My impression of duolingo was strongly influenced by a former PM who said basically what OP said without any hint of ill will in their voice. Duolingo discovered that it was easier to reward-hack short term signals of language learning instead of scaffolding those signals into longterm language learning. Today it’s essentially Candy Crush for people who think they’re too smart for Candy Crush.
That’s not even a diss, it’s just The Way Of The World when you are directly rewarded for growth and retention and very indirectly for language learning.
> Today it’s essentially Candy Crush for people who think they’re too smart for Candy Crush.
That's overly harsh. I use Duolingo for Japanese because
- I thought it would be fun to learn a little about Japanese. And I do learn some, and it is fun.
- I wanted to "understand" a bit of what was being said during subtitled anime I watch. This was _partially_ successful. I understand some words, and I notice some things like "oh, that was a question", and sometimes notice when what was said doesn't match the text. I get enough out of it that it adds to my enjoyment
So, clearly there's a group of people out there that are there to gain some knowledge out of it, and _not_ to rack up some kind of score (and feel superior).
Sorry, that came out as unnecessarily harsh on users when it was intended for Duolingo’s product department. I don’t mean to suggest that the amount of language learning is literally zero, just that whenever language learning is in tension with legible metrics, the latter tends to win out internally.
Fascism and Ayn Rand's political philosophy are pretty different from each other, however you may feel about either one. Not everything you dislike is the same bad thing.
Japanese tea gardens are pretty artificial and manicured, and they’re awesome. It’s great to have undespoiled natural beauty, and it’s also cool to see what people can do with a landscape.
Practically every culture on earth (except ours as of 10 minutes ago) had some sort of place for single-sex bonding, which suggests there’s something important to it. Traditional cultures aren’t incel, to the contrary it’s only in modern cultures that mass-scale failures of relations between the sexes seem to arise.
As for bjj, the scenario of the instructor dating a female student and breaking up the gym in the ensuing fallout is a well-deserved trope by now. There are women at my gym and you can make it work if everyone’s bending over backwards to be professional, but it’s obviously Different.
Every culture that treated women equally? Or were there male only spaces because women were seen at 2nd (or 3rd tier people, below the pets?)
I trained at a gym where that scenario happened, people were already leaving because the teacher was an ass in general, played favorites with the male students and created at cliquey environment.
There really isn't anything women can't handle in front of men. Thinking you have some dark thing that cant be said in front of women or that you need to change how you behave is odd and exclusive to you.
No culture treats men and women equally-- they differ in how they treat men and women differently. Just today in my progressive coastal startup, for example, there was a proposal to set up a dedicated ERG for the women employees. In a company where people are routinely pulling 60-80 hour weeks, it was considered a plausible priority to take time aside to especially ensure that the women were feeling comfortable.
Whether or not this proposal is a good idea is not even the point: the point is that it was considered plausible, and hence that not even coastal progressives actually think it desirable to treat men and women equally.
I'm not making any claims about what anyone can or can't handle. I'm simply observing that just about every mixed group ends up adopting female norms of communication. I'm not even saying that's necessarily a bad thing for a mixed group, I think it's to some extent natural and healthy in social settings. In fact taboos that proscribe the ways men may speak in the presence of women are also quite common cross-culturally. But the fact that there is a difference remains.
I think what many Catholics found frustrating about Pope Francis was his tendency to make apparently off-the-cuff remarks which, while never quite explicitly straying outside the bounds of faith and morals defined by the Magisterium, often seemed to strongly imply the opposite. This was especially true for audiences that did not already know the Catechism through and through, which even most Catholics do not. In that sense, Pope Francis's remarks sometimes seemed to possess a kind of not-committing-heresy-can't-get-mad character. This was exacerbated in turn by the media's selective quotation of statements that were, if quite reasonable in their entirety, not exactly robust to misinterpretation.
Although I personally wish Pope Francis had done certain things differently, God chose him for a reason. I will try reflect on that as I, along with the Church, pray for him.
