Throwaway05
5mo ago
Yeah. Unfortunately all this is not a theoretical problem, or annoying but harmless - seeing people come in with completely avoidable but fatal disease because they were led astray by alternative medicine isn't every day, but it is extremely common.
For some reason these people have no liability and it's nearly enough to make me want to fedpost.
Throwaway05
5mo ago
Haven't heard of him, but looking at it briefly looks like total quackery as per usual.
Here's why.
- Most of this stuff (and this is pattern matching accordingly) is not really "useful."
The advice "live a healthy life" is known to all, prescribed by doctors 100% of the time, totally ignored, and incredibly hard to intervene in. "You are missing some common sense lifestyle intervention X" is included within things like "eat a healthy diet for fucks sake." The few people who grab onto something (like thiamine or whatever) tend to ignore all else including extremely important medical intervention (fun fact: Steve Jobs died from one of the more survivable pancreatic cancers because he refused mainstream medicine). Outcomes in "healthstyle fad" type people tend to be incredibly bad, and then we see them avoidably dying in the hospital for no reasons with something preventable and demanding last second intervention.
- The medical industrial complex is a rapacious beast that will agressively steal anything of value from any form of medicine and put it to work (aspirin is basically repurposed willow bark). Sometimes if it can't be monetized you'll run into problems but these are generally edge cases and failing that someone will ruthlessly try and make a career out of it. It's hard to monetize Vitamin C but that doesn't change anything about the fact that we've had thirty years of people trying to make a career out of proving it's a sepsis intervention. If it worked they'd be able to prove it would be strongly incentivized to do so that they could get famous off of it.
Admittedly nutritional type interventions like OP's comment are a bit trickier because establishing evidence burden is hard, but that's not really what your link is getting at.
Throwaway05
5mo ago
Regrettably I don't think your interaction would have been any less unsatisfying if it was in the U.S unless you were seeing a concierge or something like that. While the social pressures at play are pretty different in Japan it's also possible that you were getting a "saying you should try a little iron but not too much" without saying it type interaction, as you might here but it would be more easy to understand.
The problem is that you are more likely to catch someone who demands some form of intervention, any intervention and does so incautiously and then injures themselves than someone who actually has a personal biochemistry that is somewhat atypical and would benefit. Not saying you are one of those, but the majority of the global population is total morons so the practice of medicine has to be optimized around that (and smart people can also be morons when it comes to medicine).
Throwaway05
5mo ago
I can only imagine how annoying that is as a patient but problems like that are unfortunately not what our system is optimized for.
If you recommend something that makes sense but isn't quite justified (because the labs are normal for instance) then you introduce a huge amount of liability if something goes wrong, and good luck getting it paid for if the patient doesn't meet whatever criteria.
Additionally, medical care is in general about preventing someone from dying, "minor inconveniences" (that nonetheless may be subjectively quite inconvenient) are generally not something we are equipped to manage (this being for a huge variety of reasons).
An extra level is the need to avoid fighting with patients unnecessarily.
In this specific case there are other significantly more likely causes of tiredness. Lifestyle habits (including diet, exercises, stress, substances, caffeine, sleep habits, etc etc), psychiatric issues, and boring things like aging are way more likely to be responsible.
I have no idea about you personally, but many patients are extremely resistant to having one of these pointed to.
Lastly there's a bunch of complicated stuff about reference ranges, additional studies, lab uncertainty, diagnostic nonsense... overworked primary care doctor is not going to bother.
Throwaway05
5mo ago
As usual blah blah I don't agree with Scott on most aspects of doctoring.
Therapy works, and it works great, and has a great evidence base. The problem is that unlike medication management and general medical care, it's very hard to tell if you are getting good therapy, or the therapy that is good for you - not only is proficiency level variable, but the match between the therapist and patient is important and that can be hard to manage (classically: a good chunk of men are not going to respond well to the more ooey-gooey therapists)*.
Quality therapy also intends to end, it's not open ended or indefinite.
That said it sounds like you are skeptical, had a bad experience, and aren't necessarily the best type of patient for it (plus the expense).
But it is something to consider in the future if you are not satisfied with where you at or slide a bit.
Alternatively you can use the classic man-therapy type approaches. Sportsball! Teams! Friends! Woodworking! Blah blah.
*Yeah I really don't know what Scott is going on about here. There are absolutely the type of patients who therapy isn't likely to work for but DBT for BPD is well validated, and every therapist I've ever dated (pro-tip: don't date therapists) will endorse patients with radical improvement or development, even if it's just catching a college student who needed to grow up. If Scott isn't ever seeing it work something about his catchment is fucked or he is exaggerating in an unhelpful way.
