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
23hr ago
Sorry, can't hear you. Because I'm on the sidelines waving the red flag too, and so is she.
I do know. Very well. Uncomfortably, painfully well. Falling in love is not a choice, at least for me. And I am genuinely okay with being just friends with her, which is most likely outcome.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
1d ago
Not just me, and not everyone. Somewhere in the middle. I'm just honest about things.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
2d ago
On the inadvisable one.
I have managed to fall for a lesbian. I knew better. She told me to know better, clearly and kindly, the way you'd warn a man about a missing step on the stairs. I agreed with her assessment in full and missed the step anyway.
In my defense, the trap was well constructed. She's gorgeous. She laughs at my jokes against her own better judgment and then looks annoyed about it, which is twice the reward for half the effort. She is a genuinely good person who would deny this under oath. We walk a lot, the kind of walks where the conversation outlasts the route. I hate walking, really, but I always say yes and go running anyway. We get the occasional drink. The odds of this becoming anything more than what it is sit somewhere near the odds of the city chippie getting a Michelin star. So what. We show up for each other anyway. That's the whole arrangement, and it holds.
The wanting is the manageable part. The hard part arrived a couple of weekends ago: something small I did while we were out drinking on a date and having a great time, well, it hurt her, badly, an ordinary gesture of affection that landed on old trauma I had no way to see. Even she ruled out blaming me, immediately, with a generosity I would struggle to extend to myself in her position. What kept me up was watching her treat her own body's distress as a non-event. No anger at me, no care redirected toward herself, just an administrative decision that this was not worth anyone's concern, hers least of all. She has since instructed me to stop worrying, and separately to stop being her shrink. I am complying with the second, mostly. The first is outside my jurisdiction. I know my limits.
(I'm told watching someone refuse care builds character. I had a character. I'd like a refund.)
On the more energetic developments, since @FtttG asked.
A lady, slightly older than me, exactly as fond of flowers as I'd suspected. Smart, gorgeous, laughs at my jokes, which regular readers will recognize as clear evidence of mental illness, though her prognosis is excellent. She insisted I book a hotel for the night of our date, that there was no way I could expect an invite home to hers. That she had standards. I booked it, privately confident the whole time that this was a formality. The hotel went unused. I consider the cost a donation toward the upkeep of plausible deniability.
Her dog is, per the lady herself, an excellent judge of character. The dog spent the evening filing me under family and the morning giving me side-eye, possibly over the snoring, possibly over what I did to her mum. We have since walked in a park, the three of us, like a scene from a tasteful European film. She acts as if I'm the second coming. I keep explaining that this is a low bar. She keeps declining to be discouraged, and there's a second date on the calendar. She's a busy lady with a life, and she makes time for me. And sends me interesting pictures while I'm at work, making me hot under the collar.
I know where the odds are better. I can read a prior as well as the next Bayesian on this forum. I fell for someone else anyway, and my great fortune is that it appears to be ruining nothing: the friendship holds, the dates continue, everyone involved is being implausibly adult about it. It may or may not work out. I try anyway, which has lately been my answer to most questions.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
2d ago
is it time for @self_made_human to do the British would-be-NEETs of TheMotte a favor?
Hey I'm pretty sure I bought @Corvos a drink at some point. That's technically an anxiolytic and possibly a favor. And I don't think I'm the right person for disability adjustments, though they do take psychiatric inputs.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
2d ago
Not the asexual lesbian, because she probably is an asexual lesbian with incredible sexual trauma. But I'm sure I'll write about her (the lucky one) at some point.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
2d ago
No workouts, well, barring some push-ups. I have too much going on. Good and bad. Mostly good, thank fucking God. I am holding myself accountable to more important things right now, and still getting laid so the physique isn't too bad.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
8d ago
Writing screen plays? Strong proof of mental illness. I've never been tempted, sorry, can't relate at all.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
8d ago
I'm not a trauma surgeon, and he'd definitely have died if I was the one responsible for his care. I'm definitely not qualified to gainsay the pathologist here. If that's the subclavian or axillary vein, my hunch is that the odds were very poor, but I'm not going to pretend I'm an expert here. I suppose it also depends on if they had blood products, if the lungs were punctured, and whether a chest drain was available.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
8d ago
I mean, I'm not wearing a tie. And if I did succumb to temptation, I'd make sure it's one of those ones that clips on and tears off easy. Only hot women get to choke me, on my own terms.
I'll look into things, really. I have learned the hard way to take good advice.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
8d ago
I'll consider it, thank you. I just make a point of dressing well these days, even at work, when it would be so easy to devolve into scrubs (and look decent in them). A proper shirt. Nice trousers. The shoes. I'm not insane enough to wear a tie just yet. I used to wear crocs to work, once, but while they're perfectly cromulent footwear, I've outgrown them.
I try to get some stretches in when I can. Even if it's while I'm vaping in the shitter. But the pain really is probably psychosomatic, and it's nasty.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
9d ago
I wrote an essay. It's beautiful. Too beautiful. I'm probably not going to post it, and my reasons for not wanting to post it are sensible and ugly.