> while never quite explicitly straying outside the bounds of faith and morals defined by the Magisterium, often seemed to strongly imply the opposite. This was especially true for audiences that did not already know the Catechism through and through, which even most Catholics do not. In that sense, Pope Francis's remarks sometimes seemed to possess a kind of not-committing-heresy-can't-get-mad character
He sounds like a good teacher, reminding people how much the faith encompasses outside of what they feel that it encompasses. People need prompting and guidance on the parts that feel uncomfortable, not the parts that dovetail neatly with their intuitions. If their reaction to his teaching is to trust their knee-jerk discomfort over the pope, despite not being able to formulate any concrete objections, just the feeling that it must be wrong in a sneaky way they can't put their finger on, then it seems like they have decided to let their own feelings be the highest authority.
> People need prompting and guidance on the parts that feel uncomfortable, not the parts that dovetail neatly with their intuitions.
I totally agree in general. But I wouldn't say that the issues with Francis's style amounted to knee-jerk discomfort without concrete objections. The concrete objection is that many of his comments had to be read in a kind of maximally un-Gricean way to be squared with Church teaching.
Francis's deployment of ambiguity in communication isn't something I'm making up-- it was a highly unusual and distinctive element of his papacy, most notably evidenced in his refusal to respond to (quite concrete) dubia over seemingly unorthodox comments for seven years.
But if there is a silver lining, I suppose there has been no other pope in recent years that has occasioned more clarification of the doctrine of papal infallibility, so there is that.
Pope St. Pius X put it in Pascendi: "It is one of the cleverest devices of the Modernists (as they are commonly and rightly called) to present their doctrines without order and systematic arrangement, in a scattered and disjointed manner, so as to make it appear as if their minds were in doubt or hesitation, whereas in reality they are quite fixed and steadfast."
Francis, like other Modernists, had the knack of saying heretical things in a way that the intended effect was obvious, but his defenders could say, "He never said that! And here's how you could interpret him in a completely consistent with Catholic teaching." Or they'd argue that he was speaking off-the-cuff and shouldn't be taken literally, or that he was misquoted by an atheist interviewer (to whom he kept giving interviews and never corrected the record). But everyone who wasn't in denial knew what he was doing.
I share some of your frustrations, and yet there is also a spiritual peril in failing to extend charity in the interpretation of these remarks, let alone in claiming to know that anyone who interpreted them differently is being willfully obtuse.
The greater the errors of the Franciscan papacy in your view, the more you owe the man your prayers.
Honestly, if you're going to be a member of a church and you fully believe that the dude is holding the seat of the founder of the faith, the least you could do is actually have enough of an attention span to fully hear him out. It isn't his fault that people decided to do what people do. He explained himself and people chose not to listen.
My impression formed from my time in cancer drug discovery is that bro science is, within practical bounds, a perfectly reasonable option for one arm of a comprehensive plan for treatment.
A lot of things that sound like bro science are actually broadly supported in the literature. But studying this stuff is hard because of all of the usual issues with human subjects, the less than complete reliability of our epistemic institutions, and the infeasibility of running enough trials to address every indication in every subcohort. So if anecdata supports some intervention that that isn't aggressively inconsistent with basic theory, won't make you miserable for what might be the rest of your life, and which you could try with the sober understanding that your One Weird Trick might not work, why not?
If nothing else, a well-documented case study with good adherence tells us of one more thing that didn't work, which is hardly the worst parting gift to the world.
Every single person I know who died from cancer young went down this route, from trying weird cures to going and seeing John of God in Brazil. Zero cured or delayed the cancer. All delayed acceptance and GREATLY regretted wasting that time and wishing they had had more time in the acceptance phase not the 'this can't be real' 'I can't die' 'There has to be something' denial.
This can and does hurt them, and is cruel. If they want to inflict in upon themselves, that is one thing. But to do it because OP has had enough losing friends is selfish. You will never stop losing friends to death, in fact, it will only accelerate from here on out. It will never get easy. In fact, it compounds as more and more joy/light/goodness leaves the world and those you turned to for support are gone. It's part of the deal they made when our parents volunteered us for this existence.
