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
4hr ago
I have finally used up a good chunk of my ISA, and put my money where my mouth has regularly been: In shares of the Vanguard S&P 500.
God knows how long I've been putting that off, it was surprisingly painless when I sat down and did it. Financial responsibility, brought to me by the resumption of dextroamphetamine.
Any advice on further diversification of my portfolio? I am not financially stressed, and I have no immediate plans on buying a house etc etc. The most likely significant financial liability in the near term would be a cheap(ish) car. I don't have to worry about providing for my family back home, at least unless things go horrendously, unimaginably wrong when it comes to their investments and holdings.
I would say I have a decent risk appetite, but I am of the opinion that the market is, in general, more efficient than I am. Thanks!
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
2d ago
Ah. That's a common enough story.
General advice for the men reading: taking interest in and engaging with the interests and activities of your female partners is important. If you can't generate it organically, then you better learn to fake it.
I can hear the objection already. Faking it is dishonest, she will see through it, and being caught faking is worse than never having tried. I half agree, in the sense that "fake" is probably the wrong word. What I actually mean is something closer to "build a habit."
Look at a person who sets a weekly reminder to call his mother. I wouldn't say he loves her less than the person who simply remembers on his own. The reminder is what love looks like in a brain that is bad at remembering things. The effort is the thing being measured, and is not much worse for being intentionally generated.
I've seen this before - a lot of women will become deeply dissatisfied if you're not doing this. You can be well off, handsome, good in bed, etc etc, but they'll feel that something is missing.
The gap gets filled by small things. Remembering a birthday without being reminded. Asking how her friend's surgery went. Flowers on a Tuesday for no reason, except that she appreciates flowers. Remarking on the fact that she got a haircut. None of these is individually important, which is precisely why they work as a signal. The only reason to do something that does not matter is that you were thinking about the person it does not matter to.
I've gotten better at all of that, with time and intentional effort. I've had exes complain I sometimes appeared checked out, or that I didn't get them flowers. Once that was done and dusted, I set about improving. I'm buying a bouquet today.
That is not to say that the stereotypically male side of a relationship isn't important: being a provider, making her feel safe, taking care of things. These all matter greatly. They are necessary, but in many cases, might not be sufficient.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
I find that it's helpful to attach a reference image and ask it to copy the art style closely, on ChatGPT or Gemini. Much more effective than verbally describing the style. You can use multiple different references, in case you don't want it to crib too closely.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
4d ago
Funny timing: I restarted oral semaglutide yesterday. I think you made the right call.
I'd lost a few kilos the traditional way, which in my case meant eating less, running myself into the ground at work, and taking moderate doses of prescription stimulants. Then it plateaued. For months. Still in the overweight range by the charts. After contemplating it on and off for a good while, I bit the bullet.
I skipped the titration schedule, same as last time. Mother didn't raise no pussy, but she did raise an impatient gentleman. Day one brought mild queasiness. Day two has been fine. The appetite effect is subtle so far, and seems to work mostly by early satiety, so I eat less per meal without any change in how often I think about food. It'll take several days to reach steady state, but I feel it anyway.
(Getting this through the NHS is close to impossible unless you're roughly truck-shaped , and it has to be prescribed within a Tier 3 or 4 specialist service, not by your GP. I happened to have plenty left over from a trip to India)
Do I need it? No. Do I have preferences about my own body that the word "need" fails to capture? Yes. That's true for most people, I just happen to have a degree adjacent to the topic.
What I'd want your wife to hear is about my mother:
She has diabetes and obesity, and her liver was paying for both. The kind of situation where nothing hurts until it's already quite bad. For years I carried a low-grade background dread that I'd lose her within a decade or two. I talked her into starting semaglutide. Her liver turned around.
She still has plenty of weight to lose, but I'm less terrified of losing her.
Tell your wife that. When someone you love becomes healthier and is likelier to be around longer, the available emotions are relief and gratitude. Disappointment is a shite dessert.
I'm now trying to get my mother back to her endocrinologist to raise her dose again, or to switch to the injections. I'd like my father on it too. He isn't obese by the numbers, but he has the beer belly, minus most of the beer, since Indian fat distribution handles that part unassisted. He isn't listening to me. Parents rarely do. I'm glad mine occasionally listen without me having to go and poke them with a needle myself.
We live in an age of miracles. It seems a shame to leave them on the shelf. I've taken them out of the luggage at the least.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
4d ago
SHTF comes in various flavors. Some more easy to weather than others. A rucksack full of USD can help with many problems.
I also mentioned using it to buy durable goods.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
4d ago
It is a pain, which is why I have been paying for it for a year and have gone about half as many times as there are months.
I'd need to call and email them, and it would only kick in after the next billing cycle, with a month's notice. This has been effective at squeezing plenty of money out of me.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
5d ago
If.
