The despair that was palpable among a few of my physician friends was rooted in a terrible and intractable truth: that patients mostly didn't take care of themselves or care for their own health, and then approached the doctor to "fix them up".
So the physicians are typically faced with a thankless job. It is not their job to cure or heal diseases, but to treat them. And there have been multiple times I myself have confronted a problem with my PCP, and do you know what I hoped to hear? "Rest a while" or "here's a diet I suggest" or "avoid <xyz> if you can" -- just pragmatic advice in the form of "doctor's orders" because I am the type of guy who likes to be told what to do by authority figures, you know?
But physicians are not in that business either. And so people come into the office, obese, with developing chronic disorders that will never get any better; they are stuck in their ways and can't follow good advice anyway; they're ignorant and poor, and their main sources of food are 7-Eleven and Burger King.
So if a person goes into medicine with the goal of "helping people" then they can really become disillusioned by the process itself. There are no miracles worked except by showing compassion, exercising patience, and sharing wisdom.
This is a frustration, but burnout among doctors (senior and junior) is largely due to either corporatisation of private care or defunding of public care, leading to unmanageable workloads, scapegoating after patient harm events, and loss of autonomy.
> that patients mostly didn't take care of themselves or care for their own health, and then approached the doctor to "fix them up".
The American health care system has failed people. Capitalism wants people to consume unhealthy things to unhealthy degrees. Your job (your boss and the shareholders) are killing you.
I am pretty fit and have been for a majority of my life, but from my mid-20's to 40 I wasn't any where near as fit. Why? Because of professional obligations, mandatory uncompensated overtime, ridiculous deadlines and budgets due to the capital classes short-term desires to live bloated lifestyles because they are deeply unhappy.
I recently moved back to the U.S. The obesity is incredible. And part of me does think people should take some responsibility for what they eat and how little they move, but I also have compassion because when I had a 50+ hour work week and spent 15 hours a week commuting I had just enough time to sleep and watch a movie before heading back to work. That led to unhealthy food and exercise habits and probably too much alcohol.
What helped me? Quitting full-time employment (indentured servitude). I have been self-employed for 11 years, I dropped (and kept off) 20 pounds within a year of not working for others. I rarely drink.
But not everyone is willing to take that sort of risk. And most people have lifestyle bloat (subscriptions, expensive cars, expensive clothes, houses full of cheap Chinese electronics, new iPhones every 2years, unhealthy, expensive food delivered to their doors daily, etc.).
There are billions being spent every day to incentivize people to consume shit. Most individuals don't have a chance at combating this messaging, as critical thinking is in short supply (looking at you people who voted for and support this clown car of an administration in power in the US right now).
Point is, you're not wrong, but let's not just blame "poor people who eat at 7-11". This entire country (world) is sick.
Medical school and residency is extremely stressful for extremely stupid reasons.
Medical school is still rooted in the 1950s in a lot of ways, with an emphasis on memorization which is just patently ridiculous in an age of smartphones and search engines (not even factoring in the advent of LLMs). Residency involves working shifts that are best described as absolutely insane, in an environment that would be stressful enough as a five-hour shift, for little pay and even less prestige.
Doctors should absolutely be able to handle stress, and I can appreciate some amount of "hell week" ritual to make sure all graduates are battle-hardened, but all reports I've seen indicate that the current state of affairs has way too much fire in the trial-by-fire, and the trial itself dwindles on way past the point of any benefit.
It ends up producing doctors who are very, very good at doing a lot of busywork on deadline and getting yelled at, but aren't always the greatest at human intuition or thinking outside the flowchart, which is often to the detriment of patients.
Should violinists be? I really doubt it. What about truck drivers? It doesn't seem obvious at all. Tired people make nothing but bad decisions, and inducing someone to work when they're tired other than due to, for example, war, should probably not be permitted. But if so, they should probably be on stimulants, just as fighter pilots sometimes are.
A violinist shouldn't get stage fright during a Vivaldi concert. A truck driver should know what to do if the brakes fail. A doctor shouldn't get flustered and try to leave the room when the emergency alert monitors are going off and people are yelling.
I don't know why you're attacking me on those lines. Do you really think I believe "fatigue" is the same as "battle-hardening"? Like, considering that I actually wrote "shifts that are best described as absolutely insane" and "way too much fire in the trial-by-fire".
