self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
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:
A friend to everyone is a friend to no one.
User ID: 454
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
5hr ago
I don't have an Indian accent. Quite the opposite. I get asked, almost every day, where I'm from. By people talking to me in person too, mind you.
So far, people have told me I sound American, Canadian, Dutch, German and god knows what else. The standard consensus seems to be from exactly wherever they're not, so Americans wonder if I'm Canadian/European, and Europeans wonder if I'm from the other side of the pond.
In fact, this happens so frequently I have a whole canned speech ready. Surprisingly LLMs can usually still tell I'm probably Indian from pure audio logs, last time I tried was with Gemini 2.5 Pro. I sound very slightly Scottish when very inebriated, but I avoid picking up another accent since at that point nobody would understand me.
Funny and very recent story: I had a date with my Emotional Support Lesbian yesterday. I took her to the shady gay pub that's my usual haunt. The other Lesbian at the counter (much worse at the emotional support bit) could understand precisely what I was saying, and couldn't understand the white woman with the upperclass British accent. Well, she admits that she sounds like a "posh Tory cunt", and that is all the proof I need.
For what it's worth, I hate Indian accents too, they grate on my ears, and I mostly grew up there. I do agree Roadmen sound atrocious, and I'd walk into traffic if I see them on the streets.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
18hr ago
I really don't blame her for what the NHS is really causing. I did thank her for letting me know, shook her hand goodbye, and confirmed that she made it home in one piece. I try to keep my problems my own, and she didn't need to know that something that small was all it took to make me begin unraveling.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
1d ago
Maybe a career switch is advisable. I will consult our resident furries for advice.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
1d ago
Oh god, I was so fucked last week. As in, right up until last night.
Had a patient come in. Clint Eastwood-looking fellow, albeit a bit yellow. He'd clearly been to Shanghai and had a good time, whereas I only seem to get Shanghai'd into work and am the wrong kind of Asian for it.
He was not in a good mood. When the senior consultant led the ward round, the rest of us tagging along like ducklings who'd imprinted on the wrong mother, he had concerns. Said we should help, that the NHS was clearly failing him. I cannot in good conscience disagree, having extensive evidence on the matter, but we did need a slightly more itemised complaint. Turned out the gentleman in the next bed had wet himself and nobody had come. My patient, who could not reliably tell you the year, had correctly identified a real institutional failure and appointed himself its ombudsman. The consultant was mildly put out at being mistaken for a nurse. She was far too professional to show it to a man in hepatic encephalopathy, and I was the only one who caught it, because spite recognises spite.
Later, I had to put an Adults With Incapacity form in place for him. He couldn't consent, so the job was to consent on his behalf, which is the polite clinical phrasing for deciding things about a man's body in a room he isn't really in. It wasn't urgent enough to skip waiting for the family, so I waited for the family. They came. The wife told me he used to have a sense of humour like mine. I said that probably explained the liver. She laughed, which I'm choosing to log as a therapeutic outcome. I'm sure she was a gorgeous lady once, albeit too old even for me. She was suitably apologetic for her husband getting rather angry when I put on my usual song and dance, and possibly interpreted it as coming onto his wife. Bit late for that bud. He was not amused. He said "don't quit your day job."
How rude. Wasn't planning to, but that is precisely what I would say in his shoes. And I don't even have the loving wife, lovely daughters, and the grandkids. Or the dementia and what is possibly a HPB carcinoma. Win some, lose some.
Here's what they don't put in the GMC curriculum: he was, by every account in the room, a good man. A lawyer who gardened. Combative, his wife said, but never rude to anyone he understood was trying to help, which is a finer distinction than most healthy people manage. Then dementia, then the loss of his legs, then the drink, in roughly that order, each one a door that only opens one way. I wrote the cognitive and alcohol history and I will admit, with the appropriate amount of shame, that I enjoyed writing it, because it was the first time in months the job felt like the one I trained for. My colleagues said I was the right person for it. I suspect this is because I am the only underemployed psychiatry resident in the building, but I'll take the compliment at face value, since I'm short on those and long on face.
