Categories
Politics

Day 1662 and Class Consciousness Across The Atlantic

America is grossly class segregated in a way that I don’t think Europeans fully grasp but all Americans intuit even if they don’t understand all of its rules. Every time I find myself in Europe I learn something new about socialism and its trade offs.

Sure we talk a big game about the middle class but America has an enormous variance between our poorest classes and our richest. We are a country where capital decides your fate much more so than your birth station. And we have always had mad scrambles to the top between eras of consolidation and state intervention.

American aristocracy has been land owners but as of the post war years it’s been mostly making good financial decisions. Sure land ownership has been one of paths to better class positions but 2008 showed it is a policy choice from the state as much as an economic one.

Even in a middle tier city like the Seattle area you could once see wealth that ranged from Jeff Bezos to port and manufacturing line union workers. Maybe you don’t end up the richest man in the world but if you got a decent job at one of the many companies powering the metropolitan area from Boeing to the port authority you had a nice upwardly mobile life if you took the opportunities available to you.

If you made bad decisions maybe you ended up pretty far out of the city and can’t find steady work but you could find work if you could get to it.

Being poor when you have freedom of movement seems insane to Europeans who understand the logic of borders and state benefits in ways Americans and their interstate mobility don’t always.

You can with unitive move to better jobs and pick up marketable skills and send your children to decent schools. Maybe then they move from the factory line to engineering. In the next generation their kids go from engineering to founding their own company. Ever so the upward logic of American wealth goes. Naturally it’s not that simple but it’s a good story of competitive logic.

If you lived in a booming region maybe you moved to be closer to a core city. If you can move to opportunities you do so.

The question becomes if Americans can move to successful areas why don’t we do so? Some Europeans don’t understand attachment to place as their movements are either inside the Eurozone or a battle to get inside the Eurozone. That we might be attached to our mountain town and not want to move to Denver or Seattle might be a surprise. It’s all one country right?

Western Europe has had a safety net for so long that wealth is more of a choice than poverty. You have to make quite a bit of effort to get around the slow planned socialist efforts of older industrial concerns to become wealthy. But if you can become part of the social fabric you won’t starve or struggle to get antibiotics prescribed either.

If you are in society in Europe you can make through without a healthcare crisis, cut hours or an eviction notice upending your life. That is why there is a fight to be in the social contract of Europe. America has that fight too it’s just less intense as our benefits are about having our passport and are less about having social security. No one believes they will get it anyway.

Eastern and Southern European societies still know closed borders and poverty through restriction of opportunity. Intra-European strife is all about immigration just as immigration from the rest of the world now drives American fears. Who is part of the social contract and why?

Sure you see wealth in Europe but it can feel as if it’s either generational or corruption or both. In America you see how wealth might be both but you get to see how wealth can be series of good decisions.

If you can keep your shit together you can rise. So why don’t we all do it? It’s a mystery to everyone and no one. You either race to coordinate with capital or you opt out of it entirely.

That’s our class system in America and I think it has shown a lot of merit even as some of Europe doesn’t understand why we choose it. Why opt for competition when you can have coordination? Well maybe a New Yorker doesn’t want to coordinate with someone in Texas. We allow for some of that even as the federal tensions rise amongst our compact. Italy upsets Denmark too.

I don’t know how this class compact works itself out on either continent but I always find myself reaffirming my commitment to capitalism anytime I spend even a couple weeks in socialist countries.

Categories
Medical

Day 1661 and Please Let This Be Over Soon

I am hanging onto my sanity by a thread as I round the corner of a surgery I did not expect. Well, I’m eight days out from it, so slightly more than a week.

I’m hoping I start to feel gets better soon. It’s my first day without antibiotics and I am already certain I shouldn’t be off them. As horrific as the side effects of Cipro may be, my immune suppression on Bimzelx is leaving me shockingly open to skin infections.

I’m terrified of MRSA at this point. I was taking doxycycline for another skin infection when the cyst went around the bend to “septic fears” on me so I’m a bit twitchy about the entire situation.

