Quotulatiousness

July 7, 2017

Despite the headlines, the world is getting much better, much faster

Filed under: Economics, Health, Media — Tags: , , — Nicholas @ 05:00

The mainstream media has a built-in bias for bad news, which is understandable: bad news draws eyeballs and clicks because as a species we’re much more attuned to detecting risks than anything else — it’s a good pro-survival trait. Our bias (and reinforcement offered by the media’s bias) leads us all to think things are going much worse than they really are, pretty much all the time. Scott Sumner offers a bit of counterpoint:

The news media is good at storytelling. That’s no surprise, as people like to learn through stories, indeed this preference is probably hardwired into our brains. The news media can’t survive without readers and viewers, and so naturally they focus on storytelling. And the most riveting stories involve war, terrorism, natural disasters, and other serious problems. While the individual stories are usually true, the overall effect is to present a very false image of the world. As a result, at least 90% of Americans literally have no idea as to what is actually going on in the world. Here’s Nicholas Kristof:

    Nine out of 10 Americans say in polls that global poverty has been staying the same or worsening. So let’s correct the record.

    There has been a stunning decline in extreme poverty, defined as less than about $2 per person per day, adjusted for inflation. For most of history, probably more than 90 percent of the world population lived in extreme poverty, plunging to fewer than 10 percent today.

    Every day, another 250,000 people graduate from extreme poverty, according to World Bank figures. About 300,000 get electricity for the first time. Some 285,000 get their first access to clean drinking water. When I was a boy, a majority of adults had always been illiterate, but now more than 85 percent can read.

    Family planning leads parents to have fewer babies and invest more in each. The number of global war deaths is far below what it was in the 1950s through the 1990s, let alone the murderous 1930s and ’40s.

    Aneri and I are reporting from a country whose name, Liberia, evokes Ebola, civil war and warlords like General Butt Naked. That’s partly because we journalists have a bias toward bad news: We cover planes that crash, not planes that take off.

Unfortunately these true lies are hard to push back against. Statistics tells us that the world is getting better at a mind-boggling rate (Seriously, can your brain even imagine the improvement in human welfare associated with 250,000 people a day rising above extreme poverty? I can’t.) But that’s not the world people tend to see. As a result, they elect politicians who pander to their ignorance of the world.

July 3, 2017

QotD: Smartphones, the Internet-of-things, and social controls

Filed under: Government, Health, Quotations, Religion, Technology — Tags: , , , — Nicholas @ 01:00

It’d be interesting (in a gruesome sort of way) to see what Da’esh (or the government of Saudi Arabia) could do with a citizen score. Currently enforcement of public morality in hardcore Salafi Muslim states is carried out by the Committee for the Promotion of Virtue and the Prevention of Vice in Saudi Arabia, and other religious police in other states. As with all police forces, there is a cost associated with putting boots on the ground. If you have, for example, a modest dress code, you could go some way towards enforcement by feeding purchases of garments into the citizen’s score. (Buy too much of the wrong kind of underwear and you could be singled out for an in-person check by the mutaween. And heaven forbid they catch you streaming music from a western cloud service.) Signs of non-conformity could be punished indirectly: it’s a lot harder to resist ubiquitous peer pressure than it is to dodge external resource-limited law enforcement.

In The Handmaid’s Tale, Margaret Atwood’s Republic of Gilead subordinates women rapidly by taking control over the financial system. But that’s a comparatively crude mechanism. The more data you’ve got, the more tightly you can constrain your reward/punish metrics and the more accurately you can focus your oppression — and micro-focussed oppression minimizes the risk of generating wide-scale resistance. Everybody’s experience is different, isolated, locked inside an invisible cell with asymmetric walls that their neighbors can’t see. And if you can’t see the invisible walls locking your neighbours in, you can’t establish solidarity and exert collective pressure against them.

We are heading towards a situation where we all carry smartphones, all the time; where we need them to call a cab, or check a bus timetable, or unlock our cars, or pay for something. Your smartphone knows who you are, knows where you’ve been, reads all your correspondence, and hears everything you say. The discrete activity of placing a voice phone call is in the process of replaced by barking “phone, put me through to Sandy in Sales”, followed by rapid connectivity (unless Sandy is in do-not-disturb mode or talking to someone else, in which case their phone will take a message for you). With always-on recognition, your phone (without which you can’t really exist in an internet-of-things world) will track your mood and your pulse rate and possibly award you citizenship points or penalties if you respond to the wrong stimuli.

