All a part of being a physician. My extended family has a couple. Conversations about “you’re obese and your blood sugar will kill you in 5 years unless you take this drug every day”.
And guess what? They say “that medicine is poison, I use tumeric”. Then in a few years they are dead, or blind or have both legs amputated.
Humans make horrible health choices all the time. Maybe the difference is just the scale at this point.
The real question is why have we engineered our environment so unhealthy choices are so easy to make. There are systemic issues here that go beyond individual choices. Social media is also part of the equation and we are now seeing the kind of damage it is doing to the epistemic commons. Everyone believes whatever they want to, safely cocooned in their own media echo chambers. The longer this state of affairs persists the worse things will get. Inability to deal with a pandemic is just the tip of the iceberg.
It's great that this doctor can share his experience but why is he posting this on Reddit? Why isn't this information available from trusted media sources? And for that matter, why aren't there any such trusted sources that everyone can agree is acting in their best interests and providing them with worthwhile and pertinent news?
Democracies can not survive without functional news and media sources.
It's possible to send anonymous tips to reporters. It's not hard. All he's doing with this story is farming fake internet points on Reddit. Getting something off his chest is not changing the systemic causes that made the situation he's currently in. If anything, he's actually exasperating the issue by having chosen to take this to Reddit instead of some trusted media outlet.
They're not obligated to do any of that, you know. And it's ok that they're not.
They didn't frame the post as something that should be bringing about any change. It's literally just a person sharing their story to get a sympathetic ear. Because sometimes humans need that to keep going.
Why would they want to take it to a media outlet where it has an even greater chance of getting out ? Reddits fits a niche blog like culture that allows the out-letting of emotions. Stuff like this are exactly why blogs even exist in the first place.
You don't. You can either proceed to converse taking that they are on faith (and a consistent comment history over time), or not. You're not going to get satisfying confirmation one way or another.
A conversation centered around the identity of the person is much less interesting than a conversation about the contents of their post.
The mention of Q is what makes me think it is fake. My whole family is conservative; I have a German friend who is way out in right field (I love her but she is coo coo for coco pops), and I work with folks who most would consider fringe right. Not a single one of them have ever mentioned Q in a positive manner. As far as I can tell Q is an internet hoax. Yes I know there are people online who say they follow Q, but I just don't know anyone and I only hear about it on the internet.
if you read their comment history, you'll see they're a regular on Q stuff, and the subreddit it's on is QanonCasualties, so it's not weird for them to bring up Q at all.
I think the point the person you’re replying to was making is that belief that there are believers in a QAnon conspiracy theory is actually itself a conspiracy theory. Through that lens r/QanonCasualties is itself a weirdo conspiracy sub.
As someone who has lost friends and family to QAnon, I find your statement ignorant and unhelpful. Your anecdotal experience isn’t even remotely reality. I really really wish it was.
Q is fake, but there’s a whole subset of seemingly rational people who are being sucked into the void of this cult.
The last few years have caused me to be a skeptic. I cannot take anyone at face value any more because the world has become so polarized that it is like people are willing to type anything to make their point stronger. At this point if I do not have intimate knowledge on a subject, and what I do know doesn't match what I am being told, I should be skeptical.
So if you find what I have to say ignorant and unhelpful, so be it. My words are not here for you. If you truly have a life experience with Q then I am sorry to hear that but please understand I cannot blindly accept what you say (As I don't expect you to accept on faith what I say).
So maybe I am in the magic land where the Q never travels, or maybe this whole Q thing is blown out of proportion. I do not know but my ignorant anecdote may make someone else like me ask the same question of why they don't know any Q either.
> So maybe I am in the magic land where the Q never travels
The follow-up is: what is your sociocultural environment? I'm also in the world Q never travel on my mother's side (all conservative, some could be considered liberal by US standards, but right-leaning at least). The far-right conspiracy don't touch them. They are doctors, CEOs (and retired CEOs), insurance VPs. Amongst the younger generation some are also nurses and physiotherapists, or work in marketing. Not one single conspiracy freak. Some weird claims at the beginning of the pandemic, but since one of them worked in the first national Covid "hotspot" and asked us to limit our travel 5 days before any EU government instaured a lockdown, i think any weird reactance was quashed before it could ever change how we acted.
But amongst my friends who never left my rural hometown? We don't have Q out here but this is the same type of far-right/authoritarian ethos. "We are better than the others, but the others have more money/power/education than us. This can only be because of a conspiracy led by [LGBT lobbies/jews/islamists/atlantists (aka pro-Otan/pro-US)] that we need to fight against, else our kind will die".
Conspiracy theories are not reserved to to working class, it is the whole environment that make them emerge. And i'm not saying they are reserved to the right either (hence the "atlantist" talking point), but that their talking points ethos are usually associated to the far-right. Even if far-left figures used the same (Stalin, Mao).
I started a digression on spinoza but that was only muddying the water, so i'm cutting it here.
We can’t know, but a cursory glance at the user’s post history shows that this isn’t some fly-by troll. They’ve been pretty consistent for a long time.
Given the subreddit, I don't think there's much in the way of disguise happening.
I don't find the post itself to be political at all though. It's the recount of a doctor's recent experience being physically assaulted after refusing to treat an unvaccinated covid patient with ivermectin and vitamin-c, believing that the former may be actively harmful to their health, and the latter simply ineffective.
The post isn't political. It only seems political because the rejection of modern science is along a political line.
> It's the recount of a doctor's recent experience being physically assaulted after refusing to treat an unvaccinated covid patient with ivermectin and vitamin-c, believing that the former may be actively harmful to their health, and the latter simply ineffective.
If this doctor believes that ivermectin is "harmful", the doctor was so poorly informed that medical fact was mixing up with something he saw on CNN. The assertion about effective dosage being lethal, in particular, was completely fictional -- I don't believe that it works, but the people advocating for it aren't talking about crazy doses.
Ivermectin is a very safe drug. It is given to millions of people a year to prevent parasitic infections. There is a large RCT underway to see if is an effective therapeutic for Covid-19. We should all hope that it works. This incessant political polarization of science has to stop.
Everything in this reads like a low-quality re-hash of click-bait headlines from the last year, several of which were completely debunked.
Except it hasn't been shown yet to be effective against Covid-19 yet. So why would they prescribe it? The irony is you're saying the doctor got it from CNN when antivaxxers have been screaming about ivermectin for months, without any proof it's effective.
>This incessant political polarization of science has to stop.
Lol. In comments to a post about a doctor venting about being assaulted for not giving into conspiracy theorists demands re: treatment, and people say he's making it "political". Anyone can doubt the veracity all they want, there's 1000 more stories just like this.
> Except it hasn't been shown yet to be effective against Covid-19 yet. So why would they prescribe it? The irony is you're saying the doctor got it from CNN when antivaxxers have been screaming about ivermectin for months, without any proof it's effective.
Didn't I write that I don't believe it's effective? I'm not sure who you think you're arguing with, here.
The point is, this person made a specific claim -- that the "effective dose" would be so high as to be fatal. That claim is so laughable and baseless in fact that it calls into question the credibility of the entire story. No informed doctor would say such a thing. We simply don't know what the "effective dose" is (if any), but we know what other people are recommending as effective doses, and these are not toxic.
When "doctors" go on QAnon forums on reddit, and post things that sound like re-mixes of CNN headlines while making egregious mistakes of medicine, at the very least it should make you question their objectivity, if not the credibility of the claim.
It's pretty easy to understand. The idea is that the recommended doses are demonstrably not lethal. They may or may not be effective. The effective dose (if any) may or may not be lethal.
I don't know enough to evaluate any of the claims, I only wish to note the logic is pretty easy to follow.
I suspect you already understood all of this and chose to misunderstand to ... "win" the argument?
Except what you wrote isn't what the parent comment wrote. If we know what doses other people are prescribing as "effective", then we do know the effective dose. Their immediate sentence before said we don't know the effective dose. And you accuse me of being obtuse. This is aside from the point that there's an effective (and not lethal dose) of Ivermectin for treating parasites. It does not follow that that same dosage would be effective for covid. We have no idea what that effective dose might be for covid, if any. It could be lethal, it could not be. That's the entire point.
We've banned this account for repeatedly and egregiously breaking the site guidelines. Not what this site is for!
If you don't want to be banned, you're welcome to email hn@ycombinator.com and give us reason to believe that you'll follow the rules in the future. They're here: https://news.ycombinator.com/newsguidelines.html.
The reason to prescribe it is to add another test subject to the study. The fact that there isn't a protocol for people to organize a public study of their own bodies suggests a patriarchal approach to medicine science.
People learn faster when they get to choose their own options.
I have a different feel that society simply does not condition people to involve themselves in the world. Society has become a teeter-totter of concern, a cycle of advancing to not having to care to suffering the ruin of having forgott4en what was so hard earned. I can only paraphrase the top quote, for I don't remember it nor who said it, but here's some related concerns,
> 'Society's advancement is measured by that which it may take for granted' I forgot! Help! (until it cant/that fails)
> "Every gain made by individuals or societies is almost instantly taken for granted. The luminous ceiling toward which we raise our longing eyes becomes, when we have climbed to the next floor, a stretch of disregarded linoleum beneath our feet." -Aldous Huxley
> "The true measure of any society can be found in how it treats it's most vulnerable members." -Mahatma Ghandi
But this sometimes requires not just aiding them, treating them well, but re-socializing them, re-educating them, informing them, breaking them out of their ignorance & failings.
To simply say that we must
> [re-]"engineer our environments so unhealthy choices are [not] so easy to make"
feels a folly to me. We must socialize. We must foster an aware, awake, able society. Striving to simply prevent all faults is not how we achieve success; it results in a vision of domineering & the absolute & fixedness: it bespeaks a belief that there is one true path for society & that we need only set it out & all will walk this course. It's singular utopian, a singular destiny, not a polytopia, not letting us many people discover & hunt for our own ends. Imo society must remain a dialectic, a conversation, a hunt. We must encourage growth & awareness & hunts for meaning, without insisting on a systematic & singular top choice.
I don't think social media is a part of this question:
> "Everyone believes whatever they want to,"
is a false Boogeyman, a false god, a Fear Uncertainty & Doubt (FUD), meant to scare us. We have to allow plurality, we have to allow polytopianism, we have to allow many systems, many beliefs. But we can still in aggregate steer towards informed, towards good beliefs, towards healthy ends. Trying to demonize the availability of voices & options- "safetly cocooned in their own social media echo chambers"- just misses the real point: that society doesn't have a progressive vision at large, that basically no one has a real bead on a healthy, progressive, gainful society. Everything is beset by conflict, and we are trying to make choices with very biased, limited, local regards. And there are very few clear paths, very few regardable winners.
For sure, much of what presented in the world is faulty & awful. But this too feels like a part of evolution. Simply wishing for authoritarianism, for everyone to make the right choices, for everyone to accept good dogma in the place of bad dogma: it's a disaster. And I don't think "Everyone believes whatever they want to", I think they have complex experiences which shape what they are most susceptible to, and I think most of us lack good positive role models & experiences to shape us properly forward. The world does not reward the just & righteous, it doesn't promote the healthy: it showcases greed & taking & exploitation, it showcases narcisim & delusion. It shows us an all too recent history of medical abuse & experimentation of our minorities. These aren't social media problems, these are the actual world: the actual evidence of the actual world is unclear, is deeply shadowy, is ghastly.
"The longer this state of affairs persists the worse things will get". Such appeal to authority & Fear. Such terror!!! "Inability to deal with a pandemic is just the tip of the iceberg" it itself a promise of horror & terr...
> The real question is why have we engineered our environment so unhealthy choices are so easy to make.
The combination of freedom, capitalism, and greed. This is why I can't be entirely sure that China's approach isn't potentially longer term sustainable, as much as I disagree with it - it might actually be a better way to deal with the stubborn-ness of stupidity that's so inherent to humanity (to be fair, all these traits must have served us well when Pringles and Pop Tarts weren't cheap and easily available).
Cigarettes. How did they become a thing? What, ever, was their redeeming feature? At least Pringles and Pop Tarts taste nice.
Social media is just a more-efficient distillation of what traditional media has profited from since it began. It's not new human-hacking, it's just an efficiency bump that's actually more facilitated by the internet and pocket-portable devices with access to it.
> The combination of freedom, capitalism, and greed.
Really? Last I heard, life expectancy in the USSR was quite a bit worse.
> Cigarettes. How did they become a thing?
Nicotine. Not hard at all to understand. Personally, I've always liked the smell of cigarettes. I never smoked, because I knew I'd really like it. Cigars, though, make me want to puke.
> deal with the stubborn-ness of stupidity that's so inherent to humanity
Most evil in the world is not perpetrated by evil people, but by good people believing they know what's best for everyone else, and forcing it on them.
Also monoamine oxidase inhibitors, a class of compounds that are effective against depression, panic disorder, and social phobia.
Some think that the absence of the MAO inhibitors are why nicotine replacement therapies (gum, patches) aren't really all that great at getting people to stop smoking.
> Was life expectancy in eastern block states worse if you correct for wealth?
I don't know. But I do know that people were much worse off economically in the USSR than in the US. This impacts longevity.
> They had pretty good doctors as far as I know.
I recall reading in a thread on Chernobyl where people who lived there at the time of the disaster were commenting. One comment stood out - root canals were free, but there was no anesthetic available. Having had a root canal myself, I can't imagine sitting in that chair for several hours getting drilled without anesthetic.
Life expectancy wasn't the topic, the topic was "engineered our environment so unhealthy choices are so easy to make." and I stand by my answer. No specific judgement either, just cause and effect.
> believing they know what's best for everyone else, and forcing it on them.
Agree, to an extent. Forcing things on people is required of a functioning society. Government and laws and whatnot.
I genuinely don't know where the lines should be drawn on the entire spectrum. Law of unintended consequences and all that.
> Forcing things on people is required of a functioning society.
The government's proper role is to prevent people from using force on each other. It is not forcing things that the government imagines are good for people on them.
For example, I believed for decades the advice from the government that margarine was better for me than eggs. That turned out to be backwards.
> The government's proper role is to prevent people from using force on each other. It is not forcing things that the government imagines are good for people on them.
I don't think you can necessarily separate those two things from one another so simply, except in the most extreme of examples.
> For example, I believed for decades the advice from the government that margarine was better for me than eggs. That turned out to be backwards.
I'm just going to assume you chose a bad example here. There's no force at play, you're free to choose your thing, you can even have both at the same time. Freedom!
I'm sure the original comment is merely a summation of the conversation rather than its entirety. The point I get from the above, is that it doesn't matter how, why, what, when of the conversation, recommendation, reasons, root causes, treatments, lifestyle changes - they's goin' stay the course, right over the cliff.
Research shows that nothing doctors recommend has any effect on weight loss except bariatric surgery. This has been shown over and over again in every study. Doctor moralizing is pointless, people know they are supposed to be eating right.
Every legitimate long term study of non surgical weight loss shows that it doesn't happen for the vast, vast majority of people.
1) ["In controlled settings, participants who remain in weight loss programs usually lose approximately 10% of their weight. However, one third to two thirds of the weight is regained within 1 year, and almost all is regained within 5 years. "](http://www.ncbi.nlm.nih.gov/pubmed/1580453)
2) Giant meta study of long term weight loss: ["Five years after completing structured weight-loss programs, the average individual maintained a weight loss of >3% of initial body weight."](http://ajcn.nutrition.org/content/74/5/579.full)
3) Less Scientific: [Weight Watcher's Failure - "about two out of a thousand Weight Watchers participants who reached goal weight stayed there for more than five years."](https://fatfu.wordpress.com/2008/01/24/weight-watchers/)
4) [The reason why it's impossible seems to be that although calories in < calories out works, the body of a fat person makes it extremely difficult psychologically to eat less.](http://www.nytimes.com/2012/01/01/magazine/tara-parker-pope-...) This is borne out by the above data.