You did say 'hell week' which I interpret as something involving fatigue and possibly even lack of sleep, as the final military exercises in certain military training courses often do.
It is correct that reforms are needed. It is interesting however that this generation has the lowest mental toughness, since the standards did not necessarily increase but the people changed and could not handle the stress, wait until the tough times come.
* 25y of constant combat deployments around the world
* 2008 recession
* 2026-ish recession
* Loss of company pensions and stability
* Massive housing crisis in availability of type of homes needed, and costs - builders are only incentivized to build upper middle class+ housing in many areas
* Gig work where people are working 3 jobs with no benefits or retirement becoming more popular
* College financial cost unsustainable
* Massive increase in school and public shootings
* Covid
Any ideas of stability in US society that may have come from their parents simply do not exist anymore. The path of a middle class life for most people in the US is gone.
A gazillion more things I'm not thinking of.
I'm getting close to 50, and any time somebody talks about how "x,y,z generation is weak", not even 99% of the time, but 100% of the time, I know the person saying that is simply incompetent.
> any time somebody talks about how "x,y,z generation is weak", not even 99% of the time, but 100% of the time, I know the person saying that is simply incompetent.
Don't assume incompetence when simple malice can explain the observations... especially when the topic is a blame game.
Isn’t this list seen as reasons intentionally directed perseverance has eroded, since these events condition people to just react and survive on a shorter-term horizon? You two may be using different definitions of mental toughness. Just observing you two interact.
I mean, are you really trying to say that the 2010s were worse than the 1930s or getting drafted into armed combat in the 1910s, 1940s, 1950s, and 1960s? To me, that's just playing into the stereotype of millennials.
I didn't say anything along those lines. In fact, I want to highlight something in particular that I said that makes me wonder how much you wanted to react vs how much you actually read:
"Any ideas of stability in US society that may have come from their parents simply do not exist anymore."
I alluded to the 25 years of constant background combat deployments that most people aren't even aware of happening unless they are extremely impacted by it.
It seems like you're arguing against the statement that "This generation [which we'll assume refers to millenials] has the lowest mental toughness".
Then - again, by my reading here, so correct me if I'm misinterpreting you - you attempt to support your counterpoint with a list of events which - while certainly not great - pale, in my opinion, to the day-to-day fear of atomic war and the very real knowledge that even as things stand (e.g., without atomic war), your birthday could still be picked tomorrow, and within months you'll be shipped off to the killing fields. Simply put, it's possible for a thing to be bad, but not as-bad as another thing.
I don't think previous generations were under any illusion of societal stability, except possibly the baby boomers - and they had 'Nam, JFK/MLK, Kent State, Watergate, and COINTELPRO to snap them out of that.
Even with all the events you mention, US society is still far more stable than it was in the past. Of course, it'll seem much less stable if one only chooses to focus on the unstable, but I think it's fair to label that a you-problem.
> this generation has the lowest mental toughness, since the standards did not necessarily increase but the people changed and could not handle the stress, wait until the tough times come
A bunch of people in every generation say this.
My grandparents said it about those who got to skip growing up in the depression. Their grandparents about selling everything they owned and moving to America. Some days as I trudge through the snow to work uphill both ways I think of them.
I was searching for some ancient quotes describing the same sentiment and found a page with several quotes, including this one from Aristotle (4th century BCE):
"[Young people] are high-minded because they have not yet been humbled by life, nor have they experienced the force of circumstances.
...
They think they know everything, and are always quite sure about it."
Did the standards actually "not increased?" It is very easy to just assume younger people cant possibly have more challenges then we did. And very hard to admit when they actually face harder competition then we did.
A big reason is massive educational debt. It makes it difficult to even just drop out. Medical school should be 99% free, with a 1% charge to ensure that people are not wasting their time altogether.
https://archive.ph/LTeON
The despair that was palpable among a few of my physician friends was rooted in a terrible and intractable truth: that patients mostly didn't take care of themselves or care for their own health, and then approached the doctor to "fix them up".
