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      10-07-2012, 08:25 PM   #23
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Originally Posted by GrussGott View Post
As healthcare costs continue to rise and coverages wanes I think there's going to be more of this around hospitals and clinics.

Angry patients under financial pressure due to medical costs with weak or no coverage will assume any nice car in the lot is owned by the people sending him/her the huge bills.

I'd start thinking about parking on the street a block or so away
Point taken, but unfortunately, "angry patients" should read "angry doctors." I wish I could make everyone in America understand that rising healthcare costs are not due to rising salaries of physicians. Our salaries are stagnating, and in many cases declining, while our overhead costs steadily rise. In running a medical office (essentially being a small businessperson), we also are affected by rising health insurance premiums in what we pay to cover our office staff and ourselves and our families. The rent on our office spaces increases yearly, our staffs expect yearly raises, etc. The cost of doing business goes up yearly, as it does with any other business, but our reimbursement often goes down year to year. Insurance companies on a whim can declare that they will start paying us 15, 20, 30% less next year. Medicare similarly threatens cuts to our pay every year.

So why does healthcare get more and more expensive for all of us as patients? We as a society demand the best, most expensive, cutting-edge healthcare, but we don't want to pay for it. We have great technology, and accordingly, pharmaceutical companies make record profits, medical device companies make record profits (artificial joints, pacemakers, defibrillators, etc.), insurance companies make record profits, and malpractice attorneys make a killing (pun intended). Most physicians go into medicine because they enjoy the science, the challenge, and most importantly, taking care of people. They don't choose politics or business because that's not really their skillset. And unfortunately that's a downfall for us. Pharmaceutical companies, medical device companies, insurance companies, and especially attorneys are very politically connected, with strong, well-funded lobbies. They will always get their share and much more. Whenever anyone tries to put a cap on runaway malpractice lawsuits in NY State, the proposition gets shot down in the State Assembly. Why? The Speaker of the Assembly is Sheldon Silver, a personal injury attorney. We as physicians have focused on patient care, and left the politics to others, and now we're screwed. We're not organized enough to fight for ourselves or our patients. This needs to change.

I certainly sympathize with the working patient who struggles to pay their bills, and whose insurance premiums take an inappropriate share of their income. On the other hand, realize that there are plenty of people in society who do the following: 1) As a patient, receive a check for many thousands of dollars directly from their insurance company to be used to pay the physician fee for a surgery, etc., but instead deposit the money, use it to purchase a big-screen TV or pay off credit card bills, and refuse to pay their physician. They either lie and say they never received it (easily checked against bank records), or say that they didn't realize it was to be used to pay their doctor's bill, and now it's already spent, and they don't have any money left. Or 2) Have an expensive surgical procedure performed without having any health insurance, and then refuse to pay the physician's bill afterward, saying they don't have the means to pay for it, but having bragged preop about owning a Cigarette boat and blowing through $2000 worth of gas every weekend. Both of these examples are real. The first happens almost every day. In what other profession or business is one expected to undergo 4 years of college, 4 years of professional school, and then 3 to 8 years of postgrad training at a salary that amounts to less than minimum wage when hours are factored in (seriously), take on often over $100K in student loan debt, and then start working in a sometimes rewarding, but often high-stress, tiring job under constant threat of lawsuits, and with no guarantee that your services will be paid for? Try walking into any other business and taking a good or service, and then refusing to pay for it. You would be arrested. And yet some feel it's perfectly acceptable to treat your doctor this way.

And while there are plenty of nice cars in my hospital's physicians' lot, the really nice cars around here are the ones owned by entrepreneurs, Wall Street people, celebrities, athletes, and people who run "cash businesses."

A long rant. I'm off the soapbox now.

In the end, I think it was just a random idiot who did that to the OP's car...
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      10-07-2012, 08:49 PM   #24
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Orthopaedic surgeon


Gastroenterologist


Nephrologist



How did I do?
Luckily my bumper's GFR is excellent and can handle the BID vanc dosing. I'll check a level after the 3rd dose though.
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      10-07-2012, 09:01 PM   #25
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So gross. I'd seriously press charges for something like this. That's bio-hazard shit... Camera in garage?
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      10-07-2012, 09:05 PM   #26
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Originally Posted by GrussGott View Post
As healthcare costs continue to rise and coverages wanes I think there's going to be more of this around hospitals and clinics.