But that’s the nightmarish, dystopian grim-meathook-future version of citizenship scoring: a system that facilitates the pervasive enforcement of mandated behavioural standards and punishes quantifiable expressions of individuality. Nobody would vote for (or buy into) that! So it’s going to be even more gamified, to make it fun. You can see your score in real time, get helpful tips on what to do (or not to do) to grind for points, and if you’re thinking about doing something a bit naughty a handy app will give you a chance to exercise second thoughts and erase your sin before it is recorded. But that’s not all. Obviously you didn’t really want to date that manic pixie dream girl (she’ll murder your citizenship score with her quirky and unpredictable fun transgressions) but we can apply the magic of Affinity Analysis to look for someone more suitable for you — similar preferences, similar tastes, and most importantly a similar attitude to social improvement and good citizenship.

Now eat your greens; your phone says you haven’t been getting your five a day this week and if you keep it up we’re going to have to dock you a point.

Charles Stross, “It could be worse”, Charlie’s Diary, 2015-10-09.

June 29, 2017

Homeschooling is looking like a better option all the time

Filed under: Bureaucracy, Education, Health, USA — Tags: , , — Nicholas @ 03:00

Susan Goldberg explains what some states are now asking primary school teachers to do in the way of monthly mental health evaluations of the kids they teach:

On paper it reads like a not-so-vague attempt to socially engineer your child’s behavior. In reality, teacher-led mental health assessments coming to a growing number of public schools are a bureaucratic nightmare. One that will no doubt further clog our nation’s public education system with increased paperwork and administrative costs while putting your child’s future at serious risk.

Thanks to Dr. Aida Cerundolo’s piece in The Wall Street Journal, we are beginning to understand the real-life ramifications of these dangerous educational ideas. Want the Cliffs Notes version? Head over to the excellent summation by Emmett McGroarty and Jane Robbins, detailing the ramifications of the Every Student Succeeds Act (ESSA), a federal bill focused on the buzz-phrase “Social Emotional Learning” (SEL), the latest craze in public education. Schools in states that have ESSA legislation on the books can use the Devereux Student Strengths Assessment (DESSA) to fulfill ESSA paperwork requirements.

    …every month the teacher must answer 72 questions about each of the perhaps dozens of students in her class. She must assess whether the student “carr[ies] himself with confidence,” whatever that means for a 5-year-old, and whether he can “cope well with insults and mean comments.”

    … Dr. Cerundolo’s alarm at the imposition of DESSA is shared by at least some New Hampshire teachers. One of them contacted Ann Marie Banfield, Education Liaison for Cornerstone Action in New Hampshire, to express her objections to completing the DESSA forms on her students. The teacher was especially troubled that the school neither sought parental consent nor even notified parents that their children were being screened by amateurs for mental-health issues. As the mother of public-school students, she worried that other teachers were completing this assessment on her children.

You read that right: if you live in an ESSA state, your child’s mental health will be assessed by a non-medical professional in a non-medical context. The paperwork will not be protected by HIPAA laws, which means that the school district can share a teacher’s assessment of your child’s mental health with literally anyone. Parents are not asked for permission before the DESSA is administered, nor do they have any say over where the records go once they are obtained.

I imagine that primary school teachers will be just overjoyed to take on yet another task for which they may have no formal training or aptitude, in addition to the piddling little details of actually teaching. Were you ever warned about youthful misbehaviour going on to your “permanent record”? Now, it’s not just the big ticket items that will follow your kids from now on in their school careers.

QotD: The medical equivalent of security theatre

Filed under: Health, Quotations — Tags: , , — Nicholas @ 01:00

The most common reason for admission to a psychiatric hospital is “person is a danger to themselves or others”. The average length of stay in a psychiatric hospital is about one week.

Some clever person might ask: “Hey, don’t most psychiatric medicines require more than a week to take effect?” Good question! The answer is “yes”. Antidepressants classically take four weeks. Lithium and antipsychotics are more complicated, but the textbooks will still tell you a couple of weeks in both cases. And yet people are constantly being brought to psychiatric hospitals for dangerousness, treated with medications for one week, and then sent off. What gives?

As far as I can tell, a lot of it is the medical equivalent of security theater.

Scott Alexander, “Reflections From The Halfway Point”, Slate Star Codex, 2015-06-29.

