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
5m ago
I'd rather she have left this essay in the drafts, my fellow Women Respecter. But yes, I share the general sentiment.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
6hr ago
Yes, but I still think Gwern underestimates how debilitating any nicotine dependency is.
He is absolutely correct that vaping or gum is a massive upgrade over an existing tobacco habit. But among the examples of alternatives that he considered "safe" for the nicotine-naive included snus, which was later found to increase all-cause mortality, particularly CV mortality. His speculation about the potential benefits wrt Alzheimer's or Parkinsons proved to be wrong on the basis of RCT evidence.
TLDR: It's a shit nootropic, the dependency risk is significant enough to be concerning even for gum or pouches. He didn't see the Zyn craze coming. His claims that medicinal NRT is remarkably non-addictive held up, but were clearly not applicable to recreational use. Switching away from smoking tobacco is massively positive, for someone who doesn't have a habit, don't start.
While nicotine pouches can generally be a lower-risk alternative for adults who smoke cigarettes, the use of nicotine pouches is not risk free. Nicotine pouches contain nicotine, which is highly addictive, and can deliver harmful chemicals.
Given that there is no safe tobacco product, youth and adults who do not use tobacco products should not start using nicotine pouches.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
7hr ago
Ah, I remember now. I'm glad you took my advice to unlurk, it's lonely being one of the handful of active doctors here, and probably the most incompetent one (not that that's changed).
The last time I read up the etiopathogenesis of BPD was a good while ago, but I recall that both genetic and environmental factors contribute significantly. You can have BPD without any serious life trauma, and the correlation and causation are still debated to this day, but the consensus opinion is that BPD-traits make you both more likely to be abused and to abuse, plus that the abuse likely contributes to the phenotype in the first place. This is the annoyingly complex answer that you stumble into every time you go digging about most psychiatric conditions.
I haven't done a formal rotation in an EUPD ward yet, so take this with a massive dose of salt, but I had an ex who I am 90% sure has BPD (I worked through the diagnostic checklist myself, admittedly after we broke up and I learned more about the condition) and she didn't have any sexual trauma in her childhood. Her dad was most likely schizophrenic, and I'm pretty confident that her mom had BPD. Even though she made my life hell, I did love her, and I still pity her.
Since I'm not maximally lazy, I did check after writing what I did above, and it seems my memory hasn't failed me. You'll see heritability figures from 40-60% for BPD, depending on the study, and it's well established that childhood trauma is neither necessary nor sufficient for causing BPD. Yay, if only this was relevant for my upcoming MRCPsych exam...
(And it's worth noting that the cases that warrant admission are almost certainly much more severe than you'd find on community sampling. It's not impossible to have BPD while leading a reasonably normal life.)
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
7hr ago
It's been almost 4 years, and I've found out, to my detriment, that quitting cold turkey is awful. During the periods where I am unavoidably separated from my vape, the best alternative I've found is nicotine gum, which keeps the worst of the withdrawal away. Otherwise? Brother, I'm fiending. I get angry and cranky, it's the closest I've gotten to PMSing, or what I'd imagine roid rage kinda feels like.
Quitting isn't a very high priority for me, right now. Mostly because the physical health risks of vaping are minimal, close to negligible, going off memory of my attempts to review the literature. I still resent the expense, small as it is in absolute terms, plus the dependence itself. I've found that I can cut down on total intake by opting for weaker juice, but that has little effect on the parameters I care about, which are the money spent on the habit, and the addiction itself. It's not in the top 10 things about my life that I need to fix, though I'm grateful for the words of encouragement.
(I knew the theoretical health risks were small, when I initially started. I had avoided cigarettes like the plague itself for most of my life, but I was curious about vapes, which were hard to get in India. When my ex and I landed in London several years back, we ended up locked out of our Airbnb on a cold night in October. We went to a gas station grocery store for food, where I spotted a vape. I wanted to buy it, but my ex was a cancer survivor and was scared of the risk. Being the nerd I am, I sat her down, and we went through multiple systematic reviews while eating a chicken sandwich. Eventually, we concluded that the risks were minimal, especially the carcinogenic potential, and with her assent, I ended up buying one. Still, #BlameGwern.)
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
9hr ago
I've ticked off something that's been on the bucket list for a while: telling Gwern off for his nicotine essay, which hooked me, and many a stupid rat, on the chemical. It is a frankly terrible nootropic, even if the harms of "pure" nicotine (or even a vape) are minimal, the dependency is remarkably inconvenient and I'm quite confident that his advice is net negative EV. If I had a time machine, I'd give my past self a light smack on the head and told him to never start, alongside inside baseball knowledge on exam questions.