What I did not enjoy: watching the poor bastard suffer, and the fact that my replacement NHS ID badge was not handed to me that day as promised, despite an email, an appointment, and a confirmation that very morning. Isn't there something clarifying about being trusted to make life decisions for an incapacitated stranger while the same institution cannot be trusted to hand you back a piece of laminated plastic?
Then, because the week was apparently being written by someone with a heavy hand, I went on a date. Long journey, no sleep, the usual baseline of grey. She seemed nice, but I really wasn't hoping for much. I went on that date because I wanted to do something other than dissociate in my bed that weekend. I was more unhinged than usual, past the point where I come off as charming and confident, and appear slightly delirious myself. We talked for an hour or two, as many drinks. She came back from the loo, told me she wasn't feeling it, didn't want to lead me on, and would rather go home. Which is, I want to stress, the considerate way to do it, the rejection equivalent of a clean surgical margin. I told myself this. It did not take. I'm a psychiatrist; I can narrate my own distress in correct terminology while it ignores me completely.
I won't bore the thread with the bit in the middle. There were mushrooms. There was a bus station, a kebab, an emotional support lesbian* who has so far declined to be anything more, and a great deal of being talked down off my own ledge by parties who shall remain anonymous. The short version is that I am better now than I was, by a margin that won't mean much to most of you and means a great deal to me.
The old man's still on the ward. I think about the one-way doors. I've got the kind that still open, for now, and I intend to keep walking through them, if only out of spite, which is the one mature defence mechanism Vaillant forgot to list.
*I call her that to her face, and it makes her giggle. Good to know that lesbians, old grannies, the delirious, the psychotic, and other characters find me funny. Also, she is into some really freaky stuff, and I suppose knowing what Langhans lines are might help. Shame that she is probably not lying about being asexual or a lesbian, but I've had worse company. I am nothing if not an optimist.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
1d ago
Well, if you're looking for money through writing, I can imagine. For me, it's $20, $3.50 or free.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
1d ago
I once had a pretty large indie publisher ask about my novel. I told them that I have a lot of shit on my plate, and I do not expect to finish it in a timely manner. I deserve points for honesty.
Beyond that? Someone pledged money to my Substack, which is something I only vaguely dreamed of monetizing, and do not go around begging money for. I accept upvotes and engagement as valid currency. He's a big name, and $8 is $8, even if it's a theoretical $8 that I can't be arsed to redeem just yet.
I am very glad that writing is just a hobby, and I don't want to go full-time pro. My work and life gives me the material for the writing anyway.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
2d ago
What gave it away? The deterioration of my mental health? That's cheating. But no, sometimes things just don't work out.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
2d ago
You didn't specify the direction. And we live on a globe.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
Oh I'm not quite ready to talk about everything else she's into. I wasn't kidding about her being a freak.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
I do a lot of physical work, if running around a hospital counts. Absolutely getting my steps in. Working out at home irregularly.
But no. I just hurt and ache all over. I suspect it's somatoform and a strong indicator of depressive relapse on top of undermedication for my ADHD.
Sadly, I can tell you that being too tired doesn't hide the depression.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
Hmm. I agree in principle. She'll have to work on her technique if she wants me to actually lack a choice in the matter. Right now, I'm showing up because I have to know where this leads, even if that's probably just hypoxic brain damage.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
You joke, but apparently that's an accurate description of a large chunk of her social circle.
Large numbers of people (well, dozens) who are "asexual" but enjoy "kink". I am very much not asexual, but I do have a libido. And I have done worse things for uglier women. Though some of what she's into really has me contemplating my sanity.
This will be a story for the grandkids, or at least a good essay. I've had to do reading up on the neurobiology of human sexuality to even begin to figure out wtf is going on. Can't say I've completed the process, but my conversations with her are somewhere between semi-ironic emotional engagement and a psychiatric history + field ethnography. I am listening, and perhaps I am learning.
try choking each other
I didn't do that. To her. I'm a gentleman.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
Saving that one for a second date.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
Ah, the 60 yo senior charge nurse and the gay pharmacist can openly yap (in the middle of the ward corridor) about attending a strip show, but I talk about my dating life and end up in front of HR? How rude, is it because I'm brown?
