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self_made_human

amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi

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joined 2022 September 05 05:31:00 UTC

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

				
				
				

				

					16 followers  

					follows 0 users  

					joined 2022 September 05 05:31:00 UTC
				


				
					

					
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.


				

				

				

				

					

					

					
					
					

					
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				Culture War Roundup for the week of July 13, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					
Thanks for doing that. If only anyone else who critiques me bothered to use actual data. Or actual effort.


Late 2025 onwards does not coincide with an increase in LLM usage, or the start of LLM usage. It does coincide with exams, incredible work-related stress, and the redirection of my energy.


If you care to check, you will find that for a while now, even my most innocuous comments reliably attract 2 to 3 downvotes. Who from? Dunno. I believe the informal term of art is "haters".


When I was effort posting, or putting more effort into my posting, that would have been masked by a significant number of upvotes. When I'm increasingly showing up primarily in the non-CWR threads, where most comments get a handful of votes anyway?


Still, I appreciate you checking. If you have a simple guide to how you went about it, I'd be keen. Or I can set 5.6 or Fable on it, now that I know hy3 can do it.


				

				

						

							

								
							

						


						
					

				
			


			
			
			
				

			
		

	






		

			
			
				Wellness Wednesday for July 15, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					
Because you keep asking for more weight loss?


To make up numbers:


Let's say x amount of semaglutide suppresses appetite to a degree that accounts for y kg of lost weight for the average person. They plateau there.


Then they want to lose more weight, and go on to take take 2x of the drug and lose 2y of the weight before plateauing again.


That... is the least surprising thing I can imagine. It would be bad if there wasn't a reliable dose-response curve, or if a single dose of a GLP-1 agonist meant that you lose your appetite completely. We aren't trying to induce total anorexia.


It would be something entirely different if you had lost Y weight on X, and then notice that while you're on your regular dose, the weight crept up. That is not impossible, but it is not typical either. That phenomenon would invite questions about tolerance at a physiological level.


				

				

						

							

								
							

						


						
					

				
			


			
			
			
				

			
		

	






		

			
			
				Wellness Wednesday for July 15, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					
You are talking to a doctor who has, at least on LessWrong, written a guide that might as well be called:


"Here's how you, a competent non-medical professional who knows how to use Google and ChatGPT, can maximize the value from the medical system in a manner that won't shoot your dick off."


https://www.lesswrong.com/posts/ypnYfPmn6FqAyxCpJ?commentId=PBQGQ3buve228rNXu


You are preaching to the choir. A reasonably well behaved and sympathetic choir.


At the same time, I have explained at length why the behavior of other doctors is understandable, if not laudable. You and other UMC professionals who do their own research are not representative of the super-majority of patients a typical doctor sees in clinics. There are a lot of idiots out there. Or simply average people who watch the wrong influencers on TikTok.




I am genuinely sorry to hear about your negative experiences with other doctors, either personally or second-hand. I would not be so bold as to call myself the best clinician around, but I try and make up for that with good bedside manner, patience and an open mind.






Doctors are not a homogeneous population, unfortunately there are those who react poorly to perceived challenge. I can't bring myself to hate them, I have felt my patience running short when someone with uncontrolled diabetes shows up with their toes on the verge of falling off and reveals that they refused to take medication as prescribed and decided to use a combination of old Google, influencers and other questionable sources to opt for homeopathy. This is has happened more than once, though I didn't keep the toes. Fortunately, even free ChatGPT is a clear improvement in terms of quality of information and presentation to laymen. I would be genuinely surprised if it defended homeopathy without very significant nudging.




I would be grateful if I wasn't asked to answer for the sins of a profession I am associated with. That is quite possibly not your intent, but it happens a lot. All I can do is be better myself, and try to help people navigate the system.


				

				

						

							

								
							

						


						
					

				
			


			
			
			
				

			
		

	






		

			
			
				Wellness Wednesday for July 15, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					
Doing well enough. The back is better, and I'm back to being mostly better. I become increasingly glad that I'm a doctor, and a decent one: it's the strongest ammunition there is when it comes to making other doctors take you seriously and in convincing them to do the right thing. It's a miracle that non-medics engage with the healthcare system at all, but I suppose it beats dying. The human body continues reminding me that there are riders attached to the lifetime warranty. It's good that I read the manual.


No real exercise beyond carrying my fair share of a busy ward on my back. Getting a suitable amount of professional recognition for it.


