I work at a medical device company that specializes in radiation treatment for brain tumors.

This thoughtful and profound essay brings home the lived reality of the patients who are treated by our systems.

The writer speaks lived truth that has a tone of heft and substantiality.

Human life is a fragile and temporary gift. Most of us are lucky enough to have a few moments of transporting and profound beauty and joy.

While life's journey has an inevitable end for all of us, we can help each other in innumerable ways to make the journey more bearable, and at times joyful.

I'm an old guy, and have an artificial hip and cataract implants. I'm deeply grateful for the quality of life I've been gifted to receive by the medical people who make these kinds of things possible.

I hope that the brain treatment system I work on will be a similar gift to the lives of at least some of the patients who require that kind of treatment.

>Human life is a fragile and temporary gift. Most of us are lucky enough to have a few moments of transporting and profound beauty and joy.

>While life's journey has an inevitable end for all of us, we can help each other in innumerable ways to make the journey more bearable, and at times joyful.

very nicely articulated. thank you.

the series of essays is moving and profound. what we take for granted is a miracle and we dont realize it, and are caught up in trifles.

thanks to whoever brought this our collective attention.

What a beautiful, beautiful comment. Thanks for working on a brain treatment system. Who knows, one day I might benefit from it.
Sometimes, this is the gift of having a trained chaplain, pastor, or advocate with you who has navigated these moments before. I’ve been in these moments with people in my church, and I don’t think it is always about the doctors or healthcare providers withholding info. Sometimes, you are the tenth person they have seen in a short period of time, so they are trying to communicate as best as they can, as efficiently as they can. Having someone - doesn’t have to be religious to be clear - who has been in those rooms can be helpful. They can repeat what the doctor says, because it can be so frightening and hard to hear.

I have asked doctors and anesthesiologists to come back into the room and finish answering the questions. I know they are busy. But I know they want to put you at ease and give you all the info you need.

- What side effects can we expect from the medication? - What alternatives are possible? What if the treatment doesn’t work? - What is the prognosis - worst case and best case? - How long will recovery be? - When can family members/loved ones see them? - Who will contact the family members during the procedure? - How soon will the patient be up and about? - Do you know the patients limits and directives - like no resuscitation?

More than once, I have helped the doctors hear something that they had missed, buried in all of those charts. More than once, I helped a friend or loved one gain some clarity on why the course of action is best or whether they want to explore something else.

Powerful story! And helpful language to think about them as a Bridge to Nowhere.

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Some additional context and detail about hospital chaplaincy in the US:

1) In a major metro area, it's very likely that not all of the chaplains on staff at a hospital are Christian. It's rare, but increasingly likely, that chaplains are not even religious.

2) Chaplains have a primary responsibility to and the time and relationships with hospital staff to advocate for the patient and their family in addition to their more stereotypical duties providing emotional, religious, or spiritual support.

3) Chaplains also provide various types of support and guidance for your family or other loved ones -- so having a relationship with the hospital's chaplains can be a huge help for your loved ones if you are incapacitated for advocacy to the medical team, for navigating logistics, and for providing someone dispassionate to listen.

Of course, YMMV based on your location. In the deep south or outside a major metro, the chances that a given chaplain is an evangelical Christian who might try to convert you are higher.

And even in a major metro, you might find a chaplain who doesn't really want to do their job.

But if you're in the hospital and having trouble navigating the bureaucracy or getting the attention of your medical team, asking to visit with a chaplain can be very productive toward those ends.

well put. In general , you want someone with experience who is also able to think clearly about the issue. But even having someone in there with you can make a huge difference.

I personally know of someone who almost died in a hospital from a medical error , and survived only because a family member decided to check on him at the hospital

My mom almost died from a hemorrage after my birth… Mu granma was there and noticed the sheets getiting red… This was of course many years ago, no monitors etc.
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Previous poster was pretty clear their advice has nothing to do with religion as such:

"Having someone - doesn’t have to be religious to be clear - who has been in those rooms can be helpful."

