury management and assessment for nearly 2 decades I've seen some cases that are similar although not as extreme, including a guy who was scheduled for neck surgery as part of his quest to get the "disabled for life" stamp (and thus a large settlement from WCB) until surveillance showed that he had been working installing decks and roofs with his family member, under-the-table of course. His claim that he couldn't possibly do his desk job fell apart.
This touches on the issue of how bad our surgical selection has become in the days of "The customer is always right". Which reminds me of the medical adage "A competent surgeon knows how to operate. A good surgeon knows when to operate. A great surgeon knows when NOT to operate."
I read about the guy with the fingers (now without the fingers) the other day, and honestly didn’t know what to think.
There’s the aspect of “following the line of least resistance”, meaning that the health care system supported the quick and dirty route of taking off the fingers rather than the long and complicated path of “fixing” his psychiatric disorder, although maybe it was unfixable. The reports suggest that he’s now “cured”, although you have to hope that he doesn’t develop a phantom limb syndrome or transfer his aversion to some other body part. He could end up having his limbs (or body) removed, piece by piece! Probably a short story in that idea…
There’s the obvious parallel to people with gender dysphoria wanting their body parts removed and/or rearranged. As you’ve pointed out, it’s a “thin edge of the wedge” scenario. Once you’ve agreed that some form of surgery is “reasonable”, then where do you draw the line? And in agreeing to these surgeries because they supposedly have benefits, what’s the thinking about the harms? It’s a pretty complex conversation about the benefits of losing the vagina and uterus that you hate and having them replaced, through horribly complicated surgery, with a penis that isn’t really a penis, knowing that every conversation you’ll ever have with a potential sexual partner is going to require an explanation of what you have, what you don’t have, and how your parts work (or don’t). Does the surgery make you whole, or does it make you flawed in a different way? Is informed consent, in these cases, truly informed?
It also ties in with a longer trend re plastic surgery, which used to be divided into the stuff that was “medically necessary” (like correcting disfiguring scars) and the other stuff that was “cosmetic” (breast reductions, tummy tucks, etc.). The cosmetic stuff was supposedly paid for by the patient and given lower priority in the hospital, but over time there’s been a drift to approving some cosmetic surgeries under certain circumstances (ie breast reductions when the breasts are so massive as to cause neck pain). Nonetheless, once we went down the path of “it’s theoretically possible, so we’ll start doing it, and we’ll let the patients decide what they want done”, then you’ve definitely gone over to a consumer-driven model of health care.
I wasn’t a plastic surgeon. I was a family doctor. One of my many concerns with consumer driven medicine was the phase when cannabis was approved for medical use. All of a sudden, I found myself filling out forms for people who used cannabis, unbeknownst to me, in doses I knew nothing about, for problems I never knew they had, which could have been treated by other clinically proven methods. And I was supposed to affirm that their cannabis use was medically necessary!
In any case, as we travel further down this path of giving the patients what they think they want, regardless of the actual need or the potential harms, there is a huge impact on the healthcare system, which is already struggling. The bigger cases are obviously a factor, but I can quote dozens of examples of things that come up in family practice, each individually cheap but collectively quite expensive. There’s the patients who want certain tests that they don’t really need. Or certain drugs. Or massage therapy because their insurance pays for it. Or a note for time off work because they have unused sick days. Etc.
I was talking to a fellow yesterday who came here from Eastern Europe ten years ago. He was wondering why the health care system here is so dysfunctional. The answer, increasingly, is that “you can’t always get what you need, but if you try sometimes, you’ll get what you want” (with apologies to the Rolling Stones).
I was on a national Health Canada convened committee around 2014 on creating rules around "medical" marijuana. I got to see how the sausage was made. Our conclusion was more or less that there weren't legitimate reasons for marijuana to be prescribed. Some people like it, and feel better when they are chronically a bit stoned. Fair enough I guess. But asking doctors to rubber-stamp that is no different than asking for a certificate saying that for medical reasons you have to drink 3 (or 6, or 10) beer every evening. Many of my patients don't feel well unless they do that. They don't sleep well, they are anxious, etc. Alcohol relieves those symptoms. But is it "medical"?
Part of the problem that you get into here is caused by "free" healthcare. I get into that here: https://pairodocs.substack.com/p/when-its-everyones-money-its-no-ones I don't think there are any solutions unless we move away from "free" everything in healthcare, and move to what medical insurance was first envisaged to be - coverage for exigent circumstances. Perhaps socialized healthcare is viable, but not if it covers "everything" - because "everything" translates into "whatever patients want" in practical terms.
Because of that, a smoke alarm is being installed in the new baby ward at Victoria General Hospital due to drug use by parents and families, and the need for staff to don respirators and move vulnerable babies. New mothers are smoking fentanyl in the maternity wards.