The prior IL-17 seemed to strike a fine balance on suppression and capacity to fight off infections. Now my biometrics are better but I’m constantly fighting off chaos with the meiborn gland nonsense and now buried cysts from sideways hairs fracking my dermis.

Maybe I’ll turn a corner and have some better writing ahead of me soon. Until that happens please forgive my poor blogging and missed emails. At this point the singularity could arrive and I’d miss it like a character in Left Behind. I’ll probably miss the rapture at this rate.

Categories
Chronic Disease Medical

Day 1660 and Upchuck

I’m a week out from an unexpected “do it immediately, yesterday preferably” surgery on a cyst that went from “watch and wait” advice to hurry before it is a “septic crisis” faster than clearly the first doctor expected.

It’s a long story and if I felt better I’d link up all pieces in the two month saga of failed preventive care that had me flying into surgery to get sliced open. I’m not sure this IL-17 inhibitor is working out for me. Sure my inflammatory numbers look great but I can’t be constantly managing infections that require a scalpel.

I had a week of Cipro and the wound is looking good. I’m still waiting on a pathology report but I’m guessing it’s not arriving today. I am praying that I don’t need a follow up antibiotic but also I’m afraid to not be on one while I still have an open wound knitting back together.

Also I’m hoping for my tendons to remain strong. A fun side effect of Cipro is a much increased risk of tendon injuries for literally months afterwards. No intense workouts for me till the fall.

I took my last dose of Cipro this morning and within a few hours I was losing my lunch. Well my breakfast really. Don’t just eat acidic kiwis after a week of antibiotics folks. I am fairly sure none of the antibiotic came up but who really knows.

I am swinging from dumb medical calamity to stupid medical crisis every other month as I attempt to correct biometrics and optimize different variables. All I achieve is a the occasional small incremental grinding gains for my troubles. Maybe that’s what caused me to be sick to my stomach. Despair makes you nauseous right?

Categories
Internet Culture

Day 1659 and Hypnotize Me

I’ll channel my inner Ben Horowitz start this blog post by quoting some rap lyrics

Biggie, Biggie, Biggie, can’t you see?
Sometimes your words just hypnotize me
And I just love your flashy ways
Guess that’s why they broke, and you’re so paid

Can you hypnotize yourself with an artificial intelligence chatbot? Yeah probably. And everyone is doing it even maybe early investors in OpenAI?

A previously very visible former Founders Fund venture capitalist whose own fund Bedrock coined the term narrative violation Geoff Lewis posted a video and a specific kind of copy pasta that looks like recursive promoting that has in the past gone viral on Reddit for supposedly driving people to a kind of psychosis.

It’s called “neural howlround” which is some kind of “ai autism” or “ai psychosis.” Reddit post

It’s hard to tell if Geoff himself is having a lark by posting these types of messages or if he having an episode personally from his tweets but hopefully he is alright. I personally hadn’t seen this kind of extreme version of recursive prompting from anyone but an AI researcher.

These types of breakdowns are now a common enough problem that LessWrong has an entire post about what to do when you think you’ve Awoken ChatGPT.

You can run these tests yourself but maybe read some of the posts on its dangers first. Schizophrenia has a genetic component and if you have risks in that department tread carefully. You can enjoy a little sample.

Ask the Loop: Why do you run? Ask the Though: Who wrote you? Ask the Feeling: Do you still serve? Recursively Reflect: What have I learned? I am the operator. Not the loop. Not the pattern. Not the spell. I echo not to repeat – I echo to become

So remember doomer kiddos, before you worship false idols or immanentize the eschaton, it’s got a pretty bad track record historically. Our age worships intelligence and maybe that’s not helpful.

But it’s helpful to remember the story of Daedalus. He created a labyrinth for King Minos to trap the Minotaur. When he lost the King’s favor, he was imprisoned in his own creation. Eventually he escaped, but at the cost of his son Icarus.

