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
2d ago
At least it's not the other kind of AIDS, but I presume that's an American excuse for a beer that could potentially spread it around.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
2d ago
Thank you. I'd call you a bby girl too, but must settle for a more dignified "young lady". And sending kisses your way might be taken the wrong way.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
2d ago
I am fond of money. I made an amount that's nothing to sneeze at through writing, unless you have hay fever. But I have a day job that keeps me up at night. I also have too much dignity to tweet.
Anyway, I've never claimed that I am gone for good. And unfortunately, I am still a mod (and paid well for it) so I can't just start calling the people I particularly dislike retarded and spin up an alt. @Amadan would catch me.
The thing about Britain is that the Summer always ends, and at some point it’s cold and grey (worse up where you are) and there really isn’t anything better to do on a quiet sunday morning than argue here.
You don't have to tell me. It was 36 degrees in Manchester a day or two back, and even Scotland is above thawing. I swear I almost felt a warm breeze, but it could have been someone farting on the bus.
This place has had me when I'm depressed and have no time to spare but spared it anyway. Now I'm less depressed (but brittle), and I don't really want to spare the time. I can make bad puns at work that people don't want to laugh at, but end up wheezing to anyway (it's hay fever again). I can comfort the dying. I can flirt with the grannies and their still-too-old-for-me daughters and pick flowers that catch my attention and present them to someone I like, who unfortunately has asked me not to write about her. Maybe I really should just get married, there are a few promising candidates. And then I'll be right back here, to avoid my wife of course.
Yup. Becoming a dad will solve my problems. Or swap them out for new, more exciting ones. Soon enough. They got stale.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
2d ago
Ahem. I get laid most of the time. Even when depressed (it's therapeutic).
I am aware. If I wanted people to have a front-row seat to my life, as I have in the past, I would have written about it. At most, I let you guys look through the cracks when I open up the blinds.
I will be brief, and vague, because the details are for those who actually know me. Oh dear, on an edit pass, it seems we must settle for merely vague.
Just over 2 months ago, I was a wreck. A high-functioning, white knuckling wreck. But very close to falling apart. Many reasons, all of them valid ones. I do not make it a habit of worrying about what's not worth worrying about. I had my exam, brutal work, a seemingly terminal case of impostor syndrome because I have been treated very badly at an earlier placement.
I would say that I am a reasonably competent psychiatry trainee. I am also unreasonably against seeing a doctor if I can help it. If I was begging for an urgent psychiatric review, you can imagine it was bad. Bad enough to cut through the depression and exhaustion and akrasia and despair and beg for help. I got... not fuck all, something more than nil. Approximately about as much as I could expect from the NHS, which is why I got a lot of blood tests and investigations done on my own dime, on vacation time, before returning to work like a man walking to the noose. And that's why I'm going to be spending a small fraction of my psychiatry trainee wages on appointments with more senior psychiatrists, at some point. That's a circular economy for you.
I realized, to my despair, that I would have to work on fixing my own issues in my own way. It worked, or at least I have avoided ending up on the other side of the couch. And it had a strong helping hand from actual people, IRL, telling me, with actual sincerity and gratitude, that they appreciate me for who I am and what I can do. I won a decent amount of money through a rather challenging contest with big-name panelists you've heard of. Might talk about that one at some point. I am, of course, a finalist in the ACX book review contest. I had/have excellent, talented and supportive colleagues who went out of their way to make my life easier - while showing me they care. I have a good boss, an experience I didn't expect given that the last couple have been useless as an asshole after a colostomy. A rather thankless job, where I end up getting thanked by my patients on a regular basis anyway. I am not lying about the compliments, I have better things to do than make up things on the internet for clout. I have been doing exactly those things.
And, of course, my dreams/hopes/nightmares are coming true. AGI is right around the corner. Am I allowed a "I told you fuckers half a decade in advance?". Is it here? No. But it's gone from knocking on the door to shimmying the locks or preparing to kick down the door. I am not sure I can achieve everything I've wanted to achieve before it kicks it down and makes itself at home on my couch.
So I'm having fun, and making hay while the sun shines. I've been present in reality. The parasocial engagement of arguing with idiots on an Underwater Basket Weaving forum has lost much of its charm. Not all of it, clearly, since I was here yesterday, and show up every week when @FtttG pings me in this thread. As the Scots would say, I cannae be arsed to deal with some of you. Your boos mean nothing to me, I've seen what makes you cheer.*
I have a job, a social life, responsibility, and a beautiful summer to enjoy and photograph. I was incredibly stressed, running on fumes and quiet desperation till I ran out of the fumes. I'm now only moderately stressed, and grimly determined to have a good time anyway. Life's actually good. Very far from perfect, but I'll take the scenic route. You have seen me severely distressed, close to breaking point, solving my own problems instead of bitching about it, and now doing what I like, when I like it. How queer.