The emergency departments are now dangerous places. Please read this news report: https://bit.ly/3VNg77w
VANDU has a say in deciding drug policy because "people with lived experiences" are considered experts just because they say they're experts.
I am pleased that you have shown me the medical terms on why all of this is happening.
So how do we get out of this mess? Two ways.
1.) Let it rip until it gets so extreme that much of society collapses. Or:
2.) Elect an extreme right-wing, or left-wing, political party that will shutdown this circus, scrap these laws and bring back the mental hospitals and prisons.
Or, some of kind of semi-authoritarian steps in and fixes it by force, and either way isnt going to be pretty, and not good for the federation.
My sense is that the first option is more likely, that things will just degrade, but I also see the potential rise of two parallel societies. If you look at this substack, and the video embedded of a discussion at the California State Assy, its abundantly clear that two parallel societies have already developed there, two societies with irreconcilable differences.
I don't know what happens next, in that scenario. Do states just empty of people who cant fit in, does the US Union eventually fracture, as does Canada?
At the end of the day, I an am applied scientist, so in a way I know how a lot of this ends, with reality and Mother Nature and her laws forcefully reasserting themselves, but I could anticipate a lot of damage in the meantime before that happens.
The taxpayers are having to fund all of this and the money will quickly run out.
The Canadian taxpayers are paying for COVID handouts, drug addicts that are going to be wards of the state until they die, the Ukrainian war, refugees, illegal immigrants, the need for up to a million social housing units, a health care system that is badly strained.
continued money printing keeps the system afloat, and the inflation it causes is a hidden tax to anyone who has actually saved money. Fewer and fewer citizens are productive net contributors to society and more and more are encouraged to instead drop out and suckle the government teat in some fashion (welfare, disability, early pensions, baby bonuses, and more). We increasingly discourage and tax any productivity while subsidizing and thus encouraging sloth and graft.
Sadly, we are reaping what we sow. The system is clearly unsustainable but sadly so many people now benefit from it that our democracy sustains the unsustainable.
Good observations. I agree the current situation is unsustainable, some perturbation will make it go unstable, but I am afraid to think about what real instability in Canada would look like. I fully agree with all you say, that the state is creating more and more dependents, and that not good for anyone, for lots of reasons including the fact that its an impediment to human flourishing, and an assault on human dignity.
There is so much in this post of yours that forces me to ask, "where does one begin to unravel the craziness that awaits us at every turn"? Why in the world do doctors go ahead with the cutting off of perfect fingers, legs, breasts, penises, etc? Where is the First Do No Harm oath? Where does conscience play a role? Maid is ramping up where all that ends. Every day we awaken to more "unbelievable things happening". All by design, I think. Society is breaking down. The people and institutions we used to look up to, somewhat anyway, have gone down the drain. It feels to me, that this is a big free for all, and we are freefalling into the biggest black hole we can imagine. Hang on everyone - the ride is going to be rough.
How did medicine get here? By a 1000 post-modern breadcrumbs left that were too small to see or question but that are now psychopathic in sum. We have Edward Scissorhands as doctors and doctors as heretics/witches being burned at the metaphorical stake.
May the reconning for this and gender “medicine” be swift and severe. Across the board.
How far this might go? Is the right question to ask. I cant say, who can? The amount of 'responsible' people out there, with real authority, who have bad judgment, is really quite scary.
Thank you for tackling these stories. Interesting this activist group - WPATH - World Professional Association of Transgender Health seems guilty of copywright and misleads the troubled. They really mean WRATH. Leaders name starts with S.
Thank you Drs. Julie and Chris, for once again daring to stick your heads above the parapet by simply speaking truth, and daring to question the current narrative being shoved down our throats. It’s shocking that we have reached a point where it is deemed necessary for taxpayers to pick up the tab for a biological man who wants to surgically create a vagina whilst also maintaining his penis, and yet another citizen must pay for remediation for varicose veins. It seems we’ve lost our minds if collectively we’re too afraid to take a stand against this. #TruthOverTribe
Back at the turn of the century I did a medicolegal report on a man in wheelchair after an accident, with severe chronic pain and immobility....he had been through all the usual over a few years and had persuaded a surgeon to try amputation of the leg as a last resort....indeed was scheduled for the surgery. Then the lawyers sent me the surveillance video of him trotting round on an extensive shopping trip with his wife and his case collapsed. He was essentially willing to sell his leg for 6 figure compensation......with his wife's connivance. The boundaries between personality disorder, Munchausen's, social contagion, hysteria and fraud are murky indeed! As we used to say in Yorkshire: "There's nowt so queer as folk", a comment that will get you 20 years without the option as a hate criminal in multiple jurisdictions these days. (love the Dalrymple quote....spot on as usual!)