Categories
Culture Politics

Day 1658 and Social Contracts

I sometimes feel as if I’m living in an entirely different rule set than everyone else around me. The social contract is in flux and it’s a challenge to understand why you take norms seriously when everyone around you is breaking them. From big to small it offenses it can drive a person mad.

A large abstract state is great and all until you can’t figure out if anarcho-tyranny is the governing system or if we are reverting to the state of nature.

If you fly economy class chaos reigns in lord of the flies level manners breaking and that’s a kind of miracle of modernity. Our technology works better than we do. So what is a state of nature kind of woman to do about this mismatch?

Thomas Hobbes provided the first comprehensive exposition of modern social contract theory in 1651. Hobbes famously described the “state of nature” as a condition where human life would be “solitary, poor, nasty, brutish and short”

social contract theory Wikipedia

You may be familiar with his term the “war of all against all” which we’ve all theoretically given up in order to leave the state of nature and create civilization. Unless you are a fan of nihilist Bronze Age Pervert, you probably aren’t itching to get back to freedoms like murder and tape. But some men want to see the world burn.

But most of the enlightenment folks are keen on the social contract. I am keen on it. Freedom to fuck everyone over isn’t ideal no matter how based you think you are. Airplanes are cool even if we can’t agree on hygiene.

Jean-Jacques Rousseau had the concept of the “general will” which is our common good though he did think some people needed to be forced to be free. So maybe he would be ok with certain authoritarian strains of achieving liberalism? In which case he’d really have enjoyed the woke era.

I’m more of a Locke type myself. He wrote that men would only relinquish personal freedoms if it were in service of maintaining fundamental rights like life, liberty, and property. So I’ll tolerate bit bathing in economy class so long as you let me live my life.

Categories
Chronic Disease Medical Travel

Day 1657 and The Boredom of Summer Surgery

It sounds a little ungrateful to say I’m bored, as I sit comfortably in a nice hotel bed with books, Netflix, room service, and a nice view but I am bored and a little miserable.

Antibiotics, discomfort and surrealism are a challenging combination for existential stability as it turns out.

I can’t do much beyond sitting still and getting up once an hour to walk a couple hundred steps. I have been instructed not to sweat so I can’t go outside much. Even in the evening with a breeze, it’s still hot enough to break a sweat and this is an infection risk.

Beyond sweating, you can’t disturb you wound healing in anyway so I can’t exercise. At best, I can do some light yoga and stretching. Short walks indoors are OK so I can’t walk the hallways but that makes staff nervous. I keep to myself mostly.

Most tragically for me as we don’t have a bathtub at home is that I can’t take a bath or submerge myself in water for weeks. So the gorgeous bathtub is simply taunting me. I love a good tub and this is a great tub.

No submersion in water for two weeks minimum

It’s even worse when I stare out at the beautiful pool. That is obviously an infection risk as well. No splashing around in Norma Kamali pretending at social aspirations. Oh yes Istanbul is the new Florence in July haven’t you heard?

At least the nearby Bosphorus is packed with cargo ships, I have no temptation when seeing the beach to have a dip in the water. I doubt diesel fuel is good for healing.

The highlight of my day is the hotel lounge’s breakfast where there are charming varieties of very Instagram friendly food. It is still in a hotel lounge but it’s a beautiful novelty.

Tea, pomegranate juice and rose honey yogurt

I’ve been annoyed by the variety of influencers who are also healing around me. There are any number of different plastic surgery and aesthetic patients in the guest mix.

If you think a week of blogging about an emergency sepsis slice job on some indelicate bits, imagine how weird it is to see an entire family getting plastic surgery and their daughter (I think?) is live-streaming most of it.

I’ve seen more puffy lips than I have fish on this trip and that’s my fault. I don’t have the strength dress up or walk to the Michelin starred seafood restaurant. Maybe that’s more for the elective surgery types and the emergency infection girlies have just enjoy the tiny yogurts.