June 26, 2017

QotD: Psychiatric hospitals

Filed under: Health, Quotations — Tags: , — Nicholas @ 01:00

It’s interesting that psychiatric hospitals are used as a cliche for “a situation of total chaos” – I think I’ve already mentioned the time when the director of a psych hospital I worked at told us, apparently without conscious awareness or irony, that if Obamacare passed our hospital would have too many patients and “the place would turn into a madhouse”. There’s a similar idiom around “Bedlam”, which comes from London’s old Bethlehem psychiatric hospital.

In fact, psych hospitals are much more orderly than you would think. Maybe 80% of the patients are pretty ‘with it’ – depressed people, very anxious people, people with anger issues who aren’t angry at the moment, people coming off of heroin or something. The remaining 20% of people who are very psychotic mostly just stay in their rooms or pace back and forth talking to themselves and not bothering anyone else. The only people you really have to worry about most of the time are the manic ones and occasionally severe autistics, and even they’re usually okay.

For a place where two dozen not-very-stable people are locked up in a small area against their will, violence is impressively rare. The nurses have to deal with some of it, since they’re the front-line people who have to forcibly inject patients with medication, and they have gotten burned a couple of times. And we doctors are certainly trained to assess for it, defuse it, and if worst comes to worst hold our own until someone can get help.

Yet in the two years I’ve worked at Our Lady Of An Undisclosed Location, years when each doctor has talked to each of their patients at least once a day, usually alone in an office, usually telling them things they really don’t want to hear like “No, you can’t go home today” – during all that time, not one doctor has been attacked. Not so much as a slap or a poke.

I am constantly impressed with how deeply the civilizing instinct has penetrated. When I go out of the workroom and tell Bob, “I’m sorry, but you’re disturbing people, you’re going to have to stop banging on the window and shouting threats, let’s go back to your room,” then as long as I use a calm, quiet, and authoritative voice, that is what he does. With very few exceptions, there is nobody so mentally ill that calmness + authority + the implied threat of burly security guards won’t get them to grumble under their breath but generally comply with your requests, reasonable or otherwise.

Scott Alexander, “Reflections From The Halfway Point”, Slate Star Codex, 2015-06-29.

June 22, 2017

The EU regulators want to get rid of a Belgian food tradition

Filed under: Bureaucracy, Europe, Food, Health — Tags: , , — Nicholas @ 03:00

Carol Off reports for CBC Radio’s As It Happens:

Belgian Fries, traditionally served with mayonnaise
(photo by vokimberly at Flickr)

Belgium’s government says a new proposal by the European Union could spell disaster for the country’s world-famous fries.

“We adore our fries the way we make them, so just let us do so for the next 100 years, because the last hundred years it wasn’t a problem, so why should it be a problem now?” Flemish Tourism Minister Ben Weyts told Carol Off, host of CBC Radio’s As It Happens.

Traditionally, Belgian fries, are twice fried in fat. First, they go in raw to generate a soft, fluffy interior. Then they are refried at a higher temperature to create a crispy, golden exterior.

This process sets Belgian fries apart from soft and chunky British chips, or the sleek and thin fries preferred by the French.

But the European Commission is proposing that all potatoes be blanched — briefly cooked in boiling water — before they hit the fat.

It’s part of an EU effort to curb exposure to acrylamide, a chemical that can form in foods cooked at high temperatures, and has been linked to cancer in animal tests.

[…]

On the heels of the Belgian backlash, the European Commission has insisted the proposal is a suggestion, not a ban.

“The commission has no intention whatsoever to ban Belgian frites — or any other frites, for that matter,” spokesperson Margaritis Schinas said on Tuesday.

“Instead, the commission is preparing a new regulatory measure to oblige food business operators to apply a code of practice to reduce acrylamide in food, as it is carcinogenic.

“We are all very attached to the rich culinary heritage we find in our member states.”

For more information on Belgian Fries, see The One and Only Original Belgian Fries Website (which hadn’t been updated with this latest existential threat when I checked it).

H/T to Chris Myrick for the link.

June 17, 2017

What Happens When You Take Steroids? – Earth Lab

Filed under: Health, Science — Tags: , — Nicholas @ 02:00

Published on 8 Jun 2017

Have you ever wondered what happens to a human body when it takes anabolic steroids? Well, Greg Foot is here to explain all the science you need to know about steroids and why people use them for muscle growth.