				

				

						

							

								
							

						


						
					

				
			


			
			
			
				

			
		

	






		

			
			
				Wellness Wednesday for July 15, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					
As far as I'm aware, there's nothing to be gained by taking time off GLP-1 drugs. They're not tolerance forming. They're not habit forming either.


On the contrary, the last paper I recall reading said that people gained back 2/3rds of the lost weight within a year, probably in the context of semaglutide. I've heard people say that this is a knock against it, which is pants-on-head retarded. Most drugs stop working when you don't take them. It's not an antibiotic (which you hopefully don't need by the time you stop the course).


				

				

						

							

								
							

						


						
					

				
			


			
			
			
				

			
		

	






		

			
			
				Culture War Roundup for the week of July 13, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					
You have to make it worth everyone else's time. And money. That is the benefit of having a reputation, I'm afraid.


				

				

						

							

								
							

						


						
					

				
			


			
			
			
				

			
		

	






		

			
			
				Culture War Roundup for the week of July 13, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					
Thanks. I have a lot on my plate at the moment, and figuring out a way to arrange the transfer that doesn't dox me will take effort. This might entail crypto. Enough effort that I haven't set up something along these lines so far. Remind me if I forget, I'm not kidding about being incredibly busy. I still intend to keep my word, starting from when the money comes through.


Edit:


Alternatively, I can see if Substack can do anything about it. Or if there's Kofi or whatever the hell it's called.


				

				

						

							

								
							

						


						
					

				
			


			
			
			
				

			
		

	






		

			
			
				Culture War Roundup for the week of July 13, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					
$2000 - a small piece of biocompatible plastic/rubber/metal.


$25,000 - for the cardiologist who puts it in, possibly split multiple ways. He's gotta pay off the med school debt, and feed the wife and kids, and manage a down-payment on the Ferrari.


Zorba, if he has any common sense, pays for a Max plan. He has common sense. I can just about guarantee it. That means that regardless of how much the raw tokens cost, as long as he stays within his usage limits, those marginal dollars do not come out of pocket.


I also imagine that he charges enough for his time and energy that a spend of a few dollars to save 10 minutes of his time is a very favorable trade, even accounting for the negatives. I dare say he is a good enough programmer that he is able to audit and vet the AI-expanded code base to his satisfaction, if he hasn't already gotten Claude to automate away the tests. The "better understanding" can probably be priced too, and I'd be surprised if it made a jot of difference with how good modern LLMs have gotten.


In other words, if you disagree with his approach, you do you. It's not your money. It's not your pet project you've run for what feels like a decade. If you've ever paid for a taxi for your burrito, or intend to, that's probably worth addressing first.


If Zorba wants to make the project sustainable, and scalable, and wrest back control of more of his time in exchange for a service he probably already uses professionally? I'm cheering.


				

				

						

							

								
							

						


						
					

				
			


			
			
			
				

			
		

	






		

			
			
				Culture War Roundup for the week of July 13, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					
$600 sounds fair. As long as that doesn't impinge on what I do elsewhere on the internet. I just won't post it here. $1000 if I'm not even allowed to use AI to fact check myself or others while engaging with this platform, even if I am always maximally scrupulous about checking any links or citations. The last thing I need is people breathing down my neck about a hallucination, even if the base rate is nigh negligible these days.


				

				

						

							

								
							

						


						
					

				
			


			
			
			
				

			
		

	






		

			
			
				Culture War Roundup for the week of July 13, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					
    

  1. I didn't advocate for complete replacement of human moderation. I think that is achievable, but I do have hobbies. I said the primary focus should be moderation scutwork, of which there is plenty.
    2. 

  2. I find it unlikely that the inference costs would be significant. A single thread or even a small profile dump? Tens of thousands of tokens. Hundreds of thousands at worst. I've specifically said that we can get away with using cheaper models, or at least more cost-effective models. We don't need Fable.
    3. 

  3. Moderation latency has invisible costs. You don't see the people DMing about their posts not showing up for days because we've been too busy to let them out of the cage. We do.
    4. 

  4. I do not advocate for Zorba to hand over the keys to OpenClaw. I desire human oversight. I also don't expect that the models will pull a coup, or meaningfully distort the conversation.
    5. 



				

				

						

							

								
							

						


						
					

				
			


			
			
			
				

			
		

	






		

			
			
				Culture War Roundup for the week of July 13, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					
Let me explain what is going on.


Apropos of very little, someone comes and tells me that they no longer like me, because I've done something they've disagreed with.


