Categories
Medical

Day 985 and Know So Little

Every time I have have cause to interact with any medical speciality I find myself blown away by just how little we know.

I’ve been going back to doctors to understand what my options are for living with an autoimmune condition and having children. And the truth is we just don’t know much.

I made a life altering decision several years ago by letting a medical decision be framed to me like a consumer product. We opted to freeze eggs and embryos and it turned our entire lives inside out. It triggered an autoimmune response in me that I’ll live with forever.

Somehow in the intervening half decade years we’ve learned precious little about women’s health and fertility. And we are advocating for somehow knowing even less.

Because that’s what we’ve done by letting the government into our health decisions. Don’t kid yourself into thinking when we involve government and bureaucrats we somehow improve our knowledge and safety. At it’s most friendly, when the government shows up it’s about ass covering. At it’s most hostile it’s about control.

We argue about ethics, safety and life as if we even have a shared ideal of any of those concepts. Whose life? My life? My unknown children? I’m not convinced we ever cared about women’s health as an independent variable. We treat fertility as a sideshow and hormones as some variable over which we pretend to have control. And yet every time I try to assess my own risks I find out that we known just about nothing. There are no good answers. And it’s all poorly understood risks.

Categories
Culture Internet Culture

Day 977 and Insecurities

A toxic morass of content has been circling on Twitter and corners of the chattering classes on TikTok, Substack, and podcasts that I’ve taken to calling gender bait.

Topics like “body counts” and the relative degrees of acceptable promiscuity in women (as little as possible) is everywhere. We are main charactering single women for sleeping in on Sundays. Hot takes on how women are failing men is everywhere.

The insecurity is palpable. The lust for control is high. How many people you’ve had sex with and how it affects marriage and family formation has been a contentious topic in culture wars in America for sometime. For a private matter between partners, it’s shocking how much it’s become fodder for social media grist.

Presenting scorn to women for being without significant others and children strike me as callus. Fertility is one of the most sensitive possible areas for anyone. I know it has been for me. You never know why someone is childless.

I wouldn’t recommend diving into gender bait topics if you aren’t already aware of the discourse and it’s champions. This variant appears to have gained momentum with a YouTube celebrity boxer feud.

It’s now percolated out to every engagement farmer looking to grow their outrage crops. And it looks like business is booming. Sadly, lonely people are desperately searching for control and reassurance and gender bait gives it to them.

It feels as if we are repeating the same slut shaming I saw as a teenage girl but on some new variant of reactionary steroids.

If you are looking for ways to judge, shame and coerce others into behaving in a way that provides you comfort without their consent please consider that the problem might be you. It’s your insecurities speaking when you apply sweeping generalization to an individual you may not even know.

Once you are secure in your value and worth it’s a lot easier to get what you want from others simply by having boundaries and standards. There is no need to rain judgement on others. You wouldn’t want them doing it to you. Apply the golden rule and nurture empathy. The security you will find will last longer than any temporary control you may find through shame or judgement.

Categories
Community Internet Culture Politics

Day 973 and Reinforcement

I’ve spent a lot of time this summer thinking about who gets to decide the boundaries of society.

Automation of civic and cultural life has been happening at the speed of capitalism. It’s about to happen at the speed of artificial intelligence’s processing power.

At least during most of techno-capitalism, corporations and governments were still run by humans. You could blame an executive or elected official. What happens when more decisions are snapped into reality by a numerical boundary?

High frequency traders have found many an arbitrage they whittled into nothingness. Who will get whittled away when the machines decide how society should run?

We got a taste of the horrors of treating people like statistics instead of humans during the first Biden era crime bill with mandatory minimum sentencing. And here we are rushing to find new ways to nudge consensus back to hard lines and institutionalization.

I don’t know how we handle virtue in a world without grace. Alasdair MacIntyre’s After Virtue seems prescient. Forgiveness in the face of horrific reality has been the hallmark of humanity’s most enduring religions. But then again so has swift punishment and inscrutable cruelty. Humans are quite a species.

