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
2d ago
Is there some degree of "cynicism" involved? Sure. But it's not all-consuming cynicism, I'd say much of it is becoming better calibrated on what you can trust, and how much weight to put on various findings.
I know plenty of idealistic senior doctors who go above and beyond.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
2d ago
Indeed!
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
2d ago
I wash and iron my shirts with the buttons on. If I was actually unbuttoning and rebuttoning anything, I'd have noticed.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
It's winter in Scotland, and you can feel it in your bones and in the heating bill.
A few days back, I groaned at the alarm, rushed to work, and started the ward round with a consultant. A few minutes in, a nurse approached and handed me a handwritten note. She looked genuinely concerned. I took a glance.
It said I'd put my shirt on inside out. Oh.
Ten minutes later, another nurse beckoned me aside and whispered the same thing into my ear. I told her I appreciated the concern, but I'd already got the memo.
When the round wrapped up, I fixed the problem in the loo. White shirt, white buttons, and clearly nobody of a masculine persuasion had noticed.
When I came back, the nurses were joking about it. Then one of them told me, entirely serious now, that they'd been rather worried about me. In their view, I'd only make a mistake like that if I was seriously stressed or anxious. I explained that I'd been too lazy to turn on the lights and had dressed in the dark, and thanked her anyway.
I found the whole thing very funny. Women seem to notice and care about wardrobe malfunctions far more than men do, though I suppose the social penalty is higher when it happens to one of them. I was just confused by how seriously they took it. It's a shirt! I couldn't even tell, and I was wearing it!
On the other hand, I've made a consistent effort to dress well on this placement, resisting the siren call of scrubs. Yes, I regularly wear white in an environment where ending up in blood, urine and feces is a genuine occupational hazard. I'd call it a flex/costly signaling if I cared that much, but I haven't given it much thought beyond liking white shirts and looking good in them. And I'll be damned if I stop wearing pointy shoes. The Great Male Renunciation was a mistake.
Maybe seeing me miss something so obvious made them think I'd finally lost it? I was having a good day! They've seen me on days when I'm visibly on the edge, and it has never shown in the fashion. I suppose that means they'd come to expect a certain standard from me. I hadn't realized anyone was keeping track.
I was on a medical ward, waiting on a consultant while he peered at someone's asshole, with a female med student as chaperone (and clerk, and paid for neither role). It was taking a good while, and I was stuck in the corridor with three other female med students. We struck up a conversation, and I launched into an impromptu lecture.
I offered to teach them how to do Mental State Exams. In theory, the MSE is a structured clinical assessment of a patient's cognitive and emotional functioning. In practice, Liaison Psychiatry refuses to accept referrals unless you have documented one, so the actual utility for a ward doctor is learning how to half-arse it persuasively enough that a psychiatrist will be convinced to do the real work. I explained that 90% of the exercise consists of taking completely normal human observations and gussying them up into High Church Psychiatric Jargon. The patient is not "talking really fast and jumping from topic to topic"; they are exhibiting pressure of speech with flight of ideas. "He seemed a bit off" becomes "affect incongruent, speech of normal rate but reduced volume." You can't skip the Latinate vocabulary. If you do, then they won't take you seriously.
Then I segued into the practical bits they should know: the common drugs psychiatrists would sneak into prescriptions; why they should always blame the SSRIs for GI bleeds, because someone else would anyway and now they could appear smart and proactive ; and how pretending to give a fuck about QTc prolongation would keep pharmacists off their backs, while the vibe within actual psychiatry was that the risks were grossly overrated (but don't let pharmacy hear that).
I was halfway through this random assortment of self_made_human's Clinical Pearls Earned Through Bitter Experience when one of the girls took out her notebook and started scribbling. The other two followed in close succession. I was very amused and a bit proud. In my experience, med students only take actual notes when they think the material is practically useful. I'm the same, and I know the acceptable response to a senior talking shite about an uninteresting topic is to nod politely and thoughtfully while wondering what the cafeteria has for lunch.
I get moments like that quite frequently, when people ask me questions or seek advice and I rattle off the answers from memory. Then I pause and realize that at one point I hadn't known them. Which blood tests to send, and why. Which abnormal results are concerning and which can safely be ignored. Where to even find the fucking results on a program designed in 1999, by aliens. Complaining about NHS IT is a bonding experience second only to complaining about the weather.