My own view is not that self-experimentation is an appropriate, let alone likely efficacious, substitute for reconciliation to the idea of one's death. I certainly don't endorse interference in others' treatment, however well-intentioned. If you want to say: "you shouldn't treat your terminal illness like a science fair project unless you possess extreme sang froid and are precommitted to the acceptance of your death", I'd find that totally reasonable.
But my own view is rather that institutional epistemology is somewhat overrated, and self-experimentation somewhat underrated, relative to the conventional wisdom. (Though some people go too far in this direction.) This leads to general overconfidence in epistemic efficient market hypothesis arguments ("if a protocol were worthwhile, someone would have found it already") and underconfidence in the value of crowd-sourcing trying a bunch of stuff and writing it down. This view was principally informed by developing cancer drugs for a living and coming to appreciate that it's really hard, your knowledge of what's going on during a clinical trial is highly abstracted, and you can't be everywhere at once. It was secondarily informed by watching people do bro science on certain important questions and making interesting progress in large part because they could move much faster than academic or corporate research.
If we recast the point of contention as: "what is the largest effect size that could be found by an institution outside of academia or industry?", my position is that it's plausibly non-zero.
I'm sorry for your friends and I hope they found peace.
As a pure numbers game, I’d find it more surprising if “broscience” never found a result:
- a lot of terminal patients are prone to experimenting
- their overall number probably eclipses the total number of trial patients in a given year by at least one order of magnitude and I’d believe two or three
- they don’t have institutional barriers to what they can try, eg, they’ll fund non-patentable treatments
- a lot of their approaches are taking things from published papers and trying to recreate similar effects (eg, calorie control [1])
That they’ve stumbled across at least one treatment that solved at least one case for at least one patient seems likely. Isolating that from incorrect null results is where the epistemological struggle is. And there’s a good chance that it won’t help you with your particular case.
But what’s the harm in trying? — you’re probably going to die anyway.
When you try someone else's "broscience", you're not really experimenting with the unknown, so it's unlikely you're going to stumble into a "result". They know it doesn't work. If it did work, they'd have patented it and licensed it to Merck or Pfizer.
I think your argument is that developing cancer treatments is really hard and the clinical trial process has problems. I can believe it. Do you think the mainstream epistemological process produces more false negatives or more false positives? What's the proportion of cases where a chemist finds a compound that really works, but the process incorrectly rules it out, vs cases where something that doesn't really do much still comes out the other end as a marketable drug?
I'm not in the industry, so what do I know? But I kind of doubt there are actual, effective treatments just sitting there unmonetized in Merck's basement library because the company is slow and the process makes things difficult. Especially the kinds of things that get mentioned in HN threads that don't require any chemistry research and are pretty straightforward to test, like fasting, meditation and yoga.
TBC I have no reason to believe that Big Pharma is deliberately withholding effective treatments it knows about so much as making (understandable) decisions not to investigate them in the first place. The total addressable market of a potential therapy is a central consideration for target selection-- you're roughly trying to maximize patient population times marginal willingness to pay over the standard of care. I don't think there's anything nefarious about this btw, you have to do what makes the greatest difference.
But that does mean that if you have a hyper-specific rare disease, the person who is willing to spend the most time thinking about it may very well be you. Or if you're living far from a major hospital and getting treated by a generalist with a heavy case load, you might be the most invested person within 500 miles of you, which is almost the same thing but better because you can still read the literature.
I wouldn't encourage the average patient to try doing rational drug design in their garage, but one could ask: "are there things that look promising that are still a year out from clinical trials?" and think about how to DIY some approximation to that.
At the extreme end of this spectrum, you have people like Beata Halassy who did just that, treating her own cancer with DIY viral therapy (https://www.nature.com/articles/d41586-024-03647-0, and please do note all the finger-wagging about how terrible and irresponsible of her it was to save her own life). Why did she have to do that instead of just going to a doctor? Because the route to the clinic is too slow. Why is the route to the clinic too slow? Because FDA has the institutional incentives that it's better that ten thousand patients die for lack of a cure than one die of quackery. Why's that? Because the FDA gets penalized for bad treatments but not for treatments that don't exist. But I say that dying of lack of a cure is not much better than dying of quackery, so we might as well minimize total deaths.
