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
A lot of things are "normal" with aging. Like heart attacks, and cancer, unfortunately. You're going to lose lung capacity with age, but finding it more difficult to breathe through your nose? I'd find that worth at least a mirror and a light even if it was someone genuinely elderly reporting.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
Please, do show me the rule violated. Preferably with quotes. I do have a blog.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
Go to therapy. Touchy feely bullshit aside, just the opportunity to talk to someone who is good at listening and will be discreet about things is often worth the money. This also describes friends, but I'm not sure even I have a ton of friends who would listen to me vent about things along those lines for as long as it takes for catharsis.
Alternatively, I second the questions about whether you can switch to a less... visceral branch of law.
I just fucking know that if I had opted for law, I'd have turned to drink. Sorry you're going through this.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
It's been a pleasure watching the fresh batch of baby doctors arrive on the ward, all wet behind the ears, lanyards tight around their throats. It makes me feel nostalgic, protective, and very old, all at once.
My colleagues before this lot were excellent, so the bar was set high. You can absolutely tell the new ones are new, but they compensate for the gaps with genuine diligence and a willingness to learn, which is all I can really ask.
Although "gaps in knowledge" is the wrong phrase. Talk to them for five minutes and the knowledge is plainly there, filed and indexed and ready to be recited. What makes an experienced clinician is the intuition about which parts of it apply to the person in front of you. Chess grandmasters famously don't calculate more moves than amateurs; they just see the board in chunks, and the bad moves never make it to conscious consideration in the first place. Medicine is like that, except the board is a 78-year-old with three comorbidities who has stopped taking one of her medications and hasn't mentioned which.
It's one thing to know the drugs and the diseases cold. It's another beast entirely to have a messy, inconvenient human in front of you, and that description covers the other doctors as fully as it covers the patients. Eventually, through sheer exposure, observation and practice, you just know. The relevant information stops requiring a search through your head, or a panicked Google in the loo (I am not above this). You build up what I can only describe as a mental cache, log(n) for the things that matter. Inconsistencies start to make you itch before you can articulate why.
Then there's the tacit stuff, none of which appears in any curriculum. How to refer to General Surgery without being swatted away. The exact words that make a busy Med Reg give a damn. Tactical phrasing that gets an urgent CT head done urgently rather than eventually. Presenting a patient so it parses for a doctor as exhausted as you are, who lacks the benefit of having spent the last four hours with them. Shortcuts through the hospital. Where to liberate your fair share of patient coffee, the single perk of the job. How to comfort the disturbed and disturb the comfortable, when clinically indicated. Which consultant will cheerfully field the silliest question, and which one will not suffer fools. The importance of booking annual leave early, so there is something to live for that isn't an ARCP. Getting along with your colleagues, because the NHS is a harsh mistress who will grind you down, and collegiality is a slow, reliable form of karma that they will be drawing on regularly. And, in due course, a tolerance for my worst puns.
I've been rather delighted by the FY1s and their impostor syndrome, which has a prevalence I estimate at 100%, give or take 0. They do their best to hide it, and you can always tell. I say that the shoe does fit, and eventually they'll stop noticing the blisters. They're fresh out of med school, and suddenly here is a human being who might die if you sneeze at them wrong.
Catch.
The most poignant case was the new core trainee. Lovely girl, fretting that she didn't know a thing. I told her, firmly, that if she knew everything already she'd be wildly overqualified, or at minimum a Senior Registrar. You're here to train, miss. It's in the name. You'll be fine.
On day one I told them that stupid questions do exist, and that I was issuing everyone a month of exemptions. The exemptions have been used. Expired ones remain welcome, because God knows I still ask colleagues, sotto voce, things I very much hope nobody senior overhears.
Sigh. I was there once, permanently braced for the moment someone worked out that I had no idea what I was doing. You pick up a few tricks, and hopefully avoid killing anyone en route. I think I've become the sort of senior I wanted when I started. Visibly stressed, clearly overworked, but always willing to make time for those need mine more than I do. I've certainly known worse.
As Black Wednesdays go, last week was far from the worst.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
I recommend seeing a doctor. You might have a deviated nasal septum, could be inflamed sinuses or low grade allergies, you might have nasal polyps, it might actually be an issue further downstream. But short of someone actually taking a look inside, what do you really expect anyone to suggest?