Starting a flame about religion is very not appropriate. Please don't do that.

And I started with "As you say we do need better advocacy and more transparency in difficult situations" and I agree with that.

I just want religion left out of such topics, because it makes everything worse.

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Makes everything worse for you maybe, but that gives you no right to control the discussion. Your reactions are always your responsibility.
Sorry that my requests to stick to reality are seen as an attemtp to, "Control the discussion".

No evidence based medical treatment has ever been improved (reasonable definitions like longevity and real metrics like numbers) by making it religious. The same goes for every human endeavor, religion taints and drags.

At its core religion is belief before evidence and that simply isn't a path to long term progress.

You have the freedom to hate religious people, but like the GP says, you may want to vent somewhere else.
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The only message showing any sign of hate here is yours right there. Also, I don't think it's ok to ask someone to shut up or to go elsewhere. Let's not forget that being charitable is one of the rules we try to adhere to.
It's pretty clearly against the guidelines: https://news.ycombinator.com/newsguidelines.html

"Eschew flamebait. Avoid generic tangents. Omit internet tropes."

"Please don't use Hacker News for political or ideological battle. That tramples curiosity."

Right back at you. You are the one making this an ideological battle which is clearly against the guidelines. This is a place for curiosity, not ideological witch hunts.
Forum 101: someone who posted flamebait cannot blame those who got baited for flamebaiting. Both are problematic, but the baiter is responsible for raising the temperature.
Falsely accusing someone sharing their perspective of starting a flame is very not appropriate. Please don’t do that.
They brought up religion, please don't do that let's stick to reality.
Please don’t respond to days old comments with the intention of starting an argument. Hacker news is about curious discussion.
>Previous poster was pretty clear their advice has nothing to do with religion

>Sometimes, this is the gift of having a trained chaplain, pastor

oh, yeah?

The problem with speaking in generalities (about religion, or other) is that you likely have, or present, an incomplete picture, and one which fails to cover the very wide variety of things under that topic.

For example your categorization of "cannot tell fantasy from reality" would not be a good description of say a buddhist."

Equally binding a view of mental health to religion seems a stretch. Perhaps you have experienced that, but I suspect that connection is not universal.

I didn't downvote you, I say these things to explain why you likely were downvoted. Not because your post was about religion, but because your viewpoint is both unnecessarily broad, and kinda missed the point.

The point was that having an experienced advocate on your side, who understands the process, who isn't under the mental strain of a recent terminal diagnosis, can assist you with good decisions.

If you are in a community of faith, and it's likely that the leaders in that community have walked this path before. If you are not then seek that person from wherever you are in community.

> Equally binding a view of mental health to religion seems a stretch. Perhaps you have experienced that, but I suspect that connection is not universal.

I am saying that in the US the stigma against taking mental health seriously is structural. Consider the amount of voters who think demonic possession is real (tens of millions of people) don't vote to fund mental health services. There are millions of our fellow Americans who are real people and think mental illness is punishment from god or think homosexuality or transexuality is a choice and a sin. We shouldn't start on abortion, but every argument against choice has its roots in religion.

These people have made a huge impact on healthcare and baked in tons of little decisions into healthcare that impact all of everytime we interact with the healthcare system. Live in a state where depression meds aren't covered, or maybe only some are? Might be them?

Clearly I am discussing in the US context, as such buddhism isn't a practical and a corner-case. You can pretend I am not referring to it (even though reincarnation is clearly problematic for people attached to this life based on evidence).

Narrowing the context from "religion" to US Christianity certainly changes the scope of your comment.

Certainly the US Christian approach to mental health US not reflective of non US Christians and certainly not other religions.

My experience of US Christians is that most operate in good faith, and are as open to good mental health as any other group. Some proportion, a particularly vocal portion, have weird views about lots of things.

> My experience of US Christians is that most operate in good faith, and are as open to good mental health as any other group. Some proportion, a particularly vocal portion, have weird views about lots of things.