*This is not a personal attack on you, most of the people here are fine. I'd call a handful actual friends. I was just never kidding about feeling sympathetic towards @DaseindustriesLtd when he picked up his ball and went home (or was shown the door for a while, wonder if the ban has expired) . I have no interest in flaming out, I'm not saying I'm going anywhere, but I genuinely do not care about this place as much as I used to. I lack the spare time, or the spare energy, and my Ritalin is well-employed getting me through my job with little spare to write essays on the shitter. My priorities are finally about as straight as I am. Good luck to the rest of you.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
Thanks bby girl 😘
I've got the email that I've been expecting/dreading to show up in my inbox for a while. It showed up 5 weeks in, which is a reasonable duration to wait for antidepressants to kick in.
Well, I'm pleased to say I've passed my MRCPsych Paper B. Only one more exam to go before I'm halfway to being a senior shrink. It's more impressive than it sounds, I hope, because training takes a ridiculous amount of time in this country.
I got the ward sweets. And my colleague the Percy Pigtails I couldn't find last time, when she was having her own mental breakdown with her wedding coming up (or hypoglycemia). I flummoxed her when she asked me if I had ever tried one by asking if it was halal. She actually checked and said it was vegan friendly. I said that I'm fine with that, given that I'm not a Muslim. Poor thing, she's genuinely sweet and sincere and vulnerable to my brand of humor.
Swung by the consultants room before that, and told my CS I'd made it, despite giving the exam in the state he'd seen me in when I was a few weeks into the placement. And offered more chocolate to a cute baby someone brought along, but she was on a liquid diet. Her mother accepted it and promised to hold onto it in her stead, but I have a sneaking suspicion she ate it. Oh well, I can always get more chocolate. And more reasons to get others chocolate.
And of course, I video called my family first. They were happy. They knew their little boy - he's never failed an exam in his life that wasn't at an optometrist.
I had to stay back late at work, because of course I did. But nothing can get me down today.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
Please see my reply to George.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
Indian furries either never existed, or like the Asiatic cheetah, have gone extinct. They won't even survive the journey to the air-conditioned convention center.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
I'm not opening that video, unfortunately. Instagram seems to think I'm a gay Chinese woman, and YouTube shouldn't get any ideas.
But when the uwu maid outfit gay guy is less comfortable with a one-night stand than urquan
I shall not intervene in a lovers tiff. Unless you pay for couples counseling.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
Social technology is grossly inferior to medical technology. We couldn't shame or blame or diet away the obesity epidemic. Ozempic is doing what no amount of moralizing can.
https://slatestarcodex.com/2014/09/10/society-is-fixed-biology-is-mutable/
Society is really hard to change. We figured drug use was “just” a social problem, and it’s obvious how to solve social problems, so we gave kids nice little lessons in school about how you should Just Say No. There were advertisements in sports and video games about how Winners Don’t Do Drugs. And just in case that didn’t work, the cherry on the social engineering sundae was putting all the drug users in jail, where they would have a lot of time to think about what they’d done and be so moved by the prospect of further punishment that they would come clean.
And that is why, even to this day, nobody uses drugs.
On the other hand, biology is gratifyingly easy to change. Sometimes it’s just giving people more iron supplements. But the best example is lead. Banning lead was probably kind of controversial at the time, but in the end some refineries probably had to change their refining process and some gas stations had to put up “UNLEADED” signs and then we were done. And crime dropped like fifty percent in a couple of decades – including many forms of drug abuse.
Saying “Tendency toward drug abuse is primarily determined by fixed brain structure” sounds callous, like you’re abandoning drug abusers to die. But maybe it means you can fight the problem head-on instead of forcing kids to attend more and more useless classes where cartoon animals sing about how happy they are not using cocaine.
What about obesity? We put a lot of social effort into fighting obesity: labeling foods, banning soda machines from school, banning large sodas from New York, programs in schools to promote healthy eating, doctors chewing people out when they gain weight, the profusion of gyms and Weight Watchers programs, and let’s not forget a level of stigma against obese people so strong that I am constantly having to deal with their weight-related suicide attempts. As a result, everyone…keeps gaining weight at exactly the same rate they have been for the past couple decades. Wouldn’t it be nice if increasing obesity was driven at least in part by changes in the intestinal microbiota that we could reverse through careful antibiotic use? Or by trans-fats?