I think this is what becoming a senior doctor feels like from the inside? I'm not one yet, but the process has clearly started, the way you often notice you've aged from other people's reactions before you feel it yourself. Nurses have a model of my baseline. Students write down what I say. Intellectually, I knew this was supposed to happen eventually. I just never expected it to happen to me, in the sense of actually feeling it.
Ah, fuck.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
Jesus. I joke about being occasionally mistaken for a gay man, but that's only happened when I'm loitering in a gay bar (tends to change the priors a bit).
I think a bandana would be simply confusing to everyone in Scotland, rather than a sign of being gay. Can't say I've seen a gay man with one out. Or that I've even seen a bandana in the wild.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
Of course. I saw it begin in the Rimworld community, since modding is significantly easier and less demanding in terms of art assets.
But it's a flood everywhere and anywhere. Rimworld. Helldivers 2. Warhammer 3. Arma Reforger.
The only thing approaching it in magnitude is the community arguments it produces. I don't care about the general sentiment even if I'm made my personal stance clear, revealed preferences are what they are, and the ratchet turns only one way. We're past the inflection point.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
3d ago
It is very appropriately named. Much like a soldier in UCP, it could hide very well in a grandmother's living room.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
4d ago
You've acknowledged and set aside the biggest issue, which would already explain everything: money.
Arrowhead are also particularly stubborn about responding to community feedback. Well before this all blew up.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
4d ago
The devs have access to the same tools, as I've noted before. It's also an online live service game, so even though people have already made their own offline forks (with co-op, because why not), it's not impossible to lock down official servers.
That makes it somewhat different from reverse engineering Photoshop or making a cheap and cheerful clone of a game some dev made the mistake of teasing on Steam.
I still don't know how it'll work out over the medium term. Eventually, we'll also have communities making their own feature-complete and free alternatives to proprietary games, but for now it's mostly reproducing or extending existing works.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
4d ago
I've recently posted about the Helldivers 2 modding Renaissance enabled by AI. As I had feared, it only lasted a few weeks before the developers cracked down and added Easy AntiCheat to their game. The primary impetus, of course, was the fact that their wallets were being hurt.
I left a suitably negative Steam review.
The good news is that barely a few hours after the patch, mods that bypassed EAC showed up. The bad news is that the overall difficulty of creating new mods has shot up drastically.
Why? My understanding is that the devs removed a lot of the hooks that allowed for easy scripting, and encrypted some of the code. Most modders using OAI or Anthropic models found that they'd no longer engage in intentional circumventing of DRM, leaving aside the classifiers kicking in. Previously, the devs had simply made no effort to obfuscate things, unfortunately the merest act of putting on a lock (no matter how shoddy) means many AI models suddenly develop a newfound respect for property rights.
Clearly people are finding their ways around it. I'd imagine some have resorted to using Chinese models like GLM 5.3 that are more gung-ho about greyhat territory, or found other tricks.
I make no strong claims on the balance between attack and defense here, or if it's going to turn into an endless cat-and-mouse game. We shall see.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
5d ago
I do agree that it's severely distressing to their near and dear ones, I could have phrased that better. I just don't think that the distress is all that dissimilar to what's seen with say, severe depression or schizophrenia. I'd contrast that with personality disorders, where there's more of a tendency to be actively malevolent instead of manipulation with the underlying goal of getting away with not eating.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
5d ago
I've been keeping. Stress levels are reasonable, though I occasionally have bad days. A single colleague calling in sick on a busy day can mean a ridiculous pile up.
I've also finally gotten to understand just how difficult managing eating disorders can be. There was a patient I was asked to opine on, who'd been seen by psych on a medical ward on a prior admission and not found to have an ED, on the grounds they weren't happy with their weight loss and had declared a strong commitment to improving.
I'd seen the patient, but didn't want to repeat an assessment or declare a new diagnosis other than possible ARFID because of the earlier opinion from a senior and a few real medical issues impairing eating. The med consultant had been rather peeved, and pointedly noted that the patient had ended up back in hospital a few months later in even worse condition. I had to concede the point, people can lie.
Or the med student with anorexia I saw recently. Both my seniors and the internists had noted her consistent tendency to use her medical knowledge to try and get her way and manipulate people, particularly her parents. Unfortunately for her, she's not very far into her course, and quite a few things she describes are somewhat ridiculous.
