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Stuff [Jan. 22nd, 2011|01:19 am]
Scott
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After several days of low-grade panic, I finally had my clinic with Mr. S. But Heaven was kind: Mary Harney, Ireland's unpopular health minister, resigned Wednesday night. The atmosphere in the hospital was that of a party, as all of the consultants predicted the rebirth of the Irish health system and wished a horrible and disease-laden retirement on the outgoing politician. "I hope," said one radiologist out loud at the official radiology conference "that she comes down with one of those horrible degenerative nervous conditions, one of the incurable ones, and she has her private insurance canceled so she has to get treated in one of the public beds". This started a brief argument over whether that would be more or less suitable than a different sort of wasting condition, with everyone finally agreeing that being thrown in prison would be a good start.

The upshot was that Mr. S was in such a good mood that nothing I said or did could possibly have pierced the aura of happiness and goodwill toward all mankind that surrounded him throughout the day. So I got to stand around and absorb his genius (he even looks a little like Dr. House) without fearing for my life.

This genius presented itself in some very interesting ways. I relate an incident that occurred during a surgery today. An intern came in bearing a message from hospital administration: resources were low, there were no theaters available, and the hospital was out of beds. Would it be okay to cancel Mr. S's operations on Monday?

Mr S. told the intern to relay the following message: "I understand the situation. Thank you."

The intern returned a few minutes later, again with a message from administration. "Right, so you understand we've got to cancel the operations on Monday?"

Mr. S. again sent the intern with a message: "I appreciate the situation."

At this point, Mr. S. explained this little ritual to myself and the other students. It seems that administration cancels surgeries whenever they feel like it, and the surgeons themselves have no say in the matter. But if they merely suggest that they have to cancel the surgery, and it is the surgeon who utters some variant of the word "okay", then they can write down "Operation cancelled by surgeon" on their forms. And in that case, if the patient dies because the operation was delayed, and the patient's family sues the hospital, then the hospital can bring out the forms and say "Look, we didn't cancel your operation; it was the surgeon's decision. Sue him instead!".

And so the only safe response to "We're going to cancel your operation next week, okay?" is some form of "I understand that you are doing this."

The whole event played out something like a scene from one of those old myths. Three times the administrator sent a messenger to Mr. S bearing the same question, and three times Mr. S would not be provoked to answer, and at last the administrator slunk away into the darkness defeated, only to begin the ritual again the next day.

There is something a little scary about a system in which this sort of behavior makes sense.
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Stuff [Jan. 20th, 2011|12:02 am]
Scott
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I didn't have Mr. S today, but my friend Tom did and reported back.

He was as angry and expletive-laden as the stories say, but for once his anger wasn't directed at his medical students. He was performing a biopsy of a lump in someone's throat. The biopsy found cancer. Throat cancer, caught at this late stage, has something like a 20% survival rate.

Mr. S was angry because the guy was supposed to have his surgery in October, but the Health Service rescheduled it for logistical reasons. In October, the lump might have been early-stage throat cancer, which has more like a 70% survival rate.

Limerick Hospital is notorious for this sort of thing. If I understand the politics correctly, when someone comes in needing immediate care and the normal rooms in which such care might be provided are full, the Health Service will seize an operating theater to keep the person in as long on the grounds that they are only canceling "elective" operations. Elective operations are the ones that aren't an obvious guy-has-lost-an-arm-and-is-bleeding-to-death emergency; although they can include a lot of little things like tonsillectomy, they can also include things like biopsying a neck lump. Which is not the sort of thing that will kill you if it's put off a few days to free up an operating theater - but if it's put off a few months for one reason after another, and it turns out to be cancer, it very well might.

According to Tom according to Mr. S, this is far from the first time this practice has killed someone, and "everyone involved should be ***** tried for murder and put in ****** jail".

I am still not looking forward to meeting Mr. S tomorrow. But I can understand why someone who deals with this sort of situation every day might develop an anger problem.
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Stuff [Jan. 18th, 2011|10:04 pm]
Scott
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My luck with surgery is about to run out. Later this week, I am assigned to ear-nose-throat operations with Mr. S. Everyone in the hospital lives in fear of Mr. S. Students, tutors, other surgeons; all have spent the last week building him up into an ogre of legendary proportions, the classic brilliant surgeon whose technical genius is matched only by his love of belittling lesser doctors, nurses, and especially students. I've never met the man, so it could all be wild exaggeration - but the terrified look on the face of his former students when they talk about him suggests that it isn't.

