What happens when we shift the diagnostic concept of addiction from a yes/no permanent label (a la AA) to a continuum from abstinence to chaotic use? A thread 1/6

Ke(e)n insights from ⁦@CARROT_app⁩ today.

Wife: “what’s that alien that lives in your body and is black?” Me, a huge nerd: you are going to need to be more specific (She meant venom/symbiote)

As much as healthcare loves to look to aviation as an amazing safety success that we should emulate, turns out they have a remarkably similar staffing and burnout crisis on their hands… via @NYTimes nytimes.com/2023/12/02/busin…

Thanksgiving!!!

It is #extragive time! I’m partnering with lgbtq coalition of lancaster to make sure all people are welcome in our City of Welcome @cityoflancpa mandrillapp.com/track/click/…

If you can never agree with someone because you don’t like some of their beliefs, you will never get anything done. There is a reason we are routinely split 50/50 as a country - or close to it.

The “only natural things” zeitgeist thrives off of an erroneous sense that everyone in 1,000BCE lived happy lives free of any disease and a lived until 200 years old when people only died because they wanted to or attained nirvana.

If there would be a ratio of how much trust we have in a group and how much power they have to ruin your life, I think IT professionals are at the extreme end of that scale.

I’m American and travelled internationally a lot in early 2000’s and didn’t support the american wars at that time (or ever). I found myself frequently explaining that many people in my country didn’t support the wars done in my name. I don’t doubt there are many in this war too.

You can simultaneously hate attacks on civilians (or any humans) by multiple groups. The attacks on jewish people in Israel are horrible. The attacks on arabs in Gaza are horrible. Reading posts by colleagues on both sides, everyone seems horrified. And afraid of what comes next.

Gio Reyna: "One of these days I really need to say thank you to Sergio Agüero. For a long time I have been like, I need to play against this guy, just so that I can talk to him. Not just because my grandfather is Argentine, or because Sergio is one of my family’s favorite players, or because at the World Cup two years ago we all sat in front of the TV rooting for Argentina. Nah. I have a story to tell him. Many years ago Sergio scored a goal that gave me one of the happiest moments of my life. To understand why, you need to know about my older brother, Jack. Jack was my hero when I was a kid. Some people think that my dad, Claudio, made me a good player, since he was a pro himself. Sure, he gave me great advice and some pretty good genes. But when I was growing up in Manchester, where Dad was playing for Manchester City, the one who always played with me in the backyard was Jack. We had the old Samba goals, you know? One-on-one, nowhere to hide. I was four years old and Jack was three years older, so he would sometimes let me win by letting a few shots slip under his foot. Most of the time, though, Jack would make sure I lost. And I’d get angry. I’d kick him, bite him, fight him. Then I’d cry and run to my mum, Danielle. Those games made me grow up a lot, and Dad will tell you the same thing. My competitiveness, my feistiness, all that came from trying to beat Jack. He was the perfect brother. I was always a shy kid, so he would include me in whatever he was doing with his friends, which meant that I got used to playing against kids who were several years older. That gave me confidence. When I wasn’t around, he’d say nice things about me. When he realized that I was going to be better than he was, he pushed me to become the best I could possibly be. And if I had played a good game, he would be the first person to call me to tell how well I had played. In 2007, our family moved to New York, where Dad played for the New York Red Bulls. In the summer of 2010, Jack was diagnosed with brain cancer. He was 11 years old. At one point it looked like he was going to make it, but in December 2011, the doctors discovered that the tumor had come back. Shortly after that, when we went on a vacation to Mexico, Jack started to get sick and put on pounds because of the chemotherapy. He could still walk and swim, but he got tired very quickly. That was when I figured out that this could end in a very bad way. Over the next few months I did everything I could to help him. I had to grow up fast. He couldn’t pull himself up. There was a point where he had to wear diapers. I learned how to microwave food, I did the dishes, stuff like that. I also hung out a lot with my younger brother, Joah-Mikel, and my younger sister, Carolina, who were having a tough time, too. I just wanted to make my family happy, and to make Jack happy, of course. All of us did, especially when we knew that he only had a few months left to live. Every night at the dinner table we would tell each other stories and laugh. Every night. Somehow, even in such a devastating situation, we managed to have some fun. One day in May 2012, when Jack was 13, we gathered in the living room to watch the final day of the Premier League. I think even my grandparents were there. We are all big City fans, because Dad played there, and on that particular day City could win its first league title in 44 years by beating Queens Park Rangers at home. If City didn’t win, we had to hope that Manchester United, which was behind City only on goal differential, didn’t win either. We were all pretty positive that City was going to beat QPR, one of the smaller teams in the league. When City scored in the first half, the win, and the title, seemed like a formality. But QPR turned the game around and took the lead in the second half. Since United was winning, City needed two goals. In our living room nobody was smiling anymore. I felt bad for Jack. He was so sick at that time that he couldn’t walk or talk. Now he wasn’t going to see City win the league either. Two minutes into stoppage time Edin Džeko equalized. That gave us some hope, even though the game was almost over. Two minutes later Agüero scored the winner. You’ve seen the goal. You’ve heard the commentary. “AGÜEROOOOOOO!!” We went crazy in the living room. We were jumping around, shouting and celebrating and hugging each other. A first league title in 44 years! Won in the most incredible manner. We looked at each other in disbelief. Suddenly we heard someone gasping for air. It was Jack. He was rolling around on the floor, which came out of nowhere because he barely had any energy left in his body. We got very concerned. For 20 seconds it looked like he couldn’t breathe. Then, slowly, Jack broke into a smile and began to laugh. We realized that he was celebrating the goal. He was just as happy as we were. I’ll never forget that moment. It was so amazing, so funny, so crazy. A bit more than nine weeks later, on July 19, Jack passed away."

How is everyone’s zombification going? Still haven’t felt the uncanny urge to feast on the brains of others, but good to know whats coming next.

Tonight the state of Florida executed Michael Zack. He is the 6 person to be executed in Florida and the 19th to be executed in the US this year. Please take a minute to read his final words. No one is defending what he did, not even Michael. But we are all more than the worst thing we’ve ever done. The death penalty does not heal the wounds of violence. It just creates new wounds. It is time to stop killing to try to show that killing is wrong.

What is the most rediculous reason for an insurance denial? Had a new one recently - not the wrong diagnosis code, but the codes were in the wrong order. Yeah, guess how much work it took to figure out why that was the problem…

Watching the blue zones documentary and getting that deep feeling that I/we are doing everything wrong.

Dentist: are you flossing? Me: actually yeah, several times a week. Dentist: hmmm… have you considered a water pik? Me: why can’t you just be happy for me?

Peope who treat people with HIV - do you check HSV-2 IgG on everyone? Explain why if so.

Whats the smelliest part of a dog? Its nose!

Small talk is the relationship equivalent of paperwork.

This diabetes is so advanced we need to check a hemoglobin A2c.