I'm not saying they're evil, far from it. They're very, very mentally ill, and the fallout is usually restricted to themselves. Some people can just do a very good job fasting themselves to death while declaring that's the opposite of what they want. I knew the stats, but it's another to see it for myself.
Sigh. I do what I can, when I can. It's sometimes enough.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
7d ago
My X feed decided to drop a tsunami of culture warring on me after I (rather disinterestedly) hit like on a few posts about the Hades 2 debacle.
My general opinion is that I could not give less of a shit if I tried. Sure, all else being equal, I'd prefer that a videogame have eye candy than not, but I have never been remotely tempted to mix gooning and gaming. On a Likert scale, I'd put down a weakly disapprove when a video game makes the protagonists uglier than the mocap actors they're based on (uh, TLOU 2 and that game with robotic dinosaurs, neither of which I've played?), but it's a homeopathic dose of fucks given.
If someone wants titillation, the options are endless. Hentai games certainly don't shy away from the Male Gaze™, and the Chinese pioneer finding the distinction between NSFW and SFW, or at least they find the grey area where they won't get deplatformed. There are mods, someone's going to finetune DLSS 5 to exclusively enlarge badonka-donks soon enough. The market for attractive pixels is about as close to perfectly competitive as anything gets: near-zero marginal cost, plus a customer base that has never once been accused of hiding its preferences.
I can be annoyed that a restaurant I spotted while hungry is vegan, but I really wouldn't have to go out of my way to find a more palatable alternative.
I'd go so far as to say that there isn't any grand conspiracy to Erase Conventional Beauty Standards - at best/worse some companies are disproportionately staffed by people with taste that differs from the average straight man. By which I mean they have a large number of trans or queer people on staff. Some of it is definitely the product of ideology, I think the degree is overstated.
Far be it for me to dictate what people care about it, I just find the amount of burning passion for the topic perplexing. I suppose there worse hobbies.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
10d ago
I got in a dozen hours of Helldivers 2 over the last week, mostly because the flood of new mods piqued my interest.
Now that I can actually enjoy the game and grind at the same time, I've built up enough in-game premium currency to buy a warbond. Maybe two. The upcoming one is sniper-themed and has a massive fuck-off anti-everything gun that interests me (and gives the existing anti-materiel rifle size anxiety).
(I also found that the highest difficulty level isn't just so brutal that you don't have the time to hunt for rewards, but that there are fewer premium currency drops than at the lowest difficulties. I can literally see that, with a mod that marks spawns on my map.)
Still, taking the same shit in a slightly refurbished toilet gets old. I'm waiting for the full release of Rimworld's 1.7 update, which comes with a complete change of game engine away from Unity to something made in-house.
Which would be impressive enough, but it also comes with massive performance improvements and is mostly backwards compatible with older mods to boot.
A Christmas miracle. And I'd bet good money on it being a mostly vibe-coded Christmas miracle. The lead dev, Tynan Sylvester, has always had a keen interest in AI, and even my superficial knowledge of game dev tells me that this would be a herculean undertaking for a studio of their size.
I'm not complaining. Now I can install more mods (I was already at 500+), and play a save for longer before TPS-death.
To digress: as recently as a few months back, you'd see people wondering aloud about how all this new-fangled AI hadn't shown obvious benefit to software actually used by consumers. Well guys...
Epic Games declared that they vibe-coded their new launcher for a significant performance boost. People are making pass-through mods that mash together completely unrelated games in schizophrenic ways. Halo 3 was modded to have 128 player lobbies and maps orders of magnitude larger.
Good times. I've always complained about never finding video games that quite hit the spot as often as I'd like, and we're not very far from any random autist auteur rolling their own large-scale product in a few months.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
12d ago
Almost without noticing, I had a solid most of a week without back pain. I almost couldn't believe it. Unfortunately, I woke up today with some of it back again.
Other than that? Head down, nose to the grindstone. Getting good feedback while I've been getting a ridiculous number of assessments done at work.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
17d ago
Helldivers 2 was a game I played the shit out of on release. And then, like a lot of people, I gradually fell off. The reasons aren't mysterious:
- Despite the $40 price tag, the overwhelming majority of interesting post-release content has shipped as paid DLC, or "Warbonds" in the house dialect. The latest Warhammer 40k one costs 1,500 Super Credits, roughly $15, and can't be claimed with a Premium Warbond token.