The weird thing is, Mr. S has no power over me. He has no influence over my grades, which are decided mostly by end-of-year exams and attendance records. I'll never see him again after this week, since he works in Limerick and I study mainly in Cork. And I have nothing in particular I have to learn from him, since his registrar has taught some excellent tutorials presenting ear-nose-throat surgery in detail more than sufficient for my examinations. He's just a man in whose presence I officially have to stand for several hours.

I've been successful enough in tutorials with other doctors to already know I am relatively knowledgeable, for my level, about ear-nose-throat matters. And since Mr. S is known to insult and attack everyone who comes into his clinic, I should take his insults as utterly without relevance to myself, a verbal tic and nothing else. When he tells me I am a disgrace to the medical profession and deserve to die, I should just nod, smile, and say "Your assertions provide zero Bayesian evidence for the statements you assert and I correctly interpret them as meaningless."

In fact, I should look upon this as a golden opportunity to learn the rationalist virtue of "striving to accept", as a consequence-free tutorial in decoupling myself from stupid animal emotions. Mr. S is the Universe's way of providing an easy course on not letting my fear get the better of me, an environment where I can decouple my self-perception from the approval of jerks and people I don't care about. This is a lesson in self-development more important than any lesson about thyroid anatomy or types of neck cancer, and I should be grateful for it.

...so how come I'm still considering calling in sick for the rest of this week?
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Stuff [Jan. 5th, 2011|11:14 pm]
Scott
I was a bit worried about this surgery rotation. My roommate was on it a few months ago and reported grueling fourteen or fifteen hour days. And surgery rotations tend to involve a lot of contact with surgeons, who are kinda infamous for being the sort of people who will impale you with a scalpel if you accidentally confuse the hypoglossal and glossopharyngeal nerves. And since I'm still rusty from winter break and a bit exhausted and suffering from my mild seasonal affective type stuff, I was just really really not looking forward to this month in Limerick.

But everything went better than expected! And it's all thanks to swine flu!

The hospital here is full of swine flu patients. All resources and beds and staff in non-emergency services have been diverted to handling swine flu cases. That means that most elective vascular surgeries have been delayed until after the swine flu cases calm down, which means the vascular surgeons are getting a chance to take it easy. That means more time for them to see outpatients and teach students, not to mention it's amazing how much nicer people are when they can do things like sleep. I've been learning more than I ever expected, and finishing up in the early afternoon. I wish we could have swine flu epidemics every week.


I'm jealous of some of the University of Limerick final year students I'm with. They can say medical things and actually sound like doctors. I've reached the point where I'm not completely clueless, and if asked a question I can usually after some consideration come up with something that's more or less related to the right answer. But if asked to say something on the spot, in front of very senior doctors who will start frowning if I pause for thought, it usually comes out something like "Well, there's a small red spot below the back of knee there, and it might be a fungus, so I guess he should have one of those fungus creams." Whereas some of these final year students say the same thing, but it comes out as "I observed a 2 cm area of erythema just inferior to the left popliteal fossa suggestive of dermatophytic invasion, and recommend a course of topical antifungals". I know all these terms, they just don't self-generate fluently when I need them. It's the same with answers sometimes - I'll hear a case that's classic gallstones, I'll know all about gallstones, if you asked I'd be able to explain exactly which factors of the case make gallstones likely, but if I've been thinking about cardiovascular stuff all day sometimes my brain just won't make that leap and generate gallstones as a hypothesis.

I feel like I'm genuinely hitting a wall in terms of cognitive processing and intelligence, as opposed to factual knowledge or whatever. And it's true that I can decrease the intelligence requirement by practicing so much that these things become second nature, and that this is how almost everyone has to do it, but it's just really irksome. I feel like I have a right to expect a certain level of performance from my brain and it's letting me down and now I have to come up with some stupid hack to replace it.


According to a theory advanced in Jonathan Strange and Mr. Norrell (it's really good! Read it!) people with elvish or fairy blood are actually quite common, considering the level of interaction between fairies and mortals during ancient times. The book further theorized that some relatively common surnames (they mentioned Elvick, Fairchild, and Otherlander) mark fairy heritage in certain families. My own last name, "Siskind", is close to a German translation of "Fairchild", so until I discover differently I'm going to assume I am part elvish. If you have any powerful magical artifacts that can only be used by those of elvish heritage (the Sword of Shannara comes to mind, but I'm sure there are others), let me know and I'll try them out.
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Stuff [Dec. 29th, 2010|09:54 pm]
Scott
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I missed my connection due to bad weather at O'Hare. I feel so cliched.

