Throwaway05
7d ago
I guess my point is that common sense as it applies to most people's thinking does not apply to medicine.
We can be annoyed at people for (potentially) getting things wrong, but if your take away is to replace expert opinion with common sense (as has been the case for many, especially here) then you will end up being more wrong.
The better approach is to trust the expert opinion except for the things where they are going to be reliably unreliable, which are easy to guess. COVID medications? Yeah expert opinion got that right. COVID policy? Well yeah doctors got that wrong, they aren't policy people.
Throwaway05
7d ago
My point is that the average person's understanding of common sense (or intuition) is generally a poor choice for application to medical topics. This is hurt even more by the fact that it actually works some of the time, so it is common for people to get the impression that common sense works well enough.
I do agree with some of cnet's conclusions, but I'm saying that he's right (when he is, by my reckoning) by essentially accident. While I don't think cjet does this, you see a lot of people overestimating on the topic of medicine with similar thinking.
Throwaway05
7d ago
Yes!
100% going to be a situation where we think of modern gender affirming care as being similar to lobotomy (with the same ignoring the positive side of lobotomies) at some point in the future (could be soon could be later).
I directionally agree with most posters here on this topic.
BUT.
Common sense isn't the right tree to be barking up.
Throwaway05
7d ago
I mean to some extent the fundamental problem is that patients are idiots (also, people are idiots).
For example it is pervasive common sense in the U.S. that doctors in general (and notably for this forum - psychiatrists in specific) are pill pushers first and foremost.
Meanwhile every doctor is trained to and will tell you to make lifestyle modifications and live a healthy life first. If they do not it's not because they don't believe it's because they've given up because nobody listens.
Then patients say they want to do X supplement or go to the chiropractor or whatever in order to maintain health instead of taking medication which the pill pushing doctor wants them on...
Ultimately you do what you can but people will ignore you and believe whatever they want and be resistant to being told what is or is not common sense and what is or is not good evidence.
Convincing people of stuff they don't want to believe is not something that doctors are more magically equipped to do than anyone else, but that is what would be required.
I do think public health is directionally wrong on some of this stuff, but insisting "okay but this time when people are wrong or confused you have to be more careful" isn't helpful.
Throwaway05
7d ago
With respect to Trans care-
A finicky part of this discussion is that it's really about two separate issues: 1. "Do we know if gender affirming care helps" 2. "How do we feel about it?"
Common sense is a poor guide because both sides think they have the common sense. Personally I will accept either outcome as to its usefulness, but I use the cheat of "we actively have zero idea because of poor research quality." However when most people talk about this they let question two bleed in, and that includes "what just makes the most sense?" The idea of gender identity problems is very poorly understood, including its natural history and pathophysiology (in large part because of willful blindness by advocates). It should be weird enough and unknown enough that "what makes sense" rarely applies.
With respect to COVID-
A huge problem here is the mixing of political and scientific questions. We (as in the field, but also me specifically on the old forum and with my family and so on) were upfront about lots of COVID stuff that turned out to be true. Most of it was consistent the whole time. Some of this falls into a bit of a medical talk vs regular people talk "it's just a bad flu" scares the shit out of us but most normies do not realize how bad the flu is. That's pretty normal communication problems in a fraught situation.
However when you talk about things like indefinite lock downs or nobody is allowed outside at parks those are political questions that were justified by appealing to science and having politicians (like Fauci) wear a doctor's hat. Additionally we have the problem of mandatory advocacy in the field (seriously it's a required part of medical school and residency training these days and guess which way it always leans) which resulted in a lot of doctors engaging in leftist nonsense hiding under science and medicine but it was leftist bullshit and should be treated as such - it isn't the fault of medicine or doctors its the fault of leftist institutional infiltration.
Medicine works just as well (or not well) as it always has outside the political topics. In the same way that your university or the IRS or whatever does.
The takeaway should not be "medicine is bad and we can't trust public health officials" it should be "medicine and public health officials are people and fall into the same politicking and fear and so on.
Throwaway05
7d ago
The idea that infection with a sickness does not grant any kind of immunity is also insane.