Why? Well, I'm the best shrink I've ever had. Or the worst one. This is mostly because I'm still awaiting a more senior psychiatrist (no comments on their merit, since I haven't met them yet, and that's the fucking problem). I had to take drastic measures. I did the right thing, for mostly right reasons; I knew the odds, and still flew too close to the sun.
I've complained to myself that I'm too sane for my own good. And that it might not be an entirely bad idea to exchange a little bit of sanity for a medium dose of happiness. Well, my brain red-lined, I saw an amber light, I asked people I trust if I was worrying them (I was worrying myself). The answer was a yes. I listen and I learn. I hit abort. I realized that being too happy is almost as bad as being too sad. I fixed that problem, because you can't get more insight into your condition without being a laparoscopic surgeon operating on her own endometriosis. The moment I hit my own threshold for concern, I did extremely sensible and extremely annoying things, like calling people and telling them where to find me if things went south. I was confident they wouldn't go south, but not confident enough.
They didn't go south. I'm stuck in the northern end of a cold and damp country, which is cold and damp in the summer. I did not go insane, because I do not want to go insane. Not even if the prospect of going insane felt very good.
The best/worst part? When I was sensible and fired off another cry for help to my doctor, it turned out that my beautiful self-referral and psychiatric history had never reached them. It's clearly been sent. I believe them when they say it hasn't been received. NHS IT is trying to kill me, more literally than I'd like, but I'm still here.
That essay? You should wish you could see it. I've looked at it fully sober. I can tell you that even when my brain is melting from the heat, the metabolic waste glows in the dark like radium. You want to lick it off clean. Or at least I do. That really is part of the problem, and many parts of me are telling me "I told you so", and they are correct. I intend to never go out if I can help it, but if I do, you know it'll be in style.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
9d ago
Uh... I think so? I wear Chelsea boots at work. But one of the reasons I'm not a surgeon (there are others, and too many to list) is that I fucking hate standing. I've tried a bunch of different shoes, I suppose, but my back and legs get sore. I'm literally surviving the ward rounds on paracetamol and ibuprofen (and a muscle relaxant, sometimes). And a PPI, because I never quite go full retard.
Quite convinced it's somatoform pain. Still waiting for another shrink to make me their problem.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
9d ago
Oh I wasn't away for a full 8 months, I was working out 2-3x weekly while on a prolonged vacation in India. Got the DOMS out of the way, I'm just sore because of stress. Somatoform pain hurts as much as the normal kind, it's all nerves anyway. No, it's been a month since a proper gym session, but I've been doing push-ups and swinging dumbbells even last month. Appreciate it nonetheless!
I did go to the gym yesterday. First time I've attended my Scottish gym in 6 months at the very least, maybe 8 or 9. Forced myself to. Despite all the aches and the pain and the desire to drag my sorry ass home to rot in peace. Nope, if I'm getting the muscle ache anyway, might as well grow something to show for it. I'm going today too, after work. Holding myself to it.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
11d ago
The map is not the territory, and I believe there's some acknowledging being done about it.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
11d ago
I'd do it for $9,999, just Indian like that.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
11d ago
I don't think there enough Kiwies around for people to pattern match to that one.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
12d ago
No, I don't think I'm you. Too handsome for that, and given the username, possibly less German or Dutch?
I didn't get any speech therapy. I give the speeches and the therapy. I just learned to speak English while in the States and it stuck and morphed into something so neutral it's remarkable.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
12d ago
I don't have an Indian accent. Quite the opposite. I get asked, almost every day, where I'm from. By people talking to me in person too, mind you.
So far, people have told me I sound American, Canadian, Dutch, German and god knows what else. The standard consensus seems to be from exactly wherever they're not, so Americans wonder if I'm Canadian/European, and Europeans wonder if I'm from the other side of the pond.
In fact, this happens so frequently I have a whole canned speech ready. Surprisingly LLMs can usually still tell I'm probably Indian from pure audio logs, last time I tried was with Gemini 2.5 Pro. I sound very slightly Scottish when very inebriated, but I avoid picking up another accent since at that point nobody would understand me.
Funny and very recent story: I had a date with my Emotional Support Lesbian yesterday. I took her to the shady gay pub that's my usual haunt. The other Lesbian at the counter (much worse at the emotional support bit) could understand precisely what I was saying, and couldn't understand the white woman with the upperclass British accent. Well, she admits that she sounds like a "posh Tory cunt", and that is all the proof I need.
For what it's worth, I hate Indian accents too, they grate on my ears, and I mostly grew up there. I do agree Roadmen sound atrocious, and I'd walk into traffic if I see them on the streets.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
13d ago
I really don't blame her for what the NHS is really causing. I did thank her for letting me know, shook her hand goodbye, and confirmed that she made it home in one piece. I try to keep my problems my own, and she didn't need to know that something that small was all it took to make me begin unraveling.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
13d ago
Maybe a career switch is advisable. I will consult our resident furries for advice.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
13d ago
Oh god, I was so fucked last week. As in, right up until last night.