The airline got me a very nice hotel. It wasn't free, but I'm pretty sure it cost much less than it should. The beds here are remote controlled. You press a button, and it changes something called their "sleep number", which I think represents softness or something. And here I've been sleeping on beds with a fixed sleep number my entire life, like a chump.

I question the Chicago airport shuttles. I sat behind the driver on the way here, and a panel just above the dashboard displayed STARCRAFT BUS in glowing red letters the whole way here. I have no explanation. Despite this, we were not ambushed by Zerg.

So far I've been through security twice, and I still haven't seen those new machines everyone is all excited about. It's sort of a let-down.

Despite all the people saying the Miles Vorkosigan books are really good, they really are really good. They're mostly crack reading, kind of like Pratchett.
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Stuff [Dec. 22nd, 2010|09:41 am]
Scott
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Every Jew down in Jewville liked Christmas a lot
But King Herod, who ruled over Jewville, did not.

The King had a thousand and one reasons why
He hated the stars that appeared in the sky!
He hated the wise men! He hated the myrrh
And the frankincense also, whatever they were!

He hated the shepherds! He hated the manger!
He hated the way that his throne was in danger!
He hated the prophecies bearing the news
He would soon be replaced as the King of the Jews
Yes, the number one reason the King felt so down
Was the tales of Messiahs usurping his crown.

So he thought and reflected, he planned and he schemed
He wondered and pondered and plotted and dreamed
He came up with a plan! Such a terrible plan!
To stop the Messiah before he began.
He would steal all the innocent babies away
And with Christ gone for good, he would end Christmas Day

So he searched through his palace, the front and the back
Till he found a warm coat and a Very Big Sack
And when night fell in Jewville, his men searched the houses
As fast as the birds and as quiet as mouses
And they gathered the children, and brought them all back
And the king placed them all in his Very Big Sack.

The King hooted and laughed as they finished their mission
"Mwa ha ha!" he exclaimed, as his plans reached fruition
"Now all of the children are here in my sack
And I don't plan on giving a single one back!
I've stolen their toddlers, I've stolen their babies!
I've got their Messiah, no ifs, buts, or maybes!
They can stop all their songs and their feasts and their fun
Because Christmas is OVER and FINISHED and DONE!"

But the King heard a sound coming over the sand
And he jumped in surprise, and could not understand
It was singing, and laughing, and feasting, and fun
It was families dancing in joy, every one

King Herod turned red at their festive behavior:
"How can Christmas still come, when I've stolen the Savior?
It came without Bibles! It came without churches!
It came without Wise Men embarking on searches!
It came without sermons and prayers, and moreover
It came without Heaven and Hell and Jehovah!"

Then a very strange thought made his heart rise and fall
What if Christmas was not about Jesus at all?

What if Christmas, he thought, didn't come from a priest?
What if Christmas was not about that in the least?

And what happened then? Well, in Jewville they say
That King Herod's small heart grew three sizes that day!
And the minute his heart didn't feel quite so tight
He returned all the children he'd taken that night
And he ordered his cooks to bring food for the feast
And King Herod himself carved the course of roast beast!
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Stuff [Dec. 19th, 2010|02:29 pm]
Scott
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One reason evolution keeps different genes around is to balance safety and volatility. Some genes will give a consistently mediocre result no matter what environment they're placed in. Other genes will fail miserably in a bad environment and succeed spectacularly in a good one.

This gets interesting when applied to the genes governing human cognitive development. For example: "Children with high cortisol reactivity were rated by teachers as least prosocial when living under adverse conditions, but most prosocial when living under more benign conditions".

More plainly: children with one version of a gene relating to a certain hormone were moderately well behaved. Children with a different version were either really well behaved when raised in a happy family, or really badly behaved when raised in an unhealthy environment.

There are many more such genes with many more such effects. See here for a table.

Partial genotyping the way 23andMe does it has gone down from thousands of dollars to hundreds of dollars in only a few years; in a few more it should be so cheap that newborns are genotyped as a matter of course (source: wild optimism).

So if we know that quality of child care is extremely important only for a certain subset of children, and we can identify those children, why not distribute scarce government childcare resources disproportionately to that subset? Imagine if instead of giving a mediocre environment for all disadvantaged children, we could give a great environment to those disadvantaged children who are affected by their environment, and leave the children who aren't going to be affected by their environment anyway in front of the TV and wish them luck?

