domain:astralcodexten.substack.com?page=5?page=3?page=2?page=2
bonsaii
9m ago
But who would pay for necessary infrastructure and surgical supplies. Where are the patients going to get the MRI and CT scans necessary for pre-operative planning? The places that already have resources for those things have their own surgeons to train.
My dad's theory of gifts has long been that the best gifts are something you'd want, but would never buy for yourself because you wouldn't spend the money. To this I would add things that the recipient wouldn't think of or know about, though this always has more danger of the recipient not actually liking it. There's a long theory of "buying experiences" but I generally try to avoid it unless I can personally take them there and know their schedule well enough to know they can go with me, I hate the gift card as a concept ever since I worked retail for a couple years and realized how few giftcards are ever actually used.
I broadly agree with both your dad's and your theory. The general issue with personalized gift-giving, is that often you end up muddling into subjects in which the gift-reciever is more knowledgable and idyosincratic than yourself: For example, I have a friend who really likes romantic novels, and I don't know much about them, should I gift her a critically acclaimed one? A silly, but popular one? Am I going to end up gifting something that she has already read?
My own advice, that doesn't overlap with what you've already said, would be:
- Look for things on the edges of the area of overlap of your interests: You might not be able to figure out which are the best rugby jersey to gift your rugby-obsessed cousin, but you might be able to find him a great rugby-related book.
- Rather than "gift experiences", gift consumables: Even if they're willing and able to buy it, a coffee-head will always appreciate a good bag of coffee.
- Contary to the neuroticism of my first paragraph, an obvious gift is often a good gift, most people aren't thinking too deeply about this: A lion plushie for your friend's newborn named Lionel is likely to stand out, the bar for thoughtfulness is that low.
phailyoor
25m ago
Alot of the better students in my high school went to do nursing because it's easy money and has pathways to move up such as NP. Also anecdotally I've gotten good diagnosis and treatment from NP for stuff I couldn't figure out myself.
In fact doctors are the midwits saddling themselves with debt and a late start all in pursuit of prestige as seen by the PMC for a job that's not as lucrative as it looks.
EdgeCityRed
28m ago
His family here in Florida have tens of millions of dollars. This grift would seem...unnecessary.
Shrike
33m ago
The population in New York (39) and California (37) is older than the population in Texas (median age 35). With a national median age of 38, New York is actually slightly older than the country as a whole.
However, Florida's is much higher, at about 43 (which makes sense, they are long known to be a haven for retirees!)
FiveHourMarathon
Listen to Pierre
42m ago
Obligatory reply with warmed over Jehovah's Witness nonsense that Christmas shouldn't be materialistic, or that such and such is a waste of money and you should give people I-Bonds or crypto or gold bullion or whatever.
FiveHourMarathon
Listen to Pierre
43m ago
We're coming up on the holiday shopping season in America. So, mottizens, what are your recommendations for gifts for friends, children, parents, siblings, aunts and uncles, lovers, frienemies at work, etc?
Historically I am good for one (1) banger of a gift per year. I absolutely crush it with a large and thoughtful gift for one family member, and then the rest end up as "well I spent $25-50." Marriage has been great for me, because my wife is really good at getting gifts for everyone. But she'd like me to contribute more to the process, which is fair. So I figure it's good to start getting ideas together, especially for some of the people in our circle who are difficult to buy for.
My dad's theory of gifts has long been that the best gifts are something you'd want, but would never buy for yourself because you wouldn't spend the money. To this I would add things that the recipient wouldn't think of or know about, though this always has more danger of the recipient not actually liking it. There's a long theory of "buying experiences" but I generally try to avoid it unless I can personally take them there and know their schedule well enough to know they can go with me, I hate the gift card as a concept ever since I worked retail for a couple years and realized how few giftcards are ever actually used.
Thoughts I have this year:
-- For theory one, YETI items outside of the coolers. I've long been impressed by YETI's ability to essentially invent the status cooler as a market. Over time I've gotten a few of their other items, and I have to say they are all very nice. I got their espresso cups when they were on sale at Ace Hardware (an admittedly odd place to buy espresso cups), and I really like them. Their mugs come it fun colors, are objectively high quality, and are the kind of silly indulgence that most people won't buy for themselves.