- Yes, you can, in theory, grind the premium currency in-game and never pay a cent. You are free to do so if you have no life at all, or if you value your free time at about $1/h, spent on the lowest brain-dead difficulty settings for the express purpose of farming.
- If you're trying to have actual fun with the game, you're not making any money. Sorry.
- Several awful gameplay and balance decisions by the devs, though I'll concede some of the launch-era pain points were fixed. Hellpods haven't been able to land on high ground or structures for years, and that was an intentional choice. A bad one, IMO. You can't even spawn turrets on high ground or cliffs (to the lasting fury of anyone who has watched one bounce into a ditch), because why should players be able to use the available terrain to their full advantage?
Another case in point: Arrowhead released not one but two tanks of casemate design, the Bastion and the Maelstrom. The guns point forward, and only forward, with a traverse of about 40° total. This does not work very well, and good luck finding people in public lobbies willing to actually coordinate with you on driving and positioning the thing.
I can see the argument for why the devs want to encourage teamwork. Perhaps it goes like this: a tank one person can solo is a tank that turns the other three players into spectators. Fine. But the observed outcome is a piece of potentially interesting content with no takers, which suggests the design assumed a population of pub players who will coordinate to that degree (they're an endangered species).
All of this nonsense meant I hadn't touched the game in almost a year.
However, I ended up reading, with rather keen interest, about a recent modding renaissance for the game. Kickstarted by modern LLMs, of course. (The older tooling was mostly about swapping meshes and textures in Blender; the new wave goes a lot further.)
Due to the P2P nature of the game's networking, people have been making mods that install client-side yet work in multiplayer, for both cosmetic and gameplay-altering purposes. The most ambitious is an entire fan-run alternative Galactic War with multi-faction battles, a feature Arrowhead's CEO has said would require solving a heap of technical challenges.
In short order we've gotten QOL mods that fix where you can throw stratagems. Mods that let you mix and match armor and buffs, i.e. a transmog system the devs have repeatedly refused to implement. The official line from then-CEO Johan Pilestedt was that it "doesn't make sense", since equipment is supposed to look different because it does different things, and the visual-clarity argument has been repeated ever since. The real answer is that it would get in the way of nickel-and-diming the players, and some players have said as much on the official forums.
Several of the bugs those mods fix have sat on the official to-fix list for months or years with no progress. Stratagem balls bouncing unpredictably off cliffs was listed as a "Top Priority" known issue back in December 2024. I recall that in some cases there were claims of engine limitations preventing a fix.
Well, now we've got random apes with access to Astra or Opus 5.5 making the game the way they want it, in a cave, with a box of scraps.
There's a general lesson lurking here. When a studio says it "can't" do something, that usually means it can't at a price it's willing to pay, and the price of a lot of software labour just fell through the floor. Every "engine limitation" claim was always an implicit prediction that a motivated hobbyist couldn't do it either. Several of those predictions have now resolved, and not in the studio's favour.
I updated the game. Grabbed a bunch of mods, and had a ton of fun. The recent Warhammer 40k tie-in Warbond added a bolt pistol. The game already had a similar gyrojet weapon, the JAR-5 Dominator, which, to put it bluntly, has always been underwhelming.
A quick mod changed mine to fire the bolter rounds, and now it's fun.
Or consider a more cheaty mod that spawns markers for item pickups. Now I get a handful of Super Credits every mission, without spending my limited time under the sun grinding mindlessly. How nice. (I'm aware of the irony that the "cheatiest" mod in my load order is the one that most directly addresses complaint #2.)
Oh, and we can now give the tanks actual 360° turrets. Once again, in multiplayer, with a client-side mod.
The experience has been largely painless. The first public match I joined had some stuttering and de-sync on my end, so I played the rest as host, and it was smooth as butter. Nobody who joined complained of lag or stutter, so I'm not sure whether that first match was a one-off. I had one hard crash in about four hours of play, but I've had that happen in the vanilla game too.
It remains to be seen what Arrowhead intends to do about it. There's been conjecture that they can't do anything, which I don't think is correct. It would just take actual effort on their part. Maybe they can all chip in for Claude Code.
