I use my humans.txt to give credit to the people who influenced me over the years. https://jasonmurray.org/humans.txt - not everyone needs their ego stroked, even if they do who cares.
If someone asks you how to do something or your opinion, give them a thoughtful answer. Many times I would say, “I don’t have a strong opinion” or “whatever you think is best”. It took a friend to tell me people value my advice and they are truly interested in what I have to say. When someone asks, they want to know what I think. Answer them thoughtfully. Ever since that moment I always give a thoughtful answer when someone asks for my advice.
There are a great number of people who write just for the love of writing. I wish more of these people would forego the “centralized blogging” platforms and publish using independent systems. When Covid hit I set out to write one article a day using my own self hosted site. Over time it organically started to become more popular. A few of posts are now first page search results.
As pointed out by a number of people already, money will end up corrupting what was once a great and easy outlet for people to share original ideas. A better alternative is to continue building systems that make it easier to publish independently AND create search engines that are not optimized to return SEO optimized click bait garbage for profits. I want blogs from real people who write because they want to teach me something.
Let’s get back to writing good content, share it freely, and change the world.
I could not agree more. My daily updates did stop. Writing something that is not complete shit for an entire year was hard. However, writing is also a personal experience. This again, is why I say write for the joy of writing. My goals were 1) become a better writer 2) focus on something that takes more then a few days, and see it through 3) document as much as I could about things I've learned over my career 4) write about things I love, which is something I think other nerdy people enjoy. In this example, my blog became more of a conscious stream. The articles that resinated with "my people" organically became popular. No SEO. No clickbait. No search-engine/spam shenanigans. Real writing from a real person with a real goal.
It’s been hit and miss all morning. Sometimes it will retrieve and send mail, other times the the progress bar pulses along like it’s trying without success. The status page says everything is ok. If any of their engineers are listening and the problem is geolocated, I’m in the St. Louis, MO USA area.
I know this is about Lyme disease, but let me add another word of caution while we are discussing ticks. Two years ago I was bit by the Lone Star tick. Since that time I developed an allergy to all red meat. It was hard to diagnose and a few of the doctors I worked with along the years still don’t believe its true. If your interested in learning more search for Alpha Gal. There is an excellent Radio Lab podcast about it.
> It was hard to diagnose and a few of the doctors I worked with along the years still don’t believe its true.
Did they offer alternative explanations or did they simply stonewall you and deny your reported symptoms?
One of the lessons I learned far too late in life was to not waste time with doctors who don’t believe your reported symptoms.
On some level I understand how it happens — Doctors inevitably see a number of hypochondriacs and people with psychosomatic illnesses who need to be handled delicately to avoid further entrenching their perceived illnesses. However, when you’re having legitimate symptoms and your own doctor tries to deny the symptoms without offering further diagnostics, it’s time to cut ties and move on.
I've generally had better experiences with DOs than MDs when it comes to listening and working with me to understand how and what I feel. On the other hand some people may prefer the more "clinical" (not sure if that's the best word) approach of MDs. So just something to keep in mind if you're unhappy with your current doctor.
I was bit by a tick in 2010. I pulled it off my forearm and it left a protrusion that lasted about 2 weeks. No rings. I got sick with a flu around this time. Went to the doctor, the lyme test came back negative.
Shortly after this I started to develop lesions in my mouth and scalp. Then they spread to my entire body. 6 months later got a diagnosis of an autoimmune blistering disease. The specialist said it was a usually a disease for old people, very unusual for an otherwise healthy 35 year old to develop it. 8 years of oral antibiotics and some steroids for flare ups and I was in remission.
In my opinion, everyone should be leery of tick bites.
We, as patients, pass around these apocryphal stories around, but don't look at the opposite experience of doctors. Doctors constantly, and I mean multiple times per day, get patients in that tell them their symptoms are due to disease or condition or complex X. Time and again, the patient is completely wrong. No, you don't have cancer, your lymph node hurts because it is fighting off an infection, and besides if it was cancer, the node wouldn't hurt. No, you don't have lyme disease, you're sore because you started gardening again and you are 50. No, you don't have an ulcer, you're just eating too much ice cream before going to bed.
As humans, we forget about the times we were wrong, and also don't share those stories. "I went to the doctor thinking I was dying of cancer, but it turns out I'm allergic to mushrooms" is much less likely to be passed around as a story than, "No doctors would listen to me until one did and tested me and found out I have Lyme disease."
Hilarious you brought this up: "No, you don't have an ulcer, you're just eating too much ice cream before going to bed."
