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Small-Scale Question Sunday for May 10, 2026

Do you have a dumb question that you're kind of embarrassed to ask in the main thread? Is there something you're just not sure about?

This is your opportunity to ask questions. No question too simple or too silly.

Culture war topics are accepted, and proposals for a better intro post are appreciated.

Jump in the discussion.

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So, what are you reading?

I've finished The Handmaid's Tale. It's a book I'll have to read again sometime, since there's clearly a lot which I haven't noticed. Can't say it ever came together for me, but maybe that's because I didn't really understand its thrust. The tone throughout was sterile, which was probably intentional, given the motifs of waiting and idleness. The world itself never made a convincing dystopia; it was way too lax in just about everything, and the sense of fear of reprisals or of other people never became more than a literary suggestion. The writing was quite good.

It proved as curious as Atwood, who has not been a predictable simpleton when it comes to politics. On the one hand, it could be read as a screed against the religious right, but the picture is always muddled by something, like the quoting of the communist from each according to his ability. The last chapter muddies the picture even further, making us wonder to what extent this is to be taken as history or myth. As a myth, it may be something of value, something worth a closer look. As a history, it is laced with what seems like old arguments among old activists which seems to limp on eternally, even up to paranoia over viruses.

Going to try some Agatha Christie next, which perennialy seems to be collecting dust on my shelf.

Nothing in my life at the moment but SPMM notes for the MRCPsych Paper B and the book I'm meant to review for ACX. One of these is significantly more pleasant company than the other.

Well, the end is nigh. Another week and change, and I won't have to devote quite so many irreplaceable neurons to remembering which antipsychotic is least likely to make you piss yourself in your sleep (risperidone, at a relatively continent 6.2% rate of nocturnal enuresis, versus clozapine's stately one-in-five). Or to remembering whether male British prisoners are more likely to be antisocial assholes or drug-addicts (the former, I think, given that roughly 47% of male prisoners across surveys meet criteria for ASPD; the massive overlap with substance dependence being something the syllabus and I have agreed, by tacit treaty, to disregard).

I'd appreciate recommendations, by the way. God knows I'd like to have something to read once I'm done and dusted. The first Paper A made me depressed. The second Paper B is pushing me towards a psychotic break, which would at least have the dignified completeness of a full syllabus run-through. The system makes me understand how the forensic system works, so it can drive me nuts and admit me for a firsthand tour.

A stupid syllabus full of inane questions, then further mangled by SPMM into a form whose clinical relevance is mostly aspirational, and my sorry ass parked somewhere in the middle of it. At least I'm not a gynecologist.

at a relatively continent 6.2% rate of nocturnal enuresis

Per dose or per patient?

Per patient. If it made your piss yourself that frequently, it would be a shit drug. It's still a... not great drug, but it's better than untreated schizophrenia.

Of course. I just read and wondered if some patients had an innate susceptibility to side effects while others never did. Would be interesting if so.

As a lay person, it’s always complicated looking at lists of side effects. Take a side effect of:

Very rare: stroke.

Does that mean that every time you take it, you are rolling a 1:10,000 chance of stroke. Or is it 1e-9 for a young healthy person and 1:10 for a very elderly person who’s already had one stroke? And so on.

The BNF provides a way to convert from intuitive explanations of risk to quantifiable forms. Common is like >10%. Very rare is like 1:10,000. That's not in terms of every time you take the pill, it's what you'd see in a patient who is taking the pill for prolonged periods of time.

And yes, patient demographics do change things. The elderly are particularly annoying, they'll collapse if things aren't dosed just right.