People who think demonic possession is real (again, I am asserting tens of millsions of americans and probablly close to a billion worldwide) are operating in good faith. They actually think that stuff is real and think that locking up or torturing mentally ill people is a good solution. They honestly that actually think torturing people to remove demons is good because they believe in things like souls and think these have a role to play in medicine.

> Narrowing the context from "religion" to US Christianity certainly changes the scope of your comment.

Yes, it does, but this US centric very capitalistic place to discuss tech stuff. So I am just trying to exclude fantasy because with how much we know it can't help more than it hurts.

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I'm a Christian, I lived in the USA for ten years, and AFAIK I never met a single Christian who would deny that mental illness is real or who would say that locking up or torturing mentally ill people is a good thing. And I expect most of them believe that demonic possession can also happen. These are not mutually exclusive beliefs.
I feel like this may be a regional thing. If you don't live somewhere with a lot of Pentecostals this would definitely seem abnormal. I would say the majority of Pentecostals I know effectively believe that most major mental health problems are the result of demonic possession and should be treated with exorcism
Do please note that I never said all Christians. But the label Christian does include you and tens of millions of people who think that the universe is 5,000 years old and that at some point in Real History there was a talking snake and fruit that altered consciousness for the rest of all history. If you need help finding such people do a search for young Earth creationist and a note that they routinely publish best-selling books and have their own churches, their own podcasts, and their own documentaries. But most relevant to this conversation they have their own politicians and lobbyists, many of them.

So anytime you bring up your religion I can't tell which end of this gradient you're on. And it's also a gradient that you're choosing to be on and a gradient that you're choosing to bring up.

If you don't think the fantastical elements matter then don't bring them up and don't defend them. If you do think of the elements matter, then I humbly request evidence and will change my mind when you present it. If you want to discuss reality then we can do that without any religion being involved, and that is sort of what the laws of most reasonable places demand when making policy. And if you think that the Fantastical parts of religion haven't impacted law in your area than either you're a very lucky person and don't live in any country I'm aware of or you simply haven't realized how much religion has made your country worse.

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Yes, I do believe in some things you would call fantastical. https://www.amazon.com.au/Resurrection-Christian-Origins-Que...

> you simply haven't realized how much religion has made your country worse.

https://www.amazon.com.au/Dominion-Christian-Revolution-Rema...

Was your original comment talking about ‘religious people’, or ‘American Christians who believe in demonic possession’? You seem to be shifting the subject to a favored target, rather than discussing the comment you originally replied to.
That’s the problem with HN comment threads: if you try to make a general point and use broad generalities, people will object and point out counterexamples to nit pick against those generalities. But, instead if you go into specifics, people will nit pick those specifics. You can’t win. It’s an inevitable part of arguing with software engineers who get paid to find the missing negative sign in 1M lines if code: you’re going up against pedants and nit pickers.

I understood OP’s general point as: bringing religion, particularly US Christianity, into life and death decisions is fraught due to its practitioners’ general and typical inability to separate fantasy from reality. With the disclaimer that there are always degrees and exceptions. Sure, it’s a spicy take, but I don’t think he needs to get piled on like he has in this thread.

> practitioners’ general and typical inability to separate fantasy from reality.

i don't think that is proven, nor true. simply begging the question.

to hear you debate, it's as if you believe that generally anyone in the role of chaplain, minister, priest is obviously a schizophrenic nut job (general and typical inability to separate fantasy from reality). one of these days, i hope, you will find out that there are people, of all religions, that live for nothing except to help others. why insult them?

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Neurosurgeons are extremely smart, hardworking, and (usually) amicable physicians. They are also in short supply and can determine whether an entire health system makes or loses money.

