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Makes sense. I can see how that might be the result of wishful thinking... "the world can't really be this awful, can it?" I've heard that burnout is a real problem for psychiatrists, since they have to listen to so many awful emotional problems all day every day.

I don't think Metal Gear Solid would have been nearly as iconic if it didn't successfully replicate the look, sound and feel of an action movie. Sure, by today's standards it's not "hyper realism", but by the standards of the day it was.

I'm not sure it's so much complexity I'm avoiding now but games that don't respect my time.

I used to love JRPGs, it was my favorite genre. I can't really do it anymore. They seem like so much pointless busy work. Closest thing to one I've been able to play a bit of (and even then) is Triangle Strategy, and that's a tactical JRPG. I guess tactical RPGs I can still stomach a bit because fights feel like distinct chapters that I can do one and feel done with for the night while feeling I've actually moved forward.

On the opposite side, three genres I never imagined I would ever enjoy, have become my favorites: hard simulators (the harder and drier the game, the better), shmups and fighting games. All of which are so much more challenging and complex than JRPGs, which are usually only difficult if you're impatient and don't level up properly, but all of which feel so much more significant than raising arbitrary numbers because I need them to move forward.

I think an answer that is both Americentric and true is that the culture war is waged first and foremost in English, and only can perfectly fit to America and countries more like it. The (dominant left wing angle of the) CW is something I've decried as being an extremely insidious corruption of many ideas that most people would agree with - at least they'd agree with the motte. Then the bailey gets snuck in and your average person is neither equipped nor inclined to work to decouple those from each other. As I specified that these are mostly left wing "arguments" - by which I mean streamers, ad campaigns, astroturfing on reddit, twitter, youtube, ecelebs in general inundating the general public with some toxic corruption of a more palatable left wing idea - you can make those receptive to them extremely resilient to dissent, but only if the arguments are constantly modulated to fit the current zeitgeist. Otherwise you fail to resonate with the general population at all, and the spell is broken. Not cleanly or instantly, but the absolute stranglehold can't last.

I think this only can truly happen in the US and our closest countries culturally (the UK and Canada), not only due to the above but also the fact that the vast majority of worldwide media is either from or related to America. My favorite example is the thought-terminating cliche "donate to black trans women". That makes no sense in the vast majority of European countries, because black people are just a tiny fraction of the population, especially integrated ones, and you can't make an appeal to someone's sense of fairness when none of those black people were slaves, or historically discriminated against in any way. Contrast that with the US context where guilt over all of that most certainly has a place in the public's consciousness, and it's much more likely to land.

Now, certainly there are wider schools of left wing thought that are more generally applicable, and have arguably been more popular in Western Europe; but those are less likely to be extreme or have that stranglehold over your terminally online population. Consequently, those downstream of any of the media the terminally online influence are not fed this riveting and completely relevant culture war. What remains in the public consciousness is this weird distorted holdover of 90s neoliberal thought (I've often lamented that something seems to have completely frozen the political elites, but this is not the central point of my response): Immigration good, world police kinda bad, health care good, guns bad, violence is not endemic to our society, number must go up at all costs, etc. None of this is really all that compelling except health care and being against the world police idea. It certainly doesn't hold the vitriol that American politics does.

So, when you combine those geriatric neoliberal policies with the consequences they bring (e.g. wow these migrants really seem to be causing a lot of problems), and the messaging is not able to sustain it, what do you get? Genuine grassroots support for something, anything different. Wow, there's a part called "Alternative for Germany" that's talking about these exact issues the establishment is ignoring? Sign me up!

Contrast this with America, which is much larger in scale, and arguably a lot more atomized due to its multicultural nature. This compounds with the effects of the terminally online world, meaning a lot of people's perceptions of issues that are not right next to them are completely detached from reality. It's just some streamer, or tiktoker, or AI generated youtube video that even tells them about these things. A young leftist from a hip neighborhood is likely never to see actual race crime, or when it does - as was the case when Ryan Carson was stabbed to death - the feed of content is so strong that they are completely immunized against looking at what happened critically. The hold on them is just too strong.

