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”
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.
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
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.
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.
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.
I’m a mess and somewhat scared. This abcess saga has grown from dismissive preventative care visit (which I did did out of an abundance precaution) and ended with me meeting a general surgeon at a Turkish medical tourism hospital tomorrow to discuss labs and my ultrasound. It’s my second time this year so that’s quite an endorsement as a revealed preference.
I was afraid she would be a box checking paper pusher afraid to give an opinion. But maybe younger doctors are afraid to treat that way given our system. I needed to know is it worth getting a clearer diagnosis before it is a crisis? Is imaging necessary? I have a set of drugs I take with these specific side effects. Given that risk profile and nuance at hand needed the interpersonal relationship that would guide me.
I do endorse SkincareMT’s cosmetic practice, and Addison in particular is fantastic, but their healthcare wing is clearly designed to extract maximum Medicare dollars from Montana seniors.
My failure to get an ounce of prevention means I’m flown to Istanbul to attempt to get a pound of cure. Don’t worry I was already in the Mediterranean. Not in the way way some think though.
Yesterday we found out by pulling teeth that I had a problem. It’s clear I need this excised and quickly. The ultrasound is gnarly. Drainage, removal of the foreign object, and potential curratage to make sure the walls of the cyst are removed forever are what is needed.
The sprawling medical tourism complex in Istanbul is amazing and I trust them more than any other system or talent pool on the planet right now. What they have built is an incredible achievement and in challenging conditions.
Doctors who listen, who educate you on your options, and most importantly are up to date on current research and global innovations so don’t give you glassy eyed stares when you mention a new medication like a next generation IL-17 inhibitor it’s exotic side effects. American doctors like that are rare and their hands are often tied by our horrific mess of state failure and lack of market innovation.
I’m relieved to have choices like “general surgeon or gynecological surgeon” and texting discussions with my case lead (a full time liaison for you and your family on the entire case) on how we will handle excision and culture pathology.
It does feel like I’ll have good choices. But it also seems like I booked less time than is necessary and I don’t know how I feel about that. A week of waiting on labs in a hotel while in pain is scary. Sure I can work and be productive and maybe even do some tourism but I just want this shit sliced out, an IV of the right antibiotic that will work and some sleep.
I’ve been doing some crazy bi-phasic sleeping as the Mediterranean is hot as hell from noon to 10pm. So I’ve been doing a bit of staying up late and sleeping in to avoid the heat. It’s not clear how much it’s messing with me yet because I’ve got all these odd infection fever doctor nonsense. A quick surgery and some answers can’t come fast. Thankfully I’m at the crossroads of empires.
I don’t think of myself as someone who struggles to be heard. I am loud, I speak up, I have a large social media platform and I don’t mind being impolite if I need to be heard.
And yet, the incidents where I am ignored, dismissed, or even outright insulted seem to be on the rise. I follow the rule of three assholes generally so I have to wonder if it’s me, but nothing makes you wonder more than getting really bad basic medical care.
No one can agree what doctor is right. It was a gyno who sent me to a dermatologist who wanted me to go back to a gyno last month.
Now I’ve got a gynecologist who wants me to repeat the conservative management program I’ve been doing for months.
Which hasn’t worked, but she is implacable in her iron lady demeanor. Bactine and warm soaking. Maybe she does understand the immune suppression part? Thankfully I come with receipts.
I carry my patient charts, a synopsis of my diagnosis, the side effects of drug treatment and a short “why I am here and for what.”
A radical change in size & texture on a cyst with no response to antibiotics is exactly what the last four doctors told me to watch for as it signals a need for active management.
Now this shouldn’t need years of bloodwork (which I brought and charted for them) or a paragraph on high risk patient needs or a history of my main medical issues and the rationale for why I am requesting imaging. It’s an abscess that’s growing so figure out what kind, remove it and then we figured out why.
And yet it does require all of this to get anywhere. I spent 5 hours in a doctors office today and two hours in one yesterday.
I’ll waste another two days while they will run new bloods when I have a fresh set from a week ago. And still they fought me like hell on imaging.
Which is the only way to decide on the course of treatment. Instead I should do warm compresses and iodine for a month (sorry the first four months not count?) The temptation to unleash is overwhelming.
It was a fight. I got an ultrasound. And I did get a diagnosis and it needs to be carried out asap. Figuring out a doctor and a recovery plan I trust is going to be hard but that’s a tomorrow problem.
Abcess. Filled with bad shit. There is a hair in it acting the part of irksome pearl. 17×13 mm diameter. 3 mm from skin so it’s not small.
I’ve been having some side effects from my new biologic injection Bimzelx. Whenever I travel, I do a spate of doctors appointments before I leave so I can be adequately prepared for likely scenarios. Be prepared is my motto.
The dermatologist appointment was so horrifying I’d recommend you stay away from Dr. Tara Oetken at SkincareMT as it was such a degrading and frankly useless experience. I do fully endorse their cosmetic practice and Nurse Addison.
I ended up at the dermatologist as the gynos were like “uhhh it’s on the outside and involves no reproductive organs so you need a dermatologist” and then dermatologist was a bit “its close to your vagina ewwww icky scary did you go to the gyno?”