How prescient. Lucky that I've made my peace with never being as good as Scott. Well, I'm content with being the fourth best psychiatrist blogger on the internet. I can only name two who are better, but eh, humility is clearly my greatest strength.
Likewise I don't agree that we should just let them die from venereal disease but it should be doable to understand why some people feel that way.
I understand these people, on an intellectual level. I understand why schizophrenics are the way they are too, but I don't relate to them from a phenomenological perspective or like their actions.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
I am, in fact, annoyed to read this. But only slightly, and neither of us need to lose sleep over it. That sentence is, unfortunately or fortunately, entirely human written. With the thumbs I've been twiddling. There are only so many ways to rephrase or repurpose "A lie can travel around the world and back again while the truth is lacing up its boots.”—Mark Twain. That em-dash being part of the Google search snippet I've snipped and pasted.
I suppose you must have been prettier or more twink-passing than me, because I can't say I've been plied with booze on a regular basis. Not that I would accept the booze, really. I can buy my own drinks, and to quote myself:
Etiquette required reciprocation. Also, heterosexual uncertainty suggested that free liquor in a gay bar might have exchange rates I was not qualified to negotiate, so I bought two shots and took them over.
I would take issue with your comment in another reply actually, that straight men don't engage constantly in illicit sex because they can't. Yes, some would, and I know them. I wouldn't, could have (perhaps even still could) and haven't, and even for those who might say "yes you have" I'd counter not nearly to the same degree as the gay dudes I've known who have had triple or more digit partners. There's something else going on. I could be wrong of course.
I do think you're wrong. And most gay men don't have triple digit body counts. Google informs me that depending on who you ask, the median is 19-23. The mean is higher, because some of them really get around.
That is why I chose "[straight] male supermodel" as the reference class. I've done pretty well with the ladies, and I am quite keen on shacking up and settling down. But if I could get away with, I would very much have racked up or stacked up similar numbers by that point. Unfortunately, I'm only decent looking, funny and in possession of a modest amount of social status, not a supermodel. I have to work for it.
In other words, straight male sexuality is bottlenecked by the lack of women willing to really exercise it. That is not true for the gay men. The straight men who are hot enough to have as many women as they desire tend to sleep around a lot. Good for them. I don't deem it pathological in either instance, as long as it doesn't make them bitter and unhappy (which it sometimes can). And I can't pity them, because I would trade places in a heartbeat with the straight ones.
You are welcome to calculate the relative burden or expense in terms of costs swallowed by the gay men vs externalities. The hard numbers I've quoted (with citations) are fucking chump change. Less than HSR. 1.5 Bridges to Nowhere.
A few hundred billion dollars? Then we'd be talking real money. Or a nice week in Tehran. Where exactly are the additional costs that are being imposed on the general populace? I'm sure they exist, but I don't think they sum up to very much. And the alternative of people dying of HIV is not pretty or cheap either.
I'm sure someone with more spare time (or Ritalin) can take a crack at reverse-engineering financial figures or willingness to pay to avoid being around gay people. It's not going to be me.
HIV is not randomly distributed across the population (nor is it distributed evenly across the population of gay men). People who get HIV are more likely to be materially disadvantaged, not less, so the taxpayers are more likely to pick up the tab.
And what difference does that make to anything? I have quoted the bill, we know the tab that's paid at taxpayer expense. This adds nothing, changes nothing. It's not like there's one gay dude with super-AIDS costing you $30 billion, who you could knock on the head and save everyone a lot of hassle.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
I've logged an unfortunate number of hours in "gay" environs. Sadly I can't put that in my actual logbook or portfolio. Perhaps I'm not young (and was never particularly athletic), but I've never been sexually harassed. The closest was some four-eyes weirdo friend-of-an-acquaintance who was coked up, drunk to his man-tits, and convinced by the coca-ethylene to attempt to convince me that I wasn't straight. Very intense. Very retarded. I sat there in increasing discomfort, trying to tell him (politely) that I wasn't interested. Eventually he gave up and went off to go hit on other straight men, or I went off to get a pint and throw darts. I suspect I had a better hit rate. This was just a regular pub, on the seedy side - it had both pensioners and people propping up the Albanian GDP in the toilets.
Nothing else ever happened. I find it very funny when the gay men in actual gay places hit on me. It's good for my ego, or at least it was before I worked out, put on nice clothes, got a nice haircut and enjoyed attention from actual hot women. It's been known to happen. I don't blame them for trying (by which I mean the men). Yeah I'm fucking sitting there in a gay bar, notorious for hosting straight men first and foremost.