It remains an open question, and I'm not as pessimistic as some.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
5d ago
No exercise other than running around at work. I still intend to cancel my gym membership as a lost cause.
I have other things I would love to talk about, but due to a catastrophic failure of OPSEC, I can't. They know where to find me. Hello.
Otherwise, I continue being the best I've ever been, really. Long time coming.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
5d ago
I would have signed up for cryonics, before I was middle aged. Not much point in that now. I will reconsider only if things seem to peter out.
I have accelerated my long-standing goal of marrying and having kids. In a slower world, I'd have been okay with waiting a few extra years.
I should be putting all or most of my savings in an index fund. I've been procrastinating on that.
I am more open to risky medical treatments, to a degree, because the longterm damage is more likely to be fixable.
At a recent nadir of my depression, I reminded myself that I want to see how things end, or begin, really. That we'll find a cure for treatment resistant depression, if existing interventions fail. That I just needed to live long enough to see that through.
Well, I got better anyway. Mostly because of my own actions rather than anything any other shrink did for me. If that doesn't last, I can look forward to a technological fix in a very reasonable amount of time.
None of this is really life-changing. Which is something I've always noted when people argue that believing in an imminent techno-singularity requires drastic changes in behavior or outlook, therefore this discredits the belief in the first place. Beyond retarded as an argument, but also false when you consider I've been expecting this for a while, it's priced in, and I've had a pretty normal life anyway.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
5d ago
If we have a worst-case scenario, or just any of the really bad ones, we're fucked. A hidden bunker will just mean you die last.
If things go swimmingly, then the worrying would have been pointless - in hindsight.
That means I think it still makes sense to follow general, option-preserving strategies. That covers the increasingly unlikely "business as usual" worldlines, and shelters against socio-economic/political upheaval as the changes (good, bad or meh) promulgate.
In my context, that means I just continue being a doctor, progressing through training so I keep making more money. Money is the most general of strategies. It can be exchanged for goods and services, including more durable barter goods if shit really hits the fan.
If none of it matters, maybe you decide to do that masters in philosophy or take the job in some remote and low paid location anyway, just for fun.
I like money, you know. And want a family, which is expensive. I can't stress enough how the "correct" course of action depends on someone's priorities, which I am really not in a position to dictate. If you want to go be a hobo on a tropical beach, be my guest. My approach minimizes my hindsight regret.
I continue deriving some amount of satisfaction from my career, and regardless of how this ends, I'll say that I did something important while that meant something.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
5d ago
I don't know. That's the honest answer.
How does one deal with the fact that they have a malignancy? That their loving grand uncle won the lottery, and might die in a few years and hand it to you?
Once you accept it as probable, your brain will reconfigure in the background. Maybe you can speed it up (I once did a heroic dose of psychedelics, but I wouldn't recommend that as a general solution. I wanted to get over depression and I was desperate), maybe you can't.
Maybe the knowledge consumes some people with unbearable anxiety. I'm sorry if that's the case. But I'm not in the business of reassuring lies, quite literally in terms of work. Either way, the facts are what they are.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
5d ago
I disagree. Knowing that human endeavor is going to end up redundant in less than a decade has some obvious implications as far as I'm concerned.
I wouldn't quit my job to retrain in something else, the opportunity cost will never be recouped. I have to worry less about saving up for college for my kids - they never need to attend one for credentialing purposes. Any health related concerns that would take decades to kick in become far less pressing.
It should drastically change your priorities and medium and longterm planning. That's happened to me. But I prepare for as many scenarios as I can, and at least in my case, I don't need to do anything particularly out of the ordinary.
That being said, I should max out my ISA. I am not immune to procrastination.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
5d ago
I am known to have altruistic tendencies. If that isn't enough, I dislike it when people are wrong about things, and find it satisfying to at least try and correct them. Also, there was some scope for coordinating a solution instead of having it imposed on us. Maybe it's not too late.
What are you going to do with this information? Entirely up to you. What would you do with the knowledge we're going to be raptured, or that an asteroid has a 30% chance of hitting the Earth in a few years?
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
6d ago
Well, I suspect they'll care when they start ending up unemployed, or when the world reconfigures itself faster than they can blink. In the meantime, I'm sure ignorance is bliss.
Imagine a car.
For a long time, it was a purely theoretical car. Spending any amount of time theorizing about its safety features was a charming activity for undersocialized nerds.
Then it moved. Slowly enough that you could walk alongside it. It was a mild curiosity, at best, to most.
Then it started picking up speed. The acceleration was increasing too, and some of us found that concerning. You could plot the bloody thing. I can't stress enough how little of this required a revelation.
I was around when we were trying to design safety features for a vehicle that didn't exist yet. Later, I was politely asking people to take notice when the ride started getting bumpy.
