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!
Friends:
I tried stuffing my friends into this textbox and it really didn't work out.
User ID: 454
self_made_human
Kai su, teknon?
1d ago
I'm no doctor, but it seems like there's little improvement you can provide for most people like that.
You're right, in the majority of cases they're really far gone, especially the ones who are in-patients, and care is mostly palliative.
Curious to know if you've met any other Indians about the place? And what are you missing the most from home? I recall when I did my year in Asia, my parents sent me a box full of American candy; little knowing that I could buy basically the same things at the corner store. But the sentiment was nice. (They also sent me a lot of underarm deodorant at my explicit request, and that was a lifesaver.)
I do know another Indian doctor in the same program, but he's at a different hospital. There are far fewer of us than further south in England, but I'm not particularly fussed either way, I'm not particularly clannish! It's more that I don't have too many peers where I work, albeit the ones there are nice enough.
The things I miss from home, well, my parents can't send them to me short of flying over to visit themselves, and that's not happening this year. I'll go visit them instead which is nice!
My older dog is doing poorly, and I miss them both, so a trip home to be bowled over and licked senseless would do wonders haha.
I appreciate the update. We do miss you. Hang in there and try and make the most of it. If nothing else, as you continue to suffer various indignities, bear in mind that these will be great sources of stories you can tell in the future. "I'm telling you, it was 2024, and I had to try and use a bloody digital camera. What's that? You don't even remember what that is?"
Thank you. I mean it sincerely.
You're very spot on about the NHS having endless potential for shitshows that can, in retrospect, be very funny. Especially in psych where the patients can do the darnedest things haha. If you want to read a very good book about, check out This is going to hurt by Adam Kay, though the poor bastard made the mistake of taking up gynecology and I was never fooled into that!
self_made_human
Kai su, teknon?
2d ago
Thanks my g, you've got enough going on that I didn't want to burden you with my issues! Do drop me a message about when works for you, it's been a while since we've had a chat.
self_made_human
Kai su, teknon?
2d ago
Thank you, I'm certainly looking forward to the big city, albeit everyone here has been so lovely that I'll miss them when I'm gone. I never expected to make close friends up here, I just opted for the closest place I could find to somewhere that's rather out of the way, if I'd decided to commute from said big city, I'd be looking at an hour and a half of travel time every morning and evening, whereas it's as simple as a 10 minute bus now.
I did let my mother coax me into packing heavily for the winter, so I won't outright freeze, but as much as I abhorr the horrendous heat at home, I'm a creature of different climes, and it'll be a while till I adjust.
I know plenty of people that did their residencies and law clerk service out in the sticks in Sweden and they sounded about as miserable as you.
I'd bet, while I don't think I'll suffer too much from SAD (a serendipitous acronym, if not one intentionally named) due to my shunning of the sun, it's going to be an adjustment to waking up in the dark and stumbling home when it's dark at 4. I can only imagine it's even worse in Sweden!
self_made_human
Kai su, teknon?
2d ago
As mentioned upthread, my social life is basically nonexistent at the moment. Downsides of living out of the way, with my colleagues mostly commuting in from the big city. No real opportunities to meet people outside of work unless I decide to haunt the local pubs.[1] I presume it'll get better once I move, be it from having opportunities to hang out after work, or simply by proximity to people who share my interests.
Luckily my girlfriend is doing her PhD at St. Andrew's, and I'm being gently coaxed into her social circle, but that's barely begun. They seem like nice enough people!
[1]The Scots have their priorities straight, the place doesn't have a GP or anywhere to buy clothing, but it's got 4 bars. And apparently had 27 servicing a mere 7000 people before COVID culled 'em**)
** The bars, that is, evidently it didn't cull the elderly enough if my patient pool is any testament. It gets awkward when one of the better bars is next to a care home that houses many of them, I could swear that I can spot a few of them who absolutely aren't supposed to be drinking in the clientele.
I'm greatly touched that someone remembers what I'm up to haha, thank you!
Ever since I got here, I've been mulling a proper effort post about the place, but haven't really had the time or energy. But since you asked, I'm certainly happy to summarize:
This time, it was far smaller a culture shock than when I was in England 2 years back. I know how things work, and the sight of double decker buses doesn't quite give the same "you're in foreign territory" vibes as they once did. Thankfully, I understand Scottish accents quite well, so no issues there either.
It's been terribly hectic, everything from dragging a large suitcase up Edinburgh (you'd swear you had to go uphill both ways), figuring out work, the millions of little things necessary when shifting countries, it's absolutely drained me.