I would have said it to his face if I'd actually managed to meet him at Inkhaven, but hey, sneaking it into a wider debate about LLM prose is a victory nonetheless. I can sleep easier tonight.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
10hr ago
I've found that this is less than reliable in practice. If you have GPT 5.4 Thinking at hand, it's the ur-example. I can throw just about any essay I've ever written, and munch popcorn with the confident expectation that it'll tell me to trim down something. And if I indulge it and let it do it for me? Regretfully, the results will exhibit both aggressive trimming and unacceptable levels of stylistic drift. It's a very intelligent and capable model, but this is a failure mode that I can't beat out of it. I've tried.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
10hr ago
"She's not a real person..." I say while rocking on the floor of my hospital room. "She's just three cluster B personality disorders in a trench coat, she can't get you."
With great regret, you've made a major mistake here. Admitting yourself into an inpatient psych ward is the opposite of what you should be doing if you want to avoid Cluster B types, they're swarming there like a hive. I am fortunate enough to have been stung just often enough to have developed a tolerance, without progressing into anaphylactic shock.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
10hr ago
My apologies, I think you must have been trying to get me to play classic WOW instead lol.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
10hr ago
If I thought the thoughts she did
I saw someone dig up a xeet of hers that said something along the lines of "You haven't really lived if you haven't puked while giving head". In the interest of fairness, I'll mark this is a redeeming quality, albeit one that is far from putting the ledger in the black.
I did tell someone that she's absolutely not a torta, just pudgy but cute. This probably explains why so many men have put up with her shit, but then again, men put up with more than they should when they're thinking with their dicks. Been there, done that, and might do it again.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
10hr ago
Yes. You can look at the SSC version of this post to find an example in the wild. For what it's worth (and to my immense relief), it's a minority position that is increasingly losing traction by the day. The fat-acceptance movement fizzled out with a sound somewhere between a leaky balloon and a stinky fart the moment it was approved and available at scale.
It's not presented as right-wing, at significant scale, but there are plenty of people who consider it illegitimate on the grounds that it takes away the opportunity to demonstrate grit or "build character", and even more people who are unduly suspicious about it because they implicitly believe that the universe is karmically balanced: if there's a silver bullet for a previously intractable condition, then it must have a lead core. Those people are, as far as I can tell, wrong.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
11hr ago
My front was already well furnished with a rod, and I really needed a back-scratcher.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
12hr ago
I meant the scientologists, I have, through second hand reports, heard that ayahuasca can randomly show up at hippie music festivals in England.
Also now I think you should go take one or two Scientology courses and write an article about your experience.
Mormons first. The missionaries who approached me were two hot blonde chicks, which left a very different impression than a schizophrenic DM did.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
12hr ago
The world really has all kinds, and they always seem to become my problem.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
12hr ago
You seem to be doing just fine, as long as I don't get close enough to smell you, it doesn't count. And neither do you, apparently.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
13hr ago
Yes.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
13hr ago
Too reasonable by far. When I saw the original, it almost gave me a stroke. Do they even have a presence in the UK?
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
13hr ago
Chuckles nervously
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
14hr ago
Pls spoiler tag your flair, k thx bye
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
14hr ago
Uh.. I'm not a psychologist.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
15hr ago
There's this exercise you can do, progressive relaxation of muscles. You lie in bed, intentionally relax the smaller muscles in your periphery, and work your way up to the big ones outward-in. Never tried it, but it's in my textbooks and exam syllabus so it might work?
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
15hr ago
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
15hr ago
After I posted my recent essay on /r/SSC, I was graced by the following DM. I want you to guess, and then put in writing, what you think the spoilered word is. No cheating.
This is gonna sound crazy, but
Scientology can help you. It's the only effective form of mental health treatment I've found, and I've tried a bunch
This did damage to my mental health, which is why I'm sharing it with you.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
16hr ago
LLMs can be extremely succinct, often debilitatingly so. Try out the GPT 5.4 Thinking model, it is trained to hand out tokens in such a miserly manner that you'd think it costs it money. Which, to be fair, is something OAI pays for.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
17hr ago
Met my goal, I remain unbanned another week (I'm not sure I can even ban myself, but it's the thought that counts).
I'll keep that in mind should I try, and after all, it's the same advice I gave a good friend of mine just a day or two ago!
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