About a year and a half ago, I became somewhat frantic. Did people really not see what was coming? I spent far too much time arguing about it. I should have saved my breath.
Six months ago, with Mythos? The steering wheel came off. And I considered myself done with trying to convince anyone of anything.
I have the misfortune of occasionally reading someone explaining that the car can't be dangerous because of how the engine works. Or that it's a beat up sedan, and we should only worry about F1 cars. And don't you know that the speed of limit is a hard limit on velocity? Or that our current transmission systems break down at 570 km/h?
I'm sure there's a reply to that. I've probably written one before. If writing doesn't work, look out a window before it's all a blur.
Can people see an inch beyond their noses? Apparently not.
These days, I'm doing my best to strap myself in. I have no idea how much good that will do, but I've only got so much time and attention, and I'd like to spend some of it on the assumption that I have a future.
I don't know where the road ends. But some people are about to wish for airbags, and I find that a "told you so" is a small consolation.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
6d ago
You know what, I'm past caring. At least caring enough to make a fuss about things, or spend my limited time under the untamed sun trying to convince people to see the writing on the wall.
Yeah, we just found a solution to Navier-Stokes. I know just enough to say that that's a Big Deal. It's one of many Big Deals lately, each bigger than the last.
Anyone is welcome to plot the trendlines. I'm going to continue having fun and doing things IRL while that adds anything over what the bots can do. Good luck everyone, make sure to enjoy yourself.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
11d ago
SSRIs are better than placebo, though the Number Needed To Treat (vs placebo) is an unimpressive sounding 5-7. Well, at least they're not as bad as statins.
This is me being a mild pedant, rather than disagreeing with you. They're not the best choice for him, as I've said down thread. They're still a better idea than... benzos and booze.
In all honesty, @ratherblather, the best thing for you would be to go on vacation. Or simply just get away from it all for a bit. I know, that probably sounds less than appealing, but I think it'll do a little good anyway.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
11d ago
Emotional blunting is common enough, but can take a variable amount of time to show up, typically a week or two. I would not rely on SSRIs to induce it, most people never experience that "issue".
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
11d ago
I resist the siren call of scrubs. Comfy? Yes. Practical? Yes to the yes, given the exposure to bodily fluids. But that only makes wearing white dress shirts to work even more of a standout.
I heard a senior female consultant commiserating with the junior girls about how she still gets mistaken for a nurse all the time. I told them that I get mistaken for a doctor most days of the week, and I've stopped correcting people.
Then again, I haven't been carded since I was sixteen.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
12d ago
I administered myself the relevant instruments for assessing depression. I had a handful of episodes of passive suicidal ideation. I have my own notes from the worst patches, missives to a future self who was hopefully better off. That's me, today, but it's rather grim reading.
It was exactly as serious as I feared. It really couldn't have been much worse without a complete and utter breakdown. Sure, I've been clinically depressed to some degree for >95% of the last ten years, but it's usually mild to moderate. Having thoughts about walking into traffic after something as silly as a bad date and a few drinks was... new. May it stay old.
Rather annoyingly, now that my "urgent" appointment with a shrink is coming up, I've gotten better. You can't treat depression that doesn't exist anymore, but you can put yourself on their radar and ensure that you get somewhat more timely care next time.
(The wait is... concerningly close to how long it takes to spontaneously recover from a typical depressive episode without treatment. I'd call that intentional if that wasn't giving the NHS too much credit. The service is just overburdened and under staffed, I say as someone shouldering the burden. The irony of it isn't lost on me at all.)
I'd say that my depression getting better wasn't mysterious at all. It started due to immense stress. It got better as I adjusted to the workload, and the real turning point was my slightly hardass boss telling me he was happy with my performance. I could feel the muscles unknotting, as I realized that putting in 120% effort had paid off, and even better, I would be able to sustain things at mere 80% throttle for the rest of the placement.
As I intend to tell a more qualified and better paid shrink: clearly stress reactive, or vulnerable to psychosocial stressors.
Will this relief last? I don't know. Odds are against it, probably, given my history. But it clearly had a massive component of "shit life syndrome" and I managed to make my life markedly less shit.
Anyway. Sorry you had to go through your own issues, and happy that you're better. I found it very helpful to remind myself, at the nadir, that things would get better if I toughed it out. They did. I agree that winters are awful. That is why I usually flee to warmer climes. I'll get a SAD lamp anyway, if I remember to. Or join the local lassies at a tanning booth, if I ever lose all dignity.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
12d ago
I have, unfortunately, been in bonny Albion over several winters. I can't say it's ever helped things. You should be aware I've been here long enough to know that.
More importantly, I have been depressed during the summer. Most summers. Most places, including India.