-- For theory two, these emulators haven't achieved a ton of penetration in my social circles yet. I'm looking around for the best price/quality combo, and for ones that are easy to cleanse down to kid-appropriate games. Though to be fair, Twisted Metal 2 was the first game I got for PS1 and I turned out ok, I think.
-- For experiences, I have purchased rentals on Turo for a fun car for a day. Prices for something fun have been decent since the mid-engine vette dropped, and the cybertruck is a good option this year for something wild but fairly normal.
What are y'all doing? Especially for parents and women?
2rafa
47m ago
There are women who find themselves in this sort of position too, but they're significantly more uncommon than their male counterparts.
Most friends are same gender (and most people heterosexual), though. Isolated men often aren’t even particularly ugly and lack of physical attractiveness (even if this is an issue for them) isn’t the primary reason they don’t have male friends. The reason men are more likely to be loners is likely biological, women make friends quickly but these friendships are more superficial, men have always had fewer friends but they tend to last longer and be ‘deeper’ in some ways.
into a poor Mexican cleaning lady
Is she hot, though?
EdgeCityRed
57m ago
Donating blood also helps lower your microplastics levels (and donating plasma is even better!) https://pmc.ncbi.nlm.nih.gov/articles/PMC8994130/
Primaprimaprima
Bigfoot is an interdimensional being
1hr ago
There's a lot to unpack here.
You raise a valid point in that there are a lot of ugly/undesirable women who miss out on a lot of the benefits that conventionally attractive women get. But at the same time, I think the average woman (so, not outright ugly/disabled/etc, but decidedly not 95th percentile either) still underestimates how much attention she gets just for being a woman, because she's never had to experience the other side of things.
To put things in perspective: if you even have a "social circle", like at all, then you're already doing pretty damn well for yourself relative to the entire adult population. There's a non-trivial number of men, especially among the spergy AGP population we're talking about, that have essentially no friends or social connections of any kind. They got nothin'. There are women who find themselves in this sort of position too, but they're significantly more uncommon than their male counterparts.
If only the top 5% of women were experiencing substantial amounts of male attention, could feminism really sustain itself? It's a rare woman who doesn't have a story about a bad relationship, or at least an instance of catcalling or harassment, something. Clearly there are lots of women who are having lots of interactions with men! Otherwise the "gender wars" wouldn't be a political topic in the first place. For the type of isolated recluse who's been essentially invisible for his whole life, even the idea of negative attention like catcalling can become part of the erotic fantasy.
(I'll also just note that if you actually dive deep into AGP porn, you'll find a surprising number of "status loss" stories, i.e. rich white businessman gets transformed into a poor Mexican cleaning lady, things like that. It's not always a power fantasy of being in the top 1%).
2rafa
1hr ago
If this was truly the issue you think it is, a reasonable solution would be to have some of residency take place abroad in poorer countries where there is a need for healthcare; the local would likely appreciate it and residents would get more exposure to surgery.
2rafa
1hr ago
Right, and this is crucially true even if they do the same work for the same pay.
2rafa
1hr ago
The most elite speed runners are probably similar to the most elite board game players; very intelligent, but probably not the most intelligent. And even when they are, it still requires time Musk doesn’t have because there’s a huge amount of unavoidable pattern learning even if you’re great at extrapolation.
2rafa
1hr ago
is that they are as good as a GP within their scope of practice, as long as the understand the limits of said scope.
Have you stayed abreast of the current furore? The two examples I gave of NP/AP failures were actually both from the UK.
Is it still a waste if the doctor is someone with a 120 IQ who would have got into medical school in the alternative system but ends up as a replacement-level software engineer in the US system as it is?
Sure, and this is the point. The 120 IQ person has too much dignity to accept the title of “nurse practitioner” or “physician assistant” , but let him call himself doctor and put him through some more training and he’ll do the same work for the same pay happily.
2rafa
1hr ago
Other than possible extreme edge cases in some distant regions literacy doesn’t seem to be an issue for any major human population, certainly not Bantus, and can benefit almost anyone. So I would say your church is - if the money is not taken via corruption and actually goes toward education - doing a good and valuable thing.
I have met intelligent and capable Haitians, they’re not hugely uncommon in Florida and there are a few in France too.