So the physicians are typically faced with a thankless job. It is not their job to cure or heal diseases, but to treat them. And there have been multiple times I myself have confronted a problem with my PCP, and do you know what I hoped to hear? "Rest a while" or "here's a diet I suggest" or "avoid <xyz> if you can" -- just pragmatic advice in the form of "doctor's orders" because I am the type of guy who likes to be told what to do by authority figures, you know?
But physicians are not in that business either. And so people come into the office, obese, with developing chronic disorders that will never get any better; they are stuck in their ways and can't follow good advice anyway; they're ignorant and poor, and their main sources of food are 7-Eleven and Burger King.
So if a person goes into medicine with the goal of "helping people" then they can really become disillusioned by the process itself. There are no miracles worked except by showing compassion, exercising patience, and sharing wisdom.
This is a frustration, but burnout among doctors (senior and junior) is largely due to either corporatisation of private care or defunding of public care, leading to unmanageable workloads, scapegoating after patient harm events, and loss of autonomy.
> that patients mostly didn't take care of themselves or care for their own health, and then approached the doctor to "fix them up".
The American health care system has failed people. Capitalism wants people to consume unhealthy things to unhealthy degrees. Your job (your boss and the shareholders) are killing you.
I am pretty fit and have been for a majority of my life, but from my mid-20's to 40 I wasn't any where near as fit. Why? Because of professional obligations, mandatory uncompensated overtime, ridiculous deadlines and budgets due to the capital classes short-term desires to live bloated lifestyles because they are deeply unhappy.
I recently moved back to the U.S. The obesity is incredible. And part of me does think people should take some responsibility for what they eat and how little they move, but I also have compassion because when I had a 50+ hour work week and spent 15 hours a week commuting I had just enough time to sleep and watch a movie before heading back to work. That led to unhealthy food and exercise habits and probably too much alcohol.
What helped me? Quitting full-time employment (indentured servitude). I have been self-employed for 11 years, I dropped (and kept off) 20 pounds within a year of not working for others. I rarely drink.
But not everyone is willing to take that sort of risk. And most people have lifestyle bloat (subscriptions, expensive cars, expensive clothes, houses full of cheap Chinese electronics, new iPhones every 2years, unhealthy, expensive food delivered to their doors daily, etc.).
There are billions being spent every day to incentivize people to consume shit. Most individuals don't have a chance at combating this messaging, as critical thinking is in short supply (looking at you people who voted for and support this clown car of an administration in power in the US right now).
Point is, you're not wrong, but let's not just blame "poor people who eat at 7-11". This entire country (world) is sick.
Medical school and residency is extremely stressful for extremely stupid reasons.
Medical school is still rooted in the 1950s in a lot of ways, with an emphasis on memorization which is just patently ridiculous in an age of smartphones and search engines (not even factoring in the advent of LLMs). Residency involves working shifts that are best described as absolutely insane, in an environment that would be stressful enough as a five-hour shift, for little pay and even less prestige.
Doctors should absolutely be able to handle stress, and I can appreciate some amount of "hell week" ritual to make sure all graduates are battle-hardened, but all reports I've seen indicate that the current state of affairs has way too much fire in the trial-by-fire, and the trial itself dwindles on way past the point of any benefit.
It ends up producing doctors who are very, very good at doing a lot of busywork on deadline and getting yelled at, but aren't always the greatest at human intuition or thinking outside the flowchart, which is often to the detriment of patients.
Why do you think they should be battle hardened?
Should violinists be? I really doubt it. What about truck drivers? It doesn't seem obvious at all. Tired people make nothing but bad decisions, and inducing someone to work when they're tired other than due to, for example, war, should probably not be permitted. But if so, they should probably be on stimulants, just as fighter pilots sometimes are.
A violinist shouldn't get stage fright during a Vivaldi concert. A truck driver should know what to do if the brakes fail. A doctor shouldn't get flustered and try to leave the room when the emergency alert monitors are going off and people are yelling.
I don't know why you're attacking me on those lines. Do you really think I believe "fatigue" is the same as "battle-hardening"? Like, considering that I actually wrote "shifts that are best described as absolutely insane" and "way too much fire in the trial-by-fire".
You did say 'hell week' which I interpret as something involving fatigue and possibly even lack of sleep, as the final military exercises in certain military training courses often do.
It is correct that reforms are needed. It is interesting however that this generation has the lowest mental toughness, since the standards did not necessarily increase but the people changed and could not handle the stress, wait until the tough times come.