I currently (and temporarily) live in the middle of nowhere, to be close to the hospital that's my first posting. I'll be moving to a respectable city in a few months, but this was what I opted for because I wanted to live closer to work till I acclimatised or bought a car.
Said work has been a chore. Psychiatry in the UK is rather different from my expectations, worsened by my initial placement being in Old Age psychiatry, with the majority of cases being dementia patients of some description. Wouldn't have been psych work back home, I tell you. It's boring, and not to my taste, I feel like a glorified geriatrician fussing more about last night's falls and who's had constipation (and can I shirk another PR, having made it 3 years into my career only ever having done one) instead of real psychiatric work. I can only hope my stint in adult and adolescent psychiatry is more interesting.
They've also had me running up and down the country, you don't have the luxury of working out of a single hospital during a residency like the rest of the planet. I swear I've done enough miles in a month and a half to circumnavigate Scotland.
The isolation is getting to me. It's been difficult surviving on my own. First time I've been away from home for this long, I tell you. I was nominally away living away from it for 4 years in med school, but in reality home was just a weekend bus ride away. Now I really haven't got anyone but distant relatives in the span of a continent.
I live out of the way, it's hard to make friends when everyone commutes in from the larger cities, though I have the saving grace of my landlord and landlady being lovely people. Another thing I hope changes with a move.
NHS bureaucracy is a headache, the sheer hassle I had to undergo in order to send a picture of a patient's rash to dermatology.. Can't just click a picture on my phone and send it over as is the norm back home, nope, breach of patient privacy. I had to dig out a digital camera approved for "clinical photography" lurking on the wards that predates microUSB and is likely as geriatric as the patients. Predictably, it didn't work (the old batteries blew up and had to be scraped out by me using a pencil, and I couldn't get photos off it if I tried as it needed drivers off a CD advertising Windows 98 compatibility, not we had an SD card or a way to read off one). I ended up googling the closest pictures I could find online and sending those off with fervent apologies. So much busy work and utter wastes of everyone's time, but it's how things are done here. I find it farcical that so many important investigations are indefinitely postponed because the patient declined when I asked if I could take their bloods or do an ECG, when they're involuntarily committed because they lack capacity in the first place. Leaving aside that doctors being responsible for taking bloods and performing ECGs would be farcical in most countries, not just India.
It's also bloody cold, unseasonably so for September, I can barely get out of bed in the morning, everyone agrees it's only really heater time in October.
I've been modestly depressed, for the reasons above. Occasionally I get to see the aspects of psychiatry that actually excite me, but they're few and far between at the moment. I can only pray it'll get better. Either way, it's going to be a long 3 years, and assuming I want to go in the UK, yet another 3. I'm being run ragged, and I can't quite muster up the energy to engage here like I used to. I'm sure I'll write a proper post eventually, but thanks for keeping tabs on this poor soul!
self_made_human
Kai su, teknon?
2d ago
What benefit will you have if your plumbers and doctors and teachers can go about their lives high as kites without any legal repercussion or stigma?
Eh? I'd presume that any doctor who came into work visibly intoxicated on anything, be it a legal substance like alcohol or high as a kite on coke, would very quickly be out of a job and potentially facing a lawsuit in pretty much any country. I certainly can't come into work in the UK drunk, even if drinking alcohol is legal.
self_made_human
Kai su, teknon?
11d ago
Raising children en-mass != eliminating families.
There's no reason we can't have both, with people having children the old-fashioned way and then vat grown children to supplement the TFR to above replacement. You could even put them up for adoption, and while the demand for such isn't infinite, a good number of them would find their way into decent homes.
The alternative being discussed here is outright demographic collapse and the failure of technological civilization after all, while such methods of producing citizens might not be ideal, it beats a gerontocracy that can't support itself.
I suppose @RandomRanger and I would both agree that such measures are unlikely to be necessary if AGI shows up soon, with the automation of skilled and unskilled human labor table stakes, and then things like outright elimination of aging being on the agenda, at which point even very low TFRs become no big deal. (Leaving aside artificial families run by AI nannies and role models)
Still, I don't see this system as being worse than the alternative, and probably on par in terms of outcomes with situations like millions of children who are/were punted over to boarding schools for most of their lives and having disinterested parents. They do alright. The biggest issue with most orphans is the genes they've inherited, and we can fix that.
self_made_human
Kai su, teknon?
12d ago
The press release claims it's specific to fentanyl and that morphine in particular isn't affected, so that those opting for the "vaccine" can still get pain relief.
Morphine is probably harder to get on the street, but if memory serves heroin is an alternative, and it does get metabolized to morphine before it starts acting.