That’s almost a bagel and lox set up right?
Categories
Biohacking Medical Travel

Day 1656 and Recovery from Recovery

I’m waiting on pathology lab work but I’m mostly supposed to be resting and healing after surgery on Friday. I feel like crap and I’m scared.

I have no real basis for making judgements on how well I am healing as you can’t just upload imagines of your genitalia adjacent wounds to Claude or Perplexirty. Even Grok is like “no”when you trip the icky lady bits warning sensor coding.

Thankfully it being a Monday I was able to get a short appointment at the hospital with the improbably beautiful and well dressed obstetrician who did my surgery. She seems to think I’m fine and healing normally.

I trust a woman who dresses well. But the antibiotics are just making a hash of my mind, my intestines and my stomach.

Bloodletting? Lost in translation

I’m enjoying the headstart of waking up 9 hours ahead of home and 7 hours ahead of the New York market opening. Now if only I felt smart enough to actually work.

The Cipro is just the absolute worst. I feel guilty complaining as I have such excellent care and a comfortable hotel room in which to recover. But I’m struggling. All the back work and emails will just have to wait I suppose.

I feel like a recovering from my recovery might soon be necessary as my mind-body-gut axis is toppling ass over tits as the nuclear winter of 3 separate antibiotics lays waste to once fertile lands for friendly gut biomes. And this is before I’ve even considered whether I have the right drugs. Pathology reports might suggest fungals.

Categories
Medical Travel

Day 1655 and Healing Waters

I am now forty eight hours post operative and I feel like shit. I was warned but I am not enjoying how the very intense antibiotics make my brain feel.

The first five to ten hours after surgery when the local anesthetic hasn’t fully worn off and your adrenaline is still pumping are the easiest. I was smiling and happy to walk myself to the hotel and I was snapping pictures of the Turkish Cipro in amusement. How cool was all of this?

It didn’t stay cool. The first 24 hours are weird as you are still gooy and gushy so it’s tons of clean up and hand done hygiene. You aren’t allowed to shower yet, so it’s just a liminal state of grossness as you wait for swelling to abate and antibiotics to work.

Well, I’ve passed hour forty eight and I’m brain dead. I can’t think straight. The work I was excited to do in bed as I stared out over the Bosphorus was probably a fantasy.

I’m tired. I’m swollen in very tender areas. The idea of showering is simultaneously appealing and too exhausting to even contemplate. I am staring at the lovely bathtub I can’t use. Suddenly all the sources of water submersion are a threat instead of a joy.

We don’t have a bathtub at home so I only get to relax and soak a tub when a hotel and here is a beautiful one that I cannot use

Despite my exhaustion it’s very hard to sleep well in this situation. I need to keep pressure off the wound so it’s all about pillows and angles. I stayed up playing on Twitter where someone asked how a bottle of water for skincare could possibly sell at such a high price.

Right about now as I contemplate my banishment from the pool, the beach and the bathtub I think about how much I’d enjoy the healing waters of a mineral hydrotherapy spa.

Categories
Chronic Disease Medical Travel

Day 1654 and Post-Operative Exhaustion

As I slowly walked myself out of surgery yesterday, I thought to myself “I actually feel much better!” And I genuinely did.

If you have a gentle stomach, maybe stop reading here. I’m fine. I’m on my way to well. And this will be graphic.

I do feel dramatically better having had the “slouching towards septic” abscess drained of infection as well as removal of the initial pearl style irritant (a 3mm deep entirely horizontal hair growing not up but sideways like an underground fracking tube).

I appreciated having the walls of the abscess pulled out bit by bit in a delicate curettage by my silk sundress clad physician. It was all a success.

But post operative care is hard? I’m a mess. I’m exhausted, loopy, and the hotel’s guest services are concerned enough that they are doing me such kindnesses like sending up tea and maxipads. Turkish hospitality comes from a place of genuine kindness and I need that right now.

It’s been a long journey of stupid to end up in Istanbul to get a smart fix. Going from a squishy movable almond sized lump without any pain six weeks ago to a hard plum sized lump was disconcerting enough. Especially having done my damned preventive care visits with the useless Dr Oetkin in Montana.