Reflux is a very common food allergy symptom and milk is one of the most common allergen, if not THE most common.
I've had 3 or 4 scopes that showed some mild inflammation, and GIs were simply lost. I've managed to locate a 90 year old allergist who probably began practicing before there was benadryl. After recounting the symptoms I was told "it's milk. it's always milk". I was taken aback, how can anyone be so sure? Literally 5 minutes later that was confirmed by a skin-prick test.
Most physicians are garbage. The allergist was quite thorough.
The billing rate to dismiss you in 30 seconds pays about the same as a 30 min appointment. The incentives just aren't there.
I agree with the systemic problem that our healthcare system doesn't want to get to the bottom of symptoms. It drives me crazy, especially the "most cancer is treatable if caught early, but no we won't give you a diagnostic test to actually catch cancer early". I have direct experience with this, pushing through multiple doctors that ended with my thyroid cancer diagnosis.
My doctor at the time was actually really good, not because he was good at diagnosing, but he had enough experience to recognize his inability to do so and would always send me to an expert. He literally was 100% wrong about all of my major diagnoses (my hurt knee actually was a torn ACL, my abdominal pain actually was a hernia, my throat nodule actually was cancer), but he always sent me to a specialist to be sure. And he knew really good specialists. "I don't think it is X, but lets have a specialist verify" was his common refrain.
A doctor's opinion on disease isn't merely an opinion, it's an educated guess based on experience and qualifications. New diseases and research are constantly appearing, thousands of articles are written each year. We can't expect doctors to know everything, but we can expect them to have more informed opinions, on average, than non-doctors.
I say this because there's a rising trend of anti-intellectualism and distrust of doctors in the US, which leads to massive self inflicted wounds in Covid and vaccines. Doctors aren't infallible, but they're far better than random online sources.
trend of anti-intellectualism and distrust of doctors
As someone who knows a practicing doctor who is also anti-vax, these are orthogonal issues. Sometimes, distrusting a specific doctor is the more intellectual approach.
You'd be surprised how many physicians and nurses refuse vaccination. You'll just never hear about it. AMA is one powerful beast, I wish I had a union like that.
However, sometimes fun little things like this happen that show their true colors:
"Starting in early 2003, the United States government started a program to vaccinate 500,000 volunteer health care professionals throughout the country. Recipients were healthcare workers who would be first-line responders in the event of a bioterrorist attack. Many healthcare workers refused, worried about vaccine side effects, and healthcare systems refused to participate. Fewer than 40,000 actually received the vaccine.[29]"
That doesn't mean distrust of vaccination in general - at least by doctors. It was for a potential bioterrorist attack. It perhaps more reflects the low likelihood or belief that there would be a small pox attack.
If you assume the low likelyhood of the attack was the reason, that means 90% of those physicians could be lying. The stated reason for refusal was concerns about side effects. It's in the quote.
What you stated as a fact, 96% vaccination rate, is actually a self-reported survey.
Why do a survey when public health CDC records could simply be matched with the physician licensing registrars?
Seems an automatic search like that would save physicians their valuable time, aren't they very busy with a pandemic right now? Instead of hard data from CDC, we get self-reported, likely anonymous, self-reported survey.
It's always cost-benefit. Relative risk of side effect directly relates to likelihood.
Risk of side effects vs benefit of vaccine.
I am not likely to take an HIV vaccine, since my personal chance of contracting HIV is incredibly low. So any side effect isn't "worth it" -- even a sore arm. But that doesn't mean I'm anti-vaccine.
I also don't wear a bullet proof vest around because it's too heavy ("side effect"). Does that mean I'm anti-bullet proof vest? No. But I would wear a bullet proof vest in a war zone -- even if it's heavy.
If there was a widespread small pox outbreak in the U.S., I'm certain more than 10% of physicians would take the vaccine. Does that mean they were lying before? No.
Because even if I did point to official stats, you would say they are just lying?
A few months prior to the AMA survey, Long Term Care Facilities reported a 75% vaccination rate amongst physicians at their facilities. So presumably higher now.
The stated reason for refusal was concerns about side effects.
As another comment already mentioned, smallpox vaccines (at least historically) tended to have undesirable side effects, like permanent scars. Smallpox vaccination is probably not a good proxy for vaccination overall. It's not worth getting vaccinated for smallpox unless you expect a decent risk of exposure.
I'd qualify that: "...we can expect them to have more informed opinions, on average, _for any random condition_, than non-doctors."
