self_made_human
Kai su, teknon?
I'm a transhumanist doctor. In a better world, I wouldn't need to add that as a qualifier to plain old "doctor". It would be taken as granted for someone in the profession of saving lives.
At any rate, I intend to live forever or die trying. See you at Heat Death!
User ID: 454
self_made_human
Kai su, teknon?
2d ago
does low fertility select for a higher percentage of multiple births/twins?
If their fertility is low enough to warrant IVF, then yes, absolutely, the incidence of multiple pregnancy for those undergoing it approaches 30%. Which is great, it's an expensive procedure, so who ought to complain at the chance to get twice the bang/baby for the buck?
Option 2 for me. I want my kids to have kids, and grandkids, and so on till the stars go cold.
Then again, I expect the future to be so different from "business as usual" that I don't particularly care about this hypothetical, prosaically, I intend my spouse and I to be entirely self sufficient regardless of our kids (my parents and grandparents managed that, not that I can ever claim anyone treated anyone awfully, it's nice to come from a good family). That means that other than the emotional damage from raising kids with best intentions who don't reciprocate (how the hell did it end up that way?), I can bear it.
And in the latter case? Fuck them, time for round 2, let's see if these lot turn out alright, especially when I fully expect things like gene editing and the like to be an option. And I can at least pray the grandchildren come out better, you don't have to get along with your kids to get along with grandkids after all.
The main reason I value my genes is that they're the only robustly reliable method I have right now for creating offspring that I can expect to have a great deal of overlap with me (and someone I considered amazing enough to let chip in), be it mental or physical. Why would I particularly care if I've ended up as a post-biological entity or at least genes are as malleable as makeup? It's not like similarity is the only thing that matters, I'd happily raise a clone of myself, but I'd only consider that option when it was possible to tweak or solve the issues that plague SMH Mk. 1, but obviously I'd love my kids even if they weren't a literal clone of me too.
self_made_human
Kai su, teknon?
4d ago
The problem is, I'm not fond in the least of running, especially in the tropical heat, and believe me I've given it a very good go in the past.
For me, in shape means having a significantly more defined upper body, with particular emphasis on the shoulders, biceps and forearms, though the last seem to be hard to build from calisthenics alone, not that I'd say it's impossible. My legs are fine, running about in the hospital is good for that much at least.
self_made_human
Kai su, teknon?
4d ago
Where on earth did you get that figure, presuming you mean they're physically incapable of doing so?
self_made_human
Kai su, teknon?
5d ago
Looks right up my alley, I'll give him a look, thanks!
self_made_human
Kai su, teknon?
5d ago
Thank you. I'm hopeful I can start of a tad bit ahead of the "I've fallen, and can't get up" stage, but one arm pull-ups are a mile away haha.
self_made_human
Kai su, teknon?
5d ago
Aight. I'm moderately serious about getting back into shape before I get shipped out, but also unwilling to fork out the exorbitant rates any of the nearby gyms are asking for a short subscription.
So far, I've been doing push-ups regularly, but I'm on the lookout for other exercises I can do with just my sizeable body weight and random furniture. Also at my disposal, a set of 10 kilo dumbells that have somehow lost the restraining nuts, so they'll have to be taped into place. Anyone got suggestions above and beyond what YT or reddit might throw at me?
self_made_human
Kai su, teknon?
6d ago
I must respectfully disagree, given that he's my own brother and I do know him.
We used to hit the gym together back in the day, and I was far more serious about it to boot. If he was addicted to lifting for the sake of lifting, I'd have known by now, but no, mf genuinely only does it to make other people seethe with jealousy. Sure, he probably does get some satisfaction out of starting to build muscle, but it's not the driving motive given how much he bitches after leg day.
self_made_human
Kai su, teknon?
7d ago
Ah, to live in an endless state of kenjataimu, I can only dream.
self_made_human
Kai su, teknon?
7d ago
I've only barely resumed a fitness routine (push-ups, given that I can't be bothered to take a gym membership for the months or so till I leave the country) after several years off, so I can't comment for myself.
But my younger brother? He's absolutely insane, he's hitting the gym like it owes him money, and when I ask him why the fuck he bothers since he doesn't give a shit about female (or male) attention, his justification is that "I'm doing this to mog women".
So yeah, his entire impetus for being fit is just to flex in front of women who are into him while ignoring them entirely. I'm in awe, I think he's the only sane person on the planet, and approaching levels of based I can't comprehend.
self_made_human
Kai su, teknon?
8d ago
If they're Buddhist, they're usually not that beholden to prohibitions on beef, but otherwise, they fall in with the other Hindus from down south in India who do partake in it. Those are Tamil Hindus, and even some of the Brahmins eat it.
self_made_human
Kai su, teknon?
