@self_made_human's banner p

self_made_human

amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi

14 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.


				
User ID: 454


				
				
				

			

		

	














	


		


			



	

		

			

			

				

					

						

							
						

						

							
							

								
self_made_human


								

								

								
								
									
								
								
								
								

								
							
					
 
				


				
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi

				
				
				

				

					14 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.


				

				

				

				

					

					

					
					
					

					
User ID: 454


					
					
					
				

			


					

						
					



		

	

 











			
			

			
			

			




	


		

			
‎

			

				
				

					Hour
					
					Week
					Month
					Year
					All
				

			


			
‎

			

	
	

	 Hot Bump Top Bottom Old Controversial Comments
	



		

	






	

		
		

		
		
	

	

  







		

			
			
				Wellness Wednesday for March 11, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					
Absolutely and unironically based behavior. Good luck! Probably don't tell her about the spreadsheet or the applied mathematics, at least before she's hopelessly smitten.


				

				

						

							

								
							

						


						
					

				
			


			

	


			
			
				

			
		

	






		

			
			
				Chesterton's Pill
			
		

	

	

	

		
			

			

				

			

		

			


				

					
For what it's worth, I'm not being sarcastic when I say I have a low opinion of the Hippocratic oath.


Seriously "do no harm"? Am I allowed to use a needle to prick skin. Oh, that shouldn't be taken at face value, and there's some kind of implicit utilitarian calculus involved? Why doesn't it just say so?




Similarly I will not give to a woman a pessary to cause abortion.




There's a reason very few institutions use the original oath, leaving aside the random injunction against operating on kidney stones.




Do you have second thoughts?




Not particularly! I've certainly never had anyone identify a particular person on the basis of a post. The closest was when I was almost geographically doxxed, but the person doing it was acting mostly out of curiosity. There's no way for a casual actor to identify anyone I've described, and it's far too late to deploy the kind of OPSEC that truly motivated actors would have issues cracking. In other words, pray for me and not for anyone else I've written an ink-portrait of.




Could be generational. You seem often to seek out the snark; I'm far more traditionalist.




Well, you're an unusually sincere person. I like to think that I'm usually sincere and honest, but yes, I do enjoy a helping of sarcasm. At the very least, British humor appeals to me on a spiritual level.


				

				

						

							

								
							

						


						
					

				
			


			

	


			
			
				

			
		

	






		

			
			
				Chesterton's Pill
			
		

	

	

	

		
			

			

				

			

		

			


				

					
My apologies, while I didn't interpret it as as a challenge, I was slightly snarky in my reply because of an unrelated internet argument.


When it comes to formal case reports or research publications, there are relatively bright lines doctors are expected to follow. This varies heavily from place to place, but for example, I can use a CT scan of a patient in a publication without their express consent, as long as I make sure things like name or ID is reasonably redacted.


When it comes to random writing on the internet, there is some grey, but mostly "nobody really cares." If I had mentioned actual names (and someone then raised a complaint) and provided very specific information, the GMC could theoretically come knocking (assuming they could then identify me, I doubt Reddit would care, they're not the same as the UK government, even if they're their attack dogs).


I mean, if I was writing about the UK. They don't care what I do in India as long as I don't break local laws or get into trouble with the police/local regulators. If I was in the UK, there is a small but non-zero risk associated, but once again, depends on what exactly I say. The British equivalent of this story, as written, would be fine.




not the Hippocratic oath.




Never swore it. I'm not kidding. Some places don't hold particularly high opinions of some long dead Greek bloke who said that doctors shouldn't operate on kidney stones. Not even the modernized version. It's not legally binding anyway, there are actual laws and professional codes of conduct that supersede it.


				

				

						

							

								
							

						


						
					

				
			


			

	


			
			
				

			
		

	






		

			
			
				Chesterton's Pill
			
		

	

	

	

		
			

			

				

			

		

			


				

					
Since none of this contains patient-identifiable information, I'm in the clear. And for all anyone else knows, this might be an entirely fictional scenario with all characters simply fractured fragments of my psyche. I am also a dog on the internet, woof!


Beyond that, it depends on the jurisdiction, and even the UK isn't anal enough to come after me for something so trivial and vague.


				

				

						

							

								
							

						


						
					

				
			


			

	


			
			
				

			
		

	






		

			
			
				Chesterton's Pill
			
		

	

	

	

		
			

			

				

			

		

			


				

					


Love your posts bro.




Thanks <3, whatever level of homo is socially acceptable these days haha.




Write a book.




I do, but it's about a cyborg psychiatrist who does way cooler things than I do. Also on hiatus, because his not-as-cool creator has a lot going on.


If you want a non-fiction book or memoir, I don't think I've quite got the material yet. It usually takes a lifetime to build that up. My job is usually (and thankfully) quite boring and mundane most of the time. I seem to come across something worth writing about once every few months or so, and the majority of the time it makes more sense as an essay.




And come to America, specifically Florida, I want to read your multi part write up dealing with our insurance, our minorities, and our whites.




I would if I could! I still harbor hope of moving to the States one day, at this point I would happily trade all the headaches American doctors face for the ones I have, let alone the massively higher pay. If not, I'm sure I'll visit at some point, and I would happily swing by if you'd have me. What's a gator but a very ornery dog? I can handle those just fine.




E: absolutely insane that you still have a Reddit account that’s 11 years old. I find that sort of thing fascinating as well.