June 3, 2017

The Government Hates Boobs

Filed under: Bureaucracy, Business, Government, Health, Humour — Tags: , — Nicholas @ 06:00

Published on 2 Jun 2017

From nipple censorship to breast milk regulation, the government is making it hard to have breasts. The FCC maintains oversight of how much and what kind of breasts can grace public airwaves. Its decisions have ripple effects, since cable broadcasters often voluntarily comply with FCC guidelines.

A more dire issue than strategic anatomical censorship is the issue of breast milk. Between one and five percent of American women aren’t able to produce breast milk, and some babies can’t drink formula. When the two overlap the demand for breast milk is life or death. But acquiring breast milk from donation-based milk banks can be difficult and prohibitively expensive. So some women buy their breast milk on an online “gray market” that stifles suppliers.

In this week’s Mostly Weekly Andrew Heaton explains why the government should get its hands off our boobs.

Performed by Andrew Heaton

Written by Sarah Rose Siskind with writing assistance from Andrew Heaton and David Fried.

Edited by Austin Bragg and Sarah Rose Siskind.

Produced by Meredith and Austin Bragg.

QotD: Gay, Lesbian, and Bisexual

Filed under: Health, Quotations — Tags: , , , , , , — Nicholas @ 01:00

Fascinating. This NYT article bears out a suspicion I’ve held for a long time about the plasticity of sexual orientation. The crude one-sentence summary is that, if you go by physiological arousal reactions, male bisexuality doesn’t exist, while female bisexuality is ubiquitous.

I’ve spent most of my social time for the last thirty years around science fiction fans, neopagans, and polyamorists — three overlapping groups of people not exactly noted for either sexual inhibitions or reluctance to explore sexual roles that don’t fit the neat typologies of the mainstream culture. And there are a couple of things it’s hard not to notice about them:

First, a huge majority of the women in these cultures are bisexual. To the point where I just assume any female I meet in these contexts is bi. This reality is only slightly obscured by the fact that many of these women describe themselves and are socially viewed by others as ‘straight’, even as they engage in sexual play with each other during group scenes with every evidence of enjoyment. In fact, in these cultures the operational definition of ‘straight female’ seems to be one who has recreational but not relational/romantic sex with other women.

Second, this pattern is absolutely not mirrored in their male peers. Even in these uninhibited subcultures, homoerotic behavior involving self-described ‘straight’ men is rare and surprising. Such homeoeroticism as does go on is almost all self-describedly gay men fucking other self-describedly gay men; bisexuality in men, while an accepted and un-tabooed orientation, is actually less common than gayness and not considered quite normal by anybody. The contrast with everybody’s matter-of-fact acceptance of female bisexual behavior is extreme.

It is also an observable fact that many women in these cultures change either their sexual orientation or their sexual presentation over time, but that this is seldom true of men. That is, a woman may move from being sexually involved mostly with other women to being mostly involved with men, and back, several times during her adolescent and adult lifetime; nobody considers this surprising and it doesn’t involve much of a change in either self-image or social identity. Not so for men in these cultures; they tend to start out as straight or gay and stay that way, and on the unusual occasions that this changes it tends to involve a significant break in both self-image and social identity.

Eric S. Raymond, “Gayness is hard, lesbianism soft”, Armed and Dangerous, 2005-07-06.

June 2, 2017

How does deodorant work? I James May Q&A I Head Squeeze

Filed under: Health, Science — Tags: , , — Nicholas @ 02:00

Published on 11 Oct 2013

Get a whiff of this! James May delves in to the mechanics of deodorant.

Did you know that our sweat doesn’t smell? Made up of various things like our diet and genetics, it actually does not pong. Rather it’s when your sweat mixes with the bacteria on your skin that it releases an odor that can sometimes clear a room. Your armpits and pubic areas contain thousands of hairs which then hold on to your sweat and bacteria.

Us humans aren’t alone in smelling, many animals have some serious BO too. It’s not such a bad thing for them, it helps them mark out territory, repelling enemies and, most importantly, attracting mates.

Deodorants work by killing the bacteria on your skin and they also work as an anti-perspirant by reducing the amount of sweat. No more BO!

May 30, 2017

QotD: The uses of IQ

Filed under: Books, Health, Media, Quotations — Tags: , , , — Nicholas @ 01:00

Suppose that the question at issue regards individuals: “Given two 11 year olds, one with an IQ of 110 and one with an IQ of 90, what can you tell us about the differences between those two children?” The answer must be phrased very tentatively. On many important topics, the answer must be, “We can tell you nothing with any confidence.” It is well worth a guidance counselor’s time to know what these individual scores are, but only in combination with a variety of other information about the child’s personality, talents, and background. The individual’s IQ score all by itself is a useful tool but a limited one.