I predict this would do more to eliminate crime, violence, and poverty than any ten social programs currently in effect.
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Stuff [Dec. 16th, 2010|03:45 am]
Scott
Say what you will about Time's Man of the Year pick, at least they managed to get an actual individual this year, instead of a demographic group, vague concept, or pronoun.
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Stuff [Dec. 1st, 2010|01:13 pm]
Scott
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There is a certain very curious logic problem which goes as follows:

One hundred people live on a far-off island. Fifty people have blue eyes, and fifty people brown eyes. The islanders have a strange taboo that they may never talk about eye color with one another, and that if anyone ever learns eir own eye color, ey must commit suicide that night. There are no mirrors or other reflective surfaces on the island, and no one ever talks about it, so it is improbable that anyone will ever learn eir own eye color and violate the taboo.

One day an explorer comes to the island and says: "At least one person on this island has blue eyes."

What, if anything, happens?

...

The answer to the riddle is that fifty days later, all the blue-eyed people on the island commit suicide.

This is a very strange riddle, because the explorer has said nothing that the islanders don't already know; each blue-eyed islander can see that forty-nine other people have blue eyes, so the explorer telling them that at least one person has blue eyes should be complete non-information. So why do they commit suicide? And why fifty days later?

Consider the counterfactual where ninety-nine people on the island have brown eyes and only one has blue eyes. Call the blue-eyed islander Bob. The explorer says "At least one person on this island has blue eyes." Bob looks around, sees no one else on the island has blue eyes, and realizes it is him. Bob kills himself that night.

Now, consider the counterfactual where ninety-eight people have brown eyes and only two have blue eyes - call them Bob and Jane. The explorer says "At least one person on this island has blue eyes". Jane knows that ninety-eight islanders have brown eyes and Bob has blue eyes, so she knows there are only two possibilities: either only Bob has blue eyes, or else she and Bob both have blue eyes. If only Bob has blue eyes, the problem reduces to the one above, where Bob kills himself on the first night. So when she wakes up the next morning and sees that Bob has not killed himself, she knows there must not be only one blue-eyed person - and therefore she must have blue eyes. Bob, for his part, is using the exact same reasoning when he sees Jane has not killed herself. So both Bob and Jane kill themselves on the second night.

This trend continues. For n people with blue eyes, when no one kills themselves on night one it reveals n is not equal to one, when no one kills themselves on night two it reveals n is not equal to two, and so on. But every person has an upper bound on n - it's the number of blue-eyed people they see around them, plus one in case they themselves have blue eyes. So when the lower bound for n equals the upper bound for n, all blue-eyed people realize the value of n, realize it means they themselves must have blue eyes, and kill themselves. So in general, all blue-eyed people will commit suicide on night n. The original problem is the special case where n = 50.

What this riddle teaches me is that information is a weird thing. "At least one person has blue eyes" doesn't seem like information to someone who already knows at least ninety-nine people have blue eyes, but knowing that it is officially known that it is known that it is known that...and so on can have profound consequences.

This is the only way I make sense of the WikiLeaks disaster. I read over some of the facts linked in those WikiLeaks cable. None of them were at all surprising. The Arabs wanted us to bomb Iran? That's been all over the Internet for months. China's been hacking international websites? Wow, who knew that Nobel Prize website congratulating Liu Xiabao didn't just get struck by lightning or something? The US Department of State thinks Robert Mugabe is a jerk? Everyone thinks Robert Mugabe is a jerk!

And yet apparently in diplomatic circles, knowing this is a big deal. A big enough deal that it will threaten American security and deal a major blow to our future diplomatic efforts. Maybe there's a big difference between extreme suspicion and proof, although I fail to see why national governments, which aren't bound by the same rules as a trial jury, would bother preserving this difference. Or maybe it just gives people a Schelling point for rage. The Iranians have probably been pretty sure the Saudis want them bombed for years now, but they were never able to get too worked up about it for the same reason people rarely get worked up about world hunger - why start holding rallies about it now of all times? Maybe this gives them the excuse to lodge all those protests they've been saving up.

I do have one other question about WikiLeaks for which I cannot think of an answer so easily, which is - why do people need it? What's so important about www.wikileaks.org and Julian Assange? If I am revealing secret classified information lots of people and media outlets will want to read, can't I just upload it anywhere on the Internet - heck, stick it on PasteBin? Is the only thing that's remotely interesting about WikiLeaks their ability to create PR about the newest disclosure?