Wow Duncan! That is an incredible story. Having worked in injury management and assessment for nearly 2 decades I've seen some cases that are similar although not as extreme, including a guy who was scheduled for neck surgery as part of his quest to get the "disabled for life" stamp (and thus a large settlement from WCB) until surveillance showed that he had been working installing decks and roofs with his family member, under-the-table of course. His claim that he couldn't possibly do his desk job fell apart.
This touches on the issue of how bad our surgical selection has become in the days of "The customer is always right". Which reminds me of the medical adage "A competent surgeon knows how to operate. A good surgeon knows when to operate. A great surgeon knows when NOT to operate."
Great article!
I read about the guy with the fingers (now without the fingers) the other day, and honestly didn’t know what to think.
There’s the aspect of “following the line of least resistance”, meaning that the health care system supported the quick and dirty route of taking off the fingers rather than the long and complicated path of “fixing” his psychiatric disorder, although maybe it was unfixable. The reports suggest that he’s now “cured”, although you have to hope that he doesn’t develop a phantom limb syndrome or transfer his aversion to some other body part. He could end up having his limbs (or body) removed, piece by piece! Probably a short story in that idea…
There’s the obvious parallel to people with gender dysphoria wanting their body parts removed and/or rearranged. As you’ve pointed out, it’s a “thin edge of the wedge” scenario. Once you’ve agreed that some form of surgery is “reasonable”, then where do you draw the line? And in agreeing to these surgeries because they supposedly have benefits, what’s the thinking about the harms? It’s a pretty complex conversation about the benefits of losing the vagina and uterus that you hate and having them replaced, through horribly complicated surgery, with a penis that isn’t really a penis, knowing that every conversation you’ll ever have with a potential sexual partner is going to require an explanation of what you have, what you don’t have, and how your parts work (or don’t). Does the surgery make you whole, or does it make you flawed in a different way? Is informed consent, in these cases, truly informed?
It also ties in with a longer trend re plastic surgery, which used to be divided into the stuff that was “medically necessary” (like correcting disfiguring scars) and the other stuff that was “cosmetic” (breast reductions, tummy tucks, etc.). The cosmetic stuff was supposedly paid for by the patient and given lower priority in the hospital, but over time there’s been a drift to approving some cosmetic surgeries under certain circumstances (ie breast reductions when the breasts are so massive as to cause neck pain). Nonetheless, once we went down the path of “it’s theoretically possible, so we’ll start doing it, and we’ll let the patients decide what they want done”, then you’ve definitely gone over to a consumer-driven model of health care.
I wasn’t a plastic surgeon. I was a family doctor. One of my many concerns with consumer driven medicine was the phase when cannabis was approved for medical use. All of a sudden, I found myself filling out forms for people who used cannabis, unbeknownst to me, in doses I knew nothing about, for problems I never knew they had, which could have been treated by other clinically proven methods. And I was supposed to affirm that their cannabis use was medically necessary!
In any case, as we travel further down this path of giving the patients what they think they want, regardless of the actual need or the potential harms, there is a huge impact on the healthcare system, which is already struggling. The bigger cases are obviously a factor, but I can quote dozens of examples of things that come up in family practice, each individually cheap but collectively quite expensive. There’s the patients who want certain tests that they don’t really need. Or certain drugs. Or massage therapy because their insurance pays for it. Or a note for time off work because they have unused sick days. Etc.
I was talking to a fellow yesterday who came here from Eastern Europe ten years ago. He was wondering why the health care system here is so dysfunctional. The answer, increasingly, is that “you can’t always get what you need, but if you try sometimes, you’ll get what you want” (with apologies to the Rolling Stones).
Great comment Rick.
I was on a national Health Canada convened committee around 2014 on creating rules around "medical" marijuana. I got to see how the sausage was made. Our conclusion was more or less that there weren't legitimate reasons for marijuana to be prescribed. Some people like it, and feel better when they are chronically a bit stoned. Fair enough I guess. But asking doctors to rubber-stamp that is no different than asking for a certificate saying that for medical reasons you have to drink 3 (or 6, or 10) beer every evening. Many of my patients don't feel well unless they do that. They don't sleep well, they are anxious, etc. Alcohol relieves those symptoms. But is it "medical"?
Part of the problem that you get into here is caused by "free" healthcare. I get into that here: https://pairodocs.substack.com/p/when-its-everyones-money-its-no-ones I don't think there are any solutions unless we move away from "free" everything in healthcare, and move to what medical insurance was first envisaged to be - coverage for exigent circumstances. Perhaps socialized healthcare is viable, but not if it covers "everything" - because "everything" translates into "whatever patients want" in practical terms.
