tankerslay's comments

can I ask what make/model you settled on?

"Scandal" should be avoided because it "degrades the trust of the public in the profession." An age-old saw trotted out to justify the cover-up of diverse kinds of negligence and malfeasance in all manner of professions the world over.

It works precisely until there is a scandal too big to cover-up.

>And yet some of them got the surgeries and some didn’t, so it’s unclear if the control was adequate.

It is what it is. The documented evidence suggests that the medical histories of the two groups diverged strongly at the moment of surgery.

It is possible that the decision to have surgery depended primarily upon an arbitrary judgment of the surgeon, in which case the randomization is adequate.

It is also possible that the pre-surgery health of the two groups diverged in a way that was not well-documented in the medical record, in which case the control is inadequate.

However, this latter possibility is still not flattering to the medical community. If the conclusion of the study is even possibly correct, it raises a serious question of why such a flimsy paper trail accompanied such a momentous cost-benefit decision in the lives of these children.

>The treatment cures (in around 97% of cases) tonsilitis.

I feel like this is a kind of doublespeak and a rather misleading way of phrasing things. It of course stands to reason that excising an organ in toto will be very effective at preventing a person from having continued inflammation of that organ, as it is no longer part of their body, in the same way that toenail fungus can almost certainly be "cured" by amputating the affected toe.

The latter rarely happens, because people understand the value of their toes and realize that having toenail fungus is typically better than having no toe at all. But for organs inside the body, whose function is less plain to the lay person, patients are largely at the mercy of doctors to give them an honest appraisal of the life-long risk of removing them, and whether it might be warranted in a particular situation.

It seems that in many of these cases, it would be far more straightforward and honest to simply say "If [organ X] is really bothering you, I can cut it out," rather than cite some pseudo-scientific percentage purporting to describe how often surgery can "cure" some abstracted set of symptoms or "chief complaint." Doctors (especially specialists!) seem reluctant to move beyond this rather myopic way of conceptualizing health care. The idea that medicine is simply a game of "complaint whack-a-mole" might be psychologically comforting to a doctor (as well as financially lucrative in fee-for-service jurisdictions), but, from the perspective of the patient, it makes little sense to fix one symptom only to acquire five more of greater severity.

The question people really want answered is: "If I cut out [organ X], is it going to cause me other problems down the road?" But this is the very thing that doctors/surgeons so often seem so curiously (willfully?) ignorant of, even for "routine" procedures. Isn't it rather bizarre that, despite tonsillectomies and adenoidectomies being performed on millions of children over many decades, often for the most trivial of justifications, the analysis described in the linked paper took until 2018 to be completed, by a trio of PhDs no less?

Is it just too psychologically burdensome for surgeons to worry about the long term health of their patients or the long-term consequences of their procedures?

I think tcj_phx certainly does have a point, that people are not so much interested in "treating symptoms" as they are in doing what will preserve their whole-body health well into old age. If doctors can't say what will best achieve that, either because they don't know or haven't bothered to look into it carefully, they need to be very upfront about their ignorance and inability to provide a well-considered recommendation.

>TVs have gone up massively, mostly because flatscreens make ridiculous TVs possible.

Your assertions about price movements sound rather curious as they appear nearly the opposite of what is obtained by people whose job it is to measure these things. https://fee.org/media/17509/prices2-1.png

https://fee.org/articles/why-large-screen-tvs-are-affordable...

A very limited number of features have improved (e.g. if you have HepC). At the same time there has been massive price inflation for things that are marketed as "improvements" without convincing evidence of actually being better (e.g. nexium vs prilosec, many medical devices).

Our system is such a disaster, even "preventative care" can be a wolf in sheep's clothing. There's basically nothing to disincentivize doctors or pharma from aggressively selling drugs and procedures that give no benefit or even cause harm.

Health care has leeched a huge amount of wage growth from the economy, in businesses large and small.

https://www.bloomberg.com/view/articles/2016-09-28/health-ca...

>these days it seems to be mostly about generating clickbait.

Yes it's a bastardization of their profession, but everyone needs to eat.

Who knows if we'll ever get back to the quality of journalism in the Woodward/Bernstein era, when the large majority of middle-class Americans paid a monthly subscription to have professionally composed news delivered to their doorstep every morning.

How is the marshmallow test (or "The Boy Who Ate the Marshmallow") different from "The Boy Who Cried Wolf"? Both teach a lesson with a nugget of wisdom, the former about the perils of self-indulgence, the latter about the foolishness of sounding a false alarm. Both lessons are supported by numerous examples--far more than 90--that each of us has observed in our own lives. But one is presented as a self-contained fictional story, while the other is told as the result of an experiment that revealed some kind of natural law.