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
4d ago
Ungodly levels of stress, but better overall. Managed some exercise.
I've continued to get good feedback from work, and my relationship with my boss is back to cordial. I've got a presentation tomorrow, and I asked him for his input. He was very pleased with the choice of case, and said he'd defend me from any serious pimping if the other seniors had had their cereal shat in. What more can I ask for?
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
5d ago
The floor has risen significantly. Even prior to Sonnet 5 (haven't fucked around with it it), the previous Sonnets were highly capable and treading into Opus territory at times.
I still think that for anything that isn't trivial/low-effort, the better models justify themselves very easily. I use the best that my plan allows unless I have a good reason to drop down (usage limits on a 5x plan are still annoying as hell).
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
5d ago
I am genuinely taken aback by this take. I know you're being sincere, but I can't understand where you're coming from. It's easier to say what LLMs can't do for me. And I very clearly benefit from the additional intelligence the paid models provide. They're not eating white collar work for no reason, they can do a surprising proportion of the work that a regular human can do on a computer.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
6d ago
Mu. Alternatively, invalid type.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
7d ago
Honestly, I agree she had it coming. Use the belt.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
7d ago
If adherence to the requisite format was beyond your abilities, I'm sure there would have been room for an apology. I have just learned not to expect very much.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
7d ago
I understand that your day job involves coming into a situation where you had no original stake, or direct involvement, and then assuming an advisory position despite a clearly superficial understanding of the facts of the matter. I ask that you keep it there, I'm not paying you.
On a factual basis: no, I haven't presented myself as perfectly flawless on any day of my life, even I'm convincing women to let me sleep with them. Good grief. I, like a real human being, have made actual errors. And like a responsible trainee doctor, I've disclosed that to my boss. They're not material here, because the one specific issue he raised wasn't my fault.
Have you ever considered the possibility, in theory, that someone might actually be liked and good at their job? Or is that an entirely foreign prospect for you?
Beyond that? I hope your advice finds someone who needs it. If you want the fuller picture, I can ask my boss to sign up on themotte.org. I'm sure he has the time. God knows where I find it.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
7d ago
I think going into a moshpit as someone who wears glasses is remarkably inadvisable. Always wanted to try it, at some point, but then I remember that potential traumatic brain injuries are not going to improve anything.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
7d ago
You're a clinician, what does a person who always thinks they are the greatest, and is always correct about everything, and reacts aggressively when their ego is challenged sound like?
I know perfectly well what that person is. The problem is that I resent your implication that that's a fair description of me. You don't have to go digging very far to find examples of me admitting that I'm wrong about something, really. Here, I'll make it super easy for myself and kill two birds with one stone:
The recent shakeup at Google, with the departure of Jeff Dean, puts them out of the running as a frontier lab. I'm not saying they don't have a hope at all, I'm saying that regaining the lead is going to be even more of an uphill struggle. In other words, I was wrong.
Now, back to you, Coil:
Have you stopped beating your wife? Yes or no answers only, please. I'm too old for these games.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
8d ago
He'll either get humbled in a few more years and give what you said a second thought, or turn into one of those monsters in management who's "never wrong" and lashes out at people, destroying the institution from within.
I admire the confidence with which you present these as the only possible outcomes. I hope I do end up with that much epistemic humility.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
8d ago
I'm amazed at how many people don't cough up even the $20 required for the full-fat experience. At least OpenAI has recently announced that they're making unlimited usage of a newer model, 5.6 Luna, available to the masses for free. It is still several steps down from Sol, which continues to genuinely impress me.
Google's "free AI" is an incredibly imprecise term. It can mean Gemini 3.5 (Flash? Lite?) when used through the Gemini app. It can be the search-specific Gemini 1.5, IIRC, used if you just "Google" something. As you can imagine, not even Google can afford to use the best of the best when serving so many people at such scale, with the majority being trivial queries.
I would pay a great deal more than $20 for an AI plan, but luckily, I don't have to. I've got tons of Claude Max, because I decided to accept payment in that form instead of figuring out intercontinental financial transfers after my participation in Unslop.