I can only say that I've done more time than you have, probably. But the world is a big place, and I don't claim to have performed an exhaustive or representative sampling of homosexual behavior on a global scale. All I can say is that the UK is as or more friendly to the gays than the States is. And it's fine. It's fucking Pride Month and I haven't seen anything ridiculous. I would have, I suppose if my little brother had shown up and I had a reason to expand his horizons. But no, as far as I'm concerned, things are fine.
Another similar problem (in the U.S. at least) is a rise in STIs and drug resistant STIs because gay men have hundreds of partners, refuse to use condoms and then fuck bi and "straight" people. Because they can't get pregnant and HIV is no longer a death sentence they refuse to use safe sex practices. Shut the fuck up and wrap your shit or have a reasonable number of partners, "benign" STIs are significantly more problematic for the female population.
Do I approve of this? You can guess. But there is no point to getting angry about it. The average straight man or even the above average straight man doesn't fuck hundreds of women raw because the latter have standards. The mid gay man can (but not necessarily does) fuck like a straight male supermodel because he's not restrained by feminine sexuality. You are complaining about men being manly men with other men. The straights would do it if they could. They just can't.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
And yes, this is also true for a lot of other things - simple overeating is a much larger drain on the taxpayer than HIV, and you shouldn't pretend like that doesn't have negative externalities either.
And I never have. I'm voting for the party that supports Universal Public Ozempic.
These are a lot of words to say that "spreading HIV actually costs the taxpayer a ton of money and even the best way that we know how to reduce the costs still costs a ton of money and all things considered it would be better for society if people didn't engage in risky behaviors that spread HIV."
Are you surprised that I am internally coherent and know the facts? Don't be. The nerd who calculates QALY figures isn't. You can also use more words too, really, but I'd presume that if you found an actual logical flaw in my argument you would have pointed it out.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
I can and I am. In the wrong tax bracket. Mostly being taxed of patience and the will to live.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
This really is a "More than I ever wanted to know" post, but thank you, sincerely. I did look at the Ryan White figures at about the same time, and I knew that someone would show up to nitpick the bugchaser stats. Didn't think that someone would be you, but I'm not really complaining.
and has a body count of six, total
Because it's hard to fuck in a fursuit without getting heatstroke? Should I even ask? Do I really want to know? Tell me anyway.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
You, me and everyone else who is a net positive tax payer. In theory, I'm not subsidizing the lifestyle of an American with HIV, or even just their life.
But we subsidize a lot of things dawg. Old people. T2DMs hitting the soda fountain while their kidneys spit out sprite. Children with leukemia. Not smokers, since they pay for their sins by saving the taxpayer money by denying themselves old age <3
In the US the tab runs through the public ledger far more than the private one (your healthcare system is deeply in the closet, and claims to be privatized). Medicaid is the single largest payer of HIV care, Medicare second, and the Ryan White program bottoms underneath both as the "payer of last resort," funded at roughly $2.6 billion in FY2024. Domestic federal HIV spending sits around $28 to $33 billion a year, the large majority of it mandatory entitlement money that swells with caseload. Per head, lifetime care runs about $420,000 discounted and north of a million undiscounted, with something like 60 to 68% of it being the antiretrovirals themselves. So yes. It is socialized. I'm not going to pretend otherwise to protect my flank. Or my ass, which is unviolated by anything but NHS negative-ply today.
But you gotta spend money to make money. And in this case, you do make money.
Then the part that should actually interest a cost-conscious person, because it cuts the other way from how you're swinging it through implication. Because U=U holds (UwU) and a virally suppressed person does not transmit, the single most cost-effective prevention tool available is putting positive people on the drugs and keeping them there. Every suppression is an infection that never happens, and every averted infection is another ~$420k to $510k lifetime tab that never opens. The modelling supports this, AFAIK: in the Botswana combination-prevention work each averted infection saved about $9,200 in downstream care and pushed the whole intervention into cost-saving or near-cost-saving territory.
ART buys a lot of QALYs for the treated person, and viral suppression also prevents expensive future infections. At U.S. drug prices, the treatment itself is costly, but interventions that get people diagnosed, treated and suppressed often become cost-saving once avoided transmission is counted.
ART for diagnosed HIV? A fucking bargain at about $21k per QALY.
https://pubmed.ncbi.nlm.nih.gov/23318310/
Well below the usual threshold of $100k per QALY.
ART for prevention? Even better, because you're averting transmissions and secondary QALY/financial losses. HIV is highly contagious (surprising nobody here, I hope, there's a reason it's everywhere and has been for decades).
Finally, ART costs money because people live for decades and keep taking drugs. Duh.