Frankly, my dating life should get me in front of a psychiatrist instead. I went on a date with someone who described herself as an asexual lesbian (but had, most recently, dated a dude with a dick and tits) questioning her sexuality. Apparently she thought I might have answers. The main answer I got from that date was that I do not enjoy being choked, MMA style.*
The worst part? That was my idea. Not even for erotic reasons, I was just that bored and out of good ideas. Spent them at work, curing everyone but myself. This is not even the worst date I've been on, in fact, she's very hot and pleasant company, which is more than I can say about most straight women. I am clearly doing things very right or very wrong, but I am not qualified to tell. I'll probably see her again.
*She trains, but it's clear that I could have killed her if I wanted to. I told her that up front, sometime around the start of the date, and pointed at a convenient bridge nearby. She actually agreed, and still went for a walk with me through a rather deserted neighborhood. Queen shit.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
4d ago
No gym, some exercise, my excuse is that I'm overworked and depressed. At least I get cardio when I catch my bus or when I run around the hospital.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
4d ago
For whatever it's worth, I'm sorry. I'd say that words are worth very little, but that would be a cynical lie. I know I've been in bad places and kind words even from a stranger helped.
My grandpa isn't all there anymore. At 96 and change, the actuarial tables aren't looking good. But he's at home, and goddammit, he might have spent his life at hospital but if he goes, he'll go at home. Or stay home, surrounded by people who love him. That would include me, if work lets me fly away. This is a grim hypothetical I'm forcing myself to confront instead of unaddressed, and I'm worried about my parents because I'll be damned if they don't another 20 years of reasonably healthy life. Might as well hand in my badge and walk away if I can't do that.
Hoping you're okay now, and the grief has been dulled by the passage of the time. Too much to expect it to just go, it won't.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
5d ago
This is getting out of hand, now there's two of them! Phenomenal.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
5d ago
I can't imagine taking my dad to a dive bar, and neither of us are willing to start fights (I'm a gentle soul), but I do appreciate you standing up for your dad. If someone did actually lay hands on my family, you bet I'd come in swinging.
The story makes it all worth it. I think you left an impression on your dad, the "my little boy is all grown up" kind. And that's really all we can ever expect from our dads.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
5d ago
I usually go for coffee, stronger and a quarter of a quarter of a substitute for the medication I need. But please do send it through, since you're expecting no promises about anything (and thank god for that haha, my soul is barely recovering).
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
6d ago
Heh. Fair, if you still need eyes on the final draft I can go for it with more time and energy this time.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
6d ago
I sometimes wish I was a dentist (not pretty enough to be a hygienist, but I could do with a harem). Mostly for the captive audience for my lectures.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
6d ago
Oh, different thing than I was envisioning. I was talking about the elevated risk of neurodegenerative disorders in neurosurgeons. I mean, I doubt it's all easily condensed down to a single factor, but we quite recently found out that gum infection is linked to cardiac disease too. So I suppose I'm going to keep my eyes peeled and brush my teeth better.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
6d ago
I mean, AFAIK the infectivity thing is mostly for neurosurgeons? People who are actively at risk of inhaling potential abnormal proteins.
And Alzheimer's, in particular, is quite common even without a family history. If you have the option, I would strongly advise starting on a GLP-1 drugs. It's too late when the AD has already set in, but I'm not sure if it makes a difference during the mild cognitive impairment stage, and you're better off starting early. Might be worth getting screened for APOE-4 allele if budget allows, that's a massive risk. 50% of AD cases or more have at least one of them.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
6d ago
Ouch. I'm sorry man, that's the worst, because there's very little you can do about it once it kicks in. One of the many reasons I tell my parents to start or continue semaglutide is the immediate cardiovascular benefit, which translates to drastically reduced dementia risk. I'm guessing this comes too late for you, and if so, my condolences.
No, I don't think I'm you. Too handsome for that, and given the username, possibly less German or Dutch?
I didn't get any speech therapy. I give the speeches and the therapy. I just learned to speak English while in the States and it stuck and morphed into something so neutral it's remarkable.
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