I remember when a Dutch junior of mine was consulting another senior for advice when working on a meta-analysis meant for a big name journal. I could have clapped like a seal when the latter mentioned Claude, in addition to ChatGPT, for help with the stats scutwork. Then I asked, and confirmed, that she only had a free plan. I was so dismayed that I immediately offered to share my Max, and walk her through things. It didn't hurt that she's a pretty girl, and it would have provided an opportunity to go out with her (that ended up happening anyway), but I am beyond annoyed when other doctors use free-tier LLMs for clinical work. They still function adequately, but anyone who can afford better should use better. $20 is really not an onerous ask for a significant amount of intelligence on tap.
Hahahaha. I can't even be particularly mad, this loops right around into hilarious. When I worry I'm too self-aware for my own good, I can do with a reminder of what its absence looks like.
Aight buddy. I'm sure you've got a proper Big Boy job. I know a handful of Big 4 "consultants". Probably pays the bills well, doesn't it?
I do wonder just how common it would be for an error you've made while under stress to lead to someone dying. Do you have any idea what doctors do? Been to a hospital since you were (presumably) birthed in one?
My man, last time you skimmed this story you got the sex of every crying person in it wrong, then built a thesis about British civilizational decline on top of your own lacking literacy. Now you've skimmed again and built a theory of my employment. I'm starting to see what passes for your workflow: read 30% of the text, hallucinate the blanks, invoice for the full engagement. I wish I could get away with that, I seem to have to work for the money.
In other words: knock it off.
I am sure you have perspective to share. I sample plenty, and I've heard more informed opinions from the floridly psychotic.
Based on that experience, I suspect we’re only hearing one side of the story.
It's a first-person anecdote on a forum; of course you are. I presume Deloitte or PWC pays you for such cutting edge insight.
The difference is that my side comes with documents, and yours comes with hot takes about a profession you've never worked in a country you probably don't live in.
With all due respect (guess how much), the last man who guessed at my workplace from his armchair was you, one comment ago, and every checkable claim you made was wrong.
Let me see if bullet points help:
- I had repeatedly tried to obtain the assessments.
- The ward had been severely overloaded.
- My supervisor had been away and had not spoken to the people working alongside me.
- He cited supposed clinical errors without specifics.
- The one specific error he did cite was demonstrably committed by somebody else.
- He told me to obtain broader formal feedback.
- I did exactly that.
- The feedback, including from people outside my immediate peer group, has so far been uniformly good.
- He then actively facilitated me obtaining still more of it.
This is a strange way to “agitate with staff.” Apparently I have been so disruptive that nurses, pharmacists, ward administrators, junior doctors and senior doctors keep volunteering to say nice things about me when formally asked, and have said it before, without asking, and my boss's response to my campaign of terror has been to tell his colleagues to make time to assess me.
Perhaps the inevitable reckoning is merely taking the scenic route.
And to spell it out, my male peers, which includes the senior reg, and most of the consultants? They like me too.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
8d ago
A flattering type of audience to strive for, surely.
Not my target audience at all, unfortunately. They just form a substantial portion when you write on the open internet, without pay-walls. I do this, at present, for free. And that means I do not have a particularly strong reason to care.
Less charitably, my point is that contra your response to Bartender, you evidently don't see any objections as helpful; you are committed to not noticing the problem and dismissing nooticers, in whatever form - Bartender's clipped remark and my more detailed objection get the same dismissive response, in spirit if not in word count.
Completely factually incorrect. You want a citation?
https://old.reddit.com/r/slatestarcodex/s/5FyqfDLX2L
Please review that thread, which includes correspondence with Gwern.
I give as much heed to this feedback as I think it is due. Which is not nil, clearly, or I wouldn't bother to respond at all. I am merely pointing out that I am not open to not using LLMs simply because people ask me to. I have yet to take Prima's money, which would enforce a commitment to never touching them while on this platform. You are free to complain, I am just as free to say that I've read the complaint and don't intend to act on it. I would have been more likely to be polite if you had been polite, but let's have reasonable expectations here.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
8d ago
Thanks. But I still want to note that what you chose to quote as an LLMism was human written. It is easy enough to identify entirely LLM written work. It is feasible to identify LLM-modified work. It is much harder to identify specific aphorisms, sentences or phrases. Even the makers of Pangram acknowledge this.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
8d ago
Is that sarcasm? Doesn't matter if it is, because it's true. I find that it's very helpful in my like of work to appear and act like the kind of person who is open to handling emotional dumps, and then be the guy who takes care of it. I don't have to put on some kind of suit to make it happen, it's just how I've been my whole life.