Why on earth would any average person trust a medical system that removes healthy appendages?
We are so far past "health care."
"HELL-th Care".....
B.C. Premier David Eby decriminalized drug use.
Because of that, a smoke alarm is being installed in the new baby ward at Victoria General Hospital due to drug use by parents and families, and the need for staff to don respirators and move vulnerable babies. New mothers are smoking fentanyl in the maternity wards.
The emergency departments are now dangerous places. Please read this news report: https://bit.ly/3VNg77w
VANDU has a say in deciding drug policy because "people with lived experiences" are considered experts just because they say they're experts.
I am pleased that you have shown me the medical terms on why all of this is happening.
So how do we get out of this mess? Two ways.
1.) Let it rip until it gets so extreme that much of society collapses. Or:
2.) Elect an extreme right-wing, or left-wing, political party that will shutdown this circus, scrap these laws and bring back the mental hospitals and prisons.
We may lose our democracy either way.
No matter what, we'll have a huge hangover.
As to your two solutions, I can only agree. Either the madness continues until everything falls apart, literally, check this out: https://www.palladiummag.com/2023/06/01/complex-systems-wont-survive-the-competence-crisis/
Or, some of kind of semi-authoritarian steps in and fixes it by force, and either way isnt going to be pretty, and not good for the federation.
My sense is that the first option is more likely, that things will just degrade, but I also see the potential rise of two parallel societies. If you look at this substack, and the video embedded of a discussion at the California State Assy, its abundantly clear that two parallel societies have already developed there, two societies with irreconcilable differences.
I don't know what happens next, in that scenario. Do states just empty of people who cant fit in, does the US Union eventually fracture, as does Canada?
At the end of the day, I an am applied scientist, so in a way I know how a lot of this ends, with reality and Mother Nature and her laws forcefully reasserting themselves, but I could anticipate a lot of damage in the meantime before that happens.
The taxpayers are having to fund all of this and the money will quickly run out.
The Canadian taxpayers are paying for COVID handouts, drug addicts that are going to be wards of the state until they die, the Ukrainian war, refugees, illegal immigrants, the need for up to a million social housing units, a health care system that is badly strained.
continued money printing keeps the system afloat, and the inflation it causes is a hidden tax to anyone who has actually saved money. Fewer and fewer citizens are productive net contributors to society and more and more are encouraged to instead drop out and suckle the government teat in some fashion (welfare, disability, early pensions, baby bonuses, and more). We increasingly discourage and tax any productivity while subsidizing and thus encouraging sloth and graft.
Sadly, we are reaping what we sow. The system is clearly unsustainable but sadly so many people now benefit from it that our democracy sustains the unsustainable.
Good observations. I agree the current situation is unsustainable, some perturbation will make it go unstable, but I am afraid to think about what real instability in Canada would look like. I fully agree with all you say, that the state is creating more and more dependents, and that not good for anyone, for lots of reasons including the fact that its an impediment to human flourishing, and an assault on human dignity.
Same here in the US. We are screwed.
There is so much in this post of yours that forces me to ask, "where does one begin to unravel the craziness that awaits us at every turn"? Why in the world do doctors go ahead with the cutting off of perfect fingers, legs, breasts, penises, etc? Where is the First Do No Harm oath? Where does conscience play a role? Maid is ramping up where all that ends. Every day we awaken to more "unbelievable things happening". All by design, I think. Society is breaking down. The people and institutions we used to look up to, somewhat anyway, have gone down the drain. It feels to me, that this is a big free for all, and we are freefalling into the biggest black hole we can imagine. Hang on everyone - the ride is going to be rough.
How did medicine get here? By a 1000 post-modern breadcrumbs left that were too small to see or question but that are now psychopathic in sum. We have Edward Scissorhands as doctors and doctors as heretics/witches being burned at the metaphorical stake.
May the reconning for this and gender “medicine” be swift and severe. Across the board.
Hey, I came across this, as a response to how far this can go. This is a guy I follow and like. https://substack.com/inbox/post/143338971
How far this might go? Is the right question to ask. I cant say, who can? The amount of 'responsible' people out there, with real authority, who have bad judgment, is really quite scary.
I identify as Mary, Queen of Scots. Will you please remove my head?
Thank you for tackling these stories. Interesting this activist group - WPATH - World Professional Association of Transgender Health seems guilty of copywright and misleads the troubled. They really mean WRATH. Leaders name starts with S.
My "lived experience", currently, is that we've gone completely mad.
"Anyone who can make you believe absurdities can make you commit atrocities." — Voltaire