Angry patients under financial pressure due to medical costs with weak or no coverage will assume any nice car in the lot is owned by the people sending him/her the huge bills.

I'd start thinking about parking on the street a block or so away
Point taken, but unfortunately, "angry patients" should read "angry doctors." I wish I could make everyone in America understand that rising healthcare costs are not due to rising salaries of physicians. Our salaries are stagnating, and in many cases declining, while our overhead costs steadily rise. In running a medical office (essentially being a small businessperson), we also are affected by rising health insurance premiums in what we pay to cover our office staff and ourselves and our families. The rent on our office spaces increases yearly, our staffs expect yearly raises, etc. The cost of doing business goes up yearly, as it does with any other business, but our reimbursement often goes down year to year. Insurance companies on a whim can declare that they will start paying us 15, 20, 30% less next year. Medicare similarly threatens cuts to our pay every year.

So why does healthcare get more and more expensive for all of us as patients? We as a society demand the best, most expensive, cutting-edge healthcare, but we don't want to pay for it. We have great technology, and accordingly, pharmaceutical companies make record profits, medical device companies make record profits (artificial joints, pacemakers, defibrillators, etc.), insurance companies make record profits, and malpractice attorneys make a killing (pun intended). Most physicians go into medicine because they enjoy the science, the challenge, and most importantly, taking care of people. They don't choose politics or business because that's not really their skillset. And unfortunately that's a downfall for us. Pharmaceutical companies, medical device companies, insurance companies, and especially attorneys are very politically connected, with strong, well-funded lobbies. They will always get their share and much more. Whenever anyone tries to put a cap on runaway malpractice lawsuits in NY State, the proposition gets shot down in the State Assembly. Why? The Speaker of the Assembly is Sheldon Silver, a personal injury attorney. We as physicians have focused on patient care, and left the politics to others, and now we're screwed. We're not organized enough to fight for ourselves or our patients. This needs to change.

I certainly sympathize with the working patient who struggles to pay their bills, and whose insurance premiums take an inappropriate share of their income. On the other hand, realize that there are plenty of people in society who do the following: 1) As a patient, receive a check for many thousands of dollars directly from their insurance company to be used to pay the physician fee for a surgery, etc., but instead deposit the money, use it to purchase a big-screen TV or pay off credit card bills, and refuse to pay their physician. They either lie and say they never received it (easily checked against bank records), or say that they didn't realize it was to be used to pay their doctor's bill, and now it's already spent, and they don't have any money left. Or 2) Have an expensive surgical procedure performed without having any health insurance, and then refuse to pay the physician's bill afterward, saying they don't have the means to pay for it, but having bragged preop about owning a Cigarette boat and blowing through $2000 worth of gas every weekend. Both of these examples are real. The first happens almost every day. In what other profession or business is one expected to undergo 4 years of college, 4 years of professional school, and then 3 to 8 years of postgrad training at a salary that amounts to less than minimum wage when hours are factored in (seriously), take on often over $100K in student loan debt, and then start working in a sometimes rewarding, but often high-stress, tiring job under constant threat of lawsuits, and with no guarantee that your services will be paid for? Try walking into any other business and taking a good or service, and then refusing to pay for it. You would be arrested. And yet some feel it's perfectly acceptable to treat your doctor this way.

And while there are plenty of nice cars in my hospital's physicians' lot, the really nice cars around here are the ones owned by entrepreneurs, Wall Street people, celebrities, athletes, and people who run "cash businesses."

A long rant. I'm off the soapbox now.

In the end, I think it was just a random idiot who did that to the OP's car...
Agree completely. I remember a while back a group of physicians stopped working in West Virginia. A strike of sorts...unfortunately there are too many bleeding hearts among us (perhaps myself included) that it isn't really effective on a larger scale. I can't really say that our lobby in Washington has been very effective either.