Neurosurgery is the hardest residency, and the hardest physician career. However, this difficulty is in-part due to the bravado of the neurosurgeons themselves. During neurosurgery residency, you have to learn to be a brain and spine surgeon, undertake two years of research, learn how to do endovascular interventions, and (of course) manage all of the pre-/post- operative care including clinic. It is not uncommon for a single PGY-2 neurosurgery resident to follow 100+ inpatients. Suffice to say neurosurgeons are overburdened, yet they themselves have fought against reducing training hours.

Patients can generally expect to spend less than 30 minutes speaking to their surgeon before/after their surgery.

For those unaware, you can become a spine surgeon via either the neurosurgery or orthopedic surgery routes. Just my simple opinion, but I think spine surgery should be its own residency. Brains should be left to the neurosurgeons and extremities to the orthopedists.

I had pretty much exactly the same thing happen to me, in 1996. I probably had 2 days to live. Benign brain tumors are bad. They don't have to be cancer.

I was given Option 3. I decided not to take it, and they were fairly confident that I'd be in a wheelchair, the rest of my life. That did not happen.

As things turned out, I was OK, but it took me a couple of months to learn to walk and chew gum at the same time.

> it took me a couple of months to learn to walk and chew gum at the same time

If I may ask, I am curious, how was this experience of not being able to do this and learning to do this again? We often overlook how complex doing such two things at the same time is because we master such skills quite early in life.

It was basically a joke, but the tumor was in the cerebellum, which controls balance (amongst other, much more important, things).

I was in physical therapy for two months, and it was probably two years, before pretty much all traces of the effects were gone.

Nowadays (almost 30 years later), it's as if it never happened.

I did get a cool haircut from the whole thing. Very punk.

Long may you continue to have your health and happiness. Thank you very much for sharing your story.
That's a bit harsh on the doctors. If you or your loved one have a solid mass in the brain an evening of googling can tell you that it's most likely the end of the road rather sooner than later. There's very little anyone can do to help you feel better or retain illusion of agency over your life

When you are finding this out it's usually because you already have significant symptoms that progress because growing mass puts a pressure on the brain. So Option 3 is increasingly suffer what you are already suffering till death, prompt one in case of fast growing tumor, more distant in case of the slow one. If you want to do anything else the best course of action is to remove what shouldn't be there. You could in theory remove just a small bit just to find out what it is, but it won't help with the symptoms you already have and risks of biopsy are very similar to risks of surgery which will also potentially give you more information. Also the information that biopsy could provide would be most relevant in the worst case so that the surgery is done with large margins which might result with few months longer survival but way worse quality of life.

So a surgery is basically a no brainer in your already terrible situation. If you are super lucky it might turn out that you had in your brain something relatively benign which, after recovery can give you at least years of normal life.

Context: My partner has a large grade 3 glioma and first surgery, radiation and chemotherapy gave her 5 years of completely normal life and the second one after recurrence another year.

Our approach to all of this was that no one really knows how long they specifically are going to live. And that doesn't change with diagnosis. Statistics is just that. Statistics.

Calling such life bridge to nowhere is just a bleak perspective. Same could be said about every life with similar accuracy.

Your conclusion does not seem to follow from the premises.

> There's very little anyone can do

Hence the validity of the "do nothing" option.

> If you want to do anything else

But you may want to do nothing. There are valid reasons for it.

> So a surgery is basically a no brainer

Non sequitur.

Your context suggests that you think doing something is a good idea because you know of a case where it worked out. This is availability bias.

> Statistics is just that. Statistics.

What is this even supposed to mean? Statistics is a useful tool. You're denying it with no argument. "I don't like statistics."

> Hence the validity of the "do nothing" option.