2rafa
1hr ago
I scored in the 99th percentile on verbal tests and somewhere around the 92-95th on spatial, so I’m not sure where that puts me overall, probably below you. Still, while I’ve met many much smarter people I find them generally easier to speak to and understand than people in the lower third of the population. Of course if the conversation turns to a niche special sub-field in theoretical physics or math or formal logic that I have never studied I’m not going to be able to follow, and my middling shape rotation ability means I’m not going to be able to hold my own with star traders at the poker table or when it comes to logic puzzles. But they don’t ever feel ‘foreign’ to me; I can understand the ideas even if I can’t derive them, if you want.
WhateverHappenedToNorman
1hr ago
I'm just riffing on the subject of the movie, which is very much about fictionalized Salieri's inability to cope with the fact that he was unable to "speak with the voice of god".
I'm aware the real Salieri's story does not neatly fit a morality play.
MotteAnon12345
1hr ago
Many (most?) major "infrastructural" financial institutions are based in NYC. These are often companies nobody has heard of but nevertheless end up handling most of dollars flowing through the world. Good examples would be DTC, BNY, and JPMC. These banks don't make that much money (except of course for JPMC) but they fulfill critical low level roles like clearing, asset custody (e.g. DTC nominally owns most financial assets in the US economy!), etc... If a court wants to impose their will on any actor in the USD centric financial system, they use these institutions to do it and NYC is the place to do it at.
Argentinian bonds are a good case study here: a NYC judge was able to keep Argentina from paying off any of its bond holders (and thereby choking its access to debt markets). Obviously, the judge had no jurisdiction over Argentina itself. But he did over the intermediaries needed to facilitate any dollar payments!
Honestly I think Salieri gets unfairly maligned a lot. Modern scholarship (forget that movie, I'm talking academic scholarship) thinks there was no real beef between him and Mozart but the rumours, even during his life, led to him having a nervious breakdown and even now in the modern day the general public (to they extent they know of him) still boo him even though they wouldn't be able to distinguish a piece by Mozart vs one by him.
The dude tutored both Schubert and Beethoven, give him some respect!
MadMonzer
Temporarily embarrassed liberal elite
2hr ago
I do not know what fractions of Haitians are educable, but I have worked professionally with educated Haitians who were able to perform the duties of a UMC professional job that normally requires a 120+ IQ. Of course Haiti, like most Caribbean countries, has a mixed-race elite and an almost-pure-black working class, and the people I worked with were from the Creole elite. So there is a separate question of what fraction of Haitians who are not already being privately educated are educable.
WhateverHappenedToNorman
2hr ago
My dharma is not to achieve great things but at least I am at the point where I am capable of truly appreciating greatness when it is presented to me (unlike most humans) and I am thankful for that.
Well, you're doing better than Salieri, then.
Primaprimaprima
Bigfoot is an interdimensional being
2hr ago
Compassion isn't a social affect: it's an act of the will.
This makes it sound like something you can arbitrarily turn on or off "at will", which can't be right. But it also can't be right to say that it's entirely outside of your control either.
I suppose I would say it's something like an "unchosen choice".
MadMonzer
Temporarily embarrassed liberal elite
2hr ago
Furthermore, wasting the talents of a full fledged doctor on walking into a room where a kid has a fever and runny nose and telling him he has the flu is a waste of the patient’s money and the doctor’s time.
Is it still a waste if the doctor is someone with a 120 IQ who would have got into medical school in the alternative system but ends up as a replacement-level software engineer in the US system as it is? The work of a GP in the British NHS, or in a well-run HMO where paid-for access to specialists is gatekept, does require more knowledge than an NP/PA, because you are gatekeeping access to specialists, so you need to know at least enough cardiology to know when to call the cardiologist etc. And the people doing that work don't seem to think it is meaningless - the complaints of British GPs are about pay and workload, not about the nature of the work. What it doesn't require is a gunner personality (except in so far as you need to deal with the rigours of residency) or a 130+ IQ.
FWIW, NP-equivalents in the UK are mostly people whose IQ is too high for nursing but were incorrectly sorted into it (I suspect, but don't know, that we make more errors of the "poor therefore stupid" type than the US does) and want a low-risk route to something better. My experience dealing with them (asthma care is handled by NP-equivalents, as is uncomplicated diabetes after initial diagnosis) is that they are as good as a GP within their scope of practice, as long as the understand the limits of said scope.
This may be true for some very common surgeries, but you still need the surgeons on staff to be trained in less common situations/surgeries as well. Otherwise, you have scenarios where you need a surgery but turns out the surgeon on shift has done that particular surgery once in his life and has to wing it.
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