It deserves emphasis that the writer of the manifesto was raised in a wealthy family whose Italian immigrant founder (his grandfather) made his fortune off of managed care facilities, then real estate, country clubs, & conservative radio. His sister is a doctor. Their family has an obstetrics wing in a Baltimore hospital named after them, because they've given so much $. He volunteered at his family's nursing home. He's familiar with this business. His cousin headed Trump's MD election fund.