It's hard. If you knew you are doomed that would be a valid option. But you can't know that even though it's likely. And on a slim chance you are not doomed, choosing to do nothing is pretty much impossible unless you already wanted to die and suffer unitl then. As I said, usually you don't randomly find out about tumor in your brain. Usually you learn about it because of some progressing symptoms. So you decide on a treatment based on those symptoms. Doing nothing when you suffer and something can be done to help with that is very hard despite risks involved and even ultimate pointlessness. You don't make decisions in those situations based on some theoretical existential framework. You make them on practical grounds. And "do nothing" is almost never a result. "Do nothing" is just an option you might regret not takin with hindsight or an option you might consider ahead of time entirely theoretically. In practice this option is almost never chosen and it's not because of doctors comunicate badly and could do better. It's because of practicality and need for maintaining illusion of agency over your life. It's very hard to belive your life will really end even though you know it's true. Doing something really is no brainer, bacause alternative is not really do nothing. It's lie down, suffer and most likely die suffering progressively more and you would have to consciously choose that. Rarely anone does.

> What is this even supposed to mean? Statistics is a useful tool. You're denying it with no argument. "I don't like statistics."

I love statistics. But statistics by its very nature can't predict what will be an outcome of a single coin toss you are about to do. There's nothing that can't predict that singular result. The only thing you really know is that neither head, nor tails is impossible. You life for you isn't a statistic. It's singular.

> You don't make decisions in those situations based on some theoretical existential framework. You make them on practical grounds.

Do you actually have this much insight into how all human beings make decisions? Maybe we should nominate you for a Nobel in pshychology.

More seriously, your confident assertion about how everyone makes decisions is baseless. The whole point is to allow people to make their own decisions, and you are denying it based on nothing but the implication that you know how everyone thinks and what's best for everyone.

> You life for you isn't a statistic. It's singular.

And yet you seem oddly confident about how I would decide or what would be best for me to decide.

People are unique. Like snowflakes. In one snowstorm. Oddly you were initially all for statistics. Now you think you (and other people) don't fall into it with respect to decision making.

Your "nobel prize" comment indicates that you must be an absolutist (moral, or some other kind) because you've read my comments as it was the perfect knowledge of the matter and everything related, not just my perception of and opinion on it. That's all it is, do with it what you will.

> So a surgery is basically a no brainer

I see what you did there.

The post is dated in May of this year which is now 5 months ago with no further posts. Anyone know if the author is still with us?
He is not, no.
did he choose the eol option that he spoke about in an earlier essay ?
> But more than this I would come to learn that that I'd fallen into a trap of my own making.

I'd blame the medical doctor. In similar cases, they use misleading remarks and partial information to guide the patient in the path they prefer.

It seems like the doctor has fallen victim to the politician's fallacy [0], summarized well on Wikipedia as

1. We must do something.

2. This is something.

3. Therefore, we must do this.

People seem to feel like there's merit in "trying something, anything" even if by trying something you may actively make the problem worse. We need to accept that we only have limited control. Bad things happen.

0. https://en.wikipedia.org/wiki/Politician%27s_syllogism

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He also says they said they talked about things, but he might not remember.
It's funny to me how in tech (and business maybe?) "bias for action" is widely regarded as a good thing. It's the exact thing you are describing, but phrased differently and in a different context, everyone thinks it's great.
That's because people in tech and business are overwhelmingly biased into inaction.
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Super important to investigate all medical diagnoses and treatments yourself. I was diagnosed with stage four hip osteoarthritis at age 36 due to some ongoing pain in my hip I had while playing golf.

The Harvard educated doctor treated me brusquely when I tried asking more questions. He told me to immediately get a hip replacement.

I did a bunch of research and decided to try lifestyle changes first. I quit playing golf and running. I took up cycling and taking anti inflammatory supplements (no drugs). In a couple of months, the pain was mostly gone. Now I have no pain at all and do a large variety of farming manual labor work and am roofing my own house.

Doctors see you as a paycheck. Always do your own research into diagnoses and alternative treatments.

