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
1d ago
I love you too my dude, even if you love Jesus more :(
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
2d ago
Review books? Do you mean like targeted USMLE prep books and their equivalent?
Never heard of any for the MRCPsych, and I just looked on Google with no luck. There are some for other specialties, I can see results for the MRCP (no pancreas involved, usually), but apparently psychiatry residents get the shaft.
What most people do is sign up to a repository of notes and MCQs. I opted for one known as SPMM. In a way, the notes are a book, one that condenses a ton of scattered bullshit into something the mere human mind can grasp. Unfortunately, the overall quality leaves something to be desired, the study material I had for prior exams was better (clarity, content, presentation), but the more niche the exam the fewer people willing to spend money I guess.
Honesty, I'm done with like 75% of the coaching material, with just about a month to go. The problem is that psychiatry, when flattened into a series of bullet points for an exam, becomes uniquely soul-crushing.
In contrast, the other exams I've discussed actually require a bit of critical thinking. I didn't appreciate it at the time, but I do now.
I just find it hard to make all that information stick when it's so boring, and I do not relish the necessary revision ahead. Spaced repetition sounds great until you're actually doing it.
I attempted to channel my procrastination into going through some of the Royal College's suggested reading, and as you can see, I'm regretting it. The notes make them mostly redundant anyway. ChatGPT in combination makes them entirely so.
Also medical classification systems are great. Fight me bro.
I cast F60.2
Wait, that's deprecated. Uh.. 6D10.1? Plus 6D11.3? For fuck's sake, in the most recent exams, they expect us to memorize ICD-11 and DSM-5 criteria, and the changes from ICD-10. When we still use 10 for all of our actual work and coding, with no plan to change before the current crop of consultants die of old age. And we don't even use the DSM, at least where I can see it. Is it there in our syllabus solely so we don't feel too embarrassed to attend American conferences? God knows.
You can see why this gives me a headache, though I will admit that classification systems are useful.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
2d ago
A standalone top level post needs a blurb or explainer for why it's relevant to this forum. If you went ahead and did that, we'll let this through the queue.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
2d ago
I mostly lurk because I don't feel like I have much to contribute and everyone around here seems to know what they're talking about, or at least is good enough at rhetoric to fool me.
Hey, having nothing useful to contribute doesn't stop some people! Don't let it dissuade you, you're probably wrong on that front.
But yes, having thick skin is a major benefit when it comes to regular participation on the Motte. I would encourage you to dip your toes in the water in the less contentious threads, like you're doing right now.
And my study habits were probably unhealthy. I had a few friends in med school and was generally very well liked by people who knew me, but I had more than a few people say to me at some point in our 4th year "damn wsgy why weren't we better friends? You're a great hang!". I had kind of partied way too much in university and overcorrected.
Such a shame. My parents would have loved to have you instead of me. Well, not because I partied too much (I didn't, at least in med school), but because they wished I'd studied.
I'm not actually too worried about the kids in the grand scheme of things. But it's like having one of your vital organs removed from your body and giving it a mind of its own. You can't help but get at least a bit neurotic about it getting damaged.
A fair point. It's easy for me to talk about adopting a laissez-faire attitude towards children I don't have. The changes parenthood provoke are scary, but also strangely comforting. One's own struggle and strife seem so inconsequential when there are little people who need you. Yours will turn out great!
Another doctor here? Good, please unlurk yourself! That's a genuine request. We're up to 5 and change, depending on how you count med students who may or may not be hiking naked in Alaska.
When I was a first year in med school, staring at the sheer amount of knowledge I was supposed to cram into my brain, I would get too anxious and stressed out to even concentrate enough to study. So my girlfriend suggested I take some of her Xanax, which calmed me down enough that I could hit the books. The next day though I would have forgotten everything because as you know (and I had not yet learned at the time) benzos fuck with your hippocampus and it's harder to form memories. I did this three times before I recognized the pattern enough to bother googling it. So uh, don't do that.
Evidence that pharmacology should be shoved into the first year syllabus haha. You'd have been better off drinking alcohol to steady your nerves, since (paradoxically) alcohol increases reteograde memory retention, while hampering it anterograde (at reasonable doses).
https://www.nature.com/articles/s41598-017-06305-w
For anyone else reading: don't do this.