"This generation has the lowest mental toughness"
If you are in the US, in the past 25yr:
* 9/11
* 25y of constant combat deployments around the world
* 2008 recession
* 2026-ish recession
* Loss of company pensions and stability
* Massive housing crisis in availability of type of homes needed, and costs - builders are only incentivized to build upper middle class+ housing in many areas
* Gig work where people are working 3 jobs with no benefits or retirement becoming more popular
* College financial cost unsustainable
* Massive increase in school and public shootings
* Covid
Any ideas of stability in US society that may have come from their parents simply do not exist anymore. The path of a middle class life for most people in the US is gone.
A gazillion more things I'm not thinking of.
I'm getting close to 50, and any time somebody talks about how "x,y,z generation is weak", not even 99% of the time, but 100% of the time, I know the person saying that is simply incompetent.
> any time somebody talks about how "x,y,z generation is weak", not even 99% of the time, but 100% of the time, I know the person saying that is simply incompetent.
Don't assume incompetence when simple malice can explain the observations... especially when the topic is a blame game.
Isn’t this list seen as reasons intentionally directed perseverance has eroded, since these events condition people to just react and survive on a shorter-term horizon? You two may be using different definitions of mental toughness. Just observing you two interact.
I mean, are you really trying to say that the 2010s were worse than the 1930s or getting drafted into armed combat in the 1910s, 1940s, 1950s, and 1960s? To me, that's just playing into the stereotype of millennials.
I didn't say anything along those lines. In fact, I want to highlight something in particular that I said that makes me wonder how much you wanted to react vs how much you actually read:
"Any ideas of stability in US society that may have come from their parents simply do not exist anymore."
I alluded to the 25 years of constant background combat deployments that most people aren't even aware of happening unless they are extremely impacted by it.
Some more so than others, like the old Onion joke: https://theonion.com/soldier-excited-to-take-over-father-s-o...
> I didn't say anything along those lines.
It seems like you're arguing against the statement that "This generation [which we'll assume refers to millenials] has the lowest mental toughness".
Then - again, by my reading here, so correct me if I'm misinterpreting you - you attempt to support your counterpoint with a list of events which - while certainly not great - pale, in my opinion, to the day-to-day fear of atomic war and the very real knowledge that even as things stand (e.g., without atomic war), your birthday could still be picked tomorrow, and within months you'll be shipped off to the killing fields. Simply put, it's possible for a thing to be bad, but not as-bad as another thing.
I don't think previous generations were under any illusion of societal stability, except possibly the baby boomers - and they had 'Nam, JFK/MLK, Kent State, Watergate, and COINTELPRO to snap them out of that.
Even with all the events you mention, US society is still far more stable than it was in the past. Of course, it'll seem much less stable if one only chooses to focus on the unstable, but I think it's fair to label that a you-problem.
I'm pretty sure mainecoder, the person he was responding to, isn't 95 years old, so I think you can avoid any 1930s references :D
> this generation has the lowest mental toughness, since the standards did not necessarily increase but the people changed and could not handle the stress, wait until the tough times come
A bunch of people in every generation say this.
My grandparents said it about those who got to skip growing up in the depression. Their grandparents about selling everything they owned and moving to America. Some days as I trudge through the snow to work uphill both ways I think of them.
I was searching for some ancient quotes describing the same sentiment and found a page with several quotes, including this one from Aristotle (4th century BCE):
"[Young people] are high-minded because they have not yet been humbled by life, nor have they experienced the force of circumstances. ... They think they know everything, and are always quite sure about it."
https://history.stackexchange.com/questions/28169/what-is-th...
Did the standards actually "not increased?" It is very easy to just assume younger people cant possibly have more challenges then we did. And very hard to admit when they actually face harder competition then we did.
do you know how much smoking and drinking at work there was when this system was started???
A big reason is massive educational debt. It makes it difficult to even just drop out. Medical school should be 99% free, with a 1% charge to ensure that people are not wasting their time altogether.
Suicide was a major risk factor among young female doctors even in the aughts when I was young. The gender disparity was stark, at least in Czechia.
Overall gender split among completed suicides warry between countries. You can't entirely transfer it as too much depends on local specifics.
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