What a harrowing account. Ended up reading all posts in the author's glioblastoma series, starting with the first one from May 2023. Devastating topic, excellent writing. I can only wish strength
Agree, great writing. I particularly liked 'George' -- https://depth-first.com/articles/2023/08/19/george/
Anecdotally, when negative scenarios are probable, a strategy of the medical system is hiding them from the patient (until more progress is done, at least). I wonder if that is still a common occurence in the first place, and if it is, I wonder if it is really backed up by scientific evidence of this improving prognosis and outcome of surgeries (though in cases like OP's this seems sort of irrelevant anyway, same with types of terminal cancer), or it is just part of the convenience of the medical system, or part of the medical professionals overworking and not having time to explain and have a more involved discussion with patients (or maybe also not having people with the proper psychological training assigned to actually do that and guiding patients to face the death prospect).
Probably situational. Maybe in-person it is more likely to be held until diagnosis is firm? Anecdotally, the raw results that get published to sites like MyChart are pretty to-the-point if you have any idea what you're looking for, and sometimes even for laypeople. My mom had a chest x-ray and the radiologist report came back with a great big, red, bolded "THIS IS A RED DOT CASE" stamped on it. The doctor called within a matter of minutes of that result being published. I had just barely finished googling the likely meaning of that phrase when the doc confirmed it.
I have the same questions. If it's known that disclosing certain information will stastically lead to worse outcomes due to patient reaction, what do you prioritize - better possible outcome or patient autonomy over their own life decisions?
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I've known two people with glioblastoma (both deceased now).

It is incredibly hard to come up-to-speed on a newly diagnosed (or newly undiagnosed) medical situation.

But I think many many people will encounter it and be unprepared. They may encounter it early when a friend or family member faces the situation.

Unfortunately a lot of learning happens after the fact.

For example, just finding out if someone has glioblastoma can leave you physically or mentally debilitated. One of the people I knew had a biopsy, but that caused them to be bedridden without control of one side of their body.

So in relation to preparation, I think people should prepare. Reading articles like this one (or his other articles) can be uncomfortable, but well spent.

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Incredibly poignant writing with such clarity.

I feel truly sorry for the author.

This is a surgery I absolutely would not have. I would not bet a few healthy months to roll the dice on a few more healthy months against immediate disability for the rest of my short life.
I'm not normally one to read "my road through pain and suffering" articles, and to be fair, this isn't one. And I sure am glad I read this, just in case it should ever be my turn.
my takeaway from such essays is to gain perspective and hopefully keep that perspective in the rest of the moments we have.
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Was it glioblastoma in the end? The author never said.
Yes, with round two occurring April this year.

https://depth-first.com/articles/2024/04/22/round-two/

Yes. (I read all the articles on the blog, and it does in fact turn out to be glioblastoma)
It may be a bridge to nowhere for the patient but it is a profit opportunity for hospital owners.

You're just another input in their number go up paperclip maximizer - where your road leads beyond their number go up is not a concern for them.

In one sense your comment is accurate - hospitals exist to "do something". And yes, in the US the hospital us part of a for-profit health system.

But your comment is not limited to hospitals. It's true for every business. If I sell an ice-cream my interest ends after you pay for it. Equally I'm not going to withhold ice-cream from overweight people - my job is to sell ice-cream.

If the hospital was a non-profit, and they felt there was no viable appropriate medical intervention, and they sent the patient home with no action you'd likely complain about that too. (I would, I go to hospital with an expectation that they'll at least try to fix me.)

It's somewhat trite to blame the profit motive, partly because that encompasses all of us, and partly because hospitals and doctors are primed for action, not inaction.

> partly because that encompasses all of us, and partly because hospitals and doctors are primed for action, not inaction.

This does not in any way justify pushing a patient into action when action may not be the best course for them.

I don't think that's what the previous commenter implied.

Especially in this case, that's not what happened.

Patient was facing a very painful, certain, and more immediate death. Or with surgery the patient might live long enough to discover that the tumor is benign and continue with a decent quality of life.

Action objectively offered a chance of survival that a lack of action could not.

I'd argue that even though it wasn't the outcome he hoped for, the author lived long enough to write this piece because the doctor pushed for action.

I think that fairly well removes profit from consideration. The doctor made the best call from every angle given the facts presented, in my opinion.

