Controversial 3D. Probably none of you knows about Leber congenital amaurosis type 10, congenital blindness that affects 3 out of 100,000 children, condemning them to blindness for life. The only possible treatment is through gene therapy. 1/n

Thread:
I'm thinking about Tim Keller's influence.

There is the curious fact that Keller is well-regarded among the culture elite (or at least has not suffered the sort of vilification one might expect given his influence). How can we explain this?

Looking at Prodigal God and other writings, you see that his approach to urban ministry is deeply political in a way that appeals to Democrat-heavy cities. It involves two moves:

1) equalizing sins: elevating the sin of hypocrisy, "moralism," and "religion" (the sins of "conservatives") and equating these with the sins tolerated among liberal (e.g., homosexuality)
&
2) emphasizing "self-righteousness" as a sort of chief sin (the sin of "red states").

Keller effectively downplays the sins that liberals tolerate while elevating the sins of their political enemies, the red state conservatives.

But the greatest appeal to liberals is that critiquing the "self-righteous" vilifies political action, particularly the action of social conservatives (e.g., anti-gay marriage). And the equalization of sins eases concerns over changes in social policy (e.g., gay marriage).

In medicine, reckoning with racism includes reappraising the very syntax we use every day. Proud to add my voice w/ @J_Ikeme and @RWGrantMD in this @JAMAInternMed pub addressing:

Does race/ethnicity belong in the first line of the patient

Some background: I’ve struggled with this question since early in medical school

Medical syntax is designed to communicate information in a predictable sequence with key elements prioritized to facilitate efficient communication and formation of an assessment and plan

2/

From preclinical lectures to Qbank questions to clerkship rotations, race/ethnicity was often prioritized in the same sentence as age + gender.

I grew accustomed to reading/hearing: a 70-year-old Black man w/ history of x, a 50-year-old Hispanic woman presented w/ y.

3/

However, when it came time for me to use race/ethnicity, there was always tension. Race/ethnicity are self/socially-ascribed identities that in clinical practice are almost always assumed by providers based on appearance. I was also concerned about the potential for bias

4/

I wondered how my own care would be impacted or not impacted by my ethnicity (Hispanic) – I have light skin so I’m not sure if my doctors would even identify me as such – but how would my care be different if I was presented as a 30-year-old Hispanic male?

5/