Throwaway05
5mo ago
Two thoughts:
-
Your presentation seems pretty biochemical - rapid response to an therapeutic dose (5 is too low), somatic symptoms, a significant amount of side effects (the stomach is common and usually self limited and associated with specifically the initiation of medication and changes of doses). You should keep that in mind and inform your doctor if you need to make changes or you get a new one.
-
This advice will may mean less to you if your presentation is in fact pretty biochemical, but therapy and medication is superior to either alone. Our best guess for how SSRIs work (and you may not actually be one of these it sounds) is that they make your cognitive structure more flexible and allow good decisions and therapy to stick better. If you feel like you could do more to be better, get a reputable therapist.
Additional thoughts - also sounds like you have a decent chance of being the kind of person whose brain isn't good at listening to their brain or body, so you get random ass symptoms as your brain flails around in confusion. In those situations it may be wise to reach outside yourself to try and figure out if you are doing okay/how well you are doing. Of note it's not uncommon for successful people to be like this because they establish patterns of just puttering along and getting it done and burn themselves in the process.
Throwaway05
5mo ago
I wtf and turtle-up at the thought of fucking in front of one’s own child.
Which is interesting!
While it's obviously taboo today (and for good reason in my mind), that's probably the one most present historically since large families and a lack of space meant that parents had to make do with little boundary from their kids.
Throwaway05
5mo ago
ah, makes sense
Throwaway05
5mo ago
Women spend their entire lives being hit on by men constantly, they then have to decide who and when to reject vs. accept and have significant training in establishing their boundaries for these things.
Many men spend their entire lives without being hit on without them initiating to the point that they will continue to flirt when it isn't acceptable to do so (because they are in a relationship, old, power dynamics and so on) because they don't expect it go anywhere.
If it does get reciprocated or it comes out of nowhere ....they don't know what to do and have little familiarity with saying no.
This is the flip side of the power dynamic - men may use power and prestige when they shouldn't to get laid, but women can also take advantage of men's weakness and this is seldom acknowledge or commented on.
I don't really recommend it but it's an interesting experience, just like everyone has a plan until they get punched in the mouth every guy with a reason not to feels like they can reject a pretty woman coming onto them...but many fail in that moment.
Throwaway05
5mo ago
Huh. That's fascinating.
I wonder behind the psychology of that - wanting to stare death in the eyes?
Throwaway05
5mo ago
Right, I think it works well for firing squads but as soon as you have ten people pushing buttons and only one of them work.....it just kind of looks stupid. Since the whole issue here is optics I'm not sure how to make that shake out.
Throwaway05
5mo ago
It's this.
Anesthesiologists know exactly how to kill someone reasonably cheaply and in a painless and not distressing way, it's why they have such a high suicide rate.
But finding people to sell the stuff required (and getting requisite professional staff to assist) is hard.
Then you add on the "finger on the trigger" problem (who wants to be the specific person who killed someone on purpose? Nobody you want doing it).
All this adds up to the weird dance we have.
Throwaway05
5mo ago
meth fueled
Thank god it isn't PCP...
Throwaway05
5mo ago
Officially added to the (not long at all cough cough) list.
Throwaway05
5mo ago
Ar'Kendrithyst is a more central example
Great rec for our specific community (assuming the reader is someone who can get past a slow start).
Throwaway05
5mo ago
I need a better elevator pitch for it. Any thoughts?
Every time I try I sound like that Always Sunny conspiracy board meme.
Throwaway05
5mo ago
Reverend Insanity
Goddamnit. Isn't it unfinished due to CCP fuckery though?
Also where would you rec I read it?
Throwaway05
5mo ago
I loved WtC but come on, DCC is on another level (for example: hilarious and not 110% ratfic).
Throwaway05
5mo ago
Some terms:
Cultivation Fantasy: typically means Western spin on Chinese/Eastern fantasy styles (Xianxia is one of the classic Chinese fantasy genres but not the only one).
Progression Fantasy: Fantasy with a focus on the character becoming stronger, learning magic, battles (and winning them) and other such stuff. Can be very addictive and lends itself to web serial formates well.
LitRPG: The world has some kind of game layer or something. I start out at level 1 with one level in one handed sword fighting. Kill a goblin. Now I have two levels in one handed sword fighting. Generally a sub genre of Progression Fantasy for the obvious reasons.
"The System": Often the name of or explanation for the game layer in a LitRPG. The "system" assigns you a class and tells you about your level ups or whatever. Genre often involves fighting, abusing, or changing the system.
Dungeon Crawler Carl (despite the weird sounding premise and name) is probably the "best" example of LitRPG/Systems.
Throwaway05
5mo ago
Please don't think I'm some kind of expert on this, I'm not haha, but I do have some thoughts given your question.
The tricky part is that socioeconomic class, finances/resources and location are so so important (did I see something elsewhere about you living in Japan? I know fuck all about that).