It explains why patients, stressed colleagues, IRL/online friends, and random people at the pub find me to vent. It makes me a good psychiatrist.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
8d ago
- Everyone crying in this story is a woman. Which is unsurprising, because the overwhelming majority of doctors under 35 in this ward are women, and because I have conspicuously used "she" as a pronoun to describe them. Only time I've ever cried in this ward, in the loo, is from sheer relief, when I heard I passed an important exam despite giving it at a time my brain was riddled with holes from acute stress, a depressive relapse, and regular migraines. I did very well, which was only somewhat surprising.
- My boss did not just have "mean words", he implied I was lazy and hadn't gotten important assessments done prior to a performance review due in a week or so. I hadn't gotten them done, but only because the whole ward was catching fire from the strain. I had asked my seniors to make the time to assess me half a dozen times, and they simply couldn't do it. He was unwilling to accept this, but he had been on his own vacation, and hadn't even had the opportunity to talk to said colleagues of his to confirm this. He said exactly as much, which was honest, but he spends 90% of his time away from the ward and does not have a clue as to what's going on at the ground level.
- A requirement of being a doctor in the NHS, at pretty much every level, is canvassing formal written feedback from a diverse sample of coworkers on a regular basis. Junior, senior, anything in between. The nurses, non-medical staff, anyone who has interacted with me is also fair game. And no, why the fuck would I stand over their shoulder? I handed them the forms, went away, and collected them later en-masse. The only pressure involved was simply confirming, later, that they'd finished it. They then, voluntarily, told me what they'd put in writing. I do not have any meaningful leverage over people who are quite literally on their last day at work here. I have minimal leverage on the seniors who did theirs too. The only reason I got glowing feedback is because my colleagues are very fond of me. They've seen me work hard, including at periods where I've been popping painkillers like candy so I don't get laid out with severe pain. They've seen me make time and regularly stay back late just to reassure patients and their family. They've also seen me being more supportive than you can imagine, when the new baby doctors come in and start shaking in their scrubs.
- My boss had asked me to get these assessments done, as well as several others. He was not wrong in doing this, because I am required to do them for career progression. They are read by higher-ups in the training program as well as himself. He had been annoyed that I hadn't gotten them done earlier, and had not believed it when I said this hadn't been for a lack of trying.
- I get along well with my boss, most of the time. I have no interest in making his life harder for the sake of it, but he gets paid extra to be my named supervisor and this comes with additional workload. I've been inundating him with this stuff because he's asked for it, and also because it completely undermines any concerns he's raised about me. He's a good guy, but he can be clueless, and this time he was. He has also not done several important things I've repeatedly asked him to do, and which he is obliged to do. People are complicated.
But that’s all besides the point I’m trying to make. Is it normal for Scottish/British men to weep at work or get emotionally flustered when they’re having a bad day? Is it normal for them to passive aggressively confront their bosses about it? Is it normal for them to stir the pot with the other staff?
None of the above buddy, and in part because none of that happened. If you have the time to write all of that, you have the time to do more than skim. You just have no idea what the workload can be like, this isn't a profession you opt for in the hopes of excellent work-life balance, and this particular department is on the hellish end of the spectrum.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
8d ago
A quick sort of your profile by top shows me you have a lot to contribute. I would not notice you if you were gone, because I don't think I ever notice you while you're here.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
8d ago
I don't have anything new to say that I haven't already said in that thread. If you continue to disagree with my approach, then I am happy to accept your "silent sigh and scroll". It's the end of the world, I will use every tool at my disposal till it makes me obsolete.
I will concede that you did better than Bartender, because he is completely incorrect here. Kudos for that, genuinely.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
9d ago
Please consult Pangram. I burned 16 credits checking, and it was not worth it, you can do it yourself and see if the accusation holds. It would be helpful if the people accusing me of using too much AI would be accurate about which part (if any) is actually LLM-written or rewritten.
I'd like to see a Tesla Model S redefined as an "electrical mobility vehicle". Particularly if it's in self-driving mode.
More options
Context Copy link