Moreover, you won't find any reputable study on the web where the average person lost 10%+ of their body weight and kept it off for five years. Not even one.
There are products and studies now with Liraglutide and semaglutide, which show consistent and maintainable weight loss, but neither has been on the market for 5 years yet afaik, and the longest study only ran for 2 yearsit seems. Though it seems likely sustainable results from a 2 year study will hold for 5 years.
Permanent lifestyle change is never easy. It would be great if it were a one-time thing that you could be done with, but for most people, it's a constant mental strain for the rest of their lives.
It's not impossible; some people do it. But it's not easy to change how you think about food and your body, especially when you're surrounded by your old habits every day.
I’m talking about irreversible physiological changes caused by getting fat that don’t reverse after you lose weight. This is what makes keeping weight off after losing a bunch harder than maintaining the same weight if you’ve never been fat to start with. Things like damage in the hippocampus preventing normal leptin signaling. Once you’ve gotten fat, you’re pretty much fucked for life, even if you reverse the behaviors that got you there.
My dad developed a spare tire in middle age. His doctor sent him to a nutritionist, who listlessly gave him a nutrition plan and explained it to him, and scheduled a followup in 3 months.
He returned in 3 months, and shocked the nutritionist is he was exactly on the target weight and had followed the plan. She remarked that nobody had ever followed her plans before.
He never regained the weight.
I've seen statistics that only 5% of dieters keep the weight off more than 5 years. It's not impossible, but it is unusual. I've known a couple others who've done it, too.
That's a refreshing success story, thanks for sharing.
I suspect for some people they just gained a little weight cumulatively over time due to a slightly fattening eating habit, and for those it's probably not that big an ask to change/fix.
But for many of the overweight/obese people I know, their eating is a straight up dysfunctional drug abuse-style addiction. Predictably it's as difficult to change these behaviors as it is to get a drug addict to quit their drug of choice.
In many ways it’s more difficult. With drug addiction you have the ability to quit cold turkey and avoid the stimulus, with food addiction you still are forced to partake to live. There are posisble things like completely cutting sugar, or switching to an incredibly regimented diet that can act similarly but…in the end food is a massive part of culture in a way even alcohol is not. I’m sure food issues are some of the hardest to deal with.
I don't disagree, and find it worth appreciating how blurry the actual lines of separation are between food and "drugs". Coffee/tea, Cheese, Chocolate, Nutmeg, sweets in general, they activate similar mechanisms and reward systems to "drugs".
The whole dogmatic war-on-drugs attitude creates this imaginary boundary around "food" which for many I suspect green-lights abuse of "food" because it's not "drugs".
It makes me wonder how much our societal obesity problems would change if the prevailing attitude towards drugs became more factual and nuanced. If people understood better that cocaine isn't as problematic as psilocybin in terms of addiction, maybe they'll also start thinking more critically about candy bars vs. oranges. Perhaps my optimism is showing.
I’ve been struggling for years too in my 20s. I suggest reading ‘The Hackers Diet’ by John Walker. It gives you a systems view of diets. The most useful insight for me: setting a weight loss goal based on the fact that a kg of fat is 37 MJ of energy. Want to lose a kilogram a week? You have to make up that 37 MJ deficit then. Ie. I need ~13 MJ of energy per day to subsist (calculated using an online tool). I subtract (37/7 = 5.3) from that daily energy requirement and arrive at 7.7 MJ per day that I can eat. I stick to that intake goal EVERY SINGLE DAY and I lose weight. It helps to keep punching your small energy intake amounts into a calculator (phone or watch) and keeping a running total that way. I’ve gone from 92 to 84 kg in a couple of months and it’s not that hard. Strenuous exercise doesn’t really do much when your energy intake is way too much to begin with. It all starts with the intake. Exercise actually doesn’t burn much energy at all.
Stop eating carbs: bread, crackers, pasta, cereal, fruit, juice, potatoes, sugar, starchy vegetables like beans, peas, corn, no sodas, no alcohol. Once you are at your target weight, you can go back to eating the things that are nutritious, but no junk.
If combined with a confined window of eating, like 11am to 5pm, you'll lose weight faster.
One interesting thing about obesity and bariatric surgery is the changes in the microbiome.
The following comes from a study on T2D reversal where bariatric surgery was one aspect of the study:
“Furthermore, microbial changes in the human gut have been linked to obesity, and surgical alterations to gastrointestinal anatomy have been associated with dramatic changes in gut microbiota populations with reversion from an “obesogenic” to a lean bacterial population [13,14,16,19,23,24].”
It’s a relatively new science and area of study but some of it is fascinating if not hopeful. One in particular looked at identical twins where only 1 suffered from malnutrition finding in all such cases the microbiomes were different between the twins and the malnutrition was successfully treated via the microbiome.
Well, you're going against billions of years of evolution that say "Eat everything you can and put on some extra weight. There might not be any food tomorrow."
Unfortunately, in modern times the days of short rations never come, at least in First World countries.
That drive functions at a neural level way below the level of the rational mind.
People often make poor choices vis-a-vis sexual activity, too, and for much the same reason.
The old drive to eat anything meets an industry of chemists who spend their lives making the food on the shelves as addictive as possible. It's relatively hard to become morbidly obese without snacking on highly processed food all the time.
Most of us under 40 were still raised in cultures where our parents grew up immediately after the war. The concept of "finishing your plate, whether you were full or not" was universal - precisely because their parents remembered shortages.
They passed it on to us before there was a chance to introspect the nutritional and psychological realities of food.
My partner and I are both overweight and we are trying to do a better job with our child - giving them healthy but delicious options, while also not turning any junky food into a reward or a mystery that must be guarded or doled out in careful portions.
So far, we're okay. Not sure how this is going to last once the kid gets into school age...
I'm more or less in the ballpark of 10% of weight lost and maintained in a timeline of 5+ years (although weight is always in flux). I have no genetic gifts - I must keep an eye on the nutrition and training; otherwise, my weight slowly goes up.
If I saw people permanently ban junk/fat/sugary food from their homes, do at least 3 hours/week of complete training (weights and cardio), and not being able to stay fit, I would believe that weight loss/being fit is a serious physiological and psychological challenge.
What I observe though, starting from mid-30s, is that the vast majority of people keeps junk food at home (which is, no wonder, "extremely difficult psychologically" not to eat) and/or doesn't do traning (let alone complete training). And invariably blames it on genetics and aging.
(I don't doubt that there is a minority of the people that has serious metabolic disorders, but that's not the general case)
You should carefully read what I wrote in the context of the parent comment, and see why your comment is not adding anything to the conversation.
In other words, if you're a doctor, go ahead and tell all your patients the above. You will see negligible impact on their weight, so your advice was useless (worse than useless, since you come across as an asshole).
As an aside, conscientiousness/willpower is highly heritable (as much as height and IQ), so if you're especially good at sticking to a diet, that's also genetics.
If it works for 5% of people it is by definition not useless. Bariatric surgery is not without its risks, and I would rather weed out the 5% who respond to the low risk approach before exposing them to the risks and long term side effects of bariatric surgery.
5% is really generous in the data I've seen and posted above, and I've never seen any positive data on just advice. Maybe the data on what happens if you call your patients weak willed losers would surprise us all, but I doubt it.
The data you posted shows that the average person was able to maintain about 7lbs of weight loss without surgery, so it's definitely more than 5%*.
Also, who is saying we are calling patients weak willed losers? Should we not tell patients to stop smoking, or to quit heroin, because they might think that we think of them as "weak willed losers"?
*edit for ambiguous wording: By this I mean it seems to work for at least 50% of people, with the average being 3% weight loss.
The 3% from the meta analysis above was not for a single "best case scenario fitness regime". It was a number calculated by pooling data from ~28 studies with varied methodologies. A significant portion of those studies employed dietary changes alone (no fitness regime).
Lately the medical establishment sounds like it has given up on crafting novel messaging/systems for helping people lose weight naturally, which is preposterously dumb when it is far more safe and effective than drugs when it works.
The problem with studies like these is you only need to know one person who contradicts the claim to know that it's false as an absolute. And I know several.
It more points to the limitations of studies like these than it does an incontrovertible fact. Some people who are highly internally motivated can lose weight and keep it off.
Ignoring the possibility that people have different physiologies that react to these things differently: We’re not dealing with machines, we’re dealing with humans. If only 5% of people are capable of following the advice then we need to find a better method. It could be any number of things that need to be changed, but just telling people to do x and y the way we currently are clearly isn’t working.
[1] is from 1992, [2] is from 2001. [3] evaluates a bad program[fuller2014] based on a worse metric. You find different things in more recent research, e.g.:
As far as the doctor's advice is concerned, focusing on weight loss as the sole outcome is misguided. The typical trajectory of an obese individual is to keep gaining weight; if doctors could even make their patients stop gaining weight, that would already be a major development in standards of care.
It's also important to consider the limitations of the metric. Studies don't evaluate sustained cultural shifts like "do doctors regularly talk to the patients about nutrition", because it's hard enough to track a patient for five years, let alone get a doctor to do blinded controlled interventions for five years. So what the study tests is a controlled diet for a short period followed by a period of unsupervised maintenance (with a recipe book), not the consistent availability of nutrition guidance over a period of years.
It's perhaps more important to note that while the results in adults are quite bad, it has been shown possible for adolescents to drop by more than a standard deviation in BMI after an intervention and maintain this for two years:
Professional interventions for weight loss and/or maintenance aren't infeasible, they're just hard, and it pays to start early. It's not too surprising that older people are more reluctant to change their habits.
1 year data is a lot more variable, 5 year data is still grim. Not to mention this hasn't changed in modern times - even with all the focus on health in modern culture, obesity keeps rising and rising:
"Research shows that nothing doctors recommend has any effect on weight loss except bariatric surgery." Source 2 that you posted contradicts that statement, and notes that the average person was successful in maintaining some weight loss (about 3%, or 7lbs). That means that about 50% of people are able to maintain a weight loss of greater than 7lbs 5 years after a structured weight-loss program.
Source 1 seems to be from a conference, and they don't list specific numbers or cite sources, so I have no idea what "almost all" means.
"5) [The only thing that does seem to work in the long term is gastric surgery." That study says that gastric surgery works, it says nothing about the other methods for weight loss.
The moralizing about food and diet is similar to the moralizing about drugs and addiction: "Just lock up all the homeless drug addicts in rehab for 3 months, and they'll get clean. Problem solved!"
Right, except they'll still be homeless, poor, mentally unstable, or all of the above. Drug use is often the symptom, not the root cause.
It's similar with food. For many people, food becomes the primary source of joy in life. And just like with drugs, the joy shrinks, the high gets shorter, and the health side effects soon start outweighing the benefits. But it's still quite hard to go cold turkey, and just like a recovering addict, even years after establishing a healthy diet it becomes really easy to fall off the wagon.
We can moralize about how starving children in africa have things much worse, but human happiness is contextual to the reality we know. And life in modern western society has a lot of pitfalls, anxiety, and depression. Obesity is in many ways a side effect of people's lived experience.
>Research shows that nothing doctors recommend has any effect on weight loss except bariatric surgery.
This mostly reflects on what doctors recommend rather than blanket discipline failure across a broad population. I can tell you what my local Kaiser recommended for T2D and obesity:
1) they send you to a Registered Dietician who shows you a modernized food pyramid based heavily on grains. Minimize animal fats, replacing with seed oils. 70% calories as carbohydrate.
2) MD flat tells you "you MUST eat 6 small meals a day so you never get hungry."
What was done instead: Time Restricted Feeding, 4-6 hour window, low carb, limiting to mostly keto first half of window.
A1C dropped over 3 points (10.3 to 7) by next labs.
>1) they send you to a Registered Dietician who shows you a modernized food pyramid based heavily on grains. Minimize animal fats, replacing with seed oils. 70% calories as carbohydrate.
Crazy, that's what I would recommend if you want to become obese.
>2) MD flat tells you "you MUST eat 6 small meals a day so you never get hungry."
I guess that MD really wants his patients to become insulin resistant and eventually develop diabetes.
You can't loose weight with the current food system unless you completely abandon it. It's literally impossible based on how the body works. Fad diets and weightloss programs don't work. You must address the problem at its root: How to deal with hunger. This is a hormonal problem.
Everything (hyperbole) you can buy in a supermarket is meant to make you feel full for an hour and then hungry again.
An alternative to surgery would be to just to continuously monitor blood glucose. The patient would immediately know when the food they are eating is messing up their body and the doctor can control the diet of the patient.
The GLP1s have proven to have excellent efficacy for weight loss (and cardiovascular mortality in diabetics). Their numbers approach bariatric surgery (>10% body weight in the obese).
I am facing taking the mountain of pills or die situation right now. I know what the underlying cause was but in reality it is irrelevant to anything now. The event happened and now i deal with the fallout. The cause was not predictable due to lifestyle or anything else. It was simply like being struck by lightening.
So why do i care about the cause again? I dont. it was a non reversible event
In many cases it's not even “that medicine is poison, I use tumeric”, more often it's "I don't care, I'll keep drinking the sodas, eating the chips and not exercising". The folks into the tumeric, herbs etc. are also likely to be more into exercise and eating healthier so they end up with better outcomes not due to the tumeric (or whatever herbs), but because they have at least some interest in their health. The more difficult ones are like my BiL who told me recently that drinking full sugar sodas actually lower his blood sugar.
In my opinion almost all heart surgeries can be avoided with a better diet (no I don't mean low fat). Nobody cares. Especially not the government which lets the food industry get away with giving people food that is engineered to be a health hazard.
Your opinion is so incredibly off base it is borderline insulting as someone who has heart problems that will kill me. There are a lot of us and it had nothing to do with diet
I mean isn't that basically what happened with Steve Jobs?
When he was diagnosed with pancreatic cancer, he decided to forgo the aggressive medical treatment advised by doctors, opting instead of acupuncture & fruit juices.
He got very lucky with the type of pancreatic cancer he had, it was detected so early that surgery would likely have been curative. So sad that it ended the way it did.
Exocrine Pancreatic cancer has negligible 5-year survival rates with the most radical and invasive modern treatments.
Acupuncture and fruit juices are just as effective, with a much lower incidence of side effects. I’d choose that treatment option as well. There’s nothing unethical about palliative care.
Accupuncture and juice is pallatiative care but is accepted stupidly as treatment
Pallatiative care is making the choice to travel to end of the line. I am currently going through making that decision. If i do, bring on the tasty juices and accupuncture to make me feel relieved at the time. But i am not delusional, it's not treatment. It is not going to fix anything or even stall it
> there's a bell curve distribution of risk tolerances and trust in government
OK. With you on that.
> and there can be reasonable people who find themselves on that distribution in a way that makes them more concerned about what they're not being told than the virus
It is at this point they cease being reasonable people.
There is nothing to this. Please do not spread the mindless anecdote about Fauci.
In the initial DAYS of the pandemic, it's true that he said that he didn't see there was a reason for normal citizens to be wearing PPE and masks, and that they should be reserved for medical professionals or those at higher risk. This was because:
a) we didn't even know about aerosol spread at that point
b) there was a massive run on mask-buying that was making it impossible for doctors and nurses to get masks, and it was more important for the doctors and nurses to have them
c) we didn't have data on mask effectiveness for average folks then
Then the facts changed. And the supply of masks improved. And so Fauci's advice changed, too. That's what a real scientist does. When the facts change, they change their conclusions.