Sure. It's a free country, somewhere. This is a mostly free forum too, or at least a benevolent dictatorship. People are entirely allowed to say they don't like me. All else being equal (which it never is), I'd prefer they did like me, but I sleep easy at night regardless.


I have pointed out that they have the right to say what they wish, a right I'll defend to a sensible extent, if not to the death. I also have the right to disagree right back, and point at a mountain of semi-objective evidence.


From a Bayesian perspective, I would be an absolute idiot to overindex on a small n of people taking offense to what I consider an entirely benign practice, when I quite literally am being amply rewarded - financially, or through feedback - for what I'm doing.


To be blunt, if someone wants me to do something, and feels that strongly about it? Pay me.




Now that Prima opened this can of worms, I concur. Your writing got more verbose and rambling than necessary around the time you started extolling awesomeness of AI assisted writing.




An annoying post-hoc hypothesis, regardless of factuality. I regretfully inform you that my posts have always leant towards long and rambly. If you've managed to find some kind of canonical tipping point, ran things before and after to Pangram, or simply did intensive manual textual analysis to demonstrate your point? Then I would reward that with a more in-depth rebuttal. I have provided said rebuttals in the past. I also have work, and the need to sleep before work.




I find figurative use of percentages unpersuasive in general, but here in particular, what even is the claim stranded here in the weeds of rhetorical grandstanding?




They're not figurative. You can go looking to find me counting, or estimating, at the time of writing.




All of which could have been one paragraph, not four.




"Sure."


Or: "I did not have the time to write a shorter letter."




I do not care to debate (very strongly), what I do in my free time, mostly for free.


				

				

						

							

								
							

						


						
					

				
			


			
			
			
				

			
		

	






		

			
			
				Culture War Roundup for the week of July 13, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					
You could do that. I dare say you should do that. But even the no-effort option would work adequately.


				

				

						

							

								
							

						


						
					

				
			


			
			
			
				

			
		

	






		

			
			
				Culture War Roundup for the week of July 13, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					
It could. There are uncensored models out there that will at least attempt to do anything you ask of them. I haven't kept close tabs on what the most powerful/useful one is, at the time of writing. That's a moving target, but I keep stressing that we don't even need the latest and greatest of matrix multipliers.


This isn't a particular blocker. Even the frontier models would be adequate at the task. It would be possible to set up things at the backend such that a refusal or safety discard would simply mean that a particular comment/post gets moved to the "human approval" queue. In fact, if something is so radioactive that it absolutely won't be engaged with by a typical LLM in prod, then it likely warrants human intervention. We might let it through anyway.


As I've said before, somewhere, at some point: fine-tuning is usually a waste of time. You don't need it. You can probably fit every single moderation decision ever made on this site into <1 million tokens. You only need somewhere between a few thousand or tens of thousands of tokens to enable a decent model to learn in-context. To be clear, I'm using the formal-ish definition of fine-tune, which is a form of post-training.


Example: collect every moderation decision with more than 20 upvotes. That's a strong proxy for both being mod-approved, and for being a decision supported by the community. Can't be more than a thousand of those. Go to >40 and there's probably a few hundred. That is a degenerate but perfectly functional approach.


				

				

						

							

								
							

						


						
					

				
			


			
			
			
				

			
		

	






		

			
			
				Culture War Roundup for the week of July 13, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					
I choose my own bugbears. Or rather, I have them imposed on me and make peace with the fact.


At a difference of values? I shrug and move on. I can do rhetoric. I just don't like it all that much.


When it's a matter of fact, of observing clear trendlines for years? At some point in the last year, I've concluded that most of the skeptics are simply wrong. Or simple idiots. Arguing with them is no longer the best use of my time.


https://www.themotte.org/search/comments/?sort=new&q=author%3Aself_made_human%20LLM&t=all&page=1


Nobody can claim I haven't argued. At length. With remarkably unpleasant people. All while hoping to change their minds. All I got out of it was an ulcer, hernia and an aneurysm.


"AI skeptic" is an imperfect taxonomy. There are people more conservative than I am (and it's reasonable to disagree on priors). There's the people who think we've got AGI with GPT-4. And then there's Gary Marcus, Hlynka, and other people who misuse the gift of cognition.


There are reasonable skeptics. There are people who performatively attempt to mimic being reasonable, and fail, because their reasoning is as motivated as R1 trying not to mention a certain square. There are people who never even pretended.


And then there are the normies who don't know better, with varying degrees of their own motivated cognition. The "AI drank the water from my granny's IV drip" kind. The "they turned off her ventilator because of the electricity bills" fools. The world has never lacked for useful idiots.