8d ago
In terms of what's usually consumed? Yes. But they do eat plain old beef, from cows.
self_made_human
Kai su, teknon?
9d ago
Maybe I'm sleep deprived on duty because I took you seriously for a moment and was going to go on a diatribe about that lol.
But surprisingly enough, there are Hindus who consume beef. More commonly in Southern India.
self_made_human
Kai su, teknon?
9d ago
There's an old joke in India that the country would be much better off if all control of governance was handed over to the very small group of Zoroastrians that constitute the Parsis.
They're known to be competent and not have any particular beef with others, and they could be as corrupt as they like without making a dent, given how few of them there are.
Unfortunately, there's even fewer now, to the point where there's hilarious advertising by both governments and their interest groups alike for the few eligible bachelors and bachelorettes left to attend a few sponsored dating events and just fucking hook up already.
So I suppose there's merit in looking at entrenched and bickering ethnic or religious groups, going fuck that and hoping someone else does better.
self_made_human
Kai su, teknon?
11d ago
Ah, do what you love and you'll never work a day in your life (and other lies).
Well, I suppose it's about time I get paid for deep dives into psychiatry. I do need to pad out the CV, and not just pseudonymously.
self_made_human
Kai su, teknon?
11d ago
We're aware, sadly it's the kind of issue that requires backend fiddling by Zorba with the code base.
self_made_human
Kai su, teknon?
12d ago
[REDACTED] : "They have no human capital." and subsequent description is boo outgroup [REDACTED]: boo-outgroup [REDACTED]: boo-outgroup [REDACTED]: boo-outgroup [REDACTED]: antagonistic [REDACTED]: boo-outgroup [REDACTED]: boo-outgroup [REDACTED]: boo-outgroup
My. It's rare to see a comment get quite that many reports, and have the consensus of the volunteer jannies be that it's frankly fucking terrible.
You could very well have conveyed the exact same message with much less inflammatory wording. In the words of @Amadan, while we don't police content, we very much police tone.
And yours is utterly dripping with sheer contempt, and is absolutely not what we're looking for here, or even conducive to a healthy argument.
You've been warned once for antagonism before, and I would wager it hasn't worked. I hope a day's ban will make you choose your phrasing more carefully in the future. You're welcome to share your opinion on Trump and his voters, simply not while nakedly sneering.
self_made_human
Kai su, teknon?
18d ago
Actually, yes. It's a fork of the rdrama code base, with our own bespoke additions. Open the side panel to view the source code on git, though I don't recall the license used right now.
self_made_human
Kai su, teknon?
18d ago
It's a drop down panel that has a list of every notable mod action, both good and bad. Warnings, bans, AAQCs, they all go in there. Per user, as you'd expect. We can add additional commentary in the free form text entry section.
Far superior to Reddit's implementation of mod tools. I suppose that's inevitable when the primary dev also owns and runs the site, and has a vested interest in his jannies not committing sudoku with our occasionally contentious userbase.
self_made_human
Kai su, teknon?
18d ago
I expect it's somewhat less litigious than the US, though of course it still keeps people up at night.
I've read that the SSRI and increased suicide risk is a real phenomenon, when they start working enough to overcome the lethargy and apathy, which lets users finally find the energy to apply those lovely suicidal thoughts lurking in their heads. Not that I've seen that stop anyone prescribing them, there's nothing better for the majority. Maybe jump to ECT if the depression is severe enough/psychotic?
self_made_human
Kai su, teknon?
18d ago
Excellent! Using the knowledge we just discussed, which PRNs would you administer to yourself for that aggression???
Haloperidol 😌
Then again, maybe I have PTSD from exams, and therapy (CBT, if memory serves) is first line in the UK.
B-52 is the medical slang for that PRN regimen, don't see people abusing it (if that's what you meant by that comment).
Ah, the innocence. While I'm more familiar with the bomber aircraft with that designation, you really need to visit /r/drugs, sort by top all time, and just see the RIDICULOUS things people do with or on benadryl. Who thought people could get addicted to a bad time?
Medical beer works great! We need to bring it back.
Especially for us doctors. Sadly, the glory days of the NHS when doctors smoked cigars in their chambers and they had a bar in the doctor's mess were over before I was born.
On paper you have a risk of increased adversed events (most notably respiratory depression) when those two agents are mingled.
What ChatGPT won't tell you is that is likely not real and just a recommendation generated by an abundance of caution. Origin was probably adverse events in people with comorbid substance use, including alcohol.
Hmm.. A lack of evidence based practice? In medicine? Never imagined that was a thing.
I'd be rather surprised to see respiratory depression on that combination, unless they were the kind more fit for the ICU, but I'm just a baby doctor and I'm here to learn.
self_made_human
Kai su, teknon?