Please do not present this as an example of governments "lying" to people. That is not what happened here.
The government has done a perfectly good job of "reaching out" to people. The problem here isn't the government. It's right-wing media.
> Why not just do those things and prove to the people it doesn't work?
Because that takes time away from providing actual medical help. Think of it like a DDoS, all the cranks lining up for their dose of <not even a placebo> taking up the time of actual Doctors, nurses, and other essential staff who chose jobs to try and actually help people.
Imagine being a trained Doctor and spending your day performing worthless procedures on those who refuse to take the advice it took the Doctor years to earn the right to provide.
From what I understand, ivermectin has a fantastic safety profile if taken at the correct doses. For the 5% of the population that wants to take it, I truly don't understand what harm would come from letting it be prescribed and just giving them the pills with proper instructions and dosages, so people don't die from trying to self-dose with preparations meant for animals or obtaining it from sources that lack quality control.
I would really appreciate it if someone would explain to me what the reasoning is for this not happening. Like most people here, I'm an educated professional, and I've watched hundreds of hours of video from actual doctors about the pandemic, and I still do not understand the reason.
1) it doesn't work
2) it takes valuable time, supplies, and resources away from actual medical care
3) it allows wackos from Fox News to dictate medical care, instead of, you know, doctors, or science, which is an awful precedent to set
4) see #1
> For the 5% of the population that wants to take it, I truly don't understand what harm would come from letting it be prescribed
One harm is that it would help legitimize the drug as a COVID treatment, when science shows otherwise.
Put simply, the harm is that the already harmful misinformation that ivermectin helps would become even more pervasive. The only way out of this pandemic is _towards_ reason, not away.
> Why not just do those things and prove to the people it doesn't work? None of those things are of any significant risk compared to already having COVID, and let the person have some medical autonomy... if they're going to die anyway, let the family know they tried what they wanted to try.
The problem with this is that in these people's minds, if <insert whatever magical cure to covid they know works> doesn't work, it's always some other factor than the cure itself that is causing it to not work. It doesn't prove to these people that those things don't actually work.
If the hospital administers the 10,000mg of Vitamin C, which won't work (according to what we know from medical experts), when the patient dies his family would just claim that the hospital didn't give him the right dosage, or they should've administered the vitamin C earlier, or the hospital claims that they administered the vitamin C but really didn't administer anythiung, or what they administered was not the right vitamin C / was not vitamin C at all. It doesn't cross these people's minds that maybe vitamin C doesn't work. Swap vitamin C with hydroxychloroquine or ivermectin or whatever other covid cure flavour of the month it currently is.
For those reading, high dose intravenous vitamin C is used as part of cancer therapies at institutions that provide integrative medicine (chemo + dietary/exercise advice, supplements, and off-label pharmaceuticals).
Here is a paper from one such institution published in a highly respected journal (Breast Journal) that found a significant increase in the median survival rate for women with metastatic breast cancer.
Because if you shoot your gun out a window, and hit someone who has flung themselves off the roof, you’re still guilty of murder.
If a doctor prescribes something without a reasonable (proven would be nice) expectation of a positive effect on the patient, and the patient dies, the doctor is at a minimum a target for a malpractice lawsuit, and at most liable for murder charges.
"I cannot because of the law" is a very different answer than "I will not, because I expect it not to work".
Also, there have been court cases recently where courts have ordered doctors to give alternative treatments, so it seems that the legal liability problem does not cover all cases.
>Okay, this sounds completely made up now. Someone's trying to score some Reddit upvotes with this ridiculous story.
I guess you haven't been to the rural US recently. Not only is that plausible but its very likely. Check some of the social media posts on r/hermancainaward
I'm aware, they created the account at the start of the pandemic. I've never been on reddit but I doubt they're the most dedicated liar in history. Reddit is a breeding ground for sockpuppets and astroturfing. Don't believe everything you read.
What about your history here? Your most recent submission was flagged dead.
Speaking of Occam’s Razor, if someone claims to be certain a person is lying yet provides simply “believe me” as evidence, the simplest explanation is that the accuser is lying.
Two different replies to the same post both quoted the phrase "I've been on reddit for 14 years, trust me", so presumably that phrase had been in the original post, but has since been deleted via an edit.
As someone who has been around doctors their entire life, the poster is for sure lying. The posts are written like fanfics and do not have much scientific insight, which you generally get out of people in the profession. The posts being so focused on Q and on unvaccinated people makes it seem like the user clearly has an agenda. I would point more specific details but I don’t have the time to go through several pages of comment history.
I can’t believe anyone wouldn’t see through this and see it is clearly fabricated by someone who has a lot of time on their hands (which Reddit trolls sure have), unless you’re a teen or younger. Hacker News, please do better and see through this BS. It is a facade meant to divide us. (I am pro-vaccination, but I can’t stand people who are for cause but have to lie to make a point).
> Speaking of Occam’s Razor, if someone claims to be certain a person is lying yet provides simply “believe me” as evidence, the simplest explanation is that the accuser is lying.
That risk calculator tool is awesome. My risk is similarly low.
It is rather striking how much the odds of hospitalization and death go up conditional on a positive test, but even then the odds really aren't that bad.
I don't understand what you're implying with the statistics... That doesn't necessarily invalidate the story.
I've read similar things from verified sources written by doctors in these kind of roles (not broken noses but of serious abuse from anti-masker, anti-vax nuts, as well as the kind of deaths the post is talking about). Obviously in the kind of ward implied here they're seeing the worst of the worst cases.
Are you saying it's not true because he talks about a 38 year old dying from COVID? Over 14,000 people in to 30-39 year age bracket have died from COVID in the US this far. If you were in ICU at a big hospital you might see a few dozen people in this age bracket dying (as well as many, many more older people). And yes, it's a small proportion of cases but if getting vaccinated might have stopped 90% of them dying (sadly a lot of those deaths would have been before the vaccines are available though), that's no small thing, even if the general risk for somebody in that age group is fairly low...
So who knows, maybe this particular anecdote isn't true, but it is consistent with a lot of things I've read that I know are.
I'm providing some perspective. What about the vast majority of patients whose lives were saved? The "doctor" doesn't know the massive benefit he provides to his community because of one angry woman? I have a hard time believing any doctor would throw a lifetime of education in the trash because of one person's reaction, never mind a grieving mother who just lost her husband.
They claim to work in the ICU where mortality would be much higher, 41% according to your linked article. I'm suspicious of the account as well but their experience is entirely possible.
If someone is on downward trajectory towards death, why not give them cheap generics at human safe doses? Aren't physicians supposed to do risk benefit analyses? Sure they can feel the odds of benefit are slim to none but if the risk is slim to none as well, why not let them have what they ask for?
Also the doctor made no mention of other therapeutics that do have more expert consensus of helping like monoclonal antibodies or fluvoxamine. I'm sorry to hear that they have decide to leave medicine and that they were assaulted. Violence is never called for. That said, it's unclear if all tools in the current tool belt were used in this patient's case.
i totally get that it's anecdotal. my point is more about just allowing people the opportunity to try therapeutics especially ones that have been proven to help in many cases like monoclonal antibodies or have little to no risk of harm.
I'd recommend citing a source that isn't the Epoch Times. And we shouldn't have our medical staff wasting their time on things that we know don't work just because folks who trust Facebook memes more than trained professionals think that some essential oil cures COVID-19.
I said this elsewhere, but you’re still culpable for murder if you kill someone in the process of killing themselves.
> If someone is on downward trajectory towards death, why not give them cheap generics at human safe doses?
What is a human safe dose for someone whose body is so compromised that they’re close to death? If the doctor prescribes a medication that doesn’t have, at a minimum, peer reviewed research showing its effectiveness in these situations, they are going to be liable for negligent manslaughter, if not murder.
And rightly so, when you think of the broader implications of allowing doctors to do whatever they want to the dying.
IANAL, but it’s my understanding that you can’t waive your rights to life (no matter how much amusement parks insist that you can).
It’s probably more accurate to say that when you do sign such a waiver, it’s going to be an exceptionally involved process that includes a lot of time providing information to provide for genuinely informed consent (2nd, 3rd, 10th opinions, counselors, hospital lawyers, your lawyers, etc) when you’re in your right mind.
Experimental medicines for terminal patients are hard to get, for a good reason.
All his posts are rants against qanon and he's suddenly lucky enough to be a victim and immediately quits. He doesn't press charges because he'll be a national level target. Never mind that an assault like this at the hospital would result in an arrest regardless of a desire to press charges.
Nevermind the whole thing reads like fanfic: "Through tears, he rasped out sounds I could vaguely understand as a question. I guessed at what he was asking, and assured him that yes, his family was coming."
The whole post is awful, and even entertaining it here is absurd. When people complain HN is becoming like Reddit, this is what they're talking about.
> I've been able to deal with the years of patients who attended Google Medical School
Run as fast as you can away from doctors and other healthcare providers who think like this. Healthcare providers who have this particular arrogance can create very severe health issues for you and your family with their hubris. There are incredible doctors out there who also have humility when it comes to their own knowledge and will answer your questions and listen to you and take you seriously when you come to them with your own research.
The human body is orders and orders and orders of magnitude more complex than the most elite and advanced human endeavors of engineering. It's almost not even comparable. You have to have extreme humility in the face of such complexity and in the age of Google and open access to medical journals there is just so much to know and so much that is available that any doctor or healthcare provider who would dismiss the value of patients and caretakers doing their own research is really someone who is very dangerous to you and your loved ones.
> If it is so complex why would a lay person googling things suddenly be the better way to diagnose?
It's not about "be the better way".
It's about being able to to entertain & consider multiple theories, versus just being an asshole who won't even regard any convictions except your own.
Google Medical School doesn't have to be right every time. It doesn't have to be the more consistent option to be not "the better way", but simply worth entertaining. It doesn't have to be right 10% of the time. Some suffering patients will find & learn & discover things that do seem to fit their own problems. Being an asshole doctor who disregards, who writes off alternate theories: that's the wrong fucking way, and fuck those doctors, run the fuck away, get them fired, get them blacklisted, & warn other people. That's the wrong way.
There's no one more invested in a patients health than the patient. The resources of time & analysis they'll put in to trying to figure out what could be an issue is far far higher than what the medical system can provide for all but the very very richest of people. The resources out there to figure stuff out are real. Is it a better way? No. The patient doesn't have years and years of medical school. But that doesn't make their way wrong. That doesn't make them caring about themselves wrong, doesn't make their quest for truth & healing wrong. Any doctor that would turn their nose up at a patient, would refuse to hear a patient out, that refuses to acknowledge how wonderful & accessible medical information is in the world, and how helpful that can be: they are strictly worse. Worse diagnosticians, and worse people.
This is a great question! In my experience, the differences come down to:
- The doctor is going off a very short explanation you gave in a 30-minute appointment. If you have a serious medical problem, you can dump days, weeks, or months into finding information that matches your experience down to the fine details, which can very much matter - especially if you have an unusual case of something.
- There may be new information since your doctor was trained. Medicine has advanced a lot, and while doctors do their best to keep up, there’s more new research than any one person can digest.
- You will always believe yourself, never dismiss your experiences as “exaggerated” or “drug seeking”, and never blame your conditions on obviously unrelated causes.
That last one is especially relevant to people who aren’t cis white dudes. I’ve witnessed, with my own eyes, a woman talk to a doctor about chronic nasal congestion, and his response was to tell her to lose weight. Doctors habitually not believing the experiences of their patients has done incredible harm over the years.
Well, she went to a different doctor later who helped her diagnose & treat her allergies. Which made exercising easier too, turns out. Who’d have thought? (Her. One of the reasons she’d sought treatment is that the difficulty breathing through the nose was making it unpleasant to exercise.)
Arcsech says >" I’ve witnessed, with my own eyes, a woman talk to a doctor about chronic nasal congestion, and his response was to tell her to lose weight. Doctors habitually not believing the experiences of their patients has done incredible harm over the years."<
I've seen a similar situation but felt the doctor was stating what was important. He did accept her experiences but... Her congestion was not remotely as important as her weight, her weight was going to speed her death, and she'd best lose weight soon.
IOW he was saying "regardless of how you solve your congestion, you simply must lose weight now or you will die soon from a heart attack or stroke."
It wouldn't be better necessarily. Generally you want to get the opinions of multiple doctors and do your own research and use your own judgement in evaluating the advice you're getting. The point is that in the face of such enormous complexity the difference between a layperson with a rudimentary understanding of biology and your average doctor is not much. The difference is more pronounced when you're talking about people who are in the very top of their field but those people tend to be quite open minded and curious in my experience. They have such depth of knowledge that they are aware of how little they know.
It's also important to distinguish between technique and knowledge. The difference between a layperson and their surgeon is enormous, a layperson and their doctor, not so much in the grand scheme of things.
My wife has a few chronic illnesses so I've encountered more doctors than the average person. There are two primary types that account for all but one or 2 out of around 30 that we have seen in order to attempt to get my wife effective help.
1. The type that's too incompetent to diagnose anything more complicated than a cold or a broken bone. Usually they are general practitioners, sometimes they are specialists.
2. The type that might have been a productive person but they are too arrogant and/or lazy to diagnose anything but the most common things that pop up in their specialization. If its starting to look like its going to take any amount of effort at all to diagnose they'll throw their hands up and literally claim they don't know and its probably just something you'll have to live with.
It would be foolish for a layperson to think they can train themselves to be a doctor using google and diagnose a wide range of medical conditions in a large group of random patients better than a doctor. Its not foolish at all to think that given you have all the time in the world since its your life, that you might be able to do some productive things and try to figure out what could theoretically be wrong with you so you can make a more educated guess about which specific specialist might be able to diagnose your condition or rule out one that you suspected you might have. 99% of doctors are going to make a basic effort and then pretend its just some unknown chronic thing you probably shouldn't worry about, even if you feel like you are dying on a daily basis. Or diagnose you for one of the common things that doesn't fit your symptoms, give you medicine that will either not help at all or actually exacerbate your condition, and then double down on the diagnosis. And its not just about finding the right type of specialist, you can go to two specialists within the same field and one can be completely worthless to you because they have no experience with your set of symptoms.
I've gotten too many blank stares from doctors when asking them basic things that they should know to buy into the notion we seem to promote in the US that all of them are geniuses.
FYI Not an anti-medicine, anti-vax conspiracy nut. I just went through a nightmarish ordeal for several years trying to get help for my wife. Her condition is a physical condition that's misdiagnosed 80% of the time as anxiety. Once you have anxiety listed on your medical record, good fucking luck getting any of these arrogant assholes to do their job. Once you do get a diagnosis, the results of treatment are pretty mixed, but mostly not amazing. Fortunately it doesn't significantly shorten a person's life, but it does make it difficult to live it.
I've seen mildly famous and wealthy youtubers (famous for being sick youtubers, in some cases having the same condition as my wife) get teams of doctors working together hand in hand to figure out some rare set of conditions and make a person's life better. Most doctors I've encountered will figuratively tell you to go fuck yourself if you even want them to talk to another specialist. The closest I came to that was spending several thousand dollars sending her to the Mayo clinic. They rush you through a series of tests and then send you home without doing much of anything at all, hoping that you have a good team of doctors that can pick up where they left off. If you don't (and you won't) its a massive waste of time and money.
Sadly accurate. I have a condition common enough that every doctor thinks they can treat it, but severe enough none of them will. Trips ahead to several states, possibly outside the US to address this. Local resources are too arrogant to want to look at even recent peer reviewed studies, or too busy to do so. A family member in medicine tells me what I describe is pervasive. Medicine, he says, is broken.