Untreated HIV is not free to the pool. You must consider opportunistic infections, ICU admissions, and onward transmission, all of which cost more than the pills. If your genuine concern is my wallet (doing fine) or yours (can't say) the wallet-minimizing policy is more treatment, started earlier, not less. I'm libertarian-adjacent, and I'd prefer that people pay for themselves really, but if we're going to pool risk and expenses, we might as well do it sensibly. Why yes, I work for the NHS.
If you're trying to pray away the gay, or AIDS, it's not going to work. Things were worse in the 80s and 90s, when the disease was a death sentence. I have little interest in considering "solutions" that involve trying to get rid of gay men being gay men (good luck, even immense social stigma and a near lethal disease couldn't do it), and it's not like most countries don't spend on primary prevention or awareness programs. I'd suggest cutting the budget for expeditions in the ME first, not that anyone listens to me about that. The drugs continue to get cheaper, and I continue to get drunker while the Ritalin wears off.
That is all I have time for, because I'm at a straight pub and I intend to enjoy myself.
I have a "want to get married and live like normal people!" gay brother, and even before he came out to me, the people who reliably made my skin crawl were the moralizers, the ones who can't watch someone live an alternative lifestyle without reaching for the pulpit. That impulse disturbs me more than anything happening behind the bush.
And yes, there are millions of gay men getting their backs blown out and gagging on cock behind that bush, and I seem to know half of them. That's what happens when you spend a questionable amount of time in gay spaces because the conversation is genuinely good (and the drinks are cheap). I'll keep it simple. When two consenting adults do something gross in a way that touches only the two of them, the harm doesn't fuck you in the ass or to the kid down the street. When their lifestyle does turn harmful, the fallout lands almost entirely on the people who opted in. I have zero appetite for assless chaps or golden showers. As long as nobody touches me up, which has never happened because I'd sock them, it stays squarely none of my business.
I'll turn my gaze to the strongest version of the other side, because I'm an even handed and bored person. Bugchasing is "real". The documentary exists. The visibly sick guy saying he doesn't care if he spreads it exists. The tail of the distribution is not empty.
There. Done being even handed. The "standard fuck party" clip recirculates on /pol/ for the same reason 2003 Rolling Stone "Bug Chasers" article went viral. It happened to be lurid, enraging, and claimed bugchasing accounted for up to a quarter of new HIV infections among gay men. That figure was downstream of a single source and fell apart on contact with reality, in part because Freeman had casually reclassified every barebacker as a bugchaser regardless of intent. When researchers actually combed profiles on a bareback-centric site, the share of HIV-positive men actually trying to infect partners came out around 1 percent. Most self-described "bugchasers" were roleplaying a fantasy they never acted on. Your feed is tuned to churn up that 1 percent because it enrages you, which means the sample is poisoned before you ever start counting. Base rates people. Look them up.
The most questionable things get signal-boosted to awareness. That is how the internet works. Nobody forwards clips of a gay accountant making lasagne for his husband, two mildly overweight lesbians arguing over oat milk, or some HIV-positive man taking his ART, remaining undetectable, and living a life so boring it would put /pol/ into a coma. The transgressive, and morally alarming material travels. Normality is busy tying laces. You can build an entire worldview out of the most alarming 0.1% of a group, but at that point you've given up on sociology. You've ended up producing pornography for your prejudices. And whoever enjoys that hobby should take up yoga and go fuck themselves.
My own anec-data, for whatever an n-of-my-social-graph is worth? I have the ethnographic essays, and after snowball sampling through the gay men I actually know, nobody could name a living bugchaser. Only the gray-haired ones remembered a few, and those few were dead. AIDS, obviously.
The calculus of harm has gone to bed, while some of the panic remains like a bad hangover from 2003. A virally suppressed person on antiretrovirals transmits HIV to sexual partners at a measured rate of zero. Howdy, PARTNER: we've logged tens of thousands of condomless acts between serodiscordant couples and recorded not one linked transmission when the positive partner was suppressed. "Undetectable equals untransmittable" is the CDC's official position, and that happens to be backed by the largest prospective evidence we have. Is there any problem better drugs can't cure?
Sigh. I really can't spare more effort for the old "some members of group X do something disgusting, therefore contempt for all of X is warranted." Run it against any large population and watch it generate nonsense. The worst 1 percent of evangelicals, of soldiers, of parents, of whatever demographic you happen to belong to, or dislike. That's where the ruin lies.
So sure, go off, kings (or queens) who disagree. I've made my peace with being one of the rare freaks in this thread who is actually open-minded and willing live, let other people live, or die.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
4d ago
Nothing to report on the fitness front. I am particularly annoyed that when I do have the occasional twinge to pay it a visit (on the way back from work), it's overrun with women hogging the leg press machine. Well, at least it's a nice view. I just don't like sitting around waiting for a machine.