They've been mum so far, even as the community froths over the topic. Unfortunately, the cat is very much out of the bag. I had to try it out and have my fun; the FOMO was too much. I hope this becomes the new normal, and if it doesn't, I'm going to hope someone mods in private (and popular) servers.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
17d ago
No one's given me a choice in the matter, but I take each day as it comes. Being alive isn't so bad at all.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
18d ago
I was diagnosed with migraines, but thankfully they've more or less resolved over the last few months.
No, I've been having back pain for about 6 months now, coinciding with starting my current, highly demanding placement. There's hours of standing around, pushing trolleys about, running around the hospital. Some of it is somatoform and a consequence of stress. There was a proper back injury in between too, but that's healed, the background pain still remains and worsens through a working day.
I saw physio about it. They recommended exercise. I should absolutely be doing that, I just can't make myself do it consistently while under this much pressure.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
19d ago
You know, this makes me nostalgic for when I'd effort post on AI advances in this thread. And they'd usually attract people arguing that it wasn't CW material.
Simpler days. Nobody seems to be disputing it now.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
19d ago
The main difference is that for practical purposes, it does not matter much if your p(doom) is 0.99 or 0.05. Both would be pressing problems whose solution is the most important thing in the world.
If my p(doom) was 99% over the near-term, I'd consider a heroine habit, and blowing my money on hookers and blow. A lot of people would become outright fatalistic, and I wouldn't blame them. Eliezer has sometimes said he's about there, and has fatalistic tendencies on occasion, but to his credit he's far from quit.
Instead, I'm a comparably sedate 20%. Can't do much about things, but hey, it could work out! I could also die, but oh well. No point in sitting around crying about it, the sun shines all the same.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
19d ago
You have missed clear sarcasm. Now you know better.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
19d ago
Nobody is making any money on a 1-10^xx exponent on integer multiplication's big O -- the fact that you think this shows that you are relying on an unreliable interlocuter to form your opinions.
Do I think this? Nobody told me. It's not true. I've never said it, I've never thought it, and you can go look.
I'd prefer you stick to what I've actually said. Or if that's what you thought I implied, I ask that you at least acknowledge when I clarify otherwise.
I also know how Big O works, for the record. I took CS courses in my free time once. I am a nerd.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
19d ago
The improvement in the paper goes to n(log n)^(1-(2^-182)), which while kind of neat is essentially the same as n log n (unless we're multiplying numbers on a computer larger than the universe). It's a toy result. Your amazements suggests you probably didn't even look at the paper.
Ahem. Please look at this comment I had left a scant few minutes back.
https://www.themotte.org/post/3960/culture-war-roundup-for-the-week/485779?context=8#context
I am well aware that this is practically indistinguishable from O(n log n). I know how exponents work. I haven't checked yet, but a sufficiently ridiculous constant factor would make it even more impractical. That's been known to happen.
If I understand your comments below, this is actually false, you didn't have any expectations about the bounds for this problem. Presumably this claim was just AI generated.
I had read mathematicians, on Twitter, expressing surprise that we went below the previous SOTA by any margin, no matter how minuscule. The model rephrased my notice of secondhand surprise into a first person version.
That is such an innocuous, irrelevant change that I wouldn't have bothered to correct it for it's own sake. I hadn't even told the model to only wrap my references in links. It was entirely at liberty to add minor context. The only reason I point it out is because I respect @2rafa, and wanted to declare it as a concrete example of a phrase I hadn't hand-typed.
In other words, I consider your thoughts on this totally untrustworthy. Please don't use AI to write your posts.
Totally untrustworthy? What a massive overreaction. A totally untrustworthy person would deny the whole thing. Instead, I'm punished for admitting any use. You're lucky I think the price of honesty is acceptable.
If you write me off, that's your problem rather than mine. Particularly since I didn't use AI to "write" my post, I had already written a post, and I threw into it for minor improvements and explicit citations I didn't have the time to source. By my standards, the changes I've quoted from the original are positive or at least benign.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
19d ago
No doubt. I'm sure you could describe the majority of human-derived mathematical findings in the exact same words. I'm sure figuring out optimal square-packing has made billions of dollars for someone.
I believe he said that I was having issues "translating from Indian to English". Well, I don't miss him at all, I was consistently perplexed by what people saw in that blowhard.
Now, despite the unprovoked driveby above, I've argued in favor of Dase not being permabanned. But if he continues digging his own grave, I find it difficult to care.
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