Thank you for sharing your experience. Medical science is probably the hardest endeavor we aspire to understand. We could use a lot more humility and diligence on all sides when approaching it.
chevill says >"1. The type that's too incompetent to diagnose anything more complicated than a cold or a broken bone. Usually they are general practitioners, sometimes they are specialists."<
Dermatologists! Dermatologists!
My wife and I have gone to our healthcare providers' dermatologists about 6 time in total: each time they've sent us home with a diagnosis of "allergic reaction" and a prescription for a tub of cortisone (which we have, at this point, ceased to fill):
The cortisone never works, but I have two tubs of cortisone cream in the refrigerator in case of nuclear war.
This is a shame. We once had a private dermatologist who was simply outstanding - he nailed every problem with his diagnoses. But he retired. It seems the colleagues he left behind are all candidates for the
Golgafrinchan Ark Fleet Ship B.
My wife recently was given another "allergic reaction" diagnosis for a skin irritation and got another cortisone tub prescription. I looked at her skin and then, on a hunch, sat at her computer terminal awhile. Sure enough in a few minutes I felt stings on my neck and right arm. An examination with a magnifying glass revealed very tiny fire ants on my arm. I searched above her chair and found the source - a Chinese lantern was the ants' launch platform - they were falling onto her and then stinging her.
How a trained dermatologist cannot distinguish ant bites from an "allergic reaction" is beyond me. The ant bites have a red center and form blisters, which is nothing like a generalized allergic reaction.
A little bug spray and some ant baits took care of the ants. I don't know how to fix the dermatologists.
Generally agree, but can also see the other side. What you are talking about are people who are using sources like PubMed or even WebMD, etc. These at least help patients as reasonable questions even if they don't fully understand what they read. Then a discussion can take place.
I think what they are talking about are people using terrible sources (garlic curing HIV example). Then demanding that they are right.
So really, what we see here on both sides as the root cause are people who are not interested in a discussion and simply assert they are right. Dangerous if a patient does it, also dangerous if a doctor does it.
The other thing you don't see is how stupid the p05 patient is. Its not someone reading primary sources or coming in well informed. Its someone coming in saying Dr Oz says that eating blueberries cures cancer.
> Run as fast as you can away from doctors and other healthcare providers who think like this
For every 1 person who actually has discovered something useful or accurately self-diagnosed with some very well-done research, there are surely 10,000 complete idiots who have swallowed hook, line and sinker the first nutball result they read, which they now believe 100% and if you don't agree you're an ignorant, indeed murderous enemy.
It's completely understandable to me why doctors take this stance.
Yep, while it can be frustrating to be in the small percentage of people who are able to evaluate the validity of research, it's totally understandable why doctors are dismissive given how much rubbish is flowing around that people come up with.
Often it just requires a bit of pushing if it's a simple diagnostic test. "Can we just do this blood test to completely rule out [x]?". I remember about a decade ago my father was getting this extremely bad dermatitis on his elbows for years, and mum had researched and found coeliac (celiac) disease could cause that as a symptom. The GP was prescribing steroid creams, and they really had to push him to do a blood test to check for those antibodies. He thought it was dumb but gave in just to shut them up! Came back positive, next step was an endoscopy, which showed massive inflammation in the small intestine. Dad cut gluten out of his diet and over the next year the dermatitis and intestinal inflammation disappeared.
Please consider the context here. This is specifically about people who refuse vaccines but demand their dying loved ones be treated with huge doses of vitamin C or antiparasitics with no proven effect against the disease.
Assuming you’re a software engineer: how would you feel about a customer who comes to your workplace and aggressively tells you you really should be using The Blockchain to solve everything, because he read that on Twitter and you’re obviously in Big Tech’s pocket for not using it already.
If the engineer responds by harboring a grudge against all encryption, and silently failing to employ secure industry standards, then neither he nor his other customers win. Medical professionals treat individuals, not political groups.
What if an engineer responded by harboring a grudge against all blockchain?
I mean, it would be unfortunate if that engineer decided not to donate to Scihub. But that exhausts my list of bad things that could happen due to such a grudge.
What a callous way to put it! Patients suffering from diseases & conditions aren't trying to swab some magic block-dust on problems. They have symptoms & are desperate for help. Their ability to invest time in & explore possible conditions doesn't match up to a medical degree, but it's still considerable, and in spite of there being a lot of fluff & misconstruable & useless information, there's a ton of real, valuable, & good information too.
It does have to suck to have a lot of badly informed people parroting silly ideas they casually picked up online. But to so callously write off everyone, to so easily disregard any opinion & information other than your own, with what limited time you've got to examine a patient? Detestable, just absolutely revileable: this person has deeply failed their oath.
I also don't think your scenario is fair. The customer isn't just showing up & ordering you around. As a doctor, the patient is the product. The product is speaking for itself, asking for help. It's also paying you fairly well for your time & services. And as I said above, there's a good chance the product is well informed about itself. To write this off as a case of idiots making pointless requests- I can not disagree hard enough about what a callous, disregardful view this is. There are plenty of times when yes, the patient has fed themselves garbage, the patient is way off base, but let them not be so easily out of hand dismissed, let not the workplace maintain such a sense of absolute smug over the idiot rubes of the world.
>aren't trying to swab some magic block-dust on problems
That's exactly what patients are doing. Entire industries are built around this. People don't want to be told the hard answers to their problems, they want to do whatever they want and then take one tiny pill that causes weight loss, resistance to heart and respiratory disease, and increased libido.
>I also don't think your scenario is fair. The customer isn't just showing up & ordering you around
Read the stories. Watch the news. This is exactly what is going on. There is not a good chance that the patient knows what they're talking about - the overwhelming majority saw a quack on Facebook or Oprah saying something clearly wrong and stopped looking further because they want that one easy answer.
discarding & scorning all the public because there is some noteable contemporary upswell of problematic rank populist idiocracy about is not an elitism i can get behind.
if indeed a patient is requesting modern quackery, then yes, reject that. but simply turning up your nose at "Google Medical School" & dismissing all patient concerns blanketly is not ok.
Just curious - what is your opinion of non-technical managers that, upon arriving back to work from a conference, order their teams to implement a buzzword bingo soup, without being able to articulate why their life-critical aerospace software suddenly needs to support SOAP over REST backed by HADOOP, all implemented in Golang monads.
I only agree with the sentiment. The problem is that doctors aren't here to improve your life, they are here to treat symptoms and diseases when it's already too late.
If the solution to your particular disease involves a year of changing your lifestyle then no doctor on earth is going to help you. (it's not their job)
He actually explains that in one of his other replies: after 10 days of infection, you’re not fighting the virus anymore, so monoclonal antibodies are useless.
Covid, the virus, doesn’t typically kill you directly: the cytokine storm that some people seem to have afterwards is what kills them.
That’s why people making statement about “my
immune system is strong” are speaking from a position of ignorance. You don’t want an over-reaction of your immune system in response to viral load. This is what the vaccine helps with by giving your immune system a chance to develop an immune response without having to go nuclear trying to clear the infection.
The storm is why people are ok at day 7-10, then suddenly crash on day 11-4, seemingly out of the blue. They have a hyperactive response that begins destroying healthy tissue, particularly the lungs and the heart, given the concentration of ACE-2 receptors, which is where the virus binds easiest to. Your immune system, still trying to develop an answer to this novel infection, goes scorched earth to attempt to clear any and all rogue RNA that is detected.
That’s when you lungs start to hardened and fill and pneumonia kicks in; it’s all the dead tissue in your lungs from your now CoVid-induced autoimmune disorder.
This is why steroids are given - they blunt the various inflammatory responses a cytokine storm brings on. Problem is, your immune system do go hard in the paint, and sends EVERYTHING it has.
This is why using an anti-parasitic in this moment makes a whole lot of no sense.
This is why HCQ makes no sense at this stage.
The new oral anti-virals have the same issue: you have to get tested, diagnosed, and get these into you AS SOON AS POSSIBLE. The oral antivirals that are being tested stop the replication process of the virus, or that’s the goal.
The less viral load, hopefully a more blunted immune response, the less or no organ destruction.
A sad story for sure, and I don't doubt that it is real. But I can't help but wonder, considering how many people have actually been infected with the virus and miraculously survived, are these stories the rule, or the exception?
These are undoubtedly the exception. Now, i can understand that the exception can feel like the rule when your job is to deal with the exception, but most people who get COVID don't die or go to the hospital.
That doesn't mean that COVID isn't bad, or that people shouldn't consider getting the vaccine (especially if they are old, obese, or have diabetes). It just means that his experience is not representative of what COVID is like for most people.
The issue now is doctors see the severely ill, the vast majority of whom are unvaccinated. And what other qualities go with lack of vaccination? Belief in ivermectin, love of far right conspiracies, paranoia about microchips or God knows what else. So, while I doubt doctors noses get broken frequently, I'm sure they see a ton of brainwashed Q whackos as severely ill patients.
You're seeing the reverse of survivorship bias - those who aren't getting sick don't need to present to the hospital, but from those that do, they are most likely at risk of dying.
The world wide infection fatality rate is nowhere near 1 in 50. The CDC estimated the US fatality rate at 0.6% back when hardly anyone was vaccinated, and Americans have worse survival rates than most other countries due to having a relatively old and unhealthy population.
The exception being the issue is true for many diseases. On a large scale, the exception can add up to thousands of people. Take polio, the great fear of yesterday;
> Up to 95 percent of people infected with polio have no symptoms. However, infected persons without symptoms can still spread the virus and cause others to develop polio. About four to five percent of infected people have minor symptoms such as fever, muscle weakness, headache, nausea and vomiting. One to two percent of infected persons develop severe muscle pain and stiffness in the neck and back. Less than one percent of polio cases result in paralysis.*
Despite most cases being harmless, polio was considered a huge public health issue worldwide. The small percentage of cases that developed paralysis added up, essentially becoming a roulette for the majority of children. This is because it was still transmitted easily and rapidly, so it spread through millions of people quickly.
Covid can be seen similarly. Yes most people are fine. The same way that most people that get into car accidents are fine. And yet I don't think it'd be a stretch to say most people probably know at least one person that has suffered serious health complications due to covid
Of course, most have. But the sad reality today is that those in the risk groups, are vastly overrepresented in the ICU units. Here in Norway, the stats were something like the following:
Around half of those admitted were unvaccinated people in their 50s, the other half vaccinated and in their 80s. The former group was something like 5-7 times more represented. I think 90% of them were overweight or obese.
So, yeah, seems like if you get admitted to the ICU today, you're either a fully vaccinated very old senior citizen, or unvaccinated high-risk individual in your 50s.
This is the number of people you will spread the infection to.
Flu has a R of 1.
Covid Alpha/Beta have a R of 3-5.
Delta has a R7-9.
Omicron is allegedly 15+, and unlike anything we’ve ever seen outside Measles.
Giving you a death rate of 1% infected, to keep it easy. Current numbers in the US are 1.56%.
So, 1% dead of spread of a R1 is going to be a lot slower and manageable versus 1% of R7. The exponential (Logarithmic?) rise of infections will kill a lot more, a lot faster, and have knock-on effects everywhere within the healthcare system, and society as a whole.
The only hope is that by rule, typical virus evolutions are less virulent, but we’re still not sure of that at this time. The big fear with omicron is that the spike protein mutations are immune-system dodging and faster infecting/more contagious, but that the payload within is still functionally the same. The mutations not on the spike are not changed enough that virologists are hopeful at this time.
Sorry, wall of text. Hope this addresses the question.
I actually struggle to see this guy's perspective. If a family are that desperate for their relative to be given ivermectin/hydroxychloroquine/god knows what else it isn't obvious why he wouldn't hand them out.
The role of a doctor, when someone is sick, is to offer good advice and stop them doing anything that will be really damaging to themselves. I'd see this as more similar to a dying man getting access to a priest than anything else.
Maybe this woman would have been screaming at him anyway, but I can see why she would be angry. He is obviously being a bit arrogant. The dude was dying, let the family believe what they want at that point.
Doctors take a Hippocratic oath to do no harm. They must follow an ethical code. Ivermectin is pointless for that treatment, and would have terribly harming side effects. If you think otherwise, it's clear why you don't understand the MD's rationale.
This patient died, the doctor claims he can tell who is going to die (which seems pretty reasonable). It doesn't get much worse than dying of respiratory failure as horrible side effects go. The risks from ivermectin are very low and it is a routinely proscribed drug.
He'd have made life easier for himself and the family by saying "this won't work, but if you can foot the bill and will feel better about it then OK".
My standard is my whole family gets vaccinated and I keep an eye out for when they should be getting boosters.
But I'm not forcing my standards on anyone. If this family wants a silly treatment and there isn't anything better to do, then they should get what they want if they are willing to pay.
One of the reasons this doctor got screamed at is because he took responsibility for making all the decisions and the patient died anyway. Which is good doctoring, I respect that. But if he is surprised that a family is angry that he ignored their wishes without a good reason then he is not paying attention to how the world works. He could have easily just agreed with them and kept the peace, at no undue cost to anyone.
No, doctors shouldn't give in to quack notions of a Q family, who punched said doctor in the face, just to make the conspiratorial family feel better. If doctors believe it is harmful with no benefit, they are obligated by oath to not do it, full stop.
Are you a doctor, healthcare provider, or even in the medical field? If not, I urge you to stop spouting your amateur theories about medicine on the internet, where they can spread and cause further harm.
I put it to you that (although amateur) "it won't work and may cause the listed side effects" is an entirely reasonable to spout it on the internet. You may be misinterpreting my comment.
This isn't a conflict situation and there is no obvious downside for anyone. The doctor isn't giving in to anything. The family is making a stupid request, yes. No skin off the doctors nose to grant it though and if it'll make them happier he may as well. If he thinks it is significantly harmful then he needs to make that argument instead of dismissing them.
Unless we're talking about controlled substances, tell the patient it won't help and is a bad idea. If they insist, give them a release to sign. Once you inform the patient, you're past the point of doing harm.
I think the part about not pressing charges gives this away as being fictional. As someone mentioned in the comments, an assault is a mandated report, and the author claimed security witnessed it. If charges were filed, it would be easy to verify this story.
This is naive. I have been in the doctors position of being assaulted by a patient. No one is going to force you to call the police and to talk to them and to tell them what happened and to press charges. In my case I declined because the person was having a crisis and losing everything and I didn’t feel like also making them the target of government intervention.
I don’t know what I would have done in their situation but if it caused them to quit their job I wouldn’t put it past them not to uphold the duties of said job.
Who knows if this specific story is true or not, and I'm just a random anonymous user so $0.02 more on the pile, but I have a family member who's been a hospitalist for 40 years...
Their experience basically mirrors this up until the assault. According to them, they've never had so many patients and family members fight them for every single decision they make -- they're bringing in all these ridiculous printouts about "give me these vitamins and steroids on this schedule" and of course they want HCQ and IVM still. None of them will accept responsibility for not being vaccinated, they blame the medical staff when they don't get better like they think they should, they all see intubation as the step that kills their loved ones instead of a last chance to save them.. it's enough that my family member is retiring rather than deal with it any more.
My family member works at a small hospital in the Midwest and more than one patient has accused them of "working with Dr. Fauci" to prolong the pandemic. Just complete nutball bullshit.
All of the quacks promoting these horrible "cures" while convincing millions of people to not get vaccinated should lose their licenses. I doubt there will ever be any consequences for the non-credentialed talking heads doing the same but man have they inflicted a massive amount of suffering on their viewers. I hope the culture war was worth the weight on their consciences.