Yes dear that’s how I got sent to you, this ain’t no picnic for me either.
I was embarrassed but the cyst/enflamed lymph node had been unchanging for a few months (not growing or differing in texture but malleable & squishy). So I checked in, was mostly embarrassed, got no direction that helped and left feeling degraded.
Given my previous issues with meiborn gland infections on my eyelids, I’d been instructed to keep a close eye any side effects common like folliculitis that is common Bimzelx. This was clearly a complex side effect that I’d had multiple issues with all year. The next step was imaging but I could get zero sense in the very short visit of whether or not the doctor felt it was warranted. “It’s up to you” sounds nice until you want a doctor to give you their professional advice.
Well now I’m in a foreign country and the almond sized squishy bit has ballooned in just four or five short days to thrice or quadruple its size, it’s now quite firm and not easy to move around or squish and I’ve got to do the same dance all over with doctors ago don’t speak English.
Thankfully I have artificial intelligence and an interpreter. I’ll get the imaging ultrasound done (AI says get it done immediately based on the differential it did) and then we can see if it’s a cyst or a lymph node that needs an I&D. I started antibiotics 3 days into this ballooning and it has done little to fix it so let’s find out. Hopefully I don’t need someone lancing and squeezing out stuff in a foreign country. But if I do need that I may pop a flight to Istanbul for that.
I’m fairly well branded as a doomer, so I hate to break ranks with my preparedness brethren, but I’m absolutely sick of the powerful using fear as a tool to control people.
It isn’t a new problem. This is the go-to tactic our species has used insofar as we can verify with written history.
Any time we experience a change of circumstance, material reality or technology, we hear the braying of the old guard and the panic of the precarious.
People complain for two basic reasons. If you are doing well why change a system that benefits you? If you aren’t successful but equally aren’t comfortable with change, then you resent anyone who benefit from change. Fear and resentment are the shadows of the human soul. Envy is the sin of our time.
I personally feel I’ve invested a lot in doing my part to educate people on risks from climate to currency and compute.
I am politically involved in crypto policy as well as fighting fear in artificial intelligence. I helped pass the only piece of AI legislation in the world focused on liberty. I want people to have a choice for how they engage in a virtual future.
I’m not just a nerd about being prepared either. I’ve done my wilderness first responder certification. We left Colorado for Montana for a host of reasons but top of them was a better and freer climate both literally and figuratively. We live this way because it’s a great way to live and when change happens we are hoping to be resilient.
Having all that in mind I was offline for the 4th of July long weekend as it has been a busy year on all of those fronts. So I was sleeping it off. To come back and see a spate of conspiracies over cloud seeding technology was like a punch to the gut. And I’m already feeling like I’m on the outs with some community when it comes to technology and my intentions.
I’ve only met Augustus Doricko of Rainmaker a handful of times but his circle of young technical Christians dedicated to building solutions to our modern problems are why I remain optimistic in fighting for technology and the people who build it.
These kinds of communities of builders exist in an archipelago of anarchic communities across digital and physical worlds that interlay across many systemic problems. These places will succeed no matter the future we face because they understand it’s necessary to build. That is will.
I’ve been lucky to have been the first investor in Isaiah Taylor’s Valar Atomics. He is a part of this builder world and of a part of a clan of physical builders. He faces decades of fear with a cheerful heart. I believe in his vision for energy abundance.
Nuclear energy was buckled under an old environmentalisms that was a proxy for a fear of a future whose risks, however minimal, were too scary to embrace for those in charge and the public they controlled.
I believe in a vision of a better America (and a better ecosystem and a better economy) because we embrace change to build materially better conditions.
I have frankly seen too much pessimism from older generations and cynical power brokers to be silent. The complicit rancor is slowing us down and there is nothing Christian at all about standing in the way of delivering better conditions to our fellow man.
Paradise is lost. In a fallen world we work to do what we can. It isn’t the end of the world. It’s already lost. Now we work because we must. We aren’t building an eschatology to replace the Lord. We build because that is what we are called to do by him.
I really spent some time in my feelings today which isn’t exactly how I wanted to spend my day. Though I couldn’t exactly tell you why I don’t expect to feel my way through the day. All real works requires you to balance the intuition of working from one’s gut.
The world is tense and our place in it doesn’t feel assured. Every time we experience a norm change or unsettles the balance of our social order.
It sounds so dramatic but we balance trust with the boundaries necessary to make choices that work for each of our own consciences. Some things are more the basic math of a situation. We need are feeling precarious.
As I do this writing exercise tonight there is a raging Rocky Mountain thunderstorm. They come on with such fury it can take your breath away. These storms are intense and rapid and blow in and out with inn half an hour. The atmosphere after has an uneasy calm. Rage is nature’s game not man’s.
They do drive you inside which is good as I have packing to do. I am venturing off and I’ll be feeling my way through that too. I’ll blow out myself soon and let the world show me where to go.
The good vibes of my weekend have washed out on the tides as I consider a frustrating non-interaction that has grown into anger in my heart as rapidly as a wheatgrass seed grows in an Easter basket.