The thing I think you're missing is that the resources to do good, deep research on a condition do exist, and the sufferer has very strong motivation to do that research and become very well informed in the etiology and treatment options. The doctor, less so. They have a lot of patients and a lot of demands on their time.
Will a good doctor put in the effort, do the research, and come up with a superior treatment plan? Certainly! But not all doctors will do this.
If you use the allegory of the pig and the chicken, the sufferer is the pig, the doctor is the chicken. It is reasonable that the average pig will put in more work and be better informed about their own condition than the average chicken.
The English language has a serious deficiency in the term "research".
You can do "research" by spending your days in a lab, formulating hypotheses, doing experiments, reading related academic work, drawing conclusions, publishing their findings.
You can do "research" by googling, reading blog posts and wikipedia articles, watching Youtube videos, following telegram links and possibly reading a popular-science book.
These two things are very different activities and produce very different bodies of knowledge. "Do your own research!" is a common sentiment in Covid skeptic circles. It doesn't mean being in a lab. It means following links in your Google bubble. That doesn't necessarily produce useful knowledge. Properly trained researchers are aware of things like confirmation bias, selection bias, recollection bias. The "I did my own research crowd" is not and suffers seriously from it.
Using the term with the doctor is blurring the line between both versions. They don't stand in the lab and "do their own research", but they are more educated in the medical field than the common patient and have context.
> they are more educated in the medical field than the common patient and have context.
Pompous credentialism.
This is a hacker forum. Are people outside of universities unable to learn computer science, applied math, sw dev? Sure, biomed is a different field, but that’s all it is. A different knowledge base, there are more and more biomed hackers out there too, not to mention quite a few patients are PhDs and MDs themselves.
Geez, from your words patients are simply all permanently dumb as bricks and unable to ever learn, where as MDs always know more than patients, despite having never ever done any actual research in their entire training and subsequent career.
Nice set of preconceived notions and biases there, fellow researcher.
> Geez, from your words patients are simply all permanently dumb as bricks and unable to ever learn, where as MDs always know more than patients, despite having never ever done any actual research in their entire training and subsequent career.
Wow, it's hard to misconstrue my post more than that. Impressive!
Of course there are patients with more clue than the average patient. And of course there are incompetent doctors. But the common doctor is more educated in the medical field than the common patient.
Don't believe that? Next time you have surgery, just demand that instead of the surgeon, the next patient in the waiting room does the surgery on you. That's roughly what you are babbling about. Nothing they couldn't learn with a bit of youtube, eh?
> despite having never ever done any actual research in their entire training and subsequent career.
The post you replied to literally contains the words 'They don't stand in the lab and "do their own research", '
Indeed, there is plenty of distrust. If they are doing such a great job though, why the distrust?
I don't know a single person with a significant chronic condition in the US who would say the health system and all their physicians are amazing and great. Usually you hear the exact opposite.
However, stories about that gem of a doctor they finally found over the years are very common. Most physician suck, not sure why.
Loss of trust is indeed very unfortunate, counterproductive and indeed leads to unnecessary suffering.
Physicians are highly educated professionals in a legally protected rent-seeking monopoly, backed by a powerful trade union, AMA, and the corresponding social status/wealth/authority that comes with all that. Seems to me it's only fair that the onus is entirely on them to win that trust back. I'm not holding my breath though.
Medicine is just another business. Remember that next time you see a doctor.
> I don't know a single person with a significant chronic condition in the US who would say the health system and all their physicians are amazing and great. Usually you hear the exact opposite.
> However, stories about that gem of a doctor they finally found over the years are very common. Most physician suck, not sure why.
Great example of reporting bias. Nobody goes around telling everybody "all is fine". That's not news and nobody wants to hear it. Something needs to be special, out of the ordinary, a sensation even. "All my doctors suck, listen to my 10-minute rant about my odyssey" is what people _think_ will be interesting.
Ever heard a news anchor say "Nothing remarkable happened today. Have a good evening." Of course not. They will report something, no matter how unimportant, ridiculous, sensationalist.
Yeah I think of it almost as a mathematical problem. There are simply more ways for a human body to go wrong than any number of doctors possibly can comprehend :) There is a very very long tail of diseases and disorders.
So it's not just easy to find something that ONE doctor has never heard of or seen, but you can find many that ALL doctors are unfamiliar with!
I’ve used vi for 25 years now. Every shortcut and key combination is burned into unconscious memory. This holds true for all other applications used on a regular basis.
Please stop this. Instead of insults, why not ask a clarifying question and contribute to an intellectual conversation? Your instant conclusion is not always right.