Honestly, what has been exceedingly scary to me in the past couple years is how tribalism in the US has gotten to such extremes that people are now willing to actually die instead of admit they were wrong.
I mean, sure, the ease with which people have decided they can argue against easily demonstrable facts over the past 5-10 years has been unsettling, but I thought when push came to shove, and their lives and their loved ones' lives were on the lines, people would come around. But a sizable portion of the country is now in a full-on death cult.
And to be clear, I can understand there are plenty of things about the pandemic and the pandemic response that can be debated, but a huge portion of the country is miles off the deep end into full on crazyville. Even Trump was loudly booed recently when he said he got a booster.
I think the headstrong tribalism has been around forever. The difference is that now it's being headstrong about matters that are both life & death and unavoidable in daily life.
Somebody the vehemently believes that the rapture is coming and the Earth is 3,000 years old rarely gets a reason to punch anyone over such beliefs.
Trump publicly announcing that he got a booster made me respect him more. He could have (and politically should have) kept silent.
It jumped out to me as fake immediately, as well. It's impossible to say for certain, of course, but it rhymes with other Reddit fakery. Specifically in being a one-note account that seems entirely focused on providing testimony to the awfulness of a particular group, that being QAnon.
Here's a pretty interesting video essay about online fakery, with a heavy focus on Reddit fakery.
It is the writing style that makes me tend to not believe him. Sounds like an essay of an inexperienced author more than a recapitulation by a medical professional.
Doesn't mean the story itself isn't true, but I would expect the author writing about someone else and not himself.
You may be interested in digging into some internet cultural history. I don't pretend to know if this person is lying or not, but people making a strange hobby out of lying on the internet is nothing new. I can't imagine doing that, I'm guessing you can't either, but there's some other perspectives out there that find this appealing. I don't pretend to understand, but it's just how it is.
Some examples from the top of my head:
A woman named MsScribe spent years fabricating harassment against herself so that she could gain influence in her community and join the moderation team of a fan fiction website. She would create sock puppets to attack herself, so that the community would rally around her, over and over again.
A reddit user spent years creating "fake fake stories". They made obviously fake stories, which they put a lot of effort into, such as writing poetry and drawing comics. They would post these stories to places like r/thathappened, as if someone had genuinely tried to pass these off as real stories. Their goal seemed to be to present the communities these fictional authors belonged to as ridiculous, they were building straw men. I don't remember the name of this user, but this is presented in the video I linked in a sibling comment.
(Both of these people eventually admitted to this behavior when confronted.)
One doesn’t need to look far to find similar circumstances in the public record. While the Reddit post could be an elaborate creative writing exercise, there’s many recent news articles about upswings of violence against healthcare workers where circumstances similar to the Reddit post (patient visitation restrictions) were implicated in both verbal and physical violence. Below are examples.
The moment they described how the patient was asking whether his family was coming I felt such a profound feeling of sadness. Imagine being alone in that moment of your life, the very last moment. I felt like I knew what death would be like and it was heartbreaking. Whether this was 100% real I don't care. This kicked me right in the feelings.
Imagine being alone in that moment of your life because someone couldn't bother to wear a mask around you or someone you love and you are immunocompromised. No sympathy for the devil
I wonder if there could be a market for a service to link up cooperative patients and doctors who are tired of dealing with uncooperative patients, in a non-emergency setting.
Dear ye gods, this would be awesome. Pairing up patients with difficult conditions, but who take fantastic data and are compliant to care guidelines with doctors who genuinely want to help patients over a long period of time.
The poster explicitly calls out Facebook and the risk of getting pulled into a life-ruining web of conspiracy theorists as a reason for not pressing charges:
> A recognition that doing so would be putting a target on me, my family, my colleagues and my hospital for all of the violent Q-Anon people. The arrest would be local and possibly national news. It would subject these children to deep pain. Worse, though, it would hit Facebook, and within no time, my name, my kids' names, and my wife's name would be all over their sites. All of us would be threatened. These people are unpredictable, but seem to crave violence. I don't want to be responsible for one of my colleagues being shot in the parking lot because I became a national symbol of Q-Anon hospital violence.
I smell a hoax. Looking at the poster's history there are a bunch of posts that are practically copy pastes of each other.
He makes a couple of blatantly dubious medical claims. For example he claims that Ivermectin doesn't work (probably true) with a followup claim that it does work but you have to give so much you'd OD from it.
In other posts he claims "every ICU patient is covid" which is a repeated hoax we've seen. At the very least it doesn't differentiate people in ICU who have covid vs people in ICU because of covid, and how many of the people caught their covid while in the hospital/ICU, etc.
ICUs aren't full. If this is actually a doctor and they are actually in an ICU that's temporarily full, it definitely is not always full. Statistically ICU beds in hospitals are at pre-pandemic vacancy levels.
Lastly, and this isn't really fact based, but it's too "on the nose". The whole narrative they've created is like it was written by a third rate script writer to sell the narrative. It's "too perfect" for his side. The truth is bad enough, people really are dying and suffering. There really are a lot of conspiracy people. But it's just to clean for his side.
> For example he claims that Ivermectin doesn't work (probably true) with a followup claim that it does work but you have to give so much you'd OD from it.
Ivermectin does work in vitro, but the equivalent effective dosage would kill a person.
It sets off every alarm bell I have and it's being spread far and wide by people who consider themselves too savvy to fall for something as obviously fake as QAnon. The irony is thick sometimes.
>I have seen people struggling to breathe through lungs that have hardened to near uselessness, begging us in their ignorance to give them the vaccine now.
I really have trouble believing that this isn't just a propaganda meme. What proportion of the population actually believes that a vaccine will cure them post infection? More importantly, how are all of these people uttering vaccine requests when their lungs are failing? Isn't it a little hard to talk when you're in the end stage of a severe lung infection?
Linking these unvaccinated deaths to qanon conspiracists in the second sentence further makes me doubt that this is an actual doctor reporting on their experience. This is reddit, after all, a heavily astroturfed (and opaquely controlled) propaganda machine.
Have several friends in healthcare. Multiple have relayed similar stories.
However, to your question: how many of these people are begging for the vaccine, and how?
It's a surprising number. These patients don't understand how vaccines work outside of movies and TV, and as such think it's either bullshit or at the last minute feel like it's a miracle.
Because at the end of the road, you realize that you've been told lies by those you trusted. There's a clarity in the end moments. Situations like these where you have no choice but to think about what you've been told and the ramifications of your actions.
And so these people fall back on the last thing that wasn't at least blatantly false, which is a social understanding of medicine. Vaccines cure diseases, or so we're told in our school days. So much of the American medical psyche is built around medicine being a solution for the current ailment, not a prophylactic for the likely future.
A huge part of the antivax rhetoric is "but I'm healthy now". They don't see it as preventing illness in the future. To them a vaccine is an antidote, a fix for a problem.
And so they beg for the antidote when it is obvious that they are at the end of the line. They don't understand that it's not a fix for now, it's prevention for later.
As for how they can: function degrades, yes, but its biggest impact is on duty cycle. You go from being able to talk constantly to mustering enough energy to speak a few minutes at a time to making it 30 seconds, to 4...5 seconds, to losing it entirely. You get bursts of energy, but each burst comes with a toll. Maybe a few more moments here but a long delay as you recover from it.
And vitamin C is one of the cheapest supplements, at least in that part of globe I currently in. The entire line about "expensive urine" is taken from a handbook of party conversations.
Other top subreddits include HermanCainAwards, CovIdiots, and Quit_Headquarters.
Some comments in AskReddit and others, almost exclusively about covid.
This doesn't say much about the persons identity, but they're clearly not coming to the site to have fun.
Submission by weekday is also interesting, high on weekdays, low on weekends, highest on Monday.
I hate to be skeptical because I have doctor friends that have similar covid stories, but this post is quite sensational, newsworthy even. I wonder if the user would be receptive to verifying themselves with the mods.
edit: their first comment is March 3rd, 2021 and first submission is March 2nd, 2021. Nearly a year and a half after the account was created.
Further down thread, there's multiple folk calling out similar disbelief, and stating they've looked at OP's comment history, and saying they believe it's a genuine post by an MD.
Thank you! There is no way to prove it definitively, but I'd bet this is a writer's account with an agenda.
The whole things reads like an airport novel, adjusted for a specific subject. It's what people who believe about a certain world view expect to see in that world. A tear-jerker for sure, but in practice, for example, I have a lot of anti-vaxxer friends, and even though I don't agree with their choice (but I agree with their choice to have a choice), none of them behave like the people in the story. They are not insane, they just strongly adhere to a certain set of believes.
People would point out to the writer's history, but in fact, their account is only 9 month old, with an average of a few posts per months. It's completely not unreasonable to believe that someone spends this effort to create an illusion of credibility. Heck, I know people with two dozen "active" hacker news accounts, doing the same thing, but in their case so they could promote key tech articles, instead of vaccines.
The human body absorbs 70-90% of Vitamin C taken daily at levels up to 1000mg, at which point absorption falls to 50%, the safe upper limit being 2000mg per day.
As your own source explains, “High intakes of the vitamin are generally well tolerated; a tolerable upper level was recently set at 2g based on gastrointestinal upset that sometimes accompanies excessive intakes.”
The OP’s reference to 100mg daily was evidently a typo; he probably meant 1000mg rather than 100.
FYI: I’m currently taking 1000mg daily on the advice of my primary care physician.
All posts are obviously militant and politically linked to topics related to QAnon and anti-vaxxers.
All the posts are generic advice and none of the writings reflect a profound expertise in science nor medicine. Most of the information posted by the author can be found on public government websites and news articles. Having listened to a lot of practicing physicians interviews during the last two years (and having family working in the field) the contrast in deep technical understanding and jargon is clear as day and night. At best he works in a hospital, maybe as a low-tier nurse.
I get it that nurses would quit and find other jobs, but a doctor with "14 years of medical school"?
He says that he worked "many decades" plus 14 years of school. Assuming he went med school at 20 and "many decades" is 3 decades, he would be at least 64 years old. That's very unlikely given Reddit's users demographics (https://www.oberlo.com/blog/reddit-statistics) where users of 65 only constitutes 1% of the user base. Being a militant progressive makes it even more unlikely for the same demographic reasons. If it is two decades or less, than this is not "many decades".
268 comments
[ 1.7 ms ] story [ 307 ms ] threadAnd guess what? They say “that medicine is poison, I use tumeric”. Then in a few years they are dead, or blind or have both legs amputated.
Humans make horrible health choices all the time. Maybe the difference is just the scale at this point.
It's great that this doctor can share his experience but why is he posting this on Reddit? Why isn't this information available from trusted media sources? And for that matter, why aren't there any such trusted sources that everyone can agree is acting in their best interests and providing them with worthwhile and pertinent news?
Democracies can not survive without functional news and media sources.
Because doctors are people, and they just wanted to get the experience off their chest without any personally identifying information being disclosed?
They didn't frame the post as something that should be bringing about any change. It's literally just a person sharing their story to get a sympathetic ear. Because sometimes humans need that to keep going.
Exacerbating, btw.
A conversation centered around the identity of the person is much less interesting than a conversation about the contents of their post.
Q is fake, but there’s a whole subset of seemingly rational people who are being sucked into the void of this cult.
I mean, look at the subreddit this was posted in.
So if you find what I have to say ignorant and unhelpful, so be it. My words are not here for you. If you truly have a life experience with Q then I am sorry to hear that but please understand I cannot blindly accept what you say (As I don't expect you to accept on faith what I say).
So maybe I am in the magic land where the Q never travels, or maybe this whole Q thing is blown out of proportion. I do not know but my ignorant anecdote may make someone else like me ask the same question of why they don't know any Q either.
The follow-up is: what is your sociocultural environment? I'm also in the world Q never travel on my mother's side (all conservative, some could be considered liberal by US standards, but right-leaning at least). The far-right conspiracy don't touch them. They are doctors, CEOs (and retired CEOs), insurance VPs. Amongst the younger generation some are also nurses and physiotherapists, or work in marketing. Not one single conspiracy freak. Some weird claims at the beginning of the pandemic, but since one of them worked in the first national Covid "hotspot" and asked us to limit our travel 5 days before any EU government instaured a lockdown, i think any weird reactance was quashed before it could ever change how we acted.
But amongst my friends who never left my rural hometown? We don't have Q out here but this is the same type of far-right/authoritarian ethos. "We are better than the others, but the others have more money/power/education than us. This can only be because of a conspiracy led by [LGBT lobbies/jews/islamists/atlantists (aka pro-Otan/pro-US)] that we need to fight against, else our kind will die".
Conspiracy theories are not reserved to to working class, it is the whole environment that make them emerge. And i'm not saying they are reserved to the right either (hence the "atlantist" talking point), but that their talking points ethos are usually associated to the far-right. Even if far-left figures used the same (Stalin, Mao).
I started a digression on spinoza but that was only muddying the water, so i'm cutting it here.
I don't find the post itself to be political at all though. It's the recount of a doctor's recent experience being physically assaulted after refusing to treat an unvaccinated covid patient with ivermectin and vitamin-c, believing that the former may be actively harmful to their health, and the latter simply ineffective.
The post isn't political. It only seems political because the rejection of modern science is along a political line.
If this doctor believes that ivermectin is "harmful", the doctor was so poorly informed that medical fact was mixing up with something he saw on CNN. The assertion about effective dosage being lethal, in particular, was completely fictional -- I don't believe that it works, but the people advocating for it aren't talking about crazy doses.
Ivermectin is a very safe drug. It is given to millions of people a year to prevent parasitic infections. There is a large RCT underway to see if is an effective therapeutic for Covid-19. We should all hope that it works. This incessant political polarization of science has to stop.
Everything in this reads like a low-quality re-hash of click-bait headlines from the last year, several of which were completely debunked.
>This incessant political polarization of science has to stop.
Lol. In comments to a post about a doctor venting about being assaulted for not giving into conspiracy theorists demands re: treatment, and people say he's making it "political". Anyone can doubt the veracity all they want, there's 1000 more stories just like this.
Didn't I write that I don't believe it's effective? I'm not sure who you think you're arguing with, here.
The point is, this person made a specific claim -- that the "effective dose" would be so high as to be fatal. That claim is so laughable and baseless in fact that it calls into question the credibility of the entire story. No informed doctor would say such a thing. We simply don't know what the "effective dose" is (if any), but we know what other people are recommending as effective doses, and these are not toxic.
When "doctors" go on QAnon forums on reddit, and post things that sound like re-mixes of CNN headlines while making egregious mistakes of medicine, at the very least it should make you question their objectivity, if not the credibility of the claim.
I don't know enough to evaluate any of the claims, I only wish to note the logic is pretty easy to follow.
I suspect you already understood all of this and chose to misunderstand to ... "win" the argument?
https://news.ycombinator.com/newsguidelines.html
If you don't want to be banned, you're welcome to email hn@ycombinator.com and give us reason to believe that you'll follow the rules in the future. They're here: https://news.ycombinator.com/newsguidelines.html.
People learn faster when they get to choose their own options.
> 'Society's advancement is measured by that which it may take for granted' I forgot! Help! (until it cant/that fails)
> "Every gain made by individuals or societies is almost instantly taken for granted. The luminous ceiling toward which we raise our longing eyes becomes, when we have climbed to the next floor, a stretch of disregarded linoleum beneath our feet." -Aldous Huxley
> "The true measure of any society can be found in how it treats it's most vulnerable members." -Mahatma Ghandi
But this sometimes requires not just aiding them, treating them well, but re-socializing them, re-educating them, informing them, breaking them out of their ignorance & failings.