I am considering the question of honor in the context of closed communities and events. If you go looking, the cat is out of the bag on where I was and with whom, but I don’t yet have personal permission to use a name, so I’ll keep this brief.
I’m in my Worf era
I’ve been called many names in my time and plenty of them have not been laudatory. Dirty shiksa, stupid cunt, and mostly recently, demonic. Everyone being entitled to their opinion, I don’t generally ask for apologies. I do ask that you say it to my face though.
I am a shiksa, certainly “see you next Tuesday” from time to time, but I remain skeptical that I am possessed by anything from Hades or other Lovecraftian horror from the beyond.
But so long as you use my name in the process of insulting my honor, I only request you look me in the eyes while you do it. I can take it. I stand by who I am and what I say.
So I can’t shake the feeling that I was deliberately dishonored by the speaker. And I am actually angry now. I am used to the insult throwing and name calling of Internet living, indeed I thrive in it. I am not accustomed to aspersions by celebrities as I don’t matter all that much. And I certainly didn’t expect it in a small private group.
I fight in that arena under my own banner. I take those punches under my own name. I won’t lie, someone of stature being so upset as to call me evil without felt good at first (how nice to be noticed) and slowly curdled into a fury over the disrespect.
Maybe it’s because I was one of the few women speaking. It was only after much effort he agreed to speak with my male co-speaker and not me (I’d already left). Maybe it was because after multiple attempts at engagement I was refused time and again. Maybe it’s because his gaze remained staunchly averted. Whatever triggered it has now turned to fiery anger.
I think it’s a bitch move to drop bombs and then runaway like a kicked cur when the beast stirs. And I am quite wide awake now.
It is a poor craftsman who blames his tools. Much as I’d enjoy going on a sidequest exploring ethnographies of man and his use of tools, I have an agenda. My honor has been impinged.
At a gathering of eccentrics in Wyoming, myself & a friend engaged in an hour long discourse with our audience on the use of artificial intelligence and how one might practically understand these tools. The talk was more linear algebra than immanentizing the eschaton.
Our explicitly stated goal was to understand the technology stack and its capabilities so the audience could decide for themselves how to use or leverage this tool. The blurb I wrote introducing the topic.
Concerned that artificial intelligence will be a panopticon of horror? Afraid of nerds immanentizing the eschaton? Jon and Julie have your back. Artificial intelligence is neither God nor imminent utopia but merely tools built by the hand of man. A practical discussion of how you can use these new compute tools to concretely impact the work & insight you need in your everyday life. Come prepared with questions, projects, and ideas as it will be interactive.
Our focus was on how these tools are built, what they can do and what they cannot do, and a firm stance that mathematics and compute are not imbued with divinity or demons but reflections of what we bring to them.
Indeed, we have never had more freedom than we do now to shape the weights and biases of these topological models. Our words on the public internet carry weight thanks to availability of fast compute and open source models. Our bigger issue is maintaining the capacity to supply energy and grid capacity. The real problems are human and social, much as we may wish to scapegoat a piece of code.
We were not suggesting a world ending chaos nor were we endorsing its use. We were discussing it as a piece of software and what it could do.
In a surprise to both myself and my co-speaker, the keynote of the evening spent a significant portion of his talk discussing how foolish, misguided and demonic we both were. Now the event has Chatham House rules for outside content or do I’d go into more detail.
However inside the event, the speaker could have done us the courtesy of saying our names when he made the suggestion that we are working towards evil ends.
He did not ask how we related to his positions and how we’d defend our word. At no point did he name us or address us. He merely cast aspersions.
Frankly I had no idea why he thought we were avatars for some kind of suicide squad as I doubt the gentleman is aware of MIRI or the myriad internal fights inside Silicon Valley. It was however insinuated to be true that we are the bad guys. It’s what we do.
I find this to be a cowardly position. If one holds such strong views that one would call two humans with honest intentions demonic at least say our names. We were in the audience listening intently.
So I will protest. In a past era, I feel that these heavy accusations would have been grounds for demanding satisfaction.
I am of the belief that the only way we manage the effects of adopting any new technology that impacts our culture is rigorously debating the merits from engineering to impact.
We are not asking you to trust us. We are instructing you in how to master this tool if you so desire and if it brings value to your life. We share many of the same concerns.
Alas (thankfully?) you are not summoning any demons that were not previously installed on the operating system of your soul. The shadow of humanity can be seen quite clearly in how we engage with the artifacts we call artificial intelligence.
I will continue to insist that insulting our positions without naming us or calling us to account in public is grandstanding. It was clear we were the targets of the criticism. It is poor form.
I’m an American so our manners may be different than others, but we do have them. So put some respect on our names when you say them in your real life subtweet.
We’ve asked to discuss it with him further through our host but he has declined. I frankly am delighted to find that I’ve had such an impact that I cannot even be named when raging against that machine.
One hopes a parlay possible. But it sounds like he would prefer to avoid us. This is of course fair on his part. I am however prepared to defend my positions. We all must be prepared to defend our actions in this age of change.