What ended up working out for me was getting plenty of daily exercise. I was basically trying to study for 14 hours a day, then I'd watch a movie to unwind, then go to bed. Cutting that back to 13 hours of trying to study and one hour of exercise in the morning made me a lot less stressed out.
I'm in awe. I couldn't study for 12 hours a day if my life depended on it, even on medication. I feel utterly burnt out after 4-6 hours of actual study (not just sitting there with the book open, or procrastinating, as I'm doing now). This was true even before I had a job. Well, apparently that has been enough so far, and I try to keep up the habit.
The worst thing you can do is not talk to your friends and colleagues about this.
I did. I still feel bad about it, my dad is always stressed when he hears of such episodes, and he's the old-fashioned type of doctor who believes I don't need stimulants because ADHD isn't a real condition. He loves me, so I look past that. They know, they care, but they're a continent away.
Friends? They get it, sometimes. I had a good buddy who was a bit older and burdened with kids, he passed the exam during the previous window, so I suppose I have no excuse.
Now, the thing that tends to stress me out the most is parenting. I am fully confident at times that I am fucking up my kids and they're going to need a lot of therapy in their mid-20s when they realize how much damaged my wife and I caused. But, and maybe this makes me look silly, I find the sycophantic nature of ChatGPT as well as its always available-ness is perfect for stopping me from spiraling.
I suppose it's my turn to reassure you, though I have no kids of my own. Donald Winnicot was on to something when he came up with the concept of the "good enough mother" (and father).
Once you're past levels of effort above outright neglect, the returns to additional parental effort decline steeply or become outright flat. Parenting is not a video game where grinding extra hours levels your kid up faster. When it comes to variance in life outcomes, heredity is king, non-parental environment is queen, and “parenting” (once you’ve cleared the bar of “not abuse or neglect”) is a minor courtier at best.
https://www.nature.com/articles/ng.3285
I have seen a full writeup somewhere, but I've lost it. I can look harder later.
In other words, you don't have to worry too hard. You've done the important things, like giving them your genes, amassing wealth, not abusing them (I hope, but feel free to disabuse me if you disagree) etc.
They're good genes! You're a doctor, hardworking, and probably more conscientious than is good for you. In all fairness, so were my parents, but you can't help some things. I turned out okay. I love my parents despite their minor failings, and I'm sure your kids will love you too. If you’re worried you’re messing up, that’s actually evidence you’re not the type who would really mess up.
Anyway: physician, heal thyself and so forth.
Thank you, I mean it. I've been through worse, both in terms of academic load and blindness. I'll live, and if I ever become a consultant, I will dedicate my life to involuntarily commiting some of the exam-designers. Oh, and if your kids end up needing therapy, I'll offer a steep discount as a professional courtesy.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
2d ago
I'm not aware of a comprehensive hallucination benchmark, at least one that has been updated for recent SOTA models. If there was, I'd reference it, but hallucination rates have dropped drastically since the 3.5 days (something like 40% of its citations were hallucinate).
I almost never run into them, though I only check important claims. With something like GPT-5T, I'd estimate it's correct north of 95% of the time on factual questions, though I'm not sure if that means 96% or 99.9%.
The appropriate response to hallucination handwringing from luddites is “it doesn’t matter”, not “it’s not happening”, by the way.
Uh.. I don't think anything I've said should be interpreted as "they don't happen". Right now, they're uncommon enough that I think you should check only claims that matter, not the exact amount of salt to put in your soup.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
2d ago
I wish I could do that dude. The stimulants already muck up sleep cycle, and I've never been the kind to be able to cat nap.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
2d ago
Well, your interpretation is the one I personally hold, so maybe you're onto something there.
The Oxford Handbook of Psychiatry, 4th edition:
The authors have made the bold artistic choice to employ what I call "narrative whiplash" as their primary technique. Patient vignettes follow a strict three-act structure: Act One (character introduction), Act Two (literally any psychiatric condition), Act Three (death/insanity/miraculous recovery). This eliminates any tedious middle section where character development might occur. It's rather like if War and Peace were rewritten as a series of Twitter threads, except instead of 280 characters you get exactly three sentences before Pierre either achieves enlightenment or develops catatonia.