You have to be so so careful with this kind of thinking when it comes to medicine.
First, I'll say yeah everything related to Trans healthcare is fucked and if you put a doctor in a safe space you have a shockingly high likelihood that what they have to say is grossly off-narrative, but what is allowed to be said in public is totally different.
Okay, but-
Medicine is a mix of really obvious common sense things, sometimes with a clearly understood basis (a lot of cardiac physiology is just fluid going through tubes! Easy to model!) and things that are basically the most complicated thing we know about (ex: the brain).
It is not always clear when something is common sense and when it is not. Extremely unclear. To the point where professional medical researchers in a field will get this wrong, stake research and money and decades on something and totally not understand if it was common sense or not.
The classic manifestation of this is blithely labeled "clinical significance." Something can make sense in a lab or a Petri dish, or in a monitored study, but you unleash it on our population you find out it does jack shit.
This came up a lot during COVID - such and such trend medication would appear to have an impact on viral replication in a lab and then you'd give it to people and it would have no impact at all or reduce symptoms by one hour on average or something like that.
Sometimes we'd have a common sense explanation ("oh it's kinda like Tamiflu you just need to give it super early after exposure...so it's mostly useless") sometimes we don't.
Clinical medicine involves a lot of heuristics and experience to help figure out what is common sense and to guess ahead of research because research is slow and expensive and a lot of what we do is never researched because nobody can monetize it or research would be unethical.
It's a mess, but most physicians were just like "oh it's going to be like Tamilfu" from the word go and tuned out, while everyone else in the population didn't even know they had to think that way.
I'm getting a bit unfocused so to bring it back-
Common sense in child health frequently doesn't apply. The field is going to have findings that don't make sense to you (even if I don't agree this is one of them). Consider that for a long time "spanking is good for child development" was common sense. Then it wasn't. I'd bet money the research base for both conclusions is frustratingly unhelpful.
And for your other example-
Looking at the immune system as "oh you get sick and then you get immunity" is like looking at Moore's Law and then assuming it will go on forever. Are you going to be right most of the time? Sure, but does that tell you anything about the nuances of the system or for how long it will apply? No.
Plenty of infectious organisms don't trigger your immune system in a normal way or have weird interactions. For example: Herpesviruses. You have them forever! Does that count as immunity? Or not immunity? Shit I don't know.
TLDR: Common sense applies in medicine in a lot of places but sometimes not in what seems like an obvious place. This causes angst.
Throwaway05
8d ago
I don't think this particular type of argument is very convincing given the number of years of abuse of due process, misuse of government agencies, NGOs, the cathedral, etc etc by the woke and the left.
The left has been doing more or less this kind of thing for years (just not this specific thing because they care less about deportation).
It's just asking for unilateral disarmament at this point and worse - at a time when the winner of the war is starting to change just a bit.
Throwaway05
17d ago
Absolutely agree with most of this - suppression happened and was a problem, but just because of that doesn't mean we for sure have a consensus/lies.
Throwaway05
17d ago
He is the goat (of web serials).
I wouldn't say this, he's very rationalist fiction with struggles with relatable character writing (Thresholder is the worst for this) and noodly writing about powers. This causes normies to bounce off a lot but obviously anyone here is likely to like him.
Goat status is probably going to go to something like Mother of Learning, Worm, or The Wandering Inn.
Throwaway05
17d ago
So, now we know they lied - which we knew for a long time - and now we have an undeniable proof they lied.
As usual life is a bit more complicated than that. The medical experts still don't believe in the lab leak, and they have explanations when asked that sound convincing but I don't have the expertise to evaluate. You don't have to believe, and it's entirely possible they were told what to think and are now rationalizing it, but that doesn't change that their is a counter narrative to this explanation which is still present, and is quite potent.
I doubt the truth is particularly simple.
This means that anything as rock solid as "undeniable proof they lied" is unlikely to apply to most, and those it does apply to it would be impossible to prove.