At the somewhat less extreme end, you have ideas like trying to treat GBM with Zika virus, which has a sketch of a mechanistic explanation and some support in animal models, but afaict no clinical trials yet (https://clinicaltrials.gov/search?cond=GBM&intr=Zika). Is this a cure for GBM? Complete BS? Something in between? I have no idea, which is kind of my point-- no one knows yet. Regulators probably aren't that jazzed about signing off on giving neurotropic viruses to immunocompromised patients without a lot of prior evidence that will give them cover for making that call if something goes wrong (which it totally might!). But an individual patient might look at that question with a different set of incentives.
Or consider psychiatric treatment of various mental illnesses. The best and most honest psychs I know will tell you that, past a certain point, responsiveness to a given drug is idiosyncratic and the state of the art is really just "try a bunch of stuff until something works", without much concern for hypotheses about underlying mechanisms. Is that rational medicine or bro science? Something in between, I think. And is it possible that there are behavioral protocols that help one particular schizophrenia patient to manage their quality of life better than the standard of care as defined for the entire population? Given that no one really agrees about what schizophrenia even is, this seems not totally impossible.
And then at the other end of the spectrum you basically have lifestyle interventions, as you note. Almost everyone agrees that certain of these are good for you, but some are really difficult to implement and adhere to. It seems reasonable to self-experiment with those things.
If this was the case there would be facilities in remote countries with lax law making billions off of curing cancer. While there are indeed facilities in countries with lax laws doing questionable medicine, none are known for actually working. Instead they are known for preying on people. The fact that successful facilities don't exist indicates to me that your hypothesis is incorrect.
As I’ve pointed out elsewhere, I don’t think curing cancer is the bar for sober self-experimentation. “Noticeable amelioration of disease” is.
There is substantial regulatory burden that prevents US-based companies from doing what you suggest. In fact there is regulatory burden that prevents things that 99% of American voters would prefer, like having reciprocity agreements that allow you to take any drug that had already been approved in Europe. It’s instructive to look at the case of Halassy and notice how much reflexive resistance there is to even the most self-evidently good ideas.
To make things concrete, here’s a practical idea: write down everything you eat while on a medication and rate your subjective well being everyday. Look for patterns. If anything jumps out at you, try eliminating it and seeing if your subjective wellbeing improves. Is this method fool-proof and without failure modes? Of course not. Is the prior probability that you’re eating at least one thing that’s unknowingly contraindicated for your condition / treatment pair very low? Also no.
My model is that the rate limiting factor for spotting unknown contraindications mostly just individual attention / discipline, so EMH arguments are unresponsive to this factor.
Consider the following argument: if obesity were such a big health problem, why is everyone fat? Mostly because losing weight is really hard, which I sympathize with but don’t take as an indication that it’s impossible to do anything about it.
In fact we don’t even have to bring disease into it at all. I’m sure that if i did a systematic elimination diet i would find one or two common foods that really didn’t agree with me, which i could make noticeable differences in QoL by avoiding. Why don’t I? Mostly because I’m just too lazy, and I’m fine with copping to that. But i don’t think it’s crazy for someone to choose otherwise, especially if they had a higher upside.
True. But for the highest-grade nasties, where median life expectancy is unfortunately short and progression near-universal, you don't need much signal to get above the noise.
Anyone surviving more than a handful of years with something like that is an outlier such as to merit a full work-back, and at that point it's no longer bro science.
I think that's partly a survivor (the disease surviving, not the patient) bias effect.
Things that could be solved by random discoveries are no longer considered the highest-grade nasties. There were a lot more intractably fatal conditions in 1870 than there are today.
So the likelihood of there being answers that could have been randomly discovered by medics with 1870 or 1920 levels of knowledge is tiny. At the same time, the sum of human knowledge has expanded so rapidly since then, it's not impossible for stuff to get missed.
Apparently you know many people that have died from cancer young, and this qualifies you to know how a terminally ill person should process that emotion.
You have zero qualification. How dare you imply that you know best for someone going through this.