To simply say that we must
> [re-]"engineer our environments so unhealthy choices are [not] so easy to make"
feels a folly to me. We must socialize. We must foster an aware, awake, able society. Striving to simply prevent all faults is not how we achieve success; it results in a vision of domineering & the absolute & fixedness: it bespeaks a belief that there is one true path for society & that we need only set it out & all will walk this course. It's singular utopian, a singular destiny, not a polytopia, not letting us many people discover & hunt for our own ends. Imo society must remain a dialectic, a conversation, a hunt. We must encourage growth & awareness & hunts for meaning, without insisting on a systematic & singular top choice.
I don't think social media is a part of this question:
> "Everyone believes whatever they want to,"
is a false Boogeyman, a false god, a Fear Uncertainty & Doubt (FUD), meant to scare us. We have to allow plurality, we have to allow polytopianism, we have to allow many systems, many beliefs. But we can still in aggregate steer towards informed, towards good beliefs, towards healthy ends. Trying to demonize the availability of voices & options- "safetly cocooned in their own social media echo chambers"- just misses the real point: that society doesn't have a progressive vision at large, that basically no one has a real bead on a healthy, progressive, gainful society. Everything is beset by conflict, and we are trying to make choices with very biased, limited, local regards. And there are very few clear paths, very few regardable winners.
For sure, much of what presented in the world is faulty & awful. But this too feels like a part of evolution. Simply wishing for authoritarianism, for everyone to make the right choices, for everyone to accept good dogma in the place of bad dogma: it's a disaster. And I don't think "Everyone believes whatever they want to", I think they have complex experiences which shape what they are most susceptible to, and I think most of us lack good positive role models & experiences to shape us properly forward. The world does not reward the just & righteous, it doesn't promote the healthy: it showcases greed & taking & exploitation, it showcases narcisim & delusion. It shows us an all too recent history of medical abuse & experimentation of our minorities. These aren't social media problems, these are the actual world: the actual evidence of the actual world is unclear, is deeply shadowy, is ghastly.
"The longer this state of affairs persists the worse things will get". Such appeal to authority & Fear. Such terror!!! "Inability to deal with a pandemic is just the tip of the iceberg" it itself a promise of horror & terr...
The combination of freedom, capitalism, and greed. This is why I can't be entirely sure that China's approach isn't potentially longer term sustainable, as much as I disagree with it - it might actually be a better way to deal with the stubborn-ness of stupidity that's so inherent to humanity (to be fair, all these traits must have served us well when Pringles and Pop Tarts weren't cheap and easily available).
Cigarettes. How did they become a thing? What, ever, was their redeeming feature? At least Pringles and Pop Tarts taste nice.
Social media is just a more-efficient distillation of what traditional media has profited from since it began. It's not new human-hacking, it's just an efficiency bump that's actually more facilitated by the internet and pocket-portable devices with access to it.
Really? Last I heard, life expectancy in the USSR was quite a bit worse.
> Cigarettes. How did they become a thing?
Nicotine. Not hard at all to understand. Personally, I've always liked the smell of cigarettes. I never smoked, because I knew I'd really like it. Cigars, though, make me want to puke.
> deal with the stubborn-ness of stupidity that's so inherent to humanity
Most evil in the world is not perpetrated by evil people, but by good people believing they know what's best for everyone else, and forcing it on them.
Also monoamine oxidase inhibitors, a class of compounds that are effective against depression, panic disorder, and social phobia.
Some think that the absence of the MAO inhibitors are why nicotine replacement therapies (gum, patches) aren't really all that great at getting people to stop smoking.
I don't know. But I do know that people were much worse off economically in the USSR than in the US. This impacts longevity.
> They had pretty good doctors as far as I know.
I recall reading in a thread on Chernobyl where people who lived there at the time of the disaster were commenting. One comment stood out - root canals were free, but there was no anesthetic available. Having had a root canal myself, I can't imagine sitting in that chair for several hours getting drilled without anesthetic.
> believing they know what's best for everyone else, and forcing it on them.
Agree, to an extent. Forcing things on people is required of a functioning society. Government and laws and whatnot.
I genuinely don't know where the lines should be drawn on the entire spectrum. Law of unintended consequences and all that.
The government's proper role is to prevent people from using force on each other. It is not forcing things that the government imagines are good for people on them.
For example, I believed for decades the advice from the government that margarine was better for me than eggs. That turned out to be backwards.
I don't think you can necessarily separate those two things from one another so simply, except in the most extreme of examples.
> For example, I believed for decades the advice from the government that margarine was better for me than eggs. That turned out to be backwards.
I'm just going to assume you chose a bad example here. There's no force at play, you're free to choose your thing, you can even have both at the same time. Freedom!
2. not a bad example - what if the government forced me to use margarine instead, secure it its rectitude? That's the point.
https://peterattiamd.com/ama23/
Ethics and morality used to be a cornerstone of medicine.
Every legitimate long term study of non surgical weight loss shows that it doesn't happen for the vast, vast majority of people.
1) ["In controlled settings, participants who remain in weight loss programs usually lose approximately 10% of their weight. However, one third to two thirds of the weight is regained within 1 year, and almost all is regained within 5 years. "](http://www.ncbi.nlm.nih.gov/pubmed/1580453)
2) Giant meta study of long term weight loss: ["Five years after completing structured weight-loss programs, the average individual maintained a weight loss of >3% of initial body weight."](http://ajcn.nutrition.org/content/74/5/579.full)
3) Less Scientific: [Weight Watcher's Failure - "about two out of a thousand Weight Watchers participants who reached goal weight stayed there for more than five years."](https://fatfu.wordpress.com/2008/01/24/weight-watchers/)
4) [The reason why it's impossible seems to be that although calories in < calories out works, the body of a fat person makes it extremely difficult psychologically to eat less.](http://www.nytimes.com/2012/01/01/magazine/tara-parker-pope-...) This is borne out by the above data.
5) [The only thing that does seem to work in the long term is gastric surgery.](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1421028/)
Moreover, you won't find any reputable study on the web where the average person lost 10%+ of their body weight and kept it off for five years. Not even one.
https://www.europeanpharmaceuticalreview.com/news/165203/weg...
Losing it is easy.
I’ve lost 100lbs five times in my life.
It’s fucked.
It's not impossible; some people do it. But it's not easy to change how you think about food and your body, especially when you're surrounded by your old habits every day.
https://davidgoggins.com/book/
https://suereynolds.net/journey-history/
https://www.stephanguyenet.com/thehungrybrain/
Sci hub up this paper and check out the citations too.
https://onlinelibrary.wiley.com/doi/pdf/10.1111/obr.13270
He returned in 3 months, and shocked the nutritionist is he was exactly on the target weight and had followed the plan. She remarked that nobody had ever followed her plans before.
He never regained the weight.
I've seen statistics that only 5% of dieters keep the weight off more than 5 years. It's not impossible, but it is unusual. I've known a couple others who've done it, too.
I suspect for some people they just gained a little weight cumulatively over time due to a slightly fattening eating habit, and for those it's probably not that big an ask to change/fix.
But for many of the overweight/obese people I know, their eating is a straight up dysfunctional drug abuse-style addiction. Predictably it's as difficult to change these behaviors as it is to get a drug addict to quit their drug of choice.
The whole dogmatic war-on-drugs attitude creates this imaginary boundary around "food" which for many I suspect green-lights abuse of "food" because it's not "drugs".
It makes me wonder how much our societal obesity problems would change if the prevailing attitude towards drugs became more factual and nuanced. If people understood better that cocaine isn't as problematic as psilocybin in terms of addiction, maybe they'll also start thinking more critically about candy bars vs. oranges. Perhaps my optimism is showing.
If combined with a confined window of eating, like 11am to 5pm, you'll lose weight faster.
The following comes from a study on T2D reversal where bariatric surgery was one aspect of the study:
“Furthermore, microbial changes in the human gut have been linked to obesity, and surgical alterations to gastrointestinal anatomy have been associated with dramatic changes in gut microbiota populations with reversion from an “obesogenic” to a lean bacterial population [13,14,16,19,23,24].”
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6520897/
It’s a relatively new science and area of study but some of it is fascinating if not hopeful. One in particular looked at identical twins where only 1 suffered from malnutrition finding in all such cases the microbiomes were different between the twins and the malnutrition was successfully treated via the microbiome.
Unfortunately, in modern times the days of short rations never come, at least in First World countries.
That drive functions at a neural level way below the level of the rational mind.
People often make poor choices vis-a-vis sexual activity, too, and for much the same reason.
They passed it on to us before there was a chance to introspect the nutritional and psychological realities of food.
My partner and I are both overweight and we are trying to do a better job with our child - giving them healthy but delicious options, while also not turning any junky food into a reward or a mystery that must be guarded or doled out in careful portions.
So far, we're okay. Not sure how this is going to last once the kid gets into school age...
If I saw people permanently ban junk/fat/sugary food from their homes, do at least 3 hours/week of complete training (weights and cardio), and not being able to stay fit, I would believe that weight loss/being fit is a serious physiological and psychological challenge.
What I observe though, starting from mid-30s, is that the vast majority of people keeps junk food at home (which is, no wonder, "extremely difficult psychologically" not to eat) and/or doesn't do traning (let alone complete training). And invariably blames it on genetics and aging.
(I don't doubt that there is a minority of the people that has serious metabolic disorders, but that's not the general case)
In other words, if you're a doctor, go ahead and tell all your patients the above. You will see negligible impact on their weight, so your advice was useless (worse than useless, since you come across as an asshole).
As an aside, conscientiousness/willpower is highly heritable (as much as height and IQ), so if you're especially good at sticking to a diet, that's also genetics.
Also, who is saying we are calling patients weak willed losers? Should we not tell patients to stop smoking, or to quit heroin, because they might think that we think of them as "weak willed losers"?
*edit for ambiguous wording: By this I mean it seems to work for at least 50% of people, with the average being 3% weight loss.
For the weak willed comment, that was a reference to Pizza234's comment I was responding to earlier, not yours.
It more points to the limitations of studies like these than it does an incontrovertible fact. Some people who are highly internally motivated can lose weight and keep it off.
https://www.nature.com/articles/ijo201094
>More than one out of every six US adults who has ever been overweight or obese has accomplished LTWLM [1y] of at least 10%.
review: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4777230/
As far as the doctor's advice is concerned, focusing on weight loss as the sole outcome is misguided. The typical trajectory of an obese individual is to keep gaining weight; if doctors could even make their patients stop gaining weight, that would already be a major development in standards of care.
It's also important to consider the limitations of the metric. Studies don't evaluate sustained cultural shifts like "do doctors regularly talk to the patients about nutrition", because it's hard enough to track a patient for five years, let alone get a doctor to do blinded controlled interventions for five years. So what the study tests is a controlled diet for a short period followed by a period of unsupervised maintenance (with a recipe book), not the consistent availability of nutrition guidance over a period of years.
It's perhaps more important to note that while the results in adults are quite bad, it has been shown possible for adolescents to drop by more than a standard deviation in BMI after an intervention and maintain this for two years:
https://www.sciencedirect.com/science/article/pii/S002234760...
https://www.sciencedirect.com/science/article/pii/S1054139X1...
Professional interventions for weight loss and/or maintenance aren't infeasible, they're just hard, and it pays to start early. It's not too surprising that older people are more reluctant to change their habits.
[fuller2014]: Finds that Weight Watchers underperforms standard national guidelines: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4282338/
https://www.cdc.gov/nchs/images/databriefs/351-400/db360-fig...
Those studies on adolescents is heartening though.
Source 1 seems to be from a conference, and they don't list specific numbers or cite sources, so I have no idea what "almost all" means.
"5) [The only thing that does seem to work in the long term is gastric surgery." That study says that gastric surgery works, it says nothing about the other methods for weight loss.
Right, except they'll still be homeless, poor, mentally unstable, or all of the above. Drug use is often the symptom, not the root cause.
It's similar with food. For many people, food becomes the primary source of joy in life. And just like with drugs, the joy shrinks, the high gets shorter, and the health side effects soon start outweighing the benefits. But it's still quite hard to go cold turkey, and just like a recovering addict, even years after establishing a healthy diet it becomes really easy to fall off the wagon.
We can moralize about how starving children in africa have things much worse, but human happiness is contextual to the reality we know. And life in modern western society has a lot of pitfalls, anxiety, and depression. Obesity is in many ways a side effect of people's lived experience.
Giving a diet plan for weight loss is basically an equivalent of giving an exercise plan for depression.
This mostly reflects on what doctors recommend rather than blanket discipline failure across a broad population. I can tell you what my local Kaiser recommended for T2D and obesity:
1) they send you to a Registered Dietician who shows you a modernized food pyramid based heavily on grains. Minimize animal fats, replacing with seed oils. 70% calories as carbohydrate.
2) MD flat tells you "you MUST eat 6 small meals a day so you never get hungry."
What was done instead: Time Restricted Feeding, 4-6 hour window, low carb, limiting to mostly keto first half of window. A1C dropped over 3 points (10.3 to 7) by next labs.
Crazy, that's what I would recommend if you want to become obese.
>2) MD flat tells you "you MUST eat 6 small meals a day so you never get hungry."
I guess that MD really wants his patients to become insulin resistant and eventually develop diabetes.
Everything (hyperbole) you can buy in a supermarket is meant to make you feel full for an hour and then hungry again.
An alternative to surgery would be to just to continuously monitor blood glucose. The patient would immediately know when the food they are eating is messing up their body and the doctor can control the diet of the patient.
The GLP1s have proven to have excellent efficacy for weight loss (and cardiovascular mortality in diabetics). Their numbers approach bariatric surgery (>10% body weight in the obese).
People keep the weight off too. Here's one study showing 5kg on average weight loss at 5 years according to this study: https://www.mdpi.com/1660-4601/17/1/207/pdf
So why do i care about the cause again? I dont. it was a non reversible event
Not just lets them get away with it, actively encourages them to use practically toxic amounts of high fructose corn syrup by subsidizing the grain.
https://invidious.osi.kr/watch?v=dBnniua6-oM
When he was diagnosed with pancreatic cancer, he decided to forgo the aggressive medical treatment advised by doctors, opting instead of acupuncture & fruit juices.
Acupuncture and fruit juices are just as effective, with a much lower incidence of side effects. I’d choose that treatment option as well. There’s nothing unethical about palliative care.
He had a much rarer form of pancreatic cancer that is treatable and has much better survival rates.
Pallatiative care is making the choice to travel to end of the line. I am currently going through making that decision. If i do, bring on the tasty juices and accupuncture to make me feel relieved at the time. But i am not delusional, it's not treatment. It is not going to fix anything or even stall it
OK. With you on that.
> and there can be reasonable people who find themselves on that distribution in a way that makes them more concerned about what they're not being told than the virus
It is at this point they cease being reasonable people.
In the initial DAYS of the pandemic, it's true that he said that he didn't see there was a reason for normal citizens to be wearing PPE and masks, and that they should be reserved for medical professionals or those at higher risk. This was because:
a) we didn't even know about aerosol spread at that point b) there was a massive run on mask-buying that was making it impossible for doctors and nurses to get masks, and it was more important for the doctors and nurses to have them c) we didn't have data on mask effectiveness for average folks then
Then the facts changed. And the supply of masks improved. And so Fauci's advice changed, too. That's what a real scientist does. When the facts change, they change their conclusions.
Please do not present this as an example of governments "lying" to people. That is not what happened here.
The government has done a perfectly good job of "reaching out" to people. The problem here isn't the government. It's right-wing media.