Then again, the pacing might well be a stroke of genius when you consider the target audience: exhausted junior doctors who need to absorb maximum psychiatric knowledge while standing in a hospital corridor at 3 AM. Who has time for denouement? The patients certainly don't seem to.
The real mystery is why Oxford's handbook writers haven't applied this technique to other fields. Imagine: "A 67-year-old man presents with chest pain. He has a heart. He does not have a heart. The end."
(I don't actually think there any patient vignettes in it, it's too no-nonsense for that stuff)
I have previously complained that Fish's Clinical Psychopathology has very little to do with fish, nor was it written by one. A missed opportunity, I'd like to know what the SSRIs and cocaine in the water do for salmon facing the awareness of their inevitable mortality.
Verdict: False advertising, so I won't even read it.
Then there's Making Sense of the ICD-11. It always sets certain bells ringing when a book requires another to make sense of it. I hope the authors of 11 know that it should have just been a trilogy. The DSM guys are at least more restrained about milking the franchise (galactorrhea due to hyperprolactinemia).
The main takeaway, at least for me, is that the real mental illness was the classification systems we made along the way.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
2d ago
I would imagine that smart and well-read psychiatry students would probably know that antipsychotics increase the risk of pneumonia
I... uh... didn't know that until I opened my revision notes to look for examples. You are welcome to update on how smart or well-read a psychiatry student I am. In all fairness, that knowledge is irrelevant in clinical use, I've never seen or heard of a psychiatrist not prescribing because of pneumonia risk from an antipsychotic.
But, in general, my main source of frustration is irrelevant information gumming up the syllabus rather than the fact that a lot of memorization is involved. If what I have to memorize a lot of facts to be a good psychiatrist, then that's just what I need to do. But I don't enjoy, and in fact, hate quite a bit of what I'm forced to learn. Physics majors aren't grilled on their knowledge of Aristotlian mechanics, nor are chemists asked to produce the schematics of the alembic necessary for transmuting lead to gold. It's all so tiresome.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
2d ago
I think that's overshooting in terms of adjustment.
Being a domain expert is obviously helpful when it comes to using LLMs. Being an expert is helpful for most things. Even Terence Tao benefits from using GPT-5T (and he doesn't even use Pro), so clearly an LLM doesn't have to be as good at maths as Tao in order to still be useful to him.
I think LLMs are very good at medicine, certainly at psychiatry. I suspect they'd be excellent at surgery, though my surgery days are behind me. Medicine simply doesn't require as large a "context window" in the human sense (working memory, conceptualization) as programming or IT work.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
2d ago
Verapamil is a calcium channel blocker, and a good option. I don't recall off the top of my head whether it's superior to something like metoprolol, but it is very reasonable to prescribe.
They did, in Japanese lol. Broadly they said, "Look, just don't worry about it. Do whatever exercise you like - it won't help but it won't make things worse. In practice go on living your life the same as ever." Which is... nice and all, and better than the alternative, but somehow less reassuring than 'eat salad, never let your heart get above 160, and we want you to wear a 24h ECG once a year' or whatever. I try not to think about it too much, or else I will turn into a hypochondriac
I'm sorry, I had to laugh. This is a good reminder that patients are not made alike, some of us need gentle reassurance, others desire bright lines in the sand. In all honesty, I think telling someone not to let their HR cross 160 either won't work or will be counterproductive. The anxiety of watching it maybe go to 140 might easily cause it to spike.
Something like an Apple Watch with ECG tracking might be good just for the peace of mind. I told my dad to get one, and even offered to pay. Unfortunately, despite getting a heart disease so rare it was until recently thought to only happen to the Japanese (coincidence?), he's proof that doctors make bad patients.
If you want to DM me the exact diagnosis, I can probably give you better advice, but I am still a psychiatry resident and I am blissfully forgetting everything about cardiology other than measuring QTc elongation on a trace.
It seems to be genetic (at least one of my elderly relatives used to have it I think) and to die down as you get older.
