As someone who's spent the past week randomly feeling like someone's been stabbing a push pin into my thumb because they removed my cast following surgery but neglected to remove the pin holding it in place, I endorse this post.

Sure but I think that is commonly misused/misunderstood as the disqualifying assumption. The bigger problem is people buying into it as dogma and not viewing it for what it is (a simplified model of reality). So instead of looking at real world data and saying, "welp, perfect rationality is just the edge case and not a great assumption to make here," instead they're like "welp, gigabytes of real-world data spanning multiple decades must be completely wrong."

Yeah the gaslighting is off the chain. Few doctors will straight out say "I have no idea what's wrong with you and no idea what to do next, sorry". A lot of doctors are convinced that patient problems are routinely in their heads and the way clinical experience is structured tends to reinforce that (for example, the guy who said you were making it up probably still thinks he was right). Sorry about your runaround. My ex had a similar experience.

I see the standard of care thing as an intractable problem to some extent. Most people just aren't that great at their jobs, that's a universal thing. My issue is that if what we're going to get is mediocrity, we could at least try to not pay a ludicrous mountain of cash for it and not pretend like doctors are doing awesome jobs.

I had a chest infection in London once and went to the NHS. I got seen, diagnosed (I thought I had the flu) and given antibiotics all by a nurse, I never saw a doctor. Here that all has to be done by a doctor. If it was an option here to see a nurse who had years of clinical experience equal to the difference between his/her degree and the doctor's, I would strongly prefer the nurse.

The solution eventually will be AI. I expect almighty kicking and screaming from doctors when that starts to take over.

In today's episode of News that Shocks No One, Tucker handles criticism poorly:

I don't know what it's like in Australia, but in the US a lot of routine stuff is increasingly being done by nurse practitioners and physician's assistance. Pretty sure it's a small rock

It's bad in Australia. It is not possible to see a nurse for anything without having seen a doctor first. Doctors do trivial, procedural stuff like giving sick certificates (employers here may demand a sick certificate as proof of illness if you take sick leave; if they do, the only way to get one is to see a doctor) and giving test results to patients when the results are "all clear" and that concludes their care. Nurses do things like taking blood for tests, but only under instruction from a doctor who has seen the patient.

Edit: Also don't follow "small rock", autocorrect fail?

You don't need to be a genius to be a doctor. The problem is

a) Their training is based on recall. Medical school is simply about remembering facts and regurgitating them. If you try to tell a medical student that a gene may peroform function X, but it depends on factors Y and Z, they will get pissed off and ask "what do I need to know for the test?"

b) They don't have any training in problem solving. They can match symptom A to treatment B because that's what they memorized. That's it.

c) Doctors are only adept at their own field of specialty. They don't know **** about anything else. A neurologist isn't gonna know **** about kidney disease and vice versa.

d) Doctors rarely keep up with the literature. If there are advances in the field, they won't know about it.

The good thing is, movement towards analytics and individualized medicine will automate a lot of these functions, so human doctors will be gone eventually.

The more doctors you meet the more you realize there's a spectrum from good to bad.
The more immigrants you meet the more you realize there's a spectrum from good to bad.
The more pizzas you eat the more you realize there's a spectrum from good to bad.

Also kind of a response to your, "WTF are you talking about question".

To be clear, my wife's current neuro-oncologist has been great for us. As a patient-facing specialty, it's equal parts "living with it" expert, non-surgical treatments including keeping up with and using radiation or similar as part of combination therapy (which is what we'll be doing), and knowing when to defer to surgery as a better option. In my wife's case, because her condition weirdly impacts the mechanics of how she can recover, she also works with the neuro-rehab therapists and neuro-rehab doctor to design a program that *works*. That's hard enough, but ALL of the direct treatments have always sucked ("To which degree would you like your guaranteed catastrophe, ma'am?") so she's also a real innovator and we'll be joining a trial which is actually the first remotely promising option that has ever existed. For the year since we moved to Atlanta the neuro-oncologist has been the hub for coordinating all of the other specialists who have *finally* addressed all of the symptoms which the same specialties had said, "I don't know, it probably has something to do with the brain tumor?". In Alabama, for all intents and purposes *I* was in charge of all of those things due to my dedication and willingness to research. She's quite possibly the best doctor anywhere for my wife's specific condition, even better than me!

She's still not a statistician. (See this is why people irl think I'm a "dick" and should try to be more positive.) Situational likelihood has a great deal to do with planning around this...stuff.

Plus she should just have access to other, less barbaric, options. I would say right now (and only this very month) it is at least trying to kill a fly with a sledge hammer, whereas everything else is trying to kill a sledgehammer with a fly. It's only that way for the stupidest reasons, and I mind.

get em


would be some consolation after this Mueller thing gets ****ed up & buried

Story that gets almost 0 attention despite how horrific it is:

Lt Governor of Virginia is being accused by two different women of forcible rape, and Democrats in the legislature are refusing to let the women publicly testify

Yeah, one reason I chose the expert I did was because he was the first person (afaict) to publish large variability in test results of people with confirmed disease, many of which were read normal. So it turns out that secreting tumors can be weird and are not always active; another problem is the newer assays have far higher specificity. He makes the point that one positive test can be worth more than a dozen negative ones. My experience with assembly-line docs is the exact opposite: they'd look at my labs and focus on the several negatives and ignore all of the positives. "Those were probably just lab errors, let's take another look in six months."

it is known (projection)

"voter fraud" was another of these, was the first one after he was sworn in iirc

I've seen stories about this every day not sure where you're getting news

I have an entire feed on Twitter dedicated to Virginia news! Coverage of this has died off very quickly, and the national media has largely left Richmond.

I know the allegations are widely known, what I do not think is widely known is that Democrats are trying to leave town tomorrow (General Assembly adjourns on Saturday) without allowing the women to testify. They're trying to silence the accusers.

Can't wait for the 6G space force run by weapons talented teachers

So the Secretary of Labor helped cover up a pedo sex ring that involved the president, just another day that ends in "-y"

nothing but respect for President dril

lol i was just gonna say that this Epstein/Kraft stuff was bad news for like R. Kelly, then i saw that R. Kelly was apparently charged with 10 counts today

amazing

Just here to point out the actual article wording reads; "...while working as a towel girl at Trump’s Mar-a-Lago resort."

Not as a towel girl at politico.com, which may not even have towel girl positions. BTW, what exactly *is* a towel girl and why am I expected to know this without explanation?

Uh, maybe arrest and charge Dershowitz?

Alex Acosta looks like a frustratingly near-flight dinosaur who chews live fish out of a muddy bog

Jesus that Epstein case is like movie villain unbelievable.

Lol