Had a patient come in. Clint Eastwood-looking fellow, albeit a bit yellow. He'd clearly been to Shanghai and had a good time, whereas I only seem to get Shanghai'd into work and am the wrong kind of Asian for it.
He was not in a good mood. When the senior consultant led the ward round, the rest of us tagging along like ducklings who'd imprinted on the wrong mother, he had concerns. Said we should help, that the NHS was clearly failing him. I cannot in good conscience disagree, having extensive evidence on the matter, but we did need a slightly more itemised complaint. Turned out the gentleman in the next bed had wet himself and nobody had come. My patient, who could not reliably tell you the year, had correctly identified a real institutional failure and appointed himself its ombudsman. The consultant was mildly put out at being mistaken for a nurse. She was far too professional to show it to a man in hepatic encephalopathy, and I was the only one who caught it, because spite recognises spite.
Later, I had to put an Adults With Incapacity form in place for him. He couldn't consent, so the job was to consent on his behalf, which is the polite clinical phrasing for deciding things about a man's body in a room he isn't really in. It wasn't urgent enough to skip waiting for the family, so I waited for the family. They came. The wife told me he used to have a sense of humour like mine. I said that probably explained the liver. She laughed, which I'm choosing to log as a therapeutic outcome. I'm sure she was a gorgeous lady once, albeit too old even for me. She was suitably apologetic for her husband getting rather angry when I put on my usual song and dance, and possibly interpreted it as coming onto his wife. Bit late for that bud. He was not amused. He said "don't quit your day job."
How rude. Wasn't planning to, but that is precisely what I would say in his shoes. And I don't even have the loving wife, lovely daughters, and the grandkids. Or the dementia and what is possibly a HPB carcinoma. Win some, lose some.
Here's what they don't put in the GMC curriculum: he was, by every account in the room, a good man. A lawyer who gardened. Combative, his wife said, but never rude to anyone he understood was trying to help, which is a finer distinction than most healthy people manage. Then dementia, then the loss of his legs, then the drink, in roughly that order, each one a door that only opens one way. I wrote the cognitive and alcohol history and I will admit, with the appropriate amount of shame, that I enjoyed writing it, because it was the first time in months the job felt like the one I trained for. My colleagues said I was the right person for it. I suspect this is because I am the only underemployed psychiatry resident in the building, but I'll take the compliment at face value, since I'm short on those and long on face.
What I did not enjoy: watching the poor bastard suffer, and the fact that my replacement NHS ID badge was not handed to me that day as promised, despite an email, an appointment, and a confirmation that very morning. Isn't there something clarifying about being trusted to make life decisions for an incapacitated stranger while the same institution cannot be trusted to hand you back a piece of laminated plastic?
Then, because the week was apparently being written by someone with a heavy hand, I went on a date. Long journey, no sleep, the usual baseline of grey. She seemed nice, but I really wasn't hoping for much. I went on that date because I wanted to do something other than dissociate in my bed that weekend. I was more unhinged than usual, past the point where I come off as charming and confident, and appear slightly delirious myself. We talked for an hour or two, as many drinks. She came back from the loo, told me she wasn't feeling it, didn't want to lead me on, and would rather go home. Which is, I want to stress, the considerate way to do it, the rejection equivalent of a clean surgical margin. I told myself this. It did not take. I'm a psychiatrist; I can narrate my own distress in correct terminology while it ignores me completely.
I won't bore the thread with the bit in the middle. There were mushrooms. There was a bus station, a kebab, an emotional support lesbian* who has so far declined to be anything more, and a great deal of being talked down off my own ledge by parties who shall remain anonymous. The short version is that I am better now than I was, by a margin that won't mean much to most of you and means a great deal to me.
The old man's still on the ward. I think about the one-way doors. I've got the kind that still open, for now, and I intend to keep walking through them, if only out of spite, which is the one mature defence mechanism Vaillant forgot to list.
*I call her that to her face, and it makes her giggle. Good to know that lesbians, old grannies, the delirious, the psychotic, and other characters find me funny. Also, she is into some really freaky stuff, and I suppose knowing what Langhans lines are might help. Shame that she is probably not lying about being asexual or a lesbian, but I've had worse company. I am nothing if not an optimist.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
13d ago
Well, if you're looking for money through writing, I can imagine. For me, it's $20, $3.50 or free.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
13d ago
I once had a pretty large indie publisher ask about my novel. I told them that I have a lot of shit on my plate, and I do not expect to finish it in a timely manner. I deserve points for honesty.
Beyond that? Someone pledged money to my Substack, which is something I only vaguely dreamed of monetizing, and do not go around begging money for. I accept upvotes and engagement as valid currency. He's a big name, and $8 is $8, even if it's a theoretical $8 that I can't be arsed to redeem just yet.
I am very glad that writing is just a hobby, and I don't want to go full-time pro. My work and life gives me the material for the writing anyway.
I can't help being too cool for school, which is why I'm in higher education.
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