Suppose instead that the question at issue is: “Given two sixth-grade classes, one for which the average IQ is 110 and the other for which it is 90, what can you tell us about the difference between those two classes and their average prospects for the future?” Now there is a great deal to be said, and it can be said with considerable confidence — not about any one person in either class but about average outcomes that are important to the school, educational policy in general, and society writ large. The data accumulated under the classical tradition are extremely rich in this regard, as will become evident in subsequent chapters.

[…]

We agree emphatically with Howard Gardner, however, that the concept of intelligence has taken on a much higher place in the pantheon of human virtues than it deserves. One of the most insidious but also widespread errors regarding IQ, especially among people who have high IQs, is the assumption that another person’s intelligence can be inferred from casual interactions. Many people conclude that if they see someone who is sensitive, humorous, and talks fluently, the person must surely have an above-average IQ.

This identification of IQ with attractive human qualities in general is unfortunate and wrong. Statistically, there is often a modest correlation with such qualities. But modest correlations are of little use in sizing up other individuals one by one. For example, a person can have a terrific sense of humor without giving you a clue about where he is within thirty points on the IQ scale. Or a plumber with a measured IQ of 100 — only an average IQ — can know a great deal about the functioning of plumbing systems. He may be able to diagnose problems, discuss them articulately, make shrewd decisions about how to fix them, and, while he is working, make some pithy remarks about the president’s recent speech.

At the same time, high intelligence has earmarks that correspond to a first approximation to the commonly understood meaning of smart. In our experience, people do not use smart to mean (necessarily) that a person is prudent or knowledgeable but rather to refer to qualities of mental quickness and complexity that do in fact show up in high test scores. To return to our examples: Many witty people do not have unusually high test scores, but someone who regularly tosses off impromptu complex puns probably does (which does not necessarily mean that such puns are very funny, we hasten to add). If the plumber runs into a problem he has never seen before and diagnoses its source through inferences from what he does know, he probably has an IQ of more than 100 after all. In this, language tends to reflect real differences: In everyday language, people who are called very smart tend to have high IQs.

All of this is another way of making a point so important that we will italicize it now and repeat elsewhere: Measures of intelligence have reliable statistical relationships with important social phenomena, but they are a limited tool for deciding what to make of any given individual. Repeat it we must, for one of the problems of writing about intelligence is how to remind readers often enough how little an IQ score tells about whether the human being next to you is someone whom you will admire or cherish. This thing we know as IQ is important but not a synonym for human excellence.

Charles Murray, “The Bell Curve Explained”, American Enterprise Institute, 2017-05-20.

May 28, 2017

QotD: Nostalgia

Filed under: Health, Quotations — Tags: , , , — Nicholas @ 01:00

Nostalgia has been shown to counteract loneliness, boredom and anxiety. It makes people more generous to strangers and more tolerant of outsiders. Couples feel closer and look happier when they’re sharing nostalgic memories. On cold days, or in cold rooms, people use nostalgia to literally feel warmer.

Nostalgia does have its painful side — it’s a bittersweet emotion — but the net effect is to make life seem more meaningful and death less frightening. When people speak wistfully of the past, they typically become more optimistic and inspired about the future.

“Nostalgia makes us a bit more human,” Dr. Sedikides says. He considers the first great nostalgist to be Odysseus, an itinerant who used memories of his family and home to get through hard times, but Dr. Sedikides emphasizes that nostalgia is not the same as homesickness. It’s not just for those away from home, and it’s not a sickness, despite its historical reputation.

Nostalgia was originally described as a “neurological disease of essentially demonic cause” by Johannes Hoffer, the Swiss doctor who coined the term in 1688. Military physicians speculated that its prevalence among Swiss mercenaries abroad was due to earlier damage to the soldiers’ ear drums and brain cells by the unremitting clanging of cowbells in the Alps.

John Tierney, “What Is Nostalgia Good For? Quite a Bit, Research Shows”, New York Times, 2013-07-08.

