OK sorry yeah one time we had a patient with a esophageal stricture but who couldn't comprehend what that was or why they couldn't just keep eating things normally because of an intellectual disability so they would steal food from the other patients and try to eat all of it really fast and puke it up then keep re-eating the puke and because of this and a few other things we couldn't find anywhere that would take them until the doctor and social worker made a deal with a nursing home that they would take the patient if they had a stomach tube placed surgically for feeding but again they couldn't explain this to the patient fully and the patient didn't want the tube but they didn't have legal capacity for decision making so the family that never visited and didn't really care what happened to the patient just signed off on it and the patient still had to stay for a few months because they kept ripping the tube out of their intestines and bleeding and leaking half digested food from their intestines everywhere until they finally just accepted that they were going to keep reimplanting the tube again and again and idk what happened after they finally discharged them.

But yeah the complicit petit bourgeoisie are definitely a close second given the role they play in the oppression and exploitation of my mostly homeless patients on behalf of the haute bourgeoisie who lack the numbers to enact that oppression on their own.