This isn't a simple seasonal shift. If mere exposure to sunlight sufficed, I wouldn't have been depressed at home. It coincides with... well, a lot of things. Overcoming serious adversity and taking control of my life being an important one. I managed to achieve that while rather badly depressed - which was most of this summer. I presume it showed.
I don't see much sun even on a good day at work, at the height of the summer. I'm lucky if I can nip out for half an hour during a lunch break, or catch photons on the walk to and from work.
You don't need SAD to be sad. At least I don't.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
12d ago
It would take at least 2 weeks for SSRIs to typically show effect. 5-6 if you want to really know if they're working.
Benzos? Aww man, there are very few problems that are worth starting benzos to handle. A short course is unlikely to be addictive, but if you end up addicted? You'll regret it. If you're using them expressly to relax or numb the pain, that drastically increases the risk of becoming reliant on them in the long run.
There are less legal options (presuming you even find someone willing to prescribe the above for you, at least for sounds like a grief reaction or bereavement). I'm not going to endorse them.
Raw-dogging things is probably net positive in expectation. I understand if that doesn't prove feasible. Good luck, and I hope you get through this.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
12d ago
I need to cancel my gym subscription. And do more push-ups.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
12d ago
An interesting observation: colors are literally brighter when you're not depressed. I can't stress enough the fact that this is not a metaphor. They're more saturated, and every now and then, I stop to look at the porcelain sky or a particular nice shop sign. I've even admired traffic lights. I think I'm as euthymic as I've ever been, and stress levels are, well, non-zero, but at a local minimum.
I have mixed feelings about the fact that I recently, over dinner, found out that most of my junior colleagues are older than me. An artifact of Scotland encouraging graduate entry medicine. I suppose that's a reminder that even after several years grinding exams to get here, I'm making excellent time.
And then a med student with grey hair and a look of deep despondence said he was surprised to learn that he was a few months older than me. He said he'd thought I was in my early thirties. I shrugged, and said that was one way to find out I looked decrepit. I asked him how he felt about likely becoming a consultant in his 40s, which, to be fair, isn't that late by British standards. He said he was trying not to think about. Poor guy had applied for medicine multiple times; he'd done well enough on the exams, but failed the personality screens/interviews. He was bad at even faking the extroversion. A real shame, I explained that medicine strongly selected for the Type A-s, but the rest of us could make it anyway. I told him the important thing was that he was here now.
And then I explained that I felt that grey hair or a bit of the Norwood was an asset for male doctors. Engenders confidence. Implies we know what we're doing. This is perhaps a mild amount of cope, but I retain all my hair anyway. That comes as a surprise given what I've been through.
And a little while earlier, my boss had implied that he pegged my age around 21. That would explain quite a bit about his attitude towards me. I wish that were true.
Then there was the time I snuck into a clinical skills session meant for fresh interns. I hadn't done an ABG in four years, and I have a slightly irrational fear that it'll be expected of me. Even though I work in a specialty where we literally don't keep the equipment around. It's early days, and everyone is getting to know each other at that hospital. I was asked by someone how I felt about starting my internship. I said that I was rather glad it was long over, and that I had no business being here, but they weren't checking the guest list closely. They were amused, and asked me if I was trying to blend in. I looked down at the rather different shade of lanyard, and my dress shirt and nice shoes amidst a sea of scrubs, and said that I wasn't doing very well. At least I got the ABG done first try.
Sticking to the theme: a youthful intern was rizzing up the med students. One of the ladies was Australian, and thus subject to cross-cultural discourse about Kangaroo Jack and Crocodile Dundee. Look man, it's that or Drop Bears. The intern said that these were childhood artifacts from "our generation" - and the young lady couldn't be expected to know about them - while gesturing at me. At me. As the reference generation.
I couldn't let this stand. Every now and then he says something that makes me me want to crawl into a coffin, call me an anti-pedophile the way I'm out of touch with the youth. Nice kid, nonetheless. He'll eventually live down the jokes from one of the blood cultures he'd taken off a patient coming back positive for Lactobacillus salivarius - a commensal/symbiotic organism that, as the name strongly implies, is supposed to stay in the saliva. Getting to show off in front of the med students is just about the only perk of the intern years. Well behind me, but at least I can admire public infrastructure instead. It's been a green light for the first time in years.
Thank you. I'm glad I did it, it was one of the most concrete examples of me failing in hard to see ways, my limited energy carefully rationed. Being able to overcome the tendency to procrastinate in some ways, while feeling utterly helpless in others.
I think that was the biggest ticket item. Compared to that, canceling a gym membership I don't use is nothing.
Thanks for the other advice! I am leery of gold or crypto, for various reasons, but general global exposure might not be the worst idea. Shame the Chinese stock market is borderline impenetrable...
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