If they lived to be elderly, don't you think that's a good sign?
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
2d ago
That is unfortunate. I shared your feedback, and it acknowledges it as an important omission and also provided additional configuration options it missed the first go around:
https://chatgpt.com/share/68ecf793-909c-800b-b56f-cedc5c798eaf
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
2d ago
Had keyhole surgery (catheter ablation) a couple of years back when it flared up to multiple several-minute bouts of 180bpm a day. Much better now, only once every few months, but I live in fear of it getting worse and needing surgery again. Realistically could be a lot worse but it's made me risk-averse in a way I dislike.
Now that is far more serious than I'd like. Did they not give you beta blockers for as-required symptomatic relief? Did the surgeons or cardiologists not give advice regarding lifestyle modifications or exercise tolerance? This is far out of my wheelhouse, but I don't want you to be unduly anxious, even if you are right to worry.
Cool! That's today to Weds, or next week?
Next week! I'll DM you closer, once I know the exact dates.
Best of luck!
Thank you again!
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
2d ago
If you know the right prompt, you can get the models to leak OAI's profile of you. That includes usage stats. I believe I'm now at 95%+ GPT-5T usage, and almost zero for plain 5. The only time I use it is by accident, when the app "forgets" that I chose 5T in the model picker.
For any problem where you need even a modicum of rigor, I can't see a scenario where I wouldn't pick 5T over 5. If I need an instant answer, I use Claude. The free tier lets you use 4.5 Sonnet without reasoning, but it's still solid.
I will admit that I have barely used 5, because I gave it a few tries, found it barely better than 4o, and never touched it again. I just like 5T too. It has a bit of o3 in it, even if not quite as autistic. I really appreciate the lack of nonsense or sycophancy. 5 is far from the Pareto frontier on any aspect I care about.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
2d ago
Thank you.
I’m curious about these medical exams and studying. Are there some candidates you’ve met that can just ace them without studying, based solely on general medical knowledge and above average recollection from both medical school and hands-on training in the years before their specialist qualification? Or is it like some legal qualifications, where even a towering intellect needs to rote memorize that the answer is a section 37 part 3 form and not a part 4 and that a certain period is 13 working days and not 12?
I don't think that it is possible to pass just about any medical exam with zero studying, in the literal sense. But I definitely know or have heard of people who can get by with much less of it in the way of "total hours of effort". The very best young doctors I know (in terms of academic performance and successful entry into difficult specialties) were both very smart and very hardworking.
There are people who have retained far more than I did from med school, which definitely came in handy for them. I wasn't the most motivated of candidates back then (because my performance didn't matter as long as I passed, and I only ever failed one minor exam in the last decade), but I put far more effort into career-defining or gatekeeping exams later.
For example, the very first exam a foreign doctor needs to clear to get a license to practice in the UK is the first PLAB exam. It was always oriented around a UK curriculum, but now is/will be entirely subsumed into the same British end-of-medschool exam that is the UKMLA. A British med student would have a very significant innate advantage simply because that's their default curriculum, whereas a foreign grad would need to learn additional information about UK guidelines (holding all else equal, which I will happily grant isn't true, British med students are very good on average).
Once the PLABs were done, I had to give another exam called the MSRA, where the advantages for the locals diminish. The exam has roughly the same core topics as the PLAB/UKMLA, but will drill much harder into the nitty-gritty details. These details aren't comprehensively covered in med school, so that's when your own effort begins to come through.
The next step is usually the membership exams of one of the Royal Colleges. In my case, the MRCPsychs. At that point you are well beyond "innate" or general knowledge. Almost everything is new.
Not all RC exams are made alike:
Something like the MRCPsych Paper A heavily rewards rote memorization. There's no exam where it isn't important, but some others will test your practical and critical thinking skills harder than others.
Or is it like some legal qualifications, where even a towering intellect needs to rote memorize that the answer is a section 37 part 3 form and not a part 4 and that a certain period is 13 working days and not 12?
You would have to be God to derive medicine from first principles. For mere humans, no matter how smart, there's no choice but to resort to empiricism and knowing what works. Medicine, for all its scientific underpinnings, remains a deeply empirical and at times atheoretical field.