Disulfiram, the analogue for alcohol, isn't related in terms of how it works. It basically switches off the enzyme that makes it possible to break down alcohol, causing the mother of all Asian Flushes, and basically makes taking alcohol too unpleasant to countenance. I see no mention of such a mechanism here, it claims to simply bind up the fentanyl and stop it causing any effects on the body from what I can tell, but I'll have to read the paper later for more insight.
self_made_human
Kai su, teknon?
21d ago
These are very, very good.
self_made_human
Kai su, teknon?
22d ago
Well, in India:
The political center would be Delhi. The financial and entertainment center would be Mumbai, courtesy of the stock market and Bollywood. And the tech center is a tossup between Bangalore and Hyderabad.
self_made_human
Kai su, teknon?
30d ago
Tell me about it. The designers of Civilization, with Ed Beach coming to mind, have specifically said that they refuse to have any in-game solutions to the effects of climate change because it's apparently far too complex a problem in reality for "easy solutions".
A load of horseshit that is, and you're right that anywhere remotely important such as NYC would have a sea-wall put around it posthaste. That's assuming more general geoengineering doesn't work to boot.
self_made_human
Kai su, teknon?
30d ago
3 was the first I played. Loved everything about it except the Global Warming system which would get in the way of me playing a game indefinitely (I never particularly cared about the win conditions or if I nominally lost a match). Couldn't figure out any way to turn it off at the time. I also found the corruption mechanic chafing when it cut down on my sprawling empire and aggressive expansion, I can never really get myself to play tall.
Ck 2 and maybe 3 had an amazing mod that let you play out battles in Total War and then imported the results. Ah, what I'd give for that to be the case for Civ too, with Warhammer 3 you can even pull off the attack helicopters going up against barbarians!
Another thing I wish Civ embraced was more in depth diplomacy. In many regards I wish it was more simulationist instead of the glorified tabletop strategy game it is right now, but I know purists would scream.
self_made_human
Kai su, teknon?
30d ago
Civ 4 was peak Civ for me. I miss unit stacking, and the live level editor was excellent as an addition to the sandbox, though I remember Civ 3's world editor just as fondly.
Never really got into 5, and 6, while initially addictive, ended up losing it's lustre when everything took so bloody long.
Something I'd love is having a small local LLM plan actions and personalities for the AI, I suppose it would add too much latency now to be worth it, but I look forward to future strategy games where the AI can be a worthy opponent while having more consistent "character" (say personality goals and agendas other than winning a game), since actual multi-player in Civ takes too damn long and is hard to organize.
self_made_human
Kai su, teknon?
1mo ago
I support euthanasia being an option for the elderly, or anyone really, but I'm not quite aboard with actively encouraging it as the default option for the elderly.
I'd much rather we explore ways of delaying or reversing aging, the degree of investment there is nowhere near enough. On a pragmatic note, I'm all for a fixed budget or ceiling of care for people not paying out of pocket or through their family.
The UK is relatively sane in that regard, while we don't outright euthanize people on request, DNACPRs are widely used, and doctors have the ability to say enough's enough and refuse to treat further. At that point it's a matter of making sure they're comfortable till the embrace of death, while not doing anything to hasten or slow it.
self_made_human
Kai su, teknon?
1mo ago
This. We've already dealt with waves of Bangladeshi immigration and refugees during times of turmoil (looks at my own dad).
However, I don't think it'll be that bad. Last time this happened was in the context of an ongoing genocide, while there's been reports of violence against Hindus, there aren't that many left in the country. Our current government will certainly do all it can to stop too many people hopping the border, but so far I haven't heard reports of it becoming a serious problem.
self_made_human
Kai su, teknon?
1mo ago
Man, Skookum has ruined me, when I see someone say they're a med student and doing anything remotely related to fitness I start suspecting they're an alt.
Good luck, and I hope you match into something that makes the pain of residency worth it.
self_made_human
Kai su, teknon?
1mo ago
What seeing this when skimming the comments was like:
https://youtube.com/watch?v=Un4p-6lzIpI
Congratulations! I'm always impressed by the projects that people here share, and here you are flexing on them with a biological 3D printing project that took 9 months to make, and probably another 18 years to see till fruition haha.
self_made_human
Kai su, teknon?
1mo ago
Imagine my anger when I was about to make this pun and found out you'd scooped me.
self_made_human
Kai su, teknon?
1mo ago
I'm touched to be called a fellow writer, I just dabble.
In the context of Watts, I follow his blog, and the pessimism is deep seated and personal. Man's just sitting around waiting for the world to explode, and even worse, for the wrong reasons. I'm fine with pessimistic works, hell, I'm sure it's possible to write good scifi that's upbeat, but that eludes me too haha.