Eh, it's there, I mostly use it to lurk these days and occasionally post. The closest I came to violating Reddit's TOS was Motte-posting, and that hasn't been an issue since I migrated here with everyone else. My engagement levels dropped drastically. Even if I had something to say, there are few places I'd want to say it, or where I'd expect a good reception. Culture War? That's here. Less controversial stuff? I happily crosspost.


In general, I think I'm a pretty good citizen by Reddit standards. I've only once been banned, on /r/SSC of all places for tangentially referring to the Motte as the place for CW issues, and that was quickly overturned on polite appeal. For what it's worth, it's less self-censorship than it is the fact that I do not enjoy engaging with the average Redditor.


				

				

						

							

								
							

						


						
					

				
			


			

	


			
			
				

			
		

	






		

			
			
				Chesterton's Pill
			
		

	

	

	

		
			

			

				

			

		

			


				

					
Thank you for taking the time to write that up! It aligns with what other neurologists have said on Reddit, and my attempts to dig deeper.




liked staying up late = maybe just maybe, he may have an inkling that the episodes are more common in night (=nocturnal seizures).




I didn't get that impression, but I'm not going to make strong claims either way, this clinical assessment was far from ideal. If I had the time, I would have drilled deeper, specifically looking for any temporal patterns, but at the least the mom didn't mention it. In her words, the boy just liked staying up late, and that's more likely to be because he's got a phone.




Call the Resident, if possible.




Sadly, that probably wouldn't help. It is very difficult to contact a patient like that (EMR? What EMR?) and nobody would bother short of an acute emergency. At least we arranged a followup in a month, and I expect that the other doctor will probably be there. I'll drop him a text anyway, just in case it makes a difference!


				

				

						

							

								
							

						


						
					

				
			


			

	


			
			
				

			
		

	






		

			
			
				Chesterton's Pill
			
		

	

	

	

		
			

			

				

			

		

			


				

					
The child was quite extroverted and responsive when talking to me or my colleague. If he was the shy type, he's better at hiding it than I am haha.


I can't really comment on his articulacy. My Hindi is far from the best, and his mother was the primary informant. But he sounded... fine?


If this was a once off? Kids do dumb things for no good reason. So do us adults. But the repeated pattern and general picture points towards something in the DSM and not "just a rambunctious boy child". But what precisely? Impossible to answer authoritatively with the information I have at present. I hope I do get to see the followup and final diagnosis, but I wouldn't bet on it.


				

				

						

							

								
							

						


						
					

				
			


			

	


			
			
				

			
		

	






		

			
			
				Small-Scale Question Sunday for March 8, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					
For what it's worth, you can use the contact us option in the sidebar to message (all) mods. But it's probably just faster to ping or DM us, I know that I rarely check the general mod mail.


				

				

						

							

								
							

						


						
					

				
			


			

	


			
			
				

			
		

	






		

			
			
				Small-Scale Question Sunday for March 8, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					
Yup. I've let it out of the cage, @ControlsFreak


				

				

						

							

								
							

						


						
					

				
			


			

	


			
			
				

			
		

	






		

			
			
				Chesterton's Pill
			
		

	

	

	

		
			

			

				

			

		

			


				

					


Aggression related to panic attacks?




Very unlikely! Even plain old panic attacks would be unusual at that age, let alone such a specific kind of aggression. They're also not usually associated with amnesia or dissociation, more like hyper-focus.


After I posted on /r/Medicine, I had a few actual senior neurologists show up. They lean towards my hypothesis that it's some kind of seizure activity, but there's no consensus on whether it's a temporal lobe one, a different kind of focal seizure such as one affecting the frontal lobe, or if there's a slightly different variant called absence seizures that might be causing sleep issues and poor academic performance. The only real way to know would be an EEG, which would hopefully be identified the next time they attend (I regret not insisting on it, but I was a guest and deferring to those with more local expertise).




He'd be dead, wouldn't he? Survival time is usually less than a week after symptoms appear, though I'm surprised to learn you can have morbid rabies for months or years before symptoms show up.




My mention of rabies was mostly sarcasm. The kid would have a lot of other issues before they (might) end up biting people. It would have been glaringly obvious and even here, with less than perfect triage and routing, very unlikely to show up in the psych OPD. But yes, if it was rabies, he would be done for.


I was about to claim that it's impossible for rabies to be latent for years, but apparently there are a handful of claimed cases?


https://www.nejm.org/doi/full/10.1056/NEJM199101243240401




Rabies infection in these three patients did not originate in the United States but resulted from exposures in Laos, the Philippines, and Mexico. Since the three patients had lived in the United States for 4 years, 6 years, and 11 months, our findings suggest that the onset of the clinical manifestations of rabies occurred after long incubation periods.




I am not sure how much to trust them. Either way, it's rare. But funny excerpt:




The patient's father recalled that the child had been bitten by a neighbor's dog shortly before leaving the Philippines for the United States. The dog was said to have remained healthy and was eaten about a month later.




				

				

						

							

								
							

						


						
					

				
			


			

	


			
			
				

			
		

	






		

			
			
				Culture War Roundup for the week of March 9, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					


and the CCP looks like it’s actually going to stand up to him about that




I would like to know more. I've heard about the firings, but not about any signs of the rest of the party developing a backbone.


				

				

						

							

								
							

						


						
					

				
			


			

	


			
			
				

			
		

	






		

			
			
				Culture War Roundup for the week of March 9, 2026
			
		

	

	

	

		
			

			

				

			

		

			


				

					
Oops. Thanks!