If you say that you're unhappy about OAI and Anthropic's duopoly (as fragile as it is), then what can I say except so am I? In a reply written before yours, I've already suggested Chinese models as an acceptable alternative to the privacy conscious.


I am a moderator. I know how difficult doing that task well is for a human. I know that is not particularly difficult for even an older LLM. I have quite literally tried, nodded, and thought the models got it. Years ago.


				

				

						

							

								
							

						


						
					

				
			


			
			
			
				

			
		

	






		

			
			
				Culture War Roundup for the week of July 13, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					
I am listening to your opinion. I am also going to point out that I'm an ACX BR finalist. On my first and only entry. It genuinely is too much to expect me to please everyone. I don't have the budget for it.


I can't think of a change in medication that could possibly account for what I will concede is a change. Everyone changes. It's a side effect of living, or at least learning from experience. I have no idea how much of the stylistic drift you've picked up on is due to internal processes, or because of LLM contribution. Which I have always explained has been less than 10% of the total of any given body of work. Usually less than 95%. Often less than 99%.


Incidentally, that book review is personal. I don't have to name which one it is, since it's rather obvious. If someone else can handle being repeatedly, unforgivably failed by the same system he works for better than me? Haven't met them yet. I think someone who had to pull themselves out of a moderately-severe depressive relapse, do what I've done in the last few months without writing about most of it - could get away with being much less kind and much more bitter.


So yes. Life circumstances. It's a miracle that I didn't hand in my resignation at multiple opportunities. Clearly there's something about my job that keeps me going, or my psyche has built a load-bearing pillar called "not giving up." There are worse pillars.


				

				

						

							

								
							

						


						
					

				
			


			
			
			
				

			
		

	






		

			
			
				Culture War Roundup for the week of July 13, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					
You don't need a SOTA model. I've definitely seen how well Gemini 2.0 Pro does that at job, and probably Gemini 1.5 Pro.


At scale, it would make sense to run our own open-weights model. The Chinese make them cheap, cheerful, and good-enough quality. There are "uncensored" or abliterated models falling off the back of a truck on HuggingFace.


The MVP would be something that can filter out the real dogshit, or at least flag it and reduce moderation load. Include the constitution, some worked examples (particularly tricky cases), and so on? It will work. No real need for extensive fine-tuning, the models have long been smart enough to figure it out on the fly.


				

				

						

							

								
							

						


						
					

				
			


			
			
			
				

			
		

	






		

			
			
				Culture War Roundup for the week of July 13, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					
Are you accusing me of using AI on this post? Hah. No. I considered getting Fable to do the work for me, because that would have been mildly amusing. I didn't succumb to the impulse. Go check Pangram, if you care to.


If not, then all I can say is that I do consider feedback. My decisions are rarely not considered in depth. The unfortunate reality is that I have limited time, limited energy, and that I have good reason to use LLMs the way I do. I'm just more honest about disclosing the usage (limited and scrupulous as it is) when challenged or politely asked. Annoying people has never been an end-goal, but you don't become an Unslop finalist by being bad at what you do.


I am not bad at what I do. If you believe otherwise, I can only shrug.


				

				

						

							

								
							

						


						
					

				
			


			
			
			
				

			
		

	






		

			
			
				Culture War Roundup for the week of July 13, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					
As an aside: it amuses me greatly that we have so many AI skeptics here, on a forum that is increasingly AI-coded.  I'm happy to concede that there are significant benefits to having someone who is a competent programmer running the show, but the jig was up well before the last idiot concedes it's up. May all the monkeys enjoy the last dance.


Case in point, we've got a CLAUDE.md on the github project. Fable claims 61/66 of the commits in the last 6 months as having explicit AI-labeling. 5.6 Sol claims 60/66. Your skepticism, brought to you by Claude. If I had any more irony in my system, they wouldn't let me near an MRI.




With my annoyance expressed into the ether, I'm supportive of this move. After all, it's shown dividends when deployed by rdrama, our uneasy ally with whom we share much of the code-base (or did, at some point, I'm not going to do a diff).


Stagnation is death. We've done better than I expected after our migration away from Reddit, but that is not the same as better than hoped. Reddit offered organic discovery opportunities that being a standalone (niche) forum doesn't.


I'm sure there's an audience. Particularly people who want their own quasi-independent silo but are leery of associating with the shit-flingers at rdrama (I'm fond of those monkeys, in small doses).