Why is our culture so drawn to presentations of basic life lessons as if they were the results of scientific experimentation? It's as if we have some sort of self-consciousness about "believing in" fables that drives us towards the telling of "fables-as-science".

Is this field even about "science" per se? It seems more oriented towards fashioning just-so-stories that lend a scientific veneer to some piece of folk wisdom in order to generate a buzz.

My own "experimentation" suggests that the character trait that predisposes one to bandy about pop allegories such as "marshmallow test" is a portentous sign in potential managers.

Paper records, human memory....

Comparing growth in data storage versus energy usage per capita is interesting.

Even if you look back to the founding of the U.S., the change in energy use per person is actually only a few fold, definitely less than an order of magnitude.

Harder to compare quantity of data storage but the change would seem much larger. How much data is there, per U.S. person?

>The traditional routes and social contract are broken.

There is definitely some truth here. Can you find a partner and/or community of people who share your understanding of the traditional social expectations?

PUA is a community of sorts, but also has core beliefs so inimical to the opposite sex that it doesn't seem very sustainable.

Doesn't this already violate a bunch of laws? (undisclosed advertising, wire fraud or something like it, etc) Just enforce them. Can't do much about overseas people but you can penalize the businesses that purchase fraudulent marketing. E.g. if doctors started getting medical licenses permanently revoked for buying fake "testimonials" I imagine it would end fairly quickly.

>My god, the author of this story made all the wrong choices.

Did he? He kept his job, didn't get drunk or hooked on pain pills, bailed out what sounded like a very uncooperative ex-wife, and all through it kept his house clean and even took care of the neighbor's dog. If anything, I'd say the story comes dangerously close to being a humble brag.

Whatever money difference there was be between him and pretty much any of the others, including the couple who skipped town with pizza on the counter...I'd gladly pay it twice over to have neighbors like this guy.

If it's about a public figure (even a limited-purpose public figure), there's no problem because that speech is already highly protected against libel claims.

If it's basically just non-newsworthy information about private citizens, then I do not think they should be shielded from liability.

Just eliminate the various liability shields that have been enacted for third-party content. In certain areas (e.g. the personals website crackdown) we are moving in this direction already.

If you make a search engine vulnerable to a libel lawsuit because, for example, their search results make it look like Joe So-and-So was arrested for DUI (when it was actually Joe So-and-Sew or some such thing), they'll just stop indexing that stuff entirely.

Best to avoid creating new laws where old legal concepts will work fine.

>how someone like me who only has a BS in Physics and Electrical Engineering manages to make 1.5x-4.0x what they make my first job out of college, then there is something seriously wrong with the system.

This is largely what I would expect. A PhD (actually, anything after the Master's) isn't really about acquiring new technical skills. It's about learning to put into practice the basic values that sustain the discipline, which in science consist largely of 1) a fanatical obsession with figuring out what the data is really telling you, 2) relentlessly questioning your hypotheses and entertaining alternative explanations, and 3) rooting out the various cognitive nooks and crannies wherein lie the temptations to fool yourself or others.

For most technical jobs, these kinds of habits are not really germane to what you are being asked to do. Hence many businesses are quite reluctant to hire people with PhDs at all. The ones they do pick up will tend to agree that their PhD was a "waste of time."

I actually disagree with the idea that academia doesn't teach you much about "how the world works."

In my life, my time in academia was probably the most "real world" experience of my career. I find many people who crave a more straightforward relationship between effort and recognition to be slightly naive about just how much of society is dedicated to essentially make-work tasks.

In a country where most basic needs (food, clothing, shelter) can be provided relatively cheaply by a small number of workers....well, what the heck is everyone else supposed to do?

I think it's an awesome privilege that middle class people have the opportunity to basically be paid by the government to pursue their own academic interests for a few years as a young adult, even when the return on this "investment" is highly uncertain.

The reason that the money gets dumped into STEM seems to be mainly just a coincidence of what our political culture is most likely to agree on (libs don't want to pay for theology degrees, and cons don't want to pay for gender studies or whatever).

But there's never been a better time to be alive if your interest is in mathematics or the natural sciences.

I'm not sympathetic to the gripe that there's no "proper career guidance" in grad school. If you want a ready-made career track, you should not be in a PhD program.

Yes, academia is competitive, and unforgiving, and harbors a lot of eccentric and even ugly personalities. But the fact that it is "all about the discipline" is part of the appeal. And society cannot afford to sustain young people at such a high level of intellectual freedom with anything more than a "basic income" at best. Most of the things that make academia difficult are part and parcel to what makes it special.

The biggest change I would potentially advocate is an email to all first-year students letting them know that if they just want to take classes for a few years, get a cushy job, and drive a Lexus, they should be in medical school instead.