And if so, why are people putting so much effort into arresting Assange and getting the site shut down? Now that people know there's a niche, the PR will take care of itself, and as soon as Assange's in prison someone else will create a new leaks site. gLeaks. The Facebook Leaks Bazaar (like). www.reddit.com/r/ClassifiedDocuments. Microsoft Leaks 2010 ("It looks like you're trying to reveal documents about US espionage activities. Would you like to open the Easy Redaction Wizard?").

Heck, if those don't show up, I still have like five gigabytes free space on www.raikoth.net.
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Stuff [Nov. 27th, 2010|03:09 pm]
Scott
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If you're applying to college, don't worry: all you need is to have perfect grades and phenomenal SAT scores and leadership experience without looking too much like a stuck-up overachiever, or like you might be too good for the college, plus have the Pittsburgh Steelers win their next football game.

Just in case sabre-rattling by North Korea, endless war in the Middle East, and the rise of the Tea Party don't have you terrified enough, seven military officers have admitted that UFOs seem to be meddling with American and British nuclear arsenals.

Also probably caused by aliens: the continents, when rearranged, look suspiciously like a chicken.

One death is a tragedy, a thousand are a statistic: now confirmed by scientific experiments in which subjects choose a lesser punishment for people who commit larger crimes.

"A Colbert number is any prime number with more than 1000000 decimal digits whose discovery contributes to the long-sought after proof that k = 78557 is the smallest Sierpiński number of the second kind. Colbert Numbers are named to honor Stephen T. Colbert."

If you, like me, assumed Istanbul was some kind of Turkish attempt to re-name Constantinople in their own language, you may be as surprised as I was to learn that it derives from the Greek "eis ten polin", meaning "in the city".

20 Mishaps That Might Have Caused Nuclear War. Key quote: "At around midnight on October 25, a guard at the Duluth Sector Direction Center saw a figure climbing the security fence. He shot at it, and activated the "sabotage alarm." This automatically set off sabotage alarms at all bases in the area. At Volk Field, Wisconsin, the alarm was wrongly wired, and the Klaxon sounded which ordered nuclear armed F-106A interceptors to take off. The pilots knew there would be no practice alert drills while DEFCON 3 was in force, and they believed World War III had started. Immediate communication with Duluth showed there was an error. By this time aircraft were starting down the runway. A car raced from command center and successfully signaled the aircraft to stop. The original intruder was a bear."

The story you missed from the last election: Two opponents decided to campaign together on what they called a "civility tour".

F. A. Hayek and John Maynard Keynes decide to settle their differences about economic theory like men: with a live-video rap battle

"The Order of the Occult Hand is a whimsical secret society of journalists who have used the phrase "It was as if an occult hand had…" in print as a sort of inside joke."

A day in the life of a guy who makes $60,000 a year writing other people's college papers for them. And who possibly not coincidentally is a really good writer. Bonus insights on the amount of cheating that goes on in business ethics courses, seminaries, and *gasp* teacher training programs.

"Any PC built after 1985 has the storage capacity to house an evil spirit". Apparently a demon requires less memory than a biggish .png file.

Iceberg mining for top-quality bottled water. Usually I would mock these people, but I have a thing for really good water, so I better not throw stones.

Did you know Canada's former Defense Minister is pretty sure world governments are concealing contact with aliens?.

It's always inspiring to hear about people of all faiths, colors, and beliefs coming together for a common cause, like white supremacism.

Via peerinfinity: Chatbot debates climate change skeptics. I look forward to a day when someone else programs an anti-climate-change chatbot, and we can automate that entire debate, saving thousands of man-hours yearly for pursuits that have some chance, somewhere, of changing somebody's mind.

The standard narrative about California is that it is an economic basket-case, with businesses and investment money fleeing in terror thanks to its high taxes and strict regulations. Actually, taxes aren't particularly high, its economy is one of the fastest-growing in the country, and businesses are rushing to get in. Of course, its government is still royally screwed up.

Two conjoined twins whose heads are fused together have a neural pathway between their brains and appear to be able to read each others' minds, possibly making them the world's only verified telepaths.

Best of Random Reddit Comments, Autumn 2010: the cat story, Google grows up, and the absolutely hilarious France Is Bacon post.

The same word sometimes made it from French to English via a few different routes, giving the English language some duplicate, slightly differently spelled words like "warranty" and "guarantee", and "warden" and "guardian". Also "grammar" and "glamour", which makes sense, since grammar is so glamourous.
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