For example, why do antipsychotics increase the risk of pneumonia? Nobody knows. Why do clozapine and olanzapine cause the most weight gain (within antipsychotics)? Fuck knows. There is no logical chain that leads from the pharmacology of clozapine to it causing more weight gain than ziprasidone. We only know these things through observation.
The exam questions reflect this reality. They do not ask you to model the interaction of dopamine antagonists with hypothalamic appetite centers. They ask: "Which of the following drugs is most associated with weight gain?" This is not a test of your reasoning. It is a test of your internal lookup table. You either pass the herblore skill check or you don't.
And that is a good question. It's information that is in some way relevant to clinical practice.
Freud's nonsense isn't. Neither is Monkey Business. I don't know why I need to learn the name of the dude who invented modern antipsychotics, or why I'm being asked that. Yet those make up an unfortunate amount of the syllabus.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
2d ago
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
It was either his Twitter or a Substack note. I'd look it up if it wasn't 3 am on a Monday :(
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
Hey, I draw the line at listening to TikTok on the bus, on loudspeaker. Any heathenism beyond that can surely be excused?
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
Thanks my dude. Misery loves company!
(Also, I will probably be in London sometime between Monday to Wednesday next week, let me know if you're free. We can be miserable together in person.)
I have stress-provoked tachycardia which is less crippling but certainly unfun and produces perhaps a similar ‘I need to do important things to have a good life but not too many things or else my body will go wonky’ dilemma.
I presume you've gotten that looked at? My impression is probably anxiety, and CBT or the drugs would help if that's the case. Maybe even just a beta-blocker for symptomatic relief if it gets bad.
I’m sort of failing to manage it at the moment but generally I would advise trying to separate out one’s stressors a bit. Don’t go drinking the night before the marathon. Try to have specific study times that don’t coincide with your worst work shifts.
I won't be drinking before the exams, and I've already cut it down to a single night of dissolute enjoyment at the pub. They miss me, but I actually need to lock-in.
I try to study at sensible hours, but easier said than done.
If possible, try to have the confidence that you can take a break every so often without fucking up your life.
That's true. This exam isn't the end of the world if I fail, just £500 I won't be getting back. But I do very much want to pass it in one go - deferring it is an option, but I'll only be getting busier in the future and I'm already a bit overdue for an attempt.
To moan in general, the exam is designed by sadists, with much of it of limited/negative utility in actual psychiatric practice. But I am not credentialed enough to be consulted on such topics, so I'm dealing with it. It's also pointlessly hard, but eh, I can manage that too.
Thank you for listening, it means something to me.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
True, and I apologise for not being around to play something as I said I might be. Work picked up a bit but mostly I’m too lazy even to be properly thoughtfully lazy…
Not your fault in the least! We've both got other things going on haha. If you do ever get the hankering, just drop me a message, but I'm not playing much simply because I don't feel like it, not just because I don't have anyone to play with.
I have my doubts about getting a massive screen because of eye strain. I’m told that if you have a big screen dead in front of you (ie you’re looking straight ahead rather than down a bit) your eyes instinctively try to focus on the horizon and it messes you up long term. I work on this thing most of the day so I want to be careful about that.
I'm not an ophthalmologist, but as far as I can tell whoever told you that is misinformed. A quick search doesn't come up with anything regarding horizon seeking or longterm effects on vision. We both wear glasses, there's no harm in getting close to the TV.
Having the screen lower than your head/eyes? That's good, but mostly because of the ergonomics. You don't want to be craning up for prolonged periods of time, though if you're mostly looking straight ahead I wouldn't worry too much.
Eye strain? Best handled with brightness adjustments and regular breaks.
If you're using the TV from >3 feet away, you're peachy. You might want a lower desk to put it below eye level.
Mom, hold me, I'm scared. I don't think there's anything wrong with it, but it really cements the super-villain's lair look. I'm not sure that thing can mount a TV, but maybe?
A friend and I have a pact that when our careers takes off and we become immensely rich we will buy one of these lol
At that price, I get it.
You have exams?