Hopefully no one reading this is ever in that situation. But I'll defer to the individual who's facing the death count down to process it in their own way.
Your tone policing in offensive. Psychological and quality of life in end of life situations are valid and necessary considerations to include when talking about life threatening conditions.
I said nothing about how a terminally ill person should process anything. I stated what I have found to provide the best outcome when a person close to you has a terminal disease. If OP said 'my friend asked me to research...' I would have given a different response/no response.
But when OP makes it look like this is an initiative OP took upon themselves, for themselves, because they have lost too many friends, then yeah, I'm going to highlight that might not be the best possible position to come from if OP wants the best outcome for their friend. My response about outcomes it totally valid since OP asked for help with outcomes.
To give a practical example, grapefruit juice contains some compounds that inhibit CYP3A4, a metabolic enzyme that influences the metabolism and absorption of many drugs, which is why many prescriptions tell you not to drink it while taking a given medication.
This interaction was not discovered until 1989, and not reported until two years after that. So before 1991, a simple dietary intervention that affected like half of all drugs and that could in principle have been noticed by patient who felt bad after drinking a common household beverage, was bro science.
Which is not to say "and therefore just do whatever", but just to point out that there's plausibly a lot of low-hanging fruit still left if you can figure out where to pick it.
The problem is you can't figure out where to pick it; it's lost in a sea of superstitious noise.
Even if you could find this fruit easily, "a food that cures cancer when eaten" does not exist. That would surface in epidemiological studies very quickly.
I admire your optimism in epidemiology. In point of fact, though, we have a rough natural experiment in the form of a food that doesn't cure a disease, but rather makes half of all drugs worse. That's very valuable knowledge, and under ideal epistemic conditions it might have been discovered within a few years of organized drug discovery as such. Yet was not widely known until the 1990s. So that's a failed positive control, which suggests that our practical capabilities to detect these kinds of effects are limited. Understandably so, given that there is no general requirement for dietary logging in clinical trials.
That said, "a food that cures cancer when eaten" is not the bar for experimentation. More realistic might be something like "a dietary or behavioral protocol that, in some way, ameliorates this or that illness".
For organisms with our body plan, "a cure for cancer" is like talking about "a cure for defection". But clearly there's "stuff that is efficacious against particular instances of cancer", a lot of which we found through techniques like natural product screens, i.e. "just trying stuff", rather than via rational drug design.
It is indeed somewhat surprizing why it took so long to figure out grapefruit juice (and it was by accident during the study of the effects of coffee on a drug). Some of the early drugs that interacted with grapefruit juice where short-term agents like antibiotics, and others like channel blockers didnt have obvious detrimental toxicity though they might have had effects that were above the range of typical human variability. Powerful statins became household items a bit later, and all the cancer drugs were invented after this association was already known.
I think there is a lot of efficacy left on the table with modern studies, clinical trials, and drug development. Most of the work is looking for treatments that work for the majority of the population. If a treatment was effective than standard care for 10% of people, it would be discarded.
It is more economical to start over looking for something that works for 90% of people.
Drugs an treatments aren't evaluated and discarded when proven worthless. The bottleneck is the number of treatments in development, so they are discarded when something else has a better ROI.
I love that someone asks for advice. Even for individual experience because he is miserable and some people are basically like "Nah just die. It would be uNeThIcaL."
Philosophy of mind is the branch of philosophy that attempts to account for a very difficult problem: why there are apparently two different realms of phenomena, physical and mental, that are at once tightly connected and yet as different from one another as two things can possibly be.
Broadly speaking you can think that the mental reduces to the physical (physicalism), that the physical reduces to the mental (idealism), both reduce to some other third thing (neutral monism) or that neither reduces to the other (dualism). There are many arguments for dualism but I’ve never heard a philosopher appeal to “magic spirits” in order to do so.
If architectural beauty is subjective, that’s an even stronger argument for building stuff that broad majorities find pleasing instead of stuff designed by architects who write manifestos about how much they hate beauty.
That’s not even a diss, it’s just The Way Of The World when you are directly rewarded for growth and retention and very indirectly for language learning.
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