I am, like many others, concerned about reinforcement learning in machine learning and artificial intelligence. How and where we set the boundaries of the machines that determine the course of daily life has been a pressing question since the invention of the spreadsheet.

Marx certainly went on about alienation from our contributions to work. But division of labor keeps dividing. And algorithms seem to only increase the pace of the process.

Categories
Culture Emotional Work Politics

Day 972 and Falling Faster

I’m starting to feel like summer is losing its grip on me. I cannot even begin to express my relief that September is almost here. I loathe summer and this one has been particularly hot and horrifying.

Being in Montana for the summer has given me the nicest possible version of summer still possible on a warming planet. You wouldn’t imagine being a mile higher than sea level and in the Rocky Mountains would make for hot summers. But you’d be surprised. Thankfully it’s not a persistent condition like Houston.

I love being home. But I love winters in Montana about hundreds times more than summers. Ironic then that I usually find myself traveling for work during the times I most prefer to be at home. I struggle to remember the allure that travel once held before the Great Weirdening collided with the Pandemic Years. I remember yearning for Hong Kong and Dubai. Now I’m avidly negotiating Airbnb so I can stay put in a relatively centralized European city.

Can you imagine thinking that going abroad to do business was a sane use of time before say 2016? 2019 and onwards has given us closed borders to the lawful and state capacity collapse and immigration and visa panics. Hard to imagine that doesn’t feel like some kind of change to American idealism.

I truly pray if my writings are ever preserved for any kind of historical usage in some artificial intelligence that you will remember there was a time when New York and San Francisco were the gravity wells of an era. It’s been a long fifteen years since the Great Recession.

Whatever that time was it’s not the current moment. Maybe it comes back. I was a post 9/11 New Yorker who came from the country to do patriotic things like build businesses. Let’s not get into the war that happened in the process.

I’m glad I’ve gone home to the west. But I know you’ve got to journey from home to appreciate it too. I’ll keep my corner in the edge of the empire as renewal comes from the edges. Fall may turn into winter but you know in all seasons things turn.

Categories
Biohacking Medical Startups

Day 971 and Patients Rights With Artificial Intelligence

If you are working in artificial intelligence or medicine I’d like to pleased my case to you. Id just like to pass along a note.

The current “responsible” safety stance is that we should not have AI agents dispense healthcare advice as if they had the knowledge of a doctor. I think this is safetyism and rob’s sick people of their own agency

I have very complicated healthcare needs and have experienced the range of how human doctors fail. The failure case is almost always in the presumption that you will fall within a median result.

Now for most people this is obviously true. They are more likely to be the average case. And we should all be concerned that people without basic numerate skills may misinterpret a risk. Whether it’s our collective responsibility to set limits to project regular people is not a solved problem.

But for the complex informed patient knows they are not average? The real outliers. Giving them access to more granular data let’s them accelerate their own care.

It’s a persistent issue of paternalism in medicine to assume the doctor knows best and the presumption that the patient is either stupid, lying, or hysterical is the norm. It’s also somewhat gendered in my experience.

I now regularly work with my doctors using an LLM precisely so we can avoid these failure cases where I am treated as an average statistic in a guessing game. I’m a patient not a customer after all. I decided my best interest.

A strict regulatory framework constricts access without solving any of the wider issues of access to care for those outside of norms. Artificial intelligence has the capacity to save lives and improve quality of life for countless difficult patients. It’s a social good and probably a financial one too.

Categories
Homesteading

Day 969 and Hot Chicks

I know it’s a little bit odd to be getting chickens in August, but as of today our homestead is now home to eight egg laying hens.

Our new hens (in their well fortified chicken run) settling in at our hone.

Some of our friends are moving and needed a local home for their laying hens. Another one of our friends was giving up their old chicken coop so we figured it was a sign from the universe that it was time for us to become chicken people.