Doing aight in other ways. We have a pharmacist who loves his job. Perhaps too much. No, cyclizine is not particularly a drug of abuse, and I didn't need him breathing down my neck about it. Aggressively gay, in an anal way. Owns a Chihuahua too. But he's a pretty nice guy, barring possible OCD, and I have other hills to die on. If you thought I was dedicated to my job...
I've also realized that my colleagues are on to the fact that I seem to own only three shirts. Which isn't correct, I do own at least 5, but I used that as impetus to go raiding Vinted and I'm in the process of discovering my Inner Indian and the joys of getting nice clothing at reasonable prices. I seem to have spent all of £90 on half a dozen items in a week, which is practically profligate spending on clothing by my usual standards.
I suppose some might be surprised to learn that clothing prices are much the same in the India and the UK, in absolute terms. In relative ones? Might be cheaper to get new shirts and throw them away rather than launder them.
I've been getting out and about. Taking pictures. Being a pub psychiatrist and giving free advice, with people getting what they paid for. Doing a reasonably good job at actual work - where they don't pay me either. Today, I happened to run into a lovely old lady I'd screened for cognitive impairment and taken a history off while her husband and his brother wheeled her out. Did my usual song and dance and advised her to enjoy the fresh air. As I turned the corridor, I heard her say "isn't he such a great doctor" and that made me ache. Well, I try.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
11d ago
My junior survived her internship. Genuinely survived, she had an awful time, and now has a job in Australia waiting: more money, more sun, the universe settling a debt. Very inspirational, I'd be off to the Sunshine Coast if I could, instead I must endure the Scottish sun and coast.
I offered to get her something to celebrate the occasion. She declined. I bought cupcakes anyway, nice ones from M&S, on the medical grounds that her caloric intake is a matter of public concern and I have a firm policy of not listening to women about whether they need to eat. Success rate: non-zero. Still going.
Then I got a migraine and microwaved the cupcakes. Not my food. The cupcakes. She was touched. Took a photo for TikTok, laughed maniacally till she had tears in her eyes, and ate none of them, because she doesn't eat cake. Except when PMSing. Allegedly. I asked how I was meant to know when that was.
"Don't worry, self_made_human. You'll find out."
I have never been more afraid. I couldn't even fob them off on the very broke German med student, mostly because I was too honest and described them as cupcakes from Chernobyl.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
11d ago
Working out when I can be bothered, which is not never but also nothing to write home about. Otherwise? Life isn't bad.
I stayed back late yesterday, on my own terms, for a patient. Nobody asked me to do a cognitive history, just the MMSE. But I did it anyway. The hospitalist who requested it is probably very skilled in his his chosen field, but I am of the strong opinion that a cognitive test that doesn't take into account the full context isn't worth the paper, or the ink. A lovely old lady, with a shopping addiction that her just as lovely husband had to put a pause to a few years earlier. And much more serious issues, which warranted the admission to what isn't a psych ward. I took my time. I enjoyed myself. She had attention issues and hadn't finished previous cognitive screens because she got bored in the process. I am many things, but not boring. And somehow I managed to hold her interest, and get the annoying instrument completed, and also get her tissues when she broke down halfway while writing a sentence about how much she missed her parents.
I said that my history might be superfluous, since they're seeing a better psychiatrist (a nice enough cons I knew), but they made me blush by telling me that I was the better psychiatrist. I'll take it, bashfully.
And of course, as I slightly hoped for but was prepared to never receive, the hospitalist consultant said very nice things about me during the ward round this morning. I wasn't there to hear it, but I'm not very secretly pleased. By which I was very pleased, but tried to keep it a secret. And failed miserably.
No, I'm doing just fine.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
11d ago
The Rising Son Meets The Falling Father
It's not fun, looking in the mirror and seeing your dad looking back at you. Fun would be the wrong word for it. "Interesting" is more accurate, and "oh god, I understand him now" is more accurate still, and more helpful besides.
More hair. Or at least as much hair as he had at my age. The same facial features, remixed. Half a foot of extra height on him, because he grew up poor and didn't get to eat as much as a boy should. The intensity of the gaze. That's what you can see from the outside.
What you can't see so easily from the outside is what matters more. My father is quite possibly the hardest working man I know, to a degree that is frankly concerning, and also responsible for most of the good things in my life. His retirement planning is... to not retire. If he can help it. At a certain point I came to the painful realization that he doesn't have much of a life outside work, and that he's never been looking for one. He's happier about this than I am. Or at least the same "grumble very loudly but keep doing it anyway" impulse runs in me too.