I foresee less people going into medicine and more physician extenders in the future. People will never see an actual physician. My post-med school training amounts to 10 years (7 gen surg, 2 CT, 1 advanced aortic). As the years go on, it gets harder to see any economic advantages of this career path. People I went to college with are 15 years into their career at that point and making multiples of what do for a much better lifestyle. But, on the other hand, few people get the "privilege" to see/do the crazy ass stuff we do, so that is how I talk myself out of leaving...sigh

And yes, I think it was a completely random asshat that did this, but, aside from the energy spent, no harm done luckily.
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      10-07-2012, 09:27 PM   #27
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Luckily my bumper's GFR is excellent and can handle the BID vanc dosing. I'll check a level after the 3rd dose though.
Vanco won't do it. My vote's for Zyvox
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      10-07-2012, 09:49 PM   #28
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Being from Philadelphia, living here and working in Law Enforcement here rarely warrants surprise from me at what goes on here. I'm glad and surprised the vehicle was not really damaged.
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      10-08-2012, 05:54 AM   #29
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Was on call this weekend and, as usual, I park in the hospital garage at night...on the roof, in the most far away spot. There is usually only one other car with my neurotic tendencies that parks near me, and on weekends it is usually even more sparse. Unfortunately, for this reason, the garage is also open to the public (visitors, patients, etc) on weekends and off-hours.
So...I walk out to my car this morning to find that someone has taken their bloody and pus-soaked wound bandage (looked like abscess packing) and stuck it on my bumper with silk tape. For those not in the business, silk is extremely sticky and gets even more difficult to remove once it heats.
Fortunately it was cool last night and I caught I before it really adhered. I think I should be good after some goo gone, but nonetheless it was pretty disgusting (and I've had to stick my hands in and smell some gross shit throughout the years).

Pretty unbelievable that someone went to such lengths to do this (they literally had to walk to the farthest possible spot). No doubt it was done by someone who has no idea the amount of work and sacrifice it took to own this car and keep it in this condition. Glad I get to stay up all night to help these folks. Maybe later in life this person will need a chest tube or something and there will be a convenient shortage of lidocaine.

Anyway, now off to wash my car with chlorhexidine (kidding)...
Looks like you need to do something about all those sternal wound infections
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      10-08-2012, 06:37 AM   #30
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Orthopaedic surgeon


Gastroenterologist


Nephrologist



How did I do?
I literally laughed out loud when I read your post!
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      10-08-2012, 07:01 AM   #31
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Point taken, but unfortunately, "angry patients" should read "angry doctors." I wish I could make everyone in America understand that rising healthcare costs are not due to rising salaries of physicians. Our salaries are stagnating, and in many cases declining, while our overhead costs steadily rise. In running a medical office (essentially being a small businessperson), we also are affected by rising health insurance premiums in what we pay to cover our office staff and ourselves and our families. The rent on our office spaces increases yearly, our staffs expect yearly raises, etc. The cost of doing business goes up yearly, as it does with any other business, but our reimbursement often goes down year to year. Insurance companies on a whim can declare that they will start paying us 15, 20, 30% less next year. Medicare similarly threatens cuts to our pay every year.

So why does healthcare get more and more expensive for all of us as patients? We as a society demand the best, most expensive, cutting-edge healthcare, but we don't want to pay for it. We have great technology, and accordingly, pharmaceutical companies make record profits, medical device companies make record profits (artificial joints, pacemakers, defibrillators, etc.), insurance companies make record profits, and malpractice attorneys make a killing (pun intended). Most physicians go into medicine because they enjoy the science, the challenge, and most importantly, taking care of people. They don't choose politics or business because that's not really their skillset. And unfortunately that's a downfall for us. Pharmaceutical companies, medical device companies, insurance companies, and especially attorneys are very politically connected, with strong, well-funded lobbies. They will always get their share and much more. Whenever anyone tries to put a cap on runaway malpractice lawsuits in NY State, the proposition gets shot down in the State Assembly. Why? The Speaker of the Assembly is Sheldon Silver, a personal injury attorney. We as physicians have focused on patient care, and left the politics to others, and now we're screwed. We're not organized enough to fight for ourselves or our patients. This needs to change.