Unfortunately, yes. Notoriously, unnecessarily difficult ones. And two more if I pass this one. And perhaps many more depending on where my career takes me. It's okay, I'm used to giving exams. I daresay I'm half-decent at them!
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
No, it isn't. I'm not talking about remembering a bunch of explicit instructions or preferences. I'm talking about learning in the way a competent person goes from a newbie to a domain expert. That is completely missing in LLMs. No matter how much I guide an LLM, that doesn't help it generalize that guidance because LLMs are static snapshots.
If you want truly online learning, you're in for an indefinite wait. Fortunately, most people get a great deal of mundane utility out of even static LLMs, and I'm not sure what you need that precludes this.
And if your answer is "but GPT-6 will totally have been trained better", then why on earth would I waste any time whatsoever with GPT-5?.
Because... it's the model we have? Can't have tomorrow's pie today, even if we're confident it's going to be tastier. Why buy an RTX 5090 when Nvidia will inevitably launch a better model after a few years? Why buy a car in the dealership today when you can wait for teleportation with complimentary blowjobs?
If you're trying to force everyone to use the solution you like, you better be damn sure your solution actually works for them instead of constantly resorting to "no, you're just using it wrong".
Hold your horses buddy. When have I forced anyone to do anything? @SubstantialFrivolity has clearly articulated his concerns about the weaknesses of LLMs as of Today AD. I invite you to tell me which of his concerns online learning is strictly needed to address? As far as I can tell, I have emphasized that his boss has a point, or is directionally correct, and that he could benefit from using LLMs more. I hope you've noticed multiple caveats and warnings attached.
If you are so convinced that even the best LLMs today are a waste of your precious time, then good luck with whatever you're using as an alternative. It's not like they're so entrenched that you can't lead a productive human life without one. They also happen to be very helpful for most people.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
I went blind again. Before anyone panics, it was for less than an hour, and I'm fine now.
I was previously diagnosed with a condition known as central serous chorio-retinopathy, where fluid leaks out of the vessels below the retina and makes it bulge out. It is usually due to corticosteroid consumption, which I've never done, but also due to prolonged and severe stress. Guess what I'm experiencing?
This isn't the first time. In keeping with a now-obvious pattern, it happened to me before a high-stakes exam. Once before the PLAB 1, again before the MSRA. And now, the MRCPsych Paper A looms ahead of me.
My stimulants might contribute (they're stimulating the sympathetic nervous system too), even if I take very reasonable doses. Unfortunately, my ADHD is not an affectation, I can't study without my meds, let alone pass exams. Especially exams that require months on end of grinding and memorization, when is rather be doing anything else.
So yeah, same choice as usual: lie flat, or keep fighting. I'm inclined to do the latter unless the attacks become so severe that I'm at great risk of permanent visual damage. I did see a doctor once, and it was decided that a waitful watching system was appropriate, instead of jumping to options like intravitreal injections or lasers. It's been a year and a half since then, and this attack was mild, so I suppose it wasn't the worst advice.
Anyone else have a few dangling Damocletian swords above them? Aimed at their eyeballs? Alternatively, what's the best way for me to manage my stress, when giving up or foregoing my meds isn't an option I'm willing to consider?
(I'm going to order myself some green tea. It helped in the past.)
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
Uh.. Your premise is faulty. Most LLM front-ends have memory or instruction features. You can literally make sure it remembers your preferences and takes them into account by default.
My custom instructions on ChatGPT include:
Never do any calculations manually, make sure to always use your analysis tools or write a program to calculate it.
And guess what? GPT-5 is absolutely scrupulous about this. Even for trivial calculations, it'll write and execute a Python program.
I, or you, could easily add something like:
"Always use your search functionality to review factual information. Always provide citations and references."
A more sensible approach would be to let it exercise its judgement (5T is very sensible about such things), or to tell it to do so for high stakes information.
So, yeah. A non-issue. It's been an effectively solved problem for a long time. You can even enable a general summary of all your conversations as part of the hidden context in the personalization settings, so the AI knows your more abstract preferences, tendencies and needs. It's even turned on by default for paying users.
I haven't run into an any Anki decks specifically designed for this till date. I've made a few of my own, and I intend to go through them eventually.
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