Instead of: What disease does this person have, and how do I treat it? Ask instead: What is happening to this human being, within this body, within this life, within this community, within this civilisation, and what intervention best supports their flourishing?

LLMs can be useful for certain tasks with heavy scrutiny. But ultimately I think we are confusing the ability to manipulate information with the ability to understand reality. A system can produce extremely convincing representations without possessing genuine understanding.

The epistemological crisis in medical education is the ability to acknowledge the intrinsic limits of medical knowledge and act responsibly within the radical uncertainty of the individual case. The reasoning required is scientific and probabilistic, but also dialectical, ethical, and rhetorical.

The exhaustion of modernity is that we know better. We watch preventable things happen with full knowledge that they are preventable. It is evident we know what the right actions are, but we live in a system seemingly built not to take them. It is a choice, and it weighs heavily.

There are so many epistemic errors here (reductionism, biomarker fetishism, substituting lab values for clinical judgment) but the deepest is changing the telos of medicine. What is medicine for? Physicians are not optimisation engineers whose measure of effectiveness is institutional performance.

Matthew Gault@mjgault.bsky.social · 3w ago

Hegseth announced they're gonna start screening for T and administering testosterone treatment for warriors found wanting

As the Robert’s Supreme Court continues to be a durable ideological veto point against electoral outcomes, I lament our tendency to constitutionalise every political dispute. Courts should not become the final moral authority.

"Why should Pennsylvania, founded by the English, become a Colony of Aliens, who will shortly be so numerous as to Germanize us instead of our Anglifying them, and will never adopt our Language or Customs, any more than they can acquire our Complexion." - Ben Franklin on Emmers' German ancestors

Aaron Rupar@atrupar.com · last mo.

Tom Emmer: "Minnesotans are so afraid that you're gonna call us a racist, you're gonna call us an Islamophobe. You know what? I'm done being even the least bit careful. Somalis don't assimilate. And if they don't assimilate, then they should go the hell back to where they came from."

Ultimately, I hope people are tired enough of managed outrage to want something real. And the thing that counts as real is the unglamorous willingness to give a damn about other people’s actual lives and do the boring work it requires, even after the feeling of righteousness wears off.

With equally absent animosity: a party’s resources are not property. They are delegated power held in trust for a constituency. A party that treats its own constituency as an outside threat has already conceded it no longer represents them.

Jaime Harrison@jaimeharrison.bsky.social · last mo.

I say this with no ill will or animosity: if you hate the Democratic Party, then please don’t run for our nomination. Don’t use our resources. Don’t rely on our volunteers. Don’t use our infrastructure. Don’t ask Democrats to invest their time, money, and energy in your campaign.

After everything, the sun still shines on Minneapolis ☀️

Your reminder that fairy tales are full of stepmothers because women once routinely died in childbirth, from postpartum sepsis, or from other infectious diseases and left behind housefuls of motherless children. Stable nuclear families are made possible by vaccines, antibiotics, and safe abortions.

Catherine Frieman@cjfrieman.bsky.social · 2mo ago

One reason i think everyone should take an archaeology class is to internalise with tangible examples that there is no pure, natural past utopia and that antibiotics and vaccines are what stand between us and a 50% child mortality rate and scores of women dying needlessly during pregn and birth

one thing i genuinely wish both Labour and Dems would do is stop over-relying on electoral gurus like Morgan McSweeney and actually hire political scientists and sociologists to investigate "okay, how does class formation happen now, and how does it shape political votes? how do we win?"

Sharon 🪳🌹@sharonk.bsky.social · 2mo ago

the issue is (as Skocpol pointed out in Rust Belt Union Blues) is that socialization has gone from union halls to basically Fox News, so economic populist/social con voters are socialized more towards the GOP than the Dems

Agree completely. Is there any legal mechanism that can be pursued? ICC seems appropriate but I am not sure how that would work.

Dr. Émile P. Torres@xriskology.bsky.social · 2mo ago

Some have argued that Elon Musk is a mass murderer for having terminated USAID. I examine this claim and conclude that if Hitler—who never personally killed anyone in his life—is a mass murderer, then so is Musk. Indeed, Musk is a mass murderer of world-historical proportions.

Optimism and pessimism are equally aprioristic. Hope without mechanism is wishful thinking. Despair without mechanism is just laziness with good public relations.

Medicine has no coherent account of what the patient is. Genomicist's molecular system; epidemiologist's statistical class; pathophysiologist's malfunctioning mechanism; phenomenologist's experiencing subject; narrative physician's self-narrator; ethicist's autonomous chooser. Not equivalent.

When you say capitalism is “working”, what do you mean? Growth? Efficiency? Market freedom? These are the metrics capitalism defined for itself. The real test is human flourishing: substantive freedom, dignified work, ecological stability, democratic agency. On every one, capitalism fails.

Two centuries of republican thought have insisted that arbitrary power, even unused, is incompatible with freedom. The American presidency now holds such powers in abundance against its citizens. We have entered the condition the tradition was built to warn against. Stop calling it freedom.

A question I keep returning to: When we use a diagnostic term, what are we trying to name? Not just: which criteria must be satisfied? But: what, in the person’s clinical reality, is this term trying to reach? That distinction seems small. I think it matters. [1/4]

Medical language sounds precise until you ask what the words mean. Take “normal”: does it mean average, healthy, ideal, age-expected, or just close enough? A lab value can be abnormal but harmless; a common condition can still be pathological. So what is medicine really saying when it says normal?

Medicine is stranger than it first appears. A diagnosis is not just a label. Evidence is not just data. A good decision is not always the same as a correct answer. Healing is not always cure. Fascinatingly philosophical, all the way down.