I certainly sympathize with the working patient who struggles to pay their bills, and whose insurance premiums take an inappropriate share of their income. On the other hand, realize that there are plenty of people in society who do the following: 1) As a patient, receive a check for many thousands of dollars directly from their insurance company to be used to pay the physician fee for a surgery, etc., but instead deposit the money, use it to purchase a big-screen TV or pay off credit card bills, and refuse to pay their physician. They either lie and say they never received it (easily checked against bank records), or say that they didn't realize it was to be used to pay their doctor's bill, and now it's already spent, and they don't have any money left. Or 2) Have an expensive surgical procedure performed without having any health insurance, and then refuse to pay the physician's bill afterward, saying they don't have the means to pay for it, but having bragged preop about owning a Cigarette boat and blowing through $2000 worth of gas every weekend. Both of these examples are real. The first happens almost every day. In what other profession or business is one expected to undergo 4 years of college, 4 years of professional school, and then 3 to 8 years of postgrad training at a salary that amounts to less than minimum wage when hours are factored in (seriously), take on often over $100K in student loan debt, and then start working in a sometimes rewarding, but often high-stress, tiring job under constant threat of lawsuits, and with no guarantee that your services will be paid for? Try walking into any other business and taking a good or service, and then refusing to pay for it. You would be arrested. And yet some feel it's perfectly acceptable to treat your doctor this way.

And while there are plenty of nice cars in my hospital's physicians' lot, the really nice cars around here are the ones owned by entrepreneurs, Wall Street people, celebrities, athletes, and people who run "cash businesses."

A long rant. I'm off the soapbox now.

In the end, I think it was just a random idiot who did that to the OP's car...
I too agree with you with the whole statement. Just wanted to highlight who is making the money. I cannot think at this moment of any other profession/job in which you are not guarateed getting paid. Not to talk about how stressful our profession is. What keeps me going is that I really love what I do. But between insurance companies and the lawyers (and lack of decisive action from the goverment) medical care is being ruined. End rant. I don't want to turn this into a political debate.
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      10-08-2012, 09:04 AM   #32
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It's amazing to me what a doctor goes thru to become a great doctor, then haters get pissed at them for the money they make and god forbid a doctor makes a mistake......that's where this BS the OP went thru comes from.

I for one was embarrassed when one of the best shoulder surgeons in the country fixed my shoulder (multiple surgeries) and I saw what the insurance company paid him, WTF.....guy deserves a 200k car after what he did for me......so I bought him some McCallan 25 since he loved single malt and I thought it was the least I could do

Cheers,
e46e92
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      10-08-2012, 09:31 AM   #33
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It's amazing to me what a doctor goes thru to become a great doctor, then haters get pissed at them for the money they make and god forbid a doctor makes a mistake......that's where this BS the OP went thru comes from.

I for one was embarrassed when one of the best shoulder surgeons in the country fixed my shoulder (multiple surgeries) and I saw what the insurance company paid him, WTF.....guy deserves a 200k car after what he did for me......so I bought him some McCallan 25 since he loved single malt and I thought it was the least I could do

Cheers,
e46e92
And it's patients like you, who are truly appreciative and don't act entitled, who make this profession worthwhile. Well done.
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      10-08-2012, 10:00 AM   #34
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Looks like you need to do something about all those sternal wound infections
Luckily my fiancee is plastics. The pec flap is only a phone call and trip the florist away!
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      10-08-2012, 10:52 AM   #35
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It's amazing to me what a doctor goes thru to become a great doctor, then haters get pissed at them for the money they make and god forbid a doctor makes a mistake......that's where this BS the OP went thru comes from.

I for one was embarrassed when one of the best shoulder surgeons in the country fixed my shoulder (multiple surgeries) and I saw what the insurance company paid him, WTF.....guy deserves a 200k car after what he did for me......so I bought him some McCallan 25 since he loved single malt and I thought it was the least I could do

Cheers,
e46e92
+1. Awesome post.

All you docs out there who fix people - thanks.
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      10-08-2012, 11:17 AM   #36
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+1. Awesome post.

All you docs out there who fix people - thanks.
Urologist...

now how'd I do?
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      10-08-2012, 11:20 AM   #37
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Medicine will never get fixed in the US until someone makes this one determination:

Is equal access to all healthcare a fundamental right of all citizens or not? If yes, then full government based healthcare is the only way it can happen. If, no, then, in one form or another, people will get what they can afford.

However, until we decide, philosophically, which way to go, nothing will get resolved. Right now we are in a mess because we are trying to do everything to please everybody. The result is that nobody is happy. We haven't made a firm decision as a society what health care should be within our society. Once that decision is made, we can then go on. At least somebody will be happy.