I will say that I disagree somewhat with the idea that America's young are overwhelmingly democrat. Everything I've seen has indicated that they are splitting along gender lines, with democrats still having an advantage, but only in the aggregate. I can also, emotionally and with no evidence, say that I've felt an extreme rupture in our society between the messaging and reality. I think things like the migrant bussing and ever-expanding nature of activist thought (a self preservation measure - if they don't have something to fight for, do they have jobs anymore?) have soured a lot of people on assumptions they've made. Will it be enough to change the zeitgeist? I don't know. I do know that the American right wing has utterly failed in having unifying figures that are anything short of embarrassing. I don't have a solution for that.

Lots of weird shit causes orgasms, and IIRC people have used hypnosis as a replacement for anesthesia. Dissociation is powerful.

Yes hypnosis is good at pain too. This sounds like a change of tune though?

If you are saying hypnosis can make your boobs grow then I'm going to call you a crank unless you have some damn good evidence.

I'm not saying it can, I'm asking you to predict what the literature says.

What do you think the literature says?

Separately, I just started Samuel Chamberlain's My Confession: Recollections of a Rogue and while I don't have any definite textual evidence yet I am extremely confident that George Macdonald Fraser must have read it and lifted a good deal of the style and possibly some more or less intact episodes for the Flashman books. Flash does run into the Glanton gang at one point, Fraser was never one to shy away from primary sources, and the voice will be strikingly familiar to Flashman readers.

Recently read Robert Shankland's 1954 biography of Stephen T. Mather, written apparently quite straight in what I can only describe as a jaunty Wodehousian style. This has inspired several reflections:

-1954 was of course 30-odd years into Wodehouse's career as a bestselling author (modulo the whole German radio broadcasts episode), meaning that Shankland, in writing a piece of serious if perhaps hagiographic biography, presumably knew he sounded a bit like Wodehouse and chose to write like that anyway.

-One naturally considers Wodehouse's style as a parody of the dominant straight middle-highbrow style of the time. Indeed, Wodehouse occasionally steps outside this to parody the genuinely avant-garde (the occasional modern poet character) or popular crime fiction (various episodes of jewel theft and so on.).

-At the same time, virtually everything Wodehouse ever wrote and said was in more or less the same distinctive voice--is it really a parody if you're just like that naturally, so to speak?

-This also inspires the speculation that Wodehouse's style read as relatively colorless New Yorker prose to the audiences of its day. Imagine sitting down to Psmith in the City or Right Ho, Jeeves and having it read like Atul Gawande's longform medical pieces or something. It's enough to give a guy vertigo.

-At the same time, one can see cheeky flashes of Wodehouse from time to time in A. J. Liebling, who was after all a New Yorker fixture, and perhaps even John McPhee. Was Raymond Chandler a pioneering modernist with his works of hard-boiled fiction? Maybe--but he also went to Dulwich within two years, I think, of Wodehouse.

There's probably a coherent essay lurking in all this but I can't put my finger on it.

Funnily enough, no AVM found on multiple kinds of imaging, including an MR angiogram. No kidney disease either. As far as anyone could tell, it was just bad luck.

Fuck.

Also OB/GYN is traumagenic. Complicates the psychiatric formulation.

On a more serious note it's worth thinking about the way autism has become a catch all for poor socialization, that isn't to say that these people don't have some form of autism spectrum, just that it's worth being a bit more cautious with it since it's becoming an over diagnosed thing (at least in the U.S., thanks TikTok!).

The Tories are a party of mass immigration, that's what their policies have achieved in the real world. They say stuff like 'we'll be tough on immigration' but they don't actually do it, they flail around paying Rwanda and achieving nothing. Different policies but similar results for the Australian centre-right - Abbott successfully stopped illegal immigration but kept legal immigration very high.

In the UK neither illegal nor legal immigration are combatted. In Australia Labour adopted Coalition border policies, so there's no distinguishing difference there. So on immigration both parties are roughly equivalent to their Labour equivalents. AFD is actually different.

Labour generally promises young people some kind of patronage in uni education, welfare and so on. The centre-right tend to support the old in housing and welfare. Furthermore, young people tend to revile the centre-right parties, it was considered cringeworthy to vote for Scott Morrison (former centre-right PM) in Australia. Labour and Greens parties are more socially progressive and young people care about climate change.

https://www.sbs.com.au/news/podcast-episode/voting-choices-of-young-people-shifting-to-the-left/qevszl5rb

Germany, Sweden and continental countries are also much whiter and more homogenous than Australia, the UK or especially America. Also the German Greens have tarred themselves with the horrendous performance of the traffic-light coalition and their economically damaging policies. British and Australian Greens haven't had much chance to do real damage.