18d ago
I'm not that lazy so I asked GPT-4:
A senior doctor likely provided this advice based on several important considerations regarding the safety and effectiveness of treating acute agitation in patients with psychosis:
-
Effectiveness of Current Medication:
- If a patient is already on a medication that is working well (like olanzapine, which is Zyprexa), it often makes sense to increase the dose of that medication for breakthrough agitation. This approach minimizes the introduction of new medications and potential drug interactions.
-
Drug Interactions:
- Mixing intramuscular (IM) olanzapine with benzodiazepines can pose significant risks. One of the main concerns is the potential for additive central nervous system (CNS) depression, leading to profound sedation, respiratory depression, and potentially life-threatening consequences.
-
Safety Concerns with IM Administration:
- IM olanzapine and benzodiazepines, when used together, have been associated with severe adverse effects, including respiratory depression and cardiovascular instability. This combination can lead to excessive sedation, increasing the risk of aspiration, and can complicate the clinical management of the patient.
-
Clinical Guidelines and Best Practices:
- Many clinical guidelines and pharmaceutical recommendations explicitly advise against the concurrent use of IM olanzapine and IM benzodiazepines due to these safety risks. These guidelines are based on evidence and case reports of adverse outcomes.
-
Minimizing Polypharmacy:
- Increasing the dose of an already effective medication helps avoid polypharmacy, which can complicate treatment plans, increase the risk of drug interactions, and make it harder to determine which medication is responsible for any side effects.
In summary, the senior doctor's advice is grounded in clinical safety, evidence-based practice, and the principle of minimizing harm while effectively managing acute agitation. By using more of a medication that is already working, like Zyprexa (olanzapine), and avoiding the combination of IM olanzapine with benzodiazepines, the approach aims to optimize patient outcomes while reducing the risk of serious adverse effects.
I suppose that's the gist of it?
self_made_human
Kai su, teknon?
18d ago
It's a good thing I took my Ritalin and have a psych textbook open, or I'd have permabanned for the aggressive attack with education at a vulnerable juncture /s
Thank you, while you Americans have an abominable addiction to brand names, I can understand that those are principles that'll come in handy.
Do not mix IM Zyprexa with benzos however.
I can Google that, but you're in a teaching mood, so might I know why from the horse's mouth?
Unrelated question to check reading comprehension (this is a joke). Do they use hospital prescribed alcohol to manage withdrawal in India? It's so stupidly effective and simple and I don't know why we don't do it more anymore.
Never seen it happen, and I've been here longer than I'd like. It's the usual benzos to cover the acute withdrawal, and it matches up with NICE guidance to boot.
Go assess the patient (skip if the bandwidth isn't there, admittedly). Nursing and ancillary staff are seldom reliable narrators for if a patient needs meds. Bonus points if you can learn which staff and teams are reliable for this. Sometimes you can save everyone trouble by throwing a pissed off person a sandwich. Also be aware of the risks of sedating someone you need to interview or examine later, can easily cause downstream workflow problems especially if it's a hospital setting and you are pulling in consultants.
Good stuff. I'm taking notes, albeit with the cafeteria being the way it is in the NHS, I might be tempted to steal the sandwich. Certainly not paying for one out of pocket, do I look like I make US money haha. I do prefer practical and common sense interventions where possible, Scott's story about the lady with OCD and hairdryer stuck with me.
Haldol/Ativan/Benadryl (B-52! If you've never heard the term) works well and is popular for a damn good reason. It's fine as a default.
More from hanging out in /r/drugs to watch in sheer awe at the people who choose to abuse deliriants, in the case of Benadryl, but Haldol? That's good old haloperidol and I love it like me mum.
self_made_human
Kai su, teknon?
18d ago
They bear almost no medicolegal responsibility, as long as they do their job, which is being largely useless. Seriously, if you, as a random doctor on the ward, ever get called over while harried to death in the middle of your shift and they ask you to sign off on their suggestions, then it's all on your head if something goes south. And if you refuse, well, you better be ready to face the ire of your seniors, who'll tell you to be a team player.
Fucking, hell they make more money than I do for my first year as a CT1 trainee. Matching my salary next year to boot. Maybe a quarter the time in education, exams where it's ridiculously difficult to flunk, and then they rake in the big bucks and have stable postings without rotational training and can coast until they often end up poached into managerial positions that were once expected to be done by doctors.
It might be a clown world where you're at, but here, the inmates are running the asylum. The UK has a massive shortfall of actual training positions, so it's both a miracle I made it on my first go, and people who don't are SOL till next year around while yet more medical students are pumped out. (I note the conflict of interest as an IMG, but I don't care, they have it easy compared to the shit I go through, and if they want to protest the erosion of pay and scope creep, I'm with them in the picket line)
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