How can you ever fix something if you haven't even decided in which direction you want to take your first step?

The other issue is that because we are talking about human health and well being, there is more of a cost-be-damned mentality. The quality controls in medicine are so ridiculously stringent, that they are going to be hugely expensive. For instance, when I give anesthesia for ECT, I have to use a $300 ambu bag to ventilate a patient for literally 3 minutes. That device then gets thrown away. I can not use it on another patient for infection control reasons. In all likelihood, there would no issue, but that's just what the standards are. For you surgeons out there, think about the $2000 or so that a disposable surgical stapler costs. You use it once, for 5 seconds, then toss it. And, that is also more plastic trash going into the environment. And yet, because it is human health, it is somehow okay to be wasteful.

Likewise, as a society, if we are more willing to accept death in the elderly as a normal process, significant money could be saved. We seem so hell bent on preserving physical bodily function, and calling that "life". We will all die at some point. If you have lived to see your grandchildren, what more out of human existence do you realistically wish to strive for. Is 80 year old grandma going to go climb Mt. Everest if she makes it off the ventilator?

And what about prevention? We in medicine all know how much alcohol, tobacco and obesity contribute the the morbidity in the US. It is HUGE!!!!

I joke sometimes....I want more people to smoke, drink and eat at McDonald's because that's what keeps me in business.

In the end, it is easy to blame insurance companies, drug companies, lawyers, etc. While they do contribute to the problem, the general public is just as much to blame due their irresponsible over-indulgences, ridiculous expectations and disproportionate sense of entitlement.

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      10-08-2012, 12:10 PM   #38
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Since the OP works in a hospital, my guess is he would want them to contract H-MRSA instead
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Personally hoping for pan-resistant acinetobacter.
Damn son, PDRAB? You aren't messing around. And I suppose I wouldn't either. I hope he contracts sepsis as well then.

I really hope you get this taken car of with minimal damage to your car, OP. It's a damn, disgusting shame.

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      10-08-2012, 01:07 PM   #39
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Urologist...

now how'd I do?
Hey, when you need a plumber, you call a plumber.
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      10-08-2012, 05:57 PM   #40
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Dont leave your M3 in parking garages
Park it in the ED? I don't think that there's much choice for the OP.
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      10-08-2012, 06:06 PM   #41
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Damm. Hella technical shit. But sucks for op! Hope it won't happen again.
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      10-08-2012, 07:22 PM   #42
Echo M3
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Originally Posted by gblansten View Post
That bumper will need Vancomycin 1 gram IV q 12 hours for at least two weeks.
Don't forget the Vanco trough.

OP, my car was recently keyed in a hospital parking lot. So I know how much it sucks when some ungrateful soul takes out his anguish on your car.

Last edited by Echo M3; 10-08-2012 at 07:29 PM.
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      10-08-2012, 08:01 PM   #43
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And it's patients like you, who are truly appreciative and don't act entitled, who make this profession worthwhile. Well done.
A very big +1
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      10-08-2012, 08:32 PM   #44
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Originally Posted by CardSurge View Post
Luckily my fiancee is plastics. The pec flap is only a phone call and trip the florist away!
Nicely done! Now you're protected--you can do an 8-hour Redo AVR/MVR/CABG on an 84 yo, get paid almost nothing by Medicare for it, and yet not care because your spouse will be doing noses and boobs and getting cash for it!

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Medicine will never get fixed in the US until someone makes this one determination:

Is equal access to all healthcare a fundamental right of all citizens or not? If yes, then full government based healthcare is the only way it can happen. If, no, then, in one form or another, people will get what they can afford.

In the end, it is easy to blame insurance companies, drug companies, lawyers, etc. While they do contribute to the problem, the general public is just as much to blame due their irresponsible over-indulgences, ridiculous expectations and disproportionate sense of entitlement.
Well said. I'm a cardiac anesthesiologist and agree with your whole post.

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Originally Posted by Echo M3 View Post
Don't forget the Vanco trough.

OP, my car was recently keyed in a hospital parking lot. So I know how much it sucks when some ungrateful soul takes out his anguish on your car.
Pathetic. Sometimes I wonder about society as a whole.

Looks like I'll have to "friend" all of you guys now...
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