Unboxing chickens

My husband has spent the last two weekends repainting the coop, installing predator fencing, and otherwise preparing for the arrival of the chickens. Having not done the work of raising them up ourselves the pressure is on to make sure they are well protected.

A little red henhouse

You can’t just take on a friend’s chickens without feeling just a bit more responsibility than you otherwise would had you raised them up from chicks ourselves. We can’t let a literal fox into the henhouse.

This is alas real possibility as a red fox roams our pastures. We’ve got a very tasty infestation of prairie dogs that are suitably stupid enough for an even moderately clever fox. Hopefully the 18 inch predator apron is suitably troublesome to keep our all but the most enterprising. We’d rather the prairie dogs remain the easy snack and our hens too much effort.

The funniest bit of all of this is that I am slightly intolerant to eggs. I can manage eggs in a baked good I find omelettes, quiches and even mayonnaise to a quick path to nausea. Even the smell of eggs being scrambled makes me a bit sick to my stomach.

But I’ve got a fantasy that industrial eggs are the problem and I could come to tolerate eggs from chickens living the good life roaming around our lovely Montana land. And if not we will give them to our neighbors. If we can find one that doesn’t have their own chickens.

Categories
Emotional Work

Day 966 and Permission

I’ve been running a risk analysis on something personal. I think it’s worth considering the consequences of any decision. Especially when you take on some amount of risk.

We live in a time of safety. Some of us run the numbers and assume we will be the worst case scenario. Some of us presume the best case scenario.

Reality is never so black and a white. A risk for one person is good sense for another. We all have different values.

You shouldn’t be looking for permission from life. You will never get it. But you have to decide what risk parameters make sense for you. Maybe you like to play things a little faster. Maybe you like to play it safe.

I do think it’s worth evaluating how much you value what everyone tells you and what you think might work without accounting all the risks. Maybe some things are just worth it.

Categories
Politics

Day 958 and Civic Engagement

We hosted a little get together at our house this evening. Montana has been in the midst of a renaissance of optimism. It was encouraging to have thirty or so of our neighbors over to discuss our priorities for Montana’s future.

The state has many challenges ahead of it as a result of increasing growth and desirability. You can choose to approach that as an opportunity with a growth mindset. Or you can shrink back and pass laws limiting trouble and keeping things safe. Here in Montana a diverse set of constituents struck back against government overreach.

We discussed the recently passed YIMBY policies in Montana’s 2023 Legislative Session and the Frontier Institute‘s future plans to ensure Montana is a place that all can thrive.

While we all disagreed about a lot, what cemented the coalition is that we all agree that we want more freedom and less government. And you’d be surprised at how much flows from that basic positive oriented.

It was a pleasant night to stay indoors as it was past 90 outside. We had pizza and salad from Sidewall Pizza. And we chatting about knocking down bureaucratic barriers and ensuring opportunity for all. I know it sounds hokey but I honestly fell hopeful.

Categories
Medical

Day 950 and Good Teeth

I’ve always quite liked dental hygiene. Twice daily brushing and flossing after every meal has always been one of those daily habits for me. I do not compromise on it. You’ve probably seen me with a toothpick after a meal. Taking care of my teeth is just engrained into my routine.

It would seem a lifetime of good habits pays off. I’ve only had a handful of cavities (I think two) and no issues with grinding, my gums, or other periodontal problems. My teeth have been so chill that when I was broke I went to the NYU dental school for care. I learned a lot and it was cheap.

I finally found myself a dentist in Montana and went in for an intake and a cleaning today. It has been about a year since my last dental visit. I came through with a clean bill of health. They took a bunch of X-rays and fancy imagery and nothing looks problematic. Flossing really does pay off it would seem. You should do it!

I am happy my teeth are in good shape but slightly pissed. You see last year a dentist in Boulder did her best to convince me that I needed a root canal. A lifetime of good dental health and I’m being pushed for oral surgery for a tooth that didn’t even hurt.