The Australian equivalent to AFD is One Nation, which is much more boomer-skewed (and pretty irrelevant politically). It's run by a woman called Pauline Hanson who's nearly 70 years old. They appeal most to rural white Queenslanders, the whitest parts of the whitest state in the country. Same in Britain, UKIP targeted old rural whites because there were more of them. AFD leaders are much younger, in their 40s. They appeal most in East Germany, which is the whitest part of Germany.

I think right wing politics of the anti-immigration kind has a lot to do with whiteness. Western right-wing politics in general too, to a lesser extent. In the Anglosphere the whitest demographics tend to be the old, so anti-immigration rightist parties naturally evolve to target the old. In Europe there's a broader base of potential supporters and they can target the young, so they do.

Lots of weird shit causes orgasms, and IIRC people have used hypnosis as a replacement for anesthesia. Dissociation is powerful.

If you are saying hypnosis can make your boobs grow then I'm going to call you a crank unless you have some damn good evidence.

The VA is great in BG3, because they went for option 2. Everything gets voice acting and it's really nice, but I just don't think that's sustainable for most games. You're right that AI generated voice work will probably render it moot though.

Canada is an Anglosphere exception as well. Young people are basically equally likely to vote conservative as the old.

I can recommend you an interesting pub. It's cowboy themed, ran by an old Japanese gentlemen that's obsessed with country music. It's tiny, seats like 5 people at once, so it's likely it will be just the 2 of you + the owner there, but it's worth it if you wanna sing some country songs and hear about owner's country music lore (went to America, was in a band, etc.). Name is 'PINE FIELD', address: 3-2, yotsua, shinjuku-ku, Tokyo. Owner's name is SunShine Matsuno.

Yeah, though losing his clinical license had more to do with off the cuff podcasts and irritable tweets. I disagree with Canada that irritable tweets deserves that kind of response, but it did sound like the social media presence that gave them the ammunition.

I feel most people past 28 or so who still play complex games are going back to the well of The One they started a decade ago: Dota, WoW, Counterstrike, TF2, EU4, Football Manager. Pick your poison.

I don't think changing times factor in at all, because I vaguely perceive young people forming similar attachments to games with names like "PubG" or "Genshin Impact".

Yes, though I honestly thought it was spelled that way, never having read it on paper.

It may be possible, but I'm not going to take that Al Jazeera article written by a clearly biased author as proof.

If you're going to keep them, perhaps something like a rich Udemy subscription and some theoretical deliverables are a better use of their time and your money.

Is there something you've wanted to experiment with but haven't had the time? Have them run through a course, try it out, and then present 2-3 slides to you. When I'm assigning upskill tasks around 20% of them are cert related, and the remainder are attempts to nail more than one bird with a stone.

If you don't have the time to work with him (which is possible) can you spread it out to where he only meets 2x a week? Is there another trusted lieutenant you can abstract that away to?

Maybe I'm permanently ruined for complex games, but I think I'm just slower on the uptick.

The thing with all these is if you can get over that first 30 minute hump, you're golden. Factorio and The Witcher 3 have fairly complicated control schemes and in-depth stuff going on. After learning the keyboard shortcuts I sunk 100+ hours into each....

But then when I would switch between them I would have to spend another 30 to get reacclimated! I've got too much shit in my proverbial RAM. I'm managing a marriage, a house, multiple teams, an old car, children, friendships, exercise.....

I'd like to blame it on the culture changing but I suspect it's vanilla mental decline and an order of magnitude greater responsibility that are the real culprits.

Haven't played BG3 so I can't comment on the quality of VA there.

Generally speaking, there is a special effect of the human voice that you can't get with walls of text. Obviously it can be poorly executed, however.

Nevertheless I suspect that with AI speech generation this will be largely moot in the next decade.

I'd not really fear SV that much, but what D.C. gestapo contractors and their opposite numbers in China are going to do.

I don't think that only 'technical' contradiction, in which it is logically impossible for two ideas to comport, get to be called contradictions. I think it is very common and normal for people to use the word contradiction to describe an apparent disconnect or incongruity between two things, that need not be completly irreconcilable.