Because that takes time away from providing actual medical help. Think of it like a DDoS, all the cranks lining up for their dose of <not even a placebo> taking up the time of actual Doctors, nurses, and other essential staff who chose jobs to try and actually help people.
Imagine being a trained Doctor and spending your day performing worthless procedures on those who refuse to take the advice it took the Doctor years to earn the right to provide.
I would really appreciate it if someone would explain to me what the reasoning is for this not happening. Like most people here, I'm an educated professional, and I've watched hundreds of hours of video from actual doctors about the pandemic, and I still do not understand the reason.
One harm is that it would help legitimize the drug as a COVID treatment, when science shows otherwise.
Put simply, the harm is that the already harmful misinformation that ivermectin helps would become even more pervasive. The only way out of this pandemic is _towards_ reason, not away.
The problem with this is that in these people's minds, if <insert whatever magical cure to covid they know works> doesn't work, it's always some other factor than the cure itself that is causing it to not work. It doesn't prove to these people that those things don't actually work.
If the hospital administers the 10,000mg of Vitamin C, which won't work (according to what we know from medical experts), when the patient dies his family would just claim that the hospital didn't give him the right dosage, or they should've administered the vitamin C earlier, or the hospital claims that they administered the vitamin C but really didn't administer anythiung, or what they administered was not the right vitamin C / was not vitamin C at all. It doesn't cross these people's minds that maybe vitamin C doesn't work. Swap vitamin C with hydroxychloroquine or ivermectin or whatever other covid cure flavour of the month it currently is.
Here is a paper from one such institution published in a highly respected journal (Breast Journal) that found a significant increase in the median survival rate for women with metastatic breast cancer.
https://pubmed.ncbi.nlm.nih.gov/19470134/
If a doctor prescribes something without a reasonable (proven would be nice) expectation of a positive effect on the patient, and the patient dies, the doctor is at a minimum a target for a malpractice lawsuit, and at most liable for murder charges.
Also, there have been court cases recently where courts have ordered doctors to give alternative treatments, so it seems that the legal liability problem does not cover all cases.
I guess you haven't been to the rural US recently. Not only is that plausible but its very likely. Check some of the social media posts on r/hermancainaward
> Don't believe everything you read.
You're not setting yourself up to be the most credible source here...
What about your history here? Your most recent submission was flagged dead.
Speaking of Occam’s Razor, if someone claims to be certain a person is lying yet provides simply “believe me” as evidence, the simplest explanation is that the accuser is lying.
edit: the post above literally says they've never been on reddit, why am I getting downvotes for this?
So please. Don't ask us to trust you when you give us no reason to. Instead, you could just support your argument.
Single purpose, 9 months old account. Only mentions being a doctor ~3 months ago, and then consistently mentions it.
I can’t believe anyone wouldn’t see through this and see it is clearly fabricated by someone who has a lot of time on their hands (which Reddit trolls sure have), unless you’re a teen or younger. Hacker News, please do better and see through this BS. It is a facade meant to divide us. (I am pro-vaccination, but I can’t stand people who are for cause but have to lie to make a point).
> Speaking of Occam’s Razor, if someone claims to be certain a person is lying yet provides simply “believe me” as evidence, the simplest explanation is that the accuser is lying.
It is rather striking how much the odds of hospitalization and death go up conditional on a positive test, but even then the odds really aren't that bad.
I've read similar things from verified sources written by doctors in these kind of roles (not broken noses but of serious abuse from anti-masker, anti-vax nuts, as well as the kind of deaths the post is talking about). Obviously in the kind of ward implied here they're seeing the worst of the worst cases.
Are you saying it's not true because he talks about a 38 year old dying from COVID? Over 14,000 people in to 30-39 year age bracket have died from COVID in the US this far. If you were in ICU at a big hospital you might see a few dozen people in this age bracket dying (as well as many, many more older people). And yes, it's a small proportion of cases but if getting vaccinated might have stopped 90% of them dying (sadly a lot of those deaths would have been before the vaccines are available though), that's no small thing, even if the general risk for somebody in that age group is fairly low...
So who knows, maybe this particular anecdote isn't true, but it is consistent with a lot of things I've read that I know are.
https://www.kare11.com/amp/article/news/health/covid-19-inte...
https://amp.theatlantic.com/amp/article/620713/
https://www.washingtonpost.com/health/2021/04/22/health-work...
https://www.beckershospitalreview.com/workforce/18-of-health...
Also the doctor made no mention of other therapeutics that do have more expert consensus of helping like monoclonal antibodies or fluvoxamine. I'm sorry to hear that they have decide to leave medicine and that they were assaulted. Violence is never called for. That said, it's unclear if all tools in the current tool belt were used in this patient's case.
https://www.theepochtimes.com/dying-covid-19-patient-recover...
edited to reference another site: https://www.chicagotribune.com/news/breaking/ct-ivermectin-e...
i totally get that it's anecdotal. my point is more about just allowing people the opportunity to try therapeutics especially ones that have been proven to help in many cases like monoclonal antibodies or have little to no risk of harm.
[1] https://www.scribd.com/document/538389544/Action-Order-Man-K...
Then certainly you can cite, say, one factual error they have published this week. Or month?
Or does "rag" simply mean "doesn't parrot the narrative I prefer"?
> If someone is on downward trajectory towards death, why not give them cheap generics at human safe doses?
What is a human safe dose for someone whose body is so compromised that they’re close to death? If the doctor prescribes a medication that doesn’t have, at a minimum, peer reviewed research showing its effectiveness in these situations, they are going to be liable for negligent manslaughter, if not murder.
And rightly so, when you think of the broader implications of allowing doctors to do whatever they want to the dying.
hmm could they then not simply allow patients to sign liability waivers?
It’s probably more accurate to say that when you do sign such a waiver, it’s going to be an exceptionally involved process that includes a lot of time providing information to provide for genuinely informed consent (2nd, 3rd, 10th opinions, counselors, hospital lawyers, your lawyers, etc) when you’re in your right mind.
Experimental medicines for terminal patients are hard to get, for a good reason.
Good Lord, I thought HN was smart enough to see through the reddit garbage.
Nevermind the whole thing reads like fanfic: "Through tears, he rasped out sounds I could vaguely understand as a question. I guessed at what he was asking, and assured him that yes, his family was coming."
The whole post is awful, and even entertaining it here is absurd. When people complain HN is becoming like Reddit, this is what they're talking about.
Run as fast as you can away from doctors and other healthcare providers who think like this. Healthcare providers who have this particular arrogance can create very severe health issues for you and your family with their hubris. There are incredible doctors out there who also have humility when it comes to their own knowledge and will answer your questions and listen to you and take you seriously when you come to them with your own research.
The human body is orders and orders and orders of magnitude more complex than the most elite and advanced human endeavors of engineering. It's almost not even comparable. You have to have extreme humility in the face of such complexity and in the age of Google and open access to medical journals there is just so much to know and so much that is available that any doctor or healthcare provider who would dismiss the value of patients and caretakers doing their own research is really someone who is very dangerous to you and your loved ones.
It's not about "be the better way".
It's about being able to to entertain & consider multiple theories, versus just being an asshole who won't even regard any convictions except your own.
Google Medical School doesn't have to be right every time. It doesn't have to be the more consistent option to be not "the better way", but simply worth entertaining. It doesn't have to be right 10% of the time. Some suffering patients will find & learn & discover things that do seem to fit their own problems. Being an asshole doctor who disregards, who writes off alternate theories: that's the wrong fucking way, and fuck those doctors, run the fuck away, get them fired, get them blacklisted, & warn other people. That's the wrong way.
There's no one more invested in a patients health than the patient. The resources of time & analysis they'll put in to trying to figure out what could be an issue is far far higher than what the medical system can provide for all but the very very richest of people. The resources out there to figure stuff out are real. Is it a better way? No. The patient doesn't have years and years of medical school. But that doesn't make their way wrong. That doesn't make them caring about themselves wrong, doesn't make their quest for truth & healing wrong. Any doctor that would turn their nose up at a patient, would refuse to hear a patient out, that refuses to acknowledge how wonderful & accessible medical information is in the world, and how helpful that can be: they are strictly worse. Worse diagnosticians, and worse people.
- The doctor is going off a very short explanation you gave in a 30-minute appointment. If you have a serious medical problem, you can dump days, weeks, or months into finding information that matches your experience down to the fine details, which can very much matter - especially if you have an unusual case of something.
- There may be new information since your doctor was trained. Medicine has advanced a lot, and while doctors do their best to keep up, there’s more new research than any one person can digest.
- You will always believe yourself, never dismiss your experiences as “exaggerated” or “drug seeking”, and never blame your conditions on obviously unrelated causes.
That last one is especially relevant to people who aren’t cis white dudes. I’ve witnessed, with my own eyes, a woman talk to a doctor about chronic nasal congestion, and his response was to tell her to lose weight. Doctors habitually not believing the experiences of their patients has done incredible harm over the years.
I've seen a similar situation but felt the doctor was stating what was important. He did accept her experiences but... Her congestion was not remotely as important as her weight, her weight was going to speed her death, and she'd best lose weight soon.
IOW he was saying "regardless of how you solve your congestion, you simply must lose weight now or you will die soon from a heart attack or stroke."
It's also important to distinguish between technique and knowledge. The difference between a layperson and their surgeon is enormous, a layperson and their doctor, not so much in the grand scheme of things.
1. The type that's too incompetent to diagnose anything more complicated than a cold or a broken bone. Usually they are general practitioners, sometimes they are specialists.
2. The type that might have been a productive person but they are too arrogant and/or lazy to diagnose anything but the most common things that pop up in their specialization. If its starting to look like its going to take any amount of effort at all to diagnose they'll throw their hands up and literally claim they don't know and its probably just something you'll have to live with.
It would be foolish for a layperson to think they can train themselves to be a doctor using google and diagnose a wide range of medical conditions in a large group of random patients better than a doctor. Its not foolish at all to think that given you have all the time in the world since its your life, that you might be able to do some productive things and try to figure out what could theoretically be wrong with you so you can make a more educated guess about which specific specialist might be able to diagnose your condition or rule out one that you suspected you might have. 99% of doctors are going to make a basic effort and then pretend its just some unknown chronic thing you probably shouldn't worry about, even if you feel like you are dying on a daily basis. Or diagnose you for one of the common things that doesn't fit your symptoms, give you medicine that will either not help at all or actually exacerbate your condition, and then double down on the diagnosis. And its not just about finding the right type of specialist, you can go to two specialists within the same field and one can be completely worthless to you because they have no experience with your set of symptoms.
I've gotten too many blank stares from doctors when asking them basic things that they should know to buy into the notion we seem to promote in the US that all of them are geniuses.
FYI Not an anti-medicine, anti-vax conspiracy nut. I just went through a nightmarish ordeal for several years trying to get help for my wife. Her condition is a physical condition that's misdiagnosed 80% of the time as anxiety. Once you have anxiety listed on your medical record, good fucking luck getting any of these arrogant assholes to do their job. Once you do get a diagnosis, the results of treatment are pretty mixed, but mostly not amazing. Fortunately it doesn't significantly shorten a person's life, but it does make it difficult to live it.
I've seen mildly famous and wealthy youtubers (famous for being sick youtubers, in some cases having the same condition as my wife) get teams of doctors working together hand in hand to figure out some rare set of conditions and make a person's life better. Most doctors I've encountered will figuratively tell you to go fuck yourself if you even want them to talk to another specialist. The closest I came to that was spending several thousand dollars sending her to the Mayo clinic. They rush you through a series of tests and then send you home without doing much of anything at all, hoping that you have a good team of doctors that can pick up where they left off. If you don't (and you won't) its a massive waste of time and money.
Dermatologists! Dermatologists!
My wife and I have gone to our healthcare providers' dermatologists about 6 time in total: each time they've sent us home with a diagnosis of "allergic reaction" and a prescription for a tub of cortisone (which we have, at this point, ceased to fill):
https://cdn.shopify.com/s/files/1/0996/0350/products/triamci...
The cortisone never works, but I have two tubs of cortisone cream in the refrigerator in case of nuclear war.
This is a shame. We once had a private dermatologist who was simply outstanding - he nailed every problem with his diagnoses. But he retired. It seems the colleagues he left behind are all candidates for the Golgafrinchan Ark Fleet Ship B.
My wife recently was given another "allergic reaction" diagnosis for a skin irritation and got another cortisone tub prescription. I looked at her skin and then, on a hunch, sat at her computer terminal awhile. Sure enough in a few minutes I felt stings on my neck and right arm. An examination with a magnifying glass revealed very tiny fire ants on my arm. I searched above her chair and found the source - a Chinese lantern was the ants' launch platform - they were falling onto her and then stinging her.
How a trained dermatologist cannot distinguish ant bites from an "allergic reaction" is beyond me. The ant bites have a red center and form blisters, which is nothing like a generalized allergic reaction.
A little bug spray and some ant baits took care of the ants. I don't know how to fix the dermatologists.
I think what they are talking about are people using terrible sources (garlic curing HIV example). Then demanding that they are right.
So really, what we see here on both sides as the root cause are people who are not interested in a discussion and simply assert they are right. Dangerous if a patient does it, also dangerous if a doctor does it.
For every 1 person who actually has discovered something useful or accurately self-diagnosed with some very well-done research, there are surely 10,000 complete idiots who have swallowed hook, line and sinker the first nutball result they read, which they now believe 100% and if you don't agree you're an ignorant, indeed murderous enemy.
It's completely understandable to me why doctors take this stance.
Often it just requires a bit of pushing if it's a simple diagnostic test. "Can we just do this blood test to completely rule out [x]?". I remember about a decade ago my father was getting this extremely bad dermatitis on his elbows for years, and mum had researched and found coeliac (celiac) disease could cause that as a symptom. The GP was prescribing steroid creams, and they really had to push him to do a blood test to check for those antibodies. He thought it was dumb but gave in just to shut them up! Came back positive, next step was an endoscopy, which showed massive inflammation in the small intestine. Dad cut gluten out of his diet and over the next year the dermatitis and intestinal inflammation disappeared.
What if an engineer responded by harboring a grudge against all blockchain?
I mean, it would be unfortunate if that engineer decided not to donate to Scihub. But that exhausts my list of bad things that could happen due to such a grudge.
It does have to suck to have a lot of badly informed people parroting silly ideas they casually picked up online. But to so callously write off everyone, to so easily disregard any opinion & information other than your own, with what limited time you've got to examine a patient? Detestable, just absolutely revileable: this person has deeply failed their oath.
I also don't think your scenario is fair. The customer isn't just showing up & ordering you around. As a doctor, the patient is the product. The product is speaking for itself, asking for help. It's also paying you fairly well for your time & services. And as I said above, there's a good chance the product is well informed about itself. To write this off as a case of idiots making pointless requests- I can not disagree hard enough about what a callous, disregardful view this is. There are plenty of times when yes, the patient has fed themselves garbage, the patient is way off base, but let them not be so easily out of hand dismissed, let not the workplace maintain such a sense of absolute smug over the idiot rubes of the world.
That's exactly what patients are doing. Entire industries are built around this. People don't want to be told the hard answers to their problems, they want to do whatever they want and then take one tiny pill that causes weight loss, resistance to heart and respiratory disease, and increased libido.
>I also don't think your scenario is fair. The customer isn't just showing up & ordering you around
Read the stories. Watch the news. This is exactly what is going on. There is not a good chance that the patient knows what they're talking about - the overwhelming majority saw a quack on Facebook or Oprah saying something clearly wrong and stopped looking further because they want that one easy answer.
if indeed a patient is requesting modern quackery, then yes, reject that. but simply turning up your nose at "Google Medical School" & dismissing all patient concerns blanketly is not ok.