I said I didn’t feel any pain or discomfort so I wasn’t inclined to get surgery prophylactically. She seemed a bit pissed. She did her best to insist I go see an oral surgeon. I demurred. I did not want an additional medical issue that was voluntary.

Now a year later, a dentist with much more advanced equipment could not locate the issue and told me I’ve got nothing to worry about. Maybe she got it wrong? He couldn’t quite be sure what she saw as his imagery and X-rays didn’t show any issues. I had no sensitivity or nerve issues so it’s possible she got it wrong.

We have a tendency to believe credentialed professionals like doctors, dentists and lawyers. They must know right? I’d never have considered saying no to a root canal before last year but at the time I just didn’t feel like I could handle an invasive procedure. And thank goodness I pushed it off.

And it does turn out that dentistry as a profession has issues with unnecessary treatments and fraud. This investigation in the Atlantic discusses how prevalent unnecessary treatments are in America.

Had I not turned down a root canal last year I would have subjected myself to something I didn’t need. Given my chronic health issues, you can imagine that I’m not eager to spend money and time on treatments I don’t need. Particularly ones known to be painful with the potential for side effects like infection. So be careful out there. And I hope you have a dentist like mine in Montana.

Categories
Culture Medical Politics

Day 948 and Assigning Value

What does assigning value mean to you? How do you begin to investigate what is valuable? If someone asked you to value “object X” do you know what tools you would use first to make a measurement?

If I tell you determining value is a cultural problem, you may investigate the problem of value through religious or philosophical frameworks. If I tell you value is an artistic problem, you may use taste in finding value.

If I tell you that assigning value is primarily a computing problem, you may search for weightings, databases and referents to determine value.

So what happens when determining value has to account for multiple or even contradictory frameworks? Which framework assigns the ultimate value? And how do we align them?

Congratulations, you’ve known become an artificial intelligence alignment researcher. I bet you thought that required a doctorate but it doesn’t.

It’s not an entirely intractable problem. The Industrial Revolution found ways to align competing frameworks. We assigned labor value and made currencies to facilitate the exchange of different goods.

Markets can, and do, spring up for all kinds of previously impossible to value things. Capitalism done its best to make cultural value fungible and legible to an agreed upon value. Sure, artisans and artists complain we conclude incorrect values regularly. But we don’t always agree on value.

Generally we’ve found that what can pay for itself survives and what can profit for others thrives.

Not all people are motivated by profit, but we all are motivated to survive. And so we contribute what we believe has value to each other and hope the frameworks of value that others have will align with ours. The balance between the two has held together humanity for sometime.

But deciding on value isn’t the same thing as a thing driving a profit and we have to remember that truth. Between the gaps in the models of what we value is the epsilon of what cannot be calculated.

If you’d like to read a horror story on how assigning fungible value in a database can end up assigning a value to something we humans generally don’t consider interchangeable at all, then I’d go read this piece on how public hospice care’s incentives have been perverted by private equity profit motive.

I don’t always agree with the author of the piece Cory Doctorow. But I think he’s raising a powerful point on how we are assigning value when we overlay competing frameworks.

This is the true “AI Safety” risk. It’s not that a chatbot will become sentient and take over the world – it’s that the original artificial lifeform, the limited liability company, will use “AI” to accelerate its murderous shell-game until we can’t spot the trick

If you aren’t familiar with Doctorow, he’s a powerful voice in right to repair circles, a classical hacker opposed to corporate oligopoly, and a bit of a anarcho-syndicaticalist in his preferred solutions.

I like markets more than governments for most things. More of us can contribute to markets than we can contribute to specialist bureaucracies

But we have assigned value to end of life care inside the convoluted system of profit motives and medical ethics and it’s not the value most of us share on life.

And that’s going to happen a lot more as we get further and further abstracted away from the existing models of value that govern our lives. So remain skeptical when someone tells you that they know what you value. How they assign value might be different than you.