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Tom Wallach

@mdwallach

World’s largest pediatrician. Division Chief of Pediatric GI at SUNY downstate. Pain, EED, health equity, and intestinal barrier science. formerly of UCSF/Columbia. Ed board @jpgnreports . hater of ALS. only represent me. he/him

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Latest posts by Tom Wallach @mdwallach

Mr. Cool kid

Mr. Cool kid

It’s a vibe

10.03.2026 20:49 👍 3 🔁 0 💬 0 📌 0

Yall ever seen the playground the first week it’s above 50 after a frigid winter it’s fucking on.

10.03.2026 20:46 👍 7 🔁 2 💬 1 📌 0

Do they have enough for themselves?

10.03.2026 20:03 👍 0 🔁 0 💬 0 📌 0

Huh I used the scalzi feature and it keeps just showing me pictures of unholy burritos

10.03.2026 19:28 👍 3 🔁 0 💬 1 📌 0

Yes 100%

10.03.2026 17:14 👍 0 🔁 0 💬 0 📌 0

They spent your tax money on killing children. I think it's worth us spending our tax money prosecuting and punishing them all. No one will argue against it. It is a popular stance. Don't be a pussy. Stand up for those girls who were killed in our name.

09.03.2026 22:47 👍 1190 🔁 229 💬 7 📌 6

Run on prosecuting war criminals and show ads with the missile hitting the school and show photos of the girls when they were alive. Make it a point to arrest and prosecute Hegseth and go from there. Trump won't protect him. He'll either be dead by then or cashed out.

09.03.2026 22:47 👍 941 🔁 123 💬 7 📌 5

I deeply love the crimson flag so handsome no no not red, crimson.

10.03.2026 10:20 👍 0 🔁 0 💬 0 📌 0

Look let’s not be harsh on @booker.senate.gov he has bosses just like the rest of us he’s just not supposed to by penalty of law but instead is a corrupt POS.

09.03.2026 13:19 👍 2 🔁 0 💬 0 📌 0

A loving and brave act to share your loss. May his memory be a blessing.

08.03.2026 20:12 👍 3 🔁 0 💬 0 📌 0

Anyway wasn’t trying to pile on, believe everyone is well intentioned (as a rule, and it honestly lets me down way less than it works out)

08.03.2026 15:58 👍 1 🔁 0 💬 2 📌 0

I’m not sure I know the right answer but I do know there is a major tension there. And coming in hot on one side denies the validity of the other, and when both are valid, that’s a place where people get touchy.

08.03.2026 15:57 👍 0 🔁 0 💬 1 📌 0

We have two conflicting goals: one: eliminate the influence of a toxic group of scam artists seeking to damage people for fun and profit and two: ensure maximum health. These goals are often aligned, but also can conflict. The hard part is figuring out where to give

08.03.2026 15:56 👍 1 🔁 0 💬 1 📌 0

Again there are two groups we are dealing with. The people you are talking about deserve nothing but scorn and opprobrium. The much, much larger group, the one where the bulk of kids are impacted, are potentially reachable.

08.03.2026 15:54 👍 0 🔁 0 💬 0 📌 0

In my experience the activist folks are either seeking a profit motive or so highly delusional they cannot be reached, so I think concern for their impressions is sadly immaterial. I also think there was space for you to disagree with the frame while acknowledging the intention and context

08.03.2026 15:52 👍 1 🔁 0 💬 1 📌 0

I think the gap here may just be the perception of movement antivax (who are *not* good parents or people) and the more common variants we routinely encounter

08.03.2026 15:45 👍 0 🔁 0 💬 0 📌 0

The thing is the *vast* majority of sntivax parents we interact with are not in this cult. They don’t talk like that. They have ill informed doubts, poorly sourced concerns, and aren’t at all sure or bought in. The people we see on tv are not the ones I speak to. Those people wouldn’t see me

08.03.2026 15:44 👍 1 🔁 0 💬 3 📌 0

I think, in general, that these are defrauded people. I think they are victims. Potentially very stupid ones, but victims.

08.03.2026 13:23 👍 0 🔁 0 💬 1 📌 0

When someone puts your heart outside of your body it gives you control issues. Many folks translate that into a desire to optimize. Some of those folks are either stupid, or smart in specific dangerous ways while limited in others, and believe lies.

08.03.2026 13:22 👍 0 🔁 0 💬 1 📌 0

I would actually agree with the statement that they aren’t 1:1. My definition of bad parent is someone who, knowing what should be done, does something else.

A lot of parents struggle. Poverty, discrimination, their own health, education, trauma, etc.

08.03.2026 13:21 👍 0 🔁 0 💬 2 📌 0

And broadly, if it makes a kid healthier I’ll be polite to anyone.

08.03.2026 02:06 👍 1 🔁 0 💬 0 📌 0

There is a difference between how we should treat anti vax activists (brutally) and low information parents who just happen to be dipshits but are generally trying their best.

08.03.2026 01:56 👍 1 🔁 0 💬 2 📌 0

So what you are saying is that if I, an actually pediatrician and public health professional, am generally polite to someone who expresses concerns about vaccinating their kid, in the hopes they might hear me and vaccinate their kid, I’ve done evil.

08.03.2026 01:52 👍 2 🔁 0 💬 4 📌 0

The wild part here is being a local tv reporter and thinking that makes you a big deal? Man has misunderstood the clout differential

08.03.2026 01:13 👍 7 🔁 0 💬 0 📌 0

It is the express purpose of tenure to make it difficult to fire you for not liking what you have to say. The grounds to fire folks are very specific and thinking they are wrong is explicitly protected

08.03.2026 00:45 👍 0 🔁 0 💬 0 📌 0

That is literally never minimal effort and takes years.

07.03.2026 22:07 👍 1 🔁 0 💬 1 📌 0

The reason why it’s dumb is we don’t need to have a perfect description of one thing to be able to say another thing is different. There are many fundamental reasons why the assertion is weird, but also because if it’s right, it’s irrelevant anyway, as we have no agency.

07.03.2026 18:51 👍 1 🔁 0 💬 1 📌 0

You have a radically different prime mover question. I know exactly who told an LLM what it knows. I may not be able to exactly track decision making in all cases but I can describe the root vectors. Where do people get their knowledge? How can you purport to equate those systems?

07.03.2026 18:23 👍 1 🔁 0 💬 1 📌 0

This is always such a dumb bit. At a fundamental level, even if the deeply sad view of human consciousness that we are simply LLMs with biochemistry, you still have to deal with the fact that our epistemology is entirely experimentally and self derived, whereas all LLMs inherently know what we say

07.03.2026 18:22 👍 2 🔁 0 💬 1 📌 0

He never officially left, and it’s somewhat hard to fire academic faculty. They would need to substantiate it which takes a while and commitment.

It’s weak and pathetic but not exactly what it might seem

07.03.2026 17:20 👍 3 🔁 0 💬 3 📌 0