If the solution to your particular disease involves a year of changing your lifestyle then no doctor on earth is going to help you. (it's not their job)
Covid, the virus, doesn’t typically kill you directly: the cytokine storm that some people seem to have afterwards is what kills them.
That’s why people making statement about “my immune system is strong” are speaking from a position of ignorance. You don’t want an over-reaction of your immune system in response to viral load. This is what the vaccine helps with by giving your immune system a chance to develop an immune response without having to go nuclear trying to clear the infection.
The storm is why people are ok at day 7-10, then suddenly crash on day 11-4, seemingly out of the blue. They have a hyperactive response that begins destroying healthy tissue, particularly the lungs and the heart, given the concentration of ACE-2 receptors, which is where the virus binds easiest to. Your immune system, still trying to develop an answer to this novel infection, goes scorched earth to attempt to clear any and all rogue RNA that is detected.
That’s when you lungs start to hardened and fill and pneumonia kicks in; it’s all the dead tissue in your lungs from your now CoVid-induced autoimmune disorder.
This is why steroids are given - they blunt the various inflammatory responses a cytokine storm brings on. Problem is, your immune system do go hard in the paint, and sends EVERYTHING it has.
This is why using an anti-parasitic in this moment makes a whole lot of no sense.
This is why HCQ makes no sense at this stage.
The new oral anti-virals have the same issue: you have to get tested, diagnosed, and get these into you AS SOON AS POSSIBLE. The oral antivirals that are being tested stop the replication process of the virus, or that’s the goal.
The less viral load, hopefully a more blunted immune response, the less or no organ destruction.
Make sense?
That doesn't mean that COVID isn't bad, or that people shouldn't consider getting the vaccine (especially if they are old, obese, or have diabetes). It just means that his experience is not representative of what COVID is like for most people.
So the stories are the exception.
However, they're also very common.
If 1 out of every 50 people who ate at a McDonald's in America died, 50,000 people would die every day [https://financesonline.com/number-of-mcdonalds-in-north-amer...].
I have no idea why you think they did, but that never happened.
https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...
> Up to 95 percent of people infected with polio have no symptoms. However, infected persons without symptoms can still spread the virus and cause others to develop polio. About four to five percent of infected people have minor symptoms such as fever, muscle weakness, headache, nausea and vomiting. One to two percent of infected persons develop severe muscle pain and stiffness in the neck and back. Less than one percent of polio cases result in paralysis.*
Despite most cases being harmless, polio was considered a huge public health issue worldwide. The small percentage of cases that developed paralysis added up, essentially becoming a roulette for the majority of children. This is because it was still transmitted easily and rapidly, so it spread through millions of people quickly.
Covid can be seen similarly. Yes most people are fine. The same way that most people that get into car accidents are fine. And yet I don't think it'd be a stretch to say most people probably know at least one person that has suffered serious health complications due to covid
* https://www.health.ny.gov/diseases/communicable/poliomyeliti...
And
‘History doesn’t repeat, but it does rhyme.’
Around half of those admitted were unvaccinated people in their 50s, the other half vaccinated and in their 80s. The former group was something like 5-7 times more represented. I think 90% of them were overweight or obese.
So, yeah, seems like if you get admitted to the ICU today, you're either a fully vaccinated very old senior citizen, or unvaccinated high-risk individual in your 50s.
This is the number of people you will spread the infection to.
Flu has a R of 1.
Covid Alpha/Beta have a R of 3-5.
Delta has a R7-9.
Omicron is allegedly 15+, and unlike anything we’ve ever seen outside Measles.
Giving you a death rate of 1% infected, to keep it easy. Current numbers in the US are 1.56%.
So, 1% dead of spread of a R1 is going to be a lot slower and manageable versus 1% of R7. The exponential (Logarithmic?) rise of infections will kill a lot more, a lot faster, and have knock-on effects everywhere within the healthcare system, and society as a whole.
The only hope is that by rule, typical virus evolutions are less virulent, but we’re still not sure of that at this time. The big fear with omicron is that the spike protein mutations are immune-system dodging and faster infecting/more contagious, but that the payload within is still functionally the same. The mutations not on the spike are not changed enough that virologists are hopeful at this time.
Sorry, wall of text. Hope this addresses the question.
The role of a doctor, when someone is sick, is to offer good advice and stop them doing anything that will be really damaging to themselves. I'd see this as more similar to a dying man getting access to a priest than anything else.
Maybe this woman would have been screaming at him anyway, but I can see why she would be angry. He is obviously being a bit arrogant. The dude was dying, let the family believe what they want at that point.
He'd have made life easier for himself and the family by saying "this won't work, but if you can foot the bill and will feel better about it then OK".
Ivermectin is prescribed (not proscribed) mostly for treating parasitic infection. Using it at therapeutic doses for Covid is dangerous.
But I'm not forcing my standards on anyone. If this family wants a silly treatment and there isn't anything better to do, then they should get what they want if they are willing to pay.
One of the reasons this doctor got screamed at is because he took responsibility for making all the decisions and the patient died anyway. Which is good doctoring, I respect that. But if he is surprised that a family is angry that he ignored their wishes without a good reason then he is not paying attention to how the world works. He could have easily just agreed with them and kept the peace, at no undue cost to anyone.
Are you a doctor, healthcare provider, or even in the medical field? If not, I urge you to stop spouting your amateur theories about medicine on the internet, where they can spread and cause further harm.
This isn't a conflict situation and there is no obvious downside for anyone. The doctor isn't giving in to anything. The family is making a stupid request, yes. No skin off the doctors nose to grant it though and if it'll make them happier he may as well. If he thinks it is significantly harmful then he needs to make that argument instead of dismissing them.
I’m glad my parents droned into me that nobody can take care of my health except myself.
I don’t know what I would have done in their situation but if it caused them to quit their job I wouldn’t put it past them not to uphold the duties of said job.
I worked in a similar environment and most violent incidents were not reported unless it was people doing violence on one another rather than staff.
Their experience basically mirrors this up until the assault. According to them, they've never had so many patients and family members fight them for every single decision they make -- they're bringing in all these ridiculous printouts about "give me these vitamins and steroids on this schedule" and of course they want HCQ and IVM still. None of them will accept responsibility for not being vaccinated, they blame the medical staff when they don't get better like they think they should, they all see intubation as the step that kills their loved ones instead of a last chance to save them.. it's enough that my family member is retiring rather than deal with it any more.
My family member works at a small hospital in the Midwest and more than one patient has accused them of "working with Dr. Fauci" to prolong the pandemic. Just complete nutball bullshit.
All of the quacks promoting these horrible "cures" while convincing millions of people to not get vaccinated should lose their licenses. I doubt there will ever be any consequences for the non-credentialed talking heads doing the same but man have they inflicted a massive amount of suffering on their viewers. I hope the culture war was worth the weight on their consciences.
I mean, sure, the ease with which people have decided they can argue against easily demonstrable facts over the past 5-10 years has been unsettling, but I thought when push came to shove, and their lives and their loved ones' lives were on the lines, people would come around. But a sizable portion of the country is now in a full-on death cult.
And to be clear, I can understand there are plenty of things about the pandemic and the pandemic response that can be debated, but a huge portion of the country is miles off the deep end into full on crazyville. Even Trump was loudly booed recently when he said he got a booster.
Somebody the vehemently believes that the rapture is coming and the Earth is 3,000 years old rarely gets a reason to punch anyone over such beliefs.
Trump publicly announcing that he got a booster made me respect him more. He could have (and politically should have) kept silent.
"The stories and information posted here are artistic works of fiction and falsehood. Only a fool would take anything posted here as fact."
Here's a pretty interesting video essay about online fakery, with a heavy focus on Reddit fakery.
https://www.youtube.com/watch?v=BiU7aGZ-o68
Doesn't mean the story itself isn't true, but I would expect the author writing about someone else and not himself.
Some examples from the top of my head:
A woman named MsScribe spent years fabricating harassment against herself so that she could gain influence in her community and join the moderation team of a fan fiction website. She would create sock puppets to attack herself, so that the community would rally around her, over and over again.
A reddit user spent years creating "fake fake stories". They made obviously fake stories, which they put a lot of effort into, such as writing poetry and drawing comics. They would post these stories to places like r/thathappened, as if someone had genuinely tried to pass these off as real stories. Their goal seemed to be to present the communities these fictional authors belonged to as ridiculous, they were building straw men. I don't remember the name of this user, but this is presented in the video I linked in a sibling comment.
(Both of these people eventually admitted to this behavior when confronted.)
https://www.businessinsider.com/covid-19-patients-family-mem...
https://www.sfreporter.com/news/2021/11/23/christus-st-vince...
https://www.wkyc.com/amp/article/news/health/violence-agains...
https://www.nbcnews.com/health/health-news/hospitals-refused...
And here’s a doctor describing the conflict, frustration and regret of unvaccinated late term patients:
https://www.latimes.com/opinion/story/2021-08-12/doctor-ange...
Plug for a friend: https://trustedoctor.com/
> A recognition that doing so would be putting a target on me, my family, my colleagues and my hospital for all of the violent Q-Anon people. The arrest would be local and possibly national news. It would subject these children to deep pain. Worse, though, it would hit Facebook, and within no time, my name, my kids' names, and my wife's name would be all over their sites. All of us would be threatened. These people are unpredictable, but seem to crave violence. I don't want to be responsible for one of my colleagues being shot in the parking lot because I became a national symbol of Q-Anon hospital violence.
He makes a couple of blatantly dubious medical claims. For example he claims that Ivermectin doesn't work (probably true) with a followup claim that it does work but you have to give so much you'd OD from it.
In other posts he claims "every ICU patient is covid" which is a repeated hoax we've seen. At the very least it doesn't differentiate people in ICU who have covid vs people in ICU because of covid, and how many of the people caught their covid while in the hospital/ICU, etc.
ICUs aren't full. If this is actually a doctor and they are actually in an ICU that's temporarily full, it definitely is not always full. Statistically ICU beds in hospitals are at pre-pandemic vacancy levels.
Lastly, and this isn't really fact based, but it's too "on the nose". The whole narrative they've created is like it was written by a third rate script writer to sell the narrative. It's "too perfect" for his side. The truth is bad enough, people really are dying and suffering. There really are a lot of conspiracy people. But it's just to clean for his side.
Ivermectin does work in vitro, but the equivalent effective dosage would kill a person.
I really have trouble believing that this isn't just a propaganda meme. What proportion of the population actually believes that a vaccine will cure them post infection? More importantly, how are all of these people uttering vaccine requests when their lungs are failing? Isn't it a little hard to talk when you're in the end stage of a severe lung infection?
Linking these unvaccinated deaths to qanon conspiracists in the second sentence further makes me doubt that this is an actual doctor reporting on their experience. This is reddit, after all, a heavily astroturfed (and opaquely controlled) propaganda machine.
However, to your question: how many of these people are begging for the vaccine, and how?
It's a surprising number. These patients don't understand how vaccines work outside of movies and TV, and as such think it's either bullshit or at the last minute feel like it's a miracle.
Because at the end of the road, you realize that you've been told lies by those you trusted. There's a clarity in the end moments. Situations like these where you have no choice but to think about what you've been told and the ramifications of your actions.
And so these people fall back on the last thing that wasn't at least blatantly false, which is a social understanding of medicine. Vaccines cure diseases, or so we're told in our school days. So much of the American medical psyche is built around medicine being a solution for the current ailment, not a prophylactic for the likely future.
A huge part of the antivax rhetoric is "but I'm healthy now". They don't see it as preventing illness in the future. To them a vaccine is an antidote, a fix for a problem.
And so they beg for the antidote when it is obvious that they are at the end of the line. They don't understand that it's not a fix for now, it's prevention for later.
As for how they can: function degrades, yes, but its biggest impact is on duty cycle. You go from being able to talk constantly to mustering enough energy to speak a few minutes at a time to making it 30 seconds, to 4...5 seconds, to losing it entirely. You get bursts of energy, but each burst comes with a toll. Maybe a few more moments here but a long delay as you recover from it.
https://amp.theguardian.com/us-news/2021/jul/22/us-coronavir...
https://amp.cnn.com/cnn/2021/07/22/health/hospitalized-patie...
https://www.wfxrtv.com/news/health/coronavirus/dying-covid-p...
> the body can only absorb a maximum of 100 mg a day, with the rest creating the world's most expensive urine
An adult can absorb up to 500 mg of vitamin C: https://pubmed.ncbi.nlm.nih.gov/12134712/
And vitamin C is one of the cheapest supplements, at least in that part of globe I currently in. The entire line about "expensive urine" is taken from a handbook of party conversations.
https://redditmetis.com/user/thanosrain
Account created October 14, 2019
135 total comments
102 of which are in /r/QAnonCasualties
Other top subreddits include HermanCainAwards, CovIdiots, and Quit_Headquarters.
Some comments in AskReddit and others, almost exclusively about covid.
This doesn't say much about the persons identity, but they're clearly not coming to the site to have fun.
Submission by weekday is also interesting, high on weekdays, low on weekends, highest on Monday.
I hate to be skeptical because I have doctor friends that have similar covid stories, but this post is quite sensational, newsworthy even. I wonder if the user would be receptive to verifying themselves with the mods.
edit: their first comment is March 3rd, 2021 and first submission is March 2nd, 2021. Nearly a year and a half after the account was created.
The whole things reads like an airport novel, adjusted for a specific subject. It's what people who believe about a certain world view expect to see in that world. A tear-jerker for sure, but in practice, for example, I have a lot of anti-vaxxer friends, and even though I don't agree with their choice (but I agree with their choice to have a choice), none of them behave like the people in the story. They are not insane, they just strongly adhere to a certain set of believes.
People would point out to the writer's history, but in fact, their account is only 9 month old, with an average of a few posts per months. It's completely not unreasonable to believe that someone spends this effort to create an illusion of credibility. Heck, I know people with two dozen "active" hacker news accounts, doing the same thing, but in their case so they could promote key tech articles, instead of vaccines.
Internet is a lovely place, isn't it.
As your own source explains, “High intakes of the vitamin are generally well tolerated; a tolerable upper level was recently set at 2g based on gastrointestinal upset that sometimes accompanies excessive intakes.”
The OP’s reference to 100mg daily was evidently a typo; he probably meant 1000mg rather than 100.
FYI: I’m currently taking 1000mg daily on the advice of my primary care physician.
This is a two years old account but with only 9 months of activity. (> 1 year old can be sold, see https://www.soar.sh/sell-your-reddit-account/)
No activity in other health related subreddits
All posts are obviously militant and politically linked to topics related to QAnon and anti-vaxxers.
All the posts are generic advice and none of the writings reflect a profound expertise in science nor medicine. Most of the information posted by the author can be found on public government websites and news articles. Having listened to a lot of practicing physicians interviews during the last two years (and having family working in the field) the contrast in deep technical understanding and jargon is clear as day and night. At best he works in a hospital, maybe as a low-tier nurse.
I get it that nurses would quit and find other jobs, but a doctor with "14 years of medical school"?
He says that he worked "many decades" plus 14 years of school. Assuming he went med school at 20 and "many decades" is 3 decades, he would be at least 64 years old. That's very unlikely given Reddit's users demographics (https://www.oberlo.com/blog/reddit-statistics) where users of 65 only constitutes 1% of the user base. Being a militant progressive makes it even more unlikely for the same demographic reasons. If it is two decades or less, than this is not "many decades".