More importantly, I don't see much downside in trying. Not every ambitious project achieves what it sets out to achieve, but if the workload is ameliorated by LLMs, and if we're wisely offloading some of the hosting costs to those who care to pay? Bring it on. I will observe with keen interest.




Since I've given up on winning popularity contests, I will suggest something I've idly-floated for years. LLM-moderation.


It's been feasible for a while. More than feasible, in fact. At the risk of tooting my/our own horn: what makes this forum something more interesting than rdrama is a dedicated, hardworking (or hardly working) mod team that keeps the worst of the nonsense away from tender eyes they might tenderize. This is ridiculously rare, and a precious human resource that is easy to exhaust. Where are you going to find entities above room temperature intelligence, with a borderline autistic devotion to interpreting somewhat vague guidelines and what feels like a decade of case law, in the spirit intended?


Ah. Wait.


It would be trivial. It would be easy. More importantly, it would work. Not perfectly, but nobody ever accused us human mods of being perfect. But the Motte is a relatively slow moving, text heavy forum, and API calls wouldn't break the bank. You don't need frontier intelligence. I've tried this experiment years ago, and found adequate results. It's so boringly easy that I won't bother replicating it, unless someone I like asks politely.


The biggest blockers would be radioactively-hot CW-content that provokes a safety classifier or flinch reflex. That is nothing that can't be prompted away.


We don't have to replace humans wholesale. That is not desirable at present. But a lot of the scutwork would cease to be an issue. No more posts lying in the filter. There are implementation details to consider, such as intentional abuse through token-spam, but we're smart people. We'll figure it out. Or set an expenditure cap. Or get fucking Haiku to do it. Our auto-janny can do with an upgrade.


Forgive me. I'm always in a rush to automate away my job before someone does it to me first. That way, I get to put it in my CV, instead of looking for work at a CVS.


I will elide the boring concerns about the payment processing, handling illegal content etc etc. I'm not here to teach you, Granny Zorba, to suck eggs.


				

				

						

							

								
							

						


						
					

				
			


			
			
			
				

			
		

	






		

			
			
				Small-Scale Question Sunday for July 12, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					
I paid 15 quid for them on Vinted. It'll be me, them and a toothbrush I don't miss.


				

				

						

							

								
							

						


						
					

				
			


			
			
			
				

			
		

	






		

			
			
				Small-Scale Question Sunday for July 12, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					
What's the best way to get bubblegum residue out of trousers? Feeding it back to the antisocial asshole who left it on the bench is, sadly, not an option.


				

				

						

							

								
							

						


						
					

				
			


			
			
			
				

			
		

	






		

			
			
				Friday Fun Thread for July 10, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					
I saw someone put a traffic cone on a statue in Glasgow. It felt like seeing a real, live leprechaun.


There were police waiting for him, by the time this ginger man gingerly clambered back down. They had a very polite conversation, shook his hand, and he stumbled off to to cone another day. I'm not sure what you can even charge someone for, if they do that. It's just part of the civic culture really.


				

				

						

							

								
							

						


						
					

				
			


			
			
			
				

			
		

	






		

			
			
				Friday Fun Thread for July 10, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					
I have no thoughts on Chinese Salvationist Religions. Or at least I didn't, and now I must know. More Jesus's lil bro and 1 gorillion dead stuff?


				

				

						

							

								
							

						


						
					

				
			


			
			
			
				

			
		

	






		

			
			
				Friday Fun Thread for July 10, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					
I'm surprised you missed the hoe-flation joke. Had it all lined up for you.


				

				

						

							

								
							

						


						
					

				
			


			
			
			
				

			
		

	






		

			
			
				Friday Fun Thread for July 10, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					
I haven't seen any horse-shoe desks, including at the multiple hospitals I've worked in, in Scotland. But blonde receptionists? Could buy two dozen for a dime, thanks to inflation. I can't say they've been particularly bitter, but in smaller towns, my female patients and pub acquaintances have told me that they're almost always incredibly nosy gossips. That's the main perk of the job.


				

				

						

							

								
							

						


						
					

				
			


			
			
			
				

			
		

	






		

			
			
				Friday Fun Thread for July 3, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					
There were waiters available. They seemed perfectly nice, but I had something to prove and didn't want to ask for help. Mostly because, contrary to appearances, I can sear and cook meat without killing anybody. It's been long enough that I don't think I've caught tapeworms.


Sadly, I might do it again if it wasn't for the expense, as you noted. It was as or more expensive than a conventional restaurant where you just say "medium rare" and get what you asked for. That is unconscionable.