May 26, 2017

QotD: The coming of the sexbots

Filed under: Health, Quotations, Technology, USA — Tags: , , , , — Nicholas @ 01:00

Recently I saw online a documentary on sex robots. The reporteress, a short-haired woman seething with quiet indignation, Viewed With Alarm the very idea. Progress is rapid on these love assistants, she said. They move. Some do, anyway. They talk, but not too much. Before long they will have skin-temperature silicone. Today we have all those deplorable men sitting home, lonely and isolated, choking their chickens and pondering suicide. Soon they will instead be rocking and rolling with Robo-Barbie. This worried her. She said.

If this be true, then why, one wonders, do men want sexbots? Aren’t there already women all over the place at skin temperature? Sez me, it’s because women have lived too long in a monopoly economy and so let down quality. It used to be that men had jobs and money, and women had that, so they married to let each get some of what the other had. The woman had to be agreeable as a selling point. Now women have jobs and don’t need men, or to be pleasant. Some are nice anyway, but it’s no longer a design feature. Of course they often end up old and alone with a cat somewhere on upper Connecticut Avenue, but they don’t figure this out until too late. Anyway, they stopped being agreeable. They learned from feminists that everything wrong in their lives was the fault of men.

It is a real problem: American women are inoculated from birth with angry misandry insisting that men are dolts, loutish, irresponsible, and only want sex. (To which a response might be, “Uh…What else have you got?”)

[…]

OK, back to sexbots. The short-aired reporteress wondered why men could be interested in such confections instead of real women, the tone being one of elevated moralism and horror. Beneath the usual factitious objectivity one could hear, “How could…what is wrong with….?” and so on.

In the documentary, the short-haired reporteress talked to an ugly anti-sexbot crusader woman who said testily that using sexbots “objectified women.” (To me it sounded more like womanizing objects, but never mind.) These two dragons continued to the effect that sex was about intimacy and closeness and bonding. I wondered how they knew. But understand: They weren’t worried about competition. Oh no. They wanted to preserve intimacy and bonding. They were worried about those poor miserable men.

Uh…yeah.

In modern America I see no sign that women are concerned about masculine misery, and indeed that most of them rather like the idea.

Fred Reed, “Sally Cone Hits the Dating Scene”, The Unz Review, 2017-05-11.

May 22, 2017

QotD: The nanny state’s ever-expanding reach

Filed under: Britain, Bureaucracy, Health, Quotations — Tags: , — Nicholas @ 01:00

The Royal Society for Public Health is suggesting that unusual, unhealthy or minority pursuits should be criminalised in order to set a good example to others. They want people to be arrested, fined and possibly even imprisoned for being poor role models. In a liberal society, the only appropriate response can be made with two words or two fingers.

Chris Snowdon, “A smoking ban in pub beer gardens? Stop persecuting smokers”, City A.M., 2015-08-14.

May 19, 2017

QotD: Outpatient psychiatry

Filed under: Health, Quotations — Tags: , , — Nicholas @ 01:00

Now I am halfway done with my residency. I will be switching to outpatient work. Everyone who sees me will be there because they want to see me, or at worst because their parents/spouses/children/friends/voices are pressuring them into it. I will be able to continue seeing people for an amount of time long enough that the medications might, in principle, work. It sounds a lot more pleasant.

I have two equal and opposite concerns about outpatient psychiatry. The first is that I might be useless. Like, if someone comes in complaining of depression, then to a first approximation, after a few basic tests and questions to rule out some rarer causes, you give them an SSRI [Selective serotonin re-uptake inhibitors]. I have a lot of libertarian friends who think psychiatrists are just a made-up guild who survive because it’s legally impossible for depressed people to give themselves SSRIs without paying them money. There’s some truth to that and I’ve previously joked that some doctors could profitably be replaced by SSRI vending machines.

The second concern is that everybody still screws it up. There’s an old saying: “Doctors bury their mistakes, architects cover theirs with vines, teachers send theirs into politics.” Well, outpatient psychiatrists send their mistakes to inpatient psychiatrists, so as an inpatient psychiatrist I’ve gotten to see a lot of them. Yes, to a first approximation when a person comes in saying they’re depressed you can just do a few basic tests and questions and then give them an SSRI. But the number of cases I’ve seen that end in disaster because their outpatient psychiatrist forgot to do the basic tests and questions, or decided that Adderall was the first-line medication of choice for depression – continues to boggle my mind. So either it’s harder than I think, or I’m surrounded by idiots, or I’m an idiot and don’t know it yet. In which case I’m about to learn.

Still, if it’s a disaster, it will be a different type of disaster.

Scott Alexander, “Reflections From The Halfway Point”, Slate Star Codex, 2015-06-29.

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