That said the most important thing is that sports and exercise are like diets. The most important criteria is that you actually do it and can stick with it. Team sports are obviously better for what we are talking about but if your kid will only do tennis you'd rather them have some interaction with others and healthy lifestyle habits than just play Fortnite the whole time.
So - listen to your kid you can try and convince them to some extent but it is better to work with what you got.
Something else is that kids often end up following their parents or very very much not. If you have some sport you play your kid may try follow you in it (regardless if it's helpful for what we are discussing). They also may absolutely hate it and run into the opposite direction (again, listen to the signals you get from the kids). This can be very confusing when 2 kids absolutely fucking love the parent's sport and the third fucking hates it. I have nephews like this it is hilarious for everyone except their parents.
Another thing is to look for stuff that fills multiple roles. Are you upper-PMC and belong to a country club? Get your kid involved in a country club sport so they make connections as you make connections! This doesn't have to be business, the after school soccer league may get you in touch with people in your neighborhood for playdates, just being friends and other crap like that. If something speaks to you on this front, try that, if you have benefits that increases engagement.
Speaking of which, you may be the kind of person who likes the things your kids like because they are your kids. You might need a leg up. If you fucking love basketball, try basketball - you being excited about the games, wanting to go to the games, and paying attention at the games...all these things will help with secure attachment.
Your kid will know if you consider going to events painful, and that one dad paying shit attention makes everyone uncomfortable.
Okay specifics. Teams sports are probably better until/unless your kid has something resembling specific preferences, especially for home schooled kids -meeting people (and a variety of them) working together, all that bullshit. I'm reminded of an 80s cocaine Goldman anecdote about hiring managers tossing out all the resumes without team sports backgrounds because "he wasn't a team player."
Personally I did football and martial arts as a kid. The former was great for social development, I'm just as nerdy as you'd expect from a poster here but I'm entirely capable of making my patients forget that. You'd be amazed at home much mileage you can get out of laughing at the Bears with someone you have zero commonality with. The other big American sports are good for this just not as potent. Martial arts teach personal discipline in the most condensed way and still have some social elements. Unlike football it's easy to find classes. No idea how you would pull that off for football. And no I don't have braaaaaaaaaaaaaain dammmmg.
For girls I still think team sports are the way.
My female relatives did some combination of Volleyball, Basketball, Field Hockey, and Soccer. The last I think might work best for you. Travel Soccer can be expensive but it's cosmopolitan in a way that might appeal to Motte tastes and can get some experiences like sending your kid to Europe with a bunch of other girls to see some shit, get some experience, and so on.
Can also be adjusted a little bit up and down depending on time and financial resources and it is a little lower on physical risk than some of the options (and also can attract a higher class crowd than some of the other options).
Anyway, this got long.
Number one piece of advice is obvious and basic but worth repeating - don't cram a square peg into a round hole. Use what's available, what matches your resources and interests (and also your kids!). The best diet, the best exercise, the best lifestyle change - is the one you will do, consistently. Stick with sustainable.
And don't get too mad if your kid is a hopeless nerd and not about it. There's sometimes stuff you can do (and also a time to give up).
You will also note that a lot of parents will try and use sports as a way to get a leg up on college admissions. This isn't a bad idea or anything. I've seen tons of people leverage something like a fencing or tennis background into an Ivy League, but if you are going the home school route the socializing aspect of team sports probably outweighs those benefits (and if they have the genetic potential over the average SSC reader than they'll probably smoke the coursework anyway).
Throwaway05
5mo ago
Yo. Recs please.
Since COVID I've jumped in hard on Progression Fantasy and a small amount of Xianxia is a part of that. Loved Beware of Chicken, A Thousand Li, and Ave Xia Rem Y.
I'd like to guzzle more, especially if it is unpolluted by system stuff.
Throwaway05
5mo ago
Sports will probably be important for this as well.
Yeah this will help a lot.
So many people are maladjusted now and have no or few friends and I cannot imagine how much harder it is for the young. Like it's hard enough to find a GF for functional wealthy adults now.
A freshmen in high school? Yikes. And home schooling might be much, much worse.
However it seems very clear you are actively thinking about what you are doing and what the plan is and aware of limitations - fantastic prognostic indicator.
Throwaway05
5mo ago
Sounds like you've thought a bunch about this!
Were you home schooled? Personally I feel like I'd have missed out on all of the activities and dumb stuff of school if I skipped it, but that doesn't mean that is the "only right way."
Throwaway05
5mo ago
I don't know how clear I was - what I see oncoming is an increase in anxiety disorders (for instance) and that will likely be way worse for homeschooled for non-home schooled (but both will be bad).
Same, I hear the way everyone talks about it and feel like I'm missing out on one of the great gaming experiences but.....I can't.
More options
Context Copy link