I am not sure if you thought that my argument was, the OP's example is not contradictory, but my example is, but I was not trying to make that argument. I used words like particularly, and compared to. Also, this "'Progressives seem to hold totally contradictory values'." bit was in quotes because it was intended to describe a vibe, that I felt was central to the OP. I just felt like the example the OP happened to be upset by was a kind of weak sauce example of this kind of contradiction.

Entirely from the correctness or incorrectness of the political views themselves, there's no real contradiction between "I support LGBT+/feminism/whatever" and "I am against Israel's actions in Gaza." "I support Hamas".

So, in a very narrow technical sense, I support [Blank] and I support [Group that hates Blank and actively practices violence against Blank] are not logically impossible to hold within the same mind.

Still I am confident saying that not only would most people recognize the incongruity in those statements, if I could ask progressives about a different topic where they were not primed to view it as an attack or a gotcha, most of them would recognize the contradiction in such a statement as well. In fact, just go look at the never ending stream of "if you were really pro-life' memes/posts/articles for a live (and much worse) example.

but the prospect of playing them felt like work.

yeah, that's exactly how I feel now trying to learn some new complex game. I just don't have the spare brain energy to want to play it. The only games that I actually enjoy anymore are casino gambling games, where it's simple enough that I don't have to think about it, yet there's still a real stake (money) and a crowd of real people.

Don't stick your dick in crazy, especially not when they can stick theirs back in you.

Way ahead of you fam, but I definitely need that luck.

Never, ever, EVER, sleep with someone you can diagnose with BPD easily. You're welcome. cries

Duly noted, good sir, but in my particular case I didn't have to even sleep with them for one to take a very good shot at ruining my life. That one was the ex of my own best friend at the time (and I ended up catching his schizophrenia in med school myself).

Excuse me what the fuck with that head bleed.

23 yo M med student, final year. No comorbidities is a mild exaggeration, since he had borderline hypertension. His dad was a captain in the Merchant Marine, out at sea when this all went down, but just a week prior, had gotten his son a full checkup, including a then highly unnecessary NCCT brain. All squeaky clean.

Kid was slightly obese, we had some issues getting a line in the EJ.

Anyway, he was in between his written exams and OSCEs, when he was at home with his mom and developed a splitting headache. Got taken to a GP, who told him not to think so much about exams or women, and to sleep it off with a paracetamol.

Face started drooping shortly after, was brought to the ER convulsing, immediately sedated and intubated, rolled into the ICU, then SICU, bleed considered too small for neurosurgery at the time.

I counseled his family, or rather his mom, his friends, most of them from non-medical backgrounds barring the girl, who wouldn't know what a pontine hemorrhage was if it hit her in the head

The senior consultant, the rest of the hangers on, none of them could convince his mom who was having a fully justified meltdown to go home. She wanted to spend the entire night shivering on a bench (no separate accomodations for the family of an ICU patient). I spent about two hours coaxing, cajoling, arguing, bribing and finally convincing the poor lady to go home after everyone else failed.

The dude was actually improving for the first week, with spontaneous eye opening, some degree of following of commands. Then he had said rebleed, shunt placement didn't help, his GCS dropped to 2T, I got chewed out by a neurosurgeon for asking if he was brain dead, and said brain death was informally relayed two days later, and formally declared a week later when his dad was airlifted off Taiwan and brought to say goodbye.

Funnily enough, no AVM found on multiple kinds of imaging, including an MR angiogram. No kidney disease either. As far as anyone could tell, it was just bad luck. And as far as I can tell, the stereotypes about neurosurgeon ego are entirely justified and universal.

Social media autism

Autism really is my best guess. Zero interpersonal skills, extremely blunt, genuinely curious about how men think about women and what they consider as red flags or worthy of avoidance, with absolutely no insight into her own behavior. The last bit isn't genuinely bad, just an example of how she really seemed clueless. Sure, she could definitely have asked someone far worse at answering that question, but if you need to ask. Shame Aspergers has been deprecated, it was a useful one. Plus she had the same, nigh inevitable, descent into undifferentiated insanity I've seen in every gyno resident, barring the men, who seem to be rather sane. Is she actually mentally ill? I have no idea, but she was off.

Tell them Tylenol is the absolutely worst way to die and to use Melatonin instead.

Absolutely genius. She's fucked up her sleep cycle enough as is, I can pass it off as a dangerous, controlled sleeping med.