> But your comment is not limited to hospitals. It's true for every business

Yes, the problem being wide-spread in no way diminishes it.

You can apply your logic to slavery and realize it works just as well. Look, everyone's buying and selling slaves, it's true for every business - it's somewhat trite to blame slavery, etc, etc.

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Actually a majority of hospitals in the US are not-for-profit.
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The book Outlive by Peter Attia refers to this as Medicine 2.0 (vs 3.0 which is health over an entire life).

In the end though, Medicine 2.0 is very good at discrete issues like a brain tumor. It's a good thing for those afflicted that there are profits to be made there because it means that there are huge facilities and training dedicated to these types of medical issues and their resolution.

Your comment hsitory shows you really seem to like this "paperclip maximizer" analogy; I'm not sure what it means.
The term "paperclip maximizer" is a reference to a thought-experiment explained in this 2014 interview with Nick Bostrom: https://www.huffpost.com/entry/artificial-intelligence-oxfor...

> Suppose we have an AI whose only goal is to make as many paper clips as possible. The AI will realize quickly that it would be much better if there were no humans because humans might decide to switch it off. Because if humans do so, there would be fewer paper clips. Also, human bodies contain a lot of atoms that could be made into paper clips. The future that the AI would be trying to gear towards would be one in which there were a lot of paper clips but no humans..

EDIT: While the article is from 2014, Nick Bostrom's thought-experiment dates back to his 2003 thesis: https://nickbostrom.com/ethics/ai (props to @o11c for the correction)

-----

Of course, back in 2014 was before LLMs and visual-image-generators were a thing (StyleGan's paper was 2018), but Roko's Basilisk was described in 2010, which would colour people's thoughts of "AI" back then somewhat differently to today:

2014: "AI" means perfect and unbiased reasoning ability, total objectivity (given one's axioms); it will have the ability to outthink its human operator/sysadmin and somehow "escape" onto the Internet, and make a living for itself trading its services for Bitcoin before going-on to do literally anything it wants, like hack Russian nukes to bomb the US, so a paperclip-making AI really could kill us all.

2024: "AI" means using statistical tricks to generate text which contains frequent factual errors, unsound reasoning, and reflects our cultural-biases back at us. A paperclip-making AI will be the next Juicero before running our of VC funding.

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That's not the origin, it was said in 2003 at least: https://nickbostrom.com/ethics/ai
Ah, thanks. That's odd - my Google search results didn't have anything predating 2014. Weird.

I've updated my post with the correction.

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Welcome to the enshittified google. It is becoming increasingly useless to find anything that's not recent and popular.
I’m making an effort to switch to Kagi this month; tried it?
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It is good, I have been using it for almost a year. But I found the quality of results to have gone down as they seem to remove words from searches now, you have to explicitly quote them. It reminds me of how google behave in that sense.
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I have used it for well over a year, despite being a stingy freeloader for many other things. I have never hit the usage limit.

Shopping results are terrible, but that is a good trade to have better technical results.

Yeah, it's like they're optimizing for very specific metrics that no longer correspond to what users actually want in a way that has negative side effects. Perhaps there's some short phrase that could describe such behavior...;P
Maybe they are a bot that has been trained via RL to maximize their paperclip maximizer analogies.
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Universal Paperclips, it's a clicker game where the only object of the game is to make your count of paper clips go as high as possible. With that in mind I'm sure you can reason out his intent now.
The title reminds me of the bridge outside of LA that is a 1 or 2 hour hike to a bridge to nowhere that you can bungee off of. Pretty cool!
How to avoid tumours growing in brain?
>Most brain tumors form in people without any known risk factors. But some factors may increase your risk for brain tumors, such as:

>Radiation exposure. People who have had radiation to the head are at higher risk for brain tumors. Most often this exposure comes from radiation therapy used to treat another type of cancer, like leukemia during childhood.

>Certain inherited syndromes. People who are born with certain syndromes, such as neurofibromatosis, von Hippel-Lindau disease, Li-Fraumeni syndrome, and tuberous sclerosis, have an increased risk of brain tumors.