I agree that a lab leak seems like a great explanation, but I don't have the expertise to evaluate if that's more likely than normal transmission explanation and we have to take a beat and admit to ourselves that a lot of devotion to the lab leak hypothesis stems from frustration that it wasn't allowed to be considered in the moment, not from the fact that it honestly seems more epistemically reasonable.
Throwaway05
18d ago
and my body started learning discipline meds-or-not.
Yes!
People with a good enough "life" (genetics, money, family support, intellectual reserve, whatever) can often do well or age out with enough time to establish "normal" life patterns and for some general brain development.
Even anti-socials often age out of a lot of the bad behavior.
Institutions that help with this can work! ...but are not always worth the costs.
Throwaway05
19d ago
I mean I'm just here to say it works SOMETIMES.
I suspect that part of the problem is the refusal to give up on anybody leaving everyone behind, as is common elsewhere.
Throwaway05
19d ago
Personally, I've never seen one.
I've seen a few of these in my life (both personally and as a treating physician) and have a few coworkers who meet this description. The classic example is boys who are a little too male for our current teaching paradigms. Think poor behavioral regulation or ADHD. If they have a supportive home environment and intellectual reserve it is very possible they'll stay out of just enough trouble/troubling behavioral patterns for their frontal lobe to develop and adequate coping skills/treatment to come into play.
Then they end up being productive members of society.
The American problem is the lack of sufficient home support for this to gracefully happen, then they fall out of society. School alone is pretty ineffective at covering that but you do need both.
Throwaway05
20d ago
The morality on display was virtually amorality
It's worth dialing in on this. They weren't amoral, they had morality - it is just alien to us.
For example SKILL was moral virtue. As opposed to unselfishness, which is often what we use these days.
See: https://en.wikipedia.org/wiki/Arete
Lots of Ancient Greek myths and cultural output make more sense if you go back and think about it this way.
Dialing in on this and its implications is a big piece of what Nietzsche is about and importantly this kinda stuff still lives with us today a little bit in other moral systems and countries (....could this explain woeness????).
However the general Judeo-Christian/Western ethical system is so baked into our lives and culture that it often results in a bit of "this is water" type problems.
Throwaway05
24d ago
Theo Dalrymple
Highly recommend "Life at the Bottom" by him if you haven't read it. A bit dated now but important for people who have mostly theoretical exposure to the underclass.
Throwaway05
24d ago
Second this.
I'm kinda surprised by the confusion TBH, but maybe that is from having read him - although I do wonder if the mistake would have been made 20 years ago? I can kinda see it today, maybe.
Throwaway05
29d ago
Even famously poor charisma politicians like Al Gore will totally eat the ego of an average person, especially if the meeting is accompanied by the accoutrements.
Throwaway05
1mo ago
I saw something about non-invasive mechanical ventilation, not quite the same (although medical reporting is always ass). Basically he probably has a mask on, not the same as intubated and likely sedated.
However he might get an infection from his recent misadventure.
Throwaway05
1mo ago
You know I thought he might have been intubated which would have been seriously bad news but it sounds like that isn't the case which is indeed positive.
Throwaway05
1mo ago
That....is not good.
Throwaway05
1mo ago
Look at the literature that came out later after everyone calmed down, even if it had some lab impacts it didn't seem to have a useful clinical impact.
It's probably at best very similar to Tamiflu.
Throwaway05
1mo ago
I can tell you ivermectin literally works by making the cells inner PH less conductive to fully forming the viral capsid.
How often have we cured cancer in a lab but when you apply the thing to real life clinical practice it isn't helpful?
It's nearly all the time, in fact it's the majority of medical research.
Throwaway05
1mo ago
Not really off hand, I'd want to do a lit review for that to have some certainty (although I think the answer is not high risk). You can do that yourself though! Yes it would be a bit dry but if you search "pubmed lung cancer black mold" you can probably get a reasonable impression for a pretty narrow question like this.
Throwaway05
1mo ago
I do enjoy that the one I linked has a correction haha.
Ah, no major reservations then, although I would recommend my suggested approach of "experts should be listened to with the usual amount of caution except on political topics."
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