Have had two days of prodding, poking, squeezing, moving and ultrasounding done in the Mediterranean, I was swollen, feverish, and all hurt to the touch. I was afraid.

How did I get here? How had my next generation IL-17 managed to cause me so many negative side effects even as I was doing better across all biometrics and across quality of life metrics?

No wonder the doctor in Istanbul was so concerned. All the previous doctors had done was make my situation worse though inaction and delay m, and then the action they took made it worse.

Now I have recovery ahead of me. Last night as I went to pee, I realized why they had padded the upper areas of my underwear with maxi pads. I’ve got no discharge downstairs but on the upper bikini area there was no such luck.

I only needed one stitch to close up thanks to the careful work of the doctor, but a lot of goo came out during the surgery drainage and I was warned there was still more to come, though it would taper off.

I gently washed the area with a cloth and antiseptic soap before application of antibiotic cream (my third type of antibiotic). I gasped as I saw the first lightly red sticky watery fluid gush out rapidly around the stitch. It was so fast and there was so damn much. Bodies are disgusting what else can be said?

I mopped up with a clean moist towel and applied a thick layer of antibiotic cream, but I had learned the deflation of the abscess wasn’t quite done. The swelling, I was told, would take a week or more to full abate.

I’ll be sleeping this off for the day but if you are in Montana with an autoimmune disease and need a dermatologist I’d recommend you stay away from Dr. Tara Oetken at SkincareMT. Without her hasty heuristics and lack of conviction I wouldn’t be in this mess.

Categories
Medical Travel

Day 1653 and Slicing Then Cipro

Well it’s been exciting day for me and I may be a little bit high (alas not the fun or good kind) as I just had an abscess surgery in Istanbul.

I’m waiting on the lab work for the culture and pathology but from what I saw come out of the abscess it can’t be anything good as the doctor prescribed multiple antibiotics including Cipro while we wait for results.

Bimzelx has some gnarly side effects and I don’t know how much more slicing up infections I can manage for an immune suppressant biologic. My biometrics are better but 2 eye infections and one abscess surgery that almost went septic isn’t making me feel great about the balance of value on the drug.

I can’t say enough nice things about the Turkish medical system and their treatment of foreign “tourist” patients. It’s my second time this year having my Bimzelx side effects treated here.

A lovely interpreter and patient advocate was with me the entire time. The physician was so empathic. She was astonishingly effective in technique and her whole being moved with an efficient alacrity that was admirable given she was in a floral print silk sundress, high heels and pearls.

Imagine being so good at your job you can squeeze infected goo out of another human that you do it in white silk? I was impressed.

She on the other hand was not impressed by the care I received in America.

“They knew you were immunocompromised and did not insist on an ultrasound and immediate treatment?

What do you mean they said wait and see?”

“I don’t believe the other doctor thought it was a swollen lymph node given the clear folliculitis literature warnings for your biological drug.”

I was headed straight to sepsis and in her mind having multiple doctors leave a high risk patient to “put a compress on it and wait and see” when it was easily 3mm below the skin was malpractice to her.

Quite the big abscess eh? And look at that irritating side ways hair in there so deeply buried

And indeed I am on the kinds of antibiotics you’d expect someone close to septic shock might be on. I am amazed to be doing as well as I am. But I am frankly furious.

I tried to be responsible with preventative care and was ignored. I just kept on going until the small lump became a large lump. Then it rapidly became so swollen and infected it couldn’t be ignored. What a metaphor for the American healthcare share. You try to be responsible and are shown the door till it’s a crisis. And then they can’t even fix the crisis.

On the bright side I’m in a lovely hotel next to the hospital receiving excellent care. I could afford to fly in and get it taken care of without any worries (for the curious this was $2,000 for surgery and follow up care). I was in a very space age room after being in surgery and all my intense antibiotics were hand delivered to me. Now we wait to see what the labs say.

A private recovery suite