>Family history of brain tumors. Most people with brain tumors don’t have a family history of the disease. But in rare cases, tumors can run in families.

>Weak immune system. People who have a weak immune system have a higher risk of developing central nervous system lymphoma. This includes people who have AIDS or who have had an organ transplant.

https://www.urmc.rochester.edu/encyclopedia/content.aspx?con...

This one is really promising:

>A study found that people who walked or ran at least 1.8 MET·h·d had a 42.5% lower risk of fatal brain cancer.

https://pubmed.ncbi.nlm.nih.gov/24091993/

>Radiation exposure. People who have had radiation to the head are at higher risk for brain tumors. Most often this exposure comes from radiation therapy used to treat another type of cancer, like leukemia during childhood.

Notably, dental xrays have been linked with tumors. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3396782/

The US is the "largest market" for dental xrays: https://www.grandviewresearch.com/industry-analysis/dental-x...

From the study:

Conclusion Exposure to some dental x-rays performed in the past, when radiation exposure was greater than in the current era, appears to be associated with increased risk of intra-cranial meningioma.

Some of this may deserve more research before warranting belief.

>Our ability to detect an exercise-brain cancer relationship may relate to the use of cohorts specifically designed to detect exercise-health associations

What about smoking cigarettes?
Cigarettes directly damage lung tissue, thats why the cause so much lung cancer, so probably its just when the lung cancer spreads everywhere
Probably irrelevant to consider, given that smoking will significantly raise the risk of a host of other deceases already.
Besides avoiding obvious cancer-causing agents, not much.

In my case, it was a benign tumor (a hemangioma), that sprung a leak. The leak was what caused the problem.

Doctor said it had probably been in my brain, all my life. It just started bleeding, for some unknown reason.

I've not read the article, but I understand from the comments this is about glioblastoma.

I understand that these cancers requires carbs to grow, and going into ketosis - which is to say, fully depleting the body of carbs and having none in your diet - is a highly effective coping mechanism. The cancer basically stops growing. Of course, you then have to live on protein and fat, but better that, than death.

More or less, if you enter a hospital, you need a medical case manager. The case manager should be an equal or superior specialty to the treating physician. The case manager should have a medical power of attorney to make decisions concerning your care (not so much to make decisions, but to be allowed into the decision making process to advise you, and then to regulate the execution of the treating physician).

In short if your doctor is not employed by you, you should be taking precautions accordingly.

This is an absolutely daft situation, but it is where we find ourselves.

The last case manager I dealt with (Raymond Rupert) ended up getting banned from practicing medicine.[1] To this day, he still operates and is expanding his case management consultancy service. He even claims Google Canada as a client.[2]

His MO is selling people on his "exclusive network" of service providers and getting people not to trust normal doctors. He then comes up with a bunch of fake services to bill people for. He also really likes to prey on kids, because parents don't want to see their children suffer and will pay money if the kid says he's helping. Especially those that are wealthy or have trust funds.

The last straw was overprescribing benzodiazepines (incredibly addictive) to people with addiction issues.

He has good SEO, is incredibly litigious (why I'm posting this from a burner), and makes you feel good about your decisions. Most case managers do that. The service they sell is not better healthcare, but making you feel like you're getting good healthcare. Case managers sell you the idea that medicine is a giant conspiracy to bilk you out of your money. Then you accept paying the case manager a bunch of money, because at least *he's on your side*.

Generally, the doctors I see practice medicine because they want to help people, not out of a desire to make a ton of money. Sometimes their sales and social skills aren't very good because of that. OP wouldn't have had a better health outcome from a case manager in his blog post; just someone charging thousands of dollars for needless consults.

[1] https://doctors.cpso.on.ca/DoctorDetails/R-Rupert/0020809-25...

[2] https://www.cieps.com/Faculty%20bios/bio%20-%20rupert.htm

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