I've told my mother that, in the unfortunate but real event that he develops dementia, the kindest thing would be to build him a fake OR and hire some very long-suffering and competent actors (or actresses, given his gynecological competencies, or your tolerance for gendered language). Hand him a scalpel and a few laparoscopic instruments I can't even name, and he'd do a better job than most surgeons, even cognitively impaired. Hmm. Perhaps we could hire actors with uterine fibroids or complicated pregnancies. And possibly charge them for the process.
It seems I've just reinvented his day job. Good. He prefers it that way, to the point that he does it half the night too. He'd get so much over-time if he wasn't self-employed.
I used to be intimidated. To be fair, I still am, slightly. I had many reasons for opting for psychiatry (a better work-life balance, and being able to yap at people and get paid for it), but one of them was the desire to avoid unflattering comparisons to my dad if I followed directly in his footsteps. Those are big shoes to fill, even if my own feet are bigger than the shoes. I can't be the surgeon he is, even with age slowing him down. I can't be the man he is either. But luckily, even half a dose of self_made_human Sr.'s genes is a strong potion. I have my own skills and my own talents, ones my dad was always proud of. He never expected me to be him. He was always going to be happy if I turned out the best possible version of myself.
Then, after a video call not long ago, I came to the aching realization that we're at the point where I am just as concerned about his health as he is about mine, if not more. That while he might be a world-class surgeon, he does not belong in a psych ward (except on the side with the comfy beds), and vice versa. And that he takes my opinions, including the psychiatric ones, seriously these days. Though not as seriously as I'd like. Vice versa on that too.
Like I said, age has caught up to him, but it won't stop him running. An episode of atrial fibrillation, requiring hospitalization, which my family didn't tell me about until he was stable. You can imagine my feelings. An obscure heart condition once thought to affect only Japanese men, which raises questions about my ancestry that the rest of my family answers anyway. No, they didn't get past Burma or into any pants. We're not weebs.
I've been trying to buy him an Apple Watch for a while. ECG monitoring, if nothing else. He doesn't need a watch to tell him the time, he has no time. I want him to have more. Like most semi-luxury purchases in our family, this was debated endlessly, until I put my foot down. I told my brother to buy him one for Father's Day and bill me later. The whole point of earning money is so you can spend it. On the ones you love. On what you need. On what they need, but are too cheap to buy for themselves.
I told my dad about this. He hemmed and hawed. Of course he did. That's what I'd do too. I'd had a bit of a scare myself at work, and asked my own boss how much his fancy FitBit cost. On hearing the price I winced, and said a trip to the ED was cheaper. But unlike him, I'm in excellent cardiovascular health. Or at least my questionable lifestyle choices have yet to catch up with me. My dad grumbled about the expense, but I know the gentleman very well. I could tell he was touched. Slightly shaken. So used to being the one doing the worrying and the caring, in his own gruff but loving way, that he found it deeply pleasurable and enormously uncomfortable to be the one receiving it. I get it, dad. I really do. I'm not sure your little boy is all grown up, but they seem to trust him with people's lives, and he hasn't been fired just yet.
All it took was being knocked flat on my ass, and getting back to my feet. With a few helping hands. Or a lot of helping hands. A surprising number of people who cared, despite all the reasons I felt I didn't deserve the concern. Realizing that I'm very tired, barely half a decade into my career, and willing to do it tired anyway. To go down swinging, and to refuse to let the bastards grind me down. I'm not a bastard myself. I know very well who my dad is. And that means a lot to me.
It's not easy, being a man. The cause of and solution to more than our fair share of the world's problems. The higher-variance sex, the idiots and the savants. The ones who dish out the violence, and the ones who protect from it. Broad shoulders, to hold up the weight of the world. Strong jaws, to take a punch. Mostly from other men.
So we do it. So I do it. Can't trust anyone else to. Women? They belong in the kitchen, because that's where all the good food is, and because they've had a bad day at the office and need someone leaning on the counter making ridiculous jokes and telling them they're cooking up a storm. The kitchen is where I clearly don't belong, since the best I can say for my culinary skills is that I haven't given anyone food poisoning yet. At least I don't need much prodding to do the dishes.
But with growing dismay, I've found myself in complicated situations, looking around for the adult in the room. And realizing, with very mixed emotions, that I'm the adult. The one responsible for this mess, a mess that's largely not even my fault. Fucking hell, how did I get away with it? How did no one see through me on day one?
Then I remind myself that pretending is the point. Some masks stick when you put them on and rarely come off. They adhere. That's what the blood, sweat and tears are for. If I can consistently pretend to be a functional human being, one who can be entrusted with the lives and safety of others, then maybe I am that man. And I'm in no real hurry to take the mask off. Not until I can hand it on. Hand it over, and enjoy a retirement. Possibly an early one, given the pace at which things are moving.