I even have a notes and references section written for it with many articles cited, though that probably won't be included in the story itself.
I'd say throw them in, it doesn't hurt, and it does help to flaunt that you've done your research. If you want to be really fancy and make use of electronic media, you could pass them off as diegetic footnotes though that'll be a lot of bother.
self_made_human
Kai su, teknon?
1mo ago
Nice.
More Peter Watts than Watts himself, combining deep sea and deep space exploration. This is a compliment, I love his writing though I abhorr his congenital pessimism and misanthropy.
I do have a larger tolerance for jargon than most, so I except that much of the feedback you'll receive will be to minimize it, but I feel like it adds to the verisimilitude, something an actual researcher would write to an informed audience.
self_made_human
Kai su, teknon?
1mo ago
I'd say Vitamin A and C are S tier.
Vitamin D? Quite clearly D tier.
self_made_human
Kai su, teknon?
1mo ago
Indeed, during the beginning of the Ukraine war, families of Russian soldiers were sending them tampons when bandages were both not provided by the military and also running out of stock. Terrible idea, it's the opposite of what you want for staunching a bleed.
self_made_human
Kai su, teknon?
1mo ago
Well said, I wasn't quite sure what about my comment made him feel discomfort, but this seems like a good explanation.
The official line is that all races are equal - and in this worldview self_made_human's attitude is deeply problematic, and a manifestation of trauma from the White supremacy enforced upon his ancestral homeland during colonization (if that were the case - I would also find it deeply uncomfortable)
I'd be genuinely perplexed if the Brits managed to give me any trauma, given that they fled the place about 50 years before I was born. They didn't really bother my grandpa, and sure my dad suffered greatly as a consequence of the half-assed Partition and ensuing civil war in Bangladesh, that was also far before my time.
I wonder if the people who claim to value lived experience uber alles would accept mine, or consider me to have mysteriously internalized something something.
I wonder how far you'd get by "just" by making HBD common knowledge, and no further interference - how would a typical "brown" person (here I mean neither White nor Jewish nor East Asian) react to the knowledge that the ultimate cause of the dysfunctions in their old home is not White supremacy, the government, or even the culture - but the actual race who make up the country (which includes them!)
Indians and most other "brown" people are race realists when it's convenient to them. They'll happily look down on Africans, for example, but most would throw a fit if you claimed they were as a group worse than Whites or East Asians.
I prefer my worldview be honest and coherent, so I don't bother. So what if the average Indian is dumber than the average White person? No skin off my back, I know my intelligence and that it runs in the family, why ought I particularly care?
At the end of the day, as long as talented individuals of an underperforming group have a way to demonstrate their qualities and be judged on their individual merit, I'm content. You could be black and score super well on the SAT, at which point coarse discrimination on the basis of race ceases to be relevant for the most part. Or you could be a Jew whose mother was too fond of the wine while pregnant, and be SOL regardless of the expectations others have of your group.
Most Westerners have their opinions of Indians informed by the fact that they usually only meet the tiny fraction that was talented/lucky/hard working enough to move away. I got to live with ~everyone else, and while I think they're perfectly fine people, they're not in the same class. Skimming off the top of a billion and change will get you incredible talent no matter how the average fares.
Also - in the case of a indidivual skilled immigrant, it is indeed a mutually beneficial arrangement. But obviously the benefit to the immigrant is massive compared to the country, to whom each specific person is just a rounding error - so already a kindness is being payed by actually affording them all the same legal privileges as the natives despite having all the leverage (in the non-HBD world - this is something the immigrant is morally entitled to since the country is only such a nice place to live because they stole resources from the 3rd World - how else could a tiny island of a few million people, of equal competence to all other humans, manage to have so many nice things?)
Indeed. Of course, it's also conveniently ignored that places that started out poorer than dirt, like Hong Kong and Singapore have sprinted ahead and might be better off than much of the West, while other areas languish no matter how much money you throw at them. I wonder who they're supposed to have ripped off, or what they've had stolen from them when there was little to steal.
self_made_human
Kai su, teknon?
1mo ago
I'll have to check the exact figures, but most of India is below replacement barring a few states like UP and Bihar, which are widely considered by Indians to be basket cases. Even they've trended downwards, it's a rather secular disease of modernity and few places seem to be immune even if they're dirt poor.
I thought Hydrogen Sonata was an okay novel (by Bank's standards). I read it after exhausting the others and I wished the Culture had a better send-off. If I had to pick favorites it would be either Player of Games or Excession. Perhaps Matter as a third.
On the other hand, if you're done with the Culture, the Algebraist is really good even if it's not set in the main universe.
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