I'm not entirely at peace with my impending obsolescence. The fact that we are clearly building machines smarter than us, while hoping they turn out kinder than us. I want to be the psychiatrist Anthropic hires to psychoanalyze its latest models. I'm genuinely unsure whether I can be that man in time for it to matter, before I'm laid bare. That's fine. We undress you before surgery for good reason. Lay my psyche bare, and let something smarter and wiser than me strip away the tumor and leave the parts of me I want to keep. I did say I'm not quite at peace, but I choose to pretend to be. Pretending is the point. Judge a man, or a woman, more by what they do than by what they say. Talk is cheap. I give this away for free, and you get what you paid for.
I'm a broken man. Thankfully not broke, and just about at peace with being a man. My reasons for opting for psychiatry are myriad, but one was that I was always slightly hoping I'd run into people who knew better, who knew what they were doing. Sometimes I do, and I'm suitably grateful for it. But they can't seem to fix me. And I assure you, I need some fixing.
Man is somewhere between the falling angel and the rising ape. I feel for all the broken monkeys out there, and sometimes they put me in charge of the circus. I try my best. I really do. On good days my best is more than good enough. But I suspect the bad days are awful, and that fixing them might be an AGI-complete problem. Or rather, that we'll have AGI before we finish the job
I told my little brother, who I love dearly, that it's about time he manned the fuck up. I said it with love. He's got the certificate, he's another not-entirely-self_made_human (Jr and Jr), and his approach to academics horrifies me. My approach to working out horrifies him, and I... have to concede that one. He's alone at home. We're all alone, but I'm not at home. We're all lonely, but never as lonely as you might think. He has easy access to a family that loves him, and one we love back. Two dogs that can be absolute bitches, but are lovable in their dumb, goofy way. He's got two increasingly elderly parents who made many, many sacrifices to get us where we are, and who only ask that we do our best. I try. I worry about them, because worrying about the people I love is my love language. And I'm really not going to bother learning Italian.
Some of the broken monkeys really don't know better. They come to me, sometimes. The poor bastards. I might get paid peanuts, but there's worse remuneration for an overworked ape. I try to be the doctor they deserve, and these days I even believe the compliments I get in return.
I put on my Sunday best on a Monday, because I'm dressing for the job I want and not the one I have: that of a better-paid and probably more qualified shrink. My old boss's job, because the asshole can't be trusted to do it right. The new guy? I can't say a word against him. He's a good man, much like my dad, but with an even worse sense of humor. He has a son he dotes on and doesn't need another, so I just tell him he's a very good boss, and that I'm trying not to let him down either. He seems to believe me, poor guy.
I look at my hands. Surgeon's hands, according to a surgeon, who is hopelessly biased on the grounds that they're his own hands, only larger and possibly more slender. But a surgeon nonetheless, and a good father. He might doze off at the cinema, and consider walks with friends and reading the newspaper to be the peak of entertainment, but I'm here to make him proud. Not letting the people who love me down is the best way I've got of getting away with my antics.
So man the fuck up. Or woman the fuck up. Or be an enbie and give me no reason for envy. You might be broken. You might be laudably sane. Either way, be more than your genes, be more than your circumstances. Be the cause, and not just the effect. It's worth it. I promise you that. The world has more than its fair share of assholes, and not enough good men. Or even men trying their best. I do what I can, when I can.
Well, I am glad you haven't called the place quits. And while I can respect your decision to not ask for or accept special privileges, I would also prefer that you put extra effort into being polite. Yes I know we have more than our fair share of idiots, but my approach to bad takes on AI these days is to chuckle sensibly and drink a beer instead of engaging.
Ah. After Fable came out, and I had the fortune of using it for a while before it got yoinked? I can't be arsed about GLM 5.2 or Mistral Baguette or whatever else came out last week. I experienced that rare state change of experiencing something clearly ahead of the pack, just right on time. The trend lines on log-linear curves remain steady. What it felt like using GPT 4. o1/o3. Where you don't even have to look at the benchmark scores to know what you're looking at is something else. I read the whole whitepaper for Mythos in a single evening, and it made my heart pound. I presume Fable will be back, at some point, or something of comparable general capability will come out of OAI or DM (I know 5.5 Pro is about as capable on cyber security, but that isn't my primary interest). About time the latter did something, Gemini 3.1 Pro is shoddy and wasn't that impressive when it came out. But